Postpartum mood disorders (PPMD) represent a serious health concern affecting many areas of a woman's life. In addition to adverse outcomes associated with ...
The Effect of Postpartum Mood Disorders on Quality of Life Betty‐Shannon Prevatt, MA, Sarah L. Desmarais, PhD, North Carolina State University Introduction
Results
Results
Postpartum mood disorders (PPMD) represent a serious health concern affecting many areas of a woman’s life. In addition to adverse outcomes associated with psychopathology for mother and child, research demonstrates that women with PPMD report lower perceived quality of life in the first months postpartum (Sadat et al., 2014; Webster et al., 2011). Quality of life was defined by the World Health Organization as an “individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns” (1994, p. 43). Postnatal women may experience a reduction in quality of life, particularly in physical health (Prick et al., 2015). However, women who experience PPMDs are at a greater risk for poor quality of life across many domains. Indeed, the extant literature illustrates that women experiencing a PPMD in the months following delivery report lower health‐related quality of life (Da Costa et al., 2006), and poorer physical and mental health (Dennis, 2004) than women who are not experiencing a PPMD. Yet, little is known about the impact of PPMD on quality of life beyond the early months.
Participant Characteristics Participants ranged in age from 22-46 (M = 33.3, SD = 4.3) with children an average age of 16.0 months old (SD = 11.3 , range 0-45 months). The majority of participants were white (90.4%), in a partnered relationship (98.3%), employed (58.9%), had a household income greater than $67,000 (77.0%), and had completed a 4-year college degree or greater (88.6%). Approximately one-third reported a mental health history prior to their most recent pregnancy (36.2%). Half experienced a PPMD with their most recent child (50.8%). Bivariate Analyses To determine covariates for inclusion, bivariate correlations were performed. Covariates retained for multivariate analyses included maternal age (ps ≥ .024), current employment (ps ≥ .018), household income (ps ≥ .001), and mental health history prior to most recent pregnancy (ps ≤ .003). Baby age was not significantly related to any variable but was retained to control for time since delivery (ps ≥ .121). Race was unrelated to any outcome variable (ps ≥ .226). Relationship status and education were excluded for parsimony and to conserve statistical power as they were only related to the WHOQOL-BREF Environmental domain.
Univariate Analyses Table 2 presents the univariate MANCOVA analyses examining the effect of experiencing a PPMD on the different domains of quality of life as measured by the WHOQOL-BREF. Experiencing PPMD had a negative effect on Physical, Psychological, and Overall quality of life.
The Present Study The present study examined perceived quality of life differences up to four-years postpartum between participants who experienced PPMD and those who did not.
Methods A sample of women within four-years postpartum (n = 147) participated in an online survey querying personal characteristics (age, baby age, race, relationship status, education, household income, employment status, and mental health history), presence of PPMD, treatment for PPMD, and perceived quality of life. Household income was dichotomized to reflect salaries exceeding the county median of $67,000. PPMD was assessed via self-report with participants comparing their post-natal experience to a description of PPMD criteria. The World Health Organization Quality of Life Assessment-Brief (WHOQOL-BREF) (WHOQOL Group, 1996) was used to assess perceived quality of life along four domains: Physical health, Psychological health, Social relationships, and Environmental. The WHOQOL-BREF also yields an Overall quality of life score. Bivariate analyses were conducted to determine covariates for inclusion in the model. A one-way MANCOVA was performed to examine differences in perceived quality of life between women who experienced a PPMD (n = 75) and those who did not (n = 72), controlling for associated covariates. All study procedures were approved by the Institutional Review Board at North Carolina State University.
Table 1. Mean WHOQOL-BREF Domain Scores 100 90 80
73.21
79.64
70
77.82 79.22
74.48 64.63
60
61.25
80.61
86.86
66.52
PPMD No PPMD
50 40 30
Table 2. Univariate Analyses of Variance for WHOQOL-BREF Domains WHOQOL Domain
F (1,140)
p
η2
Physical
8.76
.004
.06
Psychological
13.90
