Postpartum depression prevalence and risk factors among Indigenous, non-Indigenous and immigrant women in Canada.
OBJECTIVES
The social position of different minority groups in contemporary societies suggests different risk factors for postpartum depression (PPD). In this study, we used two cut-offs of the Edinburgh Postpartum Depression Scale (EPDS) to examine prevalence and risk factors for PPD among mothers participating in the Canadian Maternity Experiences Survey (MES), and to compare Indigenous, Canadian-born non-Indigenous and immigrant mothers.


METHODS
We used cross-sectional nationwide data from the 2006 MES (unweighted N = 6237, weighted N = 74,231) and conducted multivariate logistic regression models for EPDS ≥ 10 and EPDS ≥ 13 to explore risk factors for the total sample of mothers and in each study group.


RESULTS
Prevalence (%, 95 % CI) of EPDS ≥ 10 and EPDS ≥ 13 was significantly higher among immigrant (12.2 %, 10.2-14.2 and 24.1 %, 21.5-26.7) and Indigenous (11.1 %, 7.5-14.7 and 21.2 %, 16.5-25.9) compared to Canadian-born non-Indigenous mothers (5.6 %, 4.9-6.3 and 12.9 %, 11.9-13.9). Multivariate analysis of the total sample showed similar risk factors for EPDS ≥ 10 and EPDS ≥ 13 (ethnicity, low education, ≥ low income cut-off, taking antidepressants, experiencing abuse, low social support). Stratification by study group revealed differing risk factors in each group for EPDS ≥ 10 and EPDS ≥ 13. Indigenous mothers had the most distinct risk factors, followed by immigrant mothers. Non-indigenous Canadian-born mothers had risk factors most similar to the total sample.


CONCLUSION
Differing prevalence and risk factors for PPD within and across study groups suggest that instead of a universal approach, tailored programs and services to prevent PPD in Indigenous, immigrant and non-Indigenous Canadian-born groups could better protect the mental health of Canadian mothers.
['Daoud|Nihaya|N|0000-0003-4542-8978', "O'Brien|Kristen|K|", "O'Campo|Patricia|P|", 'Harney|Sarah|S|', 'Harney|Evelyn|E|', 'Bebee|Kerry|K|', 'Bourgeois|Cheryllee|C|', 'Smylie|Janet|J|']
D000293:Adolescent D000328:Adult D002170:Canada D003430:Cross-Sectional Studies D019052:Depression, Postpartum D054242:Emigrants and Immigrants D005260:Female D006801:Humans D008875:Middle Aged D009035:Mothers D044382:Population Groups D015995:Prevalence D011569:Psychiatric Status Rating Scales D012307:Risk Factors D055815:Young Adult
Postpartum depression Risk factors Canada Edinburgh Postnatal Depression Scale (EPDS) Indigenous, immigrant, and non-Indigenous Canadian-born mothers