Postpartum depression risk factors among recent refugee, asylum-seeking, non-refugee immigrant, and Canadian-born women: Results from a prospective cohort study

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Abstract

Purpose: The objective was to examine and compare risk factors for postpartum depression among: (1) recent (≤5 years) migrant and Canadian-born women, and (2) refugee, asylum-seeking, and non-refugee immigrant women. Methods: A sample of 1536 women (1024 migrant and 512 Canadian-born) were recruited from 12 hospitals. Women completed questionnaires at 1–2 and 16 weeks postpartum including questions on socio-demographics, biomedical history, health services, and migration and resettlement factors. Bivariate analyses and multivariate logistic regression were performed to examine and compare risk factors for postpartum depressive symptoms at 16 weeks postpartum. Results: Recent migrant women had significantly higher rates (6%) of depressive symptoms at 16 weeks postpartum than Canadian-born women (2.9%). Asylum-seekers had the highest rate (14.3%), followed by refugee (11.5%) and non-refugee immigrant women (5.1%). Migrant women at greatest risk to develop depressive symptoms were those who experienced abuse, had pain post-birth, worried about family members left behind, had food insecurity, and had reduced access to healthcare (limited insurance and/or no regular care-provider). Conversely, those with higher levels of social support and who felt they belonged to a community had a lower risk of developing depressive symptoms. Conclusion: All childbearing recent migrant women should be considered at risk for postpartum depression. To prevent and support migrant women suffering postpartum depressive symptoms, barriers to healthcare need to be addressed and interventions should include assessments and support/programmes for abuse/violence, lack of social support, food insecurity, and stress/poor mental health. Treatment of pain during the postpartum period is also critical.

Citation

Relevant Evidence Summaries

The evidence was reviewed and included in the following summaries: 

What Works to Improve Maternal Mental Health Outcomes for Refugees?

This evidence summary summarizes the state of available evidence on the impacts of interventions targeting the reduction of adverse mental health symptoms in expectant or new mothers. This summary includes interventions that are either directly impacting the mothers or aiming to increase rates of screening by medical providers.

About this study

AGE: Adults

FULL TEXT AVAILABILITY: Free

HOST COUNTRY: Canada

HOST COUNTRY INCOME: High

OUTCOME AREA: Mental Health

POPULATION: Refugees

REGION OF ORIGIN OF PARTICIPANT(S): Multiple Regions

STRENGTH OF EVIDENCE: Suggestive

TYPE OF STUDY: Suggestive evidence

YEAR PUBLISHED: 2017

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