Women living in large urban areas are at a significantly higher risk of postpartum depression after five to 14 months of giving birth compared to those living in rural areas, according to a new Canadian study led by Women's College Hospital's Dr. Simone Vigod.
The study, published today in the Canadian Medical Association Journal, strongly links geographic location and postpartum depression. The researchers suggest differences in risk factors, including place of birth, social support and history of depression, in combination with geography, may contribute to postpartum depression in women.
"Living in an urban area is a marker of more stress, less support and a potentially higher risk of postpartum depression for women," says Dr. Vigod, a staff psychiatrist at Women's College Hospital and a scientist at Women's College Research Institute. "Our study suggests we need to better target our supports and services towards women based on their geographic location to improve their outcomes and reduce their risk of postpartum depression."
Researchers reviewed the results of a Statistics Canada national, cross-sectional survey on key perinatal health indicators from more than 6,000 mothers. The researchers stratified the results by location -rural (rural and < 1,000 people), semi-rural (less than 30,000 people), semi-urban (30,000 to 499,999 people) and urban (at least 500,000 people). They found:
More than 9% of women living in urban areas had postpartum depression five to 14 months after giving birth compared to only 6-7% of women in rural, semi-rural and urban areas.
In large urban centres, women were also more likely to be non-Canadian born and report having little or no social support during or after pregnancy.
"Women in urban areas report higher rates of postpartum depression and lack social support, which appear to be key factors that explain why women in urban areas are at a disadvantage," adds Dr. Vigod. "The study's findings will allow us to design appropriate supports and services for the prevention and treatment of postpartum depression."