Article Figures & Tables
Tables
- Table 1:
Baseline characteristics of 6126 new mothers who completed the Maternity Experiences Survey, by location
Characteristic Location; weighted % (95% CI)* Rural
n = 1362Semirural
n = 1225Semiurban
n = 2187Urban
n = 1352Maternal age, yr, mean (95% CI) 29.7 (29.5–30.0) 29.5 (29.2–29.8) 29.5 (29.3–29.7) 31.1 (31.0–31.3) Parity, primiparous 39.6 (37.0–42.2) 40.8 (37.9–43.6) 49.4 (46.9–51.9) 47.0 (45.5–48.6) Marital status, married or common-law 92.7 (91.2–94.2) 91.0 (89.4–92.6) 88.6 (87.0–90.3) 93.2 (92.2–94.2) Born in Canada 89.0 (87.0–91.0) 88.1 (86.0–90.2) 87.2 (85.3–89.2) 61.9 (59.9–63.9) Household income† Lowest 10.5 (8.85–12.2) 9.9 (8.12–11.6) 12.0 (10.1–13.8) 11.2 (9.82–12.5) Lower-middle 23.9 (21.4–26.3) 18.8 (16.4–21.3) 21.5 (19.2–23.8) 20.5 (18.7–22.3) Upper-middle 37.6 (34.7–40.5) 36.9 (33.9–40.0) 36.6 (33.9–39.3) 30.9 (28.9–32.9) Highest 28.0 (25.2–30.8) 34.4 (31.4–37.4) 29.9 (27.3–32.5) 37.4 (35.5–39.4) Education level Less than high school 8.82 (7.3–10.4) 9.87 (8.10–11.6) 7.79 (6.42–9.16) 5.94 (4.98–6.90) High school 15.5 (13.4–17.6) 16.2 (13.9–18.4) 15.1 (13.0–17.1) 10.8 (9.53–12.0) Some postsecondary 19.0 (16.7–21.2) 16.2 (14.0–18.3) 16.9 (14.9–19.0) 13.9 (12.5–15.4) Postsecondary 56.8 (53.8–59.7) 57.8 (54.8–60.8) 60.2 (57.5–62.9) 69.4 (67.5–71.2) History of depression 16.4 (14.1–18.6) 16.4 (14.2–18.6) 18.7 (16.6–20.9) 13.5 (12.0–14.9) Maternal health, excellent or very good 73.3 (70.7–75.8) 73.1 (70.4–74.8) 75.1 (72.7–77.5) 70.7 (68.8–72.6) Stress No. of life stressors in last 2 yr, mean (95% CI) 1.25 (1.17–1.34) 1.37 (1.27–1.46) 1.38 (1.30–1.47) 1.19 (1.13–1.25) Abuse in last 2 yr 9.82 (8.21–11.4) 12.6 (10.6–14.5) 13.1 (11.3–14.9) 9.94 (8.79–11.1) Labour and delivery complications 14.3 (12.2–16.4) 14.4 (12.3–16.5) 14.6 (12.7–16.6) 14.9 (13.4–16.3) Preterm birth 6.06 (4.62–7.50) 6.49 (4.90–8.08) 6.67 (2.30–8.04) 6.15 (5.13–7.18) Infant in NICU 10.8 (8.98–12.5) 11.0 (9.06–12.8) 14.8 (12.8–16.8) 13.0 (11.6–14.4) Social support Pregnancy None or a little of the time 4.52 (3.28–5.76) 4.05 (2.82–5.28) 3.52 (2.54–4.51) 6.21 (5.18–7.24) Some of the time 6.65 (5.21–8.10) 6.87 (5.29–8.46) 6.25 (4.91–7.59) 9.21 (8.00–10.4) Most of the time 27.9 (25.2–30.6) 30.0 (27.1–32.9) 27.4 (24.9–29.9) 31.4 (29.5–33.4) All of the time 60.9 (58.0–63.8) 59.1 (56.0–62.1) 62.8 (60.1–65.5) 53.1 (51.1–55.2) Postpartum None or a little of the time 4.51 (3.32–5.70) 5.34 (3.89–6.79) 4.82 (3.67–5.96) 6.53 (5.50–7.55) Some of the time 9.48 (7.74–11.2) 8.51 (6.84–10.2) 8.42 (6.82–10.0) 12.2 (10.8–13.6) Most of the time 31.8 (29.0–34.5) 33.4 (30.5–36.3) 31.2 (28.6–33.9) 34.1 (32.1–36.1) All of the time 54.3 (51.4–57.1) 52.8 (49.7–55.9) 55.5 (52.8–58.3) 47.2 (45.1–49.3) - Table 2:
Postpartum depression among 6126 new mothers who completed the Maternity Experiences Survey, by score on the Edinburgh Postnatal Depression Scale*
Characteristic EPDS ≥ 13,† weighted % (95% CI) EPDS score, weighted mean (95% CI) Location‡ Rural, n = 1362 6.07 (4.66–7.48) 4.94 (4.68–5.20) Semirural, n = 1225 6.96 (5.39–8.53) 5.05 (4.78–5.33) Semiurban, n = 2187 5.31 (4.01–5.61) 5.00 (4.77–5.24) Urban, n = 1352 9.16 (7.50–10.40) 5.61 (5.41–5.81) Census metropolitan and census agglomeration areas Rural and small town, n = 1248 6.98 (5.48–8.48) 5.03 (4.77–5.30) Large urban centre n = 4878 7.56 (6.75–8.37) 5.33 (5.19–5.46) Rural and small-town areas, by metropolitan influence Strong, n = 316 5.50 (2.94–8.06) 5.18 (4.73–5.64) Moderate, n = 444 7.05 (4.53–9.58) 4.91 (4.47–5.35) Weak, n = 440 8.31 (5.60–11.00) 5.14 (4.68–5.60) None, n = 48 NR 4.06 (2.78–5.33) Note: CI = confidence interval, EPDS = Edinburgh Postnatal Depression Scale, NR = not reportable.
↵* Differences between groups were evaluated using χ2tests for categorical variables and independent t test or analysis of variance (ANOVA) for continuous variables.
↵† EPDS ≥ 13 represents likelihood that a woman has postpartum depression.
↵‡ p < 0.05 for differences between groups for both EPDS ≥ 13 and EPDS mean score.
- Table 3:
Multivariable model for the relationship between population area size and postpartum depression (EPDS ≥ 13)
Main exposure variable Odds ratio (95% CI) Unadjusted Population area size Urban Ref Semiurban 0.56 (0.41–0.75) Semirural 0.74 (0.56–0.99) Rural 0.64 (0.48–0.85) Adjusted* Population area size Urban Ref Semiurban 0.60 (0.42–0.84) Semirural 0.90 (0.65–1.24) Rural 0.80 (0.57–1.11) Parity, primiparous 0.82 (0.64–1.05) Country of origin (Canadian-born v. non-Canadian-born) 0.51 (0.39–0.67) Household income Low Ref Low-middle 0.88 (0.57–1.20) Middle-high 0.82 (0.60–1.29) High 0.80 (0.54–1.17) History of depression (v. no history) 2.11 (1.60–2.79) Life stressors 1.29 (1.20–1.38) Interpersonal abuse 1.46 (1.06–2.00) Maternal health Good/fair/poor Ref Excellent/very good 0.40 (0.31–0.51) Postpartum social support Low Ref Low-middle 0.67 (0.45–1.00) Middle-high 0.36 (0.25–0.52) High 0.15 (0.10–0.23) Note: CI = confidence interval, EPDS = Edinburgh Postnatal Depression Scale, ref = reference.
↵* All variables were adjusted for all covariates in the model. We included variables that are known predictors of postpartum depression (history of depression, life stressors in past 2 yr, interpersonal abuse in last 2 yr, social support, maternal self-reported health) or those for which there were major differences between groups for possible prognostic variables (parity, country of origin, household income). Hosmer–Lemeshow for goodness of fit of the multivariable model X2 = 8.43, p = 0.4. All variance inflation factors < 1.30.