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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.

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Acknowledgements

This study was funded by the Canadian Institutes of Health Research (CIHR), Immigration et métropoles (Center of Excellence in Immigration Studies - Montreal) and the Réseau de recherche en santé des populations du Québec (RRSPQ).

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Authors and Affiliations

  1. Lawrence S. Bloomberg Faculty of Nursing, St. Michael’s Hospital, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Canada

    Cindy-Lee Dennis

  2. School of Nursing, University of Ottawa, 1 Stewart Street, Rm 127, Ottawa, ON, K1N 6N5, Canada

    Lisa Merry

  3. Ingram School of Nursing, McGill University, Montreal, Canada

    Lisa Merry

  4. Ingram School of Nursing, McGill University, Research Institute, McGill University Health Centre, Montreal, Canada

    Anita J. Gagnon

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  1. Cindy-Lee Dennis
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  2. Lisa Merry
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Correspondence to Lisa Merry.

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Dennis, CL., Merry, L. & Gagnon, A.J. Postpartum depression risk factors among recent refugee, asylum-seeking, non-refugee immigrant, and Canadian-born women: results from a prospective cohort study. Soc Psychiatry Psychiatr Epidemiol 52, 411–422 (2017). https://doi.org/10.1007/s00127-017-1353-5

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  • DOI: https://doi.org/10.1007/s00127-017-1353-5

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