Abstract
To identify (1) the association between pre-pregnancy BMI (PP-BMI) and PPD symptoms, and (2) the association between PP-BMI
and PPD symptoms after considering PNC utilization as a moderating variable. Data from the 2004 and 2005 Pregnancy Risk Assessment
Monitoring System (PRAMS) were analyzed from 15 states. The study design utilized two risk-adjustment approaches. One approach
included all women in the dataset and used statistical analyses to risk-adjust for pregnancy risk status, and the other approach,
through a sensitivity analysis, modified the design of the study by truncating the sample to include only women with healthy
pregnancies. An initial association was seen between obesity and PPD symptoms, and PNC and PPD symptoms in the multivariate
analyses. However, the inclusion of case-mix variables into the multivariate models removed these associations. Overall, for
both approaches, there was no indication of a moderating effect of PNC utilization. Results also revealed that many of the
women were significantly affected by a variety of high-risk maternal morbidity (case-mix) variables. Although PNC is important
for the health of mothers and babies, it does not appear to moderate the association of PP-BMI and PPD symptoms. However,
since this study revealed associations between several high-risk maternal morbidities (included as case-mix variables), and
PPD symptoms, it is recommended that future research further investigate the possible association of these morbidities with
PPD symptoms. For practice, it is suggested that PNC providers focus on their patients, and establish suitable interventions
accordingly.
and PPD symptoms after considering PNC utilization as a moderating variable. Data from the 2004 and 2005 Pregnancy Risk Assessment
Monitoring System (PRAMS) were analyzed from 15 states. The study design utilized two risk-adjustment approaches. One approach
included all women in the dataset and used statistical analyses to risk-adjust for pregnancy risk status, and the other approach,
through a sensitivity analysis, modified the design of the study by truncating the sample to include only women with healthy
pregnancies. An initial association was seen between obesity and PPD symptoms, and PNC and PPD symptoms in the multivariate
analyses. However, the inclusion of case-mix variables into the multivariate models removed these associations. Overall, for
both approaches, there was no indication of a moderating effect of PNC utilization. Results also revealed that many of the
women were significantly affected by a variety of high-risk maternal morbidity (case-mix) variables. Although PNC is important
for the health of mothers and babies, it does not appear to moderate the association of PP-BMI and PPD symptoms. However,
since this study revealed associations between several high-risk maternal morbidities (included as case-mix variables), and
PPD symptoms, it is recommended that future research further investigate the possible association of these morbidities with
PPD symptoms. For practice, it is suggested that PNC providers focus on their patients, and establish suitable interventions
accordingly.
- Content Type Journal Article
- Pages 1-12
- DOI 10.1007/s10995-011-0808-7
- Authors
- Swathy Sundaram, Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, P.O. Box 100195, Gainesville, FL 32610-0195, USA
- Jeffrey S. Harman, Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, P.O. Box 100195, Gainesville, FL 32610-0195, USA
- Mary D. Peoples-Sheps, Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, P.O. Box 100195, Gainesville, FL 32610-0195, USA
- Allyson G. Hall, Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, P.O. Box 100195, Gainesville, FL 32610-0195, USA
- Sharleen H. Simpson, Department of Women’s, Children’s, and Family Nursing, College of Nursing, University of Florida, P.O. Box 100187, Gainesville, FL 32610-0187, USA
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875