Prospective study of postpartum depression in an Israeli cohort: prevalence, incidence and demographic risk factors

This study aimed to assess the prevalence and incidence of postpartum depre ssion (PPD) and to identify risk factors in a community cohort of Israeli-b orn, as well as new and veteran immigrant women. A random sample of 288 reg istrants at a community clinic was assessed for depressive symptoms at 26 w eeks' pregnancy using the Beck Depression Inventory (BDI) and at 6 weeks po stpartum using the Edinburgh Postnatal Depression Scale (EPDS). Information regarding risk factors was gathered through interviews and medical record abstracting. The prevalence of PPD was 22.6%. Two-thirds of the women had s cored 'depressed' during pregnancy, and one-third (6.9%) were new incident cases. Immigrant status was the only significant demographic predictor of P PD identified by either univariate or multivariate analysis, with Russian n ew immigrants having over twice the risk far PPD as Israeli-born subjects. The rate of PPD in this Israeli cohort was comparable to that found in othe r countries. The finding that immigrant status was the most potent demograp hic predictor may support the role of stressful life events in the etiology of PPD. The use of the EPDS for PPD screening was found acceptable and fea sible in the primary health setting.