Infant health care use and maternal depression

Objective: To determine whether women who frequently bring their neonates f or problem-oriented primary care visits or emergency department visits are at elevated risk of having depressive symptoms. Design: Analysis of 2 prospective cohort studies of mothers and their infan ts: (1) a telephone interview study of mothers and infants after birth at a n urban teaching hospital (the hospital cohort) and (2) the 1988 National M aternal and Infant Health Survey, a nationally representative sample of wom en who had live births in 1988. Participants: A total of 1015 women in the hospital cohort surveyed at 3 an d 8 weeks post partum and 6779 women with data from the national survey. Main Outcome Measure: Depressive symptoms above the Center for Epidemiologi c Studies Depression Scale cutoff score of 15. Results: After controlling for sociodemographic variables and parity, women exhibited high levels of depressive symptoms if their infants had more tha n 1 problem-oriented primary care visit (hospital cohort: odds ratio, 2.0 [ 95% confidence interval, 1.1-4.3];national survey cohort: odds ratio, 2.0 [ 95% confidence interval, 1.5-3.0]). Women were more likely to have high lev els of depressive symptoms if their infants had even 1 emergency department visit (hospital cohort: odds ratio, 3.2 [95% confidence interval, 1.5-6.9] ). Frequent well-child visits were not associated with maternal depressive symptoms. Conclusions: Neonatal health care use patterns predict women at risk for po stpartum depression. Recognition of these signature patterns of service use by pediatric health care providers may facilitate early diagnosis and trea tment of postpartum depression and improve outcomes for women and their fam ilies.