(169) Trends in Postpartum Depression by Race/Ethnicity and Pre-pregnancy Body Mass Index

Using Kaiser Permanente Southern California's electronic health records, we examined temporal trends in postpartum depression from 2010 through 2021 among births at ≥20 weeks of gestation (N=442,308). Postpartum depression was defined as the ICD-9/10 diagnostic code of depressive disorder given by a psychiatrist and the use of antidepressants for postpartum depression within 12 months of childbirth. We calculated the proportion of postpartum depression in the earliest (2010) versus most recent (2021) periods stratified by race/ethnicity and pre-pregnancy BMI and adjusted for potential confounding factors.

Results:

The prevalence of postpartum depression was 13.9%. Prevalence increased from 9.4% in 2010 to 19.3% in 2021 (a relative increase of 105%, p < 0.001). From 2010 to 2021, the postpartum depression rate increased among Whites from 13.5% to 21.8%, a relative increase of 60% (95% confidence intervals [CI] 50-70%); among Hispanics, from 8.9% to 18.8%, 110% increase (95% CI: 100-120%), and among Blacks, from 9.2% to 22.0%; 140% increase (95% CI: 110-180%). Asian/Pacific Islanders had the largest relative increase (from 3.6% to 13.8%; 280% increase (95% CI: 220-350%). Increased rates of postpartum depression were observed for all BMI categories, with a particularly high prevalence for obese and morbidly obese women.

Conclusion:

The prevalence of postpartum depression has increased dramatically over the past decade. Racial and ethnic disparities in rates of postpartum depression are persistent but could be narrowing. The drivers of these disparities are unclear and need to be investigated further.