Trajectories of Depressive Symptoms and Perceived Stress From Pregnancy to the Postnatal Period Among Canadian Women: Impact of Employment and Immigration

Am J Public Health. 2019 Jun;109(S3):S197-S204. doi: 10.2105/AJPH.2018.304624.


Objectives. To identify trajectory patterns of maternal depressive symptoms and perceived stress from midpregnancy to 2 years postpartum and determine relationships with selected sociodemographic factors including income, education, immigration, and postpartum employment. Methods. Pregnant women (n = 3307) recruited from the general population in 4 regions in Canada provided 6 waves of data from pregnancy to 2 years postpartum. The study was conducted from 2009 to 2015. Results. We determined 5 trajectory groups distinguished by time and magnitude for both depressive symptoms and perceived stress. Immigrants living in Canada for more than 5 up to 10 years, but not more recent arrivals, were at higher risk for persistent stress and depression independent of income status. Being employed at 1 year postpartum was associated with a lower likelihood of postpartum depression and perceived stress, while mothers reporting work exhaustion were substantially more likely to experience persistent depression and stress. Conclusions. The study highlighted the heterogeneous nature of depressive symptoms and perceived stress. Targeting interventions toward women 5 to 10 years after immigration and those experiencing exhaustion from postpartum work may be particularly beneficial.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Canada / epidemiology
  • Depression, Postpartum / epidemiology*
  • Emigration and Immigration / statistics & numerical data*
  • Emigration and Immigration / trends*
  • Employment / psychology*
  • Employment / statistics & numerical data
  • Female
  • Forecasting
  • Humans
  • Mothers / psychology*
  • Mothers / statistics & numerical data
  • Pregnancy
  • Socioeconomic Factors
  • Stress, Psychological / epidemiology*