Depression in the Postpartum Year and Life Course Economic Trajectories

Am J Prev Med. 2022 Feb;62(2):165-173. doi: 10.1016/j.amepre.2021.08.011. Epub 2021 Oct 23.


Introduction: Perinatal depression affects 13% of childbearing individuals in the U.S. and has been linked to an increased risk of household economic insecurity in the short term. This study aims to assess the relationship between perinatal depression and long-term economic outcomes.

Methods: This was a longitudinal analysis of a cohort of mothers from the Fragile Families and Child Wellbeing Study starting at delivery in 1998-2000 and followed until 2014-2017. Analysis was conducted in 2021. Maternal depression was assessed using the Composite International Diagnostic Interview-Short Form 1 year after childbirth, and the outcomes included measures of material hardship, household poverty, and employment. Associations between maternal depression and outcomes were analyzed using logistic regression and group-based trajectory modeling.

Results: In total, 12.2% of the sample met the criteria for a major depressive episode 1 year after delivery. Maternal depression had a strong and sustained positive association with material hardship and not working for pay in Years 3, 5, 9, and 15 after delivery. Maternal depression also had a significant positive association with household poverty across Years 3-9 and with unemployment in Year 3. Trajectory modeling established that maternal depression was associated with an increased probability of being in a persistently high-risk trajectory for material hardship, a high-risk trajectory for household poverty, and a high-declining risk trajectory for unemployment.

Conclusions: Supporting perinatal mental health is crucial for strengthening the economic well-being of childbearing individuals and reducing the impact of maternal depression on intergenerational transmission of adversity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child
  • Depression / epidemiology
  • Depression, Postpartum* / epidemiology
  • Depressive Disorder, Major*
  • Female
  • Humans
  • Life Change Events
  • Longitudinal Studies
  • Mothers
  • Postpartum Period
  • Pregnancy