Abstract
Given the high co-occurrence of depression and parental stress among adolescent mothers, we evaluated the relationship between parental stress and postpartum depression among primiparous adolescent mothers. We conducted an observational analysis among a cohort of 106 adolescent mothers at 289 postpartum visits who were enrolled in a randomized controlled trial to prevent postpartum depression. Parental stress was measured using the Parenting Stress Index, short form. The Structured Clinical Interview for DSM-IV Childhood Diagnoses was administered to assess for postpartum depression; subthreshold depression was assessed using the Children’s Depression Rating Scale, revised version. Generalized estimating equations were utilized to assess the relationship of parental stress on postpartum depression during the first 6 months postpartum. We present adjusted odds ratios (AOR) controlling for study arm, age, born in the United States, prior history of depression, and number of study visits. The median age was 16 years, 53 % were Latina, and 16 % reported a past history of depression. Nineteen adolescents (19 %) were diagnosed with postpartum depression and 25 % experienced high levels of parental stress through 6 months postpartum. Adolescent mothers who reported higher levels of parental stress were at significantly increased risk for postpartum depression [AOR 1.06 (95 % CI 1.04–1.09); p < 0.0001]. High levels of parental stress predicted subsequent postpartum depression when assessing parental stress at visits prior to a depression diagnosis to determine whether we could establish a temporal association [AOR 1.06 (95 % CI 1.02–1.09); p < 0.01]. Parental stress was also a risk factor for subthreshold depression [AOR 1.04 (95 % CI 1.01–1.07); p < 0.01]. Parental stress was a significant risk factor for developing both postpartum depression as well as subthreshold depression among adolescent mothers. Interventions that target a reduction in parental stress may lead to less depression severity among primiparous adolescent mothers.
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Martin, J., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Menacker, F., Kirmeyer, S., & Matthews, T. J. (2013). Births: Final data for 2011. National vital statistics reports [cited 62 1]; Available from http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_01.pdf.
Barnet, B., Joffe, A., Duggan, A. K., Wilson, M. D., & Repke, J. T. (1996). Depressive symptoms, stress, and social support in pregnant and postpartum adolescents. Archives of Pediatrics and Adolescent Medicine, 150(1), 64–69.
Deal, L. W., & Holt, V. L. (1998). Young maternal age and depressive symptoms: Results from the 1988 National Maternal and Infant Health Survey. American Journal of Public Health, 88(2), 266–270.
Gaynes, B., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner, G., Brody, S., & Willer, W. C. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Agency for healthcare research and quality: Evidence report/technology assessment; 19:Available from http://archive.ahrq.gov/clinic/epcsums/peridepsum.pdf.
Cox, J. E., Buman, M., Valenzuela, J., Joseph, N. P., Mitchell, A., & Woods, E. R. (2008). Depression, parenting attributes, and social support among adolescent mothers attending a teen tot program. Journal of Pediatric and Adolescent Gynecology, 21(5), 275–281.
Field, T. (2010). Postpartum depression effects on early interactions, parenting, and safety practices: A review. Infant Behavior and Development, 33, 1–6.
Abidin, R. (1997). Parenting Stress Index: A measure of the parent–child system. In R. J. Woods & C. P. Zalaquett (Eds.), Evaluating stress: A book of resources (pp. 277–291). Lanham, MD: Scarecrow Press.
Manuel, J. I., Martinson, M. L., Bledsoe-Mansori, S. E., & Bellamy, J. L. (2012). The influence of stress and social support on depressive symptoms in mothers with young children. Social Science and Medicine, 75(11), 2013–2020.
Horwitz, S. M., Briggs-Gowan, M. J., Storfer-Isser, A., & Carter, A. S. (2007). Prevalence, correlates, and persistence of maternal depression. Journal of Womens Health (Larchmt)., 16(5), 678–691.
Naerde, A., Tambs, K., Mathiesen, K. S., Dalgard, O. S., & Samuelsen, S. O. (2000). Symptoms of anxiety and depression among mothers of pre-school children: Effect of chronic strain related to children and child care-taking. Journal of Affective Disorders, 58(3), 181–199.
Sadler, L. S., & Catrone, C. (1983). The adolescent parent: A dual developmental crisis. Journal of Adolescent Health Care : Official Publication of the Society for Adolescent Medicine., 4(2), 100–105.
Hillis, S. D., Anda, R. F., Dube, S. R., Felitti, V. J., Marchbanks, P. A., & Marks, J. S. (2004). The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics, 113(2), 320–327.
Miller, B. (1998). Families matter: A research synthesis of family influences on adolescent pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy.
Milgrom, J., Westley, D., & Gemmill, A. W. (2004). The mediating role of maternal responsiveness in some longer-term effects of postnatal depression on infant development. Infant Behavior and Development., 27, 443–454.
Milgrom, J., et al. (2006). Stressful impact of depression on early mother–infant relations. Stress and Health., 22, 229–238.
Chen, L. S., Eaton, W. W., Gallo, J. J., Nestadt, G., & Crum, R. M. (2000). Empirical examination of current depression categories in a population-based study: Symptoms, course, and risk factors. The American Journal of Psychiatry., 157(4), 573–580.
Fergusson, D. M., Horwood, L. J., Ridder, E. M., & Beautrais, A. L. (2005). Subthreshold depression in adolescence and mental health outcomes in adulthood. Archives of General Psychiatry, 62(1), 66–72.
Phipps, M., Raker, C. A., Jocelyn, C. F., & Zlotnick, C. (2013). Randomized controlled trial to prevent postpartum depression in adolescent mothers. American Journal of Obstetrics and Gynecology, 208(3), 192.e1–192.e6.
Rand, N., & Greenwood, A. (2007). Baby basics: Your month by month guide to a healthy pregnancy. New York: What to Expect Foundation.
Hein, D., Matzner, F., First, M., Spitzer, R., Williams, J., & Gibbons, M. (1998). Structured clinical interview for DSM-IV childhood disorders, KID-SCID. New York: Department of Pyschiatry, Columbia University Medical School.
Abidin, R. (1995). Parenting Stress Index: Short form. Lutz, FL: Psychological Assessment Resources, Inc.
Miller, L. J. (2002). Postpartum depression. The Journal of the American Medical Association, 287(6), 762–765.
Poznanski, E., & Mokros, H. B. (2012). Children’s Depression Rating Scale, revised (CDRS-R). Torrance, CA: Western Psychological Services.
Poznanski, E. O., Grossman, J. A., Buchsbaum, Y., Banegas, M., Freeman, L., & Gibbons, R. (1984). Preliminary studies of the reliability and validity of the children’s depression rating scale. Journal of the American Academy of Child Psychiatry., 23(2), 191–197.
Poznanski, E., Mokros, H. B., Grossman, J., & Freeman, L. N. (1985). Diagnostic criteria in childhood depression. The American journal of psychiatry., 142(10), 1168–1173.
Mayes, T. L., Bernstein, I. H., Haley, C. L., Kennard, B. D., & Emslie, G. J. (2010). Psychometric properties of the Children’s Depression Rating Scale—revised in adolescents. Journal of child and adolescent psychopharmacology., 20(6), 513–516.
Allison, P. (1999). Logistic regression using the SAS system: Theory and application. Cary, NC: SAS Institute.
Allison, P. (2005). Fixed effects regression methods for longitudinal data using SAS. Cary, NC: SAS Institute Inc.
Peduzzi, P., Henderson, W., Hartigan, P., & Lavori, P. (2002). Analysis of randomized coontrolled trials. Epidemiolgic Reviews., 24(1), 26–38.
Rothman, K., Greenland, S., & Lash, T. L. (2008). Modern epidmiology (3rd ed.). Philadelphia: Walters Kluwer.
Brown, J. D., Harris, S. K., Woods, E. R., Buman, M. P., & Cox, J. E. (2012). Longitudinal study of depressive symptoms and social support in adolescent mothers. Maternal and Child Health Journal, 16(4), 894–901.
Glazebrook, C., Sheard, C., Cox, S., Oates, M., & Ndukwe, G. (2004). Parenting stress in first-time mothers of twins and triplets conceived after in vitro fertilization. Fertility and Sterility, 81(3), 505–511.
Clemmons, D. (2002). Adolescent mothers’ depression after the birth of their babies: Weathering the storm. Adolescence., 37, 551.
Lovejoy, M. C., Graczyk, P. A., O’Hare, E., & Neuman, G. (2000). Maternal depression and parenting behavior: A meta-analytic review. Clinical Psychology Review., 20(5), 561–592.
Weinberg, M. K., Olson, K. L., Beeghly, M., & Tronick, E. Z. (2006). Making up is hard to do, especially for mothers with high levels of depressive symptoms and their infant sons. Journal of Child Psychology and Psychiatry and Allied Disciplines, 47(7), 670–683.
Holub, C., Kershaw, T. S., Ethier, K. A., Lewis, J. B., Milan, S., & Ickovics, J. R. (2007). Prenatal and parenting stress on adolescent maternal adjustment: Identifying a high-risk subgroup. Matern and Child Health Journal, 11(2), 153–159.
Heneghan, A., Mercer, M., & DeLeone, N. L. (2004). Will mothers discuss parenting stress and depressive symptoms with their child’s pediatrician? Pediatrics, 113, 460–467.
Field, T., Diego, M., & Hernandez-Reif, M. (2006). Prenatal depression effects on the fetus and newborn: A review. Infant Behavior and Development., 29(3), 445–455.
Field, T., Grizzle, N., Scafidi, F., & Schanberg, S. (1996). Massage and relaxation therapies’ effects on depressed adolescent mothers. Adolescence., 31(124), 903–911.
Forman, D., O’Hara, M. W., Stuart, S., Gorman, L. L., Larsen, K. E., & Coy, K. C. (2007). Effective treatment for postpartum depression is not sufficient to improve the developing mother-child relationship. Development and Psychopathology, 19(2), 585–602.
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Venkatesh, K.K., Phipps, M.G., Triche, E.W. et al. The Relationship Between Parental Stress and Postpartum Depression Among Adolescent Mothers Enrolled in a Randomized Controlled Prevention Trial. Matern Child Health J 18, 1532–1539 (2014). https://doi.org/10.1007/s10995-013-1394-7
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DOI: https://doi.org/10.1007/s10995-013-1394-7