Is low literacy a risk factor for symptoms of depression in postpartum women?

To determine if postpartum women with limited literacy are at higher risk for depression symptoms than women with adequate literacy.

We interviewed women during their postpartum hospitalization following delivery of a healthy infant to collect baseline demographic data and assess literacy skills. We contacted these women by phone 6-10 weeks postpartum and administered the Edinburgh Postnatal Depression Scale (EPDS), using scores > or = 9 to indicate symptoms of postpartum depression. Analysis determined if EPDS scores > or = 9 were more frequent among women with low vs. higher literacy.

Of 235 women interviewed in the hospital, 138 (58.7%) were interviewed 6-10 weeks postpartum and completed the EPDS. The rate of EPDS scores > or = 9 was 26.1% among women with limited literacy vs. 8.8% among women with higher literacy (p = 0.018). On multivariable analysis that considered confounding variables, low literacy retained its significant relationship with symptoms of postpartum depression (OR 3.45, 95% CI 1.02-11.82).

Based on results of this preliminary study, low literacy may be a risk factor for symptoms of postpartum depression.