Postpartum Depression and Early Predictors of Lower Maternal Confidence at 12 to 15 Months after Delivery

The objective of the present study is to assess the association of early postpartum depression and maternal confidence with low maternal confidence at 12-15 months after delivery. Prospective study performed from 2013 to 2015 with 358 postpartum women who had participated in a cluster trial to treat their depression during pregnancy. At 6-8 months after birth, we reviewed socio-demographics, obstetric data and Postpartum Depression (PPD) with the Patient Health Questionnaire-9. Maternal Confidence (MC) was assessed at 6-8 and 12-15 months after birth with the Maternal Confidence Questionnaire. Low and High MC was defined using 50% percentile. The crude and adjusted Odds Ratios (OR) with the 95% Confidence Interval (CI) were calculated using Poisson regression with robust variance. Multivariate models estimated the ORs between postpartum depression and LMC at 12-15 months adjusted for socio-demographic variables, maternal characteristics and previous LMC. Statistical analysis was performed with STATA12 and the significance level was considered equal or lower than 5%. Among a sample of women who were depressed during pregnancy, 19% had probably moderate to severe depression, at the beginning of the child' second year of life. Low maternal confidence was associated with previous low maternal confidence (OR = 1.71; 95% CI 1.33:2.20, p = <0.001) and vaginal delivery but not with previous PPD. Based on our findings, detection and treatment of women presenting confidence problems at the first months after delivery may prevent later mother self-efficacy problems.