Feelings Matter: Predicting Postpartum Depression Symptoms from Pregnancy Planning and Emotional Reaction to...

Both emotional reaction to pregnancy and pregnancy intention have been independently found to predict postpartum depressive symptoms (PDS). However, while pregnancy intention has been widely studied, there is minimal research on emotional reaction to pregnancy, and even less research on how these two factors interact.

Data from the 2016-2021 Pregnancy Risk Assessment Monitoring System (PRAMS) survey in the state of Maine were analyzed for this study. Weighted logistic regressions were performed to predict both PDS and negative emotional reactions to pregnancy, with Odds Ratios and 95% Confidence Intervals calculated.

Of 4,520 respondents, 38.8% reported unplanned pregnancies, 5.7% reported negative initial emotional reactions to pregnancy, and 4.2% reported unplanned pregnancies and negative initial emotional reactions. Approximately 11% reported PDS, and 15.1% had unplanned pregnancies and PDS, while 9% had planned pregnancies and PDS. Individuals with unplanned pregnancies had higher PDS risk than individuals with planned pregnancies, individuals with negative or unsure reactions had higher PDS risk than those with positive reactions, and individuals with unplanned pregnancies and all emotional reactions had increased PDS risk compared to those with planned pregnancies and positive reactions. After adjusting for covariates, only those indicating negative initial emotional reactions (independently) and those indicating negative emotional reactions and unplanned pregnancy (interactively) were at greater risk for PDS. Predictors of negative emotional reactions to pregnancy included lower income, greater number of previous live births, depression diagnosis in the 3 months before pregnancy, intimate partner abuse, and unplanned pregnancy.

Negative emotional reaction to pregnancy and unplanned pregnancy independently and interactively predicted PDS. Findings highlight the importance of considering emotional and sociodemographic factors when evaluating the relationship between unplanned pregnancy and PDS.