(583) The Triple Threat of Socioeconomic Insecurity: Housing, Financial, and Food Insecurity Association with Postpartum Depression

Thursday, January 30, 2025

4:00 PM – 6:00 PM

Submitting Author and Presenting Author(s)

Noor Ali, MPH (she/her/hers)

Medical Student
Department of Obstetrics and Gynecology, University of Kentucky
Lexington, KY, United States

Coauthor(s)

ED

Emily A. DeFranco, DO, MS (she/her/hers)

Chair, Department of Obstetrics and Gynecology
Department of Obstetrics and Gynecology, University of Kentucky
Lexington, Kentucky, United States

Objective: Examine the influence of housing, financial, and food insecurity on p</span>ostpartum depression.

Study Design: Using data from the Pregnancy Risk Assessment Monitoring System (PRAMS) Core and Standard Questionnaire from 2016 to 2021 linked to US birth certificate data, a retrospective cohort study was performed to quantify the relative risk of the exposures of housing, financial, and/or food insecurity on the outcome of p</span>ostpartum depression. Pre-pregnancy depression was determined by anyone who reported depression in the three months before pregnancy. Postpartum depression was quantified by a previously created variable by PRAMS titled “Postpartum Depression Indicator.” Participant surveys occurred at 2-6 months postpartum. Generalized linear modeling (GLM) estimated adjusted relative risk (adjRR) and 95% CIs while accounting for the confounding influences of maternal race, marital status, education, and WIC utilization.

Results: 221,381 Postpartum patients completed the Pregnancy Risk Assessment Monitoring System (PRAMS) Core and Standard Questionnaire. Of those surveyed, 11,482 (5.2%), 373 (3.2%), and 4,302 (3.0%) reported financial, food, and housing insecurity, respectively, and 15,768 (7.1%) had any of the three. The prevalence of reported depression was 15.8% before pregnancy and 14.4% postpartum. Each exposure was associated with a significantly higher risk of pre-pregnancy and postpartum depression, even after adjusting for race, marital status, education, and WIC usage (see table). The highest individual risks for depression were observed with food insecurity, with greater than 2-fold increased risk for depression before pregnancy and postpartum.

Conclusion: The physical and social environments of birthing people can impact their psychological state. Postpartum depression can influence the bond between the mother-infant dyad, potentially contributing to adverse psychosocial outcomes. Public health initiatives should focus on improving access to financial, food, and housing resources for reproductive-age people to mitigate postpartum depression effects.