Abstract
Postpartum depression disorder (PDD) is a significant public health concern, with an incidence rate of 10% to 20%. Recent studies have suggested a potential association between breastfeeding and PPD, but the precise nature and direction of this relationship remain uncertain. This study aims to explore the relationship between breastfeeding and PPD by analyzing data from the Pregnancy Risk Assessment Monitoring System (PRAMS), hypothesizing that breastfeeding is a protective factor for PPD.
This study utilized the PRAMS Phase 8 dataset (2016-2021) to assess 168,780 women, focusing on postpartum depression (yes/no) as the main outcome, with breastfeeding (yes/no) as the primary predictor. Covariates included age, race, education, income, previous live births, and insurance status. Statistical analyses involved chi-square tests and multivariable binary logistic regression, with results presented as adjusted odds ratios (aOR) with 95% confidence intervals (95%CI).
Among all participants, 13.7% reported PPD, with 13.2% of breastfeeding women and 18.0% of non-breastfeeding women experiencing PPD. In the multivariable model, breastfeeding was significantly associated with lower odds of PPD (aOR=0.89; 95%CI=0.86-0.93; p<0.0001). Older age (aOR=0.61; 95%CI=0.57-0.65), higher education (aOR=0.80; 95%CI=0.76-0.85), and higher income (aOR=0.53; 95%CI=0.50-0.55) were protective against PPD. Conversely, Black, American Indian, and Asian women had higher odds of PPD compared to White participants, with the number of previous live births also positively associated with PPD.
Breastfeeding appears to protect against PPD, while younger age, lower education, minority racial status, and multiple live births increase PPD risk. Targeted interventions supporting breastfeeding, education, and economic opportunities, especially for high-risk groups, are essential for improving maternal mental health.