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Objectives
To evaluate whether progestin-only (POC) or combined hormonal contraception (CHC)
users are more likely to have a positive 12-month postpartum depression screen compared
with those using non-hormonal (NH) or no contraception.
Methods
We conducted a secondary analysis of a prospective cohort of pregnant patients followed
for one year postpartum. Participants completed the Edinburgh Postnatal Depression
Scale (EPDS) in the second or third trimester and 12 months post-delivery. We examined
differences in participant characteristics, mental health history, and 12-month EPDS
scores between method groups: POC, CHC, and NH contraception or no contraception.
We used multivariable logistic regression to assess factors associated with positive
depression screen (EPDS ≥10) at 12 months, adjusting for differences between groups
and contraceptive discontinuation.
Results
Of the 227 participants in this analysis, 47% chose POC, 19% chose CHC, and 34% chose
NH or no contraception. The overall incidence of positive depression screen at 12
months was 21.2% and did not differ by contraceptive method: POC, 18.7%; CHC, 28.6%;
and no method/NH 20.5% (p=0.39). After adjusting for confounders, contraceptive method
remained unassociated with depression (POC adjusted OR (aOR), 0.59; 95% CI, 0.28–1.40;
CHC aOR, 1.38; 95% CI, 0.53–3.58). However, last antenatal EPDS score ≥10 (aOR, 5.88;
95% CI, 2.5413.59) and postpartum mental health referral (aOR, 3.81; 95% CI, 1.94–7.49)
were significantly associated.
Conclusions
In this cohort, the incidence of postpartum depression was greater than 20%. Individuals
initiating hormonal contraception in the first 12 months postpartum were no more likely
to have a positive depression screen at 12 months postpartum.
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Copyright
© 2022 Published by Elsevier Inc.
