Postpartum Depression and Anxiety Among Mothers Whose Child was Placed in Care of Child Protection Services at Birth: A Retrospective Cohort Study Using Linkable Administrative Data
Objectives This study examines whether mothers involved with child protection services (CPS) at the birth of their first child had higher rates of postpartum depression and anxiety. Methods A retrospective cohort of mothers whose first child was born in Manitoba, Canada between April 1, 1995 and March 31, 2015 is used. Postpartum depression and anxiety among mothers whose first child was placed in care at birth (n = 776) was compared with mothers who received services from CPS (but whose children were not placed in care) (n = 4,270), and a 3:1 matched group of mothers who had no involvement with CPS in the first year of their firstborn’s life (n = 2,328). Adjusted odds ratios (AOR) of depression and anxiety diagnoses in the first year postpartum were obtained from logistic regression models. Adjusted rate ratios (ARR) of antidepressant use obtained using Poisson models. Results Mothers whose children were taken into care have greater odds of having a postpartum depression or anxiety diagnosis than mothers receiving services (AOR = 1.31; 95% CI 1.08–1.59) and those not involved with CPS (AOR = 2.13; 95% CI 1.67–2.73). Among mothers who had a postpartum depression or anxiety diagnosis, mothers whose children were placed in care had significantly higher rates of antidepressant use than mothers receiving services only (ARR = 2.00; 1.82, 2.19) and mothers who were not involved with CPS (ARR = 2.42; 95% CI 1.94–3.51). Conclusions for Practice Targeted programs should be implemented to address postpartum mental illness among mothers who are involved with CPS at the birth of their child.
KeywordsPostpartum Depression Anxiety Antidepressants Child protection services
Data used in this study are from the Population Research Data Repository housed at the Manitoba Centre for Health Policy, University of Manitoba and were derived from data provided by Manitoba Health, Seniors and Active Living, Manitoba Families, Healthy Child Manitoba, Manitoba Education and Training, Manitoba Justice, and Vital Statistics under Project #2016/2017-09. The results and conclusions are those of the authors and no official endorsement by the Manitoba Centre for Health Policy, Manitoba Health, Seniors and Active Living or other data providers is intended or should be inferred. This work was supported by a Social Sciences and Humanities Research Council of Canada Joseph-Armand Bombardier Canada Doctoral Scholarship, at Graduate Enhancement of Tri-Council Stipend, and a Women’s Health Research Foundation of Canada Full Time Scholarship.
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