Tobacco Smoking and Postpartum Depression Symptoms in the Pregnancy Risk Assessment and Monitoring System (PRAMS) Study
Abstract
Abstract: Background: Although previous studies extensively documented the association between tobacco smoking and mental health disorders, its association with postpartum depression (PPD) severity remains unclear. This study aims to assess the association between tobacco smoking and the severity of PPD. Methods: We conducted a cross-sectional analysis of 184,063 mothers participating in the Pregnancy Risk Assessment Monitoring System (PRAMS) study from 2015-2020. We assessed the prevalence OR of PPD symptom levels using multinomial logistic regression models. We used the Marginal effects to quantify the difference in the prevalence of PPD symptoms of new mothers and their recent tobacco use status. We performed a sensitivity analysis for unmeasured confounders using VanderWeele’s method. Results: There was a significant association between recent tobacco smoking and all levels of PPD severity in the adjusted model, 1.31 (1.25, 1.37), 1.59(1.50, 1.68), 1.71 (1.55, 1.89), 2.37 (1.87, 3.00) for mild, moderate, high, and severe PPD, respectively. These findings on tobacco smoking corresponded to an excess prevalence of PPD of all levels of severity: 2.67% (1.72, 3.61) for mild, 4.26% (3.52, 5.00) for moderate, 1.13% (0.79, 1.48) for high, and 0.39% (0.23, 0.56) for severe PPD, respectively. Conclusion: Tobacco smoking is associated with higher odds of all levels of PPD symptoms. These findings highlight the importance of continual education and tobacco cessation interventions for women of childbearing age during their routine healthcare management and perinatal care.
Keywords
Postpartum, Depression, Severity, Cigarette, Margins, PRAMS
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Tobacco Smoking and Postpartum Depression Symptoms in the Pregnancy Risk Assessment and Monitoring System (PRAMS) Study
Abstract: Background: Although previous studies extensively documented the association between tobacco smoking and mental health disorders, its association with postpartum depression (PPD) severity remains unclear. This study aims to assess the association between tobacco smoking and the severity of PPD. Methods: We conducted a cross-sectional analysis of 184,063 mothers participating in the Pregnancy Risk Assessment Monitoring System (PRAMS) study from 2015-2020. We assessed the prevalence OR of PPD symptom levels using multinomial logistic regression models. We used the Marginal effects to quantify the difference in the prevalence of PPD symptoms of new mothers and their recent tobacco use status. We performed a sensitivity analysis for unmeasured confounders using VanderWeele’s method. Results: There was a significant association between recent tobacco smoking and all levels of PPD severity in the adjusted model, 1.31 (1.25, 1.37), 1.59(1.50, 1.68), 1.71 (1.55, 1.89), 2.37 (1.87, 3.00) for mild, moderate, high, and severe PPD, respectively. These findings on tobacco smoking corresponded to an excess prevalence of PPD of all levels of severity: 2.67% (1.72, 3.61) for mild, 4.26% (3.52, 5.00) for moderate, 1.13% (0.79, 1.48) for high, and 0.39% (0.23, 0.56) for severe PPD, respectively. Conclusion: Tobacco smoking is associated with higher odds of all levels of PPD symptoms. These findings highlight the importance of continual education and tobacco cessation interventions for women of childbearing age during their routine healthcare management and perinatal care.
