Date of Award

Spring 5-14-2019

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Ashli Owen-Smith

Second Advisor

Dr. Dora II'yasova

Abstract

INTRODUCTION: Breastfeeding provides several health benefits for both mother and child. Breastfed infants have a lowered risk of sudden infant death syndrome (SIDS), asthma, type 2 diabetes mellitus. respiratory tract infections and obesity. Mothers who have breastfed also have a lower risk of breast and ovarian cancer, cardiovascular diseases, hypertension and have faster pregnancy weight loss after delivery. For decades, researchers have hypothesized a link between breastfeeding and self-reported postpartum depression (PPD). However, the association remains unclear due to inconsistent findings in prior studies.

AIM: The purpose of this study is to determine whether breastfeeding initiation and breastfeeding continuation up to 8 weeks are associated with a decreased risk of self-reported postpartum depression among Georgia mothers.

METHODS: Cross-sectional data from the 2017 Georgia Pregnancy Risk Assessment Monitoring System (PRAMS) was used. All data analysis was performed in SAS 9.4 and SAS-callable SUDAAN version 11.0.1 with sampling weights to account for sampling methodology and bias. Bivariate and multivariate logistic regression models were used to examine the association between breastfeeding initiation, continuation and postpartum depression.

RESULTS: Among the 955 women who were included in this analysis, 129 (12%) of mothers reported experiencing PPD. A total of 749 (82 %) mothers initiated breastfeeding while 314 (38%) of Georgia mothers reported breastfeeding their baby for at least eight weeks; 435(43%) of mothers discontinued breastfeeding before eight weeks. Two multivariate logistic regression were performed. In Model 1 breastfeeding initiation was included as the primary independent variable and Model 2 included breastfeeding continuation as the primary independent variable. In Model 1, the only significant relationship found was between history of depression during pregnancy and PPD (OR=5.81 95% CI 2.01,16.41). In model 2, history of depression during pregnancy (OR=6.62; 95% CI 2.28,19.2) and maternal NH-Asian race (OR=5.35; 95% CI 1.15,24.9; p=0.03) was significantly associated with a increased odds of having PPD after adjusting for potential confounders.

DISCUSSION: The evidence suggests that breastfeeding initiation and continuation are not associated with postpartum depression in this sample. However, the increasing trend of PPD rate is a cause for concern. Future studies should consider data form multiple years to get a better understanding of the overall trend of PPD and understand its association with breastfeeding initiation and continuation.

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