Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index
Open accessAbstract
Importance: Postpartum depression (PPD) poses significant risks to maternal and child health. Understanding temporal trends is crucial for evaluating prevalence and identifying populations at risk. Objective: To evaluate recent trends in PPD and assess how these trends are associated with race, ethnicity, and prepregnancy body mass index (BMI). Design, Setting, and Participants: A serial, cross-sectional analysis using data from the Kaiser Permanente Southern California (KPSC) electronic health records (EHRs), with live and stillbirths at 20 or more weeks of gestation who were KPSC members at the time of delivery between 2010 and 2021. Data were analyzed from July 2022 to August 2023. Exposures: Self-reported race, ethnicity, and recorded prepregnancy BMI. Main outcome measures: PPD cases were identified using validated diagnostic codes and prescription records within 12 months postpartum in the KPSC EHRs. Patients with an Edinburgh Postnatal Depression Scale score of 10 or more within 6 months postpartum were further evaluated by a mental health specialist for formal PPD diagnosis. Results: In this study of 442 308 pregnancies, the median (IQR) maternal age at delivery was 31 (27-34) years. The cohort was racially and ethnically diverse, with 62 860 individuals (14.2%) identifying as Asian/Pacific Islander, 231 837 (52.4%) as Hispanic, 33 207 (7.5%) as non-Hispanic Black, 108 201 (24.5%) as non-Hispanic White, 5903 (1.3%) as multiple or other, and 300 (0.1%) unknown. PPD prevalence doubled over the study period, increasing from 9.4% in 2010 to 19.0% in 2021. The largest increases were observed among Asian and Pacific Islander participants (280% increase) and non-Hispanic Black participants (140% increase). PPD rates increased across all BMI categories, particularly among individuals with obesity (class I) and morbid obesity (class II/III). Conclusions and Relevance: In this cross-sectional study, PPD diagnosis increased significantly across all racial and ethnic groups and BMI categories over the past decade. While rising PPD may reflect improved screening and diagnosis practices, the persistently high rates highlight the need to develop and implement interventions to prevent the condition while expanding efforts to mitigate the impact of PPD on maternal and child health.
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The prevalence of postpartum depression symptoms in the hospitalized antepartum cohort (one in three) is increased compared to one in five in the general obstetric population.
“We found increased prevalence (one in three) for PPD symptoms in our hospitalized antepartum cohort, as compared to one in five prevalence in the general obstetric population [43, 44].”
From Factors associated with postpartum depression symptoms following antepartum hospitalization (2026) · cites this paper as [43]
The Introduction reports that postpartum depression prevalence ranges from 10% to 20% globally, so one in five is the upper end of a reported range, not a general-population point estimate. It also gives a US estimate of about 13%. The Results measure diagnoses or antidepressant prescriptions, not symptoms, and do not make the hospitalized-cohort comparison; the one-in-three finding is presented as the citing authors’ own result. (LLM, conf=0.86)
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- Authors
- Khadka, N., Fassett, M. J., Oyelese, Y., Mensah, N. A., Chiu, V. Y., Yeh, M., Peltier, M. R., & Getahun, D.
- Affiliations
- Kaiser Permanente (US)
- Beth Israel Deaconess Medical Center (US)
- Brigham Young University (US)
- Jersey Shore University Medical Center (US)
- Corresponding author
- Getahun, Darios
- ORCID
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2024-11-20
- Volume
- 7
- Issue
- 11
- Pages
- e2446486
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC11579791
- OpenAlex
- W4404568211
- Cited by
- 63
- References
- 33
- Citations by year
- 2026: 41 · 2025: 22
- FWCI
- 25.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JAMA Network Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- postpartum depression, temporal trends, racial and ethnic disparities, pre-pregnancy body mass index, maternal obesity, morbid obesity, Asian/Pacific Islander women, non-Hispanic Black women, Hispanic women, postpartum mental health, Kaiser Permanente Southern California, Kaiser Permanente Northern California, Kaiser Permanente Washington, Kaiser Permanente Colorado
- MeSH terms
- Adult, California, Cross-Sectional Studies, Ethnicity, Female, Humans, Pregnancy, Body Mass Index, Prevalence, Depression, Postpartum, Racial Groups
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