Identification of postpartum symptom subgroups and associated long-term maternal depressive symptoms and well-being
Corresponding Author
Jihye Kim Scroggins
School of Nursing, Duke University, Durham, North Carolina, USA
Correspondence Jihye Kim Scroggins, School of Nursing, Columbia University, 560 W 168th St, New York, NY 10032, USA.
Email: [email protected]
Search for more papers by this authorKarin Reuter-Rice
School of Nursing, Duke University, Durham, North Carolina, USA
School of Medicine, Duke University, Durham, North Carolina, USA
Search for more papers by this authorDebra Brandon
School of Nursing, Duke University, Durham, North Carolina, USA
School of Medicine, Duke University, Durham, North Carolina, USA
Search for more papers by this authorQing Yang
School of Nursing, Duke University, Durham, North Carolina, USA
Search for more papers by this authorCorresponding Author
Jihye Kim Scroggins
School of Nursing, Duke University, Durham, North Carolina, USA
Correspondence Jihye Kim Scroggins, School of Nursing, Columbia University, 560 W 168th St, New York, NY 10032, USA.
Email: [email protected]
Search for more papers by this authorKarin Reuter-Rice
School of Nursing, Duke University, Durham, North Carolina, USA
School of Medicine, Duke University, Durham, North Carolina, USA
Search for more papers by this authorDebra Brandon
School of Nursing, Duke University, Durham, North Carolina, USA
School of Medicine, Duke University, Durham, North Carolina, USA
Search for more papers by this authorQing Yang
School of Nursing, Duke University, Durham, North Carolina, USA
Search for more papers by this authorAbstract
Many postpartum women experience postpartum symptoms which often occur in clusters (i.e., three or more co-occurring symptoms that are related to each other). To date, research has focused on individual symptoms, which limits our understanding of how postpartum symptom clusters manifest and influence health. This secondary analysis used the Community and Child Health Network study data (N = 1784). No patient or public directly participated or contributed to the current analysis. Guided by the Symptom Management Theory, latent class analysis was performed to identify subgroups of postpartum women with different symptom experiences using observed variables at 6 months postpartum: anxiety (MINI-anxiety), general stress (PSS-10), posttraumatic stress (PCL-C), postpartum depression (EPDS), sleep disturbance (PSQI-sleep disturbance), and sleep duration (PSQI-sleep duration). Bivariate and multiple regression analyses were conducted to examine the association between subgroups and (a) individual characteristics and (b) long-term depressive symptoms (CES-D-9) and well-being at 18 and/or 24 months postpartum. Five subgroups were selected that had better-fit indices, entropy, and interpretability. Subgroups were labeled as (1) Minimum overall, (2) Mild-moderate overall, (3) Moderate-high sleep symptoms, (4) High psychological symptoms, and (5) High overall. After adjusting for covariates, postpartum women in Subgroups 4 and 5 had higher CES-D-9 scores at 18 and 24 months and lower well-being scores at 24 months. More postpartum women in Subgroups 4 and 5 experienced a history of depression or unemployment. Clinicians should provide targeted interventions for postpartum women in high-symptom subgroups.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data used for the current study is available at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Data and Specimen Hub (DASH).
Supporting Information
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