Perinatal depression complicates 1 in 7 pregnancies and has adverse consequences when untreated. These may include failure to breastfeed and its known adverse effects on mother and offspring. This study sought to determine whether maternal antenatal depression was associated with the likelihood of breastfeeding initiation and continuation until the 6-week postpartum visit.METHODS:
This retrospective chart study included all deliveries after 20 weeks gestation at a single tertiary care institution between 2008 and 2015 with a documented antenatal depression screen using the Patient Health Questionnaire-9 per standard obstetric care. Breastfeeding initiation and continuation until 6 weeks postpartum were compared between women with and without a positive screen using bivariable analyses. Stepwise backwards elimination regressions were used to identify whether antenatal depression was independently associated with breastfeeding initiation and continuation.RESULTS:
Of 2,871 women meeting inclusion criteria, 302 (10.5%) screened positive for antenatal depression. Women with antenatal depression were more likely to be younger, a racial/ethnic minority, obese, have public insurance or medical co-morbidity, and deliver preterm than women without depression. Women with antenatal depression were less likely to initiate breastfeeding (81.0% versus 86.3% P=.014) and continue breastfeeding at 6 weeks postpartum (54.7% versus 68.9% P<.001). After controlling for confounders, antenatal depression was not independently associated with breastfeeding initiation (aOR 0.78, 95% CI 0.52–1.16) but did remain significantly associated with reduction in breastfeeding continuation (aOR 0.67, 95% CI 0.48–0.96).CONCLUSION:
Antenatal depression is a significant risk factor for early breastfeeding cessation. Further interventions to improve breastfeeding rates should include evaluation of maternal mental health.