Editing Postpartum depression (section)

==== Psychosocial ====

* Prenatal depression or anxiety<ref name="Beck-2001099">{{cite journal | vauthors = Beck CT | title = A meta-analysis of the relationship between postpartum depression and infant temperament | journal = Nursing Research | volume = 45 | issue = 4 | pages = 225–230 | year = 1996 | pmid = 8700656 | doi = 10.1097/00006199-199607000-00006 }}</ref>
* A personal or family history of depression<ref name="McCoy_20062"/>
* Moderate to severe premenstrual symptoms<ref name="Stuart-Parrigon_2014">{{cite journal | vauthors = Stuart-Parrigon K, Stuart S | title = Perinatal depression: an update and overview | journal = Current Psychiatry Reports | volume = 16 | issue = 9 | page = 468 | date = September 2014 | pmid = 25034859 | pmc = 4920261 | doi = 10.1007/s11920-014-0468-6 }}</ref>
* Stressful life events experienced during pregnancy<ref>{{cite journal | vauthors = Mukherjee S, Coxe S, Fennie K, Madhivanan P, Trepka MJ | title = Stressful Life Event Experiences of Pregnant Women in the United States: A Latent Class Analysis | journal = Women's Health Issues | volume = 27 | issue = 1 | pages = 83–92 | date = January 2017 | pmid = 27810166 | doi = 10.1016/j.whi.2016.09.007 }}</ref><ref>{{cite journal | vauthors = Mukherjee S, Coxe S, Fennie K, Madhivanan P, Trepka MJ | title = Antenatal Stressful Life Events and Postpartum Depressive Symptoms in the United States: The Role of Women's Socioeconomic Status Indices at the State Level | journal = Journal of Women's Health | volume = 26 | issue = 3 | pages = 276–285 | date = March 2017 | pmid = 27875058 | doi = 10.1089/jwh.2016.5872 }}</ref>
* [[Postpartum blues]]<ref name="Beck-2001099"/>
* [[Childbirth-related posttraumatic stress disorder|Birth-related psychological trauma]]
* [[Birth trauma (physical)|Birth-related physical trauma]]
* History of sexual abuse<ref name="Robertson-Blackmore_2013">{{cite journal | vauthors = Robertson-Blackmore E, Putnam FW, Rubinow DR, Matthieu M, Hunn JE, Putnam KT, Moynihan JA, O'Connor TG | title = Antecedent trauma exposure and risk of depression in the perinatal period | journal = The Journal of Clinical Psychiatry | volume = 74 | issue = 10 | pages = e942–e948 | date = October 2013 | pmid = 24229763 | doi = 10.4088/JCP.13m08364 }}</ref><ref name="Benedict_1999">{{cite journal | vauthors = Benedict MI, Paine LL, Paine LA, Brandt D, Stallings R | title = The association of childhood sexual abuse with depressive symptoms during pregnancy, and selected pregnancy outcomes | journal = Child Abuse & Neglect | volume = 23 | issue = 7 | pages = 659–670 | date = July 1999 | pmid = 10442831 | doi = 10.1016/S0145-2134(99)00040-X | doi-access = free }}</ref>
* Childhood trauma<ref name="Robertson-Blackmore_2013"/><ref name="Benedict_1999"/><ref>{{cite journal | vauthors = Lev-Wiesel R, Chen R, Daphna-Tekoah S, Hod M | title = Past traumatic events: are they a risk factor for high-risk pregnancy, delivery complications, and postpartum posttraumatic symptoms? | journal = Journal of Women's Health | volume = 18 | issue = 1 | pages = 119–125 | date = January 2009 | pmid = 19132883 | doi = 10.1089/jwh.2008.0774 }}</ref>
* Previous stillbirth or miscarriage<ref name="Stuart-Parrigon_2014" />
* Formula-feeding rather than [[breast-feeding]]<ref name="McCoy_20062" />
* Low self-esteem<ref name="Beck-2001099"/>
* Childcare or life stress<ref name="Beck-2001099"/>
* Low social support<ref name="Beck-2001099"/>
* Poor marital relationship or single marital status<ref name="Beck-2001099"/>
* Low socioeconomic status<ref name="Beck-2001099"/><ref name="Howell2">{{cite journal | vauthors = Howell EA, Mora P, Leventhal H | title = Correlates of early postpartum depressive symptoms | journal = Maternal and Child Health Journal | volume = 10 | issue = 2 | pages = 149–157 | date = March 2006 | pmid = 16341910 | pmc = 1592250 | doi = 10.1007/s10995-005-0048-9 }}</ref>
* A lack of strong emotional support from spouse, partner, family, or friends<ref name="Postpartum Depression Facts2">{{Cite web|title=Postpartum Depression Facts|url=https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml|access-date=2019-11-20|website=www.nimh.nih.gov}}</ref>
* Infant temperament problems/[[Baby colic|colic]]<ref name="Beck-2001099"/>
* [[Unintended pregnancy|Unplanned/unwanted pregnancy]]<ref name="Beck-2001099"/>
* Breastfeeding difficulties<ref>{{cite journal | vauthors = Figueiredo B, Dias CC, Brandão S, Canário C, Nunes-Costa R | title = Breastfeeding and postpartum depression: state of the art review | journal = Jornal de Pediatria | volume = 89 | issue = 4 | pages = 332–338 | date = 2013 | pmid = 23791236 | doi = 10.1016/j.jped.2012.12.002 | hdl-access = free | doi-access = free | hdl = 10216/102955 }}</ref>
* Maternal age, family food insecurity, and violence against women<ref>{{cite journal | vauthors = Hossain SJ, Roy BR, Hossain AT, Mehrin F, Tipu SM, Tofail F, Arifeen SE, Tran T, Fisher J, Hamadani J | title = Prevalence of Maternal Postpartum Depression, Health-Seeking Behavior and Out of Pocket Payment for Physical Illness and Cost Coping Mechanism of the Poor Families in Bangladesh: A Rural Community-Based Study | journal = International Journal of Environmental Research and Public Health | volume = 17 | issue = 13 | pages = E4727 | date = July 2020 | pmid = 32630173 | pmc = 7370050 | doi = 10.3390/ijerph17134727 | doi-access = free }}</ref>

The psychosocial risk factors for postpartum depression include severe life events, some forms of chronic strain, relationship quality, and support from partner and mother.<ref>{{cite journal | vauthors = Brummelte S, Galea LA | title = Postpartum depression: Etiology, treatment and consequences for maternal care | journal = Hormones and Behavior | volume = 77 | pages = 153–166 | date = January 2016 | pmid = 26319224 | doi = 10.1016/j.yhbeh.2015.08.008 | s2cid = 15205497 }}</ref> There is a need for more research regarding the link between psychosocial risk factors and postpartum depression. Some psychosocial risk factors can be linked to the [[social determinants of health]].<ref name="Yim_2015" /> Women with fewer resources indicate a higher level of postpartum depression and stress than those women with more resources, such as financial.<ref name="Segre2">{{cite journal|vauthors=Segre LS, O'Hara MW, Losch ME|year=2006|title=Race/ethnicity and perinatal depressed mood|journal=Journal of Reproductive and Infant Psychology|volume=24|issue=2|pages=99–106|doi=10.1080/02646830600643908|s2cid=144993416}}</ref>

Rates of PPD have been shown to decrease as income increases. Women with fewer resources may be more likely to have an unintended or unwanted pregnancy, increasing the risk of PPD. Women with fewer resources may also include single mothers of low income. Single mothers of low income may have more limited access to resources while transitioning into motherhood. These women already have fewer spending options, and having a child may spread those options even further.<ref name="Segre-2007">{{cite journal | vauthors = Segre LS, O'Hara MW, Arndt S, Stuart S | title = The prevalence of postpartum depression: the relative significance of three social status indices | journal = Social Psychiatry and Psychiatric Epidemiology | volume = 42 | issue = 4 | pages = 316–321 | date = April 2007 | pmid = 17370048 | doi = 10.1007/s00127-007-0168-1 | s2cid = 20586114 }}</ref> Low-income women are frequently trapped in a cycle of poverty, unable to advance, affecting their ability to access and receive quality healthcare to diagnose and treat postpartum depression.<ref name="Segre-2007" />

Studies in the US have also shown a correlation between a mother's [[Race (human categorization)|race]] and postpartum depression. African American mothers have been shown to have the highest risk of PPD at 25%, while Asian mothers had the lowest at 11.5%, after controlling for social factors such as age, income, education, marital status, and baby's health. The PPD rates for First Nations, Caucasian, and Hispanic women fell in between.<ref name="Segre2" />

Migration away from a cultural community of support can be a factor in PPD. Traditional cultures around the world prioritize organized support during postpartum care to ensure the mother's mental and physical health, well-being, and recovery.<ref name="Dennis_2007" />

One of the strongest predictors of [[Paternal depression|paternal PPD]] is having a partner who has PPD, with fathers developing PPD 50% of the time when their female partner has PPD.<ref>{{Cite journal| vauthors = Singley DB, Edwards LM |date=2015|title=Men's Perinatal Mental Health in the Transition to Fatherhood|journal=Professional Psychology: Research and Practice|volume=46|issue=5|pages=309–319|doi=10.1037/pro0000032|s2cid=21726189|url=https://epublications.marquette.edu/cgi/viewcontent.cgi?article=1488&context=edu_fac }}</ref>

[[Sexual orientation]]<ref name="Ross22">{{cite journal | vauthors = Ross LE, Steele L, Goldfinger C, Strike C | title = Perinatal depressive symptomatology among lesbian and bisexual women | journal = Archives of Women's Mental Health | volume = 10 | issue = 2 | pages = 53–59 | year = 2007 | pmid = 17262172 | doi = 10.1007/s00737-007-0168-x | s2cid = 44227469 }}</ref> has also been studied as a risk factor for PPD. In a 2007 study conducted by Ross and colleagues, lesbian and bisexual mothers were tested for PPD and then compared with a heterosexual sample group. It was found that lesbian and bisexual biological mothers had significantly higher Edinburgh Postnatal Depression Scale scores than the heterosexual women in the sample.<ref name="Ross_2009" /> Postpartum depression is more common among lesbian women than heterosexual women, which can be attributed to lesbian women's higher depression prevalence.<ref name="Maccio-2011">{{cite journal | vauthors = Maccio EM, Pangburn JA | title = The case for investigating postpartum depression in lesbians and bisexual women | language = English | journal = Women's Health Issues | volume = 21 | issue = 3 | pages = 187–190 | date = 2011-05-01 | pmid = 21521621 | doi = 10.1016/j.whi.2011.02.007 }}</ref> Lesbian women have a higher risk of depression because they are more likely to have been treated for depression and to have attempted or contemplated suicide than heterosexual women.<ref name="Maccio-2011" /> These higher rates of PPD in lesbian/bisexual mothers may reflect less social support, particularly from their families of origin, and additional stress due to homophobic discrimination in society.<ref name="Ross32">{{cite journal | vauthors = Ross LE | title = Perinatal mental health in lesbian mothers: a review of potential risk and protective factors | journal = Women & Health | volume = 41 | issue = 3 | pages = 113–128 | year = 2005 | pmid = 15970579 | doi = 10.1300/J013v41n03_07 | s2cid = 38024879 }}</ref>

Different risk variables linked to postpartum depression (PPD) among Arabic women emphasize regional influences.<ref name="Qandil_2016">{{cite journal | vauthors = Qandil S, Jabr S, Wagler S, Collin SM | title = Postpartum depression in the Occupied Palestinian Territory: a longitudinal study in Bethlehem | journal = BMC Pregnancy and Childbirth | volume = 16 | issue = 1 | page = 375 | date = November 2016 | pmid = 27887649 | pmc = 5124263 | doi = 10.1186/s12884-016-1155-x | doi-access = free }}</ref>&nbsp; Risk factors that have been identified include the gender of the infant and [[polygamy]].<ref name="Qandil_2016" /> According to three studies conducted in [[Egypt]] and one in [[Jordan]], mothers of female babies had a two-to-four-fold increased risk of postpartum depression (PPD) compared to mothers of male babies.<ref name="Qandil_2016" /> Four studies found that conflicts with the mother-in-law are associated with PPD, with risk ratios of 1.8 and 2.7.<ref name="Ayoub_2020">{{cite journal | vauthors = Ayoub K, Shaheen A, Hajat S | title = Postpartum Depression in The Arab Region: A Systematic Literature Review | journal = Clinical Practice and Epidemiology in Mental Health | volume = 16 | issue = Suppl-1 | pages = 142–155 | date = 2020-07-30 | pmid = 33029191 | pmc = 7536723 | doi = 10.2174/1745017902016010142 | doi-access = free }}</ref>

Studies have also shown a correlation between postpartum depression in mothers living within areas of conflicts, crises, and wars in the [[Middle East]].<ref name="Alshikh_Ahmad_2021" /> Studies in [[Qatar]] have found a correlation between lower education levels and higher PPD prevalence.<ref name="Ayoub_2020"/>

According to research done in [[Egypt]] and [[Lebanon]], rural residential living is linked to an increased risk. It was found that rural Lebanese women who had [[Caesarean section|Caesarean]] births had greater PPD rates. On the other hand, Lebanese women in urban areas showed an opposite pattern.<ref name="Ayoub_2020" />

Research conducted in the Middle East has demonstrated a link between PPD risk and mothers who were not informed and who are not given due consideration when decisions are made during childbirth.<ref name="Ayoub_2020" />

There is a call to integrate both a consideration of biological and psychosocial risk factors for PPD when treating and researching the illness.<ref name="Yim_2015"/>