Postpartum Depression, Risk Factors, and Child's Home Environment Among Mothers in a Home Visiting Program

This paper provides an in-depth description of predictors of elevated postpartum depression (PPD) symptoms among mothers identified as high risk for committing child maltreatment in a home visiting program. We also examine how elevated PPD symptoms in early postpartum affect subsequent maternal child interactions in the home environment, a key measure of home visiting programs. Secondary data analysis was conducted using a sample (n = 4979) from a Healthy Families America program. Multiple linear regression models examined predictors of elevated PPD symptoms and logistic regression models determined the effect of elevated PPD symptoms on the home environment. Elevated PPD symptoms at 3 months postpartum were predicted by elevated depressive symptoms prenatally (OR = 4.34, 95% CI [3.46, 5.45]) and being unemployed (OR = 1.37, 95% CI [1.18, 1.58]). Being African American (OR = .83, 95% CI [.69, .99]) or not having English as first language (OR = .51, 95% CI [.32, .83]) were associated with decreased odds of elevated PPD symptoms. In turn, elevated PPD symptoms were associated with decreased overall home environment functioning at 12 months (beta = -.87, 95% CI [-1.48, -.26]), particularly in the domains of maternal acceptance (beta = -.19, 95% CI [-.36, -.03]) and involvement (beta = -.24, 95% CI [-.39, -.08]). Elevated PPD symptoms may have long-term impact on home environment, including negative effects on mother's acceptance of and involvement with her child. Early screenings and treatment for PPD among mothers at risk for committing child maltreatment are supported.