Date of Award
Fall 2025
Document Type
Open Access Thesis
Department
Epidemiology and Biostatistics
First Advisor
Nelís Soto-Ramírez
Abstract
Postpartum depression (PPD) is common among reproductive-aged women and is associated with adverse outcomes for both mothers and their children. Financial stress during pregnancy can increase psychological distress and limit access to care. However, the relationship between household income dependency, a measure of financial strain, and PPD remains insufficiently explored. This thesis aims (1) to investigate whether women with high income dependency during pregnancy is associated with PPD; and (2) to assess whether the association between the number of income-dependent individuals (0–4 vs. >4) and postpartum depression (yes/no) differs by maternal ethnicity using data from Phase 8 of the Pregnancy Risk Assessment Monitoring System (PRAMS), covering the years 2016 to 2022. Descriptive statistics, bivariate analysis, and multivariable logistic regression analysis were conducted to assess this relationship, adjusting for key sociodemographic factors and other health conditions. Furthermore, an interaction term was added to the logistic regression model to examine whether the association differs across maternal ethnicities. The significant level was set at 0.05 and Odds Ratios and 95% Confidence Intervals were estimated. Analyses was conducted using SAS version 9.4 and analytical weights and strata were used in the analysis. It was hypothesized that women with higher household income dependency will have an increased likelihood of experiencing PPD, particularly those who are identified as a person of color. Among women with higher household income dependency (≥5 ), the odds of experiencing postpartum depression were significantly greater compared to those with fewer dependents (≤4) (OR: 1.22, 95% CI: 1.14–1.31, p < 0.0001). This study contributes to a deeper understanding of financial stressors affecting maternal mental health and inform potential policy interventions to reduce disparities in PPD.
Rights
© 2025, Christina Angela Shivanie Bhola
Recommended Citation
Bhola, C. A.(2025). The Effect of Household Income Dependency on Postpartum Depression Among Women in the United States: Evidence From the Pregnancy Risk Assessment Monitoring System. (Master's thesis). Retrieved from https://scholarcommons.sc.edu/etd/8706