A new Canadian study finds that women living in large urban centers with more than 500,000 inhabitants were at higher risk of postpartum depression than women in other areas.
Postpartum depression is a serious health concern for women and their children. Risk factors for postpartum depression include lack of social support and a history of depression.
As in the U.S., Canada has a variety of living environments ranging from rural and remote regions, semirural or semiurban areas, and large urban metropolises.
Until this study, found in the CMAJ (Canadian Medical Association Journal), the effect of urbanicity on postpartum depression was unknown.
For the study, researchers looked at data for 6,421 women living in rural, semirural, semiurban or urban areas who participated in the 2006 Canadian Maternity Experiences Survey.
Rural was defined as people living in settlements smaller than 1,000 people or with 400 or more inhabitants per square kilometer; semirural (under 30,000), semiurban (30,000-499,999) and urban (500,000 and over).
The researchers also factored in the effect of whether residents commute to larger urban centers, because this can affect the degree of social isolation.
The prevalence of postpartum depression in the sample group was 7.5 percent. Women in urban areas were at higher risk, with almost 10 percent reporting postpartum depression compared with six percent of women in rural areas, almost seven percent of women in semirural areas and about five percent in semiurban areas.
Urban areas had higher numbers of immigrant populations, and more women in these areas reported lower levels of social support during and after pregnancy.
“We found that Canadian women who lived in large urban areas … were at higher risk of postpartum depression than women living in other areas,” writes Simone Vigod, M.D., psychiatrist at Women’s College Hospital and scientist at Women’s College Research Institute, Toronto.
“The risk factors for postpartum depression (including history of depression, social support and immigration status) that were unequally distributed across geographic regions accounted for most of the variance in the rates of postpartum depression.”
The authors suggested that supports and services targeted toward increasing connections for isolated women in large urban centers may need to be increased in Canada.
“Considering the substantial negative effect of postpartum depression, such interventions could have broad-reaching social and public health impact,” they noted.