BACKGROUND Lower socioeconomic status is often thought to be associated with an elevated risk of postpartum depression; however, this relationship exhibits noticeable heterogeneity between studies. The present study examined this relationship in Japan. METHODS Data were obtained from 90,194 mothers in an ongoing birth cohort of the Japan Environment and Children's Study. Socioeconomic status was assessed based on the mothers' highest education level during pregnancy. Postpartum depression was identified at 1 and 6 months postpartum based on an Edinburgh Postnatal Depression Scale score of ≥9, and analyses were also performed based on the sub-scores for anxiety, depression, and anhedonia symptoms. Logistic and generalized linear regression model analyses were used to calculate odds ratios for postpartum depression according to education level with the highest education group (≥16 years of education) defined as the reference group, while controlling for covariates in a stepwise fashion. RESULTS Univariate analysis revealed that a lower education level was associated with a higher prevalence of postpartum depression and related symptoms. Although these relationships weakened in the fully adjusted models, odds ratios for cases and related symptoms remained significant at 1 and 6 months postpartum. Among three symptom dimensions, the relationship was strongest and weakest in the depressive and anxiety symptoms, respectively. CONCLUSIONS A lower education level was an independent risk factor for postpartum depression. In view of the low mobility of the education level, this finding suggests the potential importance of collecting information regarding education levels at the earliest opportunity.

中文翻译：

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教育水平和产后抑郁症的风险：日本环境与儿童研究 (JECS) 的结果。


背景 较低的社会经济地位通常被认为与产后抑郁症的风险升高有关。然而，这种关系在研究之间表现出明显的异质性。本研究探讨了日本的这种关系。方法 数据来自日本环境与儿童研究正在进行的出生队列中的 90,194 名母亲。社会经济地位是根据母亲怀孕期间的最高教育水平进行评估的。根据爱丁堡产后抑郁量表评分≥9分，在产后1个月和6个月时确定产后抑郁症，并根据焦虑、抑郁和快感缺乏症状的子评分进行分析。采用逻辑回归和广义线性回归模型分析，根据受教育程度计算产后抑郁症的比值比，以最高受教育程度组（受教育年限≥16年）定义为参考组，同时逐步控制协变量。结果 单变量分析显示，较低的教育水平与较高的产后抑郁症和相关症状患病率相关。尽管这些关系在完全调整的模型中减弱，但病例和相关症状的比值比在产后 1 个月和 6 个月仍然显着。在三个症状维度中，抑郁症状和焦虑症状的相关性分别最强和最弱。结论 较低的文化程度是产后抑郁症的独立危险因素。鉴于教育水平的流动性较低，这一发现表明尽早收集有关教育水平的信息具有潜在的重要性。