Number of significant life events and perinatal depression in a diverse rural population: A brief report of a cross-sectional study

Background: Significant life events (SLEs) correlate with perinatal depression (PD) risk; however, little is known about this association in rural populations.

Objectives: Using the Neuman systems model, we hypothesized that individuals with higher SLEs would have higher PD risk, and we evaluated this association with data collected from six of Utah’s diverse rural health districts.

Design/Methods: This cross-sectional study included pregnant and postpartum individuals visiting six rural public health clinics who completed screening with the Edinburgh Postnatal Depression Scale (EPDS) and an 8-item SLE assessment in Spanish or English. Multinomial logistic regression assessed the association between SLEs (0, 1, and ⩾2) and PD risk status (EPDS ⩾9).

Results: Data from 4245 screening surveys identified 2 primary racial groups: white (79.8%) and American Indian/Alaska Native (7.6%), with 20.2% of individuals identifying as Hispanic. Overall, 49.4% of individuals reported one SLE and 10.5% reported two or more SLEs. Significant predictors for PD risk included 1 SLE (OR = 1.84, 95% CI [1.56, 2.15]) or ⩾2 SLEs (5.18, 95% CI [4.31, 6.23]), regardless of racial/ethnic background.

Conclusion: Screening for PD risk in a rural population should include an assessment of SLEs, given the relationship between the two. Improving culturally appropriate local resources to support individuals and their families during the childbearing year should be considered, particularly for those experiencing SLEs.