Association between household income and postpartum depression among pregnant women with adequate or inadequate family support: a prospective cohort study

Household income (HI) or family support may have a buffering effect on postpartum depression (PPD) during pregnancy. However, no study has clarified the impact of family support on the association between HI and PPD. This study aimed to analyze the association between HI and PPD and evaluate the effect of family support on this association. Community-dwelling pregnant women recruited between July 2019 and July 2022 were included in this study. Data on HI and other factors were obtained using self-administered questionnaires. PPD was assessed using the Japanese version of the Edinburgh Postnatal Depression Scale. The incidence of PPD was analyzed according to HI levels. Risk estimation was performed, stratifying participants according to whether they received family support with housework or childcare. A total of 645 participants were included in this study. The multi-variable logistic regression analyses showed that participants with low HI had a higher incidence of PPD than those with middle HI; the odds ratio (95% confidence interval) of PPD was 2.67 (1.18-6.05). Stratified analysis by family support level revealed that the odds ratio was similar among participants with inadequate support but not among those with adequate support. HI is related to the risk of PPD among pregnant women. However, adequate support from the family during pregnancy may decrease the risk of PPD, regardless of HI level.