Physical intimate partner violence during pregnancy and maternal social context in relation to postpartum depressive symptoms in the United States

Postpartum depression (PPD) is a serious public health issue that impacts both the development of the child and the well-being of the mother. Many demographic and psychosocial risk factors for PPD have been found, but little is known about the effects of intimate partner violence (IPV) in a broad context. This study examines the relationship between physical intimate partner violence (IPV) and postpartum depressive symptoms (PDS), while accounting for potential contextual or social factors from the mother’s social context, including socioeconomic resources, stressors, and demographic characteristics. To distinguish the distinct association of physical IPV on PDS and account for possible spuriousness / contextual factor and to give a more precise estimate of the relationship between IPV and maternal mental health, these variables are included as controls. Weighted logistic regression models were used to estimate the association of physical IPV on PDS using nationally representative data from the PRAMS 2016–2022 dataset ( N = 116,826). Three models were examined: a bivariate model that included only physical IPV, a covariate-adjusted model that included demographic controls, stressors, and resource variables, and a full model that included both physical IPV and all control variables. All variables were categorical, and proportions were weighted to produce population-level estimates. Physical IPV was substantially linked to higher odds of PDS, in both the unadjusted (OR = 5.08, p < 0.001) and adjusted (OR = 2.17, p < 0.001) models. Significant associations were also found between higher PDS risk and important control variables, including lower income, unmarried status, previous diagnoses of anxiety and depression, and parity of three to five children. On the other hand, higher income, Hispanic ethnicity, and older maternal age were protective factors. Also, the adjusted predicted probabilities were 6.30% (95% CI: 6.11%–6.48%) among women who did not report physical IPV during pregnancy and 11.94% (95% CI: 8.71%–15.17%) among women who reported physical IPV. The average marginal effect indicated a 5.64-percentage-point higher adjusted probability of PDS among women reporting physical IPV (95% CI: 2.40–8.88; p = 0.001). IPV is highly associated with postpartum depression after controlling for maternal resources, stressors, and demographics. The results highlighted the necessity of integrated perinatal mental health interventions and IPV screening, particularly for socioeconomically vulnerable groups.