Mothers of multiples have 43 percent increased odds of
having moderate to severe depressive
symptoms nine months after giving birth compared to mothers
of single-born children, according to
researchers at the Johns
Hopkins Bloomberg School of Public Health.
Researchers examined the relationship between multiple
births and maternal depressive
symptoms and found that multiple births increased the odds
of maternal depression, and also that few
mothers with depressive symptoms, regardless of the
multiple births status, reported talking to a
mental health specialist or a general medical provider. The
results are published in the April 1 issue of
"Our findings suggest that 19 percent of mothers of
multiples had moderate to severe
depressive symptoms nine months after delivery, compared to
16 percent among mothers of
singletons," said Yoonjoung Choi, lead author of the study
and a research associate with the Bloomberg
of International Health.
Mothers with a history of hospitalization due to
mental health problems or a history of alcohol
or drug abuse also had significantly increased odds.
Non-Hispanic black mothers had higher odds
compared to non-Hispanic white mothers. Mothers who were
currently married, Hispanic or with a high
household socioeconomic status were less likely to have
Choi, along with colleagues, used data from the Early
Childhood Longitudinal Study-Birth Cohort, a nationally
representative sample of children born in 2001, and
symptoms in mothers using an abbreviated version of the
Center for Epidemiologic Studies Depression
scale. The researchers examined the association between
multiple births and maternal mental health,
given the rapidly increasing multiple births rate in the
U.S. over the last two decades.
They also found that among the mothers of both
singleton and multiples only 27 percent
reported talking to a mental health specialist or a general
medical provider when experiencing
The researchers said they believe greater attention is
needed in pediatric settings to address
maternal depression in families with multiple births.
Cynthia Minkovitz, senior author of the study and an
associate professor with the Bloomberg
School's Department of
Population, Family and Reproductive Health, said, "The
low numbers of women
receiving mental health counseling despite symptoms
reinforces the need for facilitating better
referral of patients with depressive symptoms. Pediatric
practices should make an additional effort to
educate new and expecting parents of multiples regarding
their increased risk for maternal
postpartum depression," she said.
"Furthermore, well-child visits are potentially
valuable opportunities to provide education,
screening and referrals for postpartum depression among
mothers of multiples. Such efforts require
linkages between pediatric and adult systems of care and
adequate community mental health
resources," she said.
The study was written by Choi, David Bishai and
Minkovitz. The research was funded by a grant
from the Maternal and Child Health Bureau.