Association of Postpartum Temperature Exposure with Postpartum Depression: A Retrospective Cohort Study in Southern California
Abstract
Background: Postpartum depression (PPD) has been associated with biological, emotional, social, and environmental factors. However, evidence regarding the effect of temperature on PPD is extremely limited. Objectives: We aimed to examine the associations between postpartum temperature exposure and PPD. Methods: We conducted a retrospective cohort study using data from Kaiser Permanente Southern California electronic health records from 1 January 2008 through 31 December 2018. PPD was first assessed using the Edinburgh Postnatal Depression Scale (score ≥10) during the first year of the postpartum period and further identified by using both diagnostic codes and prescription medications. Historical daily ambient temperatures were obtained from the 4-km resolution gridMET dataset (https://www.climatologylab.org/gridmet.html) and linked to participants’ residential addresses at delivery. Postpartum temperature exposures were measured by calculating various temperature metrics during the period from delivery to PPD diagnosis date. A time-to-event approach with a discrete-time logistic regression was applied to estimate the association between temperature exposure and time to PPD. Effect modification by maternal characteristics and other environmental factors was examined. Results: There were 46,114 (10.73%) PPD cases among 429,839 pregnancies (mean±standard deviation age =30.22±5.75 y). Increased PPD risks were positively associated with exposure to higher mean temperature…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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