Methods

PRAMS Dataset

The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing CDC surveillance program that monitors maternal behaviors and characteristics shortly before, during, and after pregnancy using telephone and mail surveys[10]. The purpose of the PRAMS program is to reduce infant mortality and identify factors associated with maternal health including behaviors, attitudes, and experiences[10].

Using the PRAMS surveillance data, this project looked at a national representative sample and their intake of vitamins in the preconception period and the development of postpartum depression and the factors surrounding these variables.

Sample Population

The PRAMS (Phase 8) survey sampled 108,110 mothers who had delivered live births between 2016 and 2018, representing an estimated 83% of all live births in the US during that time period[10].

Data from participants were included in the analysis if two conditions were met: 1) they answered the question “During the month before you got pregnant with your new baby, how many times a week did you take a multivitamin, a prenatal vitamin, or a folic acid vitamin?” (n=107,506) and 2) if they had an indicator for the postpartum depression analytic variable (n=105,313). A total of 104,761 participants provided responses for both variables and were included in the analysis.

Statistical Analysis

For this analysis, descriptive statistics and frequency counts were conducted on independent, dependent, and confounding variables. Chi-square tests were used to examine bivariate associations between vitamin supplementation and postpartum depression.

Logistic regression was conducted to determine the odds ratio (OR) and 95% confidence intervals (CI) of women taking vitamin supplements and postpartum depression. Adjusted logistic regression was conducted to incorporate potential confounders. Sociodemographic, behavioral, and health factors were used as confounding variables in the adjusted regression.