Is Military Deployment a Risk Factor for Maternal Depression?

Authors
Nguyen, S. LeardMann, C. A. Smith, B. Conlin, A. M. S. Slymen, D. J. Hooper, T. I. Smith, T.C.
Publication year
2013
Citation Title
Is military deployment a risk factor for maternal depression?
Journal Name
Journal of Women's Health
Journal Volume
22
Issue Number
1
Page Numbers
18-Sep
DOI
10.1089/jwh.2012.3606
Summary
Survey data were used to examine the relationships among deployment (before and after childbirth), combat exposure, and maternal depression with a sample of female Active Duty Service members. Women who deployed and reported combat exposure after giving birth were at increased risk of depression compared to non-deployed female Service members who gave birth.
Key Findings
Service members who deployed and reported combat-associated exposures after childbirth were significantly more likely to screen positive for maternal depression than Service members who did not deploy after childbirth.
Deployment before childbirth, regardless of combat exposure, was not significantly associated with maternal depression.
At follow-up, 11% of the Service members screened positive for depression; of those with depression, 58% also screened positive for post-traumatic stress disorder.
Implications for Program Leaders
Provide additional depression screens for female Service members who deploy with combat exposure after childbirth
Include information regarding maternal risk factor for mental health issues during post-deployment reintegration workshops
Disseminate information regarding the services and resources available to Service members and their families post-deployment
Implications for Policy Makers
Continue to provide support for reintegration and debriefing programs to prevent mental health problems and provide early intervention for deployed Service members
Continue to support programs that offer services to female Service members with children during and after deployment
Encourage collaboration among DoD and community-based services to offer seamless care to Service members coping with mental health issues following deployment
Methods
This study used data from the Millennium Cohort Study comprised of a random sample of U.S. Military personnel surveyed every three years.
Participants included Active Duty female Service members who completed a baseline survey and at least one follow-up questionnaire between 2001 and 2008, and who had a child between baseline and follow-up.
Demographic and military-specific data (e.g., service branch and component) were obtained via electronic personnel files.
Participants
The sample included 1,660 female Service members who gave birth between 2001 and 2008.
The majority of participants were White and born between 1970-1979.
Most female Service members who deployed both prior to and after childbirth were enlisted Army or Air Force members.
Limitations
Studies could replicate this methodology with National Guard and Reserve personnel.
Loss to follow-up may have impacted these results.
Reservists and National Guard Service members were not included, nor were those women with non-singleton births; relationships may differ in these groups.
Avenues for Future Research
Continue to assess the effectiveness of the Yellow Ribbon Reintegration program
Explore why female Army Service members are at an increased risk for maternal depression compared to other Service branches
Examine the prevalence of maternal depression among samples of Reserve and Guard members or with a more ethnically diverse sample of Service members
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
1 Star - There are several factors that limit the ability to extend the results to a population and therefore the results can only be extended to a very specific subset of the population.
Focus
Multiple Branches
Population Focus
Military Component
Abstract
Background: Maternal depression is a common condition among new mothers that can be associated with poor maternal health and negative consequences on infant health. Little research has been conducted to examine maternal depression, especially among military mothers, where unique conditions often exist. Using data from a large military cohort, this study prospectively examined the relationship between deployment experience before and after childbirth and maternal depression among U.S. servicewomen. Methods: The study included 1,660 female Millennium Cohort participants who gave birth during active duty service and completed baseline and follow-up questionnaires between 2001 and 2008. Maternal depression was assessed at follow-up using Primary Care Evaluation of Mental Disorders Patient Health Questionnaire criteria. Results: Deployment before childbirth, regardless of combat experience, and deployment without combat experience after childbirth did not increase the risk of maternal depression. Women who deployed and reported combat experience after childbirth were at increased risk for maternal depression compared with non deployed women who gave birth (adjusted odds ratio [OR] 2.01, 95% confidence interval [CI] 1.17-3.43). Among the subgroup of female combat deployers, however, women who gave birth did not have a significantly increased risk for depression compared with those who did not give birth. Conclusions: Military women who deployed with combat like experiences after childbirth were at increased risk for postdeployment maternal depression. The risk, however, appeared primarily related to combat rather than childbirth-related experiences.
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