Environment/Climate Change
Air pollution and postpartum psychological dysfunction symptoms: the interplay with prenatal stress. Gary Joseph* Gary Joseph Megan Niedzwiecki Itai Kloog Allan C. Just Rosalind J. Wright Ivan.Gutierrez-Avila Elena Colicino Martha María Téllez Rojo Robert O. Wright Lauren M. Petrick
Background: Postpartum depression (PPD) is a global health issue that impairs a mother’s ability to care for herself or her baby. Ambient air pollution (PM2.5) has been associated with PPD in Hispanic women, but the modifying role of psychosocial stress on this relationship is unclear. We also assessed the modifying role of prenatal stress in this relationship.
Methods: We assessed the association between prenatal PM2.5 exposure and psychological dysfunction (PPD, anhedonia, anxiety, and depression) at 6 months postpartum using PROGRESS cohort data (n=457 mothers). Daily residence level PM2.5 estimates were generated from our hybrid satellite-based machine learning model, and averaged over pregnancy. Psychological dysfunction was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 6 months postpartum. Modified Poisson regression evaluated the association between PM2.5 and PPD (EPDS≥13), stratified by negative life events (NLEs) and perceived stress score (PSS), dichotomized around the median (low/high). Negative binomial regression was used for EPDS subscales (anhedonia, anxiety, and depression).
Results: A 5-μg/m3 increase in average prenatal PM2.5 exposure was associated with an increased risk of overall PPD (RR: 1.48, 95%CI: 1.02-2.17), and new onset of PPD (RR: 2.55, 95%CI: 1.27-5.12) at 6 months. Stratifying PPD risk by NLE and PSS scores showed increased overall PPD risk per unit increase in PM2.5 in low-PSS subgroups and new-onset PPD in high-NLE and low-PSS subgroups. PM2.5 was positively associated with EPDS subscales of anhedonia and depression, with greater risk in low-PSS subgroups.
Conclusion: Prenatal PM2.5 exposure is associated with an increased risk of postpartum psychological dysfunction symptoms, especially in those with low-PSS or high-NLE scores. These findings highlight the need for interventions addressing both air pollution and prenatal stress to prevent adverse postpartum mental health outcomes.