Relation between perceived stress, social support, and coping strategies and maternal well-being: a review of the literature.
BACKGROUND Previous research suggests early postpartum fatigue (PPF) plays a significant role in the development of postpartum depression (PPD). Predicting risk for PPD via early identification of PPF may provide opportunity for intervention. OBJECTIVE To replicate and extend previous studies concerning the impact of PPF on symptoms of PPD and to describe the relationships among PPF, PPD, and other variables using the theory of unpleasant symptoms. DESIGN Correlational, longitudinal study. SETTING Participants' homes. PARTICIPANTS Convenience sample of 42 community-dwelling women recruited before 36 weeks of pregnancy. MAIN OUTCOME MEASURES PPF, depressive symptoms, and stress measured during prenatal weeks 36 to 38, and on Days 7, 14, and 28 after childbirth. Salivary cortisol was measured as a physiological marker of stress. RESULTS Significant correlations were obtained between PPF and symptoms of PPD on Days 7, 14, and 28, with Day 14 PPF levels predicting future development of PPD symptoms in 10 of 11 women. Perceived stress, but not cortisol, was also correlated with symptoms of PPD on Days 7, 14, and 28. Women with a history of depression had elevated depression scores compared to women without, but no variable was as effective at predicting PPD as PPF. CONCLUSIONS Fatigue by Day 14 postpartum was the most predictive variable for symptoms of PPD on Day 28 in this population.