{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:41:28Z","timestamp":1763037688998,"version":"3.37.3"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"16","funder":[{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","award":["UL1TR001422"],"award-info":[{"award-number":["UL1TR001422"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"crossref","award":["HD050121-09 [ESM]"],"award-info":[{"award-number":["HD050121-09 [ESM]"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Society for Maternal-Fetal Medicine\/Lumara Health Policy","award":["2016 ESM"],"award-info":[{"award-number":["2016 ESM"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>\n            Objective\u2003While postpartum depot medroxyprogesterone acetate (DMPA) is a highly effective form of contraception, some data suggest an association with depressive symptoms. Our objective was to evaluate the relationship between receipt of DMPA in the immediate postpartum period and postpartum depressive symptoms.<\/jats:p><jats:p>\n            Study Design\u2003This retrospective cohort study included all women who received prenatal and postpartum care at academic obstetric clinics affiliated with a tertiary care institution between January 1, 2008 and December 31, 2014. All women were counseled on contraception prior to hospital discharge. DMPA was available in the hospital pharmacy, and its utilization was documented in the electronic health record. The Patient Health Questionnaire 9 (PHQ-9) was used to screen for postpartum depression for all women at all postpartum visits. A score of 10 or greater was categorized as positive. Bivariable and multivariable analyses were used to identify the association between immediate postpartum DMPA use and a positive postpartum depression screen.<\/jats:p><jats:p>\n            Results\u2003Of the 5,073 women who met inclusion criteria, 410 (8.1%) received DMPA prior to hospital discharge. Compared with women who did not receive DMPA, women who received DMPA prior to hospital discharge were younger, more likely to identify as Black race or Latinx ethnicity, and more likely to be publicly insured. Clinical characteristics also differed. Women who received DMPA were more likely to be obese and to have experienced prenatal depressive symptoms, been diagnosed with a hypertensive disorder of pregnancy, delivered preterm, and delivered vaginally. Receipt of immediate postpartum DMPA was not associated with having a positive screen for postpartum depression in bivariable (5.4 vs. 6.0%, p\u2009=\u20090.29) or multivariable (adjusted odds ratio 0.94, confidence interval 0.53\u20131.68) analyses.<\/jats:p><jats:p>\n            Conclusion\u2003Receipt of postpartum DMPA is not associated with a positive postpartum PHQ-9 screen. Concerns about precipitating postpartum depression should not preclude the utilization of DMPA as a contraceptive agent.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1739431","type":"journal-article","created":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T23:31:01Z","timestamp":1636932661000},"page":"1765-1769","source":"Crossref","is-referenced-by-count":1,"title":["The Association between Immediate Postpartum Depot Medroxyprogesterone Acetate Use and Postpartum Depressive Symptoms"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9093-2343","authenticated-orcid":false,"given":"Carolyn M.","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, McGaw Medical Center of Northwestern University, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-7794","authenticated-orcid":false,"given":"Jessica Y.","family":"Shim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, McGaw Medical Center of Northwestern University, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth L.","family":"Stark","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, McGaw Medical Center of Northwestern University, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine L.","family":"Wisner","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Asher Center for the Study and Treatment of Depressive Disorders, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily S.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology- Maternal Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,11,14]]},"reference":[{"issue":"12","key":"ref1","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1001\/jamainternmed.2018.4696","article-title":"Association of short interpregnancy interval with pregnancy outcomes according to maternal age","volume":"178","author":"L Schummers","year":"2018","journal-title":"JAMA Intern Med"},{"issue":"26","key":"ref2","first-page":"878","article-title":"Update to CDC's U.S. Medical Eligibility Criteria for Contraceptive Use, 2010: revised recommendations for the use of contraceptive methods during the postpartum period","volume":"60","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s40834-018-0078-5","article-title":"Ongoing barriers to immediate postpartum long-acting reversible contraception: a physician survey","volume":"3","author":"E C Holden","year":"2018","journal-title":"Contracept Reprod Med"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/S0010-7824(98)00024-9","article-title":"Depressive symptoms and depo-provera","volume":"57","author":"C Westhoff","year":"1998","journal-title":"Contraception"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/S0010-7824(98)00022-5","article-title":"Depressive symptoms and Norplant contraceptive implants","volume":"57","author":"C Westhoff","year":"1998","journal-title":"Contraception"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S0010-7824(00)00122-0","article-title":"Depressive symptoms in users and non-users of depot medroxyprogesterone acetate","volume":"61","author":"D Civic","year":"2000","journal-title":"Contraception"},{"issue":"11","key":"ref8","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1001\/jamapsychiatry.2016.2387","article-title":"Association of hormonal contraception with depression","volume":"73","author":"C W Skovlund","year":"2016","journal-title":"JAMA Psychiatry"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/0010-7824(95)00100-O","article-title":"Depression in users of depo-medroxyprogesterone acetate","volume":"51","author":"C Westhoff","year":"1995","journal-title":"Contraception"},{"issue":"119","key":"ref10","first-page":"1","article-title":"Perinatal depression: prevalence, screening accuracy, and screening outcomes","author":"B N Gaynes","year":"2005","journal-title":"Evid Rep Technol Assess (Summ)"},{"issue":"09","key":"ref11","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"K Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1176\/appi.ajp.2020.20020154","article-title":"Contraception for women with psychiatric disorders","volume":"178","author":"L R McCloskey","year":"2021","journal-title":"Am J Psychiatry"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.contraception.2010.03.004","article-title":"Effect of depot medroxyprogesterone acetate on postpartum depression","volume":"82","author":"R Tsai","year":"2010","journal-title":"Contraception"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1136\/jfprhc-2015-101334","article-title":"The effect of depot medroxyprogesterone acetate on postnatal depression: a randomised controlled trial","volume":"42","author":"M Singata-Madliki","year":"2016","journal-title":"J Fam Plann Reprod Health Care"},{"issue":"10","key":"ref15","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1111\/j.1471-0528.1998.tb09940.x","article-title":"A double-blind randomised placebo controlled trial of postnatal norethisterone enanthate: the effect on postnatal depression and serum hormones","volume":"105","author":"T A Lawrie","year":"1998","journal-title":"Br J Obstet Gynaecol"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/S1054-139X(99)00091-9","article-title":"The timing of Norplant insertion and postpartum depression in teenagers","volume":"26","author":"C Stevens-Simon","year":"2000","journal-title":"J Adolesc Health"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.contraception.2017.08.010","article-title":"Association of hormonal contraception with depression in the postpartum period","volume":"96","author":"T A Roberts","year":"2017","journal-title":"Contraception"}],"container-title":["American Journal of 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