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Women who live in large urban areas are at higher risk of postpartum depression, according to a new study.

Canadian researchers found that women who live in urban centers with more than 500,000 inhabitants were significantly more likely to develop postpartum depression than women living in other areas.

Postpartum or postnatal depression can seriously affect both mother and baby. Postpartum depression is a severe, long-lasting form of depression that develops after childbirth. Some risk factors include lack of social support and a history of depression. 

To understand the influence of place of residence on postpartum depression, researchers examined data for 6421 women living in rural, semirural, semi-urban or urban areas who participated in the 2006 Canadian Maternity Experiences Survey. Researchers said rural was defined as people living in settlements smaller than 1000 people or with 400 or more inhabitants per square kilometer; semirural (under 30 000), semi-urban (30,000-499,999) and urban (500 000 and over). The study also accounted for whether residents commute to larger urban centers because this can affect the degree of social isolation.

Study results revealed that 7.5 percent of participants suffered postpartum depression.  They found that women in urban areas were at higher risk, with almost 10 percent reporting postpartum depression compared with 6 percent of women in rural areas, 7 percent of women in semirural areas and about 5 percent in semi-urban areas.

The study also found that urban areas had higher numbers of immigrant populations, and more women in these areas reported lower levels of social support during and after pregnancy.

"We found that Canadian women who lived in large urban areas...were at higher risk of postpartum depression than women living in other areas," researchers wrote in the study.

"The risk factors for postpartum depression (including history of depression, social support and immigration status) that were unequally distributed across geographic regions accounted for most of the variance in the rates of postpartum depression," they added.

"Supports and services targeted toward increasing connections for isolated women in large urban centers may need to be increased in Canada," researchers concluded. "Considering the substantial negative effect of postpartum depression, such interventions could have broad-reaching social and public health impact."

The findings are published in the CMAJ (Canadian Medical Association Journal).