Learning Objective #1: discuss how fatigue and depression symptoms relate over the first six months postpartum in a low-income urban sample of American women.

Learning Objective #2: identify differences in how the Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale performed over time in a low-income urban American population.

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Postpartum depression health disparities are rarely studied in low-income urban women in the United States. Although fatigue and depression symptoms after childbirth are strongly linked in the first four weeks postpartum, how these variables relate across time in this population has also not been published. The primary aim of this study was to explore the relationships of fatigue, depression symptoms and functional status in low-income, urban American women at 1, 3, and 6 months postpartum. A secondary aim was to evaluate the performance of the Postpartum Depression Screening Scale (PDSS) compared to the Edinburgh Postnatal Depression Scale (EPDS) to identify if these two tools screened participants similarly for depression symptoms. Sixty-eight women (79% African-American) were recruited during their inpatient postpartum stay from an urban hospital where more than 84% of women who give birth live at or below 150% the federal poverty level. Depression symptoms were assessed with both the EPDS and PDSS. Fatigue was assessed with the Modified Fatigue Symptoms Checklist and the Lee Fatigue Scale. Preliminary results reveal moderate to large correlations (.4 to .8) between fatigue and depression symptoms at 1 and 3 months postpartum. Correlations between fatigue and depression symptoms at one month were even more strongly correlated at 3 months postpartum. Although the EPDS and PDSS were highly correlated at each time point (r = .8), there were differences noted in the percentage of participants who screened positive for depression symptoms at any given time point on each instrument. The advantages and disadvantages to using the EPDS and PDSS in this population will be discussed. Results suggest that low-income urban American mothers having high fatigue and depression symptoms at one month postpartum may benefit from nursing interventions to promote maternal-infant sleep beginning shortly after birth and continuing as far out as three months postpartum.