Abstract:
Background: Major depression is the most common mental disorder affecting
women in the postpartum period and is associated with poor maternal and child
outcomes. The disorder is covertly suffered and often missed. Knowing the
prevalence and associated factors is the first step towards identifying those at risk.
The findings are the first in our setting and will provide a baseline in providing mental
health services to depressed women in the postnatal period.
Objective: To determine the sociodemographic and clinical factors associated with
depression among women attending the postnatal and immunization clinics within six
weeks of postpartum.
Methods: The study was a descriptive cross-sectional one in which the Edinburg
Postnatal Depression Scale (EPDS) was used for screening for the presence of
depression. A researcher designed questionnaire was administered to determine
sociodemographic and clinical factors associated with depression. A score of 13 or
more on the EPDS was considered significant for depression. The setting for the study
was at the Postnatal and Child immunization Clinics of MTRH where 707 consenting
women were systematically sampled from July 2016 to June 2017. Data was analyzed
with STATA version 14. Descriptive statistics were used to explore the data while
Chi-square test, Fishers exact test Kruskal Wallis test and logistic regression were
used to assess associations. At all analyses, a ‗p‘ value of < 0.05 was considered
statistically significant.
Results: The median age for the respondents was 26 years (IQR 22,30). Most of the
respondents were married (589) 83.3%. The prevalence of Depression within 6 weeks
was (158) 22.3%. This was associated with postpartum blues (OR,3.63, 95% CI,2.11-
6.23,p<0.001),presence of marital conflicts(OR,3.41,95%CI,2.06-5.68,p<0.001) and
Multiparity(OR,2.23, 95%CI 1.11-4.48, p=0.024).The single /separated were less
likely to express depressive symptoms within six weeks of postpartum. (OR,0.30,
95% CI 0.17-0.53, p<0.001).
Conclusion: Presence of marital conflicts, having two or more children and the
presence of postpartum blues were associated with postpartum depression.
Recommendations: I recommend for the routine screening of depression among
those married women with marital conflicts, those women with two or more children
and those with history of postpartum blues. This should be followed with prompt
referral for management.