Postpartum depression among women attending postnatal clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya

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.