Incidence of and social-demographic and obstetric factors associated with postpartum depression: differences among ethnic Han and Kazak women of Northwestern China

Abstract

BackgroundStudies on postpartum depression (PPD) in China have focused primarily on women of Han ethnicity, whereas work on other ethnic groups has proven limited. This study explored the ethnic differences of associated social-demographic and obstetric factors for PPD between Han-majority and Kazak-minority women in northwestern China.MethodsHan and Kazak women who received routine examinations at four hospitals in a multi-ethnic area of China six weeks after childbirth between March 2016 and December 2016 were included in the study. Data on the women’s socio-demographic characteristics, obstetric factors, and possible depression at six weeks after childbirth were collected. We examined the associated factors of PPD using multivariable logistic regression analyses by ethnic group.ResultsThe overall incidence of PPD was 14.6% (184/1,263) at six weeks after childbirth. PPD was detected more frequently among Kazak (16.1%) than Han women (13.1%). Kazak women exhibited a higher risk of PPD (adjusted OR = 1.561, 95% CI [1.108–2.198], P = 0.011). Urinary incontinence (UI) represented a significant risk factor of PPD for Kazak compared with Han women (OR = 1.720, 95% CI [1.056–2.804], P = 0.003). In contrast, the presence of the mother-in-law as a caregiver after childbirth demonstrated a positive association with PPD among Han (OR = 2.600, 95% CI [1.499–4.512], P = 0.001), but not with Kazak women.ConclusionsKazak women were more likely to develop PPD than Han women, even after controlling for confounders. Moreover, distinct risk factors for PPD existed for Han and Kazak women. Future research that explores the relationships between Han women and their mothers-in-law as well as Kazak women’s attitudes toward UI could help us further understand PPD in these populations.

Predictors of postpartum depression and the utilization of postpartum depression services in rural areas in the Philippines

“…Our results demonstrated that the proportion of mothers who have PPD based on EPDS outcomes is 16.4% at the sixth week after giving birth, which is in line with the findings of previous studies conducted in other Asian countries . Although this finding is considered to be higher than that among studies conducted in Western countries (13%), it is consistent with international studies, which have estimated between 10% and 41% of women experience PPD after childbirth .…”

“…A systematic review and meta‐analysis by Shorey et al reported an incidence of PPD at 17% among postpartum women, with a higher prevalence (26%) noted in the Middle East and a lower prevalence (8%) noted in Europe. In Asia, the overall prevalence of PPD has been found to range from 4.4% to 30% by 6 weeks after birth …”

Early detection of mental illness for women suffering high-risk pregnancies: an explorative study on self-perceived burden during pregnancy and early postpartum depressive symptoms among Chinese women hospitalized with threatened preterm labour

“…For instance, PPD has been found to be a putative cause of disastrous behavioural tendencies, such as suicidal intent [34]. A substantial body of research has reported possible risk factors, e.g., socio-demographic factors, obstetric factors, the course of pregnancy and social support, for the development of postpartum depressive disorders [35][36][37][38][39]. Currently, improving the screening and diagnosis processes for postpartum mental illness, especially the provision of early detection and prevention of postpartum depressive disorders, has been an important task for all health professionals working with women during pregnancy and childbirth [40].…”

Early detection of postpartum depression (PPD) for women suffering high-risk pregnancy: An explorative study on self-perceived burden and other prenatal risk factors of immediate PPD among women hospitalized with threatened preterm labour1

“…While based on the Confucian paradigm, a woman is expected to take care of and show respect and obedience to her mother-in-law; the mother-in-law, in turn, plays a key role in taking care of the pregnant and parturient woman. Previous studies [46] reported that 48.8% of mothers-in-law were caregivers after delivery among women in China. Undoubtedly, building a favorable relationship between women and their mothers-in-law is one of the keys to reducing the risk of women's PPD.…”