Postnatal depressive symptoms display marked similarities across continents

Abstract

Background Postnatal depressive symptoms measured by the Edinburgh Postnatal Depression Scale (EPDS) are reported to display measurement variance regarding factor structure and the frequency of specific depressive symptoms. However, postnatal depressive symptoms measured by EPDS have not been compared between women representing three continents. Methods A cross-sectional study including birth cohort samples from Denmark, Vietnam and Tanzania. Women were included during pregnancy at routine care sites. Depressive symptoms were selfreported 40-90 days postpartum using the EPDS. Exploratory and confirmatory factor analyses and generalized additive regression models were performed. Results A total of N=4,516 participated in the study (Denmark N=2,069, Vietnam N=1,278, Tanzania N=1,169). Factor analyses identified three factors (anhedonia, anxiety and depression) that were almost identical in the three study populations. The only variation between countries was that the item 'self-harm' loaded differently. Women from Tanzania and Denmark were more likely to have an EPDS total score above cutoff 12 (12.6% and 6.4%), compared to women from Vietnam (1.9%) (p<0.001). A low level of education was associated with significantly more depressive symptoms after adjusting for country (p<0.001). Limitations EPDS data was collected at a later time point in the Danish sample. Conclusions Postnatal depressive symptoms constitute a three-factor model across cultures including the factors anhedonia, anxiety and depression. The frequency of postnatal depressive symptoms differs between high-, medium-, and low-income countries. However, clinicians should bear in mind that low-educated women worldwide are more likely to experience postnatal depressive symptoms.

The Need for Universal Screening for Postnatal Depression in South Africa: Confirmation from a Sub-District in Pretoria, South Africa

“…Variations in frequency and scale of postnatal depressive symptoms have been explained by income categories of countries [ 27 ]. African countries have been reporting higher prevalence of PND than high-income countries [ 28 ], and South Africa has reported a higher prevalence which is consistent with high income countries [ 29 ] such as some areas in Japan and the USA, whose prevalence was more than 69% [ 30 , 31 ].…”

The Rate and Risk Factors of Postpartum Depression in Vietnam From 2010 to 2020: A Literature Review

“…Low level of education (Murray et al, 2015;Tho Tran et al, 2018;Wesselhoeft et al, 2020) 2 OR = 2.17; 95% CI: 1.21-3.89 p < 0.001 (OR were not reported)…”

“…Risk factors associated with PPD include personal issues such as a low level of education background (Do et al, 2018 ; Wesselhoeft et al, 2020 ) or a history of mental health disorders (Silverman et al, 2017 ; Tho Tran et al, 2018 ). Other reasons, such as infant gender among areas where local residents remained traditionally unscientific belief (Murray et al, 2015 ), intimate partner violence (Tho Nhi et al, 2019 ), or stressful life events (SLEs) like a job loss, death of loved one, or an economic shock (Qobadi et al, 2016 ; Gausman et al, 2020 ), can worsen the situation of PPD.…”

“…Prospective studies have shown that PPD may also lead to impaired physical, mental development for children and lower life quality, or even suicidal or self-harming behaviors of a mother (Herba et al, 2016 ; Gressier et al, 2017 ; Haddad et al, 2017 ; Tungchama et al, 2017 ). In Vietnam, there have been a number of studies about the rate and risk factors of PPD using different screening, including the Edinburgh Postnatal Depression Scale (EPDS) (Chen et al, 2012 ; Van Vo et al, 2017 ; Do et al, 2018 ; Wesselhoeft et al, 2020 ), Self-Reporting Questionaire-20 (SRQ-20) (Upadhyay et al, 2019 ; Gausman et al, 2020 ), or diagnostic guide as the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Nguyen et al, 2015 ). This current literature review aims to summarize and synthesize the current state of knowledge about PPD in Vietnam.…”

Depression and its associated factors among pregnant women in central Vietnam

“…In Vietnam, most research on depression in the perinatal period has focused on postnatal depression only (Do et al, 2018;Murray et al, 2015;Tran et al, 2018bTran et al, , 2019Upadhyay et al, 2019;Vo et al, 2017;Wesselhoeft et al, 2020), with a paucity of research focusing on antenatal depression. The two existing studies of antenatal depression amongst Vietnamese pregnant women report prevalence of 4.9% and 28.2% (Fisher et al, 2013;Ngo et al,…”