Postpartum depression and associated factors among mothers who gave birth in the last twelve months in Ankesha district, Awi zone, North West Ethiopia

Abstract

BackgroundPostpartum depression is the most common complication of childbearing age women and is a considerable public health problem. The transition into motherhood is a difficult period that involves significant changes in the psychological, social and physiological aspects, and has increased vulnerability for the development of mental illness. More than 1 in 10 pregnant women and 1 in 20 postnatal women in Ethiopia suffer from undetected depression.MethodsCommunity based cross sectional study was conducted among 596 postpartum mothers in Ankesha District, North West Ethiopia, from February 01 to March 2, 2018. One stage cluster sampling technique was employed to get the study participants. The objective was to assess the prevalence and associated factors of postpartum depression among mothers who gave birth in the last Twelve months in Ankesha District, Awi Zone, North West Ethiopia, 2018. The interviewer-administered questionnaire was used to collect data and Eden Burg Postpartum Depression Scale was used to assess postpartum depression with cutoff point ≥8. The data were entered into Epi data version 3.1 and exported to SPSS version 24 for analysis. All variables with P < 0.25 in the bivariate analysis were included in the final model and statistical significance was declared at P < 0.05.ResultIn this study, a total of 596 study participants were involved making a response rate of 97.4%, the prevalence of postpartum depression was 23.7% with 95%CI: 20.3–27.2. From the participant mothers who are divorced/widowed/unmarried (AOR = 3.45 95%CI: 1.35–8.82), unwanted pregnancy (AOR = 1.95 95%CI: 1.14–3.33), unpreferred infant sex (AOR = 1.79 95%CI: 1.13–2.86), infant illness (AOR = 2.08 95%CI: 1.30–3.34) and low social support (AOR = 3.16 95% CI: 1.55–6.43) was independent predictors of postpartum depression.ConclusionAlmost a quarter (23.7%) of women suffers from postpartum depression. Marital status, unwanted pregnancy, unwanted infant sex, infant illness, and low social support were independent predictors of postpartum depression. Therefore, integration of mental illness with maternal and child health care is important, information communication education and behavioral change communications on postpartum depression are better been given attention.

Mixed Method Synthesis of Cognitive interviews with Kenyan peripartum adolescents: Testing EPDS and PHQ questionnaires in Nairobi primary care settings

“…Items marked with an asterisk (*) are reverse scored (i.e., 3, 2, 1, and 0), and total score is a summation of the 10 item responses. EPDS is structured into four severity ranges: 1) None or minimal depression (0-6), 2) Mild depression (7-13), 3) Moderate depression (14-19), 4) Severe depression (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and a need to refer or follow up suicidal risk.…”

“…The EPDS has been validated in different cultures showing its importance in mitigating long lasting effects for mothers, their children and society at large (21). It has been widely tested globally including countries in Sub-Saharan Africa (SSA) (22,23).…”

“…Scoring is by summation of the boxes on PHQ-9 questionnaire (For every Not at all = 0; Several days = 1; More than half the days = 2; Nearly every day = 3). Interpretation of Total Score: Depression Severity 1) Minimal depression (1-4), 2) Mild depression (5)(6)(7)(8)(9), 3) Moderate depression (10)(11)(12)(13)(14), 4) Moderately severe depression (15)(16)(17)(18)(19), 5) Severe depression (20)(21)(22)(23)(24)(25)(26)(27). It too has been used widely to screen for depressive symptoms globally and widely validated in different patient populations in SSA.…”

A Systematic Review and Meta-Analysis of Depression in Postnatal Women in the Case of a Low-Income Country; Ethiopia, 2020

“…Another systematic review and meta-analysis study in India which assessed 38 studies reported a pooled prevalence of postpartum depression to be 22% (10). Moreover, other individual studies reported earlier showed that postpartum depression was 17.6% in Portugal (11), 27.3% in China(12), 61.4% in Korea(13), 18.6% in Qatar(14), 34.8% in Iraq(15), 34% in Jamaica(16) ,15.4% in Turkey (17), 13.5% and 10.3% in Oman(18), 31.7% in South Africa (19), and 43% in Uganda (20).In Ethiopia, the prevalence of postpartum depression varies between 12.2-33.8% (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36).…”

“…Poor social support (37), poverty (38), and childbirth without the presence of relatives (39), history of depression (40), and poor woman autonomy (41) from socio-demographic variables, multi-parity (42), prime-parity (43,44), multiple children at home (45), negative attitude toward to one's pregnancy (22,(46)(47)(48)(49), depression during pregnancy (42,50), premarital pregnancy (51,52), miscarriage (53), and prenatal high anxiety(47) from pregnancy and newborn related factors, alcohol use in the husband (54), intimate partner violence (22,55,56), poor husbands education (45), husbands unemployment (46,57), and psychiatric problems in the husband (58) among husband related factors were among the associated factors for the development of postpartum depression. In the context of Ethiopia too, poor marital relation (27,29,32,34,35,59), unplanned pregnancy (21,22,24,27,29,32,34), previous history of depression (21,27,28,34), domestic violence…”