Iranian Journal of Neonatology

Iranian Journal of Neonatology

Prevalence of Postpartum Depression; a longitudinal study

Document Type : Original Article

Authors
Ahmadshah Farhat 1
Reza Saeidi 1
Ashraf Mohammadzadeh 1
Hadi Hesari 2
1 Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Pediatric department, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/ijn.2015.4901
Abstract
Background: Mothers are highly vulnerable to depression within the first year after childbirth. Approximately 10-20% of mothers suffer from depression during this period, and half of these women with symptoms of prominent postpartum depression (PPD) remain undiagnosed. The Edinburgh Postnatal Depression Scale (EPDS) is the most widely applied screening instrument for PPD evaluation. In this study, we evaluated EPDS scores (score ≥12) at discharge and 2, 28 and 42 days following delivery to determine the risk factors and prevalence of PPD in mothers of infants admitted to the Neonatal Intensive Care Unit (NICU).
Methods: A sample of 682 women completed the EPDS scale upon admission and hospital discharge. PPD assessment was performed at days 28 and 42 following delivery via phone interviews.
Results: Upon admission, the average EPDS score was 9.72 (SD=4.4) and 27.4% of women (n=187) had EPDS scores ≥ 12. At discharge and 28 and 42 days following delivery, the average scores were normal as follows: 9.34 (SD=3.8), 9.12 (SD=3.7) and 8.52 (SD=3.36), respectively. Within the mentioned intervals, 25.4% (n=173), 23.3% (n=141) and 15.3% (n=88) of women presented with PPD. A positive correlation was shown between EPDS scores on admission and D42 (P = 0.001) that all PPD cases at D42 had EPDS score ≥ 12 on admission The analysis showed that multiple gestation (P=0.001) and advanced age (P=0.001) were significantly associated with PPD.
Conclusion: As the results indicated, women with EPDS scores ≥ 12 should benefit from close follow-ups during the postpartum period and be provided with psychological support.
Keywords
Depression
Edinburgh Postnatal Depression Scale
NICU
pregnancy
  1. Sayers J. The world health report 2001-Mental health: new understanding, new hope. Bull World Health Organ. 2001; 79(11):1085.
  2. Teissedre F, Chabrol H. A study of the Edinburgh Postnatal Depression Scale (EPDS) on 859 mothers: detection of mothers at risk for postpartum depression. Encéphale. 2004, 30(4):376–81.
  3. O’Hara MW, Swain AM. Rates and risk of postpartum depression–a meta-analysis. Int Rev Psychiatry. 1996; 8(1):37–54
  4. Hewitt C, Gilbody S, Brealey S, Paulden M, Palmer S, Mann R, et al. Methods to identify postnatal depression in primary care: an integrated evidence synthesis and value of information analysis. Health Technol Assess. 2009; 13(36):1–145.
  5. Nelson DR, Hammen C, Brennan PA, Ullman JB. The impact of maternal depression on adolescent adjustment: the role of expressed emotion. J Consult Clin Psychol. 2003; 71(5):935–44.
  6. Martins C, Gaffan EA. Effects of early maternal depression on patterns of infant–mother attachment: a meta-analytic investigation. J Child Psychol Psychiatry. 2000; 41(6):737–46.
  7. Klainin P, Arthur DG. Postpartum depression in Asian cultures: a literature review. Int J Nurs Stud. 2009; 46(10):1355–73.
  8. Spear ML, Leef K, Epps S, Locke R. Family reactions during infants' hospitalization in the neonatal intensive care unit. Am J Perinatol. 2002; 19(4):205-13.
  9. Veisani Y, Delpisheh A, Sayehmiri K, Rezaeian S. Trends of Postpartum Depression in Iran: A Systematic Review and Meta-Analysis. Depress Res Treat. 2013; 2013:291029.

10. Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004; 26(4):289–95.

11. Vasa R, Eldeirawi K, Kuriakose VG, Nair G J, Newsom C, Bates J. Postpartum depression in mothers of infants in neonatalintensive care unit: risk factors and management strategies. Am J Perinatol. 2014; 31(5):425-34.

12. Segre LS, McCabe JE, Chuffo-Siewert R, O'Hara MW. Depression and anxiety symptoms in mothers of newborns hospitalized on the neonatal intensive care unit. Nurs Res. 2014; 63(5):320-32.

13. American Psychiatric Association. Major depressive episode. In: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). 4th ed. Washington, DC: American Psychiatric Association; 2012. p.349.

14. Chaaya M, Campbell OMR, El Kak F, Shaar D, Harb H, Kaddour A. Postpartum depression: prevalence and determinants in Lebanon. Arch Womens Ment Health. 2002; 5(2):65–72.

15. Beck CT. Predictors of postpartum depression: an update. Nurs Res. 2001; 50(5):275–85.

16. Goker A, Yanikkerem E, Demet MM, Dikayak S, Yildirim Y, Koyuncu FM. Postpartum depression: is mode of delivery a risk factor? ISRN Obstet Gynecol. 2012; 2012: ID 616759.

17. Dennis CL. Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh Postnatal Depression Scale? J Affect Disord. 2004; 78(2):163–9.

18. Imsiragić AS, Begić D, Martić-Biocina S. Acute stress and depression 3 days after vaginal delivery–observational, comparative study. Coll Antropol. 2009; 33(2):521-7.

19. MacDorman MF, Menacker F, Declercq E. Cesarean birth in the United States: epidemiology, trends, and outcomes. Clin Perinatol. 2008; 35(2):293–307.