Descriptive Analysis of the Risk Factors Associated with Postpartum
Depression
Abhijay P.Karandikar
Advisor: Elizabeth Turf, Ph.D.
Preceptor: Ellen Brock, M.D., M.P.H.
Background: Postpartum depression occurs in approximately 10 percent of childbearing women in the United States and is considerably under diagnosed. If left undetected and untreated, it can have serious adverse effects on the mother leading to maternal disability and disturbed mother-infant relationships. Detection is easy based on a simple screening tool. Because postpartum depression is often undetected, attempts have been made to identify its predictors.
Purpose: The purpose of this study was to determine the proportion of mothers developing postpartum depression in a sample population and to analyze its association with various risk factors.
Methods: A cross-sectional survey of women coming for their postnatal checkup at clinics affiliated with the Virginia Commonwealth University Health Systems was conducted. Information was obtained by a self-administered questionnaire incorporating the Edinburgh Postpartum Depression Scale (EPDS). The questionnaire incorporated questions on basic demographics, in addition to questions on risk factors. Basic frequencies and crosstabulations were done on the demographic characteristics and risk factors. Measures of central tendencies were used for describing normality of the sample. Univariate ANOVA method was done on a select group of important variables. Prevalence odds ratios (POR) and their corresponding 95% confidence intervals and p-values were used to assess the strength of important relationships of risk factors with the development of postpartum depression. Selected variables were entered into the binary logistic regression model.
Results: Of the 104 women surveyed, 25 (24.0%) had scores consistent with postpartum depression. The development of postpartum depression was found to be most strongly associated with decreasing educational level (p = 0.02), not breastfeeding (p = 0.002) decreasing maternal age (p = 0.05), and lower maternal average income (p = 0.05). The findings also duplicated those in the literature including increased proportion of depression in African-Americans, in those with lower birth weights and among women with prior history of mental illness, although the relationships were not found to be significant.
Conclusion: The findings of this study suggest that postpartum depression is a prevalent health problem and is associated with risk factors amenable to prevention. More detailed prospective studies with a larger sample size and over a longer period of time should be carried out to study this disorder of great public health significance.
