Frequency of Postpartum Depression (PPD) in Rawalpindi and its determinants

Abstract

Background: Postpartum Depression (PPD) is a common complication after childbirth. It has serious impact on mental health of mother as well as behavioral and cognitive development of infant.

Objective: To determine frequency of PPD in a metropolitan area of Pakistan and its associated factors.

Methods: A cross sectional study was conducted at Gynecology and Obstetrics Department of Fauji Foundation Hospital, Rawalpindi over a period of six months from January to June 2022. A total of 252 female patients fulfilling the inclusion criteria were included. Patients Health Questionnaire (PHQ 9) was used for screening of PPD in the test subjects. Patients were categorized into two major groups: PPD (PHQ 9 ≥ 5) and No PPD (PHQ 9 ≤ 4). Odds ratio (OR) with 95% confidence interval was used to determine the association of various factors with PPD.

Results: Out of 252 patients, 87 (34.5%) had PPD while 165 (65.5%) had no PPD. The major determinants were Age > 35 years (OR 5.00, CI 1.286-19.440), BMI > 30 (OR 3.333, CI 0.77-14.43), Gestational Age ≤35 weeks (OR 6.354, CI 2.65-10.678), Parity >4 (OR 2.364, CI 0.548-10.19), number of female children >4 (OR 7.670, CI 3.458-9.650), Low birth weight baby (OR 2.529, CI 1.109-5.766), COVID-19 in pregnancy (OR 2.371, CI 1.162-4.838), family history of depression (OR 4.425, CI 2.119-9.242), past history of PPD (OR 3.793, CI 1.780-8.085), no social support from husband (OR 11.379, CI 3.447-37.5) and family (OR 6.322, CI 3.145- 12.707).

Conclusion: The major determinants of PPD in this study were lack of social support from husband and family members, previous female children and preterm deliveries. Other risk factors included age, obesity, multiparity, low birth weight, COVID-19 in pregnancy, family history of depression and stressful event during pregnancy, sleep deprivation, bottle feeding practice, and neonatal admission in NICU.