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Cited by 66Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

Determinants of postnatal depression in Sudanese women at 3 months postpartum: a cross-sectional study

Open access
Khalifa, Dina Sami, Glavin, Kari, Bjertness, Espen, Lien, Lars·2016·BMJ Open
DOI 10.1136/bmjopen-2015-009443PMC PMC4800153
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Abstract

OBJECTIVES: Maternal mental health is a neglected issue in Sudanese healthcare. The aim of this study was to explore the factors associated with postnatal depression (PND) at 3 months postpartum in a sample of Sudanese women in Khartoum state. SETTING: Recruitment was from two major public antenatal care (ANC) clinics in two maternity teaching hospitals in Khartoum state. The study participants were recruited during their pregnancy and were followed up and screened for PND at 3 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). PARTICIPANTS: A sample of 300 pregnant Sudanese women in their second or third trimester was included in the study. The inclusion criteria were Sudanese nationality, pregnancy in the second or third trimester and satisfactory contact information. OUTCOME MEASURES: PND was assessed using the EPDS at a cut-off score of ≥ 12. Maternal and sociodemographic factors of interest were illustrated in a directed acyclic graph (DAG) to identify which variables to adjust for in multivariate analyses and to show their type of effect on PND. A forward logistic regression model was built to assess the factors that are independently associated with PND. RESULTS: History of violence increased the odds of PND sevenfold, OR=7.4 (95% CI 1.9 to 27.6). Older age of mothers decreased the odds of PND by almost 20%, OR=0.82 (95% CI 0.73 to 0.92). Exclusive breast feeding and regular prenatal vitamins during pregnancy are associated with an 80% decrease in odds of PND, OR=0.2 (95% CI 0.06 to 0.70) and 0.17 (95% CI 0.06 to 0.5), respectively. CONCLUSIONS: Factors associated with PND in this study are comparable to factors from other developing countries, although findings should be judged with caution owing to the high number of women who refused recruitment into the study.

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  • Psychological distress among perinatal women correlates with increased maternal morbidity and mortality rates.

    “Psychological distress among perinatal women correlates with increased maternal morbidity and mortality rates (Khalifa et al., 2016; Oates, 2003), poor infant health outcomes (Gelaye et al., 2016), and adverse early childhood developmental trajectories encompassing cognitive, emotional, and developmental delays (Slomian et al., 2019), making it a substantial public health concern.”

    From Developing and validating the Sierra Leone perinatal psychological distress scale through an emic-etic approach (2025) · cites this paper as Khalifa et al., 2016

    The Introduction (page not provided) suggests that neglect of maternal mental health could have contributed to Sudan’s failure to reduce its maternal mortality ratio. It does not report a correlation between perinatal psychological distress and maternal mortality, and it does not address increased maternal morbidity. (LLM, conf=0.83)

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Research works printed but not linked: 1

  1. [46]Kalyani GHS, Saeed K, Rehman CIU Incidence of depressive illness in Pakistani women during postnatal period. JColl Physicians Surg Pak 2001; 11: 246– 8.

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Authors
Khalifa, D. S., Glavin, K., Bjertness, E., & Lien, L.
Affiliations
  • University of Oslo (NO)
  • Diakonova University College, Oslo, Norway
  • Innlandet Hospital Trust (NO)
Corresponding author
Khalifa, Dina Sami
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2016-03
Volume
6
Issue
3
Pages
e009443
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2015-009443
PMC
PMC4800153
OpenAlex
W2303913567
Cited by
66
References
49
Citations by year
2026: 5 · 2025: 5 · 2024: 10 · 2023: 2 · 2022: 9 · 2021: 6 · 2020: 14 · 2019: 7 · 2018: 5 · 2017: 3
FWCI
4.96
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
  • HighWire Press Open Archive (submittedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
postpartum depression, maternal mental health, Sudanese women, risk factors, intimate partner violence, maternal age, exclusive breastfeeding, prenatal vitamins, prenatal care, Khartoum
MeSH terms
Adult, Age Factors, Cross-Sectional Studies, Developing Countries, Female, Hospitals, Teaching, Humans, Mass Screening, Pregnancy, Psychiatric Status Rating Scales, Risk Factors, Sudan, Multivariate Analysis, Logistic Models, Depression, Postpartum, Postpartum Period, Young Adult

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