Clinical investigation of postpartum depression risk factors and screening predictors

Abstract

BACKGROUND Postpartum depression (PPD) is a common mental illness that affects 10%-20% of women globally and has a major negative influence on the health of both the mother and the child. It is highly prevalent, although many cases go undetected. The etiology is multifactorial and involves biological, psychological, and social factors. This study aims to evaluate PPD incidence and identify related risk factors to provide evidence for clinical screening and prevention. AIM To evaluate PPD prevalence and associated risk variables. METHODS This study included 376 women who delivered in University-Town Hospital of Chongqing Medical University and completed a 6-week post-partum follow-up. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess postpartum depressive symptoms, with a score ≥ 13 defined as post-partum depression. RESULTS The prevalence of PPD was 15.7% (59/376). Compared with the non-PPD group, the PPD group had significantly greater proportions of primiparas (71.2% vs 52.4%), unplanned pregnancies (33.9% vs 18.6%), and cesarean sections (54.2% vs 37.9%). The overall incidence of pregnancy complications, particularly gestational hypertension and diabetes, was significantly greater in the PPD group (47.5% vs 28.7%). Previous depression or anxiety history (27.1% vs 8.2%), lower marital satisfaction, and family dysfunction were more common in the PPD group. The Social Support Rating Scale total score was significantly lower in the PPD group than in the non-PD group (31.6 ± 7.2 vs 40.3 ± 8.1). The PPD group had significantly worse sleep quality (Pittsburgh Sleep Quality Index: 11.5 ± 3.3 vs 8.2 ± 2.7) and a higher incidence of postpartum stressful events (30.5% vs 13.9%). As independent risk factors for PPD, multivariate logistic regression analysis identified prior history of depression or anxiety [odds ratio (ORs)= 3.64], marital discord (OR = 2.53), lack of social support (OR = 2.37), pregnancy complications (OR = 2.18), poor postpartum sleep quality (OR = 1.98), economic pressure (OR = 1.75), primipara status (OR = 1.52), and cesarean delivery (OR = 1.46). With a sensitivity of 76.3% and specificity of 65.9%, an EPDS score of ≥ 9 in late pregnancy had a moderate predictive value for PPD (AUC = 0.763). CONCLUSION PPD was 15.7% common, and its pathophysiology included social, psychological, and biological factors. The biggest predictors were marital strife, prior mental illness, and a lack of social support. It is advised that high-risk moms be screened for pregnancy and that a thorough intervention system be put in place, which should include boosting social support, bolstering marital bonds, and improving psychological support.