Abstract
Postpartum depression is a worldwide public health concern. The prevalence of postpartum depression is reported to be greater in developing countries than in developed countries. However, to the best of our knowledge, no papers on postpartum depression in the Lao People’s Democratic Republic have been published. In order to strengthen maternal and child health, the current situation of postpartum depression should be understood. This study aims to determine the prevalence of postpartum depression and identify factors associated with postpartum depression in Vientiane Capital, Lao People’s Democratic Republic. Study participants were 428 women 6–8 weeks postpartum who visited four central hospitals in Vientiane Capital for postnatal care from July to August 2019. Structured questionnaires were used to collect socio-demographic, obstetrical and infant, and psychiatric data about the women and their partners. The Edinburgh Postnatal Depression Scale (EPDS) was used to identify suspected cases of postpartum depression with the cut-off score of 9/10. Multivariable logistic regression was used to examine independent factors that were associated with suspected postpartum depression (EPDS ≥10). The mean age of the 428 women was 28.1 years, and the prevalence of suspected postpartum depression was 31.8%. Multivariable logistic regression using variables that were statistically significant on bivariate analyses indicated that three variables were associated with suspected postpartum depression: unintended pregnancy (AOR = 1.66, 95% CI 1.00–2.73, P = 0.049), low birth satisfaction (AOR = 1.85, 95% CI 1.00–3.43, P = 0.049), and depression during pregnancy (AOR = 3.99, 95% CI 2.35–6.77, P <0.001). In this study, unintended pregnancy, low birth satisfaction, and depression during pregnancy were independent risk factors for postpartum depression. These results suggest that the mental health of pregnant women should be monitored, and that health care services, especially family planning and supportive birth care, should be strengthened to prevent postpartum depression.
Highlights
Postpartum depression (PPD) is defined as a non-psychotic episode of depression that may occur in women as early as four weeks after childbirth [1]
The prevalence of suspected postpartum depression (PPD) among Lao women who visited central hospitals for postnatal care in Vientiane Capital was 31.8%, which was higher than the prevalence of PPD in other Asian countries
The reported prevalence in low- or middle-income countries varies depending on participants, study settings, and diagnostic methods; 7.8% in the provinces of Sri Lanka using Edinburgh Postnatal Depression Scale (EPDS) 10, 8.4% in a nation-wide survey in Thailand using EPDS 13, 11.4% at maternity hospitals in Shanghai using EPDS 10, and 27.6% in Hanoi using EPDS 12 [7, 20,21,22]
Summary
Postpartum depression (PPD) is defined as a non-psychotic episode of depression that may occur in women as early as four weeks after childbirth [1]. According to a meta-analysis and a systematic review of PPD, 13% of postnatal women globally experience mental disorders, and this proportion is noticeably higher, at 20%, in developing countries [2, 3]. PPD is considered a public health concern, as maternal mental disorders can affect the mother’s physical condition as well as the child’s growth, and family and social relationships. Poor maternal functioning due to mental suffering can affect a child’s later behavioral and cognitive development, and lead to poor physical growth and poor social engagement [4, 5]. Many studies have reported that employment, level of education, first pregnancy, the child’s gender, a previous history of depression including during pregnancy, partner’s depression, dissatisfaction with the marital relationship, and lack of social support were the main factors associated with depression in women after delivery [6,7,8]. Some studies have claimed that these factors were less important than socio-economic status and family income, which in turn are related to education and healthcare accessibility [8]
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