Impact of pregnancy outcomes on postpartum depression among women attending primary health-care centers in Al-Madina Al-Munawarah, Saudi Arabia

Abstract

Background: Postpartum depression (PPD) afflicts women and their families negatively. Unfortunately, PPD often goes undetected and untreated. We previously reported that PPD prevalence was 19.4% in Al-Madina region, Saudi Arabia. Objectives: The objective of the study was to identify significant risk factors of PPD among women in Al-Madina, Saudi Arabia. Methodology: A multistage random sampling technique recruited women visiting primary health-care centers in Al-Madina to immunize their babies. A cross-sectional descriptive study was done using Arabic translation of Edinburgh Postnatal Depression Scale for PPD screening using a cutoff score of ≥12. Our study also investigated demographic and other possible PPD risk factors. Results: This study enrolled 216 women out of 224 (response rate is 96.4%). PPD was not significantly associated with pregnancy planning, infant's gender, or infant's age. Primiparous women (n = 92, 42.7%) had a significant PPD risk (P < 0.05). More than half of mothers enrolled in our study (n = 124, 57.4%) were multiparous. Nearly 30.6% of participants (n = 66) used breastfeeding, while formula feeding was present in 40.7% (n = 88). PDD was reported more among women who breastfed their babies (27.3%) compared to those who artificially fed their babies (15.9%) and those using mixed feeding (16.1%). PPD was more significant among women who delivered by vaginal delivery (P < 0.05) compared to those delivered by cesarean section. Congenital abnormality of babies was reported by almost one-sixth of women (n = 36, 16.7%) but were not significantly associated with PPD. Conclusion: More than half of women having PPD (n = 124, 57.4%) were multiparous. PPD may negatively impair women's future pregnancy plans due to depression. PPD is significantly associated with primiparity and vaginal delivery and increases with breastfeeding. To the authors, PPD is a serious medical condition that should be taken into account with all deliveries. Primiparity is a risk factor, and PPD should be anticipated in primiparous women. Psychiatric evaluation and psychotherapy may be needed to help women and alleviate their fears in future pregnancies. Gynecologists should be aware of PPD and should receive a clinical experience in that. Psychiatric consultation is highly recommended whenever necessary.