Incidence and determinants of postpartum depression among healthy pregnant women and high-risk pregnant women

Abstract

Not every woman associates pregnancy, childbirth and puerperium with experiencing moments of joy. In the first 3 months following childbirth, approximately 15–20% of mothers all over the world suffer from postpartum depression. The aim of this study was to answer the question of whether postpartum depression is more common among high-risk pregnant women in comparison to healthy pregnant women, and whether there are differences in the severity of symptoms as well as in correlates and predictors within the studied groups of women. A total sample of 284 healthy (N = 172) and high-risk pregnant women (N = 112) were examined. Participants were recruited at the maternity hospitals and gynaecology clinics, pregnancy classes as well as via web pages and Internet fora for birth and pregnancy. Participants completed a set of self-report questionnaires twice: during the 37th and 42nd week of pregnancy and between the 2nd and 4th week postnatally. The following methods have been used in the study: Beck Depression Inventory, Postpartum Depression Screening Scale, The Perceived Stress Scale, Social Support Scale, Coping Orientation to Problems Experienced Scale, Marital Bond Scale and Breastfeeding Self-Efficacy Scale-Short Form and demographic survey. Postpartum depression symptoms are more common (85.7%) and more intense (p < 0.001) in high-risk pregnant women in comparison to healthy pregnancies (46.5%). High-risk pregnant women achieve higher mean scores in Beck Depression Inventory (p < 0.001). The regression analysis in a group of healthy pregnant women showed that the efficacy of breastfeeding, depression in pregnancy and the type of feeding explain 46.7% of the variance of the independent variable, which is postpartum depression. Among high-risk pregnant women, 67.1% of the variance reported subsequently the efficacy of breastfeeding, depression during pregnancy, childbirth complications, type of feeding and focusing attention away from the problem. Postpartum depression symptoms occur more frequently in high-risk than healthy pregnant women. The severity of postpartum depression symptoms is also higher among high-risk pregnancy group of women. The analysis of risk factors indicates that women exposed to symptoms of postpartum depression are those who suffered from depression during pregnancy, who had difficulty in coping and experienced negative emotions after childbirth as well as had a low self-efficacy in breastfeeding. They also chose less active ways of coping and focused on experiencing emotions and restrain coping. The results emphasise the need to pay more attention to the mental state of women whose pregnancy is high risk.