Obstetric and psychosocial risk factors associated with maternity blues

Abstract

Aim To identify risk factors for maternity blues (MB) and to evaluate the impact of obstetric factors on MB prevalence. Materials and methods 194 mothers have completed the Edinburgh Postnatal Depression Scale (EPDS) 2 days after delivery. Bivariate and multivariate logistic regression models were used to identify the predictors of MB. Results 57 women (29.4%) were positive at screening. Comparing the two groups, no statistically significant difference was found in age (p = .536), nationality (p = .065) and BMI before pregnancy (p = .224). Interestingly, no significant differences were highlighted in terms of assisted reproduction technology or spontaneous pregnancies and the presence of labor analgesia, while MB was significantly more frequent in case of cesarean section (CS) (p = .035). Statistical differences have been found in previous CS (p = .022), previous voluntary interruption of pregnancy (p = .021), number of previous pregnancies (p = .007), Apgar 5′ (p = .026), lower level of education (p = .009), and previous postpartum depression (PPD) (p = .026). A logistic regression analysis was realized according to a multivariate model incorporating all the variables with a p-value ≤.25 in bivariate analysis. In the final model vaginal delivery (OR 0.451, 95% CI [0.224–0.911], p = .026) resulted to be MB protective factor, while a lower level of education (OR 3.657, 95% CI [1.482–9.023], p = .005) as well as previous PPD (OR 4.714, 95% CI [1.273–17.458], p = .020) were identified as independent risk factors. Conclusion This study showed that a lower education level and a previous PPD resulted to be important risk factors for MB development, while natural delivery was revealed as a protective factor. These results could be used to develop a better and more accurate prevention program after delivery.