Abstract
BackgroundPostpartum depression (PPD) affects women from different cultures around the world. No previous studies have investigated PPD among women in Palestine. Fertility rates in Palestine are among the highest in the world, hence even low rates of PPD could have considerable national impact. The aim of this study was to determine the prevalence of, and risk factors for, PPD among Palestinian mothers.Methods101 mothers were recruited during the registration of their child’s birth (within 1 week) at the Bethlehem branch of the Ministry of Interior. Participants were assessed via a face to face interview, and were followed up 1 week, 2 weeks, 6 weeks, 3 months, and 6 months later by telephone interview. Interviews included the Arabic Edinburgh Postnatal Depression Scale (EPDS), with PPD indicated by depressive symptoms (EPDS score ≥11) at ≥2 follow-up time points. Pearson’s correlation was calculated between repeated EPDS scores, and multivariable logistic regression was used to investigate risk factors for PPD.ResultsThe prevalence of depressive symptoms was fairly constant (14–19%) over the follow-up period. Most depressive symptoms developed within 1 month of delivery; mothers with depressive symptoms at 3 months postpartum were highly likely to still have symptoms at 6 months. 27.7% (28/101) of women met our criteria for PPD. High parity (odds ratio (OR) 4.52 (95% CI 0.90, 22.8) parity 3+ versus primiparous), unplanned pregnancy (OR 2.44 (0.99, 6.01)) and sex of child not being the one desired (OR 5.07 (1.12, 22.9)) were associated with PPD, but these associations were attenuated in multivariable analysis.ConclusionsThe prevalence of PPD in Palestine appears to be higher than in high income countries, but similar to the prevalence in other Middle Eastern countries. High parity and unplanned pregnancy were identified as risk factors for PPD, suggesting that fully meeting the need for family planning could reduce the incidence of PPD in the Palestinian population.
Highlights
Postpartum depression (PPD) affects women from different cultures around the world
The aim of our study was to estimate the prevalence of depressive symptoms and Postpartum Depression (PPD) among women in the occupied Palestinian territory, to describe the characteristics of depressive symptoms, including onset and duration, and to investigate risk factors associated with PPD
Our results showed a trend for women with ≥3 children to have greater odds of developing PPD, which is consistent with systematic reviews that have identified high parity as a risk factor for PPD [35, 36]
Summary
Postpartum depression (PPD) affects women from different cultures around the world. No previous studies have investigated PPD among women in Palestine. Postpartum depression (PPD) ( known as ‘postnatal depression’) is a complex and challenging depressive disorder affecting 10–15% of women worldwide [1] This widely cited range is predominately based on studies in high income countries, and may not represent the global magnitude of the problem [2]. Qandil et al BMC Pregnancy and Childbirth (2016) 16:375 partner and/or in-laws, polygamy, infant’s gender, whether or not the baby was planned, and lack of social support [12] Many of these factors are relevant to women globally, some are more closely related to Arabic societies, where beliefs are sometimes inextricably intertwined with Islamic values and culture [7]. Multiparity has been identified as a protective factor - in the United Arab Emirates, for example, primiparous mothers were found to report higher rates of depression [7]
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