Prevalence and associated factors of post-partum depression in Palestinian mothers: a cross-sectional study

Abstract

BackgroundPost-partum depression is a major concern for public health that can affects the mother and child. This condition has received little attention in Palestinian primary health care. In this study we aimed to determine the prevalence and associated factors of post-partum depression in women in the Nablus district, occupied Palestinian territory. MethodsIn a cross-sectional study we recruited mothers aged 18–45 years at 7–12 weeks post partum on a convenient basis from 12 conveniently chosen primary care and Maternal and Child Health (MCH) clinics in the Nablus district in 2013. Participants were interviewed with the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS; cutoff score ≥10) and other questions related to risk factors. Ethical approval was obtained and informed consent gained from participants. FindingsWe enrolled 245 mothers in our study, of whom 235 completed the ten questions of EPDS and were included in the analysis. The mean age of mothers was 26·13 years (SD 5·34). 117 mothers (50%) lived in Nablus city whereas 70 (30%) and 48 (20%) lived in villages and refugee camps near Nablus, respectively. 40 (17%) mothers scored 10 or more on the EPDS, suggesting that they had depression. Results showed that depression during pregnancy (p<0·001), positive history for mental health difficulties (p=0·016), exposure to two or more stressful events during pregnancy (p<0·001), poor satisfaction with marital relationship (p<0·001), with their husband's help and support (p<0·001), with relations with their mother-in-law (p=0·37), and perceived low social support (p<0·001), were strongly associated with post-partum depression. All results were significant at p<0·05. No significant correlations were reported with sociodemographic characteristics (ie, age, education, region of residence, and income), pregnancy-related factors (including obstetrical complications, place and type of birth, and satisfaction about care during birth), and birth factors or newborn factors. InterpretationPrevalence of post-partum depression is an important health concern affecting Palestinian mothers and is mainly associated with psychosocial stressors during pregnancy. Although further research is needed because of the small sample size and non-random approach used, we highly recommend the integration of post-partum screening into antenatal and postnatal health-care and for additional time to mothers for counselling purposes, in addition to the medical services offered. FundingAn-Najah National University.