Prevalence and factors associated with postpartum depression at a primary healthcare facility in Eswatini.

Lindelwa P Dlamini,Sizakele D Dlamini,Sotah Mahanya,Mduduzi C Shongwe

doi:10.4102/sajpsychiatry.v25i0.1404

Abstract

BackgroundRoutine mental health screening has not been integrated into maternal and child health (MCH) services in many developing countries, including in Eswatini (formerly Swaziland). As a result, the burden of postpartum depression (PPD) is not well understood and thus PPD remains untreated in such settings.AimTo describe the prevalence and factors associated with PPD among women seeking postnatal and child welfare services at a primary healthcare facility in Eswatini.SettingThe study was conducted at the King Sobhuza II Public Health Unit in Manzini, Eswatini.MethodsThis was a cross-sectional study that used convenience sampling and the Edinburgh Postnatal Depression Scale (EPDS) to screen for depression among 114 mothers during the first 6 weeks of postpartum at the King Sobhuza II Public Health Unit, Manzini, Eswatini. Multiple logistic regression analysis was conducted to determine sociodemographic and clinical factors associated with PPD.ResultsA majority of the participants were older than 24 years (52.6%) and unemployed (64.9%), whereas 47.4% screened positive for PPD (≥ 13 score). Adjusting for other covariates, those who were unemployed (odds ratio [OR] = 3.20, 95% confidence interval [CI] 1.17–8.79) and with poor social support from their partners (OR = 9.41, 95% CI: 3.52–25.14) were more likely to be depressed, while those who attended antenatal classes fewer than four times were less likely to be depressed (OR = 0.32, 95% CI 0.11–0.92).ConclusionWe found a high prevalence of PPD. There is a need to introduce routine maternal mental health screening during the postpartum period to ensure early detection and treatment of PPD.

Highlights

Postpartum depression (PPD) is one of the most common complications of childbearing, occurring in 13% of postpartum women worldwide.[1]
Postpartum depression is defined as a major depressive episode with peripartum onset, accompanied by a depressed or sad mood, marked loss of interest in virtually all activities, significant weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or guilt, diminished ability to think or concentrate, and recurrent thoughts of death.[3]
These figures show that maternal mental health disorders are common in this region, disputing assumptions in 20th century literature,[7] which postulated that somehow women in Africa were protected from perinatal mental disorders due to traditional rituals and other cultural factors

Summary

Introduction

Postpartum depression (PPD) is one of the most common complications of childbearing, occurring in 13% of postpartum women worldwide.[1] This is even higher in developing countries as 15.6% and 19.8% of women experience mental health disorders during pregnancy and after childbirth, respectively.[2] Postpartum depression is defined as a major depressive episode with peripartum onset (i.e. the most recent episode occurring during pregnancy as well as in the 4 weeks following delivery), accompanied by a depressed or sad mood, marked loss of interest in virtually all activities, significant weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or guilt, diminished ability to think or concentrate, and recurrent thoughts of death.[3] In this study, we limited the onset specifier to 6 weeks after delivery because our interest was in quantifying the prevalence of the major depressive disorder during the postpartum period, which is 6 weeks. The burden of postpartum depression (PPD) is not well understood and PPD remains untreated in such settings

Objectives

Methods

Results

Conclusion