Psychosocial risk factors to major depression after childbirth

Abstract

Risk factors to postnatal depression (PND) have generally been identified in well-defined homogenous samples of primiparous women. There is a need for studies to assess risk factors in a heterogeneous sample of women. This study is aimed to identify psychosocial risk factors to postnatal depression. Subjects underwent a baseline assessment within 2 days of childbirth and completed postal questionnaires at 6, 12, 18 and 24 weeks postpartum. Postnatal depression was defined as scoring above 12 on the Edinburgh Postnatal Depression Scale on two occasions and meeting criteria for major depression using the Structured Clinical Interview for DSM-III-R. Four hundred and twenty-five women with a mean age of 26.9 years participated in the study. Forty-two women were considered to be cases of postnatal depression. A significantly increased risk for postnatal depression was associated with (a) being 16 years old or younger, (b) a past history of psychiatric illness, (c) experiencing one or more life events, (d) marital dissatisfaction, (e) experiencing unsatisfactory social support, (f) a vulnerable personality and (g) having a baby of the nondesired sex. This study confirmed that psychosocial risk factors, predominantly in the areas of social support and personality style, are closely associated with postnatal depression.