The role of adverse childhood experience and social support type in postpartum depression in Turkey.

Abstract

Improved knowledge of causal and protective factors is crucial for Postpartum depression (PPD) prevention and management. To investigate the relationship between adverse childhood experience (ACE), perceived social support and PPD in a middle-income non-Western country, and to investigate which type of ACE and which sources of social support were associated with PPD. The study was cross-sectional study and conducted in a one center from Turkey during March-June 2019. Women up to 1-week postpartum were included in the study. The Edinburgh Postpartum Depression Scale (EPDS), a validated ACE questionnaire, and the Multidimensional Scale of Perceived Social Support were completed. Nine hundred women took part in the study. The proportion identified with PPD and ACE were 10% and 8.8%, respectively. In bivariate analysis, having previous PPD, unwanted pregnancy, insufficient antenatal care, low family income, history of ACE, and perception of low social support were associated with PPD (p < 0.05). Family support was perceived as beneficial, in both women with no history or ≥2 instances of ACE. However, perceived support from friends and/or a special person was lowest in the ≥2 ACE group (p < 0.05). In logistic regression, unwanted pregnancy, emotional abuse, and neglect, incarceration of a household member, and poor special person support were factors significantly associated with developing PPD (p=0.005). Emotional abuse, neglect, household dysfunction, and perceived poor support from a special person were risk factors for PPD. A history of maternal childhood trauma and poor social support might indicate the need for early PPD interventions.