A prospective study of prevalence and risk factors related to postpartum depression

Tomasic, Miranda Mirosevic (2005) A prospective study of prevalence and risk factors related to postpartum depression. Masters thesis, Memorial University of Newfoundland.

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Abstract

Postpartum depression (PPD) is a serious medical condition affecting many women after childbirth. Depressed mood and difficulty coping, particularly with the infant, characterize postpartum depression (Robinson, Steward, 1986). Clinical features include a pervasive state of apathy, despair, extreme fatigue, loss of appetite, insomnia, and crying spells. Postpartum depression is frequently undiagnosed. The etiology is unclear but there seems to be complex interaction between biological, psychological and social factors. The duration of the depression is unknown, since few studies have been conducted for longer than eight weeks postpartum (Jermain, 1995). For a significant percentage of women, depressive symptoms may continue for months or years after giving birth (Goodman, 2004). -- The objectives of this study were: (1) to determine the natural history of postpartum depression in the sample, including onset and duration; (2) to report the point prevalence rate for postpartum depression in the sample at one month, the period prevalence rate within three months postpartum and the incidence rate for postpartum depression at three months; (3) to examine the association between selected risk factors and the development of postpartum depression, including history of previous depression, family history of depression, inadequate social support, life stress, childcare stress, maternity blues, marital dissatisfaction, and antenatal anxiety; (4) to comment on the treatment practices currently used in dealing with postpartum depression ; and (5) to comment on the rate and time of ‘onset of dropout’ for mothers who chose not to participate in the study. -- This prospective prevalence study involved mothers who delivered children in St. John's Newfoundland during the period from the 4th of May 1999 to the 3rd of June 1999, inclusive. The convenient heterogeneous sample consisted of 71 mothers ranging from 19-40 years of age. An interview-based questionnaire was administered while each mother was a patient on the postnatal ward. Self-complete questionnaires, were mailed to the mothers at home, at one month and three months after delivery. -- The point prevalence of postpartum depression in the sample was 3.07% at one month and 3.2 % at three months, the period prevalence rate at three months after delivery was 4.8% and the incidence rate at three months after delivery was 1.6%. -- Prevalence of depression, risk factors and drop out rates were compared with previous studies in postpartum depression. In general, prevalence of postpartum depression in this study is in the lower range, comparing to prevalence reported in the other studies. However, risk factors identified in this study for mothers developing depression are comparable with those previously reported. -- The return rate for mailed questionnaires in this sample was 87.3%. As a result, recommendations for the conduct of a full prospective study were developed.

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