Prevalence of Postpartum Depression and Associated Risk Factors Among Women in Jeddah, Western Saudi Arabia

Background

Postpartum depression (PPD) is a significant psychological disorder that can affect women during or after pregnancy. Its risk increases throughout the first 90 days and may last up to almost two years, which can create an overall burden on society. Although the etiology is unknown yet, there are risk factors that contribute to developing PPD. This study aims to assess the prevalence of PPD and the risk factors among women in Jeddah, western Saudi Arabia in 2019.

Methods

A cross-sectional study was conducted in infant vaccination clinics of the primary healthcare centers (PHC) of the Ministry of Health (MOH) and Ministry of National Guard (MNGHA) Jeddah, Saudi Arabia. Data were collected through a self-administered questionnaire with Edinburgh Postnatal Depression Scale (EPDS) from mothers up to four months postpartum.

Results

Of the 172 postpartum women, the study estimated the prevalence of postpartum depression to be 20.9%. The significant risk factors predicted by multivariate regression analysis were history of previous depression (odds ratio {OR}=4.7; 95% confidence interval {CI} 1.9 to 11.5), difficult life event interval (OR=3.5; 95% CI 1.1 to 10.7), and attitude toward pregnancy (OR=2.1; 95% CI 0.9 to 4.5).

Conclusion

A fairly high prevalence of postpartum depression was revealed among the females in Jeddah. Therefore, we recommend screening of mothers after delivery to help early intervention and management along with psychosocial support.

Depressive Disorders Related to Female Reproductive Transitions

Depression is rapidly becoming a major health concern. Recent estimates rank it as the fourth leading cause of disease burden worldwide, and its incidence is steadily increasing. Women have a risk of experiencing depressive illnesses that is twice that of men. Women with depression also typically experience greater functional impairment. The incidence of depression dramatically increases during the reproductive years, which correspond to ages 25 to 44 years. During this time frame, women may experience several reproductive milestones or transitional events such as menarche, the menstrual cycle, pregnancy, infertility, miscarriage, and perimenopause/menopause. These transitions evoke neuroendocrinologic changes that appear to influence the risk for depressive episodes. Common disorders associated with these hormonal fluctuations include premenstrual dysphoric disorder, postpartum depression, and depression in the perimenopausal transition. Although the specific pathophysiologic association is still unclear, evidence supports that these reproductive transitions influence the risk of depression in women.

Chronic episodic disorders in women

Chronic episodic disorders, such as depressive disorders, IBS, migraine, and FMS, have important commonalities, including cormorbidities, an absence of classic anatomic pathology in the tissues, a lack of objective findings on physical examination, and a lack of abnormal findings by routine laboratory and radiologic tests. These CED are more prevalent in women (perhaps due to changes in estrogen levels), are generally worsened by stress (with resultant hyperactivity of the HPA axis), and often improve with aerobic exercise and common classes of medications affecting serotonin function, such as antidepressants. Thus, an increased understanding of the CED may result in improved treatment and functioning of many patients.

Mental illness in women who have young children: current literature

Postnatal depression is an illness that has been researched a great deal in recent years. While much is known about the prevalence and contributing factors, it is not clear whether antenatal interventions are successful in preventing postnatal depression. Mother-child relationships where the mother has a mental illness, have been reported to be more negative and may adversely affect the child's development. Many researchers discuss the importance of supporting such families, not only to improve their current situation, but also to help prevent the development of mental health problems in the children.