Prediction of incidence and bio-psycho-socio-cultural risk factors of post-partum depression immediately after birth in an Iranian population.
BACKGROUND
Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. The purpose of the present study was to determine the incidence of early PPD and possible relevant risk factors among women attending primary health centers in Mazandaran province, Iran for the first time.


METHODS
A longitudinal cohort study was conducted among 2279 eligible women during weeks 32-42 of pregnancy to determine bio-psycho-socio-cultural risk factors of depression at 2 weeks post-partum using the Iranian version of the Edinburgh Postnatal Depression Scale (EPDS). Univariate and hierarchical multiple logistic regression models were used for data analysis.


RESULTS
Among 1,739 mothers whose EPDS scores were ≤ 12 during weeks 32-42 of gestation and at the follow-up study, the cumulative incidence rate of depression was 6.9% (120/1,739) at 2 weeks post-partum. In the multivariate model the factor that predicted depression symptomatology at 2 weeks post-partum was having psychiatric distress in pregnancy based on the General Health Questionnaire (GHQ) (OR = 1.06, (95% CI: 1.04-1.09),p= 0.001). The risk of PPD also lower in those with sufficient parenting skills (OR = 0.78 (95% CI: 0.69-0.88),p= 0.001), increased marital satisfaction (OR = 0.94 (95% CI: 0.9-0.99),p= 0.03), increased frequency of practicing rituals (OR = 0.94 (95% CI: 0.89-0.99),p= 0.004) and in those whose husbands had better education (OR = 0.03 (95% CI: 0.88-0.99),p= 0.04).


CONCLUSIONS
The findings indicated that a combination of demographic, sociological, psychological and cultural risk factors can make mothers vulnerable to PPD.
Department of Public Health, Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Fatemeh
F
Abdollahi
Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Mehran
M
Zarghami
Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
Shariff-Ghazali
SG
Sazlina
Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
Azhar Md
AM
Zain
Injury Epidemiology and Prevention Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
Asghari Jafarabadi
AJ
Mohammad
Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
Munn-Sann
MS
Lye
depression; incidence; post-partum
Acta Obstet Gynecol Scand. 2001 Jan;80(1):39-45
11167187
J Affect Disord. 2010 Jun;123(1-3):17-29
19635636
Womens Health Issues. 2010 Mar-Apr;20(2):96-104
20133153
Gen Hosp Psychiatry. 2006 Jan-Feb;28(1):3-8
16377359
Br J Psychiatry. 2002 Dec;181:499-504
12456520
Eur Psychiatry. 2009 Jun;24(5):327-33
19328659
J Affect Disord. 1998 Jun;49(3):167-80
9629946
J Pak Med Assoc. 2003 Apr;53(4):142-7
12776898
BMJ. 2005 Apr 16;330(7496):879
15734748
J Adv Nurs. 2001 Dec;36(5):676-84
11737500
Arch Womens Ment Health. 2007;10(4):141-5
17533557
J Clin Nurs. 2010 Feb;19(3-4):422-31
20500282
J Psychosom Obstet Gynaecol. 2009 Sep;30(3):181-90
19728219
J Reprod Med. 2000 Feb;45(2):97-104
10710738
BJOG. 2004 Dec;111(12):1353-60
15663118
Obstet Gynecol. 2002 Feb;99(2):223-8
11814501
J Pediatr Health Care. 2008 Jan-Feb;22(1):64-7
18174093
Psychoneuroendocrinology. 2007 Feb;32(2):133-9
17207585
Int J Med Sci. 2012;9(1):40-6
22211088
J Psychosom Res. 1967 Aug;11(2):213-8
6059863
Can J Psychiatry. 2007 Aug;52(8):479-88
17955909
Obstet Gynecol. 1990 Aug;76(2):302-7
2371035
Midwifery. 2011 Dec;27(6):e238-45
21130548
Arch Womens Ment Health. 2003 Aug;6 Suppl 2:S33-42
14615921
Aust J Public Health. 1994 Jun;18(2):176-84
7948335
J Psychosom Obstet Gynaecol. 2008 Sep;29(3):206-12
18608817
Br J Psychiatry. 1987 Jun;150:782-6
3651732
Clin Nurs Res. 1992 Nov;1(4):336-46
1483137
J Psychosom Obstet Gynaecol. 2001 Jun;22(2):103-12
11446151
J Affect Disord. 2010 Apr;122(1-2):139-43
19651446
J Epidemiol Community Health. 2011 Apr;65(4):320-6
20515899
Br J Psychiatry. 2004 Jan;184:34-40
14702225
Gen Hosp Psychiatry. 2004 Jul-Aug;26(4):289-95
15234824
BJOG. 2000 Oct;107(10):1210-7
11028570
J Adv Nurs. 2001 Feb;33(3):279-87
11251714
Nurs Res. 2001 Sep-Oct;50(5):275-85
11570712
Psychiatry Res. 2011 Jan 30;185(1-2):113-20
20965093
Arch Womens Ment Health. 2006 Jul;9(4):197-202
16633740
Am J Psychiatry. 2002 Jan;159(1):43-7
11772688
J Affect Disord. 2003 Apr;74(2):139-47
12706515
West J Nurs Res. 2001 Oct;23(6):563-74
11569330
Arch Med Sci. 2015 Jun 19;11(3):605-11
26170855
Arch Womens Ment Health. 2003 Aug;6 Suppl 2:S43-50
14615922
J Affect Disord. 2008 May;108(1-2):147-57
18067974
Int J Nurs Stud. 2009 Oct;46(10):1355-73
19327773
J Affect Disord. 2006 Apr;91(2-3):97-111
16466664