Background. Postpartum depression (PPD) is considered as one of the mood disturbances occurring during 2-3 months after delivery. The present study aimed to determine the prevalence of PPD and its associated risk factors in border city of Ilam, western Iran. Methods. Through a descriptive cross-sectional study in 2011, overall, 197 women who attended Obstetrics & Gynecology clinics postpartumly in the border city of Ilam, western Iran, were randomly recruited. A standard questionnaire that was completed by a trained midwife through face to face interviews was used for data gathering. Results. Mean age ± standard deviations was 27.9 ± 5.2 years. Prevalence of PPD was estimated to be 34.8% (95% CI: 27.7–41.7). A significant difference was observed among depression scores before and after delivery ( ). Type of delivery ( ), low socioeconomic status ( ), and women having low educational level ( ) were the most important significant risk factors associated with PPD. The regression analysis showed that employed mothers compared to housekeepers were more at risk for PPD (adjusted OR = 2.01, 95% CI: 1.22–2.28, ). Conclusions. Prevalence of PPD in western Iran was slightly higher than the corresponding rate from either national or international reports. 1. Introduction Pregnancy, delivery, and adaptability with newborn babies are the most sensitive phases in women’s life [1]. In this period of time, women usually suffer from physiological, spiritual, and psychological crises leading to change of their positions. The first six weeks after delivery is a vulnerable period for postpartum depression (PPD) [2]; of 4 million births that occur in the world annually, approximately 40 percent of new mothers are affected with different types of postpartum mood disorders including depression symptoms before and during pregnancy [3]. Prevalence of PPD is closely linked with socioeconomic and cultural factors and it varies among different countries, ethnicities, and races [4]. The global prevalence of PPD has been estimated to be between 10–25 percent [5–7] and between 27–39 percent in Iran [8, 9]. Various putative psychosocial and obstetric factors have been studied and suggested as risk factors for the development of PPD; if these results are inconsistent and do not effectively help predict women at risk, knowledge of these factors may help identify those who are at higher risk and can benefit from early professional help [10]. Personal history of depression (prior to pregnancy or postpartum) is the major risk factor for PPD [11–14]. Family psychiatric history [15], lack of
References
[1]
A. O. Adewuya, F. O. Fatoye, B. A. Ola, O. R. Ijaodola, and S.-M. O. Ibigbami, “Sociodemographic and obstetric risk factors for postpartum depressive symptoms in Nigerian women,” Journal of Psychiatric Practice, vol. 11, no. 5, pp. 353–358, 2005.
[2]
R. Nonacs and L. S. Cohen, “Postpartum mood disorders: diagnosis and treatment guidelines,” Journal of Clinical Psychiatry, vol. 59, no. 2, pp. 34–40, 1998.
[3]
S. Iranfar, J. Shakeri, M. Ranjbar, P. NazhadJafar, and M. Razaie, “Is unintended pregnancy a risk factor for depression in Iranian women?” Eastern Mediterranean Health Journal, vol. 11, no. 4, pp. 618–624, 2005.
[4]
M. W. O'Hara, “Postpartum depression: what we know,” Journal of Clinical Psychology, vol. 65, no. 12, pp. 1258–1269, 2009.
[5]
M. Beeghly, K. L. Olson, M. K. Weinberg, S. C. Pierre, N. Downey, and E. Z. Tronick, “Prevalence, stability, and socio-demographic correlates of depressive symptoms in Black mothers during the first 18 months postpartum,” Maternal and Child Health Journal, vol. 7, no. 3, pp. 157–168, 2003.
[6]
P. Grussu and R. M. Quatraro, “Prevalence and risk factors for a high level of postnatal depression symptomatology in Italian women: a sample drawn from ante-natal classes,” European Psychiatry, vol. 24, no. 5, pp. 327–333, 2009.
[7]
P. J. Cooper, M. Tomlinson, L. Swartz, M. Woolgar, L. Murray, and C. Molteno, “Post-partum depression and the mother-infant relationship in a South African peri-urban settlement,” British Journal of Psychiatry, vol. 175, pp. 554–558, 1999.
[8]
G.-R. Kheirabadi, M.-R. Maracy, M. Barekatain et al., “Risk factors of postpartum depression in rural areas of Isfahan Province, Iran,” Archives of Iranian Medicine, vol. 12, no. 5, pp. 461–467, 2009.
[9]
A. Abbaszadeh, F. P. Kermani, H. Safizadeh, and N. Nakhee, “Violence during pregnancy and postpartum depression,” Pakistan Journal of Medical Sciences, vol. 27, no. 1, pp. 177–181, 2011.
[10]
M. Bloch, N. Rotenberg, D. Koren, and E. Klein, “Risk factors associated with the development of postpartum mood disorders,” Journal of Affective Disorders, vol. 88, no. 1, pp. 9–18, 2005.
[11]
O. Bernazzani, J.-F. Saucier, H. David, and F. Borgeat, “Psychosocial predictors of depressive symptomatology level in postpartum women,” Journal of Affective Disorders, vol. 46, no. 1, pp. 39–49, 1997.
[12]
D. P. Buesching, M. L. Glasser, and D. A. Frate, “Progression of depression in the prenatal and postpartum periods,” Women & health, vol. 11, no. 2, pp. 61–78, 1986.
[13]
R. K. Dagher, P. M. McGovern, B. H. Alexander, B. E. Dowd, L. K. Ukestad, and D. J. McCaffrey, “The psychosocial work environment and maternal postpartum depression,” International Journal of Behavioral Medicine, vol. 16, no. 4, pp. 339–346, 2009.
[14]
D. Da Costa, J. Larouche, M. Dritsa, and W. Brender, “Psychosocial correlates of prepartum and postpartum depressed mood,” Journal of Affective Disorders, vol. 59, no. 1, pp. 31–40, 2000.
[15]
C. T. Beck, “Predictors of postpartum depression: an update,” Nursing Research, vol. 50, no. 5, pp. 275–285, 2001.
[16]
E. Dearing, B. A. Taylor, and K. McCartney, “Implications of family income dynamics for women's depressive symptoms during the first 3 years after childbirth,” American Journal of Public Health, vol. 94, no. 8, pp. 1372–1377, 2004.
[17]
D. Goyal, C. Gay, and K. A. Lee, “How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers?” Women's Health Issues, vol. 20, no. 2, pp. 96–104, 2010.
[18]
E. B. Faragher, M. Cass, and C. L. Cooper, “The relationship between job satisfaction and health: a meta-analysis,” Occupational and Environmental Medicine, vol. 62, no. 2, pp. 105–112, 2005.
[19]
L. J. Mayberry, J. A. Horowitz, and E. Declercq, “Depression symptom prevalence and demographic risk factors among U.S. women during the first 2 years postpartum,” Journal of Obstetric, Gynecologic, & Neonatal Nursing, vol. 36, no. 6, pp. 542–549, 2007.
[20]
M. Dolatian, K. Hesami, J. Shams, and H. A. Majd, “Relationship between violence during pregnancy and postpartum depression,” Iranian Red Crescent Medical Journal, vol. 12, no. 4, pp. 377–383, 2010.
[21]
K. A. Yonkers, S. M. Ramin, A. J. Rush et al., “Onset and persistence of postpartum depression in an inner-city maternal health clinic system,” American Journal of Psychiatry, vol. 158, no. 11, pp. 1856–1863, 2001.
[22]
R. Warner, L. Appleby, A. Whitton, and B. Faragher, “Demographic and obstetric risk factors for postnatal psychiatric morbidity,” British Journal of Psychiatry, vol. 168, pp. 607–611, 1996.
[23]
A. Josefsson, L. Angelsi？？, G. Berg et al., “Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms,” Obstetrics and Gynecology, vol. 99, no. 2, pp. 223–228, 2002.
[24]
C. Rubertsson, B. Wickberg, P. Gustavsson, and I. R？destad, “Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample,” Archives of Women's Mental Health, vol. 8, no. 2, pp. 97–104, 2005.
[25]
R. J. Rona, N. C. Smeeton, R. Beech, A. Barnett, and G. Sharland, “Anxiety and depression in mothers related to severe malformation of the heart of the child and foetus,” Acta Paediatrica, vol. 87, no. 2, pp. 201–205, 1998.
[26]
S. Gale and B. L. Harlow, “Postpartum mood disorders: a review of clinical and epidemiological factors,” Journal of Psychosomatic Obstetrics and Gynecology, vol. 24, no. 4, pp. 257–266, 2003.
[27]
J. L. Cox, J. M. Holden, and R. Sagovsky, “Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale,” British Journal of Psychiatry, vol. 150, pp. 782–786, 1987.
[28]
J. Pitanupong, T. Liabsuetrakul, and A. Vittayanont, “Validation of the Thai Edinburgh postnatal depression scale for screening postpartum depression,” Psychiatry Research, vol. 149, no. 1-3, pp. 253–259, 2007.
[29]
C.-L. Dennis, “Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh postnatal depression scale?” Journal of Affective Disorders, vol. 78, no. 2, pp. 163–169, 2004.
[30]
A. Montazeri, B. Torkan, and S. Omidvari, “The edinburgh postnatal depression scale (EPDS): translation and validation study of the Iranian version,” BMC Psychiatry, vol. 7, article 11, 2007.
[31]
G. R. Kheirabadia and M. R. Maracy, “Perinatal depression in a cohort study on Iranian women,” Journal of Research in Medical Sciences, vol. 15, no. 1, pp. 41–49, 2010.
[32]
A. Tashakori, A. Shanesaz, and A. Rezapour, “Assessment of some potential risk factors of postpartum depression,” Pakistan Journal of Medical Sciences, vol. 25, no. 2, pp. 261–264, 2009.
[33]
H. Azimi Lolati, M. M. Danesh, S. H. Hosseini, A. R. Khalilian, and M. Zarghami, “Postpartum depression in clients at health care centers in Sari,” Iranian Journal of Psychiatry and Psychology, vol. 11, no. 1, pp. 31–42, 2005.
[34]
F. Sehhatie shafaei, F. Ranjbar koochaksariie, M. Ghojazadeh, and Zh. Mohamadrezaei, “Study of relationship between some predisposing factors and postpartum depression,” Journal of Ardabil University of Medical Sciences, vol. 1, no. 27, pp. 54–61, 2008.
[35]
S. S. Sadr, M. Dowlatian, and Z. Behboudi Moghadam, “Prevalence of postpartum depression and factors affecting it in Tehran,” Journal of Medical Council of IRI, vol. 22, no. 3, pp. 189–193, 2004.
[36]
F. Shobeiri, A. Farhadi Nasab, and M. Nazar, “Detecting postpartum depression in referents to medical and health centers in Hamadan City,” Scientific Journal of Hamadan University of Medical Sciences, vol. 14, no. 3, pp. 24–28, 2007.
[37]
H. M. Ahmed, S. K. Alalaf, and N. G. Al-Tawil, “Screening for postpartum depression using Kurdish version of Edinburgh postnatal depression scale,” Archives of Gynecology and Obstetrics, pp. 1–7, 2011.
[38]
F. H. Al Dallal and I. N. Grant, “Postnatal depression among Bahraini women: prevalence of symptoms and psychosocial risk factors,” Eastern Mediterranean Health Journal, vol. 18, no. 5, pp. 439–445, 2012.
[39]
P. N. Ebeigbe and K. O. Akhigbe, “Incidence and associated risk factors of postpartum depression in a tertiary hospital in Nigeria,” The Nigerian Postgraduate Medical Journal, vol. 15, no. 1, pp. 15–18, 2008.
[40]
E. F. Melo Jr., J. G. Cecatti, R. C. Pacagnella, D. F. B. Leite, D. E. Vulcani, and M. Y. Makuch, “The prevalence of perinatal depression and its associated factors in two different settings in Brazil,” Journal of Affective Disorders, vol. 136, no. 3, pp. 1204–1208, 2012.
[41]
V. Patel, M. Rodrigues, and N. DeSouza, “Gender, poverty, and postnatal depression: a study of mothers in Goa, India,” American Journal of Psychiatry, vol. 159, no. 1, pp. 43–47, 2002.
[42]
L. Tannous, L. P. Gigante, S. C. Fuchs, and E. D. A. Busnello, “Postnatal depression in Southern Brazil: prevalence and its demographic and socioeconomic determinants,” BMC Psychiatry, vol. 8, article 1, 2008.
[43]
C. Akman, F. Uguz, and N. Kaya, “Postpartum-onset major depression is associated with personality disorders,” Comprehensive Psychiatry, vol. 48, no. 4, pp. 343–347, 2007.
[44]
R. Jardri, J. Pelta, M. Maron et al., “Predictive validation study of the Edinburgh postnatal depression scale in the first week after delivery and risk analysis for postnatal depression,” Journal of Affective Disorders, vol. 93, no. 1-3, pp. 169–176, 2006.
[45]
T. Inandi, O. C. Elci, A. Ozturk, M. Egri, A. Polat, and T. K. Sahin, “Risk factors for depression in postnatal first year, in eastern Turkey,” International Journal of Epidemiology, vol. 31, no. 6, pp. 1201–1207, 2002.
[46]
A. Lane, R. Keville, M. Morris, A. Kinsella, M. Turner, and S. Barry, “Postnatal depression and elation among mothers and their partners: prevalence and predictors,” British Journal of Psychiatry, vol. 171, pp. 550–555, 1997.
[47]
B. Leigh and J. Milgrom, “Risk factors for antenatal depression, postnatal depression and parenting stress,” BMC Psychiatry, vol. 8, article 24, pp. 1–11, 2008.
[48]
L. Gulseren, A. Erol, S. Gulseren, L. Kuey, B. Kilic, and G. Ergor, “From antepartum to postpartum: a prospective study on the prevalence of peripartum depression in a semiurban Turkish community,” Journal of Reproductive Medicine for the Obstetrician and Gynecologist, vol. 51, no. 12, pp. 955–960, 2006.
