Prevalence of Postpartum Depression among Recently Delivering Mothers in Nablus District and Its Associated Factors

Discussion Committee: 
Dr. Amira Shaheen / Supervisor
Dr. Shakoor Hajat / Co-Supervisor
Dr. Niveen Abu-Rameileh / External Examiner
Dr. Hamzeh Al Zabadi / Internal Examiner
Dr. Amira Shaheen / Supervisor
Dr. Shakoor Hajat / Co-Supervisor
Khubaib Ammar Ayoub
Background: Postpartum Depression (PPD) is a challenging condition and a major public health problem because of its great effect on the mother and her child in a critical period of child development. Nevertheless, it has received little attention in the Palestinian primary care and MCH clinics. The aim of this study was to determine the prevalence and associated factors of PPD among women aged 18-45 years in Nablus district. Methods: This is a cross-sectional study in which 246 conveniently chosen mothers aged 18-45 years from Nablus district were interviewed at 7-12 weeks after birth in 12 primary care and Maternal and Child Health (MCH) clinics of the Ministry of Health (MOH) and UNRWA, in May and June, 2013. Participants were interviewed using an Arabic version of Edinburgh Postnatal Depression Scale (EPDS; cut off ≥ 10) and other questions of PPD related risk factors. An-Najah University IRB approval and participants’ informed consents were taken. Results: 235 interviews were valid for analysis with mean age of 26.13 (SD ±5.3) years. 49.8% of mothers live in Nablus city whilst 29.8% and 20.4% live in villages and in refugee camps respectively. Forty mothers (17%) scored ≥ 10 and were considered depressed including 21 mothers (8.9%) scored ≥ 13 and considered to have severe depression. Univariate analysis showed that depression during pregnancy [OR: 20.5; (8.84-47.74); p <0.001]; positive personal mental history [OR: 15.7; (1.59-155); p 0.016]; exposure to 2 or more stressful events during pregnancy [OR: 7.8; (2.21-27.53); p <0.001]; poor satisfaction with the marital relationship [OR: 11.9; (3.39-41.97); p <0.001], husband’s help and support [OR: 6.3; (3.03-13.2); p <0.001] and the mother-in-law relationship [OR: 2.6; (1.03-6.57); p 0.037]; and perceived low social support [OR: 13.7; (3.50-53.96); p <0.001] were strongly associated with PPD. No significant relationships were observed with socio-demographic characteristics (age, education, residence and income); pregnancy and birth factors or newborn factors. Conclusion and recommendations: Prevalence of PPD is high among Palestinian mothers and is mainly associated with psychosocial stressors during pregnancy. Although further research is needed in this area due to small sample size and non-random approach, we highly recommend the integration of PPD screening into the antenatal and postnatal healthcare services and to give more time to mothers counselling in addition to the medical services offered.
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