Prevalence And Influencing Factors Of Postpartum Depression In Women Of Reproductive Age In Hefei

Objective This study aims to describe the prevalence and determinants of postpartum depression in women of reproductive age respectively at 3-7 days and 42 days after delivery in Hefei city.And also,it is targeted to illustrate the situation changes between the occurance of depression at 3-7 days and 42 days after delivery,and to explore determiants of postpartum depression as well,so as to provide the baseline data for puerpera mental health service.Methods By simple sampling method,3 township health centers(or 3 community health service centers)were selected according to different economic conditions of totally 12 counties(cities)in Hefei.And then,5 administrative villages(community committees)were further selected in each township(community)according to various geographical locations.From March 1,2016 to June 30,2016,4027 women who met the inclusion criteria and received the first postpartum visit(3-7 days after birth)as well as physical examination at 42 days after birth were selected as the participants.Women were asked to fill inquestionnaires to collect general maternal charccteristics and basic information on newborns.The Edinburgh Postnatal Depression Scale(EPDS)was used to assess women's postpartum depression.Epidata 3.0 was used for double entry of data,SPSS19.0 statistical software was adopted for data analysis and processing.Chi-square test /Fisher's exact probability method was used for univariate analysis.All variables with P<0.1 in univariate analysis were included in the unconditional logistic regression model,and the stepwise forward method was used for multivariate analysis.P<0.05 was considered statistically significant.Results The prevalence of postpartum depression at 3-7 days and 42 days after birth was 22.3% and 11.9%,respectively,and the overall prevalence was 25.3%.The rate of major postpartum depression was 5.7% and 3.6%,respectively,and the overall rate of major postpartum depression was 7.5%.The rate of persistent postpartum depression and persistent major postpartum depression was 8.9% and 1.8%,erspectively.It had showm from univariate analysis that,women with low education,living in urban areas,having pre-pregnancy overweight/obesity,in the first pregnancy and having premature delivery,getting poor relationship with families,having newborns with low birth weight and poor health were more likely to have depression at 3-7 days after delivery.The rate of postpartum depression at 42 days after delivery was higher in women who were priparous,had low weight and poor relationship with their families in two time periods after birth,with infants of poor health.By using logistic regression model,it had shown that,at 3-7 days after delivery,the prevalence of depression was higher in women living in urban areas(P<0.001).Premature birth was positively correlated with the rate of postpartum depression(OR=30.063,95%CI:16.103~56.125).Women had high rate of postpartum depression if the babies were macrosomia(P<0.05).In the surveys if two time periods,the rate of postpartum depression was higher among women who hadpoor relationship with their family members(P<0.05).The rate of major depression was significantly higher in preterm delivery(P<0.001).Those with poor relationship with their families had higher incidence of major postpartum depression,and the rate was 2.180 times that of those with good relationship with their families.The risk of postpartum major depression was 16.482 times higher in women having infants with poor health compared with those with healthy babies.The rate of major depression in employed women was lower than those unemployed(P<0.05).Primiparas were more likely to have major postpartum depression(OR=0.557,95%CI:0.372~0.834).There was a positive correlation between poor relationship with families in both time periods and major postpartum depression.The risk of major postpartum depression was 11.758 times higher in women with infants with current poor health status than those with infants with current good health status.At the 42-day after delivery,primiparas were more prone to postpartum depression(OR=0.771,95% CI:0.619~0.960).Poor health at birth and poor health at 42 days of infants were positively correlated with mothers' postpartum depression(P<0.05).Conclusion The overall prevalence of postpartum depression among women is relatively high in Hefei city.The determinants of postpartum depression at different time periods are different.Social-demographic characteristics,perinatal factors,infants' health status and family support integatively affect the prevalence of postpartum depression in different postnatal periods.Comprehensive and targeted mental health service should be provided based on the accordingly determinants.