Investigation of Risk Factors for Postpartum Depression Development Among Reproductive Age Women Living in Yerevan Who Have 1-3 Months Old Children: A Case-Control Study

Abstract

Introduction: Postpartum depression (PPD) is a major depressive disorder with postpartum onset and is one of the most common complications of childbearing, affecting 13.00% of postpartum women. PPD has a great impact on the family and economy, and is considered as one of the major public health problems. Objective: To identify the risk factors for PPD development and measure the combined effect of maternal age at the last childbirth, mode of the last delivery, and breastfeeding (BF) status on therisk of PPD among reproductive age (18-45) women living in Yerevan. Methods: The study utilized a case-control study design. Cases were reproductive age (18-45) women living in Yerevan who had at least one 1-3 months old child registered in Primary Health Care (PHC) facilities and had probable PPD. Controls were reproductive age (18-45) women living in Yerevan who had at least one 1-3 months old child registered in the same PHC facilities and did not have probable PPD. The study conducted telephone interviews for data collection. The study measured probable PPD status through Edinburg Postnatal Depression Scale (EPDS) and assessed the exposure status among cases (n=63) and controls (n=272) through structured questionnaire. Data analysis was performed using STATA statistical software. Results: After adjusting for the identified confounders (current BMI, employment status, exposure to secondhand smoke, child care anxiety score, and self esteem score) among women who gave birth to their last child through vaginal delivery the odds ratio (OR) of probable PPD among women aged less than 25 years compared to those aged more than 25 years was 0.89 (95% CI: 0.43-1.82) while among women who gave birth to their last child through Cesarean section (C-section) the OR was 7.78 (95% CI: 1.49-40.73). Conclusion: The study revealed that the association between maternal age at the last childbirth and probable PPD was varying by the mode of delivery indicating that mode of delivery modified the effect of maternal age at the last childbirth on probable PPD. The study showed that the risk of probable PPD associated with the younger (<25 years) age at the last childbirth was statistically significantly increased only among women who delivered their last child through C-section. Meanwhile, the risk of probable PPD associated with younger (<25 years) age at the last childbirth tended to be lower among those women who delivered their last child through vaginal delivery.