Document Type : Original Article
Authors
Department of Nursery, Institute of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
Abstract
PURPOSE: Postpartum period is a critical interval in which the woman is under risk for psychiatric
disorders including postpartum depression (PD). This study was performed to investigate the impact
of the mode of delivery on the occurrence of PD in primiparous mothers.
MATERIALS AND METHODS: This correlational study was performed on 244 primiparous
women (aged 15–49 years) in 17 primary health‑care centers. Sociodemographic, obstetric, and
PD‑related data were gathered using questionnaires and the Edinburgh Postnatal Depression
Scale (EPDS) on the 1st and 3rd months after delivery. The questionnaires were administered to all
primiparous mothers who were registered to the relevant health-care center. Questionnaires were
administered by the researcher for 25–30 min with face-to-face interview technique.
RESULTS: Comparison of EPDS scores on the 1st and 3rd months indicated that there was a
remarkable decline over time (Z = 11.112, P = 0.001). There was an inverse association between
educational level and EPDS scores on the 3rd month (P = 0.037). On the other hand, no significant
relationship was detected between age groups, occupation, income, place of accommodation, and
EPDS scores. Evaluation of the relationship between obstetric features and EPDS scores revealed
that desired and performed modes of delivery, induction, episiotomy, and spinal anesthesia were
not linked with EPDS scores. The postpartum behavior (2=10.315; P = 0.035) and feeding method
of infants (2 = 6.109; P = 0.013) were associated with EPDS scores on the 1st month, but not with
EPDS scores on the 3rd month.
CONCLUSION: Effective measures must be established for early recognition of factors affecting the
occurrence of PD. Health planners and policymakers must spend their efforts for promotion of the
knowledge and attitudes of mothers during pregnancy. Identification of factors for PD necessitates
implementation of multicentric, controlled trials on larger series.
Keywords
of postnatal depression. Prospective multivariate study of
sociocultural risk factors in a Chinese population in Hong Kong.
Br J Psychiatry 2004;184:34‑40.
2. Alharbi AA, Abdulghani HM. Risk factors associated with
postpartum depression in the Saudi population. Neuropsychiatr
Dis Treat 2014;10:311‑6.
3. Turkcapar AF, Kadıoğlu N, Aslan E, Tunc S, Zayıfoğlu M,
Mollamahmutoğlu L, et al. Sociodemographic and clinical features
of postpartum depression among Turkish women: A prospective
study. BMC Pregnancy Childbirth 2015;15:108.
4. Chandran M, Tharyan P, Muliyil J, Abraham S. Post‑partum
depression in a cohort of women from a rural area of Tamil Nadu,
India. Incidence and risk factors. Br J Psychiatry 2002;181:499‑504.
5. Josefsson A, Angelsiöö L, Berg G, Ekström CM, Gunnervik C,
Nordin C, et al. Obstetric, somatic, and demographic risk
factors for postpartum depressive symptoms. Obstet Gynecol
2002;99:223‑8.
6. Hung CH. Predictors of postpartum women’s health status. J Nurs
Scholarsh 2004;36:345‑51.
7. Adewuya AO, Fatoye FO, Ola BA, Ijaodola OR, Ibigbami SM.
Sociodemographic and obstetric risk factors for postpartum
depressive symptoms in Nigerian women. J Psychiatr Pract
2005;11:353‑8.8. Fisher JR, Morrow MM, Ngoc NT, Anh LT. Prevalence, nature,
severity and correlates of postpartum depressive symptoms in
Vietnam. BJOG 2004;111:1353‑60.
9. Chaaya M, Campbell OM, El Kak F, Shaar D, Harb H, Kaddour A,
et al. Postpartum depression: Prevalence and determinants in
Lebanon. Arch Womens Ment Health 2002;5:65‑72.
10. Cox JL, Holden JM, SagovskyR. Detection of postnatal depression.
Development of the 10‑item Edinburgh postnatal depression scale.
Br J Psychiatry 1987;150:782‑6.
11. Aydin N, Inandi T, Yigit A, Hodoglugil NN. Validation of the
Turkish version of the Edinburgh postnatal depression scale
among women within their first postpartum year. Soc Psychiatry
Psychiatr Epidemiol 2004;39:483‑6.
12. Dudek D, Jaeschke R, Siwek M, Mączka G, Topór‑Mądry R,
Rybakowski J. Postpartum depression: Identifying associations
with bipolarity and personality traits. Preliminary results from
across‑sectional study in Poland. Psychiatry Res 2014;215:69‑74.
13. ReighardFT, EvansML. Use of the Edinburgh postnatal depression
scale in a Southern, rural population in the United States. Prog
Neuropsychopharmacol Biol Psychiatry 1995;19:1219‑24.
14. Schaper AM, Rooney BL, Kay NR, Silva PD. Use of the Edinburgh
postnatal depression scale to identify postpartum depression in
a clinical setting. J Reprod Med 1994;39:620‑4.
15. Kim YK, Hur JW, Kim KH, Oh KS, Shin YC. Prediction of
postpartum depression by sociodemographic, obstetric and
psychological factors: A prospective study. Psychiatry Clin
Neurosci 2008;62:331‑40.
16. DindarI, Erdogan S. Screening of Turkish women for postpartum
depression within the first postpartum year: The risk profile of a
community sample. Public Health Nurs 2007;24:176‑83.
17. Kuscu MK, Akman I, Karabekiroglu A, Yurdakul Z, Orhan L,
Ozdemir N, et al. Early adverse emotional response to childbirth
in turkey: The impact of maternal attachment styles and family
support. J Psychosom Obstet Gynaecol 2008;29:33‑8.
18. Garthus‑Niegel S, von Soest T, Knoph C, Simonsen TB,
Torgersen L, Eberhard‑Gran M, et al. The influence of women’s
preferences and actual mode of delivery on post‑traumatic stress
symptoms following childbirth: A population‑based, longitudinal
study. BMC Pregnancy Childbirth 2014;14:191.
19. Adams SS, Eberhard‑Gran M, Sandvik ÅR, Eskild A. Mode of
delivery and postpartum emotional distress: A cohort study of
55,814 women. BJOG 2012;119:298‑305.
20. Sword W, Landy CK, Thabane L, Watt S, Krueger P, Farine D,
et al. Is mode of delivery associated with postpartum depression
at 6 weeks: A prospective cohort study. BJOG 2011;118:966‑77.
21. Patel RR, Murphy DJ, Peters TJ. Operative delivery and postnatal
depression: A cohort study. BMJ 2005;330:879.
22. Yang SN, Shen LJ, Ping T, Wang YC, Chien CW. The
delivery mode and seasonal variation are associated with
the development of postpartum depression. J Affect Disord
2011;132:158‑64.
23. Houston KA, Kaimal AJ, Nakagawa S, Gregorich SE, Yee LM,
Kuppermann M, et al. Mode of delivery and postpartum
depression: The role of patient preferences. Am J Obstet Gynecol
2015;212:229.e1‑7.
24. O’NeillT, MurphyP, GreeneVT. Postnatal depression–Aetiological
factors. Ir Med J 1990;83:17‑8.
25. Durukan E, İlhan MN, Bumin MA, Aycan S. Postpartum
depression frequency and quality of life among a group of
mothers having a child aged 2 weeks‑18 months. Balkan Med J
2011;28:385‑93.
)