Prevalence and Factors Associated With Postpartum Depression Among Women Attending Arusha Lutheran Medical Centre in Arusha, Tanzania Between December 2021 and March 2022. A Descriptive Cross Sectional Study

Abstract

Background: Postpartum depression is a non-psychotic mood disorder whose onset is within 4-6 weeks and up to 12 months after childbirth. 10-15% of women are affected by postpartum depression globally. PPD is associated with significant effects on child growth and development as well as infant-mother relationship. Postpartum depression diminishes a woman’s ability to function effectively, interferes with her parenting and may lead to cognitive bias. A mother’s ongoing depression can also contribute to her child cognitive, behavioral, emotional and interpersonal relationships later in life. Prevention, timely identification and treatment of postpartum depression is paramount. Broad objective: To determine the prevalence and factors associated with postpartum depression among women attending Arusha Lutheran Medical Centre postnatal clinic between December, 2021 and March, 2022. Study design: Descriptive cross sectional study. Setting: Post natal clinic at Arusha Lutheran Medical Centre. Study population: 289 consenting women attending postnatal clinic at ALMC, six weeks after delivery. Study period: December 2021 to March 2022 Methods: Participants were recruited from ALMC postnatal clinic. Eligible participants were approached and requested to consent for participation. Consecutive sampling technique was used until the required sample size was attained. Data was collected using pre structured questionnaires and EPDS and analyzed using SPSS software. Results: 300 postnatal women were recruited into this study but only 289 were analyzed, 11 were excluded because of incomplete data. Prevalence of postpartum depression among women attending ALMC postnatal clinic was 12.1%. Factors associated with postpartum depression included being single (OR (95% CI) 5.5 (2.1 – 14.4) p=0.001), having less than four antenatal visits (OR (95% CI) 2.5 (1.2 – 5.4) p=0.016), unplanned pregnancy (OR (95% CI) 4.7 (2.2 – 9.7) p<0.001), gestational age at delivery between 28-33weeks (OR (95% CI) 3.3 (1.2 – 9.2) p=0.023), neonatal admission (OR (95% CI) 2.3 (1.1 – 4.9) p=0.030), having a previous history of PPD (OR (95% CI) 2.3 7.3 (2.3 – 23.1) p=0.001), experiencing domestic violence (OR (95% CI) 5.1 (1.6 – 16.5) p=0.007), having inadequate relationship with partner (OR (95% CI) 13.4 (5.5 – 32.6) p<0.001), inadequate relationship with in-laws (OR (95% CI) 4.1 (1.6 – 10.4) p=0.003), having inadequate support during pregnancy (OR (95% CI) 6.1 (2.1 – 17.2) p=0.001), inadequate support during delivery (OR (95% CI) 8.8 (2.9 – 26.9) p<0.001), inadequate support after delivery (OR (95% CI) 5.9 (1.7 – 19.6) p=0.004), substance abuse by partner (OR (95% CI) 4.6 (1.3 – 16.4) p=0.021) and alcohol abuse by partner (OR (95% CI) 3.5 (1.1 – 12.1) p=0.046). Statistically significant factors after multivariate analysis included being single, unplanned pregnancy, previous history of PPD and inadequate relationship with partner. Conclusion and Recommendation: Postpartum depression was found to be 12.1%. Routine screening for postpartum depression during the six week postnatal visit is recommended