Risk and protective factors for postpartum depression among Polish women – a prospective study

Figures & data

Table 1. Basic characteristics of the sample.

Variable	Total study group (n = 311)
	Mean (SD) range, or n (%)
Age, years (n = 305)	29.4 (5.1) 18.0–45.0
Body height, cm (n = 266)	166.8 (6.2) 152.0–190.0
Body weight, kg (n = 243)	80.5 (14.0) 46.0–120.0
BMI, kg/m^2 (n = 242)	28.9 (4.7) 18.0–42.0
Education (n = 307)
Primary	8 (2.6%)
Lower secondary	17 (5.5%)
Upper secondary (technical)	44 (14.3%)
Upper secondary (general)	123 (40.1%)
Tertiary	115 (37.5%)
Marital status (n = 306)
Single	4 (1.3%)
In a partnership	72 (23.5%)
Married	228 (74.5%)
Divorced	2 (0.7%)
Pregnancies (n = 305)	2.3 (1.3) 1.0–10.0
Labors (n = 299)	2.0 (1.1) 1.0–9.0
Week of delivery (n = 291)	39.2 (1.9) 26.0–42.0
Newborn’s sex (n = 304)
Female	138 (45.4%)
Male	166 (54.6%)
APGAR score in newborn at 1 min after birth (n = 229)
0–3 (Low)	1 (0.4%)
4–7 (Moderate)	6 (2.6%)
8–10 (Good)	222 (96.9%)
Maternal sleep duration postpartum, hours (n = 111)
≤5	38 (34.2%)
6–7	67 (60.4%)
8–9	6 (5.4%)
≥10	0 (0.0%)

BMI: body mass index; SD: standard deviation.

Table 2. Characteristics of the sample in terms of childbirth based on EPQ.

Variable	Total study group (n = 311)
	n/Total number of answers (%)
Cesarean section	81/306 (26.5%)
Planned	39/77 (50.7%)
In an emergency	38/77 (49.3%)
Induction of labor:
Foley catheter	47/222 (21.2%)
Prostaglandins	14/214 (6.5%)
Oxytocin drip infusion	65/223 (29.1%)
Anesthesia during labor	120/229 (52.4%)
Effective anesthesia	111/140 (79.3%)
Gas and air (Entonox)	55/138 (39.9%)
Intravenous anesthesia (Ultiva)	81/140 (57.9%)
Epidural anesthesia	7/129 (5.4%)
Episiotomy	90/234 (38.5%)
Perineal lacerations	67/235 (28.5%)
Vacuum-assisted delivery	5/222 (2.3%)
Sufficient support from the partner during hospitalization	205/226 (90.7%)
Support from the birth partner	173/245 (70.6%)
Willingness to be supported by the birth partner during the next pregnancy	200/251 (79.7%)
Birth plan	68/305 (22.3%)
Education in childbirth school	89/307 (29.0%)
Opinion that education in childbirth school reduces stress during labor	89/223 (39.9%)
Skin-to-skin contact after birth	279/301 (92.7%)

EPQ: Early Postnatal Questionnaire.

Table 3. Characteristics of the sample in terms of the results of IPPQ, WFRQ-PL, and EPDS.

Questionnaire items	Total study group (n = 311)
	Mean (SD) range
IPPQ
Attend, connect, and express (ACE) (n = 308)	15.1 (5.8) 0.0–24.0
Capacity to confide (n = 309)	14.5 (6.1) 0.0–24.0
Hardiness (n = 310)	16.7 (6.3) 0.0–24.0
Assertiveness (n = 309)	16.2 (6.6) 0.0–24.0
Affiliative trust (n = 310)	18.5 (6.8) 0.0–24.0
Healthy helping (n = 309)	13.5 (5.7) 0.0–24.0
Self-complexity (n = 307)	14.1 (5.9) 0.0–25.0
Social approval (n = 311)	18.6 (7.2) 0.0–28.0
Global score (n = 310)	107.8 (40.7) 0.0–161.0
WFRQ-PL
Belief systems (n = 311)	48.8 (10.0) 28.0–65.0
Organization patterns (n = 311)	30.5 (6.6) 18.0–40.0
Communication/problem-solving (n = 311)	39.5 (8.3) 20.0–50.0
Global score (n = 311)	42.4 (58.8) 0.0–155.0
EPDS
After delivery (n = 282)	6.0 (4.0) 0.0–21.0
At 4 weeks postpartum (n = 112)	8.8 (5.9) 0.0–21.0

EPDS: Edinburg Postnatal Depression Scale; IPPQ: Immune Power Personality Questionnaire; SD: standard deviation; WFRQ-PL: Walsh Family Resilience Questionnaire – Polish Adaptation.

Table 4. The effect of selected parameters from EPQ and LPQ on postpartum depression measured with EPDS after delivery and at 4 weeks postpartum (univariate regression analysis).

Parameters	Postpartum depression
	After delivery (n = 311)		At 4 weeks postpartum (n = 112)
	β (95% CI)	p-Value	β (95% CI)	p-Value
EPQ
Depressive episodes before pregnancy	0.30	<0.0001	0.29	0.0024
	(0.18; 0.41)		(0.11; 0.48)
Suicidal ideation before pregnancy	0.28	<0.0001	NS	NS
	(0.16; 0.39)
Antidepressants used before pregnancy	0.15	0.0153	0.22	0.0196
	(0.03; 0.26)		(0.04; 0.41)
Family history of depression	0.14	0.0165	0.26	0.0054
	(0.03; 0.26)		(0.08; 0.45)
Stressful life event not related to pregnancy	0.15	0.0126	NS	NS
	(0.03; 0.27)
Premature rupture of the membranes	0.14	0.0244	NS	NS
	(0.02; 0.25)
Risk of preterm delivery	0.17	0.0055	0.21	0.0274
	(0.05; 0.28)		(0.02; 0.40)
Cesarean delivery	0.14	0.0198	NS	NS
	(0.02; 0.26)
Inhalation analgesia (Entonox)	−0.19	0.0311	NS	NS
	(−0.36; −0.02)
Anxiety about newborn’s health	0.15	0.0097	0.20	0.0314
	(0.04; 0.27)		(0.02; 0.39)
LPQ
`Regular physical activity	NS	NS	0.25	0.0069
			(0.07; 0.44)
Anxiety about child’s health	NS	NS	0.40	<0.0001
			(0.23; 0.58)
Breastfeeding	NS	NS	−0.2	0.0143
			(-0.41; −0.05)
Breastfeeding problems	0.20	0.0373	0.30	0.0011
	(0.01; 0.39)		(0.12; 0.48)
Antidepressants use	0.19	0.0459	0.21	0.0258
	(0.01; 0.38)		(0.03; 0.40)
Adequate hours of sleep per day	NS	NS	−0.29	0.0022
			(−0.47; −0.11)
Sleep problems	0.19	0.0454	0.38	<0.0001
	(0.01; 0.38)		(0.21; 0.56)
Satisfaction with financial situation	NS	NS	−0.25	0.0087
			(−0.43; −0.06)
Average hours of sleep per day
≤5	0.20	0.0387	0.46	<0.0001
	(0.01; 0.39)		(0.29; 0.63)
6–7	NS	NS	−0.38	<0.0001
			(−0.55; −0.20)

Only statistically significant factors were included in the table. β: regression coefficient; CI: confidence interval; EPDS: Edinburg Postnatal Depression Scale; EPQ: Early Postnatal Questionnaire; LPQ: Late Postnatal Questionnaire; NS: not significant (p > 0.05).

Table 5. The effect of selected parameters from EPQ and LPQ on postpartum depression measured with EPDS after delivery and at 4 weeks postpartum (multivariate regression analysis*).

Parameters	Postpartum depression
	After delivery (n = 311)		At 4 weeks postpartum (n = 112)
	β (95% CI)	p-Value	β (95% CI)	p-Value
EPQ
Suicidal ideation before pregnancy	−0.33	0.0013	NS	NS
	(−0.52; −0.13)
LPQ
Regular physical activity	NS	NS	−0.23	0.0024
			(−0.38; −0.09)
Anxiety about child’s health	NS	NS	−0.21	0.0170
			(−0.37; −0.04)
Sleep problems	NS	NS	−0.24	0.0045
			(−0.40; −0.08)

*Multivariate regression analysis included only statistically significant parameters from univariate analysis (Table 4).

Only statistically significant factors were included in the table. β: regression coefficient; CI: confidence interval; EPDS: Edinburg Postnatal Depression Scale; EPQ: Early Postnatal Questionnaire; LPQ: Late Postnatal Questionnaire; NS: not significant (p > 0.05).

Table 6. Correlation between the subscales of IPPQ and WFRQ-PL and postpartum depression measured with EPDS after delivery and at 4 weeks postpartum (correlation analysis).

Subscales	Postpartum depression
	After delivery (n = 311)		At 4 weeks postpartum (n = 112)
	r	p-Value	r	p-Value
IPPQ
Capacity to confide	−0.23	0.0001	NS	NS
Hardiness	−0.15	0.0144	NS	NS
Assertiveness	−0.21	0.0005	NS	NS
Self-complexity	−0.16	0.0090	NS	NS
Global score	−0.17	0.0047	NS	NS
WFRQ-PL
Belief systems	NS	NS	−0.59	<0.0001
Organization patterns	NS	NS	−0.58	<0.0001
Communication/problem-solving	−0.23	0.0168	−0.59	<0.0001
Global score	−0.20	0.0398	−0.62	<0.0001

Only statistically significant factors were included in the table. EPDS: Edinburg Postnatal Depression Scale; IPPQ: Immune Power Personality Questionnaire; r: correlation coefficient; NS: not significant (p > 0.05); WFRQ-PL: Walsh Family Resilience Questionnaire – Polish Adaptation.

Data availability statement

The data analyzed during the current study are available from the corresponding author upon reasonable request.