Postpartum depression: a case-control study

Abstract

Background

Postpartum depression (PPD) is a mild to severe mood disorder, starting at 6 weeks after birth and with an incidence of approximately 25% in Brazilian puerperae. Its occurrence induce significant aggravations to maternal and child health, however, its risk factors, although known, are little explored for the appropriate diagnosis.

Purpose

To correlate PPD with anxiety, smoking, alcoholism, parity, type of birth, gestational and maternal age, identifying the possible risk factors that increase the probability of a puerpera developing a depressive episode.

Materials and methods

A case-control study performed at the Alzir Bernardino Alves Infant and Maternity Hospital in the city of Vila Velha, Espirito Santo, Brazil. The sample consisted of 227 puerperae. The cutoff point for depression was defined as >10 points according to the Edinburgh Postnatal Depression Scale (EPDS), and cutoff points for anxiety were defined as <33 points for low anxiety, between 33 and 49 for moderate anxiety and >49 for high anxiety according to the State - Trait Anxiety Inventory (STAI-T).

Results

29.1% of the 227 interviewed puerperae presented PPD and were considered “cases”, with the remaining being considered as “control”. There was a positive correlation between PPD and anxiety. No significant correlation was observed for the other risk factors. Women with moderate anxiety presented 17.38 times more probability to develop depressive episodes, and puerperae with high anxiety presented 273 times more chance of developing PPD.

Conclusions

Our results evidenced a high percentage of puerperae with PPD related to maternal anxiety, demonstrating the importance and the necessity of increasing care for women’s mental health in the gestational and puerperal periods.

Keywords:

• Anxiety
• case-control study
• Edinburgh Postnatal Depression Scale
• mental health
• postpartum depression

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The authors wish to thank the Fundação de Amparo à Pesquisa do Espírito Santo (FAPES), Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia e Insumos Estratégicos do Ministério da Saúde (Decit/SCTIE/MS) and, the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) [83164618] for financial support.