Postpartum depression: its prevalence and relation to family typology and functioning

Depresión posparto: prevalencia y relación con la tipología y función familiar

Introduction: postpartum depression (PPD) is a public health issue. Multiple biological and psychosocial risk factors have been described. In Colombia there are no studies determining its prevalence based on screening scales and diagnostic criteria, as well as its relation to family functioning assessment instruments. Objective: to determine PPD prevalence in in women in the immediate postnatal period and its association with clinical conditions, life-course, and family typology and functioning. Materials and methods: an analytical cross-sectional observational study conducted in the immediate postnatal period (2 to 48 hours after delivery), using the Edinburgh scale (EPDS) and the DSM5 criteria for PPD screening and diagnosis. Sociodemographic variables such as, gynecological-obstetric, and perinatal history, and clinical conditions, were analyzed. Family functioning assessment instruments such as life-course, family typology and family APGAR, were applied. Results: 336 participants with a mean age of 27.3 years, were included. The prevalence of PPD was 5.1%, while prevalent pathologies were preeclampsia (8.3%) and gestational diabetes (6.3%). 58% (p<0.001) had a dysfunctional family to some degree and 88% (p 0.01) belonged to nuclear families. No statistical significance was found for clinical conditions and life-course. Conclusions: PPD is a prevalent mental health issue caused by multiple factors, such as family typology and functioning. Further quantitative and qualitative studies to establish causal relationships, are needed, to better understand this phenomenon.

1. Arribas L, Bailón E, Ortega A. Embarazo. En: España E, editor. Atención Primaria Problemas de Salud en la Consulta de Medicina de Familia. 8 ed. Madrid: Elsevier; 2019. p. 112-33.
2. Daniel S, Oram L, Lee U. Postpartum Depression. Conn's Current Therapy 2021: Elsevier; 2020.
3. Shitu S, Geda B, Dheresa M. Postpartum depression and associated factors among mothers who gave birth in the last twelve months in Ankesha district, Awi zone, North West Ethiopia. BMC Pregnancy Childbirth. 2019;19(1):435. https://doi.org/10.1186/s12884-019-2594-y.
4. Wang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y, et al. Correction: Mapping global prevalence of depression among postpartum women. Transl Psychiatry. 2021;11(1):640. https://doi.org/10.1038/s41398-021-01692-1.
5. Krauskopf V, Valenzuela P. Depresión perinatal: detección, diagnóstico y estrategias de tratamiento. Rev Med Clin Condes. 2020;31(2):139-49. https://doi.org/10.1016/j.rmclc.2020.01.004.
6. Rincón-Pabón D, Ramírez-Vélez R. Depresión posparto en mujeres colombianas: análisis secundario de la Encuesta Nacional de Demografía y Salud-2010. Rev salud pública. 2014;16(4):534-546.
7. Gaviria SL, Duque M, Vergel J, Restrepo D. Síntomas depresivos perinatales: prevalencia y factores psicosociales asociados. Rev Colomb Psiquiat. 2019;48(3):166–73. https://doi.org/10.1016/j.rcp.2017.09.002.
8. Niyonsenga, J, Mutabaruka J. Factors of postpartum depression among teen mothers in Rwanda: a cross- sectional study. J Psychosom Obstet Gynaecol. 2021;42(2):356-360. https://doi.org/10.1080/0167482X.2020.1735340.
9. Zejnullahu V, Ukella-Lleshi D, Zejnullahu V, Miftari E, Govori V. Prevalence of postpartum depression at the clinic for obstetrics and gynecology in Kosovo teaching hospital: Demographic, obstetric and psychosocial risk factors. Eur J Obst Gynecol Reprod Biol. 2021;256:215-20. https://doi.org/10.1016/j.ejogrb.2020.11.025.
10. Zhuzhingo-Vásquez C, Peñaloza-Buele Y, Ajila-Vacacela J, Aguirre-Carrión C. Tamizaje para depresión posparto aplicado a la población puérpera del primer nivel de atención en salud. Psico Unemi. 2018;2(3):21-29. https://doi.org/10.29076/issn.2602-8379vol2iss3.2018pp21-29p
11. Levis B, Negeri Z, Sun Y, Benedetti A, Thombs BD. Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. BMJ. 2020:371:m4022. https://doi.org/10.1136/bmj.m4022.
12. Park S-H, Kim J-I. Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis. Arch Gynecol Obstet. 2023;307(5):1331-1345. https://doi.org/10.1007/s00404-022-06525-0.
13. Smith-Nielsen J, Matthey S, Lange T, Væver MS. Validation of the Edinburgh Postnatal Depression Scale against both DSM-5 and ICD-10 diagnostic criteria for depression. BMC Psychiatry. 2018;18(1):393. https://doi.org/10.1186/s12888-018-1965-7.
14. Mayorga-Muñoz C, Gallardo-Peralta L, Galvez-Nieto JL. [Psychometric properties of APGAR-family scale in a multiethnic sample of Chilean older people]. Rev Med Chil. 2019;147(10):1283-1290. https://doi.org/10.4067/s0034-98872019001001283.
15. Campo-Arias A, Caballero-Domínguez CC. Confirmatory factor analysis of the family APGAR questionnaire. Rev Colomb Psiquiatr (Engl Ed). 2021;50(4):234-237. https://doi.org/10.1016/j.rcpeng.2021.10.002.
16. Ordóñez Azuara Y, Gutiérrez Herrera RF, Méndez Espinoza E, Alvarez Villalobos NA, Lopez Mata D, de la Cruz de la Cruz C. [Association of family typology and dysfunction in families with adolescents from a Mexican population]. Aten Primaria. 2020;52(10):680-689. https://doi.org/10.1016/j.aprim.2020.02.011.
17. Al Nasr RS, Altharwi K, Derbah MS, Gharibo SO, Fallatah SA, Alotaibi SG, et al. Prevalence and predictors of postpartum depression in Riyadh, Saudi Arabia: A cross sectional study. PLoS One. 2020;15(2):e0228666. https://doi.org/10.1371/journal.pone.0228666.
18. Nakić Radoš S, Tadinac M, Herman R. Anxiety During Pregnancy and Postpartum: Course, Predictors and Comorbidity with Postpartum Depression. Acta Clin Croat. 2018;57(1):39-51. https://doi.org/10.20471/acc.2017.56.04.05.
19. Martínez Ortiz RA, Betancourt Gallego CX, Zúñiga Buitrón EL, Valdés Meneses YD, Fernández Muñoz NF, Barrera Gonzales MA. Prevalencia de tamiz positivo para Depresión Posparto en un Hospital de tercer nivel y posibles factores asociados. Rev Colomb Psiquiat. 2016;45(4):253-261. http://dx.doi.org/10.1016/j.rcp.2016.03.002.
20. Huang Y, Liu Y, Wang Y, Liu D. Family function fully mediates the relationship between social support and perinatal depression in rural Southwest China. BMC Psychiatry. 2021;21(1):151. http://dx.doi.org/10.1186/s12888-021-03155-9.
21. Kim Y, Dee V. Sociodemographic and Obstetric Factors Related to Symptoms of Pospartum Depression in Hispanic Women in Rural California. J Obstet Gynecol Neonatal Nurs. 2018;47(1):23-31. http://dx.doi.org/10.1016/j.jogn.2017.11.012.