Background
Methods
Population
Scales and questionnaires
Assessment methods
Statistical analysis
Results
Sample characteristics
Prevalence of depressive symptoms on D2 postpartum and PPD on D30-40
Characteristics of women with early depressive symptoms
EPDS <9 (%) | EPDS ≥9 (%) |
p*
| ||
---|---|---|---|---|
N
| 152 (66.8%) | 76 (33.2%) | ||
Mean Age
| 31.8 | 31.2 | 0.336 | |
Region of Residency
|
Beirut
| 46 (30.3%) | 24 (31.6%) | 0.621 |
South
| 5 (3.3%) | 5 (6.6%) | ||
Mount-Lebanon
| 92 (60.5%) | 40 (52.6%) | ||
North
| 3 (2.0%) | 3 (3.9%) | ||
Bekaa
| 5 (3.3%) | 3 (3.9%) | ||
Nabatiyeh
| 1 (0.6%) | 1 (1.3%) | ||
Lebanese
|
Yes
| 151 (99.3%) | 73 (96.1%) | 0.109 |
No
| 1 (0.7%) | 3 (3.9%) | ||
Education
|
Elementary
| 1 (0.7%) | 1 (1.3%) | 0.444 |
Intermediate
| 7 (4.6%) | 6 (7.9%) | ||
Secondary
| 16 (10.6%) | 6 (7.9%) | ||
University
| 98 (64.9%) | 55 (72.4%) | ||
Postuniversity
| 26 (17.2%) | 7 (9.2%) | ||
Other
| 3 (2.0%) | 1 (1.3%) | ||
Occupation
|
Unemployed
| 42 (27.8%) | 18 (24.3%) | 0.682 |
Employee
| 72 (47.7%) | 39 (52.7%) | ||
Executive
| 12 (7.9%) | 8 (10.8%) | ||
Liberal profession
| 25 (16.6%) | 9 (12.2%) | ||
Family Support
|
Absent
| 10 (6.6%) | 6 (7.9%) | 0.785 |
Present
| 142 (93.4%) | 70 (92.1%) | ||
Personnal History of Depression
|
Yes
| 10 (6.7%) | 8 (10.7%) | 0.147 |
No
| 140 (93.3%) | 67 (89.3%) | ||
Family History of Depression
|
Yes
| 8 (5.3%) | 9 (11.8%) | 0.108 |
No
| 142 (94.7%) | 67 (88.2%) | ||
Perception of Pregnancy
|
Easy
| 76 (50.7%) | 23 (30.3%) | <0.001 |
Average
| 53 (35.3%) | 25 (32.9%) | ||
Difficult
| 21 (14.0%) | 28 (36.8%) | ||
Perception of Delivery
|
Easy
| 62 (41.3%) | 21 (28.4%) | 0.002 |
Average
| 56 (37.3%) | 20 (27%) | ||
Difficult
| 32 (21.4%) | 33 (44.6%) | ||
Newborn’s gender
|
Male
| 65 (42.8%) | 42 (55.3%) | 0.091 |
Female
| 87 (57.2%) | 34 (44.7%) | ||
Pregnancy Term
|
<36 WG
| 11 (7.2%) | 8 (10.7%) | 0.390 |
36-40 WG
| 130 (85.6%) | 59 (78.6%) | ||
>40 WG
| 11 (7.2%) | 8 (10.7%) | ||
Delivery route
|
Vaginal
| 48 (31.6%) | 12 (15.8%) | 0.006 |
Vaccum
| 32 (21.1%) | 12 (15.8%) | ||
Forceps
| 6 (3.9%) | 1 (1.3%) | ||
Vaccum + Forceps
| 0 (0%) | 1 (1.3%) | ||
C-section
| 66 (43.4%) | 50 (65.8%) | ||
Birth order
|
Primiparous
| 56 (36.8%) | 25 (32.9%) | 0.660 |
Multiparous
| 96 (63.1%) | 51 (67.1%) | ||
Twin Pregnancy
|
Yes
| 3 (2.0%) | 6 (7.9%) | 0.063 |
No
| 149 (98.0%) | 70 (92.1%) | ||
Chronic medical problem for the mother
|
Yes
| 60 (39.5%) | 40 (52.6%) | 0.066 |
No
| 92 (60.5%) | 36 (47.4%) | ||
Transfer of the mother to ICU
|
Yes
| 0 (0%) | 3 (3.9%) | 0.036 |
No
| 152 (100%) | 73 (76.9%) | ||
Newborn at birth
|
Dead
| 0 (0%) | 1 (1.3%) | 0.332 |
Alive
| 152 (100%) | 75 (98.7%) | ||
Foetal medical problem
|
Yes
| 12 (7.9%) | 12 (15.8%) | 0.071 |
No
| 140 (92.1%) | 64 (84.2%) | ||
Newborn transfer to ICU
|
Yes
| 13 (8.6%) | 14 (18.7%) | 0.025 |
No
| 139 (91.4%) | 61 (81.3%) | ||
Breastfeeding
|
No (baby dead)
| 0 (0%) | 1 (1.3%) | 0.049 |
Breastfeeding + 1–2 cups during hospital stay
| 33 (21.7%) | 10 (13.3%) | ||
No breastfeeding
| 4 (2.6%) | 7 (9.4%) | ||
Breastfeeding + >2 cups/day
| 24 (15.8%) | 15 (20%) | ||
Exclusive
| 91 (59.9%) | 42 (56%) |
Prevalence of PPD on D30-40 depending on the EPDS score on D2 and correlation between the scores on D2 and D30-40
EPDS score at D2 | ||||
---|---|---|---|---|
<9 | ≥9 |
p
*
| OR [IC 95%] | |
N | 78 | 71 | ||
PPD at D30-40 | 4 (5.1%) | 15 (21.1%) | 0.006 | 1.25 [1.13-1.38] |
Characteristics of women suffering from PPD
Absence of PPD n (%) | Presence of PPD n (%) |
p*
| ||
---|---|---|---|---|
N
| 130 (87.2%) | 19 (12.8%) | ||
Mean Age
| 31.7 | 32.6 | 0.477 | |
Region of Residency
|
Beirut
| 40 (30.8%) | 4 (21.0%) | 0.653 |
South
| 6 (4.6%) | 1 (5.3%) | ||
Mount-Lebanon
| 75 (57.7%) | 12 (63.1%) | ||
North
| 3 (2.3%) | 1 (5.3%) | ||
Bekaa
| 4 (3.1%) | 1 (5.3%) | ||
Nabatiyeh
| 2 (1.5%) | 0 (0%) | ||
Lebanese
|
Yes
| 128 (98.5%) | 19 (100%) | 1.000 |
No
| 2 (1.5%) | 0 (0%) | ||
Education
|
Elementary
| 0 (0%) | 1 (5.3%) | 0.075 |
Intermediate
| 10 (7.7%) | 0 (0%) | ||
Secondary
| 7 (5.4%) | 3 (15.8%) | ||
University
| 90 (69.2%) | 11 (57.9%) | ||
Postuniversity
| 19 (14.6%) | 4 (21%) | ||
Other
| 4 (3.1%) | 0 (0%) | ||
Occupation
|
Unemployed
| 32 (25%) | 5 (26.3%) | 0.470 |
Employee
| 64 (50%) | 8 (42.1%) | ||
Executive
| 12 (9.4%) | 4 (21.1%) | ||
Liberal profession
| 20 (15.6%) | 2 (10.5%) | ||
Family Support
|
Absent
| 7 (5.4%) | 4 (21.1%) | 0.060 |
Present
| 123 (94.6%) | 15 (78.9%) | ||
Personnal History of Depression
|
Yes
| 9 (7%) | 4 (21.1%) | 0.066 |
No
| 120 (93%) | 15 (78.9%) | ||
Family History of Depression
|
Yes
| 9 (7%) | 7 (36.8%) | 0.001 |
No
| 120 (93%) | 12 (63.2%) | ||
Perception of Pregnancy
|
Easy
| 54 (41.9%) | 4 (21.1%) | 0.130 |
Average
| 44 (34.1%) | 7 (36.8%) | ||
Difficult
| 31 (24%) | 8 (42.1%) | ||
Perception of Delivery
|
Easy
| 44 (34.4%) | 4 (22.2%) | 0.544 |
Average
| 41 (32%) | 6 (33.4%) | ||
Difficult
| 43 (33.6%) | 8 (44.4%) | ||
Newborn’s gender
|
Male
| 63 (48.5%) | 12 (63.2%) | 0.326 |
Female
| 67 (51.5%) | 7 (36.8%) | ||
Pregnancy Term
|
<36 WG
| 10 (7.8%) | 3 (15.8%) | 0.473 |
36-40 WG
| 109 (84.4%) | 15 (78.9%) | ||
>40 WG
| 10 (7.8%) | 1 (5.3%) | ||
Delivery route
|
Vaginal
| 27 (20.8%) | 3 (15.8%) | 0.553 |
Vaccum
| 30 (23.1%) | 2 (10.5%) | ||
Forceps
| 2 (1.5%) | 0 (0%) | ||
Vaccum + Forceps
| 1 (0.8%) | 0 (0%) | ||
C-section
| 70 (53.8%) | 14 (73.7%) | ||
Birth order
|
Primiparous
| 50 (38.5%) | 5 (26.3%) | 0.446 |
Multiparous
| 80 (61.5%) | 14 (73.7%) | ||
Twin Pregnancy
|
Yes
| 6 (4.6%) | 0 (0%) | 1.000 |
No
| 124 (95.4%) | 19 (100%) | ||
Chronic medical problem for the mother
|
Yes
| 54 (41.5%) | 15 (78.9%) | 0.003 |
No
| 76 (58.5%) | 4 (21.1%) | ||
Transfer of the mother to ICU
|
Yes
| 1 (0.8%) | 2 (10.5%) | 0.043 |
No
| 129 (99.2%) | 17 (89.5%) | ||
Newborn at birth
|
Dead
| 1 (0.8%) | 0 (0%) | 1.000 |
Alive
| 129 (99.2%) | 19 (100%) | ||
Foetal medical problem
|
Yes
| 15 (11.5%) | 3 (15.8%) | 0.704 |
No
| 115 (88.5%) | 16 (84.2%) | ||
Newborn transfer to ICU
|
Yes
| 15 (11.6%) | 5 (26.3%) | 0.050 |
No
| 114 (88.4%) | 14 (73.7%) | ||
Breastfeeding
|
No (baby dead)
| 1 (0.8%) | 0 (0%) | 0.272 |
Breastfeeding + 1–2 cups during hospital stay
| 21 (16.2%) | 1 (5.3%) | ||
No breastfeeding
| 6 (4.6%) | 3 (15.8%) | ||
Breastfeeding + >2 cups/day
| 22 (16.9%) | 2 (10.5%) | ||
Exclusive
| 80 (61.5%) | 13 (68.4%) |
Multivariate Stepwise regression to identify significant factors associated with PPD
Risk Factor | OR (95% CI) |
p-value |
---|---|---|
EPDS score ≥9 on D2 | 1.23 (1.11′-1.36) | <0.001 |
Personal history of depression | 6.80 (1.65-28.04) | 0.008 |
Sensitivity and specificity of the EPDS for detecting a PPD on D30-40
Cut-Off score | Sensitivity (%) | Specificity (%) |
---|---|---|
5 | 100 | 33.08 |
6 | 94.74 | 40.00 |
7
|
89.47
|
47.69
|
8 | 78.95 | 50.00 |
9 | 78.95 | 56.92 |
10 | 78.95 | 70.00 |
11 | 78.95 | 77.69 |
12 | 73.68 | 82.31 |