Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria.
Afr J Prim Health Care Fam Med. 2022 Sep 30;14(1):e1-e11. doi: 10.4102/phcfm.v14i1.3031.
The factors contributing to probable postnatal depression (PND), a type of clinical depression that can affect woman after childbirth, are socially derived. Therefore, variations among groups of women necessitate studies in different communities.
This study compared the prevalence of PND and associated factors among women attending postnatal services facilities.
The study setting included Tshwane Municipal district in Gauteng province (GP) and Fezile Dabi District (FS) in Free State province (FSP), South Africa.
A total of 477 mothers within 12 weeks of giving birth were recruited by convenient sampling in health facilities. A self-developed questionnaire was used to obtain information on socio-demographics, obstetric history, and children's characteristics. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data on depression symptoms, with a score of ≥ 13 used as a cut-off for probable PND. Data were analysed using STATA 14. Multivariate logistic regression was used to determine association between probable PND and various covariates.
The overall mean age of women was 28 ± 6 years. The overall prevalence rate of PND was 22%, slightly higher in FS (23%) than in GP (21%). Most participants living in GP were married, had tertiary education, were employed and from the households with income of more than R8000.00. A chi-square test showed that planned pregnancy was significantly higher in GP compared with FS (p ≤ 0.001). Multivariate logistic regression showed that support from a partner or husband decreased the odds of a probable PND in GP (adjusted odd ratio [AOR] 0.37; 95% confidence interval [CI] [95%CI: 0.14-0.96; p = 0.041] and in the FS [AOR = 0.14, 95%CI: 0.05-0.40; p ≤ 0.001]). Significant associations of probable PND with several factors - planned pregnancy, baby age, support in difficult times, partner or husband drinking alcohol and stressful events - were more common in the FSP than in the GP.
The prevalence of probable PND and its associated risk factors in the GP and the FS indicates the need for routine screening and targeted interventions in both urban and rural settings.Contribution: The results confirm that the prevalence of PND is similar in both rural and urban areas, and that pregnancy planning remains a challenge in the FS, which calls for increased efforts to revive family planning programmes in primary health care facilities.
导致产后抑郁（PND）的因素是由社会因素引起的，这是一种产后可能发生的临床抑郁症。因此，妇女群体之间的差异需要在不同社区进行研究。
本研究比较了在产后服务机构就诊的妇女中 PND 的患病率和相关因素。
研究地点包括南非豪登省的茨瓦内市（GP）和自由州省的费泽利·达比区（FS）。
通过便利抽样，在卫生机构招募了 477 名分娩后 12 周内的母亲。使用自行设计的问卷获取社会人口统计学、产科史和儿童特征信息。采用爱丁堡产后抑郁量表（EPDS）收集抑郁症状数据，得分≥13 作为可能 PND 的截断值。使用 STATA 14 进行数据分析。多变量逻辑回归用于确定可能 PND 与各种协变量之间的关联。
妇女的平均年龄为 28 ± 6 岁。PND 的总体患病率为 22%，FS（23%）略高于 GP（21%）。大多数居住在 GP 的参与者已婚、接受过高等教育、有工作，且家庭收入超过 8000 兰特。卡方检验显示，与 FS 相比，GP 中计划妊娠的比例显著更高（p≤0.001）。多变量逻辑回归显示，在 GP 中，来自伴侣或丈夫的支持降低了发生可能 PND 的几率（调整后的优势比 [AOR] 0.37；95%置信区间 [CI] [95%CI：0.14-0.96；p=0.041]；FS 中为 AOR=0.14，95%CI：0.05-0.40；p≤0.001]）。与计划妊娠、婴儿年龄、困难时期的支持、伴侣或丈夫饮酒和压力事件等几个因素的可能 PND 显著相关，在 FS 中比在 GP 中更为常见。
GP 和 FS 中可能 PND 的患病率及其相关风险因素表明，在城乡地区都需要进行常规筛查和有针对性的干预。
研究结果证实，PND 的患病率在城乡地区相似，FS 中妊娠计划仍然是一个挑战，这需要加大努力在初级卫生保健设施中恢复计划生育方案。
