Sanni Simbiat O, Adeoye Ikeola A, Bella-Awusah Tolulope T, Bello Oluwasomidoyin O
Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Consortium of Advanced Research for Africa (CARTA), Nairobi, Kenya.
Discov Ment Health. 2024 Oct 25;4(1):46. doi: 10.1007/s44192-024-00104-2.
Postpartum Depression (PPD) is a severe mental health condition that adversely affects mothers and their infants. The influence of PPD on maternal-infant bonding and breastfeeding practices has been scarcely reported in Nigeria. Therefore, we examined the prevalence of PPD, the associated factors, and the relationship with maternal-infant bonding and breastfeeding practices in Abeokuta, Nigeria.
A descriptive cross-sectional survey was conducted among 600 mothers within the extended postpartum period (≤ 1 year) from three government-owned immunisation clinics at primary, secondary, and tertiary health facilities in Abeokuta, Ogun State. PPD was assessed using the Edinburgh postnatal depression Scale (EPDS ≥ 13), and maternal-infant bonding was evaluated using the Postpartum Bonding Questionnaire (PBQ ≥ 50). We also examined breastfeeding practices (i.e. the time to initiation by 30 min, exclusive breastfeeding for 6 months and early commencement of complementary feeding by 2 months). Data was analysed using chi-square and logistics regression models at a 5% significance level.
The prevalence of PPD was 21.8%, 95% CI (18.7-25.3). Factors associated with PPD were maternal age: 25-34 years [AOR = 0.52; 95% CI (0.29-0.90)]; ≥ 35 years [AOR = 0.44; 95% CI (0.20-0.96)], being married [AOR = 0.43; 95% CI (0.21-0.85)], perceived stress increased the odds of PPD: moderate stress level [AOR = 8.38; 95% CI (3.50-19.9)]; high-stress level [AOR = 47.8; 95% CI (8.65-263.7)] and self-reported history of emotional problems [AOR = 3.25; 95% CI (1.43-7.38)]. There was a significant direct association between PPD and poor maternal-infant bonding [AOR = 3.91; 95% CI (1.04-4.60)]. PPD reduces the odds of early breastfeeding initiation [AOR = 0.43; 95% CI (0.28-0.68)], but no association was found between PPD and exclusive breastfeeding [AOR = 1.07; 95% CI (0.07-1.67)].
The prevalence of PPD was high in our study population and associated with poor maternal-infant bonding and late breastfeeding initiation but not with exclusive breastfeeding. Promoting maternal mental health to foster stronger mother-infant relationships and better breastfeeding practices has become crucial.
产后抑郁症（PPD）是一种严重的心理健康状况，会对母亲及其婴儿产生不利影响。在尼日利亚，PPD对母婴依恋和母乳喂养行为的影响鲜有报道。因此，我们在尼日利亚阿贝奥库塔研究了PPD的患病率、相关因素以及与母婴依恋和母乳喂养行为的关系。
在奥贡州阿贝奥库塔的初级、二级和三级卫生设施的三家政府所有的免疫诊所，对600名产后延长时期（≤1年）的母亲进行了描述性横断面调查。使用爱丁堡产后抑郁量表（EPDS≥13）评估PPD，使用产后依恋问卷（PBQ≥50）评估母婴依恋。我们还检查了母乳喂养行为（即30分钟内开始母乳喂养、6个月纯母乳喂养以及2个月内尽早开始添加辅食）。数据采用卡方检验和逻辑回归模型进行分析，显著性水平为5%。
PPD的患病率为21.8%，95%置信区间（18.7 - 25.3）。与PPD相关的因素有：母亲年龄25 - 34岁[AOR = 0.52；95%置信区间（0.29 - 0.90）]；≥35岁[AOR = 0.44；95%置信区间（0.20 - 0.96）]，已婚[AOR = 0.43；95%置信区间（0.21 - 0.85）]，感知压力增加了患PPD的几率：中度压力水平[AOR = 8.38；95%置信区间（3.50 - 19.9）]；高度压力水平[AOR = 47.8；95%置信区间（8.65 - 263.7）]以及自我报告的情绪问题史[AOR = 3.25；95%置信区间（1.43 - 7.38）]。PPD与母婴依恋不良之间存在显著的直接关联[AOR = 3.91；95%置信区间（1.04 - 4.60）]。PPD降低了早期开始母乳喂养的几率[AOR = 0.43；95%置信区间（0.28 - 0.68）]，但未发现PPD与纯母乳喂养之间存在关联[AOR = 1.07；95%置信区间（0.07 - 1.67）]。
在我们的研究人群中，PPD的患病率较高，且与母婴依恋不良和母乳喂养开始较晚有关，但与纯母乳喂养无关。促进母亲心理健康以培养更紧密的母婴关系和更好的母乳喂养行为变得至关重要。
