Atuhaire Catherine, Taseera Kabanda, Atukunda Esther C, Atwine Daniel, Matthews Lynn T, Rukundo Godfrey Zari
Faculty of medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Department of Clinical Research, Soar Research Foundation, Mbarara, Uganda.
Psychol Health Med. 2025 Mar;30(3):502-518. doi: 10.1080/13548506.2024.2433545. Epub 2024 Nov 29.
Postpartum Depression (PPD) is a major health challenge with potentially devastating maternal and physical health outcomes. Development of diabetes mellitus has been hypothesized as one of the potential adverse effects of PPD among mothers in the postpartum period, but this association has not been adequately studied especially in low resource settings. This study aimed at determining prevalence of postpartum depression and its association with diabetes mellitus among mothers in Mbarara District, southwestern Uganda. We conducted a facility based cross-sectional study of 309 mothers between 6th week to 6th month after childbirth. Using proportionate stratified consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health center IV. PPD was diagnosed using the Mini-International Neuropsychiatric Interview (MINI 7.0.2) for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Diabetes mellitus was diagnosed by measuring Hemoglobin A1c (HbA1c). Logistic regression was used to determine the association of PPD and diabetes mellitus among mothers. The study established that PPD prevalence of PPD among mothers of 6th weeks to 6th months postpartum period in Mbarara was 40.5% (95% CI: 35.1-45.1%) and it was statistically significantly associated with diabetes mellitus in mothers between 6 weeks and 6 months postpartum. The prevalence of diabetes mellitus among mothers with PPD was 28% compared to 13.6% among mothers without PPD. Mothers with PPD had 3 times higher odds of being newly diagnosed with diabetes as compared to those without PPD (aOR = 3.0, 95% CI: 1.62-5.74, = 0.001). Mothers with PPD between 6 weeks and 6 months postpartum are more likely to have diabetes mellitus as compared to those without PPD. Well-designed prospective analytical studies are needed to conclude on the risk of diabetes mellitus in relation to PPD. Early screening of PPD may be considered in postpartum mothers.
产后抑郁症(PPD)是一项重大的健康挑战,可能会对母亲的身心健康造成毁灭性后果。糖尿病的发生被认为是产后母亲患PPD的潜在不良影响之一,但这种关联尚未得到充分研究,尤其是在资源匮乏地区。本研究旨在确定乌干达西南部姆巴拉拉区母亲产后抑郁症的患病率及其与糖尿病的关联。我们对309名产后6周零6个月的母亲进行了一项基于机构的横断面研究。采用按比例分层连续抽样的方法,从姆巴拉拉地区转诊医院和布维齐韦拉四级保健中心这两个医疗机构的产后诊所招募母亲。使用《精神疾病诊断与统计手册》第5版(DSM-5)的迷你国际神经精神访谈(MINI 7.0.2)对PPD进行诊断。通过测量糖化血红蛋白(HbA1c)来诊断糖尿病。采用逻辑回归分析来确定母亲中PPD与糖尿病之间的关联。研究表明,姆巴拉拉产后6周零6个月母亲中PPD的患病率为40.5%(95%置信区间:35.1-45.1%),且在产后6周零6个月的母亲中,PPD与糖尿病在统计学上存在显著关联。患PPD的母亲中糖尿病的患病率为28%,而未患PPD的母亲中这一比例为13.6%。与未患PPD的母亲相比,患PPD的母亲新诊断出糖尿病的几率高出3倍(调整后比值比=3.0,95%置信区间:1.62-5.74,P=0.001)。与未患PPD的母亲相比,产后6周零6个月患PPD的母亲更有可能患糖尿病。需要设计良好的前瞻性分析研究来确定与PPD相关的糖尿病风险。可考虑对产后母亲进行PPD的早期筛查。