El Kahwaji Christian, Barakat Elie, Fekih-Romdhane Feten, Akkari Camille, Barakat Savio, Hallit Souheil
School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
Obstetrics and Gynecology department at Notre Dame des Secours, Centre Hospitalier Universitaire, Street 93, Postal Code 3, Byblos, Lebanon.
BMC Psychol. 2025 Jan 31;13(1):91. doi: 10.1186/s40359-025-02410-y.
Cultural variations in pregnancy and childbirth experiences can influence the causes and contributing factors of postpartum depression (PPD). However, research on this issue remains scarce in Arab countries, especially in Lebanon. This study aimed to assess the prevalence of PPD and explore socio-contextual factors affecting it in Lebanon during the COVID-19 pandemic. It also sought to validate the psychometric reliability of the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) among Lebanese women.
A cross-sectional study was conducted between May 2022 and July 2022, with 402 Lebanese adult postpartum women (mean age 31.46 ± 4.88 years) enrolled from the maternity ward at CHU-Notre Dame des Secours Hospital in Byblos, Lebanon by responding to an online survey after obtaining informed concent. Along with the EPDS, the following measures were administered to participants: The Multidimensional Scale of Perceived Social Support, the Fear of COVID-19 Scale, and the Lebanese Anxiety Scale-10.
Our findings demonstrated appropriate psychometric properties of the Arabic one-factor, 10-item EPDS in our sample of Lebanese women. The scale yielded good composite reliability (ω = 0.97), and appropriate patterns of correlations with anxiety and social support measures, thus attesting for its convergent validity. A total of 239 women (59.5%) had potential postpartum depression. Multivariate analysis showed that perceived childbirth experience (as "normal" (Beta= -2.57), "good" (Beta= -3.45) and "very good" (Beta= -4.14)), with worries that the newborn will get hurt/die during labor ("rarely" (Beta = 1.43) and "never" (Beta = 1.24)), a lower financial burden (Beta = - 0.19) and a higher social support (Beta = - 0.02) were significantly associated with lower rates of PPD; while higher levels of anxiety (Beta = 0.32) were associated with increased symptoms of PPD.
The study highlights the significant burden of PPD among Lebanese women, with an alarmingly high prevalence. Key factors associated with PPD-such as anxiety, childbirth experience, and social support-are largely preventable and modifiable. Nonetheless, there is an imperative need for future longitudinal and qualitative research, to better understand obstetrical experiences, address PPD and confirm causality of the associations found.
怀孕和分娩经历中的文化差异会影响产后抑郁症（PPD）的病因和促成因素。然而，阿拉伯国家在这一问题上的研究仍然很少，尤其是在黎巴嫩。本研究旨在评估新冠疫情期间黎巴嫩产后抑郁症的患病率，并探讨影响该病的社会背景因素。研究还试图验证爱丁堡产后抑郁量表（EPDS）阿拉伯语版本在黎巴嫩女性中的心理测量可靠性。
2022年5月至2022年7月进行了一项横断面研究，从黎巴嫩朱拜勒圣母救济医院产科病房招募了402名黎巴嫩成年产后女性（平均年龄31.46±4.88岁），她们在获得知情同意后通过在线调查做出回应。除了EPDS外，还对参与者进行了以下测量：多维感知社会支持量表、对新冠的恐惧量表和黎巴嫩焦虑量表-10。
我们的研究结果表明，阿拉伯语单因素10项EPDS在我们的黎巴嫩女性样本中具有适当的心理测量特性。该量表具有良好的综合信度（ω=0.97），与焦虑和社会支持测量的相关性模式适当，从而证明了其收敛效度。共有239名女性（59.5%）有潜在的产后抑郁症。多变量分析表明，感知的分娩经历（如“正常”（β=-2.57）、“良好”（β=-3.45）和“非常好”（β=-4.14）），担心新生儿在分娩期间受伤/死亡（“很少”（β=1.43）和“从不”（β=1.24）），较低的经济负担（β=-0.19）和较高的社会支持（β=-0.02）与较低的产后抑郁症发生率显著相关；而较高水平的焦虑（β=0.32）与产后抑郁症症状增加相关。
该研究强调了黎巴嫩女性产后抑郁症的重大负担，患病率高得惊人。与产后抑郁症相关的关键因素，如焦虑、分娩经历和社会支持，在很大程度上是可以预防和改变的。尽管如此，迫切需要未来进行纵向和定性研究，以更好地了解产科经历，解决产后抑郁症问题，并确认所发现关联的因果关系。
