Prenatal and postnatal depression: prevalence, and risk factors among women seen at University Hospital Obstetrics in Damascus: a prospective cohort study, a call for early screening

Abstract

Abstract Background The perinatal period is an important and sensitive period for both mother and her newborn. Mental health is a significant component and can be marred by several issues, the most common of which are prenatal and postpartum depression. Screening for these disorders provides a golden opportunity to provide treatment and avoid risks to the mother and her child. Methods This a prospective cohort study was carried out at University Hospital Obstetrics in Damascus City, using convince sampling approach and conducted over two phases. The first phase was during the third trimester of pregnancy and the second phase involved a follow-up assessment after 6 weeks of delivery. Depression assessment was done using the Arabic-validated version of the Edinburgh Postnatal Depression Scale questionnaire (EPDS). A cutoff of 13 or higher was used to determine the presence of probable depression in both assessments. Results Of 347 pregnant women, 134 (38.6%) had a score EPDS > 13 testing positive for prenatal depression (PND). 295 patients have achieved the second assessment, of which 89 (30.2%) had a score EPDS > 13 testing positive for postpartum depression (PPD). Furthermore, 44 (42.5%) who had PND developed PPD after 6 weeks of delivery. Self-harm thoughts were more common during gestation (7.8% versus 2.3%). On multinomial regression, risk factors for PND were Non- Syrian nationality [AOR = 3.25, p- value = 0.01], the father is not alive [AOR = 2.71, P- value = 0.001], and positive history of depression independent of pregnancy [AOR = 4.68, p- value < 0.001]. while for PPD were history of PPD [AOR = 2.54, p- value = 0.01] and earlier positive prenatal depression [AOR = 2.74, p- value < 0.001]. Conclusion This study demonstrated high rates for both PND and PPD in Syrian settings. Depression rate was higher during the third trimester than after 6 weeks. This study highlights the importance of early screening for depression and applying more effective management strategies to obtain a healthy mother bond with her newborn and their well-being, especially in Syrian settings.