Postpartum depression and health-related quality of life: a Saudi Arabian perspective

The Prevalence and Risk Factors of Postpartum Depression among Mothers in Najran City, Saudi Arabia

BACKGROUND

Postpartum depression (PPD) is a significant mental health concern affecting mothers globally. However, research on PPD prevalence and risk factors in Najran City, Saudi Arabia, is limited.

STUDY AIM

this cross-sectional study aimed to determine the prevalence and risk factors associated with PPD among mothers in Najran City.

METHODOLOGY

A questionnaire-based study was conducted from September 2023 to January 2024, involving 420 mothers aged 16-50 years with newborns (2-10 weeks after delivery). The questionnaire included demographic information and the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS). Statistical analysis utilized SPSS software v. 26, including descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H test, and logistic regression.

RESULTS

The majority of participants were aged 20-35 years (61.4%), Saudi nationals (87.6%), and had university education (51.4%). EPDS scores indicated that 66.7% of mothers screened positive for possible depression. Significant associations were found between higher EPDS scores and factors such as unemployment (p = 0.004), younger age (p = 0.003), caesarean delivery (p = 0.043), mental illness (p = 0.0001), lack of adequate family support (p = 0.0001), and higher stress levels (p = 0.0001).

CONCLUSION

The study revealed a high prevalence of PPD among mothers in Najran City, with sociodemographic, obstetric, and psychosocial factors significantly influencing PPD risk. These findings emphasize the need for targeted interventions and support systems to address maternal mental health needs effectively.

Health-related quality of life of postpartum women and associated factors in Dendi district, West Shoa Zone, Oromia Region, Ethiopia: a community-based cross-sectional study

BACKGROUND

Promoting a favorable experience of postpartum care has become increasingly emphasized over recent years. Despite the fact that maternal health care services have improved over the years, postnatal care service utilization is generally low and the health-related quality of life of postpartum women remains overlooked. Furthermore, the health-related quality of life of postpartum women is not well studied. Therefore, this study aimed to assess the health-related quality of life of postpartum women and associated factors in Dendi district, West Shoa Zone, Oromia, Region, Ethiopia.

METHODS

A community-based cross-sectional study was conducted among 429 participants. A multistage stratified sampling procedure was used to select the sampling unit and simple random sampling technique was employed to select the study participants from 23 August 2022 to 16 November 2022. A pre-tested standard structured questionnaire was used to collect the data. Data were entered using Epi-Data 3.1 and then exported to Statistical package for social science version 26. Binary logistic regression analysis was computed at p-value < 0.25 were considered candidates for multivariable logistic regression. Adjusted Odds Ratios (AOR) with 95% confidence interval and statistical significance was declared at a p-value < 0.05.

RESULTS

The study revealed that 73.7% (95% CI: 69.4-77.7) had a low level of health-related quality-of-life with a mean of 44.02 (SD ± 10.4). Urban residing [AOR = 0.27, 95% CI: (0.10-0.74)], no education [AOR = 3.44, 95% CI (1.35-8.74)], received at least four antenatal contact [AOR = 0.56, 95% CI (0.33-0.95)], received at least one postnatal care [AOR = 0.30, 95% CI (0.14-0.62)], poor social support [AOR = 2.23, 95% CI: (1.025-4.893)], having postpartum depression [AOR = 2.99, 95% CI: (1.52-5.56)], cesarean delivery [AOR = 3.18, 95% CI: (1.09-9.26)], and lowest household assets [AOR = 5.68, 95% CI: (2.74-11.76)] were significant associations with low health-related quality of life of postpartum women.

CONCLUSIONS

The health-related quality of life among postpartum women was very low. Postpartum women with low socio-economic status and inadequate maternal health service utilization had a low health-related quality of life. Promoting women's education and postnatal care services is needed to improve the health-related quality of life of postpartum women.

Validity and reliability of the Arabic version of the population postpartum depression literacy scale (PoDLiS): a web-based survey in Saudi Arabia

BACKGROUND

Proper knowledge about postpartum depression (PPD) will help recognize symptoms and encourage women to seek the needed professional help. Until now, there has been a scarcity of research on the literacy level of PPD among the Saudi population and the factors affecting it. This study translated the Postpartum Depression Literacy Scale (PoDLiS) into Arabic and evaluated its psychometric properties. Furthermore, the Saudi population's mental health literacy for PPD and the factors associated with it were examined as a secondary objective.

METHODS

This cross-sectional study involved 2,336 participants selected via convenience sampling from all over Saudi Arabia, all of whom willingly agreed to participate. Data collection was done through an online questionnaire using Google Forms, covering sociodemographic characteristics and the Arabic PoDLiS.

RESULTS

The Arabic version of PoDLiS showed acceptable goodness-of-fit between the observed data and the resulting six-factor solution, RMSEA = 0.049, 90% confidence interval RMSEA (0.010-0.050), pCLOSE = 0.742, CFI = 0.962, TLI = 0.940, χ2(270) = 1576.12, p-value = 0.742. The total Cronbach's alpha (α) of the PoDLiS showed acceptable internal consistency, measuring at 0.742. High literacy was seen in married and young participants with a postgraduate degree and sufficient household income who have known someone with PPD. Significantly lower literacy was seen in male, non-Saudi participants and those residing in the central and northern regions of Saudi Arabia.

CONCLUSIONS

The Arabic version of the PoDLiS showed good psychometric properties, and it can be used to assess PPD literacy among perinatal women and to examine the impact of PPD awareness programs. Despite reporting relatively good PPD literacy in the Saudi population, there is a persistent gap in participants' beliefs about available professional help and the attitudes that facilitate recognizing PPD. Our findings highlight the importance of implementing public education campaigns to improve overall knowledge about PPD and promote prevention, early recognition, and treatment of PPD.

Coping strategies in postpartum women: exploring the influence of demographic and maternity factors

BACKGROUND

Postpartum depression is a frequent mental health issue that affects many women due to this stressful phase. The aim of the study is to gain insight into the coping strategies employed by postpartum women and to explore how these strategies are influenced by various demographic and maternity factors.

METHODS

The study adopted a quantitative, cross-sectional design. Data were collected from 239 postpartum women receiving care at a Gynecology and Obstetrics Clinic using self-reported tools, which include the Brief COPE survey and the socio-demographics and obstetric/maternal history form from October 2022 to April 2023.

RESULTS

The study findings indicate that individuals aged over 40 tend to use more emotional-focused coping compared to those aged 21-30 (p = 0.002) and 31-40. Additionally, both genders of children were associated with more emotional-focused coping (p = 0.007) compared to only having boys. Cesarean section delivery (p = 0.001) was associated with more avoidant-focused coping than normal vaginal delivery. Avoidant-focused coping was significantly predicted by problem-focused coping (p < 0.001), emotional-focused coping (p = 0.034), age (p = 0.003), and gender of children (only boys, p < 0.001; both boys and girls, p = 0.019). Furthermore, problem-focused coping was significantly predicted by age (p = 0.004), gender of children (male child, p = 0.002; both boy and girl: p = 0.014), and avoidant-focused coping (p < 0.001).

CONCLUSIONS

The study examined how postpartum women cope with the challenges of motherhood and how this relates to their demographic and maternity factors. The results suggest that healthcare professionals should promote effective coping strategies and discourage avoidance-oriented approaches in postpartum interventions.

Validation of the Arabic Maternal postpartum quality of life questionnaire among Lebanese women: A cohort study

BACKGROUND

The postpartum period is an important phase in a woman's life. Yet, there is a paucity of validated instruments that assess maternal postpartum quality of life issues. The aim of this study is to describe the adaptation and validation of the Arabic version of the Maternal Postpartum Quality of Life (MAPP-QOL) questionnaire.

METHODS

This instrument validation cohort study tested an adapted Arabic version of the MAPP-QOL questionnaire on a convenience sample of 485 healthy Lebanese postpartum women. The MAPP-QOL reliability and validity were investigated by conducting Exploratory Factor Analysis using Principal Component Analysis, and by correlating the participants' MAPP-QOL scores with their scores on the Arabic Maternal Breastfeeding Evaluation Scale (MBFES-A), age, and education. Confirmatory Factor Analysis was conducted to examine how well the original factor structure of MAPP-QOL fits with our observed data using STATA 14. All other statistical analyses were done using SPSS version 23.

RESULTS

The Cronbach's alpha reliability coefficient of the Arabic MAPP-QOL was 0.90. Exploratory factor analysis revealed the following five components: Functioning (11 items, Cronbach's alpha of 0.82), Socioeconomic (9 items, Cronbach's alpha of 0.81), Relational (9 items, Cronbach's alpha of 0.75), Psychological (4 items, Cronbach's alpha of 0.74), and Health (6 items, Cronbach's alpha of 0.59). The overall Arabic MAPP-QOL score was positively but weakly correlated with the MBFES-A score (r = 0.177, p < 0.001), its Maternal Enjoyment/Role Attainment subscale score (r = 0.108, p = 0.023), and Lifestyle/Body Image subscale score (r = 0.286, p < 0.001). There was no significant association between the type of infant feeding at one month and the Arabic MAPP-QOL score (p = 0.932). Similarly, the Arabic MAPP-QOL score was not correlated with the participant's age (r = 0.043, p = 0.362) or education (p = 0.451). After modification of indices, Confirmatory Factor Analysis revealed that the goodness of fit indices corresponding to the 5-factor model in the original questionnaire indicate a reasonable fit with RMSEA = 0.052, CFI = 0.847 and SRMR = 0.062.

CONCLUSIONS

The Arabic MAPP-QOL has good psychometric properties and may be a useful tool for clinicians and researchers interested in measuring maternal postpartum quality of life. Further replication of our findings in other Arab contexts is needed.