Prevalence of Postpartum Depression at the Postnatal Clinic of Kenyatta National and Referal Hospital
Abstract
Background: The prevalence of stillbirths is 10% globally. In Africa it ranges from 4-20%. In Kenya, the goal of Every New-born Action Plan of 12 stillbirths per 1000 births was not met, with the incidence of stillbirth deliveries at Kenyatta National Hospital estimated to be 8.0%.However, whether stillbirth increases the odds of postpartum depression has not been studied.
Objective: To compare prevalence of postpartum depression among women who delivered a living healthy baby and a stillbirth at the postnatal clinic of the Kenyatta national Hospital.
Methodology: This was a comparative analytical cross-sectional study of 144 postpartum mothers who delivered a stillbirth at ≥28weeks gestation and another 144 postpartum mothers with healthy babies attending the postnatal clinic of Kenyatta National Hospital. Participants filleddemographic and reproductive data, Relationship Assessment Scale, Edinburgh Postnatal Depression Scale and Brief Grief questionnaires, after signing informed consent, data was uploaded intothe Statistical Package for Social Scientists software (SPSS, version 25)and demographic data of mothers who delivered a living healthy baby and a stillbirth compared using the Chi-square test. Chi-square test was also used to compare the prevalence of postpartum depression between women who delivered a stillbirth and a health live baby at 95% confidence interval.The Edinburgh Postnatal Depression scale was used to screen for depression and a cut off score of 14 and above was regarded as Probable Depression. A follow up assessment at 6 weeks postpartum was carried out.This study took place during the peak of the COVID 19 pandemic. As such, all participants and the study staff (research assistants) were required to fully comply with the COVID 19 safety measures.
Results: 288 participants were evaluated with a majority belonging to age group <35 years(78.8%), married (84.7%), unemployed (74.3%), and having secondary education (54.9%). Most were primiparous (45.0%) and had a wanted pregnancy (91.3%). Prevalence of post-partum depression was 28.8%, higher among women with a stillbirth (37.5%) compared to a livebirth (20.1%), OR=2.38 (1.40-4.07), P=0.001. Odds of depression was also higher among single women (OR=2.39 (1.25-4.72), P=0.008), unemployed (OR=2.03 (1.03-4.05), P=0.036), women with secondary education (OR=2.25 (1.23-4.19), P=0.007). Women with large babies (OR=14.63 (1.88-173), P=0.001), and unwanted pregnancies (OR=3.58 (1.57-7.81), P=0.001).
Conclusion: The prevalence of postpartum depression at KNH is high at 28.8%. Women who deliver a stillbirth compared to a livebirth are 2.38 times more likely to develop postpartum depression. Being single, poorly educated, having a low socioeconomic status, delivering a big baby, and having unwanted pregnancies are the main correlates for postpartum depression.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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