Chulalongkorn Medical Journal


Background : There are evidences that postpartum depression (PPD) has major impacts on child-rearing capacities as well as disrupts mother-child bonding. Breastfeeding has been believed to have a role on increased positive mood, intensified bonding, and attenuated stress via the release of oxytocin, which has long been recognized as “love hormone”. However, the prevalence of PPD among breastfeeding women has not been studied. Objective : To examine the prevalence of postpartum depression as well as associated factors among nursing mothers at King Chulalongkorn Memorial Hospital. Design : A cross – sectional descriptive study. Setting : King Chulalongkorn Memorial Hospital. Materials and Methods : Data were collected from 313 nursing mothers who come for postpartum follow-up visits (4 - 6 weeks postpartum) at the Family Planning Clinic. Self-report questionnaires include the following: 1) general background questionnaire: 2) pregnancy, childbirth and infant care information: 3) sleep problems ininfants: 4) Edinburgh Postnatal Depression Scale (EPDS): 5) The Dyadic Adjustment Scale: 6) The Personal Resource Questionnaire (PRQ Part-II): and, 7) The Pittsburgh Sleep Quality Index (PSQI) were completed by all subjects. Univariate analysis (e.g. t-test, Chi-Square test) was used to examine associated factors with PPD and Multivariate Analysis was used to determine predictors of PPD among this group of women. Results : The prevalence of PPD among nursing mothers was 16.9%. Univariate analysis revealed 22 factors significantly associated with postpartum depression, namely : no marital ceremony, currently a student, history of lifetime depression, history of depression during pregnancy, history of premenstrual mood changes, history of caffeine use during pregnancy and postpartum period, history of alcohol use during postpartum period, unwanted pregnancy, third child, vacuum assisted delivery, delayed breastfeeding after delivery, short nipples, current sucking problem, wound pain and other disturbing symptoms in first week after delivery, others disturbing symptoms at present, combined breast milk and formula milk, had other person to take care of the baby at night, poor marital relationship, poor social support, and poor sleep quality. Multivariate analysis revealed only 7 factors significantly associated with postpartum depression, namely; history of lifetime depression, history of caffeine use during pregnancy, birth of the third child onward, assisted delivery, current baby’s sucking problem, had other person to care of the baby at night, and poor sleep quality. Conclusion : Prevalence of PPD in this study is comparable with other postpartum studies. Knowing the risk factors will help medical personnel in identifying high-risk women and provide appropriate assistance.



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