Comparison of Postnatal Depression and its Risk Factors in Females with Cesarean Section and Normal Vaginal Delivery

Abstract

Background: Postnatal depression (PND) because of its high prevalence rate, has become one of the most significant public health concern. After investigating the prevalence rates of postnatal depression in numerous countries including Pakistan, it is clearly evident that postnatal depression can have adverse outcomes in society if not detected and treated properly. Objectives: To compare postnatal depression in females with normal vaginal delivery and cesarean section; to find the associated risk factors of postnatal depression in females with normal vaginal delivery and cesarean section; and to check the reliability of EPDS. Methodology: This analytical cross-sectional study was conducted in Allied hospital and Children hospital Faisalabad during a period of 1-1-2019 to 30-06-2020. A nonprobability purposive sampling technique was used to enroll 284 women (142 in normal delivery group and 142 in cesarean section group). The Urdu version of Edinburgh Postnatal Depression Scale was used to measure postnatal depression. The reliability of EPDS was checked by Cronbach’s alpha coefficient. Results: According to cut-off score ≥13 on EPDS, 37.3% women were found depressed while 62.7% women were found non-depressed. The rate of postnatal depression was found as 28.9% among women who had normal vaginal delivery and 45.8% among women who had cesarean section. The odds of postnatal depression were 2.1 times higher in ‘cesarean section delivery’ compared to ‘normal vaginal delivery’ (OR: 2.1; C.I: 1.27 – 3.39). The women’s age, women’s education, education of head of family, monthly income of family, socio-economic class, mode of delivery, number of pregnancies, history of infant death, history of child death, history of miscarriage, number of living 13 13 children, parenting sense of competence and perceived social support from significant other, family and friends were significantly associated with postnatal depression (p<0.05). Conclusion: Postnatal depression is a serious public health concern in Pakistan and various socio-demographic, obstetric risk factors, parenting sense of competence and social support from significant other, family and friends are significant predictors of postnatal depression that must be addressed to ensure safe motherhood and healthy child development.