Psychosocial factors associated to low, middle and high risk of depressive symptoms in the immediate

PALOLINI, C.; OIBERMAN, A.; BALZANO, S.

Cap Town

Congreso; World Association for Infant Mental Health 13th Biennial World Congress; 2012

World Association for Infant Mental Health

Introduction. The presence of depressive symptoms in the immediate postpartum period is associated with an increased risk of developing Postpartum Depression Syndrome. The early detection of women more prone to develop postpartum depression is one of the biggest challenges for research. Studies concerning specific features of women at risk of developing depressive symptoms during the immediate postpartum period, contribute to early detection and treatment. Objective. Evaluate psychosocial factors associated to the presence of depressive symptoms during the immediate postpartum period within three different groups: low, middle and high risk of developing depressive symptomatology. Population. Argentine puerperal women hospitalized in a public maternal hospital of the metropolitan region of Buenos Aires, Argentina were interviewed on the 1st and 3rd day postpartum 152 from March to December 2010. Materials and Methods. Aim to assess the presence of depressive symptoms during the immediate postpartum period the Edinburgh Postnatal Depression Scale (EPDS) was administrated. Based on the scores obtained in the EPDS, the sample was separated in three different groups: low, middle and high risk. Two cutoff points -9 and 19- were used (i.e. �� 8 was considered low risk, from 9 to 18 was considered middle risk, and �� 19 was considered high risk). The Perinatal Psychological Interview (Entrevista Psicologica Perinatal – EPP) was administrated to explore socio demographic, psychological, maternal, neonatal variables, life events during pregnancy and during the last years, physical and emotional problems during pregnancy, familial and partner support, history of depression and presence of depressive symptoms during pregnancy. In order to determine associations with EPDS scores, several statistical tests were applied according to the evaluated variable: chi square test or Fisher exact test was used for categorical variables, and ANOVA or median test, for continuous variables. Associations with a p value <0.05 were considered statistically significant. Results. The total sample is composed of 45 puerperal women. From the results obtained on the EPDS, 25 and 75 percentiles were established to obtain 2 cutoff scores. The sample was divided in three groups with increasing risk of depressive symptomatology. Cut-off scores were 9 and 19 points. Out of the total psychosocial variables analyzed, statistically significant differences were found among the three groups regarding family violence, migration, previous history of depression, presence of depressive symptoms during pregnancy and increasing number of life events. Number of life events, previous history of depression, and presence of depressive symptoms during pregnancy, showed a statistically significant trend toward increasing EPDS scores. Conclusions . The presence of depressive symptoms in the immediate postpartum period is associated with an increased risk of developing Postpartum Depression Syndrome. The setting of two cut-off scores in EPDS allows the early detection of women with depressive symptoms. Even more, the variables associated with the high-risk group in the present study have been previously reported as risk factors for Postpartum Depression, suggesting the usefulness of cut-off value of 19 for early detection of women at risk to developing postpartum depression.