Sammendrag
Objectives: Maternal mental health is a neglected
issue in Sudanese healthcare. The aim of this study
was to explore the factors associated with postnatal
depression (PND) at 3 months postpartum in a sample
of Sudanese women in Khartoum state.
Setting: Recruitment was from two major public
antenatal care (ANC) clinics in two maternity teaching
hospitals in Khartoum state. The study participants
were recruited during their pregnancy and were
followed up and screened for PND at 3 months
postpartum using the Edinburgh Postnatal Depression
Scale (EPDS).
Participants: A sample of 300 pregnant Sudanese
women in their second or third trimester was included
in the study. The inclusion criteria were Sudanese
nationality, pregnancy in the second or third trimester
and satisfactory contact information.
Outcome measures: PND was assessed using the
EPDS at a cut-off score of ≥12. Maternal and
sociodemographic factors of interest were illustrated in
a directed acyclic graph (DAG) to identify which
variables to adjust for in multivariate analyses and to
show their type of effect on PND. A forward logistic
regression model was built to assess the factors that
are independently associated with PND.
Results: History of violence increased the odds of
PND sevenfold, OR=7.4 (95% CI 1.9 to 27.6). Older
age of mothers decreased the odds of PND by almost
20%, OR=0.82 (95% CI 0.73 to 0.92). Exclusive breast
feeding and regular prenatal vitamins during pregnancy
are associated with an 80% decrease in odds of PND,
OR=0.2 (95% CI 0.06 to 0.70) and 0.17 (95% CI 0.06
to 0.5), respectively.
Conclusions: Factors associated with PND in this
study are comparable to factors from other developing
countries, although findings should be judged with
caution owing to the high number of women who
refused recruitment into the study.
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