Identification Of Obstetric, Psychosocial Factors And Reproductive Hormones Changes On Post- Partum Depressive Symptoms

Objective: to identify the effects of demographic, obstetric, psychosocial risk factors and the effects of reproductive hormonal changes postnataly on postpartum depressive symptoms. Design: A prospective study based on questionnaires including special forma answered by the participants and scored according to the Edinburgh Postnatal Depression Scale (EPDS) and estimation of hormonal levels {Estrogen, Progesterone, testosterone} postnataly. Setting: AL-ZAHRA'A Maternity and Pediatric teaching hospital in AL-NAJAF city. Participants: one – hundred i-one woman who attended to the post natal and neonatal unit, during the study period from to April to October 2011. Intervention: women with high scores (13 or more) by EPDS, were advised to be seen by a psychiatrist. Main outcome measures: postpartum psychiatric symptom were assessed 2-8 weeks after delivery with the Edinburgh Postnatal Depression Scale {EPDS}, a widely used Scale, it assess symptoms of postpartum depression in the previous week; and comprises ten statements, each with four possible answers on a Scale ranging from 'no, not at all'(0) to 'yes, quite often' [6]. The EPDS sum score ranges from 0 to 30, with higher score indicating more depressive symptoms. We classified woman with a score of more than 12 as having postpartum depression. Previous researches indicated that this cut-off score has a sensitivity of over 80% and a specificity of 95% for identifying woman with clinically diagnosed postpartum depression in a community sample. [13] Results: form the one hundred one woman who assessed by the questionnaire, 24 had high score (13 or more), 36 had medium score (between 9 to 12) and 41 had low score (less than 9) according to EPDS. So, we consider the group of patients with high score as having depressive symptoms while patients with medium score and low score considered as a non-depressed. High score were found to be associated with: Presence of obstetrical complication, condition of the baby, postnatal stay, social factors (relation with husband and support at home), psychological history. Patients with depressive symptoms show lower values of reproductive hormones in comparism with the other group, but these differences are not significant statistically. Aim of study:-Study the effects of obstetrical, psychosocial factors and the relation between reproductive hormonal changes after delivery, with the post-partum depressive symptoms.