Perinatal death triples the prevalence of postpartum depression among women in Northern Uganda: A community-based crosssectional study
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Plos one
Abstract
Deaths during the perinatal period remain a big challenge in Africa, with 38 deaths per 1000
pregnancies in Uganda. The consequences of these deaths can be detrimental to the
women; some ending up with postpartum depression. We examined the association
between perinatal death and postpartum depression among women in Lira district, Northern
Uganda.
Methods
We conducted a community-based cross-sectional study of 1,789 women. Trained research
assistants screened women for postpartum depressive symptoms on day 50 postpartum
using the Edinburgh postpartum depression scale (EPDS). Socio-demographic, economic,
birth and survival status of the neonate were collected during pregnancy and within one
week postpartum. We used generalized estimating equation for the Poisson family with a
log link using Stata to estimate the prevalence ratio of the association between postpartum
depressive symptoms (EPDS scores 14) and perinatal death. Mothers who lost their
babies between 7–49 days postpartum were excluded. Of the 1,789 participants symptomatically screened for postpartum depression, 377
(21.1%) [95% confidence interval (95%CI): 17.2%, 23.0%] had probable depressive symptoms.
The prevalence of postpartum depressive symptoms among the 77 women who had
experienced perinatal death (37 stillbirths and 40 early neonatal deaths (�7 days of life))
was 62.3% [95% CI: 50.8%, 72.6%] compared to 19.2% [95% CI: 17.4%, 21.2%], among
1,712 with live infants at day 50 postpartum. Women who had experienced a perinatal death
were three times as likely to have postpartum depressive symptoms as those who had a live
birth [adjusted prevalence ratio 3.45 (95% CI: 2.67, 4.48)].
Conclusions
The prevalence of postpartum depressive symptoms, assessed by EPDS, was high among
women who had had a perinatal death in Northern Uganda. Women experiencing a perinatal
death need to be screened for postpartum depressive symptoms in order to intervene and
reduce associated morbidity.
Description
Keywords
Perinatal death, Prevalence, Postpartum depression, Women
Citation
Arach AAO, Nakasujja N, Nankabirwa V, Ndeezi G, Kiguli J, Mukunya D, et al. (2020) Perinatal death triples the prevalence of postpartum depression among women in Northern Uganda: A community-based cross-sectional study. PLoS ONE 15(10): e0240409. https://doi. org/10.1371/journal.pone.0240409