OBJECTIVE: This study compared the prevalence of PND and associated factors among women attending postnatal services facilities.
METHODS: The study setting included Tshwane Municipal district in Gauteng province (GP) and Fezile Dabi District (FS) in Free State province (FSP), South Africa.
METHODS: A total of 477 mothers within 12 weeks of giving birth were recruited by convenient sampling in health facilities. A self-developed questionnaire was used to obtain information on socio-demographics, obstetric history, and children\'s characteristics. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data on depression symptoms, with a score of ≥ 13 used as a cut-off for probable PND. Data were analysed using STATA 14. Multivariate logistic regression was used to determine association between probable PND and various covariates.
RESULTS: The overall mean age of women was 28 ± 6 years. The overall prevalence rate of PND was 22%, slightly higher in FS (23%) than in GP (21%). Most participants living in GP were married, had tertiary education, were employed and from the households with income of more than R8000.00. A chi-square test showed that planned pregnancy was significantly higher in GP compared with FS (p ≤ 0.001). Multivariate logistic regression showed that support from a partner or husband decreased the odds of a probable PND in GP (adjusted odd ratio [AOR] 0.37; 95% confidence interval [CI] [95%CI: 0.14-0.96; p = 0.041] and in the FS [AOR = 0.14, 95%CI: 0.05-0.40; p ≤ 0.001]). Significant associations of probable PND with several factors - planned pregnancy, baby age, support in difficult times, partner or husband drinking alcohol and stressful events - were more common in the FSP than in the GP.
CONCLUSIONS: The prevalence of probable PND and its associated risk factors in the GP and the FS indicates the need for routine screening and targeted interventions in both urban and rural settings.Contribution: The results confirm that the prevalence of PND is similar in both rural and urban areas, and that pregnancy planning remains a challenge in the FS, which calls for increased efforts to revive family planning programmes in primary health care facilities.
目的:本研究比较了产后服务设施妇女中PND的患病率和相关因素。
方法:研究设置包括豪登省的Tshwane市辖区(GP)和自由州的FezileDabi区(FS)(FSP),南非。
方法:通过方便的卫生机构抽样,共招募了477名分娩后12周内的母亲。使用自行开发的问卷来获取有关社会人口统计的信息,产科史,和孩子的特点。爱丁堡产后抑郁量表(EPDS)用于收集抑郁症状的数据,评分≥13作为可能的PND的截止值。使用STATA14分析数据。多变量逻辑回归用于确定可能的PND与各种协变量之间的关联。
结果:女性的总体平均年龄为28±6岁。PND的总体患病率为22%,FS(23%)略高于GP(21%)。大多数住在GP的参与者都结婚了,受过高等教育,受雇于收入超过8000.00卢比的家庭。卡方检验显示,与FS相比,GP的计划妊娠明显高于FS(p≤0.001)。多变量逻辑回归显示,伴侣或丈夫的支持降低了GP中可能发生PND的几率(调整后奇数比[AOR]0.37;95%置信区间[CI][95CI:0.14-0.96;p=0.041]和FS[AOR=0.14,95CI:0.05-0.40;p≤0.001])。可能的PND与几个因素显著相关-计划怀孕,婴儿年龄,在困难时期的支持,伴侣或丈夫饮酒和压力事件-在FSP中比在GP中更常见。
结论:GP和FS中可能PND的患病率及其相关危险因素表明在城市和农村地区都需要常规筛查和有针对性的干预措施。贡献:结果证实,PND的患病率在农村和城市地区相似,怀孕计划在FS中仍然是一个挑战,要求加大力度恢复初级保健设施的计划生育方案。