Investigating the Correlation Between Postpartum Management Approaches and Postpartum Depression Symptoms

Abstract

Background: Postpartum depression is a leading public health issue of current international concern. With the change in the concept of postpartum health care, the adjustment of fertility policies, and government support, new postpartum management methods such as maternity matrons and postpartum management centers are becoming increasingly popular. Therefore, the aim of this study is to explore the correlation between postpartum management approaches and postpartum depression symptoms.

Methods: This study recruited 450 postpartum women who gave birth at the Yongkang Women and Children's Health Hospital, and their data were collected using a convenient sampling method. Out of the total, 150 women received care at the postpartum center of the Yongkang Women and Children's Health Hospital between June 2022 and February 2024 and were included in the postpartum management centers group, while the other 300 women underwent traditional postpartum care at home, with routine follow-up at the same hospital, and included in the traditional postpartum management group. General information and Edinburgh Postnatal Depression Scale (EPDS) scores were compared between the two groups at 42 days postpartum. Based on EPDS scores, study participants were divided into a postpartum depression symptom group (n = 92) and a non-postpartum depression symptom group (n = 358). Additionally, univariate and multivariate analyses were used to evaluate the factors influencing postpartum depression symptoms.

Results: There were significant differences in maternal education level, family income, and EPDS scores between the postpartum management centers group and the traditional postpartum management group (p < 0.05). Univariate analysis identified that family income (p < 0.001), employment status (p = 0.020), preterm birth (p = 0.042), adverse pregnancy history (p < 0.001), whether the newborn's gender meets the family expectation (p = 0.005), breast-feeding (p < 0.001), adverse postpartum life events (p < 0.001), and postpartum management (p < 0.001) were associated with postpartum depressive symptoms. Furthermore, lower family income [p = 0.013, Odds ratio (OR) = 2.256, 95% Confidence interval (CI) (1.187, 4.287)], adverse pregnancy history [p < 0.001, OR = 3.786, 95% CI (1.839, 7.796)], adverse postpartum life events [p < 0.001, OR = 11.743, 95% CI (3.669, 37.579)], and traditional postpartum management [p < 0.001, OR = 2.842, 95% CI (1.591, 5.075)] were found as risk factors for postpartum depression symptoms. Additionally, neonatal gender conformity with family's expectations [p = 0.010, OR = 0.442, 95% CI (0.239, 0.819)] and breast-feeding [p < 0.001, OR = 0.318, 95% CI (0.182, 0.555)] were found as protective factors against postpartum depressive symptoms.

Conclusion: Postpartum depression symptoms are affected by a variety of factors, such as family income, preterm birth, and adverse pregnancy history. Furthermore, postpartum management style is crucial, with women who undergo care in postpartum management centers experiencing a lower risk of postpartum depression symptoms.