Predictors of postpartum depression among new mothers in Kumasi, Ghana: A multicenter study using Bayesian analysis

Abstract

Background: Postpartum depression is a significant public health challenge. Understanding the predictors of postpartum depression can inform targeted interventions and support systems for new mothers.

Objectives: To identify and quantify sociodemographic and obstetric predictors of postpartum depression among mothers in Kumasi, Ghana.

Design: A cross-sectional multicenter prospective study.

Methods: A total of 502 postpartum mothers from five hospitals were included. Bayesian logistic regression analysis was used to assess model uncertainty and complex interactions between sociodemographic, economic, and obstetric factors on postpartum depression.

Results: The pooled prevalence of postpartum depression was 25% (range 13% to 31%). Education attainment [coefficient = -0.43, 95% credible interval: -0.57 to -0.29, (adjusted odds ratio (aOR) = 0.65] and economic support from multiple earning members (coefficient = -0.28, 95% credible interval: -0.33 to -0.22, aOR = 0.75) substantially reduced the likelihood of postpartum depression. Being a single mother (coefficient = 0.34, 95% credible interval: 0.24 to 0.44, aOR = 1.40) increased the risk of postpartum depression. Planned pregnancies (coefficient = -0.25, 95% credible interval: -0.28 to -0.21, aOR = 0.78), doing physical exercise (coefficient = -0.26, 95% credible interval: -0.30 to -0.23, aOR = 0.77), and exclusive breastfeeding (coefficient = -0.23, 95% credible interval: -0.28 to -0.19, aOR = 0.79) were protective factors for postpartum depression. On the other hand, cesarean sections (coefficient = 0.34, 95% credible interval: 0.24 to 0.43, aOR = 1.40) and spontaneous vaginal deliveries (coefficient = 0.56, 95% credible interval: 0.47 to 0.65, aOR = 1.75) increased the risk of postpartum depression.

Conclusion: Our findings emphasize the importance of identifying modifiable predictors of postpartum depression, including sociodemographic, economic, and obstetrical factors, in Kumasi, Ghana. Interventions addressing these factors, such as financial support programs, maternal education, and physician training, may significantly reduce the regional burden. Policies tailored to low-resource contexts and exhibiting local cultural sensitivity are needed for enhancing maternal-child health outcomes in Ghana and comparable regions.

Keywords: Ghana; economic support; education; postpartum depression; social support.

Figure 1.

PD and the ROPE for various socioeconomic characteristics. The light blue region indicates the ROPE range within which the effect size is considered practically equivalent to zero, meaning it has no meaningful impact. Proportions of samples inside the ROPE (−0.18 to 0.18). c/: compared to; CrI: credible interval; PD: probability of directions; ROPE: region of practical equivalence.

Figure 2.

Equivalence test for socioeconomic characteristics with 95% HDR of the posterior sample. H0: null hypothesis; c/: compared to; HDR: highest density region.

Figure 3.

PD and the ROPE for various obstetric characteristics. The light blue region indicates the ROPE range within which the effect size is considered practically equivalent to zero, meaning it has no meaningful impact. Proportions of samples inside the ROPE (−0.18 to 0.18). c/: compared to; CrI: credible interval; PD: probability of directions; ROPE: region of practical equivalence.

Figure 4.

Equivalence test for obstetric characteristics with 95% HDR of the posterior sample. H0: null hypothesis; HDR: highest density region; c/: compared to.