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. 2025 Aug 6.
doi: 10.1007/s00127-025-02982-5. Online ahead of print.

Prevalence, risk and protective factors of postpartum depression and anxiety symptoms in the Allada district, Benin

Maram Youshaa  1 , Judith van der Waerden  2 , Roméo Zoumenou  3   4 , Achille Massougbodji  3 , Michael J Boivin  5   6 , Florence Bodeau-Livinec  7   4 , Ketevan Marr  1
Affiliations

Prevalence, risk and protective factors of postpartum depression and anxiety symptoms in the Allada district, Benin

Maram Youshaa et al. Soc Psychiatry Psychiatr Epidemiol. .

Abstract

Purpose: Postpartum depression symptoms (PPDS) and postpartum anxiety symptoms (PPAS) are a major global public health issue, especially in low-resource settings. This study aimed to determine the prevalence of PPDS and PPAS in Benin, Sub-Saharan Africa, at one year postpartum and to identify associated risk and protective factors.

Methods: Pregnant women were recruited for a longitudinal mother-child cohort in the Allada District of Benin, and a cross-sectional analysis was performed on data collected at one-year postpartum. Maternal depression and anxiety symptoms were assessed one year postpartum using the Edinburgh Postnatal Depression Scale (EPDS)-validated in Benin and translated into Fon-and its anxiety subscale (EPDS-3 A). Cut-off scores for high depressive and anxiety symptoms were ≥ 13 and ≥ 6, respectively. Potential risk and protective factors including maternal, child characteristics, socioeconomic status, and social support were analyzed using multivariable-adjusted logistic regression models.

Results: At one year postpartum, 13% of 742 mothers had PPDS, and 21% PPAS. Risk factors for PPDS included recent alcohol consumption (previous three months) (aOR = 1.88; 95%CI: 1.17-3.02) and food insecurity (aOR = 4.47; 95%CI: 1.29-17.4), while partner cohabitation reduced PPDS odds (aOR = 0.45; 95%CI: 0.26-0.80). PPAS risk factors included recent alcohol consumption (aOR = 2.17; 95%CI: 1.44-3.28) and regular child care support from 3 + childcare providers (aOR = 2.91; 95%CI: 1.50-5.68). Protective factors for PPAS included the minority Aizo ethnicity (aOR = 0.58; 95%CI: 0.36-0.93) and living in an individual house (aOR = 0.45; 95%CI: 0.24-0.85).

Conclusion: This study sheds light on the prevalence of PPDS and PPAS at one year postpartum in the Beninese context, as well as associated factors. Findings underscore the importance of establishing postpartum psychological follow-up and targeted strategies to support maternal mental health in low-resource settings, addressing both socioeconomic vulnerabilities and social support structures.

Keywords: Benin; Maternal mental health; Postpartum anxiety symptoms; Postpartum depression symptoms; Protective factors; Risk factors.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical approval: The MiPPAD study protocol and informed consent forms received approval from the Ethics Committee of the Faculty of Medicine of Cotonou, Benin, the Ethics Committee of the Hospital Clinic of Barcelona (Spain), the Comité Consultatif de Déontologie et d’Éthique of the Institut de Recherche pour le Développement (France), as well as all national ethics review committees and local regulatory bodies in each of the each malaria endemic countries participating in the study (Benin, Gabon, Mozambique, and Tanzania). In addition, the subsequent follow-up study received approval from the institutional review boards of both the University of Abomey-Calavi in Benin and New York University in the United States (IRB#09-1253). The trial was conducted under the provisions of the Declaration of Helsinki and in accordance with Good Clinical Practices guidelines set up by the WHO and by the International Conference on Harmonization. An independent Data Safety Monitoring Board (DSMB) was created prior to the beginning of the trial and regularly reviewed and monitored the safety data collected. The trial was registered prior to the enrollment of the first participant in both the ClinicalTrials.gov (NCT0081121) and in the Pan African Clinical Trials (PACTR2010020001429343) registries. Consent to participate: Prior to each data collection wave, the study was explained in the local language to the participant and informed written consent was obtained. In cases where the participant could not read, an impartial person who was not involved in the study served as witness and observed the participant giving their thumbprint on the informed consent paperwork. Where applicable, consent was obtained from the parents or legal guardians of minors. Women were free to interrupt their participation at any time during the study.

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