DEMOGRAPHIC AND PSYCHOSOCIAL FACTORS ASSOSIATED WITH POSTPARTUM DEPRESSION IN PRIMARY CARE FACILITIES

Abstract

The prevalence of postpartum depression (PDD) in Indonesia is higher (20-40%) compared to the prevalence in the world (13%). PPD is a public health problem that causes a variety of health risks, but it is often undetectable in postpartum mothers, especially in primary care facilities. The research aimed to analyze demographic and psychosocial factors associated with PPD in primary care facilities. This study used a cross-sectional design, that used 251 women giving birth in the delivery range between 2-8 weeks postpartum from six practicing midwife clinic partners in Bandar Lampung City. Data was collected from February to August 2023 using a purposive sampling technique. The instrument used to measure PPD was the EPDS (Edinburgh Postnatal Depression Scale) questionnaire. The demographic variables measured were age of childbearing, parity, ethnicity, education, and employment status, while psychosocial variables included length of marriage, economic status, history of depression, history of abortion, husband support, and family. The data analysis used chi square test and multiple logistic regression tests. The prevalence of PPD in Bandar Lampung City was 12%. The risk factor associated with PPD is a history of abortion which has a risk of 2.9 times (p: 0.019; 95%CI: 1.2-6.9) after being controlled by education, employment status, family income, and husband support. Independent variables that were not related to the incidence of PPD, were age of childbearing, ethnicity, parity, education, and length of marriage. There is a need for a holistic approach in primary care facilities by considering demographic and psychosocial factors in the initial screening of PPD. Intervention recommendations are aimed at improving the understanding of health workers about psychosocial risks so that they can improve the achievement of comprehensive screening and handling of mental health problems for postpartum mothers as well as more optimal preventive efforts at the primary service level.