Postpartum depression symptoms among Amazonian and Northeast Brazilian women.

BACKGROUND: Studies analyzing the prevalence of postpartum depression in Brazil have recently increased. However, few studies have examined the Northeast region of Brazil, and no studies have investigated the Amazon region. Therefore, the aim of this study was to investigate postpartum depression in these two regions. METHODS: We administered the Edinburgh Postnatal Depression Scale to a total of 3060 women who used the Brazilian public health system and had given birth between one and three months prior to the interview. A cut-off score ≥11 was used to indicate symptoms of postpartum depression. After calculating the prevalence, univariate logistic regressions were performed separately for several possible risk factors (p<0.05). RESULTS: The overall rate of reported symptoms of postpartum depression was 19.5%. The prevalence in the northeast region and Amazon region were 19.0% and 20.3%, respectively (p=0.36). In the univariate logistic regression, low education level (<7 years: p<0.001; 8-10 years: p=0.003), ethnicity (Black: p=0.02; Pardo: p=0.02), few prenatal visits (1 or 2 visits: p=0.04), prenatal care self-assessed as "not very good" (p<0.001) and the prenatal care adequacy index of partially suitable (p=0.01) or not suitable (p<0.001) were identified as significant risk factors for postpartum depression symptoms. LIMITATIONS: Mothers who did not bring their children for immunization. The cross-sectional study does not allow for causality to be established. CONCLUSION: the prevalence rates of postpartum depression were similar to the rates observed for developing countries and higher than the rates observed in developed countries. Based on these findings, we recommend that screening and treatment of pregnant women should be considered a public health priority.

Antenatal depression: Prevalence and risk factor patterns across the gestational period.

BACKGROUND: The prevalence of antenatal depression (AD) among pregnant women varies according to the populations under study and the periods of evaluation. This paper investigated patterns of AD prevalence and risk factors in a Brazilian sample. METHODS: Using semi-structured interviews as well as the Edinburgh Postnatal Depression Scale, the Beck Depression Inventory, and the Mini-International Neuropsychiatric Interview-Plus (MINI), 148 pregnant women were assessed in their second and third trimesters. Bivariate and multivariate analyses were used to determine the prevalence of and the significant risk factors for AD across both trimesters (p<0.05). RESULTS: The prevalence of AD using the MINI was 13.5% and 10.1% in the second and third trimester, respectively. Prevalence rates using the symptom scales were even higher. In our bivariate analysis, lifetime major depression was the main AD risk factor (p<0.001), along with the number of sons (p=0.02) and intimate partner abuse (p=0.03). After adjustment for confounding factors, only lifetime major depression (p<0.001) and intimate partner abuse (p=0.02) remained as independent risk factors. There were no statistically significant differences in the AD prevalence rates and risk factors found when comparing across trimesters. LIMITATIONS: The study is limited by possible selection bias introduced by the method of recruitment and the number of women lost to follow up. CONCLUSION: AD prevalence rates found are close to the worldwide rates. Lifetime major depression was the main risk factor for AD in our study.