Obstetric and sociodemographic risk of vulnerability to postnatal depression

Objective: To assess the associated obstetric and sociodemographic risk of vulnerability to postnatal depression in a population-based study. Methods: All women presenting for postpartum care (n = 1656) were surveyed at pregnancy care units of southern-eastern Hungary between January 2004 and May 2006 with an anonymously completed Leverton questionnaire (LQ). The demographic characteristics, obstetric data and related variables were determined as potential correlates of vulnerability to postnatal depression. Significant predictive factors associated with vulnerability were analysed by means of linear correlation and multiple regression analysis. Results: The Leverton score significantly differed between primiparous and multiparous women [primiparous 11.3 +/- 7.0 (mean standard deviation) and multiparous women 12.1 +/- 7.1]. The univariate difference was not significant as regards previous infertility [infertility: 11.4 +/- 6.2 and no infertility: 11.7 +/- 7.2]. Vulnerability to depression was diagnosed in 892 (53.9%) of the postpartum women. The predictors of vulnerability to postnatal depression include an unwanted pregnancy (AOR: 5.6, 95% CI: 3.97-9.71) and an unfavourable pregnancy case history (AOR: 2.27, 95% CI: 2.912-5.76). The higher number of children represent significantly lower odds for postpartum vulnerability in the case of multiparous women (AOR: 0.11, 95% CI: 0.05-0.16). Conclusion: The risk of postnatal depression can be modified by the sociodemographic and obstetric history data. Practice implications: Our predictive data reflect that the LQ is useful screening method for postnatal vulnerability and determine the advisability of intervention/preventive therapy control the effects of the risk factors concerning vulnerability. (C) 2007 Elsevier Ireland Ltd. All rights reserved.