DEMOGRAPHIC AND OBSTETRIC RISK-FACTORS FOR POSTNATAL PSYCHIATRIC MORBIDITY

Background. Postnatal depression follows 10% of live births but there is little consensus on the risk factors associated with its developmen t. Previous smaller studies have been unable to quantify the impact of independent risk factors as relative and attributable risks. Method. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen a s ystematic sample of 2375 women, six to eight weeks after delivery. Inf ormation on socio-demographic and obstetric variables was collected at the screening interview. The risk factors associated with high EPDS s cores (>12) were determined and entered stepwise into a regression mod el. Results. Four independent variables were found to be associated wi th an EPDS score above this threshold. These were an unplanned pregnan cy (OR 1.44); not breast-feeding (OR 1.52), and unemployment in either the mother, i.e. no job to return to following maternity leave (OR 1. 56), or the head of household (OR 1.50). These four variables appeared to explain the risk associated with other risk factors. Conclusions. Although a direct aetiological role for these risk factors is not cert ain, they may indicate strategies for the prevention of affective morb idity in postnatal women. These may include reducing unwanted pregnanc y and employment for women after childbirth.