Obstetric risk factors for postnatal depression in urban and rural community samples

Objective: The objective of this study was to examine obstetric risk factor s for postnatal depression in an urban and rural community sample, with con current consideration of personality, psychiatric history and recent life e vents. Methods: This was a prospective study with women planning to give birth in one of the four participating hospitals recruited antenatally. Obstetric in formation was obtained from the New South Wales Midwives Data Collection, c ompleted shortly after delivery. Personality, psychiatric history and life- events information were obtained from a questionnaire, administered within 1 week postpartum. Depression status was assessed at 8 weeks postpartum usi ng the Edinburgh Postnatal Depression Scale. Results: Complete data were obtained from 490 women. Several non-obstetric risk factors for the development of postnatal depression at 8 weeks postpar tum were reported including: sociodemographic (up to technical college leve l education, rented housing, receiving a pension/benefit), personality (tho se who described themselves as either nervy, shy/self-conscious, obsessiona l, angry or a worrier), psychiatric history (familial history of mental ill ness, personal history of depression or anxiety or a history of depression in the participant's mother) and recent life-events (major health problem, arguments with partner and friends/relatives). None of the obstetric variab les were significantly associated with increased risk for postnatal depress ion, but several showed marginally significant increases (multiparous women , antepartum haemorrhage, forceps and caesarean section deliveries). Conclusions: The results emphasize the importance of psychosocial risk fact ors for postnatal depression and suggest that most obstetric factors during pregnancy and birth do not significantly increase risk for this depression . Early identification of potential risk for postnatal depression should in clude assessment of sociodemography, personality, psychiatric history and r ecent life events, as well as past and present obstetric factors.