Diagnosis of postpartum depression and associated factors in South Africa: a cohort study of 47,697 women

作者：Chiara Gastaldon, Veronika Skrivankova, Georgios Schoretsanitis, Naomi Folb, Kimia Taghavi, Mary‐Ann Davies, Morna Cornell, Georgia Salanti, Cristina Mesa-Vieira, Mpho Tlali, Gary Maartens, Matthias Egger, Andreas D. Haas · 发表于：Epidemiology and Psychiatric Sciences · 年份：2025 · DOI：10.1017/s2045796025100103 · 被引用次数：2 · 研究领域：Maternal Mental Health During Pregnancy and Postpartum、Mental Health Treatment and Access、Family Caregiving in Mental Illness

AIMS: About one-third of South African women have clinically significant symptoms of postpartum depression (PPD). Several socio-demographic risk factors for PPD exist, but data on medical and obstetric risk factors remain scarce for low- and middle-income countries and particularly in sub-Saharan Africa. We aimed to estimate the proportion of women with PPD and investigate socio-demographic, medical and obstetric risk factors for PPD among women receiving private medical care in South Africa (SA). METHODS: In this longitudinal cohort study, we analysed reimbursement claims from beneficiaries of an SA medical insurance scheme who delivered a child between 2011 and 2020. PPD was defined as a new International Classification of Diseases, 10th Revision diagnosis of depression within 365 days postpartum. We estimated the frequency of women with a diagnosis of PPD. We explored several medical and obstetric risk factors for PPD, including pre-existing conditions, such as HIV and polycystic ovary syndrome, and conditions diagnosed during pregnancy and labour, such as gestational diabetes, pre-term delivery and postpartum haemorrhage. Using a multivariable modified Poisson model, we estimated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for factors associated with PPD. RESULTS: Of the 47,697 participants, 2,380 (5.0%) were diagnosed with PPD. The cumulative incidence of PPD increased from 0.8% (95% CI 0.7-0.9) at 6 weeks to 5.5% (5.3-5.7) at 12 months postpartum. PPD...