Postpartum Depression Risk in Mothers According to Infant Level of Care: A Cross-Sectional Study

Abstract

Postpartum depression is a common maternal mental health problem. This study aimed to compare postpartum depression risk among mothers of healthy infants, mothers of infants evaluated as outpatients, and mothers of hospitalized infants, and to identify factors independently associated with elevated risk. This cross-sectional study included 240 mothers of infants aged 1–3 months recruited from three clinical settings at a single children's hospital. Postpartum depression risk was assessed using the Edinburgh Postnatal Depression Scale (EPDS >12). Associated factors were evaluated using univariate and multivariable logistic regression analyses. A total of 120 mothers of healthy infants, 61 mothers of infants evaluated as outpatients, and 59 mothers of hospitalized infants were included. Overall, 30.4% of participants had elevated postpartum depression risk. The proportion with elevated risk differed significantly across the three groups (chi-square test, p=0.020): 44.1% among mothers of hospitalized infants, versus 28.3% among mothers of healthy infants and 21.3% among mothers of infants evaluated as outpatients. In multivariable analysis, infant hospitalization (adjusted OR=2.22, 95% CI 1.09–4.56), having more than three children (OR=5.27, 95% CI 2.02–14.54), lower self-reported marital satisfaction (OR=6.75, 95% CI 2.45–20.71), and smoking during pregnancy (OR=2.95, 95% CI 1.19–7.46) were independently associated with elevated risk. Infant hospitalization, lower self-reported marital satisfaction, having more than three children, and smoking during pregnancy were independently associated with elevated postpartum depression risk. Routine psychosocial assessment during postpartum follow-up may facilitate early identification of mothers requiring additional support.