Postpartum Depression and Anxiety among Lebanese Women: Correlates and Scales Psychometric Properties

Background: We found that it was important to fill a gap in the literature and check the psychometric properties of the Edinburgh Postnatal Depression Scale (EPDS) and Perinatal Anxiety Screening Scale (PASS) in the Arabic language and delineate factors associated with postnatal depression (PPD) and anxiety (PPA) among Lebanese women 4-6 weeks after delivery. Methods: This cross-sectional study carried out between July 2018 and March 2019 enrolled 295 participants who came for a postnatal checkup at four clinics. Results: The EPDS and PASS scales' items converged over two- and four-factor solutions, explaining 62.51% and 53.33% of the variance, respectively (KMO EPDS = 0.816, alpha Cronbach EPDS = 0.826; KMO PASS = 0.878, alpha Cronbach PASS = 0.920; Bartlett's test of sphericity p < 0.001). Higher postpartum anxiety (Beta = 0.256), higher postpartum insomnia (Beta = 0.079), having hypotension during pregnancy (Beta = 2.760), and having a second (Beta = 1.663) or a third baby or more (Beta = 2.470) compared with the first one were significantly associated with higher postpartum depression. Higher postpartum depression (Beta = 1.33) was significantly associated with higher postpartum anxiety, whereas having a baby through a planned pregnancy (Beta = -4.365) and having a baby who ate regularly (Beta = -3.639) were significantly associated with lower postpartum anxiety. Conclusion: Depression and anxiety prevalence rates in the Lebanese population were higher compared with other countries, which may be due in part to the differences in regional, social and environmental culture.

Automated summary

It is important to assess the psychometric properties of depression and anxiety scales in Arabic and identify factors associated with postnatal depression (PPD) and anxiety (PPA) among Lebanese women. In this cross-sectional study, the EPDS and PASS scales showed good convergent validity and explained a significant amount of variance. Higher postpartum anxiety, insomnia, hypotension during pregnancy, and higher birth order were significantly associated with higher postpartum depression. Higher postpartum depression was significantly associated with higher postpartum anxiety, while planned pregnancy and regular infant feeding were associated with lower postpartum anxiety.