The prevalence of perinatal depression and its associated factors in two different settings in Brazil

Background: The prevalence of antepartum and postpartum depression (PPD) and its association with certain risk factors was evaluated. Method: The Edinburgh Postnatal Depression Scale (EPDS) was applied and sociodemographic data was obtained at the beginning of the third trimester of pregnancy and at 4-6 weeks postpartum. Results: The prevalence of depression was 24.3% during pregnancy (n=600 women) and 10.8% in the postpartum period (n = 555). The factors independently associated with antepartum depression were the absence of a partner (PRadj 1.93; 95%CI: 1.44-2.58), a lower socioeconomic class (1.75; 1.18-2.60), being non-white (1.48; 1.09-2.01) and multiparity (1.32; 1.01-1.74). For postpartum depression, the factors were the occurrence of psychological violence (PRadj 3.31; 95%CI: 2.02-5.43), use of alcohol during pregnancy (2.14; 1.33-3.45), being nonwhite (1.85; 1.11-3.08) and physical violence (2.14; 1.13-4.08). The sensitivity of depression during pregnancy as a predictor of PPD was 75%, while specificity was 81%. There were no differences between the two settings. Limitations: EDPS does not diagnose depression and as a screening instrument it could overestimate the true prevalence of depression. Conclusions: The use of the EPDS instrument during pregnancy would allow a screening for identifying women at higher risk of developing PPD and then a proposal of specific interventions to manage this condition. Postpartum depression was prevalent in around 10% of the women and was associated with unfavorable sociodemographic conditions including the use of alcohol and with the occurrence of psychological and physical violence. (C) 2011 Elsevier B.V. All rights reserved.