Incidence and predictors of postpartum depression among postpartum mothers in Kuala Lumpur, Malaysia: A cross-sectional study

Abstract

Postpartum depression (PPD) is one of the mental health complications that may arise following childbirth. This cross-sectional study explores the association between socioeconomic factors and PPD literacy with PPD incidence in 350 participants (mean age: 30.58±4.72 years) at one to six months postpartum, who attended the Kuala Lumpur Health Clinic from May to October 2020. PPD incidence and literacy were assessed using the validated Malay versions of the Edinburgh Postpartum Depression Scale (EPDS) and the Postpartum Depression Literacy Scale (PoDLiS), respectively. The participants’ socioeconomic characteristics were collected using a self-administered questionnaire. Chi-square tests were performed to determine the association between these factors and PPD incidence. Binary logistic regression models were used to determine the odds ratios (OR). The incidence of postpartum depressive symptoms was 14.29%. Those with low household income were twice likely to have PPD symptoms (OR:2.58, 95% CI:1.23–5.19; p = 0.01) than those with higher incomes. Unemployment (i.e., participants who were housewives/homemakers) was associated with higher PPD incidence (Χ2(2, 350) = 6.97, p = 0.03), but it was not a significant PPD predictor. In conclusion, PPD incidence in the sample of Kuala Lumpur postpartum mothers is significantly associated with low household income. Other socioeconomic characteristics, including PPD literacy, were not significant predictors of PPD incidence.

Cross-cultural adaptation and psychometric properties of the Chinese version of the postpartum depression literacy scale

“…Results of this study painted a preliminary picture of the level of PoDLi in perinatal women in China. The findings suggested that the PoDLi level (3.80 ± 0.38) among Chinese perinatal women was in the moderate range, which was very close to the findings in the Iran (3.79 ± 0.39) (Mirsalimi et al, 2020) and Malaysia (3.78 ± 0.37) (Hairol et al, 2021) samples, and a study in India (Poreddi et al, 2021) showed that only half of postpartum mothers had adequate levels of PoDLi. Consequently, there is an imperative need, both in China and many other developing countries, to sensitize perinatal women about PPD via various approaches such as presenting knowledge of PPD in community campaigns and pregnancy schools, thereby creating awareness of PPD and improving helpseeking behaviors.…”

“…It will be beneficial to conduct rasch analysis based on the non-parametric item response theory in future research, which allows conclusion to be drawn independently from the tested population (Nguyen et al, 2022), to provide additional important information on C-PoDLiS psychometric properties. Third, it is difficult for us to adequately compare our findings with the other relevant studies (Mirsalimi et al, 2020;Hairol et al, 2021;Poreddi et al, 2021) for the reason that, except for the study of developing the original version of PoDLiS (Mirsalimi et al, 2020), none of the others (Hairol et al, 2021;Poreddi et al, 2021) had performed formal evaluation of the psychometric properties of PoDLiS with Cronbach's α reported only. As such, future studies need to evaluate and report the psychometric properties of the PoDLiS formally, which can enable the comparison between different versions of the PoDLiS and promote the popularization of the scale internationally.…”

“…For reliability, the total Cronbach’s α was estimated to be 0.862 for excellent internal consistency, indicating that all items contribute to the global construct measured, which is far higher than the original version (Cronbach’s α 0.78) ( Mirsalimi et al, 2020 ) and the Malay version (Cronbach’s α 0.73) ( Hairol et al, 2021 ). When considering the factor structure, α values exceeding 0.7 were discovered for five factors, whereas factor 4 consisting of 2 items had a lower but acceptable Cronbach’s α (0.679).…”

“…Given the above situation, Mirsalimi et al (2020) initially developed the postpartum depression literacy scale (PoDLiS) in the guide of Jorm’s MHL framework for measuring perinatal women’s PoDLi levels. To date, PoDLiS has been adapted into the Malay version ( Hairol et al, 2021 ), applied in Iran ( Mirsalimi et al, 2020 ), India ( Poreddi et al, 2021 ), and Malaysia ( Hairol et al, 2021 ), and tested to be reliable and valid. But it is unclear whether PoDLiS is generalizable to other cultural contexts, as the existence and adaptation of one scale version does not guarantee measurement equivalence across other populations ( Canino and Alegría, 2008 ; Onchonga et al, 2021 ).…”

Experiences of women with psychological suffering in the puerperium: interpretations and meanings

“…To avoid and/or mitigate this, there is a need to strengthen the supportive bonds, restore sleep and rest, and provide psychotherapeutic treatment using a cognitivebehavioural approach [70]. No relationship was observed between the number of children, ethnicity, women's education, and puerperal depressive symptoms [71].…”