key: cord-0289615-a0kdwb9z
authors: Ngasa, S. N.; Dingana, T. N.; Ngasa, N. C.; Tchouda, L. A. S.; Abanda, C.; Niba, J.; Mbianyor, B. E.; Sanji, E. W.; Babila, C.-S.
title: Prevalence and factors associated with post-partum depression in a remote area of Cameroon: a cross-sectional study
date: 2022-04-17
journal: nan
DOI: 10.1101/2022.04.12.22273774
sha: b33860aa822af6302b60f2b6e3988b2af8e754b4
doc_id: 289615
cord_uid: a0kdwb9z

Postpartum depression is one of the many challenges associated with childbirth. In Cameroon, the focus is more on postpartum obstetric complications resulting in underdiagnosis and misdiagnosis of this condition. The current socio-political crisis plaguing the English-speaking part of Cameroon has increased the stressors that may inherently increase the prevalence. There is no published data describing post-partum depression in a rural setting in Cameroon. We seek to determine the prevalence and factors associated with PPD in women attending the Tubah District hospital, North West Region, Cameroon. We conducted a cross-sectional hospital-based study at the Tubah District Hospital. A consecutive convenience sampling technique was used to recruit participants. Our main outcome was post-partum depression which was assessed using the Edinburgh Post-partum Depression Scale. A total of 207 post-partum women took part in this study with a mean age of 27.54 {+/-} 5.78 years. The prevalence of depression was 31.8%. Gender-based violence (OR: 4.67, P = 0.013), financial stress (OR:3.57, P = 0.002) and male baby (OR: 2.83, P < 0.001) were independent psychosocial factors associated with PPD. Independent psycho-clinical factors of post-partum depression include family history of mental health illness (OR: 4.34, P = 0.04) and previous history of depression (OR: 4.17, P = 0.02). The prevalence of post-partum depression in women attending the Tubah District Hospital, Northwest Region, Cameroon is high. The factors associated with PPD are many. Identification of risk factors, early diagnosis and proper management can prevent PPD, disabling morbidity, and suicide in mothers.

Bringing a child into the world is the joy of most women. However, many challenges are 50 associated with childbirth some of which are not given appropriate attention. Amongst these is partner violence, history of psychiatric illness, low maternal literacy levels, stress, early life abuse, 65 anxiety, previous history of depression as predisposing factors [10, 11] . In Cameroon, 66 unemployment, unsatisfactory support of baby, marital issues, serious family problems, 67 unplanned pregnancy, problems with baby feeding and sleep were recorded as associated factors 68 [8, 9] . Long-term negative effects can occur if PPD goes untreated. Some examples include major 69 depression, cognitive, behavioural and physical effects which could reflect on the entire maternal 70 family, mother and child bonding as well as child growth and development [11, 12] . 71 In sub-Saharan Africa, the focus has been more on postpartum obstetric complications 72 and this has caused many cases of PPD to go undiagnosed and underreported, hence increasing 73 the probability of having long term complications. Despite the magnitude of PPD, very few 74 studies have been carried out in Cameroon. The previous studies in Cameroon were done in . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) given birth at the Tubah District Hospital. Women were recruited into the study 6 weeks after 89 delivery at the post-natal clinic. Eligible participants who provided consent were recruited in the 90 study. A structured questionnaire was administered to the participants by the duty midwives. 91 The midwives had received adequate training on how to administer the questionnaire. We pre-92 tested our questionnaire on a group of 20 women prior to data collection. These women were 93 excluded from the study. All poorly filled questionnaires were not included in the final analysis. . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted April 17, 2022. ; birth to live babies (94.20%) and chose exclusive breast feeding as the main mode of feeding 154 (80.68%). (Table 2) . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted April 17, 2022. ; https://doi.org/10.1101/2022.04.12.22273774 doi: medRxiv preprint 156 A total number of 123 participants reported never having any self-harm thoughts while 24 157 participants reported self-harm thoughts are sometimes common (Figure 1 ).

Prevalence of depression amongst participants 159 The prevalence of probable depression in participants was 31.8%. (Figure 2 ). (Table 2) 167 is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted April 17, 2022. ; https://doi.org/10.1101/2022.04.12.22273774 doi: medRxiv preprint post-partum depression include family history of mental health illness (OR: 4.34, P = 0.04) and 176 previous history of depression (OR: 4.17, P = 0.02). (Table 3) 177 is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted April 17, 2022. [15] . Thus, given the adverse long-term 190 outcomes of PPD on both mother and child, it raises a major concern and calls for therapeutic is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted April 17, 2022. ; https://doi.org/10.1101/2022.04.12.22273774 doi: medRxiv preprint this study was done in the North West region of Cameroon which has suffered socio-political 208 instability for over 5 years now. This has hindered access to healthcare by many and therefore 209 the prevalence obtained in our study might be an underestimate of the actual situation. Hence, 210 there is a need for more community-based studies in this era of socio-political instability to have 211 a better appraisal of this major postpartum complication. In addition to socio-political instability, 212 the ongoing Covid-19 pandemic might have also contributed to our higher rates of PPD, an with PPD were gender-based violence, financial stress and having a male baby. These findings 256 will be fundamental in designing antenatal and postnatal screening tools that will be used by 257 health care providers to screen for these psycho-clinical and social factors to prevent PPD, 258 disabling morbidity, and suicide in mothers.

. CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted April 17, 2022. ; https://doi.org/10.1101/2022.04.12.22273774 doi: medRxiv preprint

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 260 The authors declare no competing interest