Postpartum depression in Northeastern China: a cross-sectional study six weeks after giving birth

XuDong Huang¹Lifeng Zhang²Chenyang Zhang¹Jing Li^1*Chenyang Li^1*

• ¹Shenyang Maternity and Child Health Hospital, Shenyang, Liaoning Province, China
• ²Shenyang Medical College, Shenyang, Liaoning Province, China

Postpartum depression (PPD) is a prevalent mental health issue that poses significant challenges to maternal well-being and infant development. We aimed to determine the prevalence of PPD and to investigate its associated determinants and predictors in in Shenyang, China. This cross-sectional study, conducted between January and December 2021, included 1,065 postpartum women in Shenyang, China, at six weeks postpartum. PPD was screened using the Edinburgh Postnatal Depression Scale (EPDS, score ≥ 9). Key risk factors were identified through machine learning techniques, including LASSO regression and the Boruta algorithm, and their associations were evaluated using logistic regression. A total of 1,065 postpartum mothers were included in this study, of whom 23.57% were identified as having postpartum depressive symptoms. Significant risk factors included prenatal anxiety (OR=7.16, 95% CI: 4.67-11.11), poor sleep quality (OR=5.30, 95% CI: 3.45-8.20), poor marital relationships (OR=4.41, 95% CI: 2.47-7.99), poor in-law relationships (OR=4.89, 95% CI: 3.11-7.74), unplanned pregnancy (OR=2.92, 95% CI: 2.01-4.27), and lack of prenatal education (OR=1.7, 95% CI: 1.15-2.52). A non-linear relationship was observed with gestational weight gain: gains <11 kg were associated with reduced risk (OR=0.91, 95% CI: 0.83-0.99), whereas gains >11 kg increased risk (OR=1.06, 95% CI: 1.02-1.10). Other factors included smoking history(OR=1.8, 95% CI: 1.08-2.98) and expected fetal sex (OR=3.39, 95% CI: 2.02-5.70). PPD affects a significant proportion of postpartum women in Shenyang, China. Routine screening and targeted interventions are essential to identify and support high-risk 2 individuals with PPD.