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Postpartum Depression in Young Mothers in Urban and Rural Indonesia

  • Alifa Syamantha Putri (Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency) ;
  • Tri Wurisastuti (Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency) ;
  • Indri Yunita Suryaputri (Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency) ;
  • Rofingatul Mubasyiroh (Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency)
  • Received : 2022.12.24
  • Accepted : 2023.04.20
  • Published : 2023.05.31

Abstract

Objectives: Young mothers are vulnerable to postpartum depression due to role transition-related stress. Understanding the causes underlying these stressors is essential for developing effective interventions. Methods: This study analyzed the 2018 Indonesian Basic Health Research data. The Mini International Neuropsychiatric Interview was used to assess postpartum depression symptoms in mothers aged 15-24 years with infants aged 0-6 months. In 1285 subjects, the risk factors for postpartum depression were evaluated using multivariate logistic regression. Results: The overall prevalence of depression in the 6 months postpartum was 4.0%, with a higher prevalence in urban areas (5.7%) than in rural areas (2.9%). Urban and rural young mothers showed distinct postpartum depression risk factors. In urban areas, living without a husband (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.24 to 11.76), experiencing preterm birth (OR, 4.67; 95% CI, 1.50 to 14.50), having pregnancy complications (OR, 3.03; 95% CI, 1.20 to 7.66), and having postpartum complications (OR, 5.23; 95% CI, 1.98 to 13.80) were associated with a higher risk of postpartum depression. In rural areas, postpartum depression was significantly associated with a smaller household size (OR, 3.22; 95% CI, 1.00 to 10.38), unwanted pregnancy (OR, 4.40; 95% CI, 1.15 to 16.86), and pregnancy complications (OR, 3.41; 95% CI, 1.31 to 8.88). Conclusions: In both urban and rural contexts, postpartum depression relates to the availability of others to accompany young mothers throughout the postpartum period and offer support with reproductive issues. Support from the family and the healthcare system is essential to young mothers' mental health. The healthcare system needs to involve families to support young mothers' mental health from pregnancy until the postpartum period.

Keywords

Acknowledgement

The authors would like to express their gratitude to the Head of the Health Policy and Development Agency of the Ministry of Health of the Republic of Indonesia for providing the dataset and allowing us to analyze, represent, and publish the results.

References

  1. Vigod SN, Villegas L, Dennis CL, Ross LE. Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: a systematic review. BJOG 2010;117(5):540-550. https://doi.org/10.1111/j.1471-0528.2009.02493.x
  2. O'Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol 2013;9:379-407. https://doi.org/10.1146/annurev-clinpsy-050212-185612
  3. Buttner MM, O'Hara MW, Watson D. The structure of women's mood in the early postpartum. Assessment 2012;19(2):247-256. https://doi.org/10.1177/1073191111429388
  4. Halbreich U, Karkun S. Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. J Affect Disord 2006;91(2-3):97-111. https://doi.org/10.1016/j.jad.2005.12.051
  5. Andajani-Sutjahjo S, Manderson L, Astbury J. Complex emotions, complex problems: understanding the experiences of perinatal depression among new mothers in urban Indonesia. Cult Med Psychiatry 2007;31(1):101-122. https://doi.org/10.1007/s11013-006-9040-0
  6. Idaiani S, Basuki B. Postpartum depression in Indonesian women: a national study. Health Sci Indones 2012;3(1):3-8.
  7. Kingston D, Heaman M, Fell D, Chalmers B; Maternity Experiences Study Group of the Canadian Perinatal Surveillance System, Public Health Agency of Canada. Comparison of adolescent, young adult, and adult women's maternity experiences and practices. Pediatrics 2012;129(5):e1228-e1237. https://doi.org/10.1542/peds.2011-1447
  8. Hudson DB, Elek SM, Campbell-Grossman C. Depression, selfesteem, loneliness, and social support among adolescent mothers participating in the new parents project. Adolescence 2000;35(139):445-453.
  9. Duko B, Wolde D, Alemayehu Y. The epidemiology of postnatal depression in Ethiopia: a systematic review and meta-analysis. Reprod Health 2020;17(1):180.
  10. Birkeland R, Thompson JK, Phares V. Adolescent motherhood and postpartum depression. J Clin Child Adolesc Psychol 2005;34(2):292-300. https://doi.org/10.1207/s15374424jccp3402_8
  11. Meltzer-Brody S, Bledsoe-Mansori SE, Johnson N, Killian C, Hamer RM, Jackson C, et al. A prospective study of perinatal depression and trauma history in pregnant minority adolescents. Am J Obstet Gynecol 2013;208(3):211.e1-211.e7. https://doi.org/10.1016/j.ajog.2012.12.020
  12. Dinwiddie KJ, Schillerstrom TL, Schillerstrom JE. Postpartum depression in adolescent mothers. J Psychosom Obstet Gynaecol 2018;39(3):168-175. https://doi.org/10.1080/0167482X.2017.1334051
  13. Indonesia Central Bureau of Statistics. Population by age groups and sex, 2022 [cited 2023 Apr 3]. Available from: https://www.bps.go.id/indikator/indikator/view_data_pub/0000/api_pub/ YW40a21pdTU1cnJxOGt6dm43ZEdoZz09/da_03/1 (Indonesian).
  14. Wurisastuti T, Mubasyiroh R. Prevalence and predictors of postpartum depression: 2018 RISKESDAS community data. In: Prosiding Seminar Nasional Kesehatan Masyarakat; 2020 Sep 20; Jakarta. 2020, p. 147-163 (Indonesian).
  15. Indonesia Ministry of Health. Public Health Program Action Plan 2020-2024 [cited 2023 Apr 3]. Available from: https://erenggar.kemkes.go.id/file2018/e-performance/1-465909-3tahunan-974.pdf (Indonesian).
  16. Cahyaningtyas AY. Determinants of postpartum depression in rural area, Central Java, Indonesia. J Health Sci Prev 2021;5(1):49-57. https://doi.org/10.29080/jhsp.v5i1.464
  17. Indonesian Ministry of Health. The 2018 Indonesia Basic Health Survey (Riskesdas): national report; 2019 [cited 2023 Apr 3]. Available from: https://labmandat.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf (Indonesian).
  18. Dany F, Dewi RM, Tjandrarini DH, Pradono J, Delima D, Sariadji K, et al. Urban-rural distinction of potential determinants for prediabetes in Indonesian population aged ≥15 years: a crosssectional analysis of Indonesian Basic Health Research 2018 among normoglycemic and prediabetic individuals. BMC Public Health 2020;20(1):1509.
  19. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59(Suppl 20):22-33.
  20. Idaiani S. Validity and reliability of depression, anxiety and psychosis questionnaire of Mini International Neuropsychiatric Interview (MINI) in Indonesia. ASEAN J Psychiatry 2020;21(1):1.
  21. Aoki A, Togoobaatar G, Tseveenjav A, Nyam N, Zuunnast K, Lkhagvasuren G, et al. Socioeconomic and lifestyle factors associated with mental health problems among Mongolian elementary school children. Soc Psychiatry Psychiatr Epidemiol 2022;57(4):791-803. https://doi.org/10.1007/s00127-021-02178-7
  22. Hipwell AE, Tung I, Krafty RT, Leong AW, Spada M, Vaccaro H, et al. A lifespan perspective on depression in the postpartum period in a racially and socioeconomically diverse sample of young mothers. Psychol Med 2022:1-9.
  23. Johnstone M, Mulherin K. From distress to flourishing: towards a strengths-based approach for young mothers. J Reprod Infant Psychol 2020;38(2):166-183. https://doi.org/10.1080/02646838.2019.1621277
  24. Wang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y, et al. Mapping global prevalence of depression among postpartum women. Transl Psychiatry 2021;11(1):543.
  25. Vigod SN, Tarasoff LA, Bryja B, Dennis CL, Yudin MH, Ross LE. Relation between place of residence and postpartum depression. CMAJ 2013;185(13):1129-1135. https://doi.org/10.1503/cmaj.122028
  26. Chaaya M, Campbell OM, El Kak F, Shaar D, Harb H, Kaddour A. Postpartum depression: prevalence and determinants in Lebanon. Arch Womens Ment Health 2002;5(2):65-72. https://doi.org/10.1007/s00737-002-0140-8
  27. Villegas L, McKay K, Dennis CL, Ross LE. Postpartum depression among rural women from developed and developing countries: a systematic review. J Rural Health 2011;27(3):278-288. https://doi.org/10.1111/j.1748-0361.2010.00339.x
  28. Amato PR. Urban-rural differences in helping friends and family members. Soc Psychol Q 1993;56(4):249-262. https://doi.org/10.2307/2786662
  29. Wang JL. Rural-urban differences in the prevalence of major depression and associated impairment. Soc Psychiatry Psychiatr Epidemiol 2004;39(1):19-25. https://doi.org/10.1007/s00127-004-0698-8
  30. Nunes AP, Phipps MG. Postpartum depression in adolescent and adult mothers: comparing prenatal risk factors and predictive models. Matern Child Health J 2013;17(6):1071-1079. https://doi.org/10.1007/s10995-012-1089-5
  31. Yim IS, Tanner Stapleton LR, Guardino CM, Hahn-Holbrook J, Dunkel Schetter C. Biological and psychosocial predictors of postpartum depression: systematic review and call for integration. Annu Rev Clin Psychol 2015;11:99-137. https://doi.org/10.1146/annurev-clinpsy-101414-020426
  32. Hanach N, Radwan H, Fakhry R, Dennis CL, Issa WB, Faris ME, et al. Prevalence and risk factors of postpartum depression among women living in the United Arab Emirates. Soc Psychiatry Psychiatr Epidemiol 2023;58(3):395-407. https://doi.org/10.1007/s00127-022-02372-1
  33. Chertok IR, McCrone S, Parker D, Leslie N. Review of interventions to reduce stress among mothers of infants in the NICU. Adv Neonatal Care 2014;14(1):30-37. https://doi.org/10.1097/ANC.0000000000000044
  34. Goutaudier N, Lopez A, Sejourne N, Denis A, Chabrol H. Premature birth: subjective and psychological experiences in the first weeks following childbirth, a mixed-methods study. J Reprod Infant Psychol 2011;29(4):364-373. https://doi.org/10.1080/02646838.2011.623227
  35. Blom EA, Jansen PW, Verhulst FC, Hofman A, Raat H, Jaddoe VW, et al. Perinatal complications increase the risk of postpartum depression. The generation R study. BJOG 2010;117(11):1390-1398. https://doi.org/10.1111/j.1471-0528.2010.02660.x
  36. Gaillard A, Le Strat Y, Mandelbrot L, Keita H, Dubertret C. Predictors of postpartum depression: prospective study of 264 women followed during pregnancy and postpartum. Psychiatry Res 2014;215(2):341-346. https://doi.org/10.1016/j.psychres.2013.10.003
  37. Qiu X, Zhang S, Sun X, Li H, Wang D. Unintended pregnancy and postpartum depression: a meta-analysis of cohort and case-control studies. J Psychosom Res 2020;138:110259.
  38. Faisal-Cury A, Menezes PR, Quayle J, Matijasevich A. Unplanned pregnancy and risk of maternal depression: secondary data analysis from a prospective pregnancy cohort. Psychol Health Med 2017;22(1):65-74. https://doi.org/10.1080/13548506.2016.1153678