The factors effect on postpartum depression and relationship between postpartum depression symptom with breastfeeding

INTRODUCTION AND PURPOSE: Pregnancy and birth can be a major source of stress for women as well as being a usual situation. The next 6 months after birth is a high-risk period for depression. Postpartum depression (PPD) is a common and serious mental health problem and symptoms can be evaluated with self-report scales. While depression is already a disability disease, it is getting more important for the newborn mother. PPD is an important public health problem because it affects the health of both the mother and the baby. The purpose of this study is to determine the frequency of PPD symptoms in a district of Manisa and identifying the factors associate with the PPD symptom. The second purpose is to determine the relationship of PPD symptoms to breastfeeding. METHOD: The universe of this cross-sectional study was taken as the live-born women in Alaşehir District in Manisa in 2016. The smallest sample size was calculated as 345, assuming that the size of the universe will be similar to that of a year ago (n = 1464). From March to May 2016, postpartum 316 women of 4-12 weeks were reached, with a reach of 91.6%. Dependent variable of the first aim is symptom postpartum depression. It was eveluated with Edinburgh Postpartum Depression Scale (EPDS). The independent variables include socioeconomic, fertility and psycho-social factors. For the second aim, dependent variable breastfeeding status is the basic on independent variable PPD. Breastfeeding status was evaluated as exclusive breastfeeding and supplementation. Descriptive findings are presented in terms of number, percent, and mean or median. The relationship between dependent variables and independent variables was evaluated by chi-square, Fisher's Exact Test, Linear-by-Linear Association, t test, Mann Whitney U test and logistic regression analysis. Statistical significance level was accepted as p <0.05. RESULTS: Depressive symptom was detected in 24.7% of the participants. The risk of having PPD symptoms in women who are illiterate or primary school graduates compared to women who are high school graduates was significantly higher by 4.4 times. The risk of having PPD symptoms was 2.8 times more in the large family, 3.1 times more in women with a history of depression, 4.8 times more in women with a history of premenstrual syndrome, 2.8 times more women with fewer husband support, 9.4 times more in women with severe stress in their lives. There was no significant relationship between PPD and cessation of exclusively breastfeeding, initiation of supplementary food. CONCLUSION: The low level of education, living in large family, depression story, premenstrual syndrome story, less spouse support and serious stress in life increase the risk of PPD symptoms. It is important to take measures to address gender inequality by implementing policies that increase the level of education of women. There was no significant effect of PPD on giving up exclusive breastfeeding and starting supplementary food. It is recommended to conduct follow-up surveys in larger groups to evaluate the effects of PPD on breastfeeding. PPD evaluation is included in the postpartum care management guide in the primary health care. It is important that routine postpartum implementation of EPDS is followed. KEY WORDS: Postpartum depression, prevelance, risk factors, Edinburg Postpartum Depression Scale, breastfeeding