Maternal 3-Month Postpartum Physical Health Problems, Depression, and their Relations to the Mode of Delivery: A Cohort Study in Jeddah

Background: Postpartum physical and emotional health remains unaddressed by researchers, clinicians and women themselves. An important factor that affects postpartum recovery is the method of delivery. The objectives of this study were to estimate the incidence of postpartum physical health problems and depression in the first three months after delivery and to identify their relationship with mode of delivery along with other factors associated with the incidence of postpartum depression (PPD).
Methods: In this prospective cohort study, women were recruited from three public hospitals within 24-48 hours after delivery. Edinburgh postpartum depression scale (EPDS) and structured validated questionnaires were used. Follow-ups were conducted at 1-week and 3-months after delivery.
Results: The most prevalent 3-month physical health problems were insomnia (75%), fatigue (70%), and back pain (65%). There was a high incidence of nipple pain (73%) and vaginal itch (25%) in the spontaneous vaginal delivery (SVD) group during the immediate (1-week) postpartum period, whereas wound pain was
higher in the cesarean section (CS) group during the immediate (94%) and 3-month follow-up (55%) postpartum period. The incidence of 3-month PPD (EPDS>=12) was 28% in SVD group and 24% in CS group. There was no effect of the delivery mode on EPDS scores (p=0.59). Wanted pregnancy (OR=0.507), higher number of living children (OR=0.631), gravidity (OR=1.36), and income (OR= 0.536) were protective factors for immediate PPD.
Conclusions: Postpartum physical health problems and depression are common after delivery. Health care providers should be aware of these to perform early screening and interventions to alleviate them.