The incidence of postpartum depression among mothers of newborns in the intensive care unit compared to mothers of normal births in Sana’a, Yemen: a prospective cohort study
ackground: Postpartum depression (PPD) is a major public health problem affecting women worldwide, with higher rates reported in low and middle income and conflict affected settings. Mothers whose newborns are admitted to the Neonatal Intensive Care Unit (NICU) may experience additional psychological stressors that increase their vulnerability to postpartum depression.
Objective: To estimate the incidence of postpartum depression and examine its association with NICU admission among postpartum mothers in Sana’a City, Yemen.
Methods: A prospective cohort study was conducted among 442 postpartum mothers recruited from four hospitals in Sana’a City. Participants were categorized into exposed (NICU admission) and non-exposed (non-NICU admission) groups and followed up for six weeks postpartum. Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff score of ≥ 13. Data were analyzed using chi-square tests and multivariate logistic regression.
Results: The overall incidence of postpartum depression at six weeks postpartum was 19.9%. The incidencewas higher among mothers exposed to NICU admission than among non-exposed mothers (24.0% vs. 15.8%). A statistically significant association was observed between NICU admission and postpartum depression (χ2 = 4.597, p = 0.032). After adjusting for potential confounders, NICU admission remained an independent predictor of postpartum depression (RR = 1.52; 95% CI: 1.05–2.22; p = 0.033). Recent painful life events were the strongest predictors (RR = 2.68; 95% CI: 2.05–3.55; p < 0.001). Other significant predictors included poor financial status (RR = 1.86) and higher child order (RR = 2.16). Husband support had a protective effect (RR = 0.54).
Conclusion: Neonatal intensive care unit (NICU) admission significantly increases the risk of postpartum depression in Yemeni mothers. The inclusion of early screening using a validated instrument such as the EPDS is highly warranted.
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