Research in Psychology and Behavioral Sciences
ISSN (Print): 2333-4371 ISSN (Online): 2333-438X Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
Research in Psychology and Behavioral Sciences. 2020, 8(1), 18-24
DOI: 10.12691/rpbs-8-1-3
Open AccessArticle

Prevalence and Factors Associated with Postpartum Depression among Women Attending Primary Health Care Centers in Al-Madina, Saudi Arabia

Yasmeen Talal Aljehani1, Mariam Eid Alanzi2, Suzan Talal Aljehani3, Khalid Saad Alghamdi4, Naser Awadh ALHarthi5, Abdulraheem Alshareef6, Hanan Yousef Ali7 and Salah Mohamed El Sayed8, 9,

1Director of the Research and Studies Department of Health Affairs in AL-Medina Region, Consultant of Family Medicine & Director Trainer at Unit of Joint Post-graduate Family Medicine Program

2Diabetic Center in King Fahd Hospital & Sayed Al-Shohada Primary Health Care Center, Al-Madinah Al-Munawwarah, Saudi Arabia

3Director of the Infection Control Department, Al Amal Hospital, Directorate of Health, Al-Madinah Al-Munawara, Saudi Arabia

4Consultant Family and Community Medicin, Senior Trainer at the Joint Program for Postgraduate Studies of Family Medicine, Al-Madina, Saudi Arabia

5Health Affairs for Patients’ Services, Directorate of Health, Al-Madina Al-Munawara, Saudi Arabia

6Medical Laboratories Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia

7Lecturer of psychiatry, Department of neuropsychiatry, Sohag Faculty of medicine, Sohag University, Egypt

8Prophetic Medicine Course and Research, Taibah College of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia

9Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Egypt

Pub. Date: October 20, 2020

Cite this paper:
Yasmeen Talal Aljehani, Mariam Eid Alanzi, Suzan Talal Aljehani, Khalid Saad Alghamdi, Naser Awadh ALHarthi, Abdulraheem Alshareef, Hanan Yousef Ali and Salah Mohamed El Sayed. Prevalence and Factors Associated with Postpartum Depression among Women Attending Primary Health Care Centers in Al-Madina, Saudi Arabia. Research in Psychology and Behavioral Sciences. 2020; 8(1):18-24. doi: 10.12691/rpbs-8-1-3


Clinical picture and triggering factors for postpartum depression (PPD, postnatal depression) may vary across culturally diverse women with different causes e.g. lack of breast-feeding and consanguinity. The reported incidence of PPD among samples of Arabic women ranges from 10% to 37%. In this study, we investigated a sample of mothers (n=216) attending the primary health care centers in Al-Madina, Saudi Arabia. Data acquisition was done via a cross-sectional design. Ethical committee approval was taken and participation in the study was optional. Herein, we report that PPD prevalence in this sample was 19.4% using the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) with a cut-off score of ≥ 12. Our study included mothers of different age groups: <20 years, 20-30 years, 30-40 years and >40 years. Majority of investigated women were in the age group 20-30 years (60.2%, n= 130). Predictors of PPD were related to parity and gravidity. Primiparous women were at almost double-folded risk of getting PPD compared to multiparous women (adjusted OR=1.91; 95% CI: 1.01-3.38). Women who delivered by normal vaginal method were more likely to have PPD compared to those delivered by cesarean section (Adjusted OR=3.11; 95% CI: 1.35-7.16). However, PPD was not significantly associated with the presence of mothers of delivering women during their confinement. Vast majority of investigated women had a regular marital life (90.6%, n=196) i.e. not widows or divorced and were house wives (79.6, n = 172). There was no significant association between PPD and women`s age or women`s family income. Compared to non-working women, those working were at slightly higher risk for PPD. However, this was also not statistically significant. Likewise, mothers’ history of depression was not associated with having postnatal depression. Moreover, PPD was not associated with regular marital status or the level of education. The relatively low number of investigated cases in our study may be limitation. More future research studies are warranted.

Postpartum depression prevalence risk factors Al-Madina

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  American Psychiatric Association. Postpartum onset specifiers. In: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association; 2000: 386-387.
[2]  Hirst KP, Moutier CY. Postpartum major depression. Am Fam Physician. 2010 Oct 15; 82(8): 926-33
[3]  Cohen LS. Gender-specific considerations in the treatment of mood disorders in women across the life cycle. J Clin Psychiatry. 2003; 64(Suppl 15): 18-29.
[4]  Miller LJ. Postpartum depression. JAMA. 2002; 287: 762-765.
[5]  Lovestone S, Kumar R. Postnatal psychiatric illness: the impact on partners. Br J Psychiatry 1993; 163: 210-6.
[6]  Boath EH, Pryce AJ, Cox JL. Postnatal depression: the impact on the family. J Reprod Infant Psychol1998; 16: 199-203.
[7]  Lovestone S, Kumar R. Postnatal psychiatric illness: the impact on partners. Br J Psychiatry 1993; 163: 210-6.
[8]  Murray L, Fiori-Cowley A, Hooper R, Cooper P. The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome. Child Dev 1996; 67: 2512-26.
[9]  Murray L, Sinclair D, Cooper P, Ducournau P, Turner P, Stein A. The socioemotional development of 5-year-old children of postnatally depressed mothers. J Child Psychol Psychiatry 1999; 40: 1259-71.
[10]  Cogill S, Caplan H, Alexandra H, Robson K, Kumar R. Impact of maternal postnatal depression on cognitive development of young children. BMJ1986; 292: 1165-7.
[11]  Murray J, Cooper PJ. The impact of postpartum depression on child development. Aetiological Mechanisms in Developmental Psychopathology. Oxford University Press, Oxford, 2004.
[12]  Earls MF; Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics 2010; 126: 1032-1039.
[13]  Patel V, Rahman A, Jacob KS, Hughes M. Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia. BMJ 2004; 328: 820-823.
[14]  Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R. Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry 2004; 61: 946-952.
[15]  Patel V, DeSouza N, Rodrigues M. Postnatal depression and infant growth and development in low income countries: a cohort study from Goa, India. Arch Dis Child 2003; 88: 34-37.
[16]  Adewuya AO, Ola BO, Aloba OO, Mapayi BM, Okeniyi JA. Impact of postnatal depression on infants’ growth in Nigeria. J Affect Disord2008; 108: 191-193.
[17]  Milne V. Postpartum depression makes headlines: celebrities talk about postpartum depression. Canadian Available News.asp?idNews=232682&idSM=318. Accessed on April 13, 2006.
[18]  Dennis CL. Preventing and treating postnatal depression. BMJ. 2009; 15; 338: a2975.
[19]  Hearn G, Iliff A, Jones I, et al. Postnatal depression in the community. Br J Gen Pract. 1998; 48(428): 1064-2066.
[20]  Fisher JR, de Mello MC, Izutsu T, Tran T. The Ha Noi Expert Statement: recognition of maternal mental health in resource-constrained settings is essential for achieving the Millennium Development Goals. Int J Ment Health Syst. 2011; 5(1): 2.
[21]  Beck CT. Predictors of postpartum depression: an update. Nurs Res. 2001; 50(5): 275-285.
[22]  Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004; 26(4): 289-295.
[23]  Beck CT. Postpartum Mood and Anxiety Disorders: Case Studies Research, and Nursing Care. 2nd ed. Washington, DC AWHONN; 2008.
[24]  Patel M, Bailey RK, Jabeen S, Ali S, Barker NC, Osiezagha K. Postpartum depression: a review. J Health Care Poor Underserved. 2011; 23(2): 534-542.
[25]  American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders. 6th ed. Washington, DC: American Psychological Association; 2010.
[26]  Chen C, Kuo S, Chou Y, Chen H. Postpartum Taiwanese women: their postpartum depression, social support, andhealth-promoting lifestyle profiles. J ClinNurs. 2007; 16: 1550-1560.
[27]  Governor of Madinah Province Receives UN Under-Secretary-General - gcc_press. Gulf in the Media, 6 June 2010.
[28]  Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: Development of the 10-itemEdinburgh Postnatal Depression Scale. British Journal of Psychiatry 1987; 150: 782-786.
[29]  Bina R. The impact of cultural factors upon postpartum depression: a literature review. Health Care Women Int.2008; 29(6): 568-592.
[30]  Hamany H, Jamhawi L, Al-Darawsheh J, Ailouni K. Consanguineous marriages in Jordan: why is the rate changing with time? Clin Genet. 2005; 67(6): 511-516.
[31]  Yehia DB, Callister LC, Hamdan-Mansour A. Prevalence and predictors of postpartum depression among Arabic Muslim Jordanian women serving in the military.J Perinat Neonatal Nurs. 2013 Jan-Mar; 27(1): 25-33.
[32]  Green K, Broom H, Mirabella J. Postnatal depression amongmothers in the United Arab Emirates: socio-cultural and physicalfactors. Psychol Health Med. 2006; 11(4): 425.431.
[33]  Al Dallal FH, Grant IN. Postnatal depression among Bahrainwomen: prevalence of symptoms and psychosocial risk factor. East Mediter Health J. 2012; 18(5): 439-445.
[34]  O'Hara MW, Swain AM. Rates and risks of postpartum depression: a meta-analysis. Int Rev Psychiatry. 1996; 8: 37-54.
[35]  Josefsson A, Berg G, Nordin C, Sydsjö G. Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand. 2001; 80: 251-255.
[36]  Helbreich U, Karkun S. Cross-cultural and social diversity ofprevalence of postpartum depression and depressive symptoms. Journal of Affective Disorders, 2006; 91: 97-111.
[37]  Ghubash R, Abou-Saleh MT. Postpartum psychiatric illness in Arab culture: prevalence and psychosocial correlates. British Journal of Psychiatry 1997; 171: 65-68.
[38]  Agoub M, Moussaoui D, Battas O. Prevalence of postpartum depression in Moroccan sample. Archives of Women’s Mental Health 2005; 8(1):37-43.
[39]  Chaaya M, Campbell OMR, El Kak F, Shaar D, Harb H, Kaddour A. Postpartum depression: prevalence and determinantsin Lebanon. Archives of Women’s Mental Health2002; 5(2): 65-72.
[40]  Goker A1, Yanikkerem E, Demet MM, Dikayak S, Yildirim Y, Koyuncu FM. Postpartum depression: is mode of delivery a risk factor? ISRN Obstet Gynecol. 2012; 2012: 616759.
[41]  Inandi T, Elci OC, Ozturk A, Egri M, Polat A, Sahin TK.. Risk factors for depression in postnatal first year, in eastern Turkey. International Journal of Epidemiology 2002; 31: 1201-1207.
[42]  Verkerk GJM, Pop VJ, Van Son MJ, Van Heck GL. Prediction of depression in the postpartum period: a longitudinal follow-up study in high-risk and low-risk women. Journal of Affective Disorders 2003 Nov; 77: 159-166.
[43]  Lanes A, JKuk JL, Tamim H. Prevalence and characteristicsof Postpartum Depression symptomatology among Canadia women: a cross-sectional study. BMC Public Health 2011; 11: 302
[44]  Tannous L, LGigante LP, Fuchs SC, Busnello EDA. Postnatal depression in Southern Brazil: prevalence and its demographic and socioeconomic determinants. BMC Psychiatry 2008; 8: article 1.
[45]  Kumar R. Postnatal mental illness: a transcultural perspective. Soc Psychiatry Psychiatr Epidemiol. 1994; 29: 250-264.