Factors Associated With Postpartum Depression Among Women Who Conceived With Infertility Treatment
Chuan-Chen Li, MS
Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei City 23143, Taiwan
Li-Yin Chien, ScD, RN
Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan
Around 15% of all couples of childbearing age in Taiwan have infertility. About 7~20% of women have depressive symptoms during infertility treatment, and the psychological pressure might remain high when they become mothers. Postpartum mood disorder of mothers will lower the ability of taking care of themselves and the baby, thus affect the health of the mother and the baby. Most of previous researches on infertile women focused on psychosocial problems during infertility treatment, few focused on examining the effect of different infertility treatments on postpartum depression.
This study was a cross-sectional survey performed from November 2014 through May 2015. The study participants were 180 women who conceived with infertility treatment and were within 6 months postpartum at a medical center in Taipei, Taiwan. Data were collected by telephone interviews and chart review using a structured questionnaire. The study variables included socio-demographics, personal and family history of depression , women and infant health history, breastfeeding, pressure change, social support, history of infertility, and infertility treatment. The dependent variable is postpartum depression within 6 months after delivery as measured by the Edinburgh Postnatal Depression Scale with a cutoff score of 10.
The prevalence of postpartum depression within 6 months after delivery is estimated at 34.4% among the study women. The binary logistic regression revealed that breastfeeding (OR=0.347,95% CI=0.123~0.980), social support (OR=0.901, 95% CI=0.853~0.952), and baby gender in line with expectations (OR=0.177, 95% CI=0.060~0.523) were negatively associated with postpartum depression. Perceived postpartum pressure higher than before infertility treatment (OR=4.403, 95% CI=1.512~12.822), duration since infertility diagnosis longer than 3 years (OR=5.158, 95% CI=1.825~14.577), maternal age older than 35 years old (OR=8.313, 95% CI=2.642~26.155), pregnancy via IVF (OR=5.738, 95% CI=1.420~23.189), and experiencing three or more different courses of infertility treatment (OR=8.671, 95% CI=2.382~31.567) were associated with a higher risk for postpartum depression. These eight variables explained 50.6% of variances for postpartum depression.
Women who conceived with infertility treatment in Taiwan had a high prevalence of postpartum depression. Longer duration since infertility diagnosis, older maternal age, conception via invasive treatment, and multiple courses of infertility treatment were associated with an increased risk for postpartum depression. Policies regarding infertility treatment should incorporate mental health counseling and prevention of postpartum depression. Health care professionals should enhance pregnancy- and labor-related health education for women who conceived through infertility treatment and offer them more support and help after delivery.