Prevalence of Postpartum Depression and Associated Factors during the COVID-19 Pandemic: Evidence from a Cross-Sectional Study in a Medium-Sized City, Minas Gerais, Brazil

Aims: To identify the prevalence and the factors associated with postpartum depression (PPD) during the COVID-19 pandemic, in Teófilo Otoni, MG, Brazil.

Methodology: This is a cross-sectional study that included 183 puerperal women aged 18 and 42 years, who were attended at the city's public maternity hospital, between the months of February and August 2021. The cut-off point used was ≥ 11 on the Edinburgh Postpartum Depression Scale (EPDS). The Microsoft Excel program was used to tabulate the data; subsequently, they were transported to the Jamovi program, version 1.6.23.0. Descriptive statistical analysis used measures of central tendency, dispersion and Pearson's chi-square test. The reliability analysis of the EPDS was performed with Cronbach's alpha (α).

Results: The prevalence of PPD was 35.5%. Only education level was the sociodemographic factor that obtained a significant association with PPD (χ2 (2) = 8.72, p = 0.013). Anxiety about giving birth during the pandemic; fear of the child having COVID-19; fear of being infected in the hospital and desire not to be pregnant for fear of acquiring COVID-19 were associated factors with PPD. Multivariate analysis revealed that postpartum women experiencing anxiety during the pandemic had a 50% prevalence of PPD (cutoff ≥ 11), corresponding to a 2.46 times higher risk compared to those without anxiety. The results should be interpreted considering their limitations. As a cross-sectional study, it does not allow for the establishment of causality. Data were collected through a bedside questionnaire, which may have influenced participants' responses due to the fatigue experienced after childbirth.

Conclusion: The significant occurrence of PPD suggests that health providers should take the following measures: monitor the mental health of postpartum women more carefully; increase the number of psychologists working in the maternity hospital studied; and improve the counter-referral of these postpartum women with PPD so that they can be monitored in primary care in their home municipalities. On the other hand, policymakers should recognize the influence of extreme epidemiological events on the mental well-being of postpartum women and need to adopt structural measures to strengthen public education, ensuring that students develop up to university level.