Effect of postpartum depression on women's mental and physical health four years after childbirth

Background: Postpartum depression has been shown to affect women's health in the long term but no studies have assessed this in the Islamic Republic of Iran. Aims: This study determined the prevalence of current depression and illness in women who had experienced postpartum depression four years after childbirth, and evaluated the factors associated with current depression. Methods: In a cohort study in 2009, 1801 pregnant women without depression at 32-42 weeks of pregnancy attending Mazandaran primary healthcare centres were examined for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS). After four years, 204 women of the original cohort with postpartum depression and 467 without postpartum depression were again evaluated using the EPDS, and other questionnaires to determine the prevalence of current depression and other health problems. Multivariable logistic regression analysis was used to evaluate the factors associated with current depression and other health problems. Results: The mean age of the women was 30.13 (SD 5.21) years. Women with postpartum depression were two times more likely to experience depression four years after childbirth (OR = 2.16, 95% CI: L38-3.36). They were also significantly more likely to experience chronic diseases (OR = 2.49, 95% CI: 1.38 -4.50) and score higher on the General Health Questionnaire (OR = 2.50, 95% CI:1.38-4.50). Conclusions: Postpartum depression predisposes women to later depression and other mental and physical health problems. Women with postpartum depression need to be identified and provided with support and appropriate interventions to avoid later health problems.