A Comparison of the Prevalence and Related Risk Factors for Post-Partum Depression in Urban and Rural Areas

Background: Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. Studies are inconsistent as to whether geographical location is linked with the risk of post-partum depression. Objectives: The current study examined and compared the prevalence and risk factors for post-partum depression in urban and rural areas. Methods: A prospective cohort study was conducted on 2279 pregnant women in Mazandaran based urban and rural areas. Edinburgh postnatal depression scale (EPDS) and other validated instruments were applied to assess the similarities and differences between depression prevalence rate within 12 postpartum weeks and two women groups' characteristics. Logistic regression model was used to distinguish PPD risk factors in urban and rural residents. Results: PPD prevalence rate was slightly higher among the urban women (20.1%) than that of the rural ones (17.8%) with no significant difference. Although the established PPD risk factors such as prenatal depression and lack of parental self-efficacy were associated with PPD in both groups of women, the rural-specific risk factors such as socio-demographic and health problems were related to PPD in rural areas and social isolation predisposed urban women to PPD. Conclusions: PPD is a significant health problem among women regardless of their place. The increased PPD risk in each residence is associated with unique risk factors requiring specific interventions.