Postpartum physical symptoms and depressive symptomatology at 1 month and 1 year after delivery: A longitudinal questionnaire survey

Background: A high prevalence of postpartum physical symptoms and depressive symptomatology has been reported in Western countries. Although previous studies have shown postpartum physical symptoms and emotional problems are correlated, a causal relationship between the two variables has not been established. Objectives: The objectives of this study were to examine the prevalence and persistence of postpartum physical symptoms and depressive symptomatology at 1 month and 1 year after delivery among women in Taiwan. We further examined the interrelationship between the severity of physical symptoms and depressive symptomatology at 1 month and 1 year postpartum. Methods: The study participants were 166 women who completed a structured questionnaire at 1 month and 1 year after delivery in Taipei, Taiwan. The presence and severity of postpartum physical symptoms were assessed using an 18-item, 4-point Likert scale. Depressive symptomatology was measured by the Center for Epidemiologic Studies Depression Scale. Structural equation modeling (SEM) was used to examine the causal relationship between the severity of physical symptoms and depressive symptomatology at the two time points. Results: At 1 year postpartum, 23.5% of the women reported depressive symptomatology. The average number of physical symptoms present was 3.35. There was a significant decrease in the mean scores for severity of physical symptoms, and there was no significant difference in depressive symptomatology between 1 month and 1 year postpartum. Women who reported depressive symptomatology and physical symptoms at I month were more likely to report them at 1 year postpartum. The SEM results did not support direct and causal relationships between the severity of physical symptoms and depressive symptomatology at the two time points. Conclusions: A high prevalence of postpartum health problems was noted in Taiwan. This study revealed a persistence of physical symptoms and depressive symptomatology found at 1 month postpartum. Careful assessment of the physical and emotional health problems of women after childbirth is needed to improve the quality of postpartum care. (C) 2009 Elsevier Ltd. All rights reserved.