Obstetric and Neonatal Factors Associated with Postpartum Depressive Symptoms: A Retrospective Multicenter EPDS-Based Study.

INTRODUCTION

To evaluate postpartum depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) and identify demographic, obstetric, and neonatal factors associated with EPDS positivity in women without prior psychiatric history.

METHODS

This retrospective, archive-based multicentre study enrolled 763 women aged 20-35 years who delivered at two public hospitals in Turkey (June 2022-June 2025). Variables included educational attainment, employment, pregnancy planning, mode of delivery, abortion/stillbirth history, preeclampsia, birth weight, and neonatal intensive care unit (NICU) admission. Participants were classified as EPDS < 13 or ≥ 13 at the fourth postpartum week; comparisons used univariable and multivariable logistic regression with Bonferroni adjustment.

RESULTS

Of 763 women, 198 (26.0%) scored ≥ 13. After adjustment and Bonferroni correction, history of abortion and preeclampsia remained statistically significant. Working status and history of stillbirth showed nominal associations before correction but did not remain significant after Bonferroni correction. NICU admission was significant in unadjusted analysis but did not remain significant after adjustment (aOR 1.44, 95% CI 0.80-2.60, p = 0.226).

CONCLUSION

Postpartum depressive symptoms affected one in four women. After adjustment and Bonferroni correction, preeclampsia and history of abortion remained associated with EPDS positivity. Targeted psychological screening may be considered for women with high-risk pregnancy or neonatal complications.