Postpartum depression among mothers attending postnatal clinics in Bole sub-city, Addis Ababa, Ethiopia, in the post-COVID-19 era: A cross-sectional study.

Postpartum depression (PPD) harms maternal and child health. Evidence showed elevated PPD during the COVID-19 pandemic, but post-pandemic data from low-resource urban settings are limited. We measured PPD prevalence and its correlates among mothers attending postnatal clinics in Bole sub-city, Addis Ababa, Ethiopia, during the post-COVID-19 period (data collection: 1 March-30 April 2024). An institution-based cross-sectional study enrolled 410 mothers who delivered 2 weeks-1 year prior, attending five primary health centres. Participants were selected using systematic random sampling, with proportional allocation based on client flow across five primary health centers. Depressive symptoms were screened with the Edinburgh Postnatal Depression Scale (EPDS); a cutoff ≥11 defined probable PPD. Data were entered in EpiData and analysed in SPSS. Bivariate analyses (p < 0.25) identified candidates for multivariable logistic regression; adjusted odds ratios (AOR) with 95% confidence intervals (CI) and p < 0.05 indicated statistical significance. A total of 410 mothers participated (mean age 28.8 ± 4.7 years). The prevalence of postpartum depression (PPD) was 20.0% (82/410; 95% CI: 16.4-24.1%). In multivariable logistic regression analysis, primiparity (AOR = 7.83; 95% CI: 1.29-47.71), unplanned pregnancy (AOR = 2.49; 95% CI: 1.25-4.95), poor partner support (AOR = 13.23; 95% CI: 3.08-56.94), low social support (AOR = 3.31; 95% CI: 1.13-9.74), and induction of labor (AOR = 2.73; 95% CI: 1.13-6.60) were independently associated with higher odds of postpartum depression. One in five mothers screened positive for PPD in this post-COVID-19 urban primary-care sample. First-time mothers and those with limited partner or social support, unplanned pregnancies, or induction of labour are at elevated risk. Integrating routine PPD screening into postnatal care, strengthening partner- and community-based support, and expanding family-planning and counselling services are priority measures to reduce PPD burden in Addis Ababa and similar settings.