Postpartum Depression among Kenyan Adolescents

Abstract

Background: Adolescents may have elevated risks of postpartum depression compared to adults due to unique socioeconomic stressors. Hormonal contraception has been associated with higher risks of depression in adults and may also contribute to higher risks of postpartum depression in adolescents; however postpartum depression among adolescents in low and middle-income countries (LMIC) is largely understudied. Methods: We enrolled adolescents (aged 14-21). attending a 9-month maternal child health visit at two clinics in the Nyanza Province in western Kenya. Postpartum depression was measured using the Edinburgh Postnatal Depression Scale and classified as a score of 12 or above. Results: Among 498 adolescents, 50 (10%) had postpartum depression. The prevalence of postpartum depression in adolescents age 14-18 was 12%, while adolescents age 19-21 had a prevalence of 9%. In univariate analyses, sexual and relationship power (Odds Ration [OR] 11.55, 95% Confidence Interval [CI] 4.90-27.21), ever use of hormonal contraceptives (OR 2.26, 95% CI 1.25-4.10), pregnancy intention (OR 2.40, 95% CI 1.17-4.91), and household income (OR 4.72, 95% CI 1.31-17.02) were associated with higher risks of postpartum depression. Past ever use of hormonal contraception did lead to a higher risk of postpartum depression (OR 2.26 (1.25-4.10), although this may be a confounder for pregnancy intention. Discussion: Prevalence of postpartum depression was moderate among postpartum adolescents, but similar between younger and older adolescents. These findings underscore the importance of screening and treatment for postpartum depression among adolescents in LMIC.