Prevalence, predictors, and functional impact of postpartum depression using the Patient Health Questionnaire-9 (PHQ-9) among 830 women

Abstract

Background: Postpartum depression (PPD) is a prevalent maternal mental health condition with significant consequences for mothers, infants, and families. The determinants and functional implications of PPD vary across populations, highlighting the need for population-specific data. This study aimed to determine the prevalence of PPD, identify associated risk factors, and assess functional impairment using the Patient Health Questionnaire-9 (PHQ-9). Methods: This was a prospective cross-sectional observational study. Sociodemographic, obstetric, neonatal, and psychosocial characteristics were collected through structured face-to-face interviews during routine postpartum visits between days 7 and 21. Depressive symptoms were assessed using the validated Turkish version of the PHQ-9, with PPD defined as a score ≥ 10. Functional impairment was evaluated using item 10 of the PHQ-9. Initially, depression and non-depression groups were compared, followed by multivariable logistic regression to identify independent predictors. Results: A total of 830 postpartum women were included, of whom 19.2% (159/830) met the diagnostic threshold for PPD. Multivariate logistic regression identified three independent predictors of PPD: functional impairment (strongest predictor, nearly eightfold increased odds), history of pre-gestational psychiatric disorder (over fourfold increased odds), and maternal unemployment (approximately twofold increased odds). No obstetric or neonatal variables—including mode of delivery, gestational age, or birth weight—remained significant after adjustment. Conclusion: Postpartum depression affects nearly one in five women and is strongly associated with functional impairment, prior psychiatric illness, and maternal unemployment. Our findings highlight the need to incorporate routine mental health screening, functional assessment, and targeted follow-up into standard postpartum care to enable earlier identification and intervention, ultimately mitigating the burden of PPD on the mother, infant, family, and society.