Postpartum Depression in Mothers of Sick Newborns in Ghana

Background: Pregnancy and the postpartum are vulnerable periods for maternal mental health globally, but there is sparse data about postpartum depression in low-income nations. In such countries, maternal depression has been associated not only with maternal morbidity but also with higher prevalence of poor infant nutritional status, diarrhea, respiratory illness, and growth stunting, all of which put young children at significantly greater risk of mortality.

Methods: We interviewed mothers with hospitalized newborns in Kumasi, Ghana and assessed postpartum depression using the Patient Health Questionnaire. We evaluated depression scores and conducted multivariable linear regression controlling for demographics, pregnancy variables, and personal/social risk factors for depression, and prior pregnancy or infant loss as potential confounders.

Results: Of 153 mothers with hospitalized infants, 70% of mothers endorsed symptoms of at least mild depression, and 37% had symptoms of moderate or severe depression. In multivariable analysis, only fair or poor self-rated health status predicted higher depression scores. Among the total cohort, a third reported a past history of depression, nearly a third had a history of prior loss, and a quarter reported their current health status as fair or poor. Nearly half reported interpersonal violence with a current partner.

Conclusions: A huge majority of mothers with sick infants in Ghana had symptoms of postpartum depression. Given the clear link between maternal depression and poor infant outcomes, this research suggests a significant need to address postpartum mental health and subsequent neonatal morbidity and mortality in this population.