767 - Postpartum Depression in Rwanda: Prevalence and Associated Factors

Poster Number: 767
Publication Number: 767.12

Nudshanunth Pasahahnunwut, University of Washington - Seattle, Seattle, WA, United States; Eyael Getachew, University of Washington - Seattle, Shoreline, WA, United States; Didier Habiyaremye, University of Rwanda, Kigali, Kigali, Rwanda; Innocent Mugisha, University of Rwanda, Huye, Sud, Rwanda; vincent Ndebwanimana, University of Rwanda, Kigali, Sud, Rwanda; Richard Nduwayezu, University of Rwanda, Kigali, Kigali, Rwanda; Daniel A. Enquobahrie, University of Washington, Seattle, WA, United States; Esther K.. Chung, University of Washington School of Medicine, Seattle, WA, United States

Background: Postpartum depression (PPD), with prevalence rates in East Africa ranging from 17% to 24%, is associated with adverse health outcomes among offspring of affected mothers including emotional and developmental delays and poor growth. The 2022 World Health Organization (WHO) recommendations on maternal and newborn care call for routine PPD screening using a validated screening tool. In Rwanda, a low-income country severely impacted by the 1994 genocide, routine PPD screening has not yet been implemented.

Objective: 1) Describe the prevalence of PPD among new mothers, and 2) determine sociodemographic characteristics and health factors associated with PPD and recent suicidal ideation.

Design/Methods: This study is based on data collected in a cross-sectional survey of postpartum mothers delivering a live birth between August and September 2022. Data were collected as part of coursework by students via face-to-face interviews conducted in Kinyarwanda at the Kabutare District Hospital (KDH) in Huye, Rwanda. Postpartum mothers, following written consent, responded to sociodemographic and maternal and infant health questions and completed the Edinburgh Postnatal Depression Scale (EPDS). Postpartum depression was defined as an EPDS score of > 10. Data collection was approved by the KDH Ethics Committee.

Results: The study population consisted of 66 exclusively Kinyarwanda-speaking mothers who were largely married (59%), < 35 years old (88%), low-income (70%), from rural areas (92%), with < primary school education (79%). Over 65% had first-trimester prenatal care and 99%, health insurance. Thirty percent of mothers reported a pregnancy-related complication and 50%, a history of mental illness. Over half (52%) had PPD and 26% had recent suicidal thoughts. Many reported a history of depression (39%), PPD (18%), or anxiety (29%). Mothers with a history of depression, anxiety, or PPD were more likely than their counterparts to have PPD and/or recent suicidal ideation. A greater prevalence of PPD was found among mothers with pregnancy-related complications or a history of mental illness when compared to their counterparts (70% v. 44%, p < 0.05; 67% v. 36%, p < 0.05). Recent suicidal ideation was more common among unmarried mothers (44% v 13%, p < 0.05).

Conclusion(s): Postpartum depression and suicidal ideation rates were high among new mothers screened at a district hospital in Rwanda. Mothers at particularly high risk for PPD are those with pregnancy-related complications and a history of mental illness. These findings  demonstrate a need for routine PPD screening among new mothers in Rwanda, as recommended by WHO.