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Contextual Effect of Village on the Risk of Postpartum Depression after Earthquake in Lombok, Indonesia

Baiq Tuhu Abdiani, Didik Tamtomo, Hanung Prasetya

Abstract

Background: Postpartum depression is a feeling disorder experienced by the mother after giving birth that can occur at any time within one year. According to the WHO, the post-disaster of most of the affected population have normal psychological reactions and around 15 to 20% will expe­rie­n­ce men­tal disorders that refer to Post Traumatic Stress Disorder (PTSD). 3 to 4% experience severe dis­­or­ders such as psychosis, major depression and high anxiety. This study aims to analyze the vil­la­ge contextual influence on postpartum depression post earthquake.

Subjects and Method: This was observational analytic study with cross sectional approach, conducted in 25 villages in East Lombok district, Indonesia in March to April 2019. The total sam­ple of 225 postpartum mothers was selected using stratified random sampling. The dependent va­ri­able was postpartum depression. The independent variables were age, parity, education, em­ploy­ment, income, obstetric history, social support, stress coping, government support, the role of he­a­lth personnel, and the level of loss. The data collection was conducted using questionnaires and ana­lyzed using multilevel multiple logistic regression analysis.

Results: Postpartum depression was affected by age <20 or > 35 years (b = 1.79; 95% CI = 2.85 to 13.37; p = 0.001), parity <2 or > 4 (b = 1.45; 95% CI = 0.37 to 2.53; p = 0.008), high income (b = -1.68; CI 95% = -2.75 to -0.61; p = 0.002), there was an obstetric history (b = 1.03; CI 95% = -0.03 to 2.11; p = 0.059), strong social support (b = -1.62; 95% CI = -2.76 to -0.48; p = 0.005, good coping stress (b = -3.95; 95% CI = -5.42 to -2.47; p <0.001), strong government support (b = -1.26; 95% CI = -2.34 to -0.18; p = 0.022), the role of health personnel (b = -2.06; CI 95% = -3.29 to -0.83; p = 0.001), and the rate of loss (b = 2.69; 95% CI = 1.46 to 3.92; p <0.001) Postpartum depression was not influenced by higher education (b = -0.60; 95% CI = -1.63 to 0.42; p = 0.250) and low employment (b = 0.57; 95% CI = -0.44 to 1.59; p = 0.272). Villages has a contextual in­flu­en­ce on postpartum depression after the earthquake (ICC = 8.36%).

Conclusion: Age, parity, income, obstetric history, social support, stress coping, government sup­port, the role of health personnel, and the level of loss have an influence on postpartum depression af­ter the earthquake. There is a contextual influence between the villages on average on the in­ci­den­ce of postpartum depression after the earthquake.

Keywords: postpartum depression, stress coping, post earthquake, multilevel analysis

Correspondence: Baiq Tuhu Abdiani, Public Health Master’s Program, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Jawa Tengah. Email: tuhuabdiani8@gmail.com. Mobile: 081999546500.

Journal of Maternal and Child Health (2019), 4(5): 380-391
https://doi.org/10.26911/thejmch.2019.04.05.12

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