Prevalence, correlates of postpartum depression during the COVID-19 pandemic; and validation of the arabic edinburgh postnatal depression scale among Lebanese women

• DOI: 10.1186/s40359-025-02410-y
• Publication Date: 2025-01-31T18:38:28Z
• Authors: Christian El Kahwaji; Elie Barakat; Feten Fekih-Romdhane; Camille Akkari; Savio Barakat; Souheil Hallit
• Keywords: Depression; Pandemic; 2019-20 coronavirus outbreak

BACKGROUND: Cultural variations in pregnancy and childbirth experiences can influence the causes and contributing factors of postpartum depression (PPD). However, research on this issue remains scarce in Arab countries, especially in Lebanon. This study aimed to assess the prevalence of PPD and explore socio-contextual factors affecting it in Lebanon during the COVID-19 pandemic. It also sought to validate the psychometric reliability of the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) among Lebanese women. METHODS: A cross-sectional study was conducted between May 2022 and July 2022, with 402 Lebanese adult postpartum women (mean age 31.46 ± 4.88 years) enrolled from the maternity ward at CHU-Notre Dame des Secours Hospital in Byblos, Lebanon by responding to an online survey after obtaining informed concent. Along with the EPDS, the following measures were administered to participants: The Multidimensional Scale of Perceived Social Support, the Fear of COVID-19 Scale, and the Lebanese Anxiety Scale-10. RESULTS: Our findings demonstrated appropriate psychometric properties of the Arabic one-factor, 10-item EPDS in our sample of Lebanese women. The scale yielded good composite reliability (ω = 0.97), and appropriate patterns of correlations with anxiety and social support measures, thus attesting for its convergent validity. A total of 239 women (59.5%) had potential postpartum depression. Multivariate analysis showed that perceived childbirth experience (as “normal” (Beta= -2.57), “good” (Beta= -3.45) and “very good” (Beta= -4.14)), with worries that the newborn will get hurt/die during labor (“rarely” (Beta = 1.43) and “never” (Beta = 1.24)), a lower financial burden (Beta = − 0.19) and a higher social support (Beta = − 0.02) were significantly associated with lower rates of PPD; while higher levels of anxiety (Beta = 0.32) were associated with increased symptoms of PPD. CONCLUSION: The study highlights the significant burden of PPD among Lebanese women, with an alarmingly high prevalence. Key factors associated with PPD—such as anxiety, childbirth experience, and social support—are largely preventable and modifiable. Nonetheless, there is an imperative need for future longitudinal and qualitative research, to better understand obstetrical experiences, address PPD and confirm causality of the associations found.