EFFECTS OF FATIGUE, SLEEP QUALITY, AND RESILIENCE ON DEPRESSIVE SYMPTOMS DURING THE POSTPARTUM PERIOD: AN EMPHASIS ON MATERNAL MENTAL HEALTH

B.A. Baattaiah¹, M.D. Alharbi¹, N.M. Babteen¹, H.M. Al-Maqbool¹, F.A. Babgi¹, A.A. Albatati¹

¹King Abdulaziz University, Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, Jeddah, Saudi Arabia

Background: Several factors could contribute to the development of postpartum depression (PPD) and negatively affects mothers’ mental and physical well-being.

Purpose: The aim of this study was to characterize the levels of fatigue, sleep quality, and resilience after childbirth, and to measure the impact of fatigue, sleep quality, and resilience on the development of PPD during postpartum period.

Methods: A cross-sectional study was conducted using an online questionnaire distributed to mothers during their postpartum. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS), postpartum fatigue (PPF) was assessed using the Fatigue Severity Scale (FSS), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and resilience was assessed using the Brief Resilience Scale (BRS). The Pearson correlation coefficient was calculated to determine the relationship between the study variables. A simple and multiple linear regressions analysis were performed to explain the contribution of PPF, sleep quality, and resilience as independent predictors of PPD.

Results: A total of 1409 postpartum women were included in the analysis, with 75% of the participants reporting PPD, 61% reporting PPF, 97% reporting having sleep problems, and 36% being in the category of ‘low resilience level’. In terms of correlations, the FSS and the PSQI showed moderate positive relationships with the EPDS (r= 0.344 and r= 0.447 respectively, p= .000). The BRS was negatively associated with the EPDS (r= -0.530,p= .000). Fatigue, sleep quality, and resilience were predictors of the depressive symptoms (β= 0.127, β= 0.262, and β= -0.393 respectively, R²= 0.37, p= .000). The association remained significant in the regression model after adjustment for mothers’ age, mothers’ BMI, and child’s age.

Conclusions: PPD was reported by most mothers in our sample. Mothers with higher fatigue, poor sleep quality, and low resilience were more likely to develop PPD. A high percentage of participants reported fatigue and poor sleep during postpartum. About a third of our participants reported low levels of resilience. We found that resilience was a strong negative predictor of PPD development. Our data suggested that resilience could be a promising coping strategy to buffer the development of PPD. A greater emphasis should be placed on psychological aspects of mothers during postpartum to enhance overall maternal mental health.

Implications: Understanding the relationship between PPD and fatigue, sleep quality, and resilience is vital for healthcare providers and decision makers who seek to evolve existing plans and implement effective rehabilitative therapeutic strategies to promote maternal and overall women’s health and thus the quality of life, particularly during such a stressful period for mothers.

Funding acknowledgements: This research received no funding.

Keywords:
Postpartum Depression
Resilience
Maternal health

Topics:
Mental health
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: King Abdulaziz University, Jeddah, Saudi Arabia

Committee: The Ethics Committee of the Faculty of Medical Rehabilitation Sciences (FMRS)

Ethics number: (FMRS-EC2022-006)