Association of Antepartum Perceived Maternal Social Support with Postpartum Depression among women in Mbarara district, rural southwestern Uganda

Background: Postpartum depression (PPD) remains a global maternal mental health concern, particularly in low-income settings. Maternal social support has been identified as a potential protective factor, yet little prospective evidence exists from rural Uganda. This study examined the association between Antepartum Perceived Maternal Social Support and Postpartum Depression among women in rural southwestern Uganda. Methods: A multi-facility prospective cohort study was conducted among pregnant women attending three health facilities in Mbarara District, rural Southwestern Uganda. Participants were enrolled during latent labor and followed up at six weeks postpartum. Perceived Maternal Social Support was measured using the Maternity Social Support Scale (MSSS), and PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the MINI International Neuropsychiatric Interview. These were assessed antepartum in latent labour and 6 weeks following childbirth. Data were analyzed using logistic regression in both univariable and multivariable analyses. Results: A total of 502 pregnant women were included in this analysis aimed at establishing the association between Antepartum Perceived Maternal Social Support with Postpartum Depression. The overall prevalence of PPD was 4.8%. Inadequate social support was reported by 46% of participants. Bivariate analysis showed a great association between inadequate social support and PPD (OR: 0.3; 95% CI: 0.1–0.8; p = 0.017). In multivariate analysis, adequate maternal social support was associated with a 60% reduction in the odds of developing postpartum depression (OR: 0.4; 95% CI: 0.2–1.0; p = 0.056). Other significant predictors of postpartum depression were experiencing complications during delivery, preterm birth, and stressful life events during labour. Conclusion: Perceived Maternal Social Support is a protective factor against Postpartum Depression. Strengthening social support systems during the antepartum period and the early postpartum period may help reduce the burden of PPD among women, especially those living in rural settings where access to mental health resources may be limited.