Prevalence, associated factors and outcomes of maternity blues among postpartum mothers: A Multi-Facility Prospective Cohort in rural southwestern Uganda

Background: Maternity blues are mild and self-limiting depressive symptoms that occur within the first week postpartum. However, failure to identify and manage affected mothers can lead to maternal emotional and cognitive impairment, disrupt infant care, and increase the risk of postpartum depression (PPD), infanticide, or suicide. The average prevalence of maternity blues in sub-Saharan Africa (SSA) is 39%, with 10–15% of affected mothers progressing to develop PPD. Therefore, providing timely support and management to mothers experiencing maternity blues is crucial to prevent this progression. We determined the prevalence, associated factors and outcomes of maternity blues among postpartum mothers in rural south western Uganda. Methods: The findings in this manuscript were part of a prospective cohort that aimed at investigating Perceived Maternal Social Support and Perinatal Depression among women from latent labor to six weeks postpartum. We conducted a multi-facility study to assess maternity blues among mothers at six hours and six days postpartum from November 2023 to March 2024. The study was carried out in three health facilities in Mbarara District, rural southwestern Uganda. The prevalence of maternity blues was based on the Mini International Psychiatric Interview (M.I.N.I 7.0.2). Factors associated with maternity blues were analyzed using bivariate and multivariate logistic regression. Variables with a p-value <0.2 in bivariate analysis were included in the multivariate model, with statistical significance set at p<0.05. Odds ratios (OR) and 95% confidence intervals (CI) were reported. Data were entered into EPI Info software version 7.2 and analyzed using STATA software version 14.0. Results: Of the 523 enrolled participants, 33 had maternity blues at six hours and or six days postpartum giving a prevalence of 6.3% (95% CI: 4.5 - 8.8). No significant disparities were noted in the prevalence of maternity blues across maternal age groups. In multivariate analysis, the following factors showed an independent statistically significant association with maternity blues at either six hours and six days postpartum: baby not breastfeeding well (AOR=5.2; 95% CI: 1.7 – 16.4, p=0.005) and mother having had any Stressful life event during labor (AOR=15.2; 95% CI: 4.9 – 47.1, p=0.001). Overall, the odds of developing PPD was 5.3 times higher among mothers with maternity blues as compared to those without, p=0.0038. Conclusion: This study provides new insights into the prevalence of maternity blues in rural southwestern Uganda, highlighting a reduction in the prevalence of antepartum depression within the same cohort of mothers. However, there remains a need for additional preliminary data on maternity blues, as well as improved screening and intervention strategies, to enhance maternal mental health outcomes.