Social support in peripartum depression: cross-sectional analytical study at a district hospital in Gauteng province, South Africa
Marko Breedt-Kriek, Hendrik Stefan Bosman, Tshepiso Daphne MoeketsiBackground
Peripartum depression is a common complication of pregnancy and the postpartum period, with adverse consequences for maternal and infant well-being. Perceived social support may be a modifiable protective factor, but South African data linking social context and depressive symptoms remain limited.
Aims
To estimate the proportion of peripartum women screening positive for clinically significant depressive symptoms; describe perceived social support and selected social determinants of health; examine associations between social support and screening outcome; and explore whether findings differed between ante- and postpartum participants.
Method
This cross-sectional analytical study was conducted at Tshwane District Hospital, Gauteng, South Africa. Two hundred peripartum women (100 antenatal clinic, 100 postnatal ward) completed a sociodemographic questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and the Oslo Social Support Scale. Screening positivity was defined primarily as EPDS ≥13, with a sensitivity analysis using EPDS ≥11.
Results
Using the primary EPDS threshold (≥13), 36.5% ( n = 73) screened positive for clinically significant depressive symptoms and 48.0% ( n = 96) screened positive in the sensitivity analysis (EPDS ≥11). Poor, moderate and strong perceived social support were reported by 29.5, 45.5 and 25.0% of participants, respectively. Lower perceived social support was significantly associated with screening positivity at EPDS ≥13 ( p = 0.0062) and remained significant at EPDS ≥11 ( p = 0.0008). At EPDS ≥13, lack of access to electricity ( p = 0.0252) and a prior depressive disorder diagnosis ( p = 0.0251) were also associated with screening positivity. In the sensitivity analysis (EPDS ≥11), reported discrimination/violence/abuse ( p = 0.0077) and antepartum status ( p = 0.0106) were additionally associated with screening positivity.
Conclusion
Lower perceived social support showed a robust association with screening positivity, supporting the value of integrating brief screening for depressive symptoms and support needs into routine antenatal and postnatal care, with clear referral pathways for psychosocial support.