Variation in the Prevalence of Postpartum Depressive Symptoms in Brazil: National Health Survey, 2013 and 2019

Abstract Postpartum depression (PPD) is considered a public health issue due to its prevalence and its impact on the health of women and children [4,5]. A literature review of studies published between 2009 and 2022 on the Brazilian population regarding the prevalence and associated factors of PPD found that the prevalence of PPD ranged from 7.2% in Recife to 50.6% in Salvador [5]. The main objective of this study is to analyze the variation of postpartum depression in Brazil in the years 2013 and 2019. Additionally, the specific objectives are to calculate the prevalence of postpartum depression in Brazil and to evaluate the variation of postpartum depression according to socioeconomic, demographic, and regional characteristics. This study utilized data from two population-based, cross-sectional surveys: the National Health Survey (PNS) conducted in 2013 and 2019. The primary outcome assessed was postpartum depressive symptoms in women aged 18 years or older who had given birth within the 18 months prior to the interview date. The evaluation of depressive symptoms was based on the Patient Health Questionnaire-9 (PHQ-9), with a cutoff score of 10 or higher indicating the presence of significant depressive symptoms. The variation in prevalence between the 2013 and 2019 surveys was expressed both in absolute terms and as a percentage change of the prevalence ratio. Notably, there was a shift in the demographic profile of the women, particularly concerning age and educational attainment. An increase in the prevalence of postpartum depressive symptoms was observed across all variables and categories studied, with a relative increase of 41.3% in Brazil, rising from 9.9% in 2013 to 14% in 2019. When evaluating the selected age groups, it is noteworthy that the greatest relative variation in prevalence was among women aged 35 years or older (148.4%). Additionally, a high variation was found for the lowest level of education considered—up to incomplete primary education (94.7%). This study demonstrated an increase in postpartum depressive symptoms between 2013 and 2019 in Brazil. Among the main explanations for these increases are the economic crisis that occurred in the country during this period and changes in Brazilian family structures. Therefore, it is important to highlight the need for public investment in maternal mental health during the postpartum period. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study did not receive any funding Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study will utilize secondary data from the 2013 and 2019 PNS, which were approved by the National Research Ethics Committee (CONEP) of the National Health Council (CNS), in June 2013 (Ordinance No. 328.159) and August 2019 (Ordinance No. 3.529.376), respectively. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced are available online at IBGE's official website.