{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T01:55:10Z","timestamp":1784771710248,"version":"3.55.0"},"reference-count":55,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"unspecified","delay-in-days":209,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2045796025100103_sec1a\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>About one-third of South African women have clinically significant symptoms of postpartum depression (PPD). Several socio-demographic risk factors for PPD exist, but data on medical and obstetric risk factors remain scarce for low- and middle-income countries and particularly in sub-Saharan Africa. We aimed to estimate the proportion of women with PPD and investigate socio-demographic, medical and obstetric risk factors for PPD among women receiving private medical care in South Africa (SA).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796025100103_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>In this longitudinal cohort study, we analysed reimbursement claims from beneficiaries of an SA medical insurance scheme who delivered a child between 2011 and 2020. PPD was defined as a new International Classification of Diseases, 10th Revision diagnosis of depression within 365\u00a0days postpartum. We estimated the frequency of women with a diagnosis of PPD. We explored several medical and obstetric risk factors for PPD, including pre-existing conditions, such as HIV and polycystic ovary syndrome, and conditions diagnosed during pregnancy and labour, such as gestational diabetes, pre-term delivery and postpartum haemorrhage. Using a multivariable modified Poisson model, we estimated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for factors associated with PPD.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796025100103_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Of the 47,697 participants, 2,380 (5.0%) were diagnosed with PPD. The cumulative incidence of PPD increased from 0.8% (95% CI 0.7\u20130.9) at 6 weeks to 5.5% (5.3\u20135.7) at 12\u00a0months postpartum. PPD risk was higher in individuals with history of depression (aRR 3.47, 95% CI [3.14\u20133.85]), preterm delivery (1.47 [1.30\u20131.66]), PCOS (1.37 [1.09\u20131.72]), hyperemesis gravidarum (1.32 [1.11\u20131.57]), gestational hypertension (1.30 [1.03\u20131.66]) and postpartum haemorrhage (1.29 [0.91\u20131.85]). Endometriosis, HIV, gestational diabetes, foetal stress, perineal laceration, elective or emergency C-section and preeclampsia were not associated with a higher risk of PPD.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796025100103_sec4d\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>The PPD diagnosis rate was lower than anticipated, based on the PPD prevalence of previous studies, indicating a potential diagnostic gap in SA\u2019s private sector. Identified risk factors could inform targeted PPD screening strategies.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s2045796025100103","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T06:22:15Z","timestamp":1753770135000},"source":"Crossref","is-referenced-by-count":2,"title":["Diagnosis of postpartum depression and associated factors in South Africa: a cohort study of 47,697 women"],"prefix":"10.1017","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7257-2962","authenticated-orcid":false,"given":"C.","family":"Gastaldon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Whitesell Skrivankova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3851-4117","authenticated-orcid":false,"given":"G.","family":"Schoretsanitis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Folb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Taghavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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