Comparison of Maternal Functioning between Iranian Mothers with and without Depressive Symptoms: A Case-Control Study

Postpartum depression (PPD) has adverse effects on the mother's ability to work, her relationships, performance in other roles, and caregiving ability. The aim of this study was to compare levels of maternal functioning between mothers with depression symptoms and those without. The participants of this case-control study included 80 postpartum women (n = 40 with depressive symptoms and n = 40 with no depressive symptoms) referred to health centers in Tabriz, Iran, in 2018-2019. The case and control groups were matched for the number of deliveries (first or second deliveries) and the type of delivery (vaginal or cesarean section). A sociodemographic questionnaire, Edinburgh Postpartum Depression Scale (EPDS), and Barkin Index of Maternal Functioning (BIMF) were used for data collection. The relationship between maternal functioning and depression was assessed by conducting independent t-tests and Pearson correlation tests in bivariate analysis and applying the general linear model (GLM) in a multivariate analysis. There was no statistically significant difference between the two groups in terms of sociodemographic information. The mean (SD) total scores of maternal functioning in the case (depressed) and control (non-depressed) groups were 63.4 (12.2) and 93.3 (13.0), respectively. According to the independent t-test, this value in the control group was significantly higher than that of the case group (mean difference: -30.0; 95% confidence interval: -35.6 to -24.3; p < 0.001). In terms of the domains of the BIMF, based on the independent t-test, the mean score of all domains in the control group was significantly higher than that of the case group, except for the mother-child interaction dimension (p = 0.219). Based on the Pearson correlation test, there was significant negative correlation between the PPD score and total score of BIMF (r = -0.79, p < 0.001) and its domains (r = -0.81 to -0.54, p < 0.001). In addition, based on the GLM with adjusting the sociodemographic and obstetrics characteristics, the score of maternal functioning was significantly lower in the case group compared to the control group [β = -30.1; 95% CI: -36.8 to -23.4; p = 0.001]. The results of this study indicate that women with depressive symptoms have lower maternal functioning. Depressed women may find it difficult to perform their maternal duties and take care of themselves and other family members due to the burden of the depressive symptoms. Therefore, early diagnosis and treatment of postpartum depression can play an important role in improving daily maternal functioning.