Workplace Stress, Overcommitment, and Maternal Health as Predictors of Postpartum Depression: A Case-Control Study...

Postpartum depression (PPD) is a major mental health concern for employed mothers in low-resource settings, where workplace stress, gendered expectations, and limited support are prevalent. This study aimed to examine the associations between workplace stress, overcommitment, family support, and selected maternal health factors with postpartum depression among employed married women in Dhaka, Bangladesh.

A hospital-based matched case-control study was conducted between March 2025 and May 2025 across five Surjer Hashi Clinics in Dhaka City. A total of 374 participants were recruited, consisting of 187 cases (EPDS score ≥ 12) and 187 matched controls (EPDS < 12). Cases and controls were individually matched on age and profession. Workplace stress was assessed using the Workplace Stress Scale (WSS), overcommitment was measured via the Effort-Reward Imbalance (ERI) model's OC subscale, and family support was evaluated using the Family APGAR scale. Conditional Logistic Regression (CLR) was employed to estimate matched adjusted odds ratios (mAOR) with 95% confidence intervals.

Higher parity (≥ 3 children) (mAOR = 4.27, 95% CI: 2.11-8.38), cesarean delivery (mAOR = 2.29, 95% CI: 1.84-5.91), and anemia during pregnancy (mAOR = 4.11, 95% CI: 2.26-38.32) were significantly associated with PPD. Severe anxiety emerged as a strong predictor (mAOR = 14.61, 95% CI: 2.09-43.81). Workplace-related factors demonstrated robust associations: women with severe workplace stress were over 18 times more likely to develop PPD (mAOR = 18.45, 95% CI: 5.33-57.96), while high overcommitment increased the odds nearly ninefold (mAOR = 8.16, 95% CI: 4.22-31.65). Family dysfunction was also a significant predictor, with women from severely dysfunctional families exhibiting 6.37 times higher odds of PPD compared to those from functional families.

Workplace stress, overcommitment, and dysfunctional family environments are strongly associated with PPD, highlighting the need for targeted workplace reforms, family support interventions, and maternal mental health policies in urban, low-resource settings.