Comparison of depression scores between teenagers with unintended pregnancy who underwent medical abortion and those who underwent delivery in Ramathibodi Hospital using the Thai Edin-burgh Postnatal Depression Scale
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Abstract
Aim: To compare teenagers with unintended pregnancy that terminated their pregnancy and those who delivered using the Thai Edinburgh Postnatal Depression Scale (EPDS), and determine predisposing factors for depression.
Methods This prospective cohort study was conducted at a tertiary hospital between September 2018 and July 2019. Unintended teenage pregnancies that underwent medical abortion or delivery were included. Exclusion criteria were intended pregnancy, history of major depressive disorder diagnosis, and refusal to participate. All participants completed the EPDS within 2 weeks after termination or delivery.
Results In total, 131 teenage pregnancies were recorded over the study period. We excluded 10 intended pregnancies and one woman with history of major depressive disorder diagnosis. Sixty-five women underwent medical abortion (abortion group) and 55 underwent delivery (delivery group). There were 23 women (19.2%) with an EPDS score ≥11. The delivery group was more likely to have developed depression compared with the abortion group (25.4% vs. 13.8%, risk ratio [RR] 0.87, 95% confidence interval [CI] 0.72–1.04). The delivery group was more likely to live with a partner than the abortion group (54.5% vs. 9.2%, p<0.01). Significant protective factors for postpartum depression were having family support (RR 2.26, 95%CI 1.16–3.27), continuing education (RR 1.27, 95%CI 1.07–1.51), and living with a partner (RR 1.20, 95%CI 1.03–1.41).
Conclusion More teenagers with unintended pregnancy who deliver have postpartum depression than those who terminate their pregnancy, although the difference was not statistically significant. No family support, dropout from school, and living alone are predisposing factors for depression.
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