Prevalence and associated risk factors of postpartum depressive symptoms among women in the Pwani region, Tanzania: a cross-sectional study

Postpartum depression (PPD) is a major public health concern, particularly in low- and middle-income countries, where it adversely affects women’s wellbeing, mother–infant bonding, and children’s social, behavioral, and cognitive development. However, research on PPD in Tanzania remains scarce. This study assessed the prevalence and factors associated with, postpartum depressive symptoms (PDS) among mothers in the Pwani region of Tanzania. This is a cross-sectional study, and the data was obtained from an implementation study on portable cardiotocography (iCTG) of fetal monitoring in the late antepartum period in the Pwani region, Tanzania. The study was conducted in four purposively selected health facilities in the Kisarawe and Bagamoyo districts of the Pwani region. Data was collected from 763 mothers who were enrolled in the iCTG implementation study and attended the selected health facilities within 4–6 weeks of postpartum. Sociodemographic and obstetric data were collected using a structured questionnaire. Postpartum depressive symptoms were assessed with the validated Edinburgh Postnatal Depression Scale (EPDS), using a cut-off score of ≥ 10. Chi square test along with univariable and multivariable logistic regression analyses were performed to identify the associated factors. The overall prevalence of PDS was 19.79%, comprising 12.84% with mild symptoms (EPDS score 10–13), 4.46% with moderate symptoms (EPDS score 14–19), and 2.49% with severe symptoms (EPDS score ≥ 20). In the univariable analysis, mothers with ≥ 35 years of age [odds ratio (OR):1.67, 95% confidence interval (CI): 1.04–2.68; P = 0.035], single mothers (OR:1.75; 95% CI: 1.06–2.90; P = 0.029), working mother (OR:1.58, 95% CI: 1.09–2.31; P = 0.017), and unplanned pregnancy (OR:1.64, 95% CI: 1.14–2.37; P = 0.008) were associated with PDS. In multivariable logistic regression analysis, PDS was significantly associated with single mothers [adjusted odds ratio (aOR):1.96, 95% 1.05–3.68; P = 0.035] and working mothers (aOR: 1.58, 95% CI: 1.04–2.40; P = 0.032). The burden of PDS among mothers in Tanzania remains high, particularly among single and employed women. Integrating routine mental health screening, health education, and counseling into maternity services may help reduce PDS and improve maternal and newborn outcomes.