Discussion
Our study found that the odds of PPD were lower in females
who received epidural analgesia for labor compared with
those who chose nonepidural analgesia. We found a very
strong association between development of PPD and previous
history of depression or PPD and family history of depression.
Predisposing effect of these psychiatric risk factors has been
well established and proved to be independent risk factors
for PPD.10,19,20 Our finding of association between increasing
maternal age and higher risk of PPD (OR 1.56 for every
5-year increase) is similar to the finding of Canadian community
health survey, which identified the prevalence of
depression in females who had recently delivered was significantly
higher in females aged 40–44 years than in females
aged 30–35 years (OR 3.72, 95% CI 2.15–6.41).21 This could
be due to the fact that older females have higher rates of
multiple births and pregnancy complications, such as high