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Research Article: Beyond the blues: marital dissatisfaction as a stronger predictor of postpartum depression than maternity blues among postpartum women: a prospective study in a Turkish cohort

Date Published: 2026-01-28

Abstract:
This study aimed to determine whether maternity blues (MBs) act as an independent predictor of postpartum depression (PPD), after controlling for key psychosocial factors in a Turkish cohort. In this prospective cohort study, 324 women were followed for 6?weeks postpartum. MB status was assessed in the first week, and PPD risk was evaluated at 4–6?weeks via the Edinburgh Postnatal Depression Scale (EPDS; cutoff ?12). A propensity score matching (PSM) analysis was conducted to control for confounding variables, followed by multivariate logistic regression on the matched cohort. The study was reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Of the 324 participants, 84 (25.9%) were at high risk for PPD. In the matched cohort ( n =?168), multivariate analysis confirmed MB as a significant independent predictor (adjusted odds ratio [aOR]?=?3.52, 95% CI: 1.98–6.24, p <?0.001). Critically, marital dissatisfaction emerged as a stronger independent predictor (aOR?=?5.98, 95% CI: 2.95–12.14, p <?0.001) than maternity blues. While MB is a significant predictor, its standalone accuracy is modest (AUC?=?0.62). Marital dissatisfaction is a more powerful determinant in this cohort. Screening should integrate psychosocial risk factors alongside MB symptoms.

Introduction:
The postpartum period is a critical phase of profound physical and emotional changes, representing a time of heightened vulnerability of women to psychiatric disorders ( 1 ). Among the mood disturbances that can occur during this period, maternity blues (MBs) and postpartum depression (PPD) are of significant clinical importance. PPD is a global public health concern ( 2 ), and its prevalence in Turkey is notably high. Meta-analyses suggest a rate of approximately 24%, whereas individual studies report rates…

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