Socio-Demographic and Reproductive Factors Associated with Depression Among Postmenopausal Women in Obio/Akpor Local Government Area, Rivers State

Abstract

Depression is a common but under-recognised mental health problem among postmenopausal women, particularly in low- and middle-income countries where mental health services are limited. In Nigeria, community-based evidence on factors associated with depression in this population remains scarce. This study assessed the reproductive and socio-demographic factors associated with depression among postmenopausal women in Obio/Akpor Local Government Area, Rivers State, Nigeria. A community-based cross-sectional study was conducted among 341 postmenopausal women aged 51 years and above, selected through multistage sampling. Data were collected using an interviewer-administered questionnaire comprising socio-demographic characteristics, reproductive history, and the Patient Health Questionnaire-9 (PHQ-9). Descriptive statistics, chi-square tests, and ordinal logistic regression were performed. Statistical significance was set at p < 0.05. Of the 341 respondents, 24.6% had no depression, while 27.3%, 21.7%, 15.8%, and 10.6% had mild, moderate, moderately severe, and severe depression, respectively. Marital status, educational level, employment status, monthly income, physical activity, history of miscarriage, and type of menopause were significantly associated with depression. In the multivariable analysis, being widowed (aPOR = 1.45), unemployed (aPOR = 1.92), having a history of miscarriage (aPOR = 1.42), and experiencing surgical or medical menopause (aPOR = 1.85) increased the odds of higher depression severity, while tertiary education (aPOR = 0.54), higher income (aPOR = 0.42), and physical activity (aPOR = 0.71) were protective. This study showed evidence of a high burden of depressive symptoms among postmenopausal women and identified significant reproductive and socio-demographic factors associated with depression. Our findings have implications for strengthening mental health policies and the need to integrate mental health screening into routine care for postmenopausal women.