Knowledge and Attitudes of Pediatricians and Pediatric Residents Towards Postpartum Depression Screening of Women in Lebanon.

Abstract

BACKGROUND: Postpartum depression (PPD) is a major public health concern affecting maternal well-being and child development. In Lebanon, nearly one-third of postpartum women screen positive for PPD, yet routine screening remains inconsistent. The American Academy of Pediatrics recommends that pediatricians screen for PPD during early well-child visits, but pediatric clinicians’ knowledge, attitudes, and practices in Lebanon remain unclear. METHODS: A national cross-sectional online survey targeted practicing pediatricians and pediatric trainees in Lebanon. Online questionnaires, shared via institutional emails and personal social media connections, assessed knowledge of screening tools, attitudes toward responsibility, current practices, perceived barriers, and training needs. Responses were received from 102/1221 pediatricians and 89/155 trainees (response rates: 8.3% and 57.4%). Descriptive statistics, bivariate analyses, and multivariable logistic regression identified predictors of knowledge, resource awareness, and willingness to attend training. RESULTS: Only 34.0% identified the Edinburgh Postnatal Depression Scale as a commonly used screening tool, and 20.4% correctly identified recommended screening timing. Overall, 86.9% reported no formal training in PPD screening. Although 69.1% supported standardized tools, only 22.8% of pediatricians used them in practice, with most relying on clinical impression. Nearly half (48%) believed obstetricians/gynecologists should be primarily responsible for screening, whereas 32.8% identified pediatricians. Pediatricians were more aware of referral resources than trainees (aOR 6.24; 95% CI 2.52–15.48) but less willing to attend training (aOR 0.15; 95% CI 0.05–0.44). Major barriers included limited awareness of mental health services (31.9%), cultural stigma (29.3%), and time constraints (20.9%). CONCLUSION: Significant gaps exist in knowledge, training, and implementation of PPD screening among pediatric clinicians in Lebanon. Despite recognizing its importance, pediatricians often defer responsibility and rely on subjective assessment rather than standardized tools. Addressing training deficits, clarifying professional roles, and improving access to referral resources are essential to enhance early detection.