Assessment of knowledge and attitude toward postpartum depression among Saudi women aged 18 and above in Al-Ahsa, Eastern Province, Saudi Arabia

Background: Postpartum depression (PPD) is a common and serious mental health condition occurring after childbirth, with important consequences for mothers, infants, and families. Despite its public health relevance, awareness, and attitudes toward PPD remain variable across different populations. 
Aim: This study aimed to assess knowledge and attitudes toward PPD among Saudi women in Al-Ahsa and to identify associated sociodemographic and obstetric factors. 
Methods: A cross-sectional study was conducted among 378 Saudi women aged ≥18 years in Al-Ahsa, Eastern Province, Saudi Arabia, between March and May. Participants were recruited using a convenience sampling technique through online platforms. Data were collected using a structured, self-administered questionnaire covering sociodemographic characteristics, knowledge of PPD, and attitudes toward PPD. 
Results: Out of 378 participants, 298 (78.8%) had good knowledge of PPD, while 80 (21.2%) had poor knowledge. Regarding attitudes, 287 (75.9%) demonstrated a positive attitude, 68 (18.0%) were neutral, and 23 (6.1%) had a negative attitude. High awareness was observed for key risk factors, including domestic violence (320, 84.7%), lack of social support (317, 83.9%), and stress (316, 83.6%). Commonly recognized symptoms included intense sadness (318, 84.1%), social withdrawal (315, 83.3%), and suicidal thoughts (292, 77.2%). In multivariable analysis, age ≥40 years was associated with lower odds of good knowledge (AOR = 0.28, 95% CI: 0.07-1.00, p = 0.049), while employment increased odds (AOR = 1.85, 95% CI: 1.02-3.36, p = 0.04). Women with 1-3 pregnancies had higher odds of good knowledge (AOR = 2.41, 95% CI: 1.59-6.81, p = 0.049), whereas those with >5 children had lower odds (AOR = 0.52, 95% CI: 0.26-0.99, p = 0.048).
Conclusion: Women in Al-Ahsa demonstrated generally good knowledge and positive attitudes toward PPD, although gaps in specific risk factor awareness and persistent stigma-related beliefs remain.