MEDIATORS OF DEPRESSION ON BAROREFLEX DYSFUNCTION IN POSTPARTUM ORTHOSTATIC HYPOTENSION WITH FAMILY SCAPEGOATING ABUSE

Background: Orthostatic hypotension (OH) poses cardiovascular risks to postpartum women amid physiological shifts, yet its interplay with psychosocial stressors like family scapegoating abuse (FSA) remains underexplored. Methods: This cross-sectional study recruited 666 postpartum women aged 20-30 years from Ndola, Zambia health facilities. OH diagnosis involved supine and standing blood pressure measurements. FSA-25 and DASS-21 assessed psychosocial factors. Structural equation modeling tested mediation pathways; ROC analysis determined FSA-25 cutoffs. Results: OH prevalence reached 13.96%, strongly linked to elevated FSA (χ²(3) = 223.72, p < 0.001). Depression heightened OH risk (Coef. = 0.248, p < 0.001), with employment and FSA partially mediating (employment: Coef. = -0.112 for OH, 0.055 for depression, both p < 0.005; FSA: Coef. = 0.865 for depression, p < 0.001). Anxiety amplified effects; education attenuated depression; BMI directly predicted OH (Coef. = 0.077, p < 0.001). Stress influenced depression without OH impact; parity and symptom severity showed no significance. ROC identified an FSA cutoff of 4.00 for depression-aligned grading. Conclusions: FSA, employment, anxiety, education, and BMI mediate depression's role in postpartum OH. Routine integrated screening with FSA ordinal scales could enhance maternal cardiovascular care.