A preliminary study on identifying specific risk factors of post-partum depression
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20195589Keywords:
Demographic factors, Obstetric factors, Post-partum depression, Risk factors, Social factorsAbstract
Background: Pregnancy and childbirth are important events in the life of a woman and also highly vulnerable period of various physiological and psychological illnesses. Several literatures propound that 22% young Indian mothers are showing depressive symptoms after delivery. The consequence of maternal depression is adverse both for mother and development of the child. Objective of this study was to examine the social and obstetric factors contributing post-partum depression.
Methods: Women, 18-35 years of age, having four days to one-year postpartum period was taken from the tertiary care hospital settings. Terminal illness, still birth delivery and comorbid psychiatric illness was excluded. Screening and diagnosis of postpartum depression done based on international classification of diseases (ICD 10) using Edinburgh post-natal depression scale (EPDS). A comparative approach by the means of descriptive statistics was implied for data analysis where mothers with depressive symptoms are experimental group and non-depressed mothers were acted as the controls.
Results: Study findings indicated a statistically significant association between postpartum depression and risk factors such as occupation and average social economic class, first time delivery.
Conclusions: It is a preliminary study in a restricted geographical area, not covering the neurobiological risk factors of postpartum depression. Hence, the future study will focus on the large sample size in a multi areal population for assuring the accuracy of the result.
References
Smith MV, Shao L, Howell H, Lin H, Yonkers KA. Perinatal depression and birth outcomes in a Healthy Start project. Matern Child Health J. 2011;15(3):401-9.
Alipour Z, Lamyian M, Hajizadeh E. Anxiety and fear of childbirth as predictors of postnatal depression in nulliparous women. Women Birth. 2012;25(3):e37-43.
Stocky A, Lynch J. Acute psychiatric disturbance in pregnancy and the puerperium. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14:73-87.
Beyond Blue. Clinical practice guidelines for depression and related disorders: anxiety, bipolar disorder, and puerperal psychosis in the perinatal period. A Guideline for Primary Care Health Professionals. Melbourne: The National Depression Initiative; 2011. Available at: https://cope.org.au/wp-content/uploads/2013/12/Perinatal-Mental-Health-Clinical-Practice-Guidelines.pdf. Accessed on 28th May 2017.
O'Hara, MW, Swain AM. Rates and risk of postpartum depression - a meta-analysis. Int Rev Psychiatry. 1996;8(1):37-54.
Nonacs R, Cohen LS. Postpartum mood disorders: diagnosis and treatment guidelines. J Clin Psychiatry. 1998;59(Suppl 2):34-40.
Kendell RE, Chalmers JC, Platz C. Epidemiology of puerperal psychoses. Br J Psychiatry. 1987;150:662-73.
Miller LJ. Postpartum depression. JAMA. 2002;287(6):762-5.
Brockington IF, Cernik KF, Schofield EM, Downing AR, Francis AF, Keelan C. Puerperal psychosis. phenomena and diagnosis. Arch Gen Psychiatry. 1981;38(7):829-33.
American psychiatric association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013.
World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.
Wisner KL, Parry BL, Piontek CM. Clinical practice. Postpartum depression. N Engl J Med. 2002;347(3):194-9.
The World Health Report 2001. Mental Health: New Understanding, New Hope. Available at: https://www.who.int/whr/2001/en/whr01_en.pdf. Accessed on 28th May 2017.
Fisher J, Tran T, Duc Tran T, Dwyer T, Nguyen T, Casey GJ, et al. Prevalence and risk factors for symptoms of common mental disorders in early and late pregnancy in Vietnamese women: a prospective population-based study. J Affect Disord. 2013;146(2):213-9.
Upadhyay RP, Chowdhury R, Aslyeh S, Sarkar K, Singh SK, Sinha B, et al. Postpartum depression in India: a systematic review and meta-analysis. Bull World Health Organ. 2017;95(10):706-717C.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry. 1987;150:782-6.
Patel V, Rodrigues M, De Souza N. Gender, poverty and post-natal depression: a cohort study from Goa, India. Am J Psychiatry. 2002;159:43-7.
Prabhu TR, Asokam TV, Rajeshwari A. Post-partum psychiatric illnesses. J Obstet Gynecol India. 2005;55(4):329-32.
Rahman A, Iqbal Z, Harrington R. Life events, social support and depression in childbirth: perspectives from a rural community in the developing world. Psychol Med. 2003;33:1161-7.
Sood M, Sood AK. Depression in pregnancy and postpartum period Indian. J Psychiatry. 2003;45(1):48-51.
Klainin P, Arthur DG. Postpartum depression in Asian cultures: A literature review. Int J Nurs Stud. 2009;46:1355-73.
Bödecs T, Szilágyi E, Cholnoky P, Sándor J, Gonda X, Rihmer Z, et al. Prevalence and psychosocial background of anxiety and depression emerging during the first trimester of pregnancy: data from a Hungarian population-based sample. Psychiatr Danub. 2013;25(4):352-8.
Dibaba Y, Fantahun M, Hindin MJ. The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: evidence from rural Southwestern Ethiopia. BMC Pregnancy Childbirth. 2013;13:135.
Selix NW, Goyal D. Postpartum Depression Among Working Women: A Call for Practice and Policy Change. The J Nurse Pract. 2015;11(9):897-902.
Goyal D, Gay C, Lee K. Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum. Arch Womens Ment Health. 2009;12(4):229-237.
Saldanha D, Rathi N, Bal H, Chaudhari B. Incidence and evaluation of factors contributing towards postpartum depression. Med JDY Patil Univ. 2014;7(3):309-16.
Chandran M, Tharyan P, Muliyil J, Abraham S. Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors. Br J Psychiatry. 2002;181:499-504.
Karmaliani R, Asad N, Bann CM, Moss N, McClure EM, Pasha O, et al. Prevalence of anxiety, depression and associated factors among pregnant women of Hyderabad, Pakistan. Int J Soc Psychiatry. 2009;55:414-24.
Raisanen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002-2010 in Finland. BMJ Open. 2014;4:e004883.
Johnstone SJ, Boyce PM, Hickey AR, Morris-Yatees AD, Harris MG. Obstetric risk factors for postnatal depression in urban and rural community samples. Aust New Zealand J Psychiatry. 2001;35:69-74.
Pfost KS, Stevens MJ, Lum CU. The relationship of demographic variables, antepartum depression, and stress to postpartum depression. J Clin Psychol. 1990;46:588-92.