DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20210721

Prevalence and risk factor analysis for postpartum depression: a cross sectional study at tertiary care center, Mangalore

Vatsala Kamath, Disha Ajila, Shashirekha H. D.

Abstract


Background: The overall pooled estimate of the prevalence of Postpartum depression in Indian mothers is 22%. In India, women who deliver at a health facility often stays less than 48hrs after delivery and this leaves little opportunity for health personnel to counsel the mother and family members on the signs and symptoms of Postpartum depression (PPD) and when to seek care. So, it is important to screen the postpartum woman for depression. Edinburgh Postnatal Depression Scale is used as an effective tool to assess the level of postnatal depression. The objective of the study was to assess the prevalence and risk factors associated with postpartum depression in the postnatal mothers using EDPS scale.

Methods: This study was conducted at A. J. Institute of Medical Sciences and Research Center from January 2019 to May 2020. A total of 950 postnatal mothers were interviewed using Edinburgh Postnatal Depression Scale.

Results: A total of 950 cases were studied. Prevalence of Postpartum depression was 15.78%. Increased incidence was seen in the primigravida (12.2%) compared to multigravidas (3.57%). This study showed 1.89% mothers belonging to upper middle class, 5.05% belonging to lower middle class had PPD and 7.26% belonging to upper lower class and 1.57 % patients belonging to lower class had PPD. In our study, 9.26% patients who underwent normal vaginal delivery had PPD and 6.52% of patients who underwent lower segment caesarean section had PPD. In the present study, it was found that 1.05% mothers having IUD babies and 5.2% (96/950) mothers who required NICU admission developed PPD.

Conclusions: In this study, the prevalence of postpartum depression was 15.78%. Risk of PPD is more with primigravida, belonging to lower middle class status, mothers who had NVD and mothers of IUD babies. Postpartum depression screening should be an integral part of postnatal care using EPDS scale. A multidisciplinary approach including obstetrician and psychiatrists and counsellor can jointly take care of the depressed mothers. Early screening of the women may reduce the adverse outcomes among both mother and child. Proper counselling should be done to all the pregnant women and the family members for the birth preparedness.


Keywords


EDPS scale, Postpartum depression, Prevalence

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References


Upadhyay RP, Chowdhury R, Salehi A, Sarkar K, Singh SK, Sinha B, et al. Post partum depression in India:A systematic review and metanalysis. Bulletin of the World Health Organization. 2017;95:706-17C.

Joseph G, da Silva IC, Wehrmeister FC, Barros AJ, Victora CG. Inequalities in the coverage of place of delivery and skilled birth attendance: analyses of cross-sectional surveys in 80 low and middle-income countries. Reprod Health. 2016;13(1):77.

Home based newborn care operational guidelines (revised 2014). New Delhi: Ministry of Health and Family welfare; 2014. Available at; http://nhm.gov.in/images/pdf/programmes/child-health/guidelines/Revised_Home_Based_New_Born_Care.

O’hara MW, Swain AM. Rates and risk of postpartum depression -a meta-analysis. Int Rev Psychiatr. 1996;8(1):37-54.

Blackmore ER, Jones I, Doshi M, Haque S, Holder R, Brockington I, et al. Obstetric variables associated with bipolar affective puerperal psychosis. Br J Psych. 2006;188:32-6.

Mayberry LH, Horowitz JA, Declercq E. Depression symptom prevalence and demographic risk factors among U.S. women during the first 2 years postpartum. J Obstet Gynecol Neonatal Nurs. 2007;36:542-9.

Afiya M.Shafi, Rohi Jain, Smita Pandey. A preliminary study on identifying specific risk factors of post partum depression. Int J Reprod Contracept Obstet Gynecol 2020;9(1):48-55.

Mathur P, Mathur R, Singh A. A clinical study of postpartum depression and its association with postnatal factors. Int J Reprod Contracept Obstet Gynecol. 2018;7:2120-2.

Patel V, Abas M, Broadhead J, Todd C, Reeler A. Depression in developing countries: lessons from Zimbabwe, BMJ. 2001;322:482-4.

Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatr. 2016;3(10):973-82.

Shidhaye P, Giri P. Maternal depression: a hidden burden in developing countries. Ann Med Health Sci Res. 2014;4(4):463-5.

Field T. Postpartum depression effects on early interactions, parenting and safety practices: a review. Infant Behav Dev. 2010;33(1):1-6.

Surkan PJ, Kennedy CE, Hurley KM, Black MM. Maternal depression and early childhood growth in developing countries :systematic review and meta analysis. Bull World Health Organ. 2011;89(8):608-15D.

Stewart DE, Robertson E, Dennis CL, Grace SL, Wallington T. Postpartum depression: literature review of risk factors and interventions. Toronto: University Health Network Women’s health Program; 2003.

Dennis CL, Stewart DE. Treatment of postpartum depression, part 1: a critical review of biological interventions. J Clin Psychiatr. 2004;65(9):1242-51.

Dadi AF, Akalu TY, Baraki AG, Wolde HF. Epidemiology of post natal depression and its associated factors in Africa: A systematic review and meta anlysis PLoS One. 2020;15(4);e0231940.

Rani R, Nandi N, Parmar SS, Rathore P. Prevalence and risk factor analysis for post partum depression in women: a cross sectional study at tertiary care center. Int J Reprod Contracept Obstet Gynecol. 20209(1):266-9.

Azad R, Fahmi R, Shreshta S, Joshi H, Hasa M, Khan ANS. Prevalence and risk factors of postpartum depression within one yaer after birth in urban slums of Dhaka, Bangaldesh, PLoS ONE. 14(5):e0215735.

Kruthika K, Udayar SE, Mallapur MD. An epidemiological study of postnatal depression among women availing maternal health services in rural areas of Belgavi, Karnataka, India. Int J Community Med Public Health. 2017;4:759-63.

Hegde S, Latha KS, Bhat SM, Sharma PSVN, Kamth A. Postpartum Depression: Prevalence and Associated Factors among Women in Indian J Women Health Issues care. 2012;1:13-7.

D C Dutta’s textbook of obstetrics, 9th edition.