Depression during pregnancy is a significant public health problem because of its negative effects on the health of both mother and infant. Data on its prevalence and determinants are lacking in Bangladesh. To estimate the prevalence of depression during pregnancy and to identify potential contributory factors among rural Bangladeshi women, a community-based study was conducted during 2005 in Matlab sub-district, a rural area of eastern Bangladesh. Three hundred and sixty-one pregnant women were identified through an existing health and demographic surveillance system covering a population of 110,000 people. The women were interviewed at home at 34-35 weeks of pregnancy. Information on risk factors was collected through structured questionnaires, with the Bangla version of the Edinburgh Postnatal Depression Scale (EPDS-B) used to measure their psychological status. Both univariate analysis and multivariate logistic regression were applied using the SPSS 15.0 statistical software. The prevalence of depression at 34-35 weeks pregnancy was 33% (95% CI, 27.6-37.5). After adjustment in a multivariate logistic regression model, a history of being beaten by her husband either during or before the current pregnancy had the highest association with depression followed by having an unhelpful or unsupportive mother-in-law or husband, and family preference for a male child. Of the antenatally depressed women, 17 (14%) admitted to thoughts of self-harm during the pregnancy. This paper further explores the reasons why women have considered some form of self-harm during pregnancy. Depression during pregnancy is common among Bangladeshi women, with about a third being affected. The study highlights the need to allocate resources and develop strategies to address depression in pregnancy.

The high prevalence of PND in the study was similar to other countries in the South Asian region. The study findings highlight the need for programme managers and policy makers to allocate resources and develop strategies to address PND in Bangladesh.

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Short and long inter-pregnancy intervals are associated with increased incidence of some maternal morbidities.

In developing countries, postnatal depression (PND) is estimated to affect a high proportion of women following childbirth. There are no reliable estimates for the magnitude of the problem in Bangladesh, a country of 140 million people. The lack of a validated Bangla version of screening scale such as the Edinburgh Postnatal Depression Scale (EPDS) has hindered attempts to quantify and address the problem in the country. This study was carried out among Bangladeshi women to validate the Bangla version of the EPDS with the help of a multi‐disciplinary research consultative group. A research assistant administered the Bangla EPDS to a convenience sample of 100 mothers at 6–8 weeks postpartum attending an urban childhood immunization clinic. A psychiatrist examined all women using the Structured Clinical Interview (SCID) for DSM‐IV diagnosis of depression. Nine (9%) women were found to have depression. Internal consistency was tested using Cronbach\u27s alpha coefficient (0.84). The optimal Receiver Operating Characteristic (ROC) cut‐off score of Bangla EPDS was 10 with a sensitivity of 89%, specificity of 87 %, positive predictive value of 40%, and negative predictive value of 99%. The Bangla EPDS is thus a valid and reliable screening scale for identifying PND in Bangladesh

BackgroundIn developed countries, perinatal death is known to cause major emotional and social effects on mothers. However, little is known about these effects in low income countries which bear the brunt of perinatal mortality burden. This paper reports the impact of perinatal death on psychological status and social consequences among mothers in a rural area of Bangladesh.MethodsA total of 476 women including 122 women with perinatal deaths were assessed with the Edinburgh Postnatal Depression Scale (EPDS-B) at 6 weeks and 6 months postpartum, and followed up for negative social consequences at 6 months postpartum. Trained female interviewers carried out structured interviews at women's home.ResultsOverall 43% (95% CI: 33.7-51.8%) of women with a perinatal loss at 6 weeks postpartum were depressed compared to 17% (95% CI: 13.7-21.9%) with healthy babies (p = < 0.001). Depression status were significantly associated with women reporting negative life changes such as worse relationships with their husband (adjusted OR = 3.89, 95% CI: 1.37-11.04) and feeling guilty (adjusted OR = 2.61, 95% CI: 1.22-5.63) following the results of their last pregnancy outcome after 6 months of childbirth.ConclusionsThis study highlights the greatly increased vulnerability of women with perinatal death to experience negative psychological and social consequences. There is an urgent need to develop appropriate mental health care services for mothers with perinatal deaths in Bangladesh, including interventions to develop positive family support.

Standardized questionnaires for screening common health problems in the community often need to be translated for use in non-English speaking countries. There is a lack of literature documenting the process of translation of such questionnaire/scale that would enable their application in cross-cultural settings and standardization of the procedure. This paper reports the process of translation into Bangla of the widely used Edinburgh Postnatal Depression Scale (EPDS) for use in Bangladesh. Three methods: forward translation, committee translation, and back translation were used to ensure the equivalence of the translated version. Both the English and Bangla versions were piloted among 10 social science graduates who were proficient in both the languages. The concurrence of each respondent between the two versions showed a correlation coefficient of 0.98 (p<0.01). The BlandAltman test also showed a high degree of agreement. The piloted version was also tested with 15 women in the postnatal period and found to be suitable for women with lower educational attainment. The documentation of the translation process and the lessons learnt would be helpful in similar settings where screening questionnaires need to be adapted for local use.