Assessment of magnitude and predictors of postpartum depression among mothers attending immunization clinics in Bihar, India

Abstract

Background: Postpartum depression (PPD) is characterized by a protracted phase of emotional turmoil which ensues at the time of major life change and increased responsibilities in the upkeep of a newborn child. In fact, it represents a considerable public health problem and has been found to have multiple etiologies including sociodemographic, economical, psychosocial, obstetrical, and medical risk factors. Hence, this study was conducted with the objective of estimating the proportion of PPD among mothers attending the immunization clinics and its association with various sociodemographic and other risk factors. Methods: All eligible mothers (up to 3 months after delivery) attending the immunization clinics at the health centers were interviewed using a pre-designed questionnaire and relevant information on sociodemographic, obstetrical, and other psychosocial factors was obtained. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) where the cutoff score of ≥ 13 was considered as being at risk for PPD. Results: A total of 400 mothers were included. The overall proportion of PPD came out to be 15.0% (95% CI 11.83–18.83%) while the median EPDS score was 6.5. Logistic regression analysis revealed that Muslim religion, preterm or low birth weight baby, current medical illness, family pressure to have male child, lack of support from family networks, and domestic violence remained independent predictors of PPD. Conclusion: This study identified certain important risk factors for PPD. Thus, the sensitization of the primary healthcare providers and early screening and counseling of the mothers and their families is essential for reduction of associated morbidities and unfavorable outcomes.

Prevalence and associated risk factors of postpartum depression in India: A comprehensive review

“…Some mothers have symptoms of self harming as well as harming their children, which were reported in Kerala and Karnataka, [ 18 , 19 ] and improper caring of children. [ 16 , 20 ] The psychosomatic symptoms are sadness, less interest in all activities, insomnia or hypersomnia, anxiety, irritability, psychomotor agitation or retardation. The psychic symptoms of PPD are excessive guilt, lowered self-esteem, self-confidence, difficulties concentrating, and suicide thought.…”

“…The psychic symptoms of PPD are excessive guilt, lowered self-esteem, self-confidence, difficulties concentrating, and suicide thought. [ 20 ]…”

“…[ 1 ] The biological factors include bad obstetric histories, unplanned pregnancy, pregnancy complications, complications during delivery, an unsatisfactory delivery experience, high parity, a C-section birth, problems with body image, child care, a sick newborn, premature birth (<34 weeks gestation), and having a child with a congenital disability. [ 20 , 24 ] Other risk elements of PPD are poor physical health of mothers, adverse life events, cultural practices, and poor environmental conditions. [ 25 ] Some studies show that personality traits such as dependency, neuroticism, obsessionality, perfectionism, and interpersonal sensitivity are risk factors for PPD.…”

A review on postpartum depression and its homoeopathic management

“…2 It can start sooner or after labour or as a continuation of depressive symptoms during pregnancy period and it needs to be treated. The worldwide prevalence has been estimated as 100-150 per 1000 births [5,6] . It frequently has potential negative effects on the new mother, her child, and her family if it is not treated.…”

“… Reformation of psyche in accordance with the new mother-role.  Unconscious Intrapsychic conflicts concerning pregnancy, labour and motherhood [23]  Birth of a female child, where a she was expecting a male child [5,6,14,19,24,25] . One study says the contrary, that male child is associated with PPD [26] .…”