Prevalence and risk factors of postpartum depression within one year after birth in urban slums of Dhaka, Bangladesh

Abstract

25Postpartum depression (PPD) is a serious pubic health concern and known to have 26 the adverse effects on mother 's perinatal wellbeing; and child 's physical and codnitive 27 development. There were limited literatures on PPD in Bangladesh, especially in urban slum 28 context. The aim of this study was to assess the burden and risk factors of PPD among the 29 urban slum women. A cross-sectional study was conducted between November-December 30 2017 in three urban slums on 376 women within first 12 months of postpartum. A validated 31 Bangla version of Edinburgh Postnatal Depression Scale was used to measure the depression 32 status. Respondent's socio-economic characteristics and other risk factors were collected with 33 structured validated questionaire by trained interviewers . Unadjusted Prevalence Ratio (PR) 34 and Adjusted Prevalence Ratio (APR) were estimated with Generalized Linear Model(GLM) 35 and Generalized Estimating Equation (GEE) respectively to identify the risk factors of PPD. 36 The prevalence of PPD was 39.4% within first 12 months following the child birth. Job 37 involvement after child delivery (APR=1.9, 95% CI= 1.1, 3.3), job loss due to pregnancy 38 (APR=1.5, 95% CI= 1.0, 2.1), perinatal and postnatal death (APR=1.4, 95% CI= 0.97, 2.0), 39 unintended pregnancy (APR=1.8, 95% CI= 1.3, 2.5), management of delivery cost by 40 borrowing, selling or mortgaging assets (APR=1.3, 95% CI= 0.94, 1.9), depressive symptom 41 during pregnancy (APR=2.5, 95% CI= 1.7, 3.8) and intimate partner violence (APR=2.0, 95% 42 CI= 1.2, 3.3), were identified as risk factors.PPD was not associated with poverty, mother in 43 law and any child related factors. The burden of postpartum depression is high in the urban 44 slum of Bangladesh. Maternal mental health services should be integrated with existing 45 maternal health services. Research is required for the innovation of effective, low cost and 46 culturally appropriate PPD case management and preventive intervention in urban slum of 47 Postpartum depression (PPD) is a common, non-psychotic mood or mental disorder 51 which typically manifests in mothers within one year of delivery (first year postpartum) [1, 2]. 52Globally, the prevalence of PPD among mothers ranges from 0.5% to 60.8% [3]. In 53 comparison to women of developed countries, women of developing countries showed higher 54 rates of PPD [4]. A systematic review of 28 developed countries reported that the prevalence 55 PPD symptom (PPDS) was 6-13% among women in high income nations [5]. An independent 56 systematic review on low and middle income countries (LMIC) found the prevalence of 57 postpartum common mental disorder was approximately 20% [6]. Asian countries reported 58 between 3.5-63.3% prevalence rates of depression in postpartum women [7]. In India the 59 prevalence of depression varied from 11% to 16% within fourteen weeks of delivery [8]. 60Several studies conducted in rural Bangladesh found the prevalence of PPD ranged from 18% 61 to 35% among rural women [1, 2, 9]. 62 63 ...

Postpartum depression and associated factors among postpartum women in Ethiopia: a systematic review and meta-analysis, 2020

“…However, this finding is slightly lower than a study conducted in Bangladesh [ 11 ] and previously conducted evidence in Ethiopia [ 43 ]. This might be due to the study conducted in Bangladesh that uses a purposive sampling technique and a small sample size which may overestimate the magnitude of PPD.…”

“…This finding is in accordance with another meta-analysis report [ 39 ]. A study conducted in Bangladesh and Malaysia also identified unplanned pregnancy as a significant risk factor for PPD [ 11 , 47 ]. Other evidence also found the risk of depression is threefold higher among mothers who had unplanned pregnancy [ 43 ].…”

“…It is estimated that the prevalence of PPD is about 10% in developed countries [ 6 ] and nearly 20% in developing countries [ 7 ]. The magnitude of PPD is 6.7% in China [ 8 ], 21% in Japan [ 9 ], 11 to 16% in India [ 10 ], and 39.4% in Bangladesh [ 11 ]. In Africa, the prevalence of PPD is 18.7% in Kenya [ 12 ], 7% in Ghana [ 13 ], and 9.2% in Sudan [ 14 ].…”

“…Studies have shown that factors such as low monthly income, age under 24 years, unemployment due to pregnancy, dissatisfaction in marital condition, and intimate partner violence were associated with postpartum depression [ 11 , 12 , 14 , 16 , 22 ]. Obstetric-related factors such as unplanned pregnancy, history of miscarriage/stillbirth, and being the first-time mother were associated with postpartum depression [ 11 , 22 , 23 ].…”

“…Studies have shown that factors such as low monthly income, age under 24 years, unemployment due to pregnancy, dissatisfaction in marital condition, and intimate partner violence were associated with postpartum depression [ 11 , 12 , 14 , 16 , 22 ]. Obstetric-related factors such as unplanned pregnancy, history of miscarriage/stillbirth, and being the first-time mother were associated with postpartum depression [ 11 , 22 , 23 ]. Social and behavioral factors such as having a history of substance use, poor social support, history of previous depression, and experiencing the death of infants were also some of the factors associated with postpartum depression [ 16 , 22 , 23 ].…”