Prevalence and predictors of postnatal depression in mothers of Karachi

Introduction: Postnatal depression (PND) is a vital public health problem affecting maternal and child health. The prevalence of postnatal depression varies between 3.5% and 40%. Postnatal depression normally occurs within 6–8 weeks after childbirth. This study examined the etiological role of risk factors recognized to be relevant to the onset of postpartum depression and poverty in developed societies faced by women. Objectives: The first objective was to determine the prevalence of postnatal depression in mothers of Karachi. The second objective was to determine the risk factors associated with postnatal depression in mothers of Karachi.

Method: This was a cross sectional study, data was collected from three different districts of Karachi from December 2010 till April 2011. The study population was selected by a cluster sampling method. Using probability cluster sampling 150 women were selected from each cluster for the study population of 700 women. A total of 450 women were selected for participation in the study. All women who gave their written consent and were more than 30 weeks pregnant were included. Women, who were transient visitors and had missing data, were excluded. General Health Questionnaire, a 12 item measure was used for psychological health. Cronbach’s alpha was 0.71. At 6–8 weeks after birth, the mothers were administered Edinburgh Postnatal Depression Scale. Cronbach’s Alpha of Edinburgh Postnatal Depression Scale 0.80. Postnatal depression was determined from binary logistic regression analysis of antenatal and early postnatal variables. Result: Among antenatal factors mothers who had current score of five or more on twelve item General Health Questionnaire had a prevalence of 48.6% of postnatal depression(252/519; p=0.037) These mothers were 1.52 times (95% CI, 1.026-2.263) at the risk of postnatal depression. Protective factors against post natal depression include planned pregnancy, (relative risk=0.63, CI: 0.431-0.946) help from family members, (relative risk=0.62, 95% CI: 0.418-0.918) and help from husband (relative risk=0.54, 95% CI: 0.369-0.817). Among postnatal factors, mothers who had cesarean delivery had a prevalence of 48.4% of postnatal depression (251/519; p-value=0.025. These mothers were 1.57 times (95% CI, 1.057-2.33) at the risk of postnatal depression.

Conclusion: Postnatal depression is a common mental illness in our local population; it is usually a consequence of preexisting antenatal morbidity and is a chronic disorder for one half of the women who suffer from this illness. Key message: Cognitive behavioral therapy and antidepressants help for postnatal depression.

Author(s): Musleh Uddin Kalar , Iqbal Fatima , Kalar Nabila , Ausaf Zainab , Ghori Wardah , Rizwan Zara , Waseem Wajiha , Rasheed Umaima , Farhat Jafri

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