A cross-sectional study of postpartum depression in a tertiary care hospital in South India

Abstract

South India has a high prevalence of postpartum depression (PPD) compared to other regions. With declining maternal mortality, physicians need to focus on decreasing maternal morbidities, including postpartum mental health disorders. To evaluate the incidence of PPD and the influence of demographic and pregnancy related factors on PPD, and to identify major symptom subsets manifested postnatally. This cross-sectional study, conducted on 435 women between 2 weeks to 6 months postpartum, in a tertiary care centre in South India, was administered with questionnaires including Edinburgh Postnatal Depression Scale (EPDS) and patient demographics and pregnancy related factors. Chi squared test was used to evaluate the association between EPDS scores and demographic and pregnancy variables. Subset analysis was carried out to identify the predominant symptoms in the patients. Completed questionnaires were obtained from 427 postpartum women, among which 26.2% (n=112) had EPDS score >12. Among demographic variables, EPDS scores showed a significant association with relationship problems (p=.000) only, while among pregnancy factors, preterm birth (p=.019), neonatal intensive care admission (p=.005), pregnancy complications (p=.009), and history of depression (p=.043) were significantly associated with EPDS scores. Subset analysis revealed a high mean EPDS score for anxiety (1.91), followed by depressive (1.38) and anhedonia (0.91) symptoms. Several clinical factors and adverse events during pregnancy, including socio-demographic factors and pregnancy-related complications itself, can set the stage for PPD and other mental health conditions. Simple assessments like EPDS can be considered part of routine postnatal check-up examinations for early recognition and treatment of PPD.