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

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.