Prevalence and correlates of postpartum depression in the puttalam district

Abstract

OBJECTIVES: To study the prevalence and the correlates of postpartum depression. METHODOLOGY: This was a community based prospective study, carried out in the District of Puttalam during the period of October 2003 to April 2004. The sample size computed was 1100. The validated Sinhala translation of the Edinburgh Postnatal Depression Scale (EPDS) was used to determine the prevalence of postpartum depression, at 6 weeks postpartum at home, where the cut off for depression was determined to be 9/10. In addition, the questionnaires on socio demographic data and reproductive health, the Maternity Social Support Scale, the Abuse Assessment Questionnaire, the Modified Life Events Inventory and the questionnaire on delivery and the index child were administered to identify the independent variables associated with postpartum depression. Multivariate logistic regression analysis was carried out and the results are expressed as Odds Ratios (OR) and 95% Confidence Intervals (95% CI). RESULTS: The prevalence of postpartum depression in the district of Puttalam was 32.1%. From multivariate analysis, unplanned pregnancy (OR=1.6; 95% CI= 1.1-2.3) , conflicts with the husband (OR=1.5; 95% CI= 1.1-2.0), physical abuse during pregnancy (OR=5-2; 95% CI= 1.6-16.1), death of a close friend (OR=2.2; 95% CI= 1.3-3.7), use of harsh words by the husband (OR=2.1; 95% CI= 1.2-3.1), normal vaginal delivery (OR=1.7; 95% CI= 1.1-2.6), low birth weight of the baby (OR=1.6; 95% CI= 1.01-2.4), illness in the baby (OR=2.1;95%CI= 1.2-3.4) and poor sleeping pattern of the baby at night (OR=1.6; 95% CI= 1.1-2.2), were the factors found to be significantly associated with postpartum depression. CONCLUSIONS: Postpartum depression which had a prevalence of 32.1% is considered a major public health problem in Sri Lanka. Therefore it is important to address the factors found to be associated with it, because of its negative impact on the mother, the child and the family.