Prevalence and Determinants of Postpartum Depression in a Tertiary Care Hospital

Purpose: Postpartum depression is one of the common complication of postpartum period and a major public health issue. It adversely affects the mother, her child, and the family. To determine the prevalence and determinants of postpartum depression in women delivered in a tertiary hospital Karachi. Methods: This was a cross-sectional study carried out in a private hospital of Karachi, from 1st February 2014 to 31st January 2016. All women having age between 20-49 years between 4-6 weeks postpartum period consented to participate were included. Women with pre-existing co-morbid like diabetes mellitus, hypertension, physical and psychiatric illnesses, having multigestation and had the previous history of perinatal loss were excluded. A pretested research proforma was translated into local (Urdu) language and data on demographic and determinant were collected. PPD was assessed using Edinburgh Post Natal Depression Scale and score of >12 was considered having PPD. Results: A total of 600 patients were enrolled in this study. The mean age of enrolled participants was 26.2±3.2 years and mean gestational age was 38.5±1.1 weeks. One hundred and thirty-four women had an EPDS score of >12 giving the prevalence of PPD of 22.3%. Multivariable analysis adjusted for age and gestational age showed no family support OR 2.01 (95% CI: 1.07-3.75), primiparity OR 2.28 (95%CI: 1.28-4.07), uneducated women OR 1.78 (95% CI: 1.04-3.05), women experience complications at time of delivery OR 7.55 (95% CI: 2.98-19.12), unintended pregnancy OR 2.82 (95% CI: 1.59-5.02), obesity OR 3.84 (95%CI: 2.3-6.43) and financial issues OR (95% CI: 1.78-11.01) were independent determinants of postpartum depression. Conclusions: It was concluded from this study that the prevalence of postpartum depression was 22.3%. No family support, parity, educational status, complications during delivery, unintended pregnancy, obesity and financial issues are independent determinants of post-partum depression.