Psychiatric morbidity in puerperium: incidence, associated socio-demographic and obstetric risk factors

Introduction: The puerperium is the period during which the maternal organs, particularly the reproductive organs, return to the non-pregnant or near normal state. It is during this critical postpartum period that the mother and her infant are the most vulnerable to both physical and emotional problems. Aim: To study psychiatric morbidity; assessment of various obstetric factors; correlation between obstetric factors and psychiatric morbidity; correlation of socio-demographic variables in validation to psychiatric morbidity in postpartum period. Study design: This was hospital based cross-sectional study of women in postpartum period. Materials and methods: A sample of 100 was recruited through systematic random sampling over a period of one year from October 2010 to September 2011. They were screened using Mini-International Neuropsychiatric Interview (M.I.N.I.-Plus), and then severity of psychiatric illnesses was assessed using Hamilton Rating Scale for Depression (HRSD) and Brief Psychiatric Rating Scale (BPRS). The statistical analysis was done using t-test, chi-square test, and Pearson’s and Spearman’s correlations. Results: Twelve, three, and one per cent of cases had postpartum depression, panic disorder, and mixed anxiety and depressive disorder. There were significant correlation between socio-demographic variables such as age, education, socioeconomic status, religion, residence, type of family, and psychiatric morbidity (P value < 0.01). The obstetric variables such as birth order, mode of delivery, and gender of baby were significantly correlated with psychiatric morbidity (P value < 0.01). Conclusion: The postpartum depression is the most common psychiatric morbidity in puerperium. The socio-demographic and obstetric variables have significant impact on the occurrence of psychiatric diseases in puerperium.