Postpartum depression and its clinico-social correlates - A community-based study in aligarh

Context: Postpartum depression (PPD) is onset of depressive symptoms in postpartum period from 2 weeks to 1 year. It causes maternal morbidity and long-term negative effects on growth and development of infant and child. It is often unreported and underdiagnosed. Aims: (1) To estimate the prevalence of PPD, (2) To determine socio-demographic, clinical, and obstetric correlates of the same. Settings and Design: A cross-sectional study was done in urban and rural areas of District Aligarh. Methods: A total of 304 females between 6 weeks and 6 months' postpartum period giving consent were included in this study. Sociodemographic, obstetric, and clinico-social factors were recorded using predesigned, pretested questionnaire. Edinburgh Postnatal Depression Scale (EPDS) score ≥10 was used to screen for PPD and International Classification of Disease (ICD-10) criteria for confirmation. Statistical Analysis Used: Correlates of PPD were determined using logistic regression analysis. Results: The prevalence of PPD was 9.5% using EPDS and was confirmed by ICD-10 criteria. History of abortion (adjusted odds ratio [AOR]: 6.0, 95% Confidence Interval [CI] 2.2-16.5), poor relationship with in-laws (AOR: 5.1; 95% CI 1.3-20.5), marital conflict (AOR: 13.3; 95% CI 2.2-77.6), and substance abuse in husband (AOR: 3.1; 95% CI 1.1-9.0) were found to be significant correlates for PPD. Conclusions: About one in every 10 postpartum females suffered from depression but did not seek health care for the same. Women facing social pathologies such as substance abuse in husband, marital conflict, and poor relationship with in-laws are more at risk of PPD. Screening for PPD should be included in the maternal and child health care programs to ensure early diagnosis and treatment.