Postpartum Depression and Its Determinants: A Cross-Sectional Study

Abstract

Background Postpartum depression (PPD) is the most prevalent psychological disorder after childbirth associated with a negative impact on the daily functioning of mothers and the cognitive development of infants. Inequitable primary mental health access in lower-middle-income countries (LMICs) further aggravates this major public health problem. Objective The objective of this study is to estimate the prevalence and determinants of PPD among women reporting to secondary care facilities in Delhi, India. Methods A cross-sectional study was conducted in the outpatient settings of two secondary care (one government and one private) hospitals in the Delhi-National Capital Region among mothers of infants aged below six months. The study was conducted from January to June 2023. Data were collected by a single trained investigator using a self-designed interview schedule, while PPD was measured by administering the Edinburgh Postnatal Depression Scale (EPDS). Data were analyzed with Stata statistical software, version 15.1 (StataCorp LLC, College Station, TX). P < 0.05 was considered statistically significant. Results The mean age of the study participants was 28.49 ± 3.77 years with 53 (18.28%) detected as having possible postpartum depression on screening with the EPDS. On adjustment for covariates, the participants with husbands consuming alcohol (adjusted odds ratio, 6.97; 95% confidence interval {CI}, 2.73-17.8), those who underwent C-section (adjusted odds ratio, 4.39; 95% CI, 1.02-18.85), and those giving birth in private hospitals (adjusted odds ratio, 5.48; 95% CI, 1.53-19.55) had significantly higher odds of having PPD. In contrast, mothers staying at home (not employed) (adjusted odds ratio, 0.08; 95% CI, 0.02-0.41), without specific preference for the newborn's gender (adjusted odds ratio, 0.07; 95% CI, 0.01-0.78), and those living in nuclear families (adjusted odds ratio, 0.03; 95% CI, 0.005-0.19) had significantly lower odds of PPD. Conclusion Nearly one in five mothers were screened for having possible PPD. Prioritizing birth preparedness during the antenatal period and strengthening health system screening protocols may prevent and mitigate the effects of PPD.

Keywords: depression; health systems; india; postpartum depression; women's mental health.