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Al‐Mamun F, Sultana MS, Momo MA, Malakar J, Bahar SB, Uddin I, Murshida M, Akter MM, Begum MM, Nodi TS, Al Habib A, Kaggwa MM, Roy N, Mamun MA. Exploring the burden of postpartum depression in urban Bangladesh: Prevalence and its associations with pregnancy-related factors from a cross-sectional study. Health Sci Rep 2024; 7:e2035. [PMID: 38655422 PMCID: PMC11035751 DOI: 10.1002/hsr2.2035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/22/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Background and Aims Postpartum depression (PPD) is a globally recognized public health concern, yet research focusing on women in urban areas of Bangladesh remains unexplored. This study aimed to address this research gap by investigating the prevalence and associated factors of PPD within the first 2 years after childbirth. Methods A cross-sectional study was conducted, enrolling 259 women (26.66 ± 4.57 years) residing in urban areas who were attending healthcare delivery centers. Sociodemographic factors, child-related issues, pregnancy-related complications, and PPD using the Edinburgh Postnatal Depression Scale (EPDS) were used for data collection. Data analysis involved the application of χ 2 tests and logistic regression analysis using SPSS software. Results This study found a 60.6% prevalence of PPD using a cutoff of 10 (out of 30) on the EPDS scale. Logistic regression analysis identified several significant factors associated with PPD, including high monthly family income (odds ratio [OR] = 47.51, 95% confidence interval [CI]: 8.34-270.54, p < 0.001), income dissatisfaction (OR = 14.28, 95% CI: 4.75-42.87, p < 0.001), up to two gravidities (OR = 2.94, 95% CI = 1.25-6.90, p = 0.013), pregnancy-related complications (OR = 2.70, 95% CI = 1.05-6.96, p = 0.039), increased antenatal care visits, and higher childbirth expenses. Conclusion This study underscores the high prevalence of PPD among urban mothers in Bangladesh. The identified risk factors emphasize the need for targeted mental health initiatives, specifically tailored to support the vulnerable group. Implementing such initiatives can effectively address the challenges posed by PPD and enhance the well-being of postpartum women in urban areas.
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Affiliation(s)
- Firoj Al‐Mamun
- CHINTA Research Bangladesh, SavarDhakaBangladesh
- Department of Public Health and InformaticsJahangirnagar University, SavarDhakaBangladesh
- Department of Public HealthUniversity of South AsiaDhakaBangladesh
| | - Most Sabiha Sultana
- CHINTA Research Bangladesh, SavarDhakaBangladesh
- Dhaka Central International Medical College and HospitalDhakaBangladesh
| | | | - Jyotie Malakar
- Department of Maternal and Child HealthNational Institute of Preventive and Social MedicineDhakaBangladesh
| | - Saad Bin Bahar
- CHINTA Research Bangladesh, SavarDhakaBangladesh
- Department of Public HealthUniversity of South AsiaDhakaBangladesh
- BGC Trust Medical CollegeUniversity of ChittagongChattogramBangladesh
| | - Imtiaz Uddin
- CHINTA Research Bangladesh, SavarDhakaBangladesh
- Department of SociologyUniversity of ChittagongChattogramBangladesh
| | - Murshida Murshida
- CHINTA Research Bangladesh, SavarDhakaBangladesh
- Department of Public Health and InformaticsJahangirnagar University, SavarDhakaBangladesh
| | - Mst. Morsheda Akter
- CHINTA Research Bangladesh, SavarDhakaBangladesh
- Department of AnthropologyJagannath UniversityDhakaBangladesh
| | - Mst. Mohsina Begum
- International Centre for Diarrhoeal Disease Research, BangladeshDhakaBangladesh
| | - Tasmin Sayeed Nodi
- CHINTA Research Bangladesh, SavarDhakaBangladesh
- Department of Public Health and InformaticsJahangirnagar University, SavarDhakaBangladesh
| | - Abdullah Al Habib
- CHINTA Research Bangladesh, SavarDhakaBangladesh
- Department of Government and PoliticsJahangirnagar University, SavarDhakaBangladesh
| | - Mark M. Kaggwa
- Department of PsychiatryMbarara University of Science and TechnologyMbararaUganda
- Department of Psychiatry and Behavioral NeurosciencesMcMaster UniversityHamiltonOntarioCanada
| | - Nitai Roy
- Department of Biochemistry and Food AnalysisPatuakhali Science and Technology UniversityPatuakhaliBangladesh
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, SavarDhakaBangladesh
- Department of Public Health and InformaticsJahangirnagar University, SavarDhakaBangladesh
- Department of Public HealthUniversity of South AsiaDhakaBangladesh
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Hossain SJ, Hamadani JD, Tofail F, Fisher J, Rahman MA, Rahman SM. Factors associated with children's cognitive, language, and motor development in deprived urban settings in Bangladesh. Child Care Health Dev 2024; 50:e13225. [PMID: 38265136 DOI: 10.1111/cch.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 10/30/2023] [Accepted: 12/17/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Children's development is multifactorial. Although there have been several studies exploring the association of children's development with maternal, child, and environmental factors, we are unaware of any study that assessed those factors in children whose mothers were enrolled in a social safety net programme in low- and middle-income countries. This study aimed to identify the factors associated with disadvantaged children's cognitive, language, and motor development at age 6-16 months in deprived settings of urban Bangladesh and to identify relative importance of these factors of children's development. We also explored if there were any gender differences in child development. METHODS This cross-sectional study was conducted in a deprived setting of urban Bangladesh. Bayley III was used for assessing children's cognitive, language, and motor development. Multivariable linear regression model was used to find the factors associated with children's development, and dominance analysis was used to explore the relative importance of the factors. RESULTS Out of the total 599 mother-child dyads, 303 (50.58%) were girls. The factors associated with children's development were length-for-age Z-score (cognitive: B = 1.21 [95% CI = 0.31, 2.11], P = 0.008; language: 1.67 [0.79, 2.55] P < 0.001; motor: 2.15 [1.01, 3.29] P < 0.001) and home environment (cognitive: 0.58 [0.27, 0.89] P < 0.001; language: 0.59 [0.27, 0.92], P < 0.001; motor: 0.44 [0.09, 0.79] P = 0.013). Girls had higher cognitive (1.90 [0.17, 3.6], P = 0.031) and language (2.53 [0.55, 4.51], P = 0.013) development compared with boys. Families with a higher number of under five children within the households had lower language (-1.57 [-2.78, -0.36], P = 0.011) development. Violence against the mother and the families' food security status were not associated with the children's development. Children's length-for-age Z-score (27%) and home stimulation environment (23%) were the most important factors of cognitive development. CONCLUSION Children's nutritional status and home environment are important factors for disadvantaged children's development in deprived urban settings of Bangladesh. Both early child development-focussed parenting and nutrition interventions should be considered when designing child development programmes in urban settings in low- and middle-income countries.
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Affiliation(s)
- Sheikh Jamal Hossain
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Bangladesh
| | | | - Fahmida Tofail
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Bangladesh
| | - Jane Fisher
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Md Anisur Rahman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Bangladesh
| | - Syed Moshfiqur Rahman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Bangladesh
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Koly KN, Tasnim Z, Ahmed S, Saba J, Mahmood R, Farin FT, Choudhury S, Ashraf MN, Hasan MT, Oloniniyi I, Modasser RB, Reidpath DD. Mental healthcare-seeking behavior of women in Bangladesh: content analysis of a social media platform. BMC Psychiatry 2022; 22:797. [PMID: 36529761 PMCID: PMC9760542 DOI: 10.1186/s12888-022-04414-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mental health remains a highly stigmatized area of healthcare, and people often conceal their concerns rather than seek assistance or treatment. The Women Support Initiative Forum (WSIF) is a social media platform established in 2018 to provide expert and peer-led psychosocial support services to women of all ages in Bangladesh. The anonymous nature of the forum means that mental health concerns can be aired without fear of identification. METHOD A content analysis was conducted on the anonymous posts retrieved from the WSIF platform between 8th March 2020 and 7th July 2022. Around 1457 posts were initially selected for analysis which was reduced to 1006 after removing duplicates and non-relevant posts, such as queries about the addresses of the doctors and other non-mental health-related issues. A thematic analysis of the data was conducted using an inductive approach. RESULT The 1006 posts generated four themes and nine sub-themes. All the women mentioned mental health symptoms (n = 1006; 100%). Most also mentioned reasons for seeking mental healthcare (n = 818; 81.31%), healthcare-seeking behavior (n = 667; 66.30%), and barriers to seeking mental healthcare (n = 552; 54.87%). The majority of women described symptoms of stress, depression, and anxiety-like symptoms, which were aggregated under common mental health conditions. Mental health symptoms were ascribed to various external influences, including marital relationship, intrafamilial abuse, and insecurities related to the COVID-19 pandemic. A large proportion of posts were related to women seeking information about mental healthcare services and service providers (psychologists or psychiatrists). The analysis found that most women did not obtain mental healthcare services despite their externalized mental health symptoms. The posts identified clear barriers to women accessing mental health services, including low mental health literacy, the stigma associated with mental healthcare-seeking behavior, and the poor availability of mental health care services. CONCLUSION The study revealed that raising mass awareness and designing culturally acceptable evidence-based interventions with multisectoral collaborations are crucial to ensuring better mental healthcare coverage for women in Bangladesh.
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Affiliation(s)
- Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
| | - Zarin Tasnim
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, 1213 Bangladesh
| | - Sharmin Ahmed
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Jobaida Saba
- grid.414142.60000 0004 0600 7174Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh ,grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Dhaka, 1342 Bangladesh
| | - Rudbar Mahmood
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Faria Tasnim Farin
- grid.254444.70000 0001 1456 7807Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI USA
| | - Sabrina Choudhury
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Mir Nabila Ashraf
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - M. Tasdik Hasan
- grid.1002.30000 0004 1936 7857Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia ,grid.443034.40000 0000 8877 8140Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh ,grid.10025.360000 0004 1936 8470Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - Ibidunni Oloniniyi
- grid.10824.3f0000 0001 2183 9444Departmental of Mental Health, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria ,grid.459853.60000 0000 9364 4761Mental Health Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun Nigeria
| | - Rifath Binta Modasser
- grid.443005.60000 0004 0443 2564School of Public Health, Independent University Bangladesh (IUB), Bashundhara, Dhaka, 1229 Bangladesh
| | - Daniel D. Reidpath
- grid.440425.30000 0004 1798 0746Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia
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Odufuwa OT, Olaniyan O, Okuonzi SA. Determinants of Mental Healthcare-Seeking Behavior of Postpartum Women in Ibadan, Nigeria. Front Glob Womens Health 2022; 3:787263. [PMID: 35846560 PMCID: PMC9276997 DOI: 10.3389/fgwh.2022.787263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 05/12/2022] [Indexed: 12/01/2022] Open
Abstract
The mental healthcare-seeking behavior of postpartum mothers has received little attention in Nigeria. Previous studies in the country have focused on determinants of physical health-seeking behavior, choice of maternal healthcare provider, prevalence, and determinants of maternal mental illness, yet, determinants of maternal mental health-seeking behavior among Nigerian women has been understudied. This study, therefore, examined the determinants of mental health-seeking behavior among postpartum women in Ibadan, Nigeria. Maternal mental illness, which was proxied using postpartum depression, was computed using the Edinburgh Postpartum Depression Scale. Data for the study were obtained through a survey method using a 9-page questionnaire. A 3-stage sampling technique was employed. The first stage was a stratified sampling to disaggregate the health facilities offering postnatal and immunization services on the basis of ownership of public and private healthcare providers. In the second stage, seven healthcare facilities comprising three (3) private and four (4) public healthcare were purposively selected based on the number of attendees. The final stage was a random selection of 390 postpartum mothers attending postnatal and immunization clinics across seven healthcare facilities. The prevalence of depression among the mothers was 20.8%. While only 39.5% of the depressed women sought care, 22.3% of the non-sufferers also sought mental healthcare. This revealed that both sufferers and non-sufferers sought mental healthcare. Also, a higher incidence of postpartum depression among the sufferers increased the likelihood of seeking mental healthcare. Age, family history of postpartum depression, and having the desired gender of child were determinants of mental health-seeking behavior. Among the sufferers of postpartum depression who failed to seek care, a low perceived need for mental healthcare, the perception that the depressive symptoms will go on their own, as well as fear of being stigmatized as a "weak mother", were reasons for not seeking mental healthcare. Thus, to promote mental healthcare, the non-cost factors, like availability and accessibility to a mental healthcare facility should be addressed. To achieve this, mental healthcare sensitization programs should be integrated into maternal healthcare at all levels, and mothers attending antenatal clinics should be routinely screened for early symptoms of depression in the postpartum period.
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Affiliation(s)
- Oyeteju T. Odufuwa
- Department of Economics, University of Ibadan, Ibadan, Nigeria
- Health Policy Training and Research Programme, Department of Economics, University of Ibadan, Ibadan, Nigeria
| | - Olanrewaju Olaniyan
- Department of Economics, University of Ibadan, Ibadan, Nigeria
- Health Policy Training and Research Programme, Department of Economics, University of Ibadan, Ibadan, Nigeria
| | - Sam A. Okuonzi
- African Centre for Global Health and Social Transformation (ACHEST), Kampala, Uganda
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Luo N, Wang Y, Xia Y, Tu M, Wu X, Shao X, Fang J. The effect of acupuncture on condition being studied emotional disorders in patients with postpartum: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28669. [PMID: 35089211 PMCID: PMC8797587 DOI: 10.1097/md.0000000000028669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/06/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND As one of the common postpartum diseases, postpartum emotional disorders (PEDs) mainly include postpartum depression, postpartum anxiety, posttraumatic stress disorder, and obsessive-compulsive disorder, which significantly affect the patient's quality of life. Acupuncture has been widely used as a popular alternative complementary therapy for the treatment of PEDs. Nevertheless, its effectiveness and safety remain uncertain. Hence, the first systematic review and meta-analysis will be urgently executed to explore the effectiveness and safety of acupuncture in the treatment of PEDs. METHODS Eight databases will be searched, including the PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database, and Technology Periodical Database. Only randomized controlled trials of acupuncture for PEDs will be considered. The languages are limited to English and Chinese. All publications were retrieved by 2 researchers independently. Assessment of the Edinburgh Postpartum Depression Scale will be dedicated as a primary outcome, and secondary outcomes include the Hamilton Anxiety Inventory, the Hamilton Depression Inventory, the Orientation to Life Questionnaire (sense of coherence 29-item scale), and adverse effects of acupuncture. The Cochrane Risk of Bias tool will be used to assess the quality of the eligible publications. Additionally, the level of evidence for results will be evaluated by using the Grades of Recommendation, Assessment, Development, and Evaluation method. All data will be analyzed statistically by using RevMan V.5.3 software. RESULTS This study will provide a high level of the evidence-based basis for the effectiveness and safety of acupuncture in the treatment of PEDs. CONCLUSION The findings of this study will assess the safety, efficacy, and adverse effects of acupuncture in the treatment of PEDs. ETHICS AND DISSEMINATION No ethical approval is required as patient data will not be collected. In addition, the results of this meta-analysis will be disseminated through publication in peer-reviewed scholarly journals or relevant academic conferences. REGISTRATION NUMBER INPLASY 2021120091.
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Mohsin S, Waqas A, Atif N, Rabbani MW, Ali Khan S, Bilal S, Sharif M, Bibi A, Sikander S. Accuracy of Community Informant Led Detection of Maternal Depression in Rural Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1075. [PMID: 33530396 PMCID: PMC7908615 DOI: 10.3390/ijerph18031075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 01/27/2023]
Abstract
Maternal depression is a global mental health and a public health priority. Despite the priority its active detection is still a challenge. We tested the accuracy of an adapted version of Community Informant Detection Tool for Maternal Depression (CIDT-MD) in rural settings of Pakistan. Using a single stage design, trained community informants (lady health workers and lay peers) identified women (pregnant and/or with children) with symptoms of probable depression using CIDT-MD. This was immediately followed by diagnostic interviews of all the women using the Structured Clinical Interview for the Diagnostic and Statistical Manual (SCID-V) for current major depressive episode by trained assessors, blinded to the outcome of CIDT-MD. Data were analyzed using Statistical Package for Social Sciences (Version 25.0, IBM Corp., Armonk, NY, USA) and FACTOR software (Version. 10.3.01, Virgili University, Tarragona, Spain). Descriptive statistics, factor analysis, validity, reliability and known group validity was conducted to evaluate the psychometric properties of the adapted CIDT-MD. In all, 425 women, with mean age of 28 years (SD = 4.7), participated. Nearly 10% were illiterate, while the rest (90%) had an education ranging from eight to 15 years of schooling. The majority (73.2%) of the participants had 1-3 children while only 17.4% had >3 children. The sensitivity and specificity of CIDT-MD in detecting depressive symptoms was 97.5% (95% CI: 94.2-99.1) and 82.4% (95% CI: 77.8-86.4) respectively. It's positive predictive value (PPV), 77.3% (95% CI: 72.9-81.2) and the negative predictive value (NPV) was 98.17% (95% CI: 95.7-99.2). While factor analysis revealed high inter-item correlation for most items (0.62-0.77) with an adequately fair Kaiser-Meyer-Olkin (KMO) sampling adequacy (0.73), significant Bartlett's test of sphericity (p < 0.001). Uni-dimensionality for the CIDT-MD based on one-dimensional congruence (0.97), explained common variance (0.85), excellent internal consistency (0.90), good criterion validity (Area Under Curve = 81%), tester-test reliability (0.87-0.89) and statistically significant known group analysis (p < 0.001). The adapted version of the Community Informant Detection Tool for Maternal Depression is a valid and a reliable tool for active case detection of maternal depression in rural settings of Pakistan.
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Affiliation(s)
- Shamaila Mohsin
- Department of Community Medicine, Army Medical College, University of Medical Sciences, Punjab 46000, Pakistan
- Department of Public Health, Health Services Academy, Opposite National Institute of Health, Islamabad 44000, Pakistan;
| | - Ahmed Waqas
- Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK;
- Human Development Research Foundation, Punjab 46000, Pakistan; (N.A.); (S.B.); (M.S.); (A.B.)
| | - Najia Atif
- Human Development Research Foundation, Punjab 46000, Pakistan; (N.A.); (S.B.); (M.S.); (A.B.)
| | - Muhamamd Waqas Rabbani
- Department of Behavioral Sciences, Shifa College of Medicine, Tameer-e-Millat University, Islamabad 44000, Pakistan;
| | - Shahzad Ali Khan
- Department of Public Health, Health Services Academy, Opposite National Institute of Health, Islamabad 44000, Pakistan;
| | - Samina Bilal
- Human Development Research Foundation, Punjab 46000, Pakistan; (N.A.); (S.B.); (M.S.); (A.B.)
| | - Maria Sharif
- Human Development Research Foundation, Punjab 46000, Pakistan; (N.A.); (S.B.); (M.S.); (A.B.)
| | - Amina Bibi
- Human Development Research Foundation, Punjab 46000, Pakistan; (N.A.); (S.B.); (M.S.); (A.B.)
| | - Siham Sikander
- Department of Public Health, Health Services Academy, Opposite National Institute of Health, Islamabad 44000, Pakistan;
- Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK;
- Human Development Research Foundation, Punjab 46000, Pakistan; (N.A.); (S.B.); (M.S.); (A.B.)
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Singh DR, Sunuwar DR, Adhikari S, Singh S, Karki K. Determining factors for the prevalence of depressive symptoms among postpartum mothers in lowland region in southern Nepal. PLoS One 2021; 16:e0245199. [PMID: 33481863 PMCID: PMC7822291 DOI: 10.1371/journal.pone.0245199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022] Open
Abstract
Background Postpartum depression is the most common mental health problem among women of childbearing age in resource-poor countries. Poor maternal mental health is linked with both acute and chronic negative effects on the growth and development of the child. This study aimed to assess the prevalence and factors associated with depressive symptoms among postpartum mothers in the lowland region in southern Nepal. Methods A hospital-based analytical cross-sectional study was conducted from 1st July to 25th August 2019 among 415 randomly selected postpartum mothers attending the child immunization clinic at Narayani hospital. The postpartum depressive symptoms were measured using the validated Nepalese version of the Edinburg Postnatal Depression Scale (EPDS). The data were entered into EpiData software 3.1v and transferred into Stata version 14.1 (StataCorp LP, College Station, Texas) for statistical analyses. To identify the correlates, backward stepwise binary logistic regression models were performed separately for the dichotomized outcomes: the presence of postpartum depressive symptoms. The statistical significance was considered at p-value <0.05 with 95% confidence intervals (CIs). Results Among the total 415 study participants, 33.7% (95% CI: 29.2–38.5%) of postpartum mothers had depressive symptoms. Study participant’s whose family monthly income <150 USD compared to ≥150 USD (aOR = 13.76, 95% CI: 6.54–28.95), the husband had migrated for employment compared to not migrated (aOR = 8.19, 95% CI:4.11–15.87), nearest health facility located at more than 60 minutes of walking distance (aOR = 4.52, 95% CI: 2.26–9.03), delivered their last child by cesarean section compared to normal (vaginal) delivery (aOR = 2.02, 95% CI: 1.12–3.59) and received less than four recommended antenatal care (ANC) visits (aOR = 2.28, 95% CI:1.25–4.15) had higher odds of depressive symptoms. Participants who had planned pregnancy (aOR = 0.44, 95% CI: 0.25–0.77) were associated with 56% lower odds of depressive symptoms. Conclusions One-third of the mothers suffered from postpartum depressive symptoms. The participant’s husband migrated for employment, family income, distance to reach a health facility, delivery by cesarean section, not receiving recommended ANC visits, and plan of pregnancy were independent predictors for postpartum depressive symptoms. The study results warranted the urgency for clinical diagnosis of PPD and implementation of preventive package in study settings. Mental health education to pregnant women during ANC visits and proper counseling during the antepartum and postpartum period can also play a positive role in preventing postpartum depression.
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Affiliation(s)
- Devendra Raj Singh
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
- Research and Innovation Section, Southeast Asia Development Actions Network (SADAN), Lalitpur, Nepal
- Research Section, Swadesh Development Foundation (SDF), Province-2, Siraha, Nepal
- * E-mail:
| | - Dev Ram Sunuwar
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
- Department of Nutrition and Dietetics, Armed Police Force Hospital, Kathmandu, Nepal
| | - Shraddha Adhikari
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
| | - Sunita Singh
- Central Department of Home Science, Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Kshitij Karki
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
- Group for Technical Assistance, Lalitpur, Nepal
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