Postpartum depression and its accomplices in Peshawar; a metropolitan city of Pakistan.

Abstract

Objective: To analyze prevalence and severity of postnatal depression among females of a major but socio-culturally traditional city of Pakistan, with an aim to pinpoint eminent demographic and medical accomplices. Study Design: Cross Sectional Study. Setting: Combined Military Hospital Peshawar. Period: Feb 2016 to Feb 2017. Material & Methods: Sample was collected via random probability technique. A self-designed questionnaire was used; encompassing demographic details and information regarding obstetric and family history. Screening tool was Standardized “Edinburgh Postpartum Depression Scale (EPDS)”. Descriptive analysis done via SPSS-21. Outcome variable (EPDS) was cross-tabulated with independent variables, correlations were generated by Pearson 2-tailed bivariate analysis; p-value<0.05 was considered as significant. Results: Response rate was 52.2% (n-402). Low, moderate and high risk patients for developing depression were 27.1% (n-109), 15.4% (n-62) & 12.9% (n-52) respectively. There was a strong relation between outcome and age(p<0.001), education(p-0.001), socio-economic class(p-0.013), bad obstetric history(BOH)( p-0.009), age of Last Child Born(LCB)( p-0.010), mode of delivery(p-0.011), postpartum phase(p<0.001) and postpartum complications(p-0.003). Number of sons was negatively correlated with EPDS-scores (Pearson correlation co-efficient -0.128 and p-0.01). There was no significant impact of years since married (p-0.349; husband’s education (p-0.397), number of children (p-0.966) or daughters (p-0.063) and previous offspring’s death (p-0.076). Conclusion: Considerable risk of developing postpartum depression was detected among the respondents. Sociodemograhic aggravators were identified to be maternal age, less interpregnancy interval, delivery by SVD, gender of children and postpartum complications. Postpartum depression can be detected by screening/diagnosing every postnatal woman and then promptly treating the sufferers. Imperative measures are opined to identify and vigorously address the sociodemographic and medical aggravating factors. Collaboration of psychiatrists/psychologists is highly recommended in obstetric set-ups.