ASSESSMENT OF POSTPARTUM DEPRESSION IN A TERTIARY CARE INSTITUTE

Abstract

Introduction: India is in a state of obstetric transition, where indirect causes of maternal morbidity and mortality are now more common. Depression is one such entity that goes unscreen and untreated, contributing to maternal morbidity. Objective: The study aimed to find the incidence of postpartum depression (PPD) in a tertiary care institute and determine the associated risk factors contributing to PPD. Methods: This was a prospective cross-sectional study conducted in the Department of Obstetrics and Gynecology, Government Medical College and Rajindra Hospital, Patiala, from June 1, 2020 to July 31, 2022. All the patients who were in the postpartum period and gave consent were included in the study. They were subjected to the Edinburgh Postnatal Depression Scale (EPDS) questionnaire, and their responses were recorded. The same patients were subjected to the same EPDS questionnaire at 6 months, and the score was calculated. A score of more than or equal to 12 was considered statistically significant for depression, and patients were referred to a psychiatrist for further evaluation and management. Results: In total, 102 were enrolled in the study. The incidence of PPD in the study participants was 12.75% at the immediate postparity period and 15.69% at 6 months postpartum. Husband’s unemployment (p<0.05), low family income (p<0.05), unplanned pregnancy (p<0.05), development of antenatal complications (p<0.05), lack of regular ANC care (p<0.05), neonatal death (p<0.05), bad relationship with in-laws (p<0.05), and low self-esteem (p<0.05) were the main contributors to the development of PPD in both immediate postpartum period as well as at 6 months postpartum. Only four patients agreed to visit the psychiatrist, the rest refused the evaluation and treatment. Conclusion: In India, despite the National mental health program 1983, maternal mental health is still not a prominent component of the program which needs to be included. Screening tools should be used to identify and treat women.