Prevalence and risk factors of postpartum depression within one year after birth in urban slums of Dhaka, Bangladesh

Abstract

Postpartum depression (PPD) is a serious pubic health concern and known to have the

adverse effects on mother’s perinatal wellbeing; and child’s physical and cognitive develop- ment. There were limited literatures on PPD in Bangladesh, especially in urban slum context.

The aim of this study was to assess the burden and risk factors of PPD among the urban slum women. A cross-sectional study was conducted between November-December 2017 in three urban slums on 376 women within first 12 months of postpartum. A validated Bangla

version of Edinburgh Postnatal Depression Scale was used to measure the depression sta- tus. Respondent’s socio-economic characteristics and other risk factors were collected with

structured validated questionaire by trained interviewers. Unadjusted Prevalence Ratio (PR) and Adjusted Prevalence Ratio (APR) were estimated with Generalized Linear Model (GLM) and Generalized Estimating Equation (GEE) respectively to identify the risk factors of PPD.

The prevalence of PPD was 39.4% within first 12 months following the child birth. Job involve- ment after child delivery (APR = 1.9, 95% CI = 1.1, 3.3), job loss due to pregnancy (APR =

1.5, 95% CI = 1.0, 2.1), history of miscarriage or still birth or child death (APR = 1.4, 95% CI = 1.0, 2.0), unintended pregnancy (APR = 1.8, 95% CI = 1.3, 2.5), management of delivery cost by borrowing, selling or mortgaging assets (APR = 1.3, 95% CI = 0.9, 1.9), depressive symptom during pregnancy (APR = 2.5, 95% CI = 1.7, 3.8) and intimate partner violence (APR = 2.0, 95% CI = 1.2, 3.3), were identified as risk factors. PPD was not associated with poverty, mother in law and any child related factors. The burden of postpartum depression

was high in the urban slum of Bangladesh. Maternal mental health services should be inte- grated with existing maternal health services. Research is required for the innovation of effec- tive, low cost and culturally appropriate PPD case management and preventive intervention

in urban slum of Bangladesh.