Prevalence of postpartum depression & anxiety among women in rural India: Risk factors & psychosocial correlates.

ABSTRACT

BACKGROUND OBJECTIVES: Postpartum depression and anxiety (PPD/A) impact a woman's physical and psychological wellbeing. In the absence of corroboratory evidence from the community setting in India, the present study was undertaken to examine the prevalence, psychosocial correlates and risk factors for PPD/A in the rural community of India. METHODS: This cross-sectional study included 680 women during the postpartum period from a rural community in northern India. Screening for PPD/A was done using Edinburg Postnatal Depression Scale and State and Trait Anxiety Inventory. Diagnostic assessment of screened-positive women was done using Mini-International Neuropsychiatric Interview (MINI). The psychosocial evaluation was done on parameters including women's social support, bonding with the child, functionality, parental stress, interpersonal violence and marital satisfaction. RESULTS: The overall prevalence of PPD/A/both in community women was 5.6 per cent, with a specific prevalence of 2.2 per cent for PPD, 0.74 per cent for PPA and 2.8 per cent for both disorders. Comparative analysis indicated that women with PPD/A/both experienced significantly higher levels of parenting stress, poor lifestyle (prior two weeks), less support from their partner, parents-in-law and parents, less marital satisfaction, high intimate partner violence, poor bonding with infants and higher infant-focussed anxiety. On multivariable logistic regression analysis, higher education, marital satisfaction, support from partners and in-laws were associated with reducing the risk of PPD/A/both. INTERPRETATION CONCLUSIONS: Rural Indian women experience PPD/A/both which causes stress and impacts their functionality, bonding with the infant and relationship with their spouse and parents. Higher education, marital satisfaction and higher support from partners and in-laws reduce the risk of developing PPD/A/both.