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 development. 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 status. 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 involvement 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 integrated with existing maternal health services. Research is required for the innovation of effective, low cost and culturally appropriate PPD case management and preventive intervention in urban slum of Bangladesh.

Magnitude and associated factors of postpartum depression among women in Nekemte town, East Wollega zone, west Ethiopia, 2019: A community-based study

“…An unplanned pregnancy may also lead to economic burden and social judgment on the women which may be responsible for postnatal depression. This finding is consistent with the study done in South West Ethiopia [31], Bangladesh [34], public hospitals of Addis Ababa [28] and Benchi Maji Zone, Ethiopia [29]. In this study, mothers who gave birth for the first time were more likely to develop postnatal depression than those who gave birth more than four times This finding is consistent with a study done in Vietnam [32] and contradict with study done in Udupi Taluk, India [27].…”

“…This level of postnatal depression is almost similar with study done in Udupi Taluk, India (21.5%) [27], public hospitals of Addis Ababa (23.3%) [28], Benchi Maji Zone, Ethiopia (22.4%) [29] and Kenya (18.7%) [30]. However; it is lower than a study done in Southwest Ethiopia (33.82%) [31], Vietnam (27.6%) [32], China (30%) [33] and Bangladesh (39.4%) [34]. On the other hand, the level of postnatal depression in this study is higher than study done in Netaji Subhash medical college, India (12.8%) [35], Ghana (7%) [36], Sudan (9.2%) [37] and Eastern province capital of Saudi Arabia (17.8%) [38].…”

Prevalence of Maternal Postpartum Depression, Health-Seeking Behavior and Out of Pocket Payment for Physical Illness and Cost Coping Mechanism of the Poor Families in Bangladesh: A Rural Community-Based Study

“…A higher prevalence of depressive symptoms was found in our study to be supported by a recent community-based urban study in the country [34] and in other developing contexts, e.g., a rural study in Nigeria [40]. Higher numbers of child marriages, higher rates of girls' dropout from high school despite GoB initiatives, little knowledge of the childcare of these mothers, increasing trends of nuclear families, and women's participation in economic activities resulting in reduced time for child care might have negative impacts on a mothers' higher mental stress, resulting in depression.…”

“…The slightly higher prevalence of depressive symptoms in our study could be due to participation of relatively poorer mothers in the study. A recent population-based study in three urban slums of Dhaka city, Bangladesh found a prevalence of 39.4% using the Edinburgh Postnatal Depression Scale (EPDS) among mothers within 12 months following delivery [34] and 46.2% in another urban settings using SRQ-20 [35]. In the South Asian context, the prevalence of depression varied in different countries.…”

Slums, Space, and State of Health—A Link between Settlement Morphology and Health Data

“…Mental health problems represent 5.6% of the total studies. Depression in particular has been studied regularly (e.g., [74]), often in connection with abortion (e.g., [75]). Non-specific studies were mentioned 106 times, with most of the studies also being conducted on the city level (50%).…”