Background:

Postpartum depression (PPD) is the commonest mental health disorder post-childbirth, yet there is a paucity of data in rural areas regarding the actual incidence of PPD, which excludes pre-existing or antenatal depression. To estimate the incidence of PPD among rural women of south Karnataka and identify predictors of PPD, including antenatal psychiatric disorders.

Methods:

A longitudinal study in 25 villages in south Karnataka among 150 pregnant women in the third trimester of pregnancy using simple random sampling. Baseline data collected and revised Clinical Interview Schedule used to screen antenatal psychiatric disorders. Participants followed-up 6–8 weeks postpartum, end-line data collected, and Edinburg Postnatal Depression Scale administered. Chi-square and Fischer’s exact tests for association between PPD and covariates. Logistic regression to calculate adjusted odds ratios.

Results:

Prevalence of antenatal psychiatric disorders was 15.3%. The incidence of PPD was 11%. A significantly higher proportion of PPD was found among women with adverse events in the last year, low socioeconomic status, and perceived lack of care/support at home. Predictors of PPD were antenatal psychiatric disorders (AOR = 4.3, 95% CI = 1.22–5.11; P = 0.028), mothers reporting worry about their infant’s health (AOR = 7.7, 95% CI = 1.22–48.32; P = 0.012) and mothers receiving postpartum care by caregivers other than their own mother (AOR = 4.0, 95% CI = 1.13–8.09; P = 0.030).

Conclusions:

Our study found that one in ten rural women is developing PPD and there is a strong link between PPD and antenatal psychiatric disorders and family factors. This calls for capacity building of general physicians and village-level workers and strengthening of the Home-Based Newborn Care Program, where weekly postpartum home visits by ASHA are an opportunity for screening and counselling mothers.

中文翻译：

---

产后抑郁症的发病率及其与产前精神症状的关联：在南卡纳塔克邦农村 25 个村庄的纵向研究

背景：

产后抑郁症 (PPD) 是最常见的产后心理健康障碍，但农村地区缺乏有关 PPD 实际发病率的数据，其中不包括预先存在的或产前抑郁症。估计南卡纳塔克邦农村妇女的 PPD 发病率，并确定 PPD 的预测因素，包括产前精神疾病。

方法：

使用简单随机抽样在卡纳塔克邦南部 25 个村庄对 150 名妊娠晚期孕妇进行纵向研究。收集基线数据并修订用于筛查产前精神疾病的临床访谈时间表。参与者在产后 6-8 周进行随访，收集最终数据，并使用爱丁堡产后抑郁量表。卡方和 Fischer 对 PPD 和协变量之间关联的精确检验。逻辑回归计算调整后的优势比。

结果：

产前精神疾病的患病率为 15.3%。PPD的发生率为11%。在去年发生不良事件、社会经济地位低以及在家中缺乏护理/支持的女性中，发现 PPD 的比例明显更高。PPD 的预测因素是产前精神疾病（AOR = 4.3, 95% CI = 1.22-5.11; P = 0.028），母亲报告担心婴儿的健康（AOR = 7.7, 95% CI = 1.22-48.32; P = 0.012）和母亲接受除自己母亲以外的照顾者的产后护理（AOR = 4.0, 95% CI = 1.13–8.09; P = 0.030）。

结论：

我们的研究发现，十分之一的农村妇女患有 PPD，而且 PPD 与产前精神疾病和家庭因素之间存在密切联系。这需要加强全科医生和村级工作人员的能力建设，并加强以家庭为基础的新生儿护理计划，在该计划中，ASHA 每周产后家访是筛查和咨询母亲的机会。