Antenatal psychological distress and postnatal depression: A prospective study from an urban clinic

Postnatal depression is a significant public health problem in developing countries. In addition to traditional risk factors, studies from developing countries have identified some cultural factors related to the development of postnatal depression. The present prospective study conducted at a teaching general hospital in an urban setting sought to examine the prevalence and risk factors in the development of postpartum depression. 132 pregnant mothers attending antenatal clinic were assessed for psychological distress at third trimester on General Health Questionairre-28. 27 women (20%) obtained a score of >8 on General Health Questionairre-28. Mothers were interviewed again between 6 and 10 weeks after childbirth. Variables that were measured included postnatal depression, obstetric history and socio-demographic characteristics. 39 women (30%) scored greater than 12 on Edinburgh Postnatal Depression Scale at 6-10 weeks indicative of postpartum depression. 44% of women with antenatal psychological distress developed postpartum depression. A significantly greater proportion of women with postpartum depression were from lower socio-economic strata. The finding that antenatal psychological distress was a risk factor in the development of postpartum depression calls for routine screening of psychological distress during antenatal visits.