Prevalence and Determinants of Postnatal Depression in Ernakulam District, India: A Cross-Sectional Study

Background Most studies on postnatal depression (PND) in India are hospital-based, focusing on assessments within the first month of postpartum. Therefore, community-based studies are required to capture the full spectrum of PND. Factors associated with PND are required to be addressed to improve maternal and child health outcomes. Objectives We conducted this study to estimate the prevalence of PND and associated factors in one district of Kerala. Methods We conducted a community-based cross-sectional study among 330 postnatal women selected using multistage cluster sampling. A validated interview schedule was used to collect the data, which captured the socio-demographic details, obstetric factors, newborn characteristics, and individual and family-related factors. Information on PND was collected using the Edinburgh Postnatal Depression Scale. Log binomial regression analysis was done to find out the factors associated with PND.  Results The mean (standard deviation) age of the mothers was 29.4 (4.89) years, and most were graduates (n=179, 54.2%). The prevalence of PND was 20% (95% confidence interval [CI] 16.04-24.65). Muslim mothers (adjusted prevalence ratio [APR] 2.07, CI: 1.18-3.41], scheduled caste/scheduled tribe (SC/ST) mothers (APR=2.49, CI: 1.22-5.09), those who had some stressful events during pregnancy (APR=2.05, CI: 1.11-3.77), and mothers experiencing loneliness (APR=5.83, CI: 3.84-8.87) were more likely to report PND than their counterparts.  Conclusion About 20% of all the mothers reported PND. Prevalence was significantly higher among Muslim mothers, SC/ST mothers, and those experiencing prenatal stress or loneliness. Targeted community-based interventions for high-risk groups are the need of the time to reduce the prevalence of PND.