Frequency and Correlates of Depressive Symptoms Among Postpartum Mothers: A Cross-sectional, Community-based Study

Community-based studies on postpartum depression (PPD), a major maternal and public health issue, are scarce in India. We aimed to assess the proportion of postpartum mothers with depressive symptoms in the Malappuram district of Kerala and examine the correlates of PPD in this group.

Between August and December 2024, we recruited eligible postpartum mothers using a cross-sectional, community-based design through a multistage cluster sampling procedure. We used the Edinburgh Postnatal Depression Scale to screen the sample for PPD symptoms. Multivariable linear regression analysis was employed to investigate the relationship between socio-demographic, maternal, or infant-related factors and postpartum depressive symptoms in mothers.

The mean age of the sample (N = 560) was 27.3 (±4.6) years. The mean years of education were 13.3 (±1.8) years. Eleven percent of women (n = 63) screened positive for PPD symptoms. Higher risk of PPD symptoms was linked to living separately from husband (B = 0.91, 95% confidence intervals [CI] = 0.17-1.65), adverse birth outcomes (B = 0.99, 95% CI = 0.17-1.82), antepartum depression (B = 8.26, 95% CI = 4.07-12.46), antenatal anxiety (B = 5.39, 95% CI = 1.07-9.71), and chronic diseases (B = 2.87, 95% CI = 0.78-4.96).

More than one in 10 mothers reported PPD symptoms. Not living with a husband, anxiety or depression during pregnancy, maternal chronic illnesses, and adverse pregnancy outcomes were all linked to PPD symptoms. These findings suggest the need for routine mental health screening during postnatal and immunization visits. Integrating screening using task-shifting models may enhance sustainability and scalability.