RESEARCH ARTICLE

Postnatal Depression among Rural Women in South India: Do Socio-Demographic, Obstetric and Pregnancy Outcome Have a Role to Play? Siddharudha Shivalli*, Nandihal Gururaj Department of Community Medicine, Yenepoya Medical College, Yenepoya University, Deralakatte, Mangalore, Karnataka, India * [email protected]

Abstract OPEN ACCESS Citation: Shivalli S, Gururaj N (2015) Postnatal Depression among Rural Women in South India: Do Socio-Demographic, Obstetric and Pregnancy Outcome Have a Role to Play? PLoS ONE 10(4): e0122079. doi:10.1371/journal.pone.0122079 Academic Editor: Robert Stewart, Institute of Psychiatry, UNITED KINGDOM Received: October 22, 2014 Accepted: January 24, 2015 Published: April 7, 2015 Copyright: © 2015 Shivalli, Gururaj. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Due to ethical restrictions imposed by the author's Ethics committee, it is not possible to deposit data to a public repository. Interested researchers are kindly asked to send appropriate requests for the data to the "Postnatal depression among rural women in south India: Do socio-demographic, obstetric and pregnancy outcome have a role to play?" study whose authors may be contacted at shivalli. [email protected]. Funding: The authors have no support or funding to report.

Introduction Postnatal depression (PND) is one of the most common psychopathology and is considered as a serious public health issue because of its devastating effects on mother, family, and infant or the child.

Objective To elicit socio-demographic, obstetric and pregnancy outcome predictors of Postnatal Depression (PND) among rural postnatal women in Karnataka state, India.

Design Hospital based analytical cross sectional study

Setting A rural tertiary care hospital of Mandya District, Karnataka state, India.

Sample PND prevalence based estimated sample of 102 women who came for postnatal follow up from 4th to 10th week of lactation.

Method Study participants were interviewed using validated kannada version of Edinburgh Postnatal Depression Scale (EPDS). Cut-off score of 13 was used as high risk of PND. The percentage of women at risk of PND was estimated, and differences according to sociodemographic, obstetric and pregnancy outcome were described. Logistic regression was applied to identify the independent predictors of PND risk.

PLOS ONE | DOI:10.1371/journal.pone.0122079 April 7, 2015

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Postnatal Depression among Rural Women in South India

Competing Interests: The authors have declared that no competing interests exist.

Main Outcome Measures Prevalence, Odds ratio (OR) and adjusted (adj) OR of PND

Results Prevalence of PND was 31.4% (95% CI 22.7–41.4%). PND showed significant (P21 years

1

Education Literate

1.05

Illiterate

1

Religion Muslim

0.701

Hindu

1

Type of family Joint

2.73

Nuclear

1

1

Working status Employed

2.73

Unemployed

1

1.1–6.8

0.028¶

2.8 1

Husband’s occupation Others

2.73

Farmer

1

1.1–6.8

0.028¶

1.016

0.06–18.1

0.991

1.8–110.8

0.002¶

11.95

1.36–105.0

0.025¶

0.519–5.3

0.394

-

-

-

Socio-economic status BPL‡

14.2

APL§

1

1

Parity Multipara

2.09

Primipara

1

0.87–5.0

0.096

1.658 1

Pregnancy planning Unplanned

0.6

Planned

1

0.26–1.4

Mode of delivery Cesarean section

0.97

Normal

1

0.30–2.64

0.401

-

-

-

0.4–52.7

0.231

-

-

-

1.34–7.6

0.008¶

3.6

1.26–10.23

0.017¶

2.5–121.2

0.004¶

Type of delivery Pre term

4.6

Full term

1

Gender of the newborn Female

3.19

Male

1

1

Complications in pregnancy/Known medical illness Yes

11.3

No

1

2.25–57.1

0.001¶

17.4 1

Cox and Snell R Square = 0.365 & Nagelkerke R Square = 0.487 †

By binomial logistic regression; Below poverty line;

‡ §

Above poverty line;

¶

Significant (p