Confinement and other psychosocial factors in perinatal depression: a transcultural study in Singapore.
BACKGROUND
To investigate the prevalence, socio-cultural and psychosocial risk factors for perinatal depression in Singaporean women.


METHODS
A prospective cohort of 559 women was interviewed antenatally and at six weeks' postpartum at a tertiary hospital. Women were interviewed for diagnosis of depression using a two-stage design, with a screening questionnaire and diagnostic interview.


RESULTS
Postnatally, a negative confinement experience was associated with depression. Other independent factors included poor emotional support, a past history of depression, unplanned pregnancy and perceived potential conflicts with relatives over childcare antenatally and dissatisfaction, poor instrumental support postnatally. The prevalence of depression antenatally and postnatally was 12.2% and 6.8%, respectively.


CONCLUSIONS
Measures of satisfaction with social support were based on self-report; there were high dropout rates at six weeks' postpartum; and other modulating social factors such as pre-existing interpersonal conflicts were not studied.


CONCLUSIONS
Perinatal depression in Singaporean women is common. Contrary to expectations, a negative 'confinement' experience is a significant risk factor for postnatal depression, and is not universally welcomed by women. Depression is modulated by dissimilar sets of psychosocial factors antenatally and postnatally.
Chee
Cornelia Y I
CY
Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. pcmcheec@nus.edu.sg
Lee
Dominic T S
DT
Chong
Y S
YS
Tan
L K
LK
Ng
T P
TP
Fones
Calvin S L
CS
D000328:Adult; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000523:psychology*; D008297:Male; D008393:Marriage / Q000523:psychology; D011247:Pregnancy; D012044:Regression Analysis; D012307:Risk Factors; D012846:Singapore; D012944:Social Support; D012959:Socioeconomic Factors