title: Confinement and other psychosocial factors in perinatal depression: a transcultural study in Singapore.
abstract: 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.
authors.affiliation: Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. pcmcheec@nus.edu.sg
authors.forename: Cornelia Y I
authors.initials: CY
authors.lastname: Chee
authors.forename: Dominic T S
authors.initials: DT
authors.lastname: Lee
authors.forename: Y S
authors.initials: YS
authors.lastname: Chong
authors.forename: L K
authors.initials: LK
authors.lastname: Tan
authors.forename: T P
authors.initials: TP
authors.lastname: Ng
authors.forename: Calvin S L
authors.initials: CS
authors.lastname: Fones
mesh_terms: 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