Factors associated with depressive symptoms among postnatal women in Nepal.
BACKGROUND
Depression after childbirth affects both the mother and her infant. In South-Asia, maternal depression might also contribute to poor infant growth. Knowledge of risk factors could improve the health workers' recognition of depression.


OBJECTIVE
To examine possible risk factors for depression in the postnatal period among women in one clinical, one urban and one rural population in Lalitpur district, Nepal.


METHODS
A total of 426 postnatal women were included in a cross-sectional structured interview study, 5-10 weeks after delivery. Depressive symptoms were measured by the Edinburgh Postnatal Depression Scale [EPDS].


RESULTS
Multivariate analysis showed that depression (EPDS>12) was strongly associated with husband's alcoholism, polygamy and previous depression. Other significant factors were stressful life events, multiparity, smoking and depression during pregnancy. There was a non-significant trend of lower depressive scores among women living in arranged marriages, and among women practicing the tradition of staying in their maternal home after delivery.


CONCLUSIONS
In addition to previously documented risk factors, traditional family structures may influence the risk of depression among postnatal women in Nepal.
Ho-Yen
Signe Dørheim
SD
Department of Public Health and Primary Health Care, Section for General Practice, University of Bergen, and Division of Psychiatry, Stavanger University Hospital, Norway. sdhy@sus.no
Bondevik
Gunnar Tschudi
GT
Eberhard-Gran
Malin
M
Bjorvatn
Bjørn
B
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D019052:Depression, Postpartum / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008016:Life Change Events; D008393:Marriage / Q000523:psychology; D015999:Multivariate Analysis; D009390:Nepal / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012424:Rural Population; D012907:Smoking / Q000453:epidemiology; D018454:Spouses; D014505:Urban Population