title: Prevalence and risk factors for postnatal depression in Sabah, Malaysia: a cohort study.
abstract: BACKGROUND
  Postnatal depression can have serious consequences for both the mother and infant. However, epidemiological data required to implement appropriate early prevention are still lacking in Malaysia.
  
  
  OBJECTIVE
  To investigate the prevalence of postnatal depression within six months postpartum and associated risk factors among women in Sabah, Malaysia.
  
  
  METHODS
  A prospective cohort study of 2072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36-38 weeks of gestation and followed up at 1, 3 and 6 months postpartum. The presence of depressive symptoms was assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale. Logistic regression analyses were performed to ascertain risk factors associated with postnatal depression.
  
  
  RESULTS
  Overall, 14.3% of mothers (95% confidence interval (CI) 12.5-16.2%) had experienced depression within the first six months postpartum. Women depressed during pregnancy (odds ratio (OR) 3.71, 95% CI 2.46-5.60) and those with consistent worries about the newborn (OR 1.68, 95% CI 1.16-2.42) were more likely to suffer from depression after childbirth. Women whose husband assisted with infant care (OR 0.43, 95% CI 0.20-0.97) and mothers who were satisfied with their marital relationship (OR 0.27, 95% CI 0.09-0.81) appeared to incur a reduced risk of postnatal depression.
  
  
  CONCLUSIONS
  A substantial proportion of mothers suffered from postnatal depression in Sabah, Malaysia. Screening and intervention programmes targeting vulnerable subgroups of women during antenatal and early postpartum periods are recommended to deal with the problem.
authors.affiliation: School of Medicine, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
authors.forename: Aza Sherin
authors.initials: AS
authors.lastname: Mohamad Yusuff
authors.affiliation: School of Public Health, Curtin University, Perth, WA, Australia.
authors.forename: Li
authors.initials: L
authors.lastname: Tang
authors.affiliation: School of Public Health, Curtin University, Perth, WA, Australia.
authors.forename: Colin W
authors.initials: CW
authors.lastname: Binns
authors.affiliation: School of Public Health, Curtin University, Perth, WA, Australia. Electronic address: Andy.Lee@curtin.edu.au.
authors.forename: Andy H
authors.initials: AH
authors.lastname: Lee
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008296:Malaysia / Q000453:epidemiology; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000523:psychology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: EPDS; Malaysia; Postnatal depression; Prevalence; Risk factors