title: Prevalence and factors associated with depressive symptoms among post-partum mothers in Nepal.
abstract: BACKGROUND
  Post-partum depression is a common complication of women after childbirth. The objective of this study was to determine the prevalence of and factors associated with depressive symptoms among post-partum mothers attending a child immunization clinic at a maternity hospital in Kathmandu, Nepal.
  
  
  METHODS
  This cross-sectional study was conducted among 346 post-partum mothers at six to ten weeks after delivery using systematic random sampling. Mothers were interviewed using a semi-structured questionnaire. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for depressive symptoms. Logistic regression analysis was used to calculate the association of post-partum depressive symptoms with socio-demographic and maternal factors.
  
  
  RESULTS
  The prevalence of post-partum depressive symptoms among mothers was 30%. Mothers aged 20 to 29 years were less likely to have depressive symptoms (adjusted odds ratio (aOR) = 0.40; 95% CI: 0.21-0.76) compared to older mothers. Similarly, mothers with a history of pregnancy-induced health problems were more likely to have depressive symptoms (aOR = 2.16; CI: 1.00-4.66) and subjective feelings of stress (aOR = 3.86; CI: 1.84-4.66) than mothers who did not.
  
  
  CONCLUSIONS
  The number of post-partum mothers experiencing depressive symptoms was high; almost one-third of the participants reported having them. Pregnancy-induced health problems and subjective feelings of stress during pregnancy in the post-partum period were found to be associated with depressive symptoms among these women. Screening of depressive symptoms should be included in routine antenatal and postnatal care services for early identification and prevention.
authors.affiliation: Department of Ayurveda, Ministry of Health and Population, Kathmandu, Nepal. giri72rajendra@gmail.com.
authors.forename: Rajendra Kumar
authors.initials: RK
authors.lastname: Giri
authors.affiliation: Save the Children, Saving Newborn Lives Program, Kathmandu, Nepal. rkchettri@gmail.com.
authors.forename: Resham Bahadur
authors.initials: RB
authors.lastname: Khatri
authors.affiliation: Nepal Development Society, Kathmandu, Nepal. shivarajmishra@gmail.com.
authors.forename: Shiva Raj
authors.initials: SR
authors.lastname: Mishra
authors.affiliation: School of Public Health, Curtin University, Perth, Australia. Khanal.vishnu@gmail.com.
authors.forename: Vishnu
authors.initials: V
authors.lastname: Khanal
authors.affiliation: Department of Psychiatry, Institute of Medicine, Tribhuwan University, Kathmandu, Nepal. vdsharma@healthnet.org.np.
authors.forename: Vidya Dev
authors.initials: VD
authors.lastname: Sharma
authors.affiliation: Department of Community Medicine and Public Health, Institute of Medicine, Tribhuwan University, Kathmandu, Nepal. dr_gartoula@yahoo.com.
authors.forename: Ritu Prasad
authors.initials: RP
authors.lastname: Gartoula
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D009035:Mothers / Q000523:psychology; D009390:Nepal / Q000453:epidemiology; D036801:Parturition; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires