Screening for postpartum depression in recently delivered mothers

Objective: To identify the risk factors for postpartum depression and compare the rate and severity in abdominal versus vaginally delivered women at Fatima Hospital at Baqai Medical University using Edinburgh Postnatal Depression Sale (EPDS).
Methodology: It was a cross sectional comparative study conducted from 1st December 2007 to 28th February 2009. At Fatima Hospital total 393 women were interviewed using translated questionnaire of EPDS at 6-8 weeks postnatal, when they came for their post-delivery checkup in OPD. Women of all parities and age groups, who consented for the interview, were included in the study. Women who delivered stillborn, malformed and preterm babies were excluded. Additionally, women with complicated deliveries e.g. instrumental deliveries, extended episiotomies and with PPH were also excluded. Women were studied in two groups. Group-1 consisted of 195(47.3%) vaginally delivered women and group-2 consisted of 198(50.4%) abdominally delivered women. For convenience of patients EPDS was translated into Urdu. Statistical analysis was done by using SPSS version 15.
Result: Score of >12 out of 30-point scale was used to diagnose postpartum depression while score of >15 indicated severe postpartum depression. According to this criteria, over all 15% of women had confirmed PPD; while 22/195 (11.3%) vaginally delivered women and 35/198(17.8%) women delivered by caesarean section were found to have PPD. Risk of postpartum depression was higher in the women delivered by caesarean section compared to vaginally delivered women (p-value of 0.004). Both groups had the same chance of severity of symptoms.
Conclusion: By using EPDS criteria our study identified that 15% of delivered women at Fatima Hospital at Baqai Medical University had sign and symptoms of postpartum depression. Risk of post partum depression increased with traumatic birth experience, while the risk of severe postpartum depression was independent of mode of delivery.