22% of new mothers in India suffer from postpartum depression : WHO

 

About 22 percent of Indian mothers suffer from postpartum depression (PPD) and the country requires more resources for capacity building in maternal health care, finds a report recently published by the World Health Organisation (WHO). While a mild depression called ‘baby blues’ is common in new mother, PPD requires medical attention, and if left untreated affects a woman’s ability to take care of the baby and herself.

The extensive meta-analysis was carried out by researchers and doctors from the clinical evaluations and was a part of the report submitted to the WHO on PPD.

Ravi Prakash Upadhyay, from Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India, and colleagues conducted the study to provide an estimate of the burden of postpartum depression in Indian mothers and investigate some risk factors for the condition.

Postpartum psychiatric disorders are divided into three categories: postpartum blues, postpartum psychosis, and postpartum depression. Postpartum blues, with an incidence of 300 -750 per 1000 mothers globally, may resolve in a few days to a week, has few negative effects and usually requires only reassurance. Postpartum psychosis, which has a global prevalence ranging from 0.89 to 2.6 per 1000 births, is a severe disorder that begins within four weeks after delivery and requires a hospital stay. PPD, the third type, can start soon after childbirth or as a continuation of antenatal depression and needs medical attention.

The findings were based on a systematic review and analysis of 38 studies involving 20,043 women, provide an estimate of the burden of PPD in Indian mothers and investigate some risk factors for the condition.

Key Findings of the report:

• The southern region of the country tops the PPD chart with an estimated overall pooled prevalence of 26 percent, followed by eastern (23 percent), south-western (23 percent) and western regions (21 percent).
• The northern region had the lowest prevalence of PPD (percent).
• The pooled prevalence was higher, but not significantly so, for studies conducted in hospital settings than in community settings and in urban versus rural areas.
• The most commonly reported risk factors for PPD include financial difficulties, domestic violence, past history of psychiatric illness in the mother, marital conflict, lack of support from the husband and birth of a female baby. Other reported risk factors include recent stressful life event, family history of psychiatric illness, sick baby or death of the baby and substance abuse by the husband.
• PPD can predispose to chronic or recurrent depression, which may affect the mother-infant relationship and child growth and development.
• Children of mothers with PPD have greater cognitive, behavioral and interpersonal problems and are at greater risk of being underweight and stunted.

“India is experiencing a steady decline in maternal mortality, which means that the focus of care in the future will shift towards reducing maternal morbidity, including mental health disorders. Despite the growing number of empirical studies on PPD in India, there is a lack of robust systematic evidence that looks not only at the overall burden of PPD but also its associated risk factors. Our current understanding of the epidemiology of postpartum depression is largely dependent on a few regional studies, with very few nationwide data. The current review was done to fill this gap,” observed the authors.

 “These estimates in low- and middle-income countries are similar to ours and, taken together, they support an argument for placing greater importance on maternal mental health as part of overall efforts to improve maternal and child health,” the report pointed out.

The research was done in a specific population, for instance, mothers living with human immunodeficiency virus or mothers with any current chronic disease were excluded. And studies published before 2000 were not considered for the review.

“With maternal mortality declining in India, the focus must also be on maternal mental health and it must be addressed effectively,” concluded the authors.