Depression in mothers at four weeks and twenty-four weeks postpartum: a study on the prevalence and selected risk factors in Sri Lanka.

Although Sri Lanka has shown a significant improvement in maternal health care indicators during the past few decades, PPD could be identified as a significant public health concern. The main purpose of the current study was to assess the most recent status of PPD in Sri Lanka in relation to its prevalence and selected risk factors. A population-based quantitative study was conducted among 401 mothers from 18 maternal clinics in the Colombo district, Sri Lanka. The cross-culturally validated Sinhala translation of the Edinburgh Postnatal Depression Scale (EPDS), with a cut-off score of nine or more, was used to estimate the prevalence of PPD. Two questionnaires were designed specifically for the present study to collect data on sociodemographic factors and to extract data from the pregnancy record card. The prevalence of postpartum depression (PPD) was 29.2% (95% CI 21.6-36.8) at four weeks postpartum and 18.0% (95% CI 13.2-22.8) at twenty-four weeks postpartum. Multivariable analysis identified maternal age 20-24 years (AOR 9.1, 95% CI 1.5-57.2, p < 0.05), age 25-34 years (AOR 2.8, 95% CI 1.3-6.4, p < 0.05), having three children (AOR 7.9, 95% CI 0.4-44.7, p < 0.05), maternal education at Ordinary Level (AOR 4.9, 95% CI 1.2-21.0, p < 0.05), maternal history of psychiatric illness (AOR 1.31, 95% CI 1.12-1.55, p < 0.01), and abnormalities in the baby (AOR 3.7, 95% CI 1.5-9.1, p < 0.01) as factors significantly associated with PPD. In contrast, higher paternal education (AOR 0.3, 95% CI 0.1-0.8, p < 0.05) and was associated with lower odds of PPD. Mothers who did not attend prenatal care sessions had markedly higher odds of PPD (AOR 38.1, 95% CI 6.5-222.3, p < 0.001). This study indicates that PPD is highly prevalent among mothers residing in the Colombo district of Sri Lanka. Screening mothers for PPD at various postpartum periods and a multidisciplinary team approach could be introduced to better manage this condition.