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Tuesday, 24 July 2012

Perinatal depression among Bangladeshi mothers

According to the National Mental Health Survey of Bangladesh in 2003-’05, 16% of the adult population has some kind of mental health problems. However, there is no strategy to screen women during pregnancy and post-partum period for mental illness. Depression (and associated anxiety) immediately after childbirth and in the postpartum period (six weeks following delivery) is not recognized as an illness in Bangladesh and as such rarely reported in the literature.

A recent community-based study in two rural sub-districts of Bangladesh of 671 mothers (and babies) at 2-3 months post-partum and at 6-8 months post-partum found the prevalence of post-partum depression to be 8% and 18% respectively. Prevalence of ante-partum depression was found to be 18% while prevalence of anterpartum anxiety symptoms was 29%.A validated Bangla version of Edinburgh Postnatal Depression Scale (EPDS-B) was used to measure depression in mothers.

Poor socioeconomic status, physical partner violence during pregnancy, anxiety symptoms during pregnancy, and previous depressive symptoms were identified as the main risk factors for perinatal depression. Perinatal depression also has deleterious effects on the infant. It was found to be independently associated with underweight, and responsible for impaired motor development (at 6-8 months). On the other hand, ante-partum depression was found to be associated with stunting of the infant.

Though the results cannot be generalized (more studies are needed to explore the situation in other parts of the country), it is pretty indicative of the existence of the problem in the country and needs urgent attention from the MNCH and Public Health community. Policies and actions are needed to address the problem, thereby contributing to the reduction of low birth weight (LBW), underweight and stunting among infant in Bangladesh. This also draws our attention towards the incorporation of maternal mental health issues in the broader arena of mental health problems in the country.

Source: Nasreen HE. (2011). Risk factors and consequences of maternal perinatal depressive and anxiety symptoms: A community-based study in rural Bangladesh. PhD Thesis. Karolinska Institutet, Stockholm, Sweden. Available from: http://publications.ki.se/jspui/bitstream/10616/40713/5/Thesis_Hashima-E-Nasreen.pdf  

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