Risk factors for postnatal depression among recently delivered young women in Rural Karnataka, South India

Postnatal depression (PND) is a global public health issue that is associated with devastating and persistent outcomes in mothers and children. In India, PND affects one-in-five first-time mothers. Research on PND among populations in rural settings in India is limited. We aim to describe the prevalence of and risk factors for postnatal depression among a sample of women in their postnatal period in a rural setting in Mysore, South India. Participants were recruited from a large quasi-experimental study that examined the feasibility and acceptability of using mobile medical clinics for antenatal care and HIV testing for pregnant women living in rural communities. All postpartum women completed the PHQ-9 along with a brief survey after completion of the informed consent process. Logistic regression was used to identify factors associated with PND. A total of 148 mothers 16-20 weeks postpartum completed the study (M_age = 22.9 years, SD ±3.40). About 18.9% met the screening cut-off for postnatal depression using PHQ-9 with scores ≥10. After controlling for age and interaction term for participants’ age and their spouses’ education level, postnatal mothers residing with husbands with higher levels of education had significantly lower odds of depression symptoms (Odds Ratio: 0.25; 95% CI: 0.10-0.6) as compared to those whose husbands had lower education levels. High prevalence of PND indicates the need for early screening, evidence-based intervention programs, and capacity building for frontline health workers such as Auxiliary Nurse Midwives and Accredited Social Health Activists who work closely with pregnant and postnatal mothers in rural communities. This study also indicates the need for research on husbands’ level of understanding of PND, and their attitudes immediately after their wives’ delivery in rural communities.