Postnatal depression in primary care populations in Nigeria

Objective: The purpose of this study is to determine the prevalence and associated factors for postnatal depression in primary health care (PHC) centers of a developing society. Method: A two-stage screening procedure involving the 10-item self-report Edinburgh Postnatal Depression Scale (EPDS) and the Present State Examination Schedule was employed. Results: The prevalence of postnatal depression in the primary care populations studied was 18.6%. Postnatal depression was found on logistic regression to be independently predicted by younger age (OR, 5.42; 95% CI, 2.61-10.32; P <.05), by being primigravida (OR, 2.73; 95% CI, 1.44-4.24; P <.05), by not having the desired gender for their babies (OR, 2.86; 95% CI, 1.62-5.93; P <.05) and by in-law relationship problems (OR, 3.64; 95% CI, 1.84-7.22; P <.05). The EPDS was shown to be a feasible screening instrument for postnatal depression in the PHC centers (sensitivity, 88.1%; specificity, 84.3%; minimum misclassification rate, 15.0%). Conclusion: The EPDS should be incorporated into the maternal and child health care programs of PHC centers in developing countries in order to ensure early detection and appropriate therapeutic intervention in cases of postnatal depression. (c) 2006 Elsevier Inc. All rights reserved.