Maternal mental health matters: understanding postpartum depression using EPDS

Prabhjot Kaur; Akshaj Mehta; Sangeeta; Sumita Mehta

doi:10.18203/2394-6040.ijcmph20261783

Authors

Prabhjot Kaur Department of Obstetrics and Gynecology, Babu Jagjivan Ram Memorial Hospital, Delhi, India
Akshaj Mehta University College of Medical Sciences and GTB Hospital, Delhi, India
Sangeeta Nursing Officer, Babu Jagjivan Ram Memorial Hospital, Delhi, India
Sumita Mehta Department of Obstetrics and Gynecology, Babu Jagjivan Ram Memorial Hospital, Delhi, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20261783

Keywords:

Postnatal depression, Edinburgh postnatal depression scale, Postpartum mental health, Maternal mental health, EPDS

Abstract

Background: Postnatal depression (PND) is a global public health concern with significant implications for maternal and infant health. It is a common but underdiagnosed mental health disorder affecting women during the postpartum period, particularly in low- and middle-income countries. A validated screening tool such as the Edinburgh Postnatal Depression Scale (EPDS) is essential for early detection and prevention of adverse maternal and infant outcomes.

Methods: A cross-sectional observational study was conducted at BJRM Hospital, Delhi in 250 postpartum women using the Edinburgh Postnatal Depression Scale (EPDS) at 6 to 8 weeks postpartum. A score ≥13 indicated probable depression and data was analysed using descriptive statistics.

Results: Probable postnatal depression (EPDS≥13) was observed in 23% (n=59), with 17% showing possible depression (EPDS 10–12) mainly anxiety symptoms. Mean EPDS scores did not show any significant association with maternal age(p=0.086), parity (p=0.086) or mode of delivery (p=0.363). There was significant association of EPDS scores with the newborn sex (p=0.002).

Conclusions: Nearly 25% of postpartum women screened positive for probable depression. Extremes of maternal age, primiparity, mode of delivery and sex of newborn were associated with higher EPDS scores. Routine postpartum screening using EPDS should be integrated into maternal health services to enable early identification and timely intervention.

References

Amer SA, Zaitoun NA, Abdelsalam HA, Abbas A, Ramadan MS, Ayal HM, et al. Exploring predictors and prevalence of postpartum depression among mothers: Multinational study. BMC Public Health. 2024;24(1):1308.

Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis. J Psychiatr Res. 2018;104:235-48.

WHO. Maternal mental health. Geneva: World Health Organization. Available at: https://www.who.int/teams/mental-health-and-substance-use/promotion-prevention/maternal-mental-health. Accessed on 24 February 2026.

Silva CS, Lima MC, Sequeira-de-Andrade LAS, Oliveira JIC, Monteiro JS, Lima NMS, et al. Association between maternal age and postpartum depression: A population-based study. BMC Pregnancy Childbirth. 2020;20:1-9.

Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and health predictors of national postpartum depression prevalence: A systematic review. Arch Women’s Ment Health. 2018;21(4):455-63.

Putnam KT, Wilcox M, Robertson-Blackmore E, Sharkey K, Bergink V, Munk-Olsen T, et al. Clinical phenotypes of perinatal depression and parity associations. Am J Psychiatry. 2019;176(4):295-302.

Alshikh Ahmad H, Alkhatib A, Luo J. Prevalence and risk factors of postpartum depression in the Middle East: A systematic review. BMC Pregnancy Childbirth. 2021;21:542.

Yim IS, Tanner Stapleton LR, Guardino CM, Hahn-Holbrook J, Dunkel Schetter C. Biological and psychological predicters of postpartum depression: systematic review and call for integration. Annu Rev Clin Psychol. 2015;11:99-137.

Gao L, Chan SWC, Mao Q. Depression, anxiety and stress in Chinese postpartum women and their correlates. Int J Nurs Pract. 2019;25(1):e12700.

Xu H, Ding Y, Ma Y, Xin X, Zhang D. Cesarean section and risk of postpartum depression: A meta-analysis. J Psychosom Res. 2018;97:118-26.

Goker A, Yanikkerem E, Demet MM, Dikayak S, Yildirim Y, Koyuncu FM. Postpartum depression: Is mode of delivery a risk factor?. ISRN Obstet Gynecol. 2020;2020:1-7.

Carter FA, Frampton CMA, Mulder RT. Cesarean delivery and postpartum depression: A meta-analysis. Aust N Z J Psychiatry. 2021;55(5):483-95.

Patel V, Prince M. Maternal psychological morbidity and low birth weight in India. Br J Psychiatry. 2018;188:284-5.

Ahmad N, Hussain S, Khan Z, Riaz M, Riaz MA, Iqbal Z, et al. Gender of newborn and postpartum depression: A cross-sectional study in Pakistan. BMC Psychiatry. 2020;20:1-8.

Dadi AF, Miller ER, Woodman RJ, Azale T. Newborn sex and maternal depression in low-income settings: A systematic review. J Affect Disord. 2021;278:602-10.

O’Hara MW, Wisner KL. Perinatal mental illness: Definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol. 2019;62:3-12.