Use of the Edinburgh Postnatal Depression Scale to identify postpartum depression and its risk factors in Southeastern Nigeria

Objectives: To determine the prevalence of postpartum depression and the demographic and clinical characteristics associated with a positive screen.Subjects and methods: Five hundred and fifty consecutive and consenting postnatal women at five postnatal clinics in Aba, Southeastern Nigeria over the period 1 June – 1 November, 2010. Using the 10-question Edinburgh Postnatal Depression Scale (EPDS), the postnatal women were screened for postpartum depression during postnatal and childhood immunization visits at six weeks postpartum. Consenting clients self-completed the questionnaire or were assisted to do so by research assistants.Results: The prevalence of women with a positive screen for postpartum depression was 23.5%. Women who had a positive screen were more likely to have attained primary education (OR 0.19; CI 0.70-1.34; p<0.001) and tertiary education (OR 1.59; CI 1.07-2.36; p<0.05), be unpartnered (OR 0.20; CI 0.05-0.83; p<0.05), had caesarean delivery (OR 0.58; CI 0.35-0.97; p<0.05), have a history of depression (OR 0.16; CI 0.07-0.36; p<0.001) and belong to ethnic minorities in Nigeria (OR 0.20; CI 0.08-0.46; p<0.001).Conclusion: Postpartum depression is as prevalent in this African culture as in Western and Asian cultures. Women should be screened for depressive symptoms during pregnancy and postpartum periods so that timely and appropriate follow-up evaluation and treatment may be initiated.Key words: Postpartum, Depression, Southeastern, Nigeria