[Postnatal depression in a Colombian city. Risk factors]

Abstract

Objective: Depression is a major public health problem, which women present, as well as at other periods of their lives, at the puerperium. Postnatal depression is the most frequent complication at this period, with worldwide prevalence as high as 15%. In Colombia, its frequency and associated factors were not clearly defined.

Design: To establish the incidence and associated factors for postnatal depression in the Bucaramanga, Colombia, metropolitan area.

Methods: Between May 2003 and April 2004, a cohort was assembled of 286 puerperal women from 11 health centres at different levels, within the Bucaramanga metropolitan area. Women were monitored for 6 weeks. Information was obtained on social, demographic and obstetric variables, psychiatric history, variables concerning the newborn, satisfaction with delivery, and breast-feeding. Postnatal depression was established by a psychiatrist, in a semi-structured clinical interview, using DSM-IV criteria. Incidence rate and associated factors were calculated through a regression model.

Results: Incidence rate of postnatal depression was: 1 case per 1000 days/person monitored (95% CI, 0.5-1.7). After the data were then fitted, only these factors were associated with postnatal depression: depression background, HR 3.87 (95% CI, 1.02-14.7), absence of prenatal monitoring, HR 3.87 (95% CI, 1.1-13.2), and background of dysphoria, HR 15.13 (95% CI, 1.9-118.2).

Conclusions: Postnatal depression is little recognized during the puerperium. It is a major public health problem in Bucaramanga, where an appropriate prenatal monitoring program could reduce it. A follow-up program for mother and child would help its early diagnosis and management.