Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors.

BACKGROUND Community-based epidemiological data on post-partum depression from developing countries are scarce. AIMS To determine the incidence of and risk factors for developing post-partum depression in a cohort of women living in rural south India. METHOD We assessed 359 women in the last trimester of pregnancy and 6-12 weeks after delivery for depression and for putative risk factors. RESULTS The incidence of post-partum depression was 11% (95% CI 7.1-14.9). Low income, birth of a daughter when a son was desired, relationship difficulties with mother-in-law and parents, adverse life events during pregnancy and lack of physical help were risk factors for the onset of post-partum depression. CONCLUSIONS Depression occurred as frequently during late pregnancy and after delivery as in developed countries, but there were cultural differences in risk factors. These findings have implications for policies regarding maternal and childcare programmes.