Sociodemographic and Obstetric Determinants of Postpartum Depression in a Tertiary Care Setting of Pakistan: A Cross-Sectional Study

Abstract

Background: Postpartum depression (PPD) is a multifactorial psychiatric disorder influenced by biological, psychological, and social determinants. While inflammatory markers have gained attention, sociodemographic and obstetric factors remain critical in understanding vulnerability to postpartum depression, particularly in low- and middle-income countries.

Objectives: To determine the association of sociodemographic and obstetric factors with postpartum depression among women attending a tertiary care hospital.

Methods: This cross-sectional study was conducted at Civil Hospital Hyderabad, Pakistan. A total of 236 postpartum women within six months of delivery were recruited. Postpartum depression was assessed using the Urdu version of the Edinburgh Postnatal Depression Scale (EPDS). Sociodemographic and obstetric variables were recorded using a structured proforma. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of postpartum depression.

Results: The prevalence of postpartum depression was 50.8%. Significant associations were observed between postpartum depression and rural residence (OR = 2.34; 95% CI: 1.38–3.96), low educational status (OR = 2.91; 95% CI: 1.69–5.01), low socioeconomic status (OR = 2.47; 95% CI: 1.44–4.23), and multiparity (OR = 1.88; 95% CI: 1.02–3.46). In multivariate analysis, rural residence, low education, and low socioeconomic status remained independent predictors of postpartum depression.

Conclusions: Sociodemographic disadvantage plays a substantial role in the development of postpartum depression. Strengthening psychosocial screening and targeted community-based interventions may reduce the burden of postpartum depression in resource-limited settings.