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Background: Recent evidence suggests that the prevalence of postnatal depression (PND) is highest in low-income developing countries. This study aimed to estimate the prevalence of PND and its associated risk factors among Bangladeshi women. Method: The study was conducted in the Matlab subdistrict of rural Bangladesh. A cohort of 346 women was followed up from late pregnancy to post-partum. Sociodemographic and other related information on risk factors was collected on structured questionnaires by trained interviewers at 34–35 weeks of pregnancy at the woman's home. A validated local language (Bangla) version of the Edinburgh Postnatal Depression Scale (EPDS-B) was used to measure depression status at 34–35 weeks of pregnancy and at 6–8 weeks after delivery. Results: The prevalence of PND was 22% [95% confidence interval (CI) 17.7–26.7%] at 6–8 weeks post-partum. After adjustment in a multivariate logistic model, PND could be predicted by history of past mental illness [odds ratio (OR) 5.6, 95% CI 1.1–27.3], depression in current pregnancy (OR 6.0, 95% CI 3.0–12.0), perinatal death (OR 14.1, 95% CI 2.5–78.0), poor relationship with mother-in-law (OR 3.6, 95% CI 1.1–11.8) and either the husband or the wife leaving home after a domestic quarrel (OR 4.0, 95% CI 1.6–10.2). Conclusions: The high prevalence of PND in the study was similar to other countries in the South Asian region. The study findings highlight the need for programme managers and policy makers to allocate resources and develop strategies to address PND in Bangladesh.

In developing countries, postnatal depression (PND) is estimated to affect a high proportion of women following childbirth. There are no reliable estimates for the magnitude of the problem in Bangladesh, a country of 140 million people. The lack of a validated Bangla version of screening scale such as the Edinburgh Postnatal Depression Scale (EPDS) has hindered attempts to quantify and address the problem in the country. This study was carried out among Bangladeshi women to validate the Bangla version of the EPDS with the help of a multi‐disciplinary research consultative group. A research assistant administered the Bangla EPDS to a convenience sample of 100 mothers at 6–8 weeks postpartum attending an urban childhood immunization clinic. A psychiatrist examined all women using the Structured Clinical Interview (SCID) for DSM‐IV diagnosis of depression. Nine (9%) women were found to have depression. Internal consistency was tested using Cronbach's alpha coefficient (0.84). The optimal Receiver Operating Characteristic (ROC) cut‐off score of Bangla EPDS was 10 with a sensitivity of 89%, specificity of 87 %, positive predictive value of 40%, and negative predictive value of 99%. The Bangla EPDS is thus a valid and reliable screening scale for identifying PND in Bangladesh.

Standardized questionnaires for screening common health problems in the community often need to be translated for use in non-English speaking countries. There is a lack of literature documenting the process of translation of such questionnaire/scale that would enable their application in cross-cultural settings and standardization of the procedure. This paper reports the process of translation into Bangla of the widely used Edinburgh Postnatal Depression Scale (EPDS) for use in Bangladesh. Three methods: forward translation, committee translation, and back translation were used to ensure the equivalence of the translated version. Both the English and Bangla versions were piloted among 10 social science graduates who were proficient in both the languages. The concurrence of each respondent between the two versions showed a correlation coefficient of 0.98 (p

ObjectiveThis study explored the risk of antenatal psychosocial distress (APD) and associated potential factors and examined management aspects of risk of APD in women attending Aboriginal primary health care services in Australia.MethodAudits of medical records of 797 pregnant women from 36 primary health centres in five jurisdictions (NSW, QLD, SA, WA and NT) were undertaken as part of a quality improvement programme. Information collected included mental health assessed by a standard screening tools, enquiry regarding social and emotional well-being (SEWB), depression management (including antidepressant medications) and referral.ResultsAround 18% (n= 141) of women were at risk of APD based on assessment using a standard screening tool or by SEWB enquiry. There was a significant association between risk of distress and women’s life style behaviours (e.g., alcohol, illicit drug use) and health centre characteristics. Of the 141 women, 16% (n= 22) were prescribed antidepressant drugs during pregnancy. A range of nonpharmaceutical mental health interventions were also recorded, including brief intervention of 61% (n= 86), counselling of 57% (n= 80) and cognitive behaviour therapy of 5% (n= 7). About 39% (n= 55) of women with APD were referred to external services for consultations with a psychiatrist, psychologist or social worker or to a women’s refuge centre.ConclusionsThe higher risk of APD associated with women’s life style behaviour indicates that the better understanding of mental health in its cultural context is essential.

Background: In developed countries, perinatal death is known to cause major emotional and social effects on mothers. However, little is known about these effects in low income countries which bear the brunt of perinatal mortality burden. This paper reports the impact of perinatal death on psychological status and social consequences among mothers in a rural area of Bangladesh. Methods: A total of 476 women including 122 women with perinatal deaths were assessed with the Edinburgh Postnatal Depression Scale (EPDS-B) at 6 weeks and 6 months postpartum, and followed up for negative social consequences at 6 months postpartum. Trained female interviewers carried out structured interviews at women's home. Results: Overall 43% (95% CI: 33.7-51.8%) of women with a perinatal loss at 6 weeks postpartum were depressed compared to 17% (95% CI: 13.7-21.9%) with healthy babies (p = < 0.001). Depression status were significantly associated with women reporting negative life changes such as worse relationships with their husband (adjusted OR = 3.89, 95% CI: 1.37-11.04) and feeling guilty (adjusted OR = 2.61, 95% CI: 1.22-5.63) following the results of their last pregnancy outcome after 6 months of childbirth. Conclusion: This study highlights the greatly increased vulnerability of women with perinatal death to experience negative psychological and social consequences. There is an urgent need to develop appropriate mental health care services for mothers with perinatal deaths in Bangladesh, including interventions to develop positive family support.

Postnatal depression (PND) is a major public health problem worldwide. Recent evidence suggests that PND affects a high proportion of women in developing countries. The present study was carried out in Bangladesh where there are no reliable data on the magnitude and determinants of PND. The study comprised two phases. In Phase 1, a BangIa version of the internationally accepted screening tool, the Edinburgh Postnatal Depression Scale (EPDS), was developed and validated. Phase 11 was an epidemiological investigation to measure the magnitude of PND and its potential contributing risk factors in Bangladeshi women.