Association between Postpartum Depression and Premenstrual Dysphoric Disorder in Primigravida after Elective Caesarean Section: A Prospective Cohort Study

Abstract

Introduction: The determinants of Postpartum Depression (PPD), such as Premenstrual Dysphoric Disorder (PMDD) are not properly focused specially in the developing countries like India. But, it may help in proper screening, early diagnosis and management of such cases with improved prognosis. Aim: To determine the association between PPD and PMDD in primigravida undergoing elective caesarean section. Materials and Methods: This prospective cohort study included 78 primigravida undergoing elective caesarean section conducted in a tertiary centre from February 2019 to January 2020. PPD was screened by Edinburgh Postnatal Depression Scale (EPDS) and the severity assessed by Beck’s Depression Inventory (BDI) on day 7,14,42 postpartum. Primarily, the association of PPD with PMDD was assessed by Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The socio-demographic determinants of PPD were the secondary outcome measurement of this study. Unpaired Student’s t-test and Chi-square test were used to determine the association. Numerical variables were analysed by Unpaired Student’s t-test and categorical variables were analysed by Chi-square test. Results: Total 78 primipara females undergoing elective caesarean section participated, out of which six females were lost to follow-up, hence 72 were the study subjects. Total 22 participants (30.55%) developed PPD. The prevalence of PMDD was n=26 (36.11%) in study population (81.81% in depression group, 16% in non depression group). So, a greater prevalence of PMDD was noted in patients with PPD (p-value <0.0001). In the present study, marital satisfaction, planned pregnancy and family without any history of psychiatric disorders were found to be associated with lower prevalence of PPD. Conclusion: This study with a small sample size gives a direction to assess the determinant of PPD for timely intervention with better prognosis.

Keywords

• beck depression inventory
• diagnostic and statistical manual of mental disorder
• edinburgh postnatal depression scale