Maternal and infant correlates of postpartum depression: a study from low socioeconomic communities in Karachi, Pakistan

Background: Postpartum depression (PPD) is a significant community issue impacting maternal health, child growth and development and family life. In Pakistan, its prevalence is notably high, particularly in socioeconomically disadvantaged settings, however, there is still limited community-based research done in examining its multiple contributing factors. Objective: To estimate the point prevalence of PPD among three groups of mothers at 1, 3, and 6 months postpartum and to identify maternal, socioeconomic, and psychosocial correlates in low-income peri-urban communities of Karachi, Pakistan. Methods: A cross-sectional analysis was conducted among 268 mothers of infants with ages of 1, 3, and 6 months, in the low socioeconomic districts of Karachi. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) with a country specific cut-off of 14 and above being the symptoms of clinically significant importance. Structured questionnaires were used to gather data on sociodemographic and obstetric and psychosocial characteristics. Data collected between July 2022 and December 2024. Poisson regression models were used to estimate crude prevalence ratios, adjusted prevalence ratios (aPR) with 95% confidence intervals (CIs). Results: The overall prevalence of possible PPD was 29.1% (95% CI: 23.7–34.5). Multivariable analysis identified significant associations of PPD with child’s male gender (aPR = 1.474, 95% CI:1.003–2.167), middle-born children (aPR = 2.104, 95% CI:1.119–3.956), intimate partner violence (aPR = 3.430, 95% CI:1.566–7.509), maternal employment (aPR = 2.706, 95% CI:1.468–4.987), household income (aPR = 0.259, 95% CI:0.088–0.761), and previously breastfeeding of two children (aPR = 0.413, 95% CI: (0.205–0.830) and three children (aPR = 0.181, 95% CI: (0.082–0.396). Additionally, significant intimate partner violence and household income interaction was observed (aPR = 7.049, 95% CI:1.714–28.982). Conclusion: This paper examined maternal and infant predictors of postpartum depression among low socioeconomic groups in Karachi, Pakistan. Our results highlight the necessity of context-based solutions to postpartum mental health in resource-constrained appropriations. Screening in communities, better houses, economical support and violence prevention helps are essential to decrease PPD load in resource constrained peri-urban environment.