Maternal perinatal mental health and associated factors during the first postpartum year from a longitudinal birth cohort study in Rahim Yar Khan, Pakistan

During the perinatal period, women in low- and middle-income countries experience high rates of common mental disorders (CMDs). We aimed to estimate CMD prevalence at 6 and 12 months postpartum in Rahim Yar Khan (RYK), Pakistan, and identify factors associated with postpartum mental health. We conducted secondary analysis of a longitudinal birth cohort study, which was nested within the control arm of a community-based, cluster-randomized trial that enrolled pregnant women in their third trimester (n = 2,122). Mental health was assessed using the Self-Reporting Questionnaire. Factors associated with postpartum mental health were explored using mixed-effects linear regression, and associations between preconception, antenatal and postpartum CMDs were assessed using robust Poisson regression. The prevalence of CMDs was 16% and 17% at 6 and 12 months postpartum, respectively. Women who reported that their husbands were unhappy had poorer postpartum mental health, whereas high social support was associated with improved postpartum mental health. History of antenatal CMDs was associated with increased risk of CMDs at 6 and 12 months postpartum (adjusted risk ratio = 2.60 and 1.90, 95% confidence interval: 1.69–4.01 and 1.40–2.58, respectively). Mothers with identified risk factors may benefit from targeted mental health support during the perinatal period.