Browsing by Author "Rowel, D.D.S."

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    Prevalence and correlates of postpartum depression in the puttalam district
    (Sri Lanka College of Obstetricians and Gynaecologists, 2004) Rowel, D.D.S.; Jayawardena, P.L.; Fernando, N.
    OBJECTIVES: To study the prevalence and the correlates of postpartum depression. METHODOLOGY: This was a community based prospective study, carried out in the District of Puttalam during the period of October 2003 to April 2004. The sample size computed was 1100. The validated Sinhala translation of the Edinburgh Postnatal Depression Scale (EPDS) was used to determine the prevalence of postpartum depression, at 6 weeks postpartum at home, where the cut off for depression was determined to be 9/10. In addition, the questionnaires on socio demographic data and reproductive health, the Maternity Social Support Scale, the Abuse Assessment Questionnaire, the Modified Life Events Inventory and the questionnaire on delivery and the index child were administered to identify the independent variables associated with postpartum depression. Multivariate logistic regression analysis was carried out and the results are expressed as Odds Ratios (OR) and 95% Confidence Intervals (95% CI). RESULTS: The prevalence of postpartum depression in the district of Puttalam was 32.1%. From multivariate analysis, unplanned pregnancy (OR=1.6; 95% CI= 1.1-2.3) , conflicts with the husband (OR=1.5; 95% CI= 1.1-2.0), physical abuse during pregnancy (OR=5-2; 95% CI= 1.6-16.1), death of a close friend (OR=2.2; 95% CI= 1.3-3.7), use of harsh words by the husband (OR=2.1; 95% CI= 1.2-3.1), normal vaginal delivery (OR=1.7; 95% CI= 1.1-2.6), low birth weight of the baby (OR=1.6; 95% CI= 1.01-2.4), illness in the baby (OR=2.1;95%CI= 1.2-3.4) and poor sleeping pattern of the baby at night (OR=1.6; 95% CI= 1.1-2.2), were the factors found to be significantly associated with postpartum depression. CONCLUSIONS: Postpartum depression which had a prevalence of 32.1% is considered a major public health problem in Sri Lanka. Therefore it is important to address the factors found to be associated with it, because of its negative impact on the mother, the child and the family.
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    Validation of the Sinhala translation of the Edinburgh Postnatal Depression Scale
    (Sri Lanka Medical Association, 2005) Rowel, D.D.S.; Jayawardena, P.L.; Fernando, N.
    OBJECTIVE: To validate the Sinhala translation of Edinburgh Postnatal Depression Scale (EPDS) to detect depression in antenatal and postnatal mothers. METHODOLOGY: Content validity of EPDS was checked by a panel of experts. Translation of the English questionnaire by bilingual experts to Sinhala by 'translation back translation1 method followed. Thereafter alternate form reliability of the instrument was checked. Criterion validity of the instrument was assessed against a 'gold standard', which was the clinical diagnosis by a consultant psychiatrist based on ICD 10 Research Diagnostic Criteria. This was done in field combine clinics of Medical Officer of Health area Kolonnawa. The antenatal mothers completing 34 weeks of period of amenorrhea and postnatal mothers 6 weeks after partus were administered the EPDS followed by the clinical psychiatric interview. The cut off scores for EPDS to identify depression in antenatal and postnatal mothers were determined using the Receiver Operator Characteristic (ROC) curves. RESULTS: The cut off score of 9/10 (sensitivity of 90.7% and a specificity of 86.8%) was the best cut off to screen for depression in antenatal mothers. In postnatal mothers a cut off score of 9/10 (sensitivity of 89.9% and a specificity of 78,9%) was the best cut off score to screen for postpartum depression.CONCLUSION: Sinhala translation of EPDS is a reliable and a valid instrument to detect depression in antenatal and postnatal mothers in Sri Lanka.