Original Articles

Prevalence of Paternal Postpartum Depression in Anuradhapura District in Sri Lanka and Its Association With Maternal Postpartum Depression as a Risk Factor


Objective: This study aimed to determine the prevalence of PPPD in Anuradhapura district, its association with maternal PPD, and relevant risk factors.
Materials and methods: Cross sectional study was conducted among fathers in Anuradhapura district having infants 1-5 months by giving questionnaire specifically developed for the study with Edinburgh postnatal depression scale (EPDS) and self-constructed questions. Out of 6324 fathers, 435 fathers and their partners were randomly selected and proportionately allocated to 5 Medical Officer of Health (MOH) areas. R Program and SPSS have used for the data analysis.
Results: Our results revealed that the PPPD prevalence is approximately 11% (95%CI: 8.08-14.67) based on cut off score of 7 points in the EPDS. PPPD was correlated with maternal PPD (OR 19.16, 95%CI 5.0473-85.1203), income decrement (OR 8.1571, 95%CI 2.4621-32.6289), increased time stayed at home in postpartum period (OR 3.7775, 95%CI 1.2365–13.8175).  But other parameters such as infant`s age, work time and number of children were not significantly influenced risk factors for PPPD.
Conclusion: PPPD is prevalent in the Anuradhapura district and maternal postpartum depression has positively influenced. But currently, screening programmes for PPPD is lacking in Sri Lanka. Thus, these deficiencies urgently need to be addressed and should provide information and instructions to fathers regarding this new transition. However, these results need replication in more expanded case control study. Since the prevailing covid-19 pandemic at the time of data collection may have impacted the mental health of the fathers specially in countries like Sri Lanka, where mental health support is limited.


1. Stewart DE, Robertson FE, Dennis C-L, Grace SL, Wallington T. Postpartum depression: literature review of risk factors and interventions. Toronto: University Health Network Women’s Health Program, 2003.
2. Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. J Psychiatr Res. 2018;104:235-248.
3. Cameron EE, Sedov ID, Tomfohr-Madsen LM. Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. J Affect Disord. 2016;206:189-203.
4. Edoka IP, Petrou S, Ramchandani PG. Healthcare costs of paternal depression in the postnatal period. J Affect Disord. 2011;133(1-2):356-60.
5. Halbreich U, Karkun S. Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. J Affect Disord. 2006 Apr; 91(2-3):97-111.
6. Paulson JF, Bazemore SD. Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. JAMA. 2010; 303 (19):1961-9.
7. Ramchandani P, Stein A, Evans J, O'Connor TG; ALSPAC study team. Paternal depression in the postnatal period and child development: a prospective population study. Lancet. 2005;365(9478):2201-5.
8. Quevedo L, da Silva RA, Coelho F, Pinheiro KA, Horta BL, Kapczinski F, Pinheiro RT. Risk of suicide and mixed episode in men in the postpartum period.
J Affect Disord. 2011;132(1-2):243-6.
9. Pinheiro RT, Magalhães PV, Horta BL, Pinheiro KA, da Silva RA, Pinto RH. Is paternal postpartum depression associated with maternal postpartum depression? Population-based study in Brazil. Acta Psychiatr Scand. 2006;113(3):230-2.
10. Narayanan MK, Nærde A. Associations between maternal and paternal depressive symptoms and early child behavior problems: Testing a mutually adjusted prospective longitudinal model. J Affect Disord. 2016; 196:181-9.
11. Fletcher RJ, Feeman E, Garfield C, Vimpani G. The effects of early paternal depression on children's development. Med J Aust. 2011;195(11-12):685-9.
12. Chzhen Y, Gromada A, Rees G. Are the world’s richest countries family friendly? Policy in the OECD and EU. Florence: UNICEF Office of Research, 2019.
13. Agampodi TC, Agampodi SB, Wickramasinghe WA, Adhikari AM, Chathurani HK. Post partum depression - a problem that needs urgent attention. Ceylon Med J. 2011;56(4):183-4.
14. Ierardi JA, Fantasia HC, Mawn B, Watson Driscoll J. The Experience of Men Whose Partners Have Postpartum Depression [Formula: see text]. J Am Psychiatr Nurses Assoc. 2019;25(6):434-444.
15. Shaheen NA, AlAtiq Y, Thomas A, Alanazi HA, AlZahrani ZE, Younis SAR, Hussein MA. Paternal Postnatal Depression Among Fathers of Newborn in Saudi Arabia. Am J Mens Health. 2019;13(1):1557988319831219.
16. Goyal K, Purbiya P, Lal SN, Kaur J, Anthwal P, Puliyel JM. Correlation of Infant Gender with Postpartum Maternal and Paternal Depression and Exclusive Breastfeeding Rates. Breastfeed Med. 2017;12:279-282.
17. Nath S, Psychogiou L, Kuyken W, Ford T, Ryan E, Russell G. The prevalence of depressive symptoms among fathers and associated risk factors during the first seven years of their child's life: findings from the Millennium Cohort Study. BMC Public Health. 2016;16:509.
18. Doran CM, Kinchin I. A review of the economic impact of mental illness. Aust Health Rev. 2019;43(1):43-48.
19. Lachaine J, Beauchemin C, Bibeau J, Patenaude J, Chokka P, Proulx J, Bougie J. Canadian economic impact of improved workplace productivity in patients with major depressive disorder treated with vortioxetine. CNS Spectr. 2020;25(3):372-379.
20. http://www.statistics.gov.lk/Resource/en/LabourForce/Bulletins/LFS_Q1_Bulletin_2020. Accessed: August 2022.
21. Markos M, Arba A. Prevalence and Predictors of Postpartum Depression Among Male Partners Who Came to Postnatal Follow-up Clinic with Their Partner in Selected Public Health Centers of Wolaita Zone, Ethiopia, 2019. Neuropsychiatr Dis Treat. 2020;16:2307-2316.
22. Clavenna A, Seletti E, Cartabia M, Didoni A, Fortinguerra F, Sciascia T, et al. Postnatal depression screening in a paediatric primary care setting in Italy. BMC Psychiatry [Internet]. 2017 Jan 25 [cited 2021 Feb 9];17(1):42. Available from: http://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1205-6
23. Clavenna A, Seletti, Cartabia M, Didoni A, Fortinguerra F, Sciascia T, et al. Postnatal depression screening in a paediatric primary care setting in Italy. BMC Psychiatry. 2017; 17(1):42.
24. Da Costa D, Danieli C, Abrahamowicz M, Dasgupta K, Sewitch M, Lowensteyn I, Zelkowitz P. A prospective study of postnatal depressive symptoms and associated risk factors in first-time fathers. J Affect Disord. 2019;249:371-377.
25. Saxbe DE, Schetter CD, Guardino CM, Ramey SL, Shalowitz MU, Thorp J, Vance M; Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network. Sleep Quality Predicts Persistence of Parental Postpartum Depressive Symptoms and Transmission of Depressive Symptoms from Mothers to Fathers. Ann Behav Med. 2016;50(6):862-875.
26. Zhang YP, Zhang LL, Wei HH, Zhang Y, Zhang CL, Porr C. Post partum depression and the psychosocial predictors in first-time fathers from northwestern China. Midwifery. 2016 Apr;35:47-52.
IssueVol 16, No 4 (December 2022) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/jfrh.v16i4.11351
Depression Maternal Post-Partum Depression Paternal Post-Partum Depression

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Siriwardhana R, Somarathna M, Sooriyaarachchi M, Subasinghe S, Sumanasekara H, Thalagala pyara, Hapuarachchi C, Dinasena J, Hewabostanthirige D. Prevalence of Paternal Postpartum Depression in Anuradhapura District in Sri Lanka and Its Association With Maternal Postpartum Depression as a Risk Factor. J Family Reprod Health. 2022;16(4):239-242.