Although there have been many studies of the biological and psychosocial causations of postnatal depression, studies of sociocultural risk factors are rare.

To investigate the sociocultural risk factors of postnatal depression using ethnographically informed epidemiological methods.

Atotal of 959 women were assessed at their first ante-partum visit (baseline), in the third trimester, immediately after delivery, and 3 months post-partum. Six domains of risk factors were examined. The dependent variable was postnatal depression (as defined by the Edinburgh Postnatal Depression Scale) at 3 months post-partum.

Conflict with mother-in-law, marital dissatisfaction, past depression and antenatal depression independently predicted the occurrence of postnatal depression. The cultural practice of peiyue – a Chinese post-partum custom of mandated family support – was associated with better social support and a slightly lower risk of postnatal depression.

Sociocultural aspects of the immediate puerperium shape maternal emotional well-being. In-law conflict is an important source of household distress in many Asian societies. The findings have implications for clinical practice and future studies.

We evaluated the utility of the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) and measured the prevalence of major depression six weeks after confinement among Chinese women in Hong Kong.

A prospective cohort of 145 women completed the EPDS, the 12-item General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) six weeks after giving birth. They were then assessed with the Structured Clinical Interview for DSM–III–R, non-patient version (SCID–NP) to establish psychiatric diagnosis. The criterion validity of EPDS was tested against this clinical diagnosis, and the concurrent validity against the GHQ and BDI scores was also evaluated. The internal consistency of the scales was measured by Cronbach's α coefficient.

The Chinese EPDS had satisfactory psychometric properties and a cut-off score of 9/10 is recommended for screening depressive illness in a general postnatal population. At six weeks postpartum, 5.5% of the study population suffered from major depression.

The Chinese EPDS will be useful for screening for postnatal depression.