Postpartum depression and traditional postpartum care in China: Role of Zuoyuezi

Objective: To determine the relationship between the traditional Chinese practice of postpartum care, known as zuoyuezi, and postpartum depression (PPD) in China. Methods: A total of 342 Chinese women were surveyed 6- to 8-weeks post partum using the Edinburgh Postnatal Depression Scale (EPDS) and items assessing sociodemographics, health history, peripartum experiences, zuoyuezi, and social support. Results: Prevalence of PPD was 15.5% (EPDS cutoff >= 13). PPD was associated with lower income, difficult pregnancy experience, poor infant health status, not attending childbirth classes, and low spousal involvement before and after delivery. Among the 96% of women who practiced zuoyuezi, those for whom the caregiver was her mother-in-law or who perceived zuoyuezi as unhelpful had twice the odds of PPD. Conclusion: These data highlight the importance of the peripartum experience in assessing PPD risk. Zuoyuezi is still commonly practiced in urban China, and further research is needed to explore its role in the potential prevention of PPD. (C) 2008 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.