Prevalence of antenatal depressive symptoms among women in Sabah, Malaysia

Maternal Depression during Pregnancy and Postpartum Period among the Association of Southeast Asian Nations (ASEAN) Countries: A Scoping Review

Identification of mothers with depression is important because untreated perinatal depression can have both short- and long-term consequences for the mother, the child, and the family. This review attempts to identify the prevalence of antenatal and postnatal depression (AD and PD, respectively) of mothers among the ASEAN member countries. A literature review was conducted using PubMed, Scopus, and the Asian Citation Index. The reviews covered publications in peer-reviewed journals written in the English language between January 2010 and December 2020. Of the 280 articles identified, a total of 37 peer-reviewed articles conducted in 8 out of 11 ASEAN member countries were included. The Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument used to identify depression. This study showed the number of studies reporting the prevalence of AD was 18 in five countries. For PD, 24 studies in eight countries were included. The prevalence of AD ranged from 4.9% to 46.8%, and that of PD ranged from 4.4% to 57.7%. This first review among ASEAN countries showed very few studies conducted in lower-middle-income and substantial heterogeneity in prevalence among studies reviewed. Further research should be conducted to estimate the prevalence using a large representative sample with a validated assessment tool among the ASEAN countries.

Factors associated with the mental health status of pregnant women in China: A latent class analysis

Background

Prenatal mental health is a neglected public health issue that places pregnant women at a higher risk for mental disorders. The purpose of this study was to investigate the influencing factors of prenatal mental disorders and provide a scientific basis to guide and promote the mental health of pregnant women.

Methods

The study sample comprised 973 women in their first pregnancy, who were in their second trimester and third trimester, who underwent obstetric outpatient checkups at the Maternal and Child Health Hospital in Huai'an, who were recruited in the survey that was conducted from July to December 2017. The Chinese mental health scale (CMHS) was used to assess the mental health of pregnant women. The present study uses the chi-square test to compare the rates of class with different demographic variables, a latent class analysis to identify psychological symptoms, and multiple logistic regression analysis to examine whether the demographics predicted class membership.

Results

The chi-square test results showed that participants who reported feeling different in the perinatal period (χ² = 6.35, P = 0.04), having marital satisfaction (χ² = 15.8, P < 0.001), with an in-law relationship (χ² = 29.43, P < 0.001), with a friend relationship (χ² = 24.81, P < 0.001), with basic diseases (χ² = 8.04, P = 0.02), and taking birth control pills (χ² = 8.97, P = 0.01) have different probabilities of being classified. Three latent classes were identified: the high symptoms group (6.89%), the moderate symptoms group (20.56%), and the low symptoms group (72.56%). Pregnant women in the third trimester [odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.04-3.25, P = 0.04], with a poor in-law relationship (OR = 2.82, 95% CI:1.45-5.51, P = 0.002), with a bad friend relationship (OR = 3.17, 95% CI: 1.31-7.71, P = 0.01), and who had basic diseases (OR = 1.70, 95% CI: 1.00-2.90, P = 0.04) tended to be classified under the high symptoms group than under the low symptoms group. Pregnant women with a bad friend relationship (OR = 2.15, 95% CI: 1.08-4.28, P = 0.03) and taking birth control pills (OR = 1.51, 95% CI: 1.08-2.11, P = 0.02) were more likely to be placed under the moderate symptoms group than under the low symptoms group.

Conclusions

A pregnant woman's mental health status factors include feeling different in the perinatal period, those with marital satisfaction, those with an in-law relationship, those with a friend relationship, those with basic diseases, and those taking birth control pills. To ensure a smooth progress of pregnancy and promote the physical and mental health of pregnant women, psychological screening and psychological intervention measures should be strengthened.

[Vulnerable to mental health problems: Pregnant women and husband's perception in Surakarta, Indonesia]

OBJECTIVE

This study aims to explore the perception of women and their husbands on the vulnerability of pregnant women to mental health disorders.

METHOD

Qualitative study using a phenomenological approach. The inclusion criteria were pregnant women of the second and third-trimester gestation (13-35 weeks). The exclusion criteria were pregnant women with complications and who had a family record of mental disorders. Data was collected using focus group discussion and in-depth interviews at four Primary Health Cares in Surakarta, Indonesia. Then, the data were analyzed through thematic analysis, which was supported by the OpenCode 4.02® software.

RESULTS

This study uncovered two main topics, firstly the factors that trigger the vulnerability of pregnant women to experience mental disorders and secondly perceived barriers to managing mental health during pregnancy and postpartum. Pregnant women and husbands recognize that they need to get mental health information.

CONCLUSION

Unstable emotions during pregnancy are considered normal and neglected by their surroundings. Lack of knowledge about mental health in pregnancy justifies the need to increase education in this area in order to prevent prenatal and postpartum depression.

Psychosocial predictors of mental health among pregnant women

PURPOSE

The vulnerability and prevalence of common psychiatric illnesses, that is, anxiety and depression are very high at the time of pregnancy in the socio-cultural context of Southeast Asian low- middle-income countries' pregnant women. However, the issue remains poorly understood despite the fact that pregnancy can be stressful for women, their families and is strongly connected with marital quality and perceived social support. The present study examines the impact of anxiety proneness, marital satisfaction, and perceived social support on fear of childbirth and development of depression among pregnant women.

DESIGN AND METHODS

Participants were purposively selected 136 pregnant women who were in the third trimester with ages ranging between 19 and 35 years and were selected through a purposive sampling technique from six hospitals in Pakistan. The STICSA, RAS, MSPSS, CAQ, and PADQ scales and questionnaires were used as study tools.

FINDINGS

Anxiety proneness positively predicted childbirth fear and depression; marital satisfaction and perceived presence of social support were negative predictors among pregnant women.

PRACTICE IMPLICATIONS

Obstetricians, nurses, midwives, and mental health professionals can imply these findings towards developing targeted antenatal programs that focus on the pregnant woman's mental health.

The magnitude and determinants of depressive symptoms amongst women in early pregnancy in Southern Nigeria: A cross-sectional study

Background

Antenatal depression (AD) is prevalent and associated with adverse pregnancy, maternal and child outcomes, yet no study has addressed its magnitude and predictors in early pregnancy in Nigeria.

Aim

To determine the prevalence and factors associated with AD in first half of pregnancy.

Setting

Multicentric health facilities in Southern Nigeria.

Methods

A multicentric health-facilities-based cross-sectional study was conducted from January to July 2018. Using pretested structure interviewer-administered questionnaires, antenatal depressive symptoms were assessed amongst 511 pregnant mothers with the Edinburg Postnatal Depressive Scale tool. Socio-demographic, socio-economic, clinical, family and social factors were also measured. Descriptive statistics, bivariate and multivariable logistic regression analyses were employed to describe and identify factors associated with AD.

Results

The prevalence of antenatal depressive symptoms in early pregnancy in this study was 29.4% (95% confidence interval [CI] 26.6–32.9). Factors independently associated with AD were intimate partner violence (adjusted odds ratios [AOR] = 8.10, 95% CI 5.00–13.14), marital dissatisfaction (AOR 5.48, 95% CI 3.48–8.38), poor social support (AOR 4.70; 95% CI 2.99–7.38), past history of depression (AOR 4.67; 95% CI 2.47–8.80), previous pregnancy complication (AOR 2.50, 95% CI 1.57–3.89), low socio-economic status (AOR 2.41, 95% CI 1.61–3.66) and unplanned pregnancy (AOR 2.35, 95% CI 1.47–3.64).

Conclusions

The prevalence of antenatal depression is high with modifiable risk factors requiring context-specific policies such as provision of family, social and economic support for mothers at the earliest possible contact in the antenatal period.

Magnitude and associated factors of antenatal depression among mothers attending antenatal care in Arba Minch town, Ethiopia, 2018

BACKGROUND

Depression is a common mental disorder. The burden of antenatal depression is higher in developing countries which is 20% as compared to developed ones 10% to 15%. In Ethiopia around one-fifth of pregnant mothers are depressed. Despite the severity of the problem, only a few studies have been done in Ethiopia, and there is no study done in Arba Minch on the problem.

OBJECTIVE

To assess the magnitude and associated factors of antenatal depressive symptoms among pregnant women attending Public Health facilities in Arba Minch town Southern Nations and Nationalities Peoples Region, Ethiopia 2018.

METHODS

Health Institution based, cross-sectional study design was used to assess the magnitude and associated factors of antenatal depression among 323 pregnant mothers who came for antenatal care follow-up in all public health facilities in Arba Minch town. The systematic random sampling technique was applied. Interviewer administered, pretested structured Questionnaire containing Edinburgh postpartum depression scale was utilized. EPI INFO was used to enter data and then the data were analyzed by logistic regression using SPSS. Variables with P-value less than 0.2 in the bivariate logistic regression were inserted in for multivariable analysis to see their independent effect and those with P-value less than 0.05 were used to determine the significant association between dependent and independent variables.

RESULT

The magnitude of antenatal depression was 35.4%. Variables that were significantly associated with antenatal depression on multivariate analysis were anxiety (AOR = 5.49, 95%CI: 2.56, 11.77), un-planned pregnancy (AOR = 2.71, 95%CI: 1.21, 6.07), and Primigravida (AOR = 2.96, 95%CI: 1.28, 6.8). Similarly, uneducated mothers and those who attend only elementary school had AOR 4.92, 95% CI 1.36,17.73 and AOR 4.04955CI 1.23, 13.39 respectively.

CONCLUSION

The magnitude of antenatal depression, intimate partner violence, and threatening life event in Arba Minch town was high. Anxiety, unplanned pregnancy, educational status, and Primigravida were significantly associated factors with depression. There should be a mechanism for routine screening and management of antenatal depression and intimate partner violence during antenatal care follow-up.

Postpartum depression symptoms in survey-based research: a structural equation analysis

BACKGROUND

Since the last decade, postpartum depression (PPD) has been recognized as a significant public health problem, and several factors have been linked to PPD. Mothers at risk are rarely undetected and underdiagnosed. Our study aims to determine the factors leading to symptoms of depression using Structural Equation Modeling (SEM) analysis. In this research, we introduced a new framework for postpartum depression modeling for women.

METHODS

We structured the model of this research to take into consideration the Malaysian culture in particular. A total of 387 postpartum women have completed the questionnaire. The symptoms of postpartum depression were examined using the Edinburgh Postnatal Depression Scale (EPDS), and they act as a dependent variable in this research model.

RESULTS

Four hundred fifty mothers were invited to participate in this research. 86% of the total distributed questionnaire received feedback. The majority of 79.6% of respondents were having depression symptoms. The highest coefficients of factor loading analysis obtained in every latent variable indicator were income (β = 0.77), screen time (β = 0.83), chips (β = 0.85), and anxiety (β = 0.88). Lifestyle, unhealthy food, and BMI variables were directly affected by the dependent variable. Based on the output, respondents with a high level of depression symptoms tended to consume more unhealthy food and had a high level of body mass indexes (BMI). The highest significant impact on depression level among postpartum women was unhealthy food consumption. Based on our model, the findings indicated that 76% of the variances stemmed from a variety of factors: socio-demographics, lifestyle, healthy food, unhealthy food, and BMI. The strength of the exogenous and endogenous variables in this research framework is strong.

CONCLUSION

The prevalence of postpartum women with depression symptoms in this study is considerably high. It is, therefore, imperative that postpartum women seek medical help to prevent postpartum depressive symptoms from worsening.

Prenatal Depression in Women in the Third Trimester: Prevalence, Predictive Factors, and Relationship With Maternal-Fetal Attachment

Objective: The prevalence of prenatal depression in pregnant women has found to be high, which may adversely affect the intimacy of a mother to her fetus. Few studies have investigated the relationship between prenatal depression and maternal-fetal attachment in pregnant Chinese women. This study is thus designed to evaluate the prevalence rate, predictive factors of prenatal depression in Chinese pregnant women in the third trimester of pregnancy, and the effect of prenatal depression on maternal-fetal attachment.

Methods: A total of 340 pregnant women in the third trimester of pregnancy were recruited from a hospital in Anhui Province. The Edinburgh Postpartum Depression Scale (EPDS) was rated to assess the prenatal depression; the Pittsburgh Sleep Quality Index (PSQI) and Zung Self-Rating Anxiety Scale (SAS) were used to assess sleep quality and anxiety level for all participants. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal-fetal attachment.

Results: The prevalence of prenatal depression in the participants was high (19.1%) in our study. The scores of prenatal anxiety and sleep disorders were higher with prenatal depression than in those without prenatal depression (47.6 ± 9.5 vs. 38.9 ± 6.9; 8.3 ± 3.3 vs. 6.1 ± 2.7, all p < 0.01). MAAS quality was lower in prenatal depression women than those in non-prenatal depression women (43.8 ± 5.6 vs. 46.4 ± 4.5, p < 0.01). Correlation analysis showed that prenatal depression was associated with parity, prenatal education, education level, marital satisfaction, anxiety and sleep disorders (all p < 0.05). Furthermore, binary logistic regression results showed that anxiety and sleep disorders were risk factors for prenatal depression. Prenatal education, higher marriage satisfaction were protective factors for prenatal depression. In addition, correlation analysis also showed that prenatal depression was positively correlated with MAAS intensity, but negatively correlated with MAAS quality.

Conclusions: Our results indicated a high prevalence of prenatal depression in women in the third trimester. Prenatal education and higher marital satisfaction were protective factors for prenatal depression; antenatal anxiety and sleep disorders during pregnancy were risk factors for prenatal depression. Prenatal depression was negatively correlated with MAAS quality, but positively correlated with MAAS intensity.

Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image

Background

Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI).

Methods

This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R).

Results

Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P <  0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P <  0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score.

Conclusion

Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-03575-1.

Changes in Depressive Symptoms During the Antenatal Period: A Cohort Study from Bangladesh

BACKGROUND

Antenatal depressive symptoms adversely affect the health and well-being of women, babies, and their families. This study aimed to explore the prevalence and probable associated factors of depressivse symptoms.

METHODS

A prospective cohort approach was adopted, and 435 pregnant women were assessed longitudinally at an antenatal clinic in the first, second, and third trimesters. Edinburgh Postnatal Depression Scale (EPDS) was used to measure self-reported depressive symptoms. The multivariate approach of the general linear model was used to evaluate the mean differences of depression scores among the trimesters. To investigate the associated factors of depressive symptoms, generalized estimating equation (GEE) was used to take into account the clustering effect.

RESULTS

More than half (58.13%) of the pregnant women had antenatal depressive symptoms in at least one trimester. Depressive symptoms decreased throughout the pregnancy; they were higher in the first trimester and declined toward the third trimester. Significant mean differences were found in depression scores among the three trimesters. GEE showed that trimester, education, family income, and body mass index (BMI) are significantly associated with antenatal depressive symptoms.

CONCLUSIONS

First trimester is the most critical period for identification of depressive symptoms. At-risk women need to be treated. Proper education achievement, economic solvency, and adequate nutrition could reduce the depressive symptoms.

Gender of infant and risk of postpartum depression: a meta-analysis based on cohort and case-control studies

BACKGROUND

It is inconclusive nowadays for the association between infant's gender and their mothers' risk of developing postpartum depression (PPD). In addition, a complete overview is missing. A meta-analysis of cohort and case-control studies was performed to address the question of whether women who gave birth to a female infant were at an increased risk of developing PPD, compared with those giving birth to a male infant.

METHODS

Unrestricted searches were conducted, with an end date parameter of 31 January 2018, of PubMed, Embase, Google Scholar, Cochrane Libraries, and Chinese databases, to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates.

RESULTS

Twenty-three studies involving 119,736 women were included for analysis. Overall, mothers who gave birth to a female infant experienced a significantly increased risk of developing PPD compared with the reference group (OR = 1.15, 95%CI: 1.01-1.31; p = .03). However, substantial heterogeneity (p < .00001; I² = 75%) was observed across studies. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed.

CONCLUSIONS

Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, the present study suggests women giving birth to a girl are associated with a higher risk of developing PPD when compared with those giving birth to a boy. Improving family and social communication and reducing gender preference should be important components of any such interventions.Statement of significanceProblem or issue Interestingly, the known risk factors leading to PPD are basically the same in different regions and cultures, but the gender of the infant seems to be an exception.What is already known Some studies conducted in traditional western countries indicated that there is a weak or null association between infant's gender and risk of PPD, while others suggested a positive association. In contrast, studies conducted in Nigeria, India, Turkey and China showed that mothers giving birth to a female infant were at a higher risk of developing PPD.What this paper adds Today, the association between infant's gender and risk of developing postpartum depression (PPD) is still uncertain; additionally, a complete overview is missing. Our study represents the first meta-analysis of risk of PPD associated with infant's gender.

Validation of hindi version of Edinburgh postnatal depression scale as a screening tool for antenatal depression

BACKGROUND

Antenatal depression is recognized as one of the strongest predictors of postnatal depression, which itself is a strong predictor of mental disorders. The detection of antenatal depression is important and requires an accurate and valid screening tool. The Edinburgh Postnatal Depression Scale (EPDS) is one of the most extensively studied screening instruments for assessing postnatal depression.

AIM

To validate a linguistically and contextually appropriate Hindi version of the EPDS for use in women attending antenatal care in Sehore, Madhya Pradesh.

METHODS AND MATERIAL

A rigorously translated and modified Hindi version of the EPDS was developed and validated using the Hindi version of the PHQ-9 as a gold standard. A consecutive sample of women (n = 100) attending antenatal check-ups in healthcare facilities in Sehore district were interviewed.

RESULTS

The validity measure of Receiver Operator Characteristic curve was plotted for different cutoffs of EPDS. The optimal cutoff score for the Hindi validation of the EPDS was 9/10 for antenatal depression with sensitivity, specificity, positive and negative predictive value of 65.38%, 79.73%, 53.13%, and 86.76% respectively and area under the curve 0.7346. The internal consistency using Cronbach's alpha was 0.86 indicating good homogeneity.

CONCLUSION

Findings of this study suggest that the Hindi version of the EPDS can be used as a valid measure to screen antenatal depression in India.

Development of a Psychological Intervention to Address Anxiety During Pregnancy in a Low-Income Country

Background: One in five women suffer from anxiety during pregnancy. Untreated anxiety is a risk factor for postnatal depression and is associated with adverse birth outcomes. Despite the high prevalence of prenatal anxiety in low- and middle-income countries (LMICs), efforts to develop and evaluate context-specific interventions in these settings are lacking. We aimed to develop a culturally appropriate, feasible, and acceptable psychological intervention for perinatal anxiety in the context of a low-income population in Pakistan. Methods: We conducted this research in Rawalpindi District at the Obstetrics Department of the Holy Family Hospital, Rawalpindi Medical University a government facility catering to a mixture of low-income urban, peri-urban, and rural populations. We used a mixture of research methods to: a) investigate the clinical, cultural, and health-service delivery context of perinatal anxiety; b) select an evidence-based approach that suited the population and health-delivery system; c) develop an intervention with extensive reference documentation/manuals; and d) examine issues involved in its implementation. Qualitative data were collected through in-depth interviews and focus group discussions, and analyzed using framework analysis. Results: Informed by the qualitative findings and review of existing evidence-based practices, we developed the "Happy Mother, Healthy Baby" intervention, which was based on principles of cognitive behavior therapy. Its evidence-based elements included: developing an empathetic relationship, challenging thoughts, behavior activation, problem solving, and involving family. These elements were applied using a three-step approach: 1) learning to identify unhealthy or unhelpful thinking and behavior; 2) learning to replace unhealthy or unhelpful thinking and behavior with helpful thinking and behavior; and 3) practicing thinking and acting healthy. Delivered by non-specialist providers, the intervention used culturally appropriate illustrations and examples of healthy activities to set tasks in collaboration with the women to encourage engagement in helpful behaviors. Feedback from the non-specialist providers indicated that the intervention was acceptable, feasible, and perceived to be helpful by the women receiving it. Conclusion: This new psychosocial intervention for perinatal anxiety, based on principles of cognitive behavior therapy and delivered by non-specialists, has the potential to address this important but neglected condition in LMICs.

Anxiety, Prenatal Attachment, and Depressive Symptoms in Women with Diabetes in Pregnancy

The purpose of this study was to evaluate the relationship between anxiety, prenatal attachment, and depressive symptoms among women with diabetes in pregnancy. Participants were 131 consecutive pregnant women between the ages of 20 and 45 with a diagnosis of gestational or pregestational type 1 or type 2 diabetes. Data on previous psychiatric symptoms were obtained from the Anamnestic and Social Questionnaire and the Mini-International Neuropsychiatric Interview (MINI). Information on prenatal attachment was collected using The Prenatal Attachment Inventory (PAI), and The Edinburgh Postnatal Depression Scale (EPDS) assessed depressive symptoms in the third trimester of pregnancy (at a mean of 25 weeks). Results demonstrated that in women affected by diabetes in pregnancy, two facets of prenatal attachment (anticipation, interaction) were negatively correlated with depressive symptoms, and a history of anxiety, assessed with the MINI, moderated the relation between the prenatal attachment interaction factor and depressive symptoms during pregnancy.

Magnitude of Antenatal Depression and Associated Factors among Pregnant Women in West Badewacho Woreda, Hadiyya Zone, South Ethiopia: Community Based Cross Sectional Study

BACKGROUND

Antenatal depression is prevalent and serious problems that is associated with psychosocial factors, obstetric history, and history of psychiatric illness. Evidence on prevalence and factors associated with antenatal depression at community level is limited in Ethiopia. The aim of this study was assessing the prevalence of antenatal depression and associated factors among pregnant women in West Badewacho Woreda, Hadiyya Zone, South Ethiopia, 2018.

METHODS

A community based cross sectional study was conducted from March 15 to April 12, 2018. To draw a total sample size of 541 pregnant women, multistage sampling technique was used. Pretested semi-structured questionnaire and standardized scale was used to collect data from each study subject. Data were entered and cleaned using Epi-Data version 3.1 and exported to SPSS version 23 for analysis. Bivariate analysis was carried out to see crude association between each independent variable and outcome variable. Odds ratios at 95%CI were computed to measure the strength of the association between the outcome and the independent variables. P-value < 0.05 was considered as statistically significant in multivariate analysis.

RESULTS

The prevalence of antenatal depression in the study population was 23.3% (CI: 19.8-26.8). Factors significantly associated with antenatal depression were marital status other than married (single, widowed, divorced) [AOR: (2.807; 95%CI: (1.268, 6.227); p-value = 0.042], history of previous depression [AOR: 3.414; 95%CI: (1.154, 12.999); p-value = 0.001] family history of mental illness [AOR: 3.874; 95%CI: (1.653, 7.052); p-value = 0.028], recent violence from intimate partner [AOR: 3.223; 95%CI: (1.359, 7.643); p-value = 0.008], unsatisfactory marital relation [AOR: 7.568; 95%CI: (3.943, 14.523); p-value < 0.001], lack of adequate social support [AOR: 5.491; 95%CI: (2.086, 14.451); p-value < 0.001] and unplanned current pregnancy [AOR: 2.013; 95%CI: (1.025, 3.953); p-value = 0.042].

CONCLUSION

The prevalence of antenatal depression in west Badewacho woreda was high and it is associated with marital status, unplanned current pregnancy, history of previous depression, family history of mental illness, recent violence from intimate partner, poor marital satisfaction level, and poor social support. Improving maternal and child health services and introducing screening for depression as part of routine antenatal assessment to curb antenatal depression should get due attention.

Magnitude and Predictors of Antenatal Depression among Pregnant Women Attending Antenatal Care in Sodo Town, Southern Ethiopia: Facility-Based Cross-Sectional Study

BACKGROUND

Depression affects approximately 10 to 20% of pregnant women globally, and one in ten and two in five women in developed and developing countries develop depression during pregnancy, respectively. However, evidence regarding its magnitude and predictors in Southern Ethiopia is limited. The present study is aimed at assessing the magnitude and predictors of antenatal depression among pregnant women attending antenatal care in Sodo town.

METHODS

A facility-based cross-sectional study was conducted among 403 antenatal care attendants in Sodo town from November 2 to January 30, 2017. Systematic random sampling was used to select the study population, and data were collected by using a pretested and structured questionnaire. Data were entered using Epi-data 4.2 and then exported and analyzed using SPSS version 20. Bivariate and multivariable logistic regression analyses were used to assess the association between the dependent variable and independent variables. Variables with P value less than 0.05 were considered as statistically significant.

RESULTS

A total of 400 pregnant women were interviewed. The magnitude of antenatal depression was 16.3% (95% CI (12.8%, 19.9%)). Husband's educational status, at the college and above (AOR: 0.09; 95% CI (0.03, 0.34), regular exercise (AOR: 0.16; 95% CI (0.07, 0.36)), planned pregnancy (AOR: 0.16; 95% CI (0.06, 0.44)), use of family planning (AOR: 0.31; 95% CI (0.14, 0.66)), previous history of anxiety (AOR: 2.96; 95% CI (1.30, 6.74)), previous history of obstetric complications (AOR: 19.03; 95% CI (5.89, 61.47)), and current obstetric complications (AOR: 30.38; 95% CI (3.14, 294.19)) were significant predictors of antenatal depression.

CONCLUSION

Nearly one in six pregnant women had antenatal depression. The husband's educational status, regular exercise, planned pregnancy, use of family planning, previous history of anxiety, previous history of obstetric complications, and current history of obstetric complications were significant predictors of antenatal depression. Screening for depression during routine antenatal care could be essential and recommended to identify early and prevent further morbidities and mortalities due to antenatal depression.

Prevalence and associated risk factors of antenatal depression among women attending antenatal clinics in primary health care centers in the Ministry of Health in Al-Ahsa City, Saudi Arabia

Objectives:

This study was aimed to measure the prevalence and associated risk factors of antenatal depression (AD) among women attending antenatal clinics at primary care centers in the Ministry of Health in Al-Ahsa, Saudi Arabia.

Materials and Methods:

A cross-sectional study was conducted on 357 pregnant women attending antenatal clinics at primary care centers, Ministry of Health, Al-Ahsa, Saudi Arabia between April 1, 2018 and July 1, 2019. A self-administered questionnaire was used for collection of information including questions relevant to sociodemographic variables and a screening tool Edinburgh Postnatal Depression Scale (EPDS) was used to assess the probable depression.

Results:

The prevalence of AD among pregnant women in Al-Ahsa is 31.9%. We found a significant association (P < 0.005) between AD and factors such as difficulty in sleeping, having a smoker husband, having one previous pregnancy, and having postabortion psychological complications.

Conclusion:

It was observed that depression prevails among pregnant ladies in Al-Ahsa city. Hence, in the present study, we tried to rule out the factors that led to depression in pregnant ladies during our antenatal care. In addition, we found that there is a need to train the physicians for asking questions (only two simple PHQ-2 questions) for the screening of depression during antenatal care visite.

Prenatal Depression and Its Associated Risk Factors Among Pregnant Women in Bangalore: A Hospital Based Prevalence Study

Background: Depression is the commonest psychological problem that affects a woman during her perinatal period worldwide. The risk of prenatal depression increases as the pregnancy progresses and clinically significant depressive symptoms are common in the mid and late trimester. There is a paucity of research on depression during the prenatal period in India. Given this background, the present study aimed to assess the prevalence of prenatal depression and its associated risk factors among pregnant women in Bangalore, Southern India. Methods: The study was nested within an on-going cohort study. The study participants included 280 pregnant women who were attending the antenatal clinic at Jaya Nagar General Hospital (Sanjay Gandhi Hospital) in Bangalore. The data was collected by using a structured questionnaire which included. Edinburgh Postnatal Depression Scale (EPDS) to screen for prenatal depression. Results: The proportion of respondents who screened positive for prenatal depression was 35.7%. Presence of domestic violence was found to impose a five times higher and highly significant risk of developing prenatal depression among the respondents. Pregnancy related anxiety and a recent history of catastrophic events were also found to be a positive predictors of prenatal depression. Conclusion: The high prevalence of prenatal depression in the present study is suggestive of its significance as a public health problem. Health care plans therefore can include screening and diagnosis of prenatal depression in the antenatal care along with other health care facilities provided.

Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia

BACKGROUND

Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers.

METHODS

We used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS).

RESULTS

Prevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband's depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife's depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers.

CONCLUSION

Both ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.

Prevalence of Antenatal Depression and Associated Factors among Pregnant Women Attending Antenatal Care at Dubti Hospital: A Case of Pastoralist Region in Northeast Ethiopia

BACKGROUND

Globally, depression affects an estimated 10 % to 20% of women during pregnancy. There is limited evidence on antenatal depression in Northeast Ethiopia. This study aimed to assess prevalence of antenatal depression and associated factors among Dubti Hospital Antenatal care attendants.

METHODS

Institution based cross-sectional study was conducted among 363 Antenatal care attendants at Dubti Hospital from March 07 to May 07, 2016. Beck's Depression Inventory tool was used to collect data. Data were entered into Epi-Data 3.1 and analyzed using SPSS 20. Bivariable and multivariable logistic regression analyses were fitted. Variables having p value < 0.05 were considered as statistically significant.

RESULTS

A total of 357 pregnant women were interviewed. The prevalence of antenatal depression was 17.9% [95% CI (14.0, 22.0%). Pregnancy planning [AOR: 0.04; 95% CI (0.014, 0.114), social support [AOR: 0.21; 95% CI (0.07, 0.66), and marital conflict [AOR: 6.45; 95% CI (2.1, 17.9)] were significantly associated with antenatal depression.

CONCLUSIONS

Nearly one in five pregnant women had depression. Marital conflict, pregnancy planning, and social support were significant predictors of antenatal depression. Dubti Hospital should strengthen its effort on prevention of unplanned pregnancy. Healthcare workers in antenatal care unit have to deal with marital conflict and social support as part of their routine investigation to avoid complications through early detection of antenatal depression.