Sociodemographic and Medical Risk Factors Associated With Antepartum Depression

Giridhara R Babu, G V S Murthy, Neeru Singh, Anita Nath, Mohanbabu Rathnaiah, Nolita Saldanha, R Deepa, Sanjay Kinra, Giridhara R Babu, G V S Murthy, Neeru Singh, Anita Nath, Mohanbabu Rathnaiah, Nolita Saldanha, R Deepa, Sanjay Kinra

Abstract

Background: The increasing recognition of antenatal depression is an emerging area of concern in developing countries. We conducted a study to estimate the prevalence of antenatal mental distress and its relation with sociodemographic factors, obstetric factors, and physiological wellbeing in pregnant women attending public health facilities in Bengaluru, South India.

Methods: Nested within a cohort study, we assessed the mental status in 823 pregnant women in two public referral hospitals. Kessler Psychological Distress Scale (K-10 scale) was used to assess maternal depression. We collected information related to social-demographic characteristics and recent medical complaints. Descriptive statistics and odds ratios were calculated using SPSS version 20.

Results: Results show that 8.7% of the women exhibited symptoms of antenatal depression. Sociodemographic characteristics, such as respondent occupation, husband education, husband's occupation, total family income showed significance. First time pregnancy, anemia, and high blood pressure were also associated with mental distress.

Conclusion: Our study has demonstrated feasibility of screening for mental health problems in public hospitals. Early detection of mental distress during pregnancy is crucial as it has a direct impact on the fetus. The public health facilities in low- and middle-income countries such as India should consider piloting and scaling up screening services for mental health conditions for pregnant women.

Keywords: antenatal; cohort; mental distress; pregnancy; public hospital; stress.

References

    1. Fisher J, Mello MCd, Patel V, Rahman A, Tran T, Holton S, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ (2012) 90(2):139–49.10.2471/BLT.11.091850
    1. Morylowska-Topolska J, Makara-Studzińska M, Kotarski J. The influence of sociodemografic and medical variables on severity of anxiety and depressive symptoms during particular trimesters of pregnancy. Psychiatr Pol (2014) 48(1):173–86.
    1. Bisetegn TA, Mihretie G, Muche T. Prevalence and predictors of depression among pregnant women in Debretabor town, northwest Ethiopia. PLoS One (2016) 11(9):e0161108.10.1371/journal.pone.0161108
    1. DiPietro JA, Hilton SC, Hawkins M, Costigan KA, Pressman EK. Maternal stress and affect influence fetal neurobehavioral development. Dev Psychol (2002) 38(5):659.10.1037/0012-1649.38.5.659
    1. O’Connor TG, Heron J, Glover V, Team AS. Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Adolesc Psychiatry (2002) 41(12):1470–7.10.1097/00004583-200212000-00019
    1. Latendresse G, Wong B, Dyer J, Wilson B, Baksh L, Hogue C. Duration of maternal stress and depression: predictors of newborn admission to neonatal intensive care unit and postpartum depression. Nurs Res (2015) 64(5):331–41.10.1097/NNR.0000000000000117
    1. Leadbeater BJ, Bishop SJ. Predictors of behavior problems in preschool children of inner-city Afro-American and Puerto Rican adolescent mothers. Child Dev (1994) 65(2):638–48.10.2307/1131406
    1. Huang H, Faisal-Cury A, Chan Y-F, Tabb K, Katon W, Menezes PR. Suicidal ideation during pregnancy: prevalence and associated factors among low-income women in São paulo, Brazil. Arch Womens Ment Health (2012) 15(2):135–8.10.1007/s00737-012-0263-5
    1. Gausia K, Fisher C, Ali M, Oosthuizen J. Antenatal depression and suicidal ideation among rural Bangladeshi women: a community-based study. Arch Womens Ment Health (2009) 12(5):351.10.1007/s00737-009-0080-7
    1. Bavle AD, Chandahalli AS, Phatak AS, Rangaiah N, Kuthandahalli SM, Nagendra PN. Antenatal depression in a tertiary care hospital. Indian J Psychol Med (2016) 38(1):31–5.10.4103/0253-7176.175101
    1. George C, Lalitha AR, Antony A, Kumar AV, Jacob K. Antenatal depression in coastal South India: prevalence and risk factors in the community. Int J Soc Psychiatry (2016) 62(2):141–7.10.1177/0020764015607919
    1. Hegde SS, Pai KK, Abhishekh HA, Sandeep KR. Prevalence of antenatal depression and gender preference: a cross sectional study among Mangalore population, Karnataka, India. J Pharm Biomed Sci (2013) 30(30):1011–4.
    1. Ajinkya S, Jadhav PR, Srivastava NN. Depression during pregnancy: prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai. Ind Psychiatry J (2013) 22(1):37.10.4103/0972-6748.123615
    1. Babu GR, Garadi L, Murthy G, Kinra S. Effect of hyperglycaemia in pregnancy on adiposity in their infants in India: a protocol of a multicentre cohort study. BMJ Open (2014) 4(6):e005417.10.1136/bmjopen-2014-005417
    1. Kessler RC, Keller MB, Wittchen H-U. The epidemiology of generalized anxiety disorder. Psychiatr Clin North Am (2001) 24(1):19–39.10.1016/S0193-953X(05)70204-5
    1. Spies G, Stein D, Roos A, Faure S, Mostert J, Seedat S, et al. Validity of the Kessler 10 (K-10) in detecting DSM-IV defined mood and anxiety disorders among pregnant women. Arch Womens Ment Health (2009) 12(2):69–74.10.1007/s00737-009-0050-0
    1. Bendel RB, Afifi AA. Comparison of stopping rules in forward “stepwise” regression. J Am Stat Assoc (1977) 72(357):46–53.10.1080/01621459.1977.10479905
    1. Mickey RM, Greenland S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol (1989) 129(1):125–37.10.1093/oxfordjournals.aje.a115101
    1. Patel V, Prince M. Maternal psychological morbidity and low birth weight in India. Br J Psychiatry (2006) 188(3):284–5.10.1192/bjp.bp.105.012096
    1. Pawlby S, Hay DF, Sharp D, Waters CS, O’Keane V. Antenatal depression predicts depression in adolescent offspring: prospective longitudinal community-based study. J Affect Disord (2009) 113(3):236–43.10.1016/j.jad.2008.05.018
    1. Ryan D, Milis L, Misri N. Depression during pregnancy. Can Fam Physician (2005) 51(8):1087–93.
    1. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol (2005) 106(5, Pt 1):1071–83.10.1097/01.AOG.0000183597.31630.db
    1. Rosenthal HE, Slaunwhite WR, Jr, Sandberg AA. Transcortin: a corticosteroid-binding protein of plasma. X. Cortisol and progesterone interplay and unbound levels of these steroids in pregnancy. J Clin Endocrinol Metab (1969) 29(3):352–67.10.1210/jcem-29-3-352
    1. Abou-Samra AB, Pugeat M, Dechaud H, Nachury L, Bouchareb B, Fevre-Montange M, et al. Increased plasma concentration of N-terminal beta-lipotrophin and unbound cortisol during pregnancy. Clin Endocrinol (1984) 20(2):221–8.10.1111/j.1365-2265.1984.tb00077.x
    1. Helbig A, Kaasen A, Malt UF, Haugen G. Does antenatal maternal psychological distress affect placental circulation in the third trimester? PLoS One (2013) 8(2):e57071.10.1371/journal.pone.0057071
    1. Hanke W, Saurel-cubizolles MJ, Sobala W, Kalinka J. Employment status of pregnant women in central Poland and the risk of preterm delivery and small-for-gestational-age infants. Eur J Pub Health (2001) 11(1):23–8.10.1093/eurpub/11.1.23
    1. Raatikainen K, Heiskanen N, Heinonen S. Does unemployment in family affect pregnancy outcome in conditions of high quality maternity care? BMC Public Health (2006) 6(1):46.10.1186/1471-2458-6-46
    1. Bolton H, Hughes P, Turton P, Sedgwick P. Incidence and demographic correlates of depressive symptoms during pregnancy in an inner London population. J Psychosom Obstet Gynaecol (1998) 19(4):202–9.10.3109/01674829809025698
    1. Ban L, Gibson JE, West J, Fiaschi L, Oates MR, Tata LJ. Impact of socioeconomic deprivation on maternal perinatal mental illnesses presenting to UK general practice. Br J Gen Pract (2012) 62(603):e671–8.10.3399/bjgp12X656801
    1. Goyal D, Gay C, Lee KA. How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first time mothers? Womens Health Issues (2010) 20(2):96–104.10.1016/j.whi.2009.11.003
    1. Maselko J, Bates L, Bhalotra S, Gallis JA, O’Donnell K, Sikander S, et al. Socioeconomic status indicators and common mental disorders: evidence from a study of prenatal depression in Pakistan. SSM Popul Health (2018) 4:1–9.10.1016/j.ssmph.2017.10.004
    1. Spice K, Jones SL, Hadjistavropoulos HD, Kowalyk K, Stewart SH. Prenatal fear of childbirth and anxiety sensitivity. J Psychosom Obstet Gynaecol (2009) 30(3):168–74.10.1080/01674820902950538
    1. Madhavanprabhakaran GK, D’Souza MS, Nairy KS. Prevalence of pregnancy anxiety and associated factors. Int J Afr Nurs Sci (2015) 3:1–7.10.1016/j.ijans.2015.06.002
    1. Lowe NK. Self-efficacy for labor and childbirth fears in nulliparous pregnant women. J Psychosom Obstet Gynaecol (2000) 21(4):219–24.10.3109/01674820009085591
    1. Saisto T, Halmesmäki E. Fear of childbirth: a neglected dilemma. Acta Obstet Gynecol Scand (2003) 82(3):201–8.10.1034/j.1600-0412.2003.00114.x
    1. Paterson JA, Davis J, Gregory M, Holt SJ, Pachulski A, Stamford DE, et al. A study on the effects of low haemoglobin on postnatal women. Midwifery (1994) 10(2):77–86.10.1016/S0266-6138(05)80249-9
    1. Patel V, Kirkwood BR, Weiss H, Pednekar S, Fernandes J, Pereira B, et al. Chronic fatigue in developing countries: population based survey of women in India. BMJ (2005) 330(7501):1190.10.1136/bmj.38442.636181.E0
    1. Leeners B, Neumaier-Wagner P, Kuse S, Stiller R, Rath W. Emotional stress and the risk to develop hypertensive diseases in pregnancy. Hypertens Pregnancy (2007) 26(2):211–26.10.1080/10641950701274870
    1. Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol (2010) 202(1):5–14.10.1016/j.ajog.2009.09.007
    1. Smith-Nielsen J, Tharner A, Krogh MT, Vaever MS. Effects of maternal postpartum depression in a well-resourced sample: early concurrent and long-term effects on infant cognitive, language, and motor development. Scand J Psychol (2016) 57(6):571–83.10.1111/sjop.12321
    1. Heron J, O’Connor TG, Evans J, Golding J, Glover V, Team AS. The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord (2004) 80(1):65–73.10.1016/j.jad.2003.08.004

Source: PubMed

3
Abonnere