Frequency and Risk Factors of Anxiety and Depression among Pregnant Women in Abbottabad, Pakistan: A Facility-Based Cross-Sectional Study

Abstract

Objective: We determined the frequency and risk factors of anxiety and depression in pregnant patients at an Abbottabad tertiary care hospital district of Khyber Pakhtunkhwa, Pakistan. Methods: Using the validated Urdu version of the Hospital Anxiety and Depression Scale, we conducted a cross-sectional study among 200 pregnant women from April to August 2019 at Ayub Teaching Hospital, a tertiary care hospital (HADS). Unadjusted and adjusted odds ratios for independent factors related with anxiety and depression were calculated using univariate and multivariable logistic regression. Results: Around 70% of the pregnant women were classified as anxious, while 57.5% were depressed. About half of the pregnant women had both depression and anxiety. Multivariate regression analysis showed that combined pregnant women were more likely to experience anxiety and despair belonging to Urdu ethnicity, having low level of education, household income of greater than 30 thousand PKR, husband’s higher level of managerial and professional position, and in 3rd trimester of pregnancy. Conclusion: Depression and anxiety are prevalent throughout pregnancy, according to our research. We suggest that interventions should be designed and implemented through mental health integration at all level of health care by taking into account the associated risk factors can lessen prenatal depression and anxiety among expecting mothers. Keywords: Anxiety, depression, risk factors, pregnant women, Pakistan.

Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries

“…Given that generalized anxiety disorder was reported across 184 studies, we were able to further interrogate the prevalence of this disorder across important subgroups (Figure 3). While investigating generalized anxiety by country income status, we found a higher prevalence among studies performed in lower-middle–income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109) compared with low-income countries (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961). Upper-middle–income countries had the lowest prevalence (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496).…”

“…Generalized anxiety disorder (including anxiety not specified) was the most commonly reported anxiety disorder, examined by 184 of 203 studies (90.6%) . The pooled point prevalence for generalized anxiety disorder was 22.2% (95% CI, 19.4%-25.0%; n = 173 553).…”

“…Our search identified 10 617 studies; 1231 full texts were reviewed, and of these, 203 studies were included (Figure 1; eTable 2 in Supplement 1). Cumulatively, outcomes were reported for 212 318 perinatal women (from conception to 12 months post birth) from 33 LMICs. The prevalence estimates of 6 anxiety and related disorders were reported: generalized anxiety disorder, social anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, and adjustment disorder.…”

“…The majority of studies reported the prevalence of generalized anxiety antenatally (150 [81.5%]). Among these, the pooled point prevalence was 23.9% (95% CI, 20.5%-27.4%; n = 149 485).…”

“…Next, we assessed the prevalence of generalized anxiety by method of assessment. Screening tools were used in 153 studies (17 different questionnaires), and 30 studies used a structured or semistructured diagnostic interview (8 types). One study used both .…”