Frequency and Risk Profiles Associated with Antenatal Anxiety and Depression in Middle Socioeconomic Women

Abstract

Objective: To determine the frequency of antenatal anxiety and depression and its risk profile including demographic, psychosocial and obstetric risk factors, in middle socioeconomic women.
 Methods: A cross-sectional study was carried out at two private hospital centres of Karachi, over a pe- riod of five months from October 2016 to March 2017. A questionnaire (age, education, parity, socio- economic status, employment) and the Hospital Anxiety and Depression Scale (HADS) were the tools used to gather required information from pregnant women. Data collected was entered in SPSS 16 software. Descriptive statistics were used to calculate frequency and mean values. Logistic regres- sion both binary and multinomial was performed to identify significant predictors of anxiety and de- pression.
 Results: Our study showed that out of 520 pregnant women, 130 (25%) women had anxiety, whereas
 220 (42.3%) had depression. The mean age of women was 26.9 ± 4.198 years. The range being from 18 years to 35 years. Significant risk factors among anxiety group were: working woman; 30.8% (p-value=0.000, OR=0.286), domestic violence; 84.6% (p-value=0.000, OR=2.8), difficult relationship with in-laws; 84.6% (p-value=0.000, OR=12.375), sleep disturbance; 76.9% (p-value=0.000, OR=9.667), primigravida; 23% (p-value=0.000, OR=2.576) and unplanned pregnancy; 23.1% (p- value=0.029, OR=0.511).
 Significant risk factors among women with depression were: working woman; 31.8% (p- value=0.000,OR=0.286), domestic violence; 68.2% (p-value=0.000, OR=3.571), difficult relationship with in-laws; 22.7% (p-value=0.000, OR=4.8), sleep disturbance; 54.5% (p-value=0.008, OR=2.0), primigravida; 45.5% (p-value=0.000, OR=17.246) and unplanned pregnancy; 18.2% (p-value=0.000, OR=3.0). Other factors that were found to be significant in the depression group only were: unsatis- factory relationship with husband; 22.7% (p-value=0.000, OR=4.118), stressful life event in previous year; 45.5% (p-value=0.000, OR=2.167), and tertiary education; 68.2% (p-value=0.002, OR=0.916).
 Conclusion: Psychosocial and demographic factors such as working woman, domestic violence, and difficult relationship with in-laws and sleep disturbance had a significant association with antenatal anxiety and depression. Obstetric risk factors were primigravida and unplanned pregnancy. Significant association with depression was unsatisfactory relationship with husband, stressful life event in a previous year and tertiary education.