Predictors of Prenatal Depression: A Cross-Sectional Study in Rural Pakistan

Abstract

Objective: To determine the prevalence and association of prenatal depression with socioeconomic, demographic and personal factors among pregnant women living in Kallar Syedan, Rawalpindi, Pakistan.Methods: Five hundred women in the second and third trimester of pregnancy, living in Kallar Syedan, a rural area of district Rawalpindi Pakistan, were included in the study. Depression was assessed using “Patient health questionnaire” (PHQ9) in Urdu, with a cut-off score of 10. Multi-dimensional scale of perceived social support (MSPSS) was used to assess perceived social support. Life Events and Difficulties Schedule (LEDS) were used to measure stressful life events in past 1 year. Tool to assess intimate partner violence (IPV) was based on WHO Multi Country Study on “Women's Health and Domestic Violence against Women.”Results: Prevalence of prenatal depression was found to be 27%. Number of pregnancies was significantly associated with prenatal depression (p < 0.01). Women living in a joint family and those who perceived themselves as moderately satisfied or not satisfied with their life in the next 4 years were found to be depressed (p < 0.01, OR 6.9, CI 1.77–26.73). Depressive symptomatology in women who experienced more than five stressful life events in last 1 year was three times higher (p < 0.001, OR 3.2, CI 1.68–5.98) than in women with 1–2 stressful events. Women who were supported by their significant others or their family members had 0.9 times (p < 0.01, OR 0.9, CI 0.85–0.96) less chance of getting depressed. Pregnant women who were psychologically abused by their partners were 1.5 times more depressed (p < 0.05 CI 1.12–2.51). Odds of having depression was also high in women who had less mean score of MSSI (p < 0.05, OR 1.1, CI 1.01–1.09). Women who had suitable accommodation had 0.5 times less chance of having depression than others (p < 0.05, OR 0.5, CI 0.27–0.92).Conclusion: Over a quarter of the women in the study population reported prenatal depression, which were predicted predominantly by psychosocial variables.

Antenatal depression and its associated factors among women of Godawari Municipality, Lalitpur, Nepal: a cross-sectional study

“… 18 Likewise, a study from Pakistan revealed that women who had multiple pregnancies were twice (OR: 2.3, 95% CI: 1.33 to 3.91) more likely to suffer from antenatal depression. 46 A similar finding was revealed by a study from India where the women who had multiple pregnancies had twice (AOR: 2.36, 95% CI: 1.19 to 4.66) the odds of depression as compared with women who were pregnant for the first time. 47 Women in multigravida not only have more exposure to the potential complications associated with pregnancy and childbirth, but they are also more stressed to fulfil the demands of the newborn child while bearing responsibility as a mother to their other children.…”

The prevalence and associated factors of prenatal depression and anxiety in twin pregnancy: a cross-sectional study in Chongqing, China

“…Our participants, in particular, are primarily city dwellers. Women with twin pregnancies having antenatal examinations in rural hospitals may be more prone to anxiety and depression [ 68 ]. So, this study cannot represent the entire population of women pregnant with twins.…”

Resilience and prenatal mental health in Pakistan: a qualitative inquiry

“…Despite teenage pregnancy and coming from low-income backgrounds 15 pregnant adolescents delivered healthy babies because of possessing positive factors such as self-efficacy, motivation to achieve career goals, and having a strong support system, which the authors referred to as a resiliency framework [67]. In Pakistan, however, the majority of women belong to patriarchal family systems, lack participation in domestic decision making, lack autonomy, and with illiteracy this leads to indecisiveness, poor self-confidence, and prenatal depression, culminating in low resilience [68].…”