Social support and antenatal depression in extended and nuclear family environments in Turkey: a cross-sectional survey

Abstract

BackgroundSocial support is strongly implicated in the aetiology of perinatal mental disorder: particularly the quality of the marital and family environment. Family structures are important under-researched potential modifiers. Turkey offers particular advantages for research in this area because of long-standing coexistence of Western and Middle Eastern family structures. We aimed to investigate associations between the quality of key relationships and depression in women in their third trimester of pregnancy, and the extent to which these associations were modified by family structure.MethodWomen attending antenatal clinics in their third trimester were recruited from urban and rural settings in Ankara. A nuclear family structure was defined as a wife and husband living alone or with their children in the same household, whereas a traditional/extended family structure was defined if another adult was living with the married couple in the same household. Depression was ascertained using the Edinburgh Postnatal Depression Scale (EPDS) and social support was assessed by the Close Person Questionnaire with respect to the husband, mother and mother-in-law. Social support was compared between participants with/without case-level depression on the EPDS in linear regression models adjusted for relevant covariates, then stratified by nuclear/traditional family structure.ResultsOf 772 women approached, 751 (97.3%) participated and 730 (94.6%) had sufficient data for this analysis. Prevalence of case-level depression was 33.1% and this was associated with lower social support from all three family members but not with traditional/nuclear family structure. The association between depression and lower emotional support from the husband was significantly stronger in traditional compared to nuclear family environments.ConclusionsLower quality of relationships between key family members was strongly associated with third trimester depression. Family structure modified the association but, contrary to expectations, spousal emotional support was a stronger correlate of antenatal depression in traditional rather than nuclear family settings. Previous psychiatric history was not formally ascertained and the temporal relationship between mood state and social support needs to be clarified.

Prevalence and predictors of antenatal depressive symptoms among women attending Adama Hospital Antenatal Clinic, Adama, Ethiopia

“…Fear of pregnancy complications [AOR=3.49, CI (1.45, 8.41)] and previous abortion [AOR=2.86, CI (1.13, 7.24)] showed strong association; analogous with a prior report in Africa (Lee et al, 2007). A positive relationship between presence of chronic illness and antenatal depressive disorders was seen prior to controlling confounders but no longer existed; opposite to previous findings (Senturk et al, 2011). This might be explained by the variation in sample size and instruments.…”

“…Standard survey was carried out on ten Michigan Obstetric units and the report viewed 20% prevalence rate (Marcus et al, 2003). Another study conducted among rural and urban pregnant women at Ankara antenatal settings found prevalence of 33.1% (Senturk et al, 2011). And also; a hospital based study in Hong Kong took the samples at the antenatal clinic and revealed 37% prevalence of depressive symptoms (Lee et al, 2007).…”

Gender preference and perinatal depression in Turkey: A cohort study

“…In general, research in Turkey has tended to confirm risk factors suggested from Western populations such as low income and socio-economic status, previous mental disorders and perceived poor child health. Lack of support from the husband and wider family has also been implicated [5, 6, 25, 26]. It is generally assumed that male gender preference is not as prominent in Turkey as in some of the low and middle income countries in which it has been previously researched; however, it has received little systematic investigation, and may well vary by region and sub-culture.…”

Social support and maternal stress during pregnancy: a PATH model

“…[26] Prevalence of maternal stress has been reported 33%-37% and 5%-7% in England and Sweden, respectively. [27] This rate is also estimated to about 16.7% and 13.6% for severe and mild pregnancy stress, respectively, amongst Iranian women. [28] Given the potential buffering effects of social support on maternal stress and improving pregnancy outcomes on the one hand, and shortage of relevant studies in Iran, on the other hand, this study was performed to investigate the relationship of social support and maternal stress level among Iranian pregnant women.…”