Antenatal depression and its correlates - a cross-sectional study in an urban resettlement colony of Delhi

Background- Antenatal depression is affecting 10% pregnant women worldwide with higher prevalence in developing countries. This causes poor maternal and foetal outcome and also affects cognitive development of the child. Aim and objective: To estimate magnitude of antenatal depression and its risk factors. Methodology- A cross-sectional survey was done at the antenatal clinic of community health department catering to an urban resettlement colony, East Delhi. Estimated sample size was 216 (including 10% non-response rate). Pregnant women attending the ANC clinic from October 2019 to February 2020 were enrolled. EPDS questionnaire was used to assess depression during pregnancy. Results-The antenatal depression was found in 11.8% subjects as per EPDS score. Working female and belonging to Muslim religion, past history of abortion, complications in previous pregnancy, financial debt, physical violence and substance use in family showed significant association with antenatal depression. Conclusion –Depression was prevalent among antenatal women and was found to be associated with various risk factors.

Association between circulating concentrations of vitamin D and risk of antenatal, postnatal depression: a meta-analysis

ABSTRACT Background: Previous studies showed consistent results for associations between circulating concentrations of vitamin D and risk of antenatal, postnatal depression. Methods: Articles published in English before November 2020 were searched in databases as follows: PubMed, EMBASE, Web of Science, Medline, Google Scholar and Cochrane. These articles explored associations between circulating concentrations of vitamin D and risk of antenatal, postnatal depression.The present meta-analysis was conducted using STATA 12.0 software. Odds ratios (ORs) and 95% confidence intervals (CIs) extracted from included studies were computed using a random effects model or a fixed effects model according to heterogeneities between included studies. Q test and I2 were used to explore heterogeneities between included studies. Results: 7 cohort studies (including 1567 depression cases and 5254 controls) and 3 case-control studies (including 995 depression cases and 1265 controls) were included in the present study. The study showed that low circulating levels of 25-hydroxy (OH) vitamin D is significantly associated with a higher risk of antenatal and postnatal depression (OR = 1.02, 95% CI 1.01 to 1.04, I2 = 90.7%, p < 0.001). Conclusion: Our results have shown that the low level of vitamin D may be an adverse factor of antenatal and postnatal depression.

Prevalence and risk factors for depression among antenatal women during third trimester of pregnancy in a tertiary care centre

Background: With the rising incidence of Maternal deaths due to suicide as evident from reports of Kerala state confidential review of maternal deaths, there is a felt need for screening for depression in study antenatal population. Though there have been various screening tools used, a simplified tool validated in study population was not used in study antenatal women till now. The objective of this study was to estimate the prevalence of depression among antenatal women admitted in the department of obstetrics and gynecology, Government Medical College, Thrissur and also to study the risk factors associated with depression in the study population.Methods: A questionnaire based cross sectional observational study was conducted among 100 antenatal women in their third trimester. PHQ-9 questionnaire was used to screen for depression and the information regarding risk factors was collected from the patient, her caregivers and from clinical records. Data analysis was done using EPI-INFO/SPSS software.Results: Prevalence of depression among hospitalized mothers: 53%. Most cases (70%) had: mild depression (PHQ Score: 5-9). Only very few (2%) of them had severe depression (PHQ score: more than 20). 9% had: moderately severe depression (PHQ score: 15-19). 19% had: moderate depression (PHQ score: 10-14). Statistically significant risk factors identified in this study were fetal gender preference, anxiety about labour process, anxiety about labour pain, anxiety about making the baby a part of their life and anxiety about baby’s health.Conclusions: The prevalence of depression among hospitalized mothers using PHQ-9 scale is high (53%). Screening for depression was found to be feasible and can be made a part of routine antenatal care so that appropriate interventions can be provided to improve maternal mental health and thereby prevent the maternal mortality occurring due to suicides.

Antenatal Depression In A High-Risk Pregnancy

Objective: This case report highlights antenatal depression as a common condition with potentially grave outcomes if left untreated. However, treatment options can be limited by the need to protect the fetus from medication-induced side effects. Methods: We report a young female obstetric patient who was carrying twins conceived through assisted reproduction, and her pregnancy was complicated by placenta previa major and repeated antepartum hemorrhages, which necessitated multiple admissions and strict bed rest. She became intensely depressed and anxious, developed suicidal ideation and refused examinations that were necessary to her physical health. She was referred to a psychiatrist and was given low-dose medication, supportive counseling, and case management. Results: She responded well to treatment, showing marked improvement in her mood and cooperation with obstetric care. Her twins were delivered at 35 weeks’ gestation in good health. Her progress was maintained into the postpartum period. Conclusions: This case of antenatal depression was successfully treated using a combination of medication, case management and psychological support. It adds to evidence that this illness benefits from early identification and is highly treatable.

Major depressive disorder during teenage pregnancy: socio-demographic, obstetric and psychosocial correlates

OBJECTIVES: To describe the prevalence of Major Depressive Disorder (MDD) during pregnancy in teenage mothers and to assess its association with socio-demographic characteristics, obstetric history and psychosocial variables. METHODS: A cross-sectional study was conducted with a sample of pregnant teenagers enrolled in the national public health system in the urban area of Pelotas, southern Brazil. MDD was assessed with the Mini International Neuropsychiatric Interview, the Abuse Assessment Screen was used to identify physical abuse within the last 12 months and during pregnancy, and social support was assessed with the Medical Outcomes Survey Social Support Scale. RESULTS: Forty-three (4.94%) potential subjects refused to participate, resulting in 828 total participants. The prevalence of MDD was 17.8%, 9.2% reported they had been subjected to violence within the last 12 months, while 5.8% had suffered violence during pregnancy, and the mean (SD) overall social support score was 87.40 (11.75). After adjustment, we found the highest incidence of MDD in adolescents with less than 8 years of education, followed by those with previous episodes of MDD and those with lower overall social support. CONCLUSIONS: MDD is a relatively common condition in pregnant teenagers and appears to be more prevalent in young mothers who are both socioeconomically and psychosocially underprivileged.

Antenatal Depression in East Asia: A Review of the Literature

This current study's goal is to summarize the literature regarding Antenatal Depression (AD) in the East Asian countries of Taiwan, China (including Hong Kong and Macau), Japan, and Korea. The main search utilized a Pub med Chinese Electronic Periodical Service (CEPS) literature review using keywords 'AD', and 'Prenatal Depression' with searches for 'Japan', 'Korea', 'Taiwan', 'Hong Kong' and Macau'. The rates of AD in East Asia appear to be relatively close to those in the Western literature, although certain studies showed slightly decreased rates. Many of the risk factors for AD were the same in the Eastern and Western literature. These risk factors included demographic factors such as younger age, smoking, low education and income, and unemployment. Other risk factors were physical symptoms such as menstrual pains and nausea. Finally, psychological factors such as a poor response to the pregnancy, poor spousal support, and poor family support were associated with AD. With regard to treatment, there were no studies examining the administration of psychotropic medications for AD. The literature from East Asia both confirmed many Western findings and made unique contributions to the literature on AD. The treatment of AD in East Asia appears to be an entity which, despite its morbidity, has not been adequately studied.