Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry.

BACKGROUND: Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum. METHODS: A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions. RESULTS: The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (ß = 1.776, P < 0.001), as well as its three subscales: somatization (ß = 1.355, P = 0.019), anxiety symptoms (ß = 2.249, P < 0.001), and depressive symptoms (ß = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (ß = 1.344, P = 0.038) and the somatization subscale (ß = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (ß = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (ß = 1.998, P = 0.012) and depressive symptoms (ß = 1.949, P = 0.020). CONCLUSION: The high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.

Women's worries about prenatal screening tests suspected of fetal anomalies: a qualitative study.

BACKGROUND: Pregnant women with suspected fetal anomalies experience a great deal of stress following prenatal screening tests. The present study aimed to investigate women's worries about prenatal screening tests suspected of fetal anomalies. METHODS: Through the use of qualitative content analysis, the reports of women whose prenatal screening tests were suspected of fetal anomalies were analyzed and the results were interpreted. The participants were selected from four public and private maternity care clinics of Babol, Iran, from December 2021 to January 2022, using targeted convenience sampling. Data were collected from 20 women aged 24 to 41 years old, who underwent prenatal screening tests and were suspected of fetal anomalies, using semi-structured face-to-face interviews. RESULTS: The four main themes included the "causes of worries" (with sub-themes of challenge with spouse and relatives, medical diagnosis processes, previous unpleasant experiences, physical and mental problems, financial worries, and misinformation), "anxiety-coping styles" (with cognitive emotion-oriented, behavioral emotion-oriented, and problem-oriented sub-themes), "reactions to a possible diagnosis of anomaly" (with three sub-themes, namely concealment, extreme fear and worry, and denial), and "attribution of the cause of the anomaly" (with sub-themes of consanguine marriage, evil eyes, tendency to have a baby of a particular gender, a history of anomalies in the previous child, the spouse's medical illness, unplanned pregnancy, and high maternal anxiety). CONCLUSION: Women with suspected fetal anomalies experience a great deal of stress, the most important reason for which is the "physician's uncertainty". "Sharing worries with relatives" was the most common style of coping with worries. Establishing emotional support and empathetic communication between midwives and physicians with pregnant women suspected of fetal anomalies were important ways to reduce their worries.

The role of psychological self-care on worry of vaccination against COVID-19 in Iranian pregnant women: A cross-sectional study.

Background and Aims: Although previous studies have reported some psychological factors to prevent the worry of vaccination against COVID-19 in pregnant women, the role of psychological self-care is unclear. The present study aimed to investigate the role of psychological self-care in pregnant women on the depressive symptoms, psychological distress, and worry of vaccination against COVID-19. Methods: The present cross-sectional study was conducted during the peak of the Delta variant of COVID-19 in Babol city (North, Iran) from August to November 2021. Two hundred pregnant women referring to three prenatal clinics completed five questionnaires including; demographic characteristics, Edinburgh postnatal depression scale, psychological self-care, brief symptom inventory 18, corona disease anxiety scale, and acceptance of vaccination-3 inventory. Results: Pregnant women were in relatively good condition based on psychological self-care but were not significantly associated with demographic characteristics, such as age, gestational age, educational background, pregnancy, and risk of parity. It was psychological self-care of pregnant women which negatively predicted the depressive symptoms (ß = -0.311, p < 0.001), anxiety symptoms (ß = -0.269, p < 0.001), psychological distress (ß = -0.269, p < 0.001), and worry of vaccination against COVID-19 (ß = -0.214, p < 0.001). Conclusion: Women's psychological self-care plays a protective role against the depressive symptoms, anxiety symptoms, psychological distress, and worry of vaccination against COVID-19 during pregnancy. Clinicians need to pay more attention to the role of psychological self-care as an important factor in preventing the symptoms of anxiety and depression during regular pregnancy visits.

Prevalence and factors related to psychiatric symptoms in low risk pregnancy.

BACKGROUND: Psychiatric disorders are associated with poor pregnancy outcomes both for mother and child. This study aimed to determine the prevalence and related demographic risk factors of psychiatric symptoms among the pregnant women in Babol City. METHODS: This cross-sectional study was conducted in five private and public obstetrics clinics of Babol city. During routine appointments of prenatal care, 176 pregnant women filled in three questionnaires including; sociodemographic questionnaire, Edinburg Prenatal Depression Scale (EPDS), and Symptom Checklist-25 (SCL-25). Wilcoxon test, Spearman correlation, and multivariate logistic regression tests were used to interpret the data. RESULTS: The prevalence of depressive disorders was 15.4%% for Edinburg scores ≥13. The overall rate of maternal psychiatric symptoms (global severity index or GSI scores ≥ 1.75) was 48.5%. The prevalence of psychiatric symptoms was high; for 25% somatization, 258% anxiety, obsession-compulsion disorders or OCD 6.4%, 8.8% interpersonal sensitivity, 5.3% phobia, 7.6% paranoid ideation, and 1.2% psychoticism. Multivariate logistic regression revealed that pregnant women with history of abortion in previous pregnancy were at risk of depressive symptoms more (ß=3.18, CI 1.28-7.93, p=0.01) than those without history of abortion. Also, the only demographic factor related to psychiatric symptoms was the age of pregnant women; younger age was associated with higher symptom levels for GSI ((r=-0.17). CONCLUSION: The high prevalence of psychiatric symptoms, especially depressive symptoms, in pregnant women highlights the need for continued research on screening, identifying the risk factors, and developing effective treatments for mental disorders in pregnant women.