IAJPS 2020, 07 (09), 125-129 Hafiza Zarka Yaqoob et al ISSN 2349-7750

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INDO AMERICAN JOURNAL OF

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http://doi.org/10.5281/zenodo.4013089

Available online at: http://www.iajps.com Research Article

DETERMINE THE FREQUENCY OF DEPRESSIVE

DISORDERS IN PREGNANT WOMEN VISITING
OBSTETRICS & GYNAECOLOGY DEPARTMENT
Dr. Hafiza Zarka Yaqoob1, Dr. Sumbul Maryam2, Dr. Asif Khan3
1
Woman Medical Officer at THQ Sanglahill
2
Woman Medical Officer at FHC THQ Hospital Choubara, Distt Layyah
3
Khyber Medical College, Peshawar
Article Received: July 2020 Accepted: August 2020 Published: September 2020
Abstract:
Objective: The aim of the study is to determine the frequency of depressive disorders in pregnant women
visiting antenatal clinic also examine the association of depression and anxiety with socio-economic status.
Study Design: Cross-sectional/observational study
Place and Duration: This study was conducted in Department of Obstetrics & Gynaecology, Jinnah hospital,
Lahore from 1st September 2019 to 30th April 2020.
Materials and Methods: Total 340 women visiting antenatal clinic were enrolled in this study. Patients ages
were ranging from 18 to 40 years. Detailed demographics including age, socioeconomic status, residence,
education and gravidity were recorded after written consent. Hospital Anxiety and Depression scale was used to
examine the frequency of depression and anxiety. Association of depression and anxiety with socio-economic
status was examined.
Results: 32 (9.41%) patients were ages <20 years, 115 (33.82%) were ages 20 to 25 years, 140 (44.11%) were
ages 26 to 30 years and 53 (15.59%) were ages above 30 years. Depression was found in 180 (52.94%) patients
among those 70 (20.58%), 55 (16.18%), 40 (11.76%) and 15 (4.41%) patients had mild, moderate, severe and
very severe level of depression. 72 (21.18%), 80 (23.53%), and 48 (14.12%) had mild, moderate and severe
anxiety score. A significant association was observed between low-socio-economic status and depression and
anxiety.
Conclusion: Frequency of depressive disorders like depression and anxiety was very high in pregnant women
attending antenatal clinic.
Keywords: Antenatal women, Depression, Anxiety. Socio-economic status
Corresponding author:
Dr. Hafiza Zarka Yaqoob, QR code
Woman Medical Officer at THQ Sanglahill

Please cite this article in press Hafiza Zarka Yaqoob et al, Determine The Frequency Of Depressive Disorders
In Pregnant Women Visiting Obstetrics & Gynaecology Department., Indo Am. J. P. Sci, 2020; 07(09).

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 IAJPS 2020, 07 (09), 125-129 Hafiza Zarka Yaqoob et al ISSN 2349-7750

INTRODUCTION:
Depressive disorders during pregnancy are major April 2020. 340 women visiting antenatal clinic
public health problems because of their high were enrolled. Patient’s ages were ranging from 18
prevalence.1 The world Health Organization to 40 years. Detailed demographics including age,
(WHO) estimates that the depressive disorders will socioeconomic status, residence, education and
be the second leading cause of global disease gravidity were recorded. Patients with severe
burden by 2020.2 Rates of depressive illness in maternal complications, patients with
women of reproductive age group are reported to cardiovascular diseases, less than 18 years of age
be twice than those in men.3 Some women may were excluded. Hospital Anxiety and Depression
experience their first depressive episode during scale HADS was used to examine the frequency of
pregnancy, whereas others with a history of depression and anxiety. Severity of depression and
depression are at increased risk for its recurrence, anxiety were recorded. Association of depression
continuation, or exacerbation.4,5 and anxiety with socio-economic status was
examined. Data was analyzed by SPSS 24. Chi-
Recently antenatal anxiety has received increased square test was done to examine the association
attention with regards to both its impact on infant between socio-economic status and depression and
outcomes and as a risk factor for postnatal anxiety, P-value <0.05 was taken as significant.
depression.6 Several cohort studies have reported
that the antenatal psychiatric morbidity is the RESULTS:
strongest risk factor for postnatal depression.7 Thirty two (9.41%) patients were ages <20 years,
Secondly, new evidence shows that depression 115 (33.82%) were ages 20 to 25 years, 140
during pregnancy is also associated with adverse (44.11%) were ages 26 to 30 years and 53
child outcomes8 including premature births, low (15.59%) were ages above 30 years. Mean BMI
birth weight, and poor infant growth.9 was 22.57±2.84 kg/m2. 210 (61.76%) patients were
primigravida while 130 (38.24%) were
Among South Indian women, the prevalence of multigravida. 150 (44.12%) were literate while 190
depression during the last trimester was found to be (55.88%) were illiterate. 161 (47.35%) patients had
around 16%.10 A study conducted in a rural area of urban residence and 179 (52.64%) had rural
Pakistan has reported that 25% of women suffered residence. 145 (42.65%) patients had low socio-
from depression during pregnancy.11 Another study economic status, 138 (40.59%) had middle and 57
from an urban community in Pakistan found that (16.76%) patients had high socio-economic status
18% of pregnant women were anxious and/or (Table 1)
depressed.12
According to the HADS scale, depression was
Assessment of psychosocial problems and mental found in 180 (52.94%) patients among those 70
health is an integral part of antenatal services to (20.58%), 55 (16.18%), 40 (11.76%) and 15
ensure safe pregnancy and delivery. But developing (4.41%) patients had mild, moderate, severe and
countries lack such antenatal care (ANC) services; very severe level of depression. 72 (21.18%), 80
and even if available, lack coverage, quality or (23.53%), and 48 (14.12%) had mild, moderate and
support from stake holders. In accordance with this severe anxiety score (Fig. 1). We found that
fact, a study at Nottingham University notified that patients with low socioeconomic status had higher
WHO has formulated a focused ANC guideline depression and anxiety rate. Overall 55 (16.18%)
including women’s mental health package to be patients had severe and very severe depression
used during ANC assessment. The present study among these 35 (63.64%) had low socio-economic
was conducted aimed to examine the frequency of status, 16 (29.09%) had middle and 4 (7.27%) had
depressive disorders such as depression and anxiety high socio-economic status, a significant
in pregnant women attending antenatal clinic at our association was observed between severe
institute. This study will help to reduce the depression and low socio-economic status with p-
complications associated with depressive disorders. value <0.05. Overall 48 (14.12%) patients had
severe anxiety level, among those 32 (66.67%)
MATERIALS AND METHODS: patients had low, 13 (27.08%) had middle and 3
This cross-sectional/observational study was (6.25%) had high socio-economic status. A
conducted at of Obstetrics & Gynaecology, Jinnah significant association was observed with p-value
hospital, Lahore from 1st September 2019 to 30th <0.05 (Table 2).

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previous studies demonstrated that women with

low socioeconomic status had higher rate of
Table 1: Baseline characteristics of all the patients depression and anxiety.14,15 We conducted this
Variable No. % study with aimed to examine the frequency of
Age (years) de3pression and anxiety in antenatal women also
<20 32 9.41 determines the association between low-
21 to 25 115 33.82 socioeconomic status and depression and anxiety.
26 to 30 140 44.11 In this regard 340 pregnant women visiting
> 30 53 15.59 antenatal clinic were enrolled in this study.
BMI (kg/m2) 22.57±2.84 Majority of patients 44.11% were ages 26 to 30
Gravidity years followed by 33.82% were ages 21 to 25
Primigravida 210 61.76 years. These results showed similarity to many of
Multigravida 130 38.24 previous studies in which age group 26 to 30 years
was most frequent in women attending antenatal
Education
clinics.16,17
Literate 150 44.12
Illiterate 190 55.88
In present study we found that 210 (61.76%)
Residence patients were primigravida while 130 (38.24%)
Urban 161 47.35 were multigravida. 150 (44.12%) were literate
Rural 179 52.64 while 190 (55.88%) were illiterate. 161 (47.35%)
Socioeconomic status patients had urban residence and 179 (52.64%) had
Low 145 42.65 rural residence. 145 (42.65%) patients had low
Middle 138 40.59 socio-economic status, 138 (40.59%) had middle
High 57 16.76 and 57 (16.76%) patients had high socio-economic
status. A study conducted by Ghaffar et al18
reported in their study that majority of pregnant
women belongs to urban area 86.6% and above
40% had low income <15000 PKR/month. Another
study by Bavle AD et al [19] regarding depression
and anxiety among antenatal women reported that
low income and illiteracy were the most important
risk factors of depression and anxiety among
pregnant women attending antenatal clinic.

In our study depression was found in 180 (52.94%)

Fig. 1: Frequency of Depression and anxiety patients among those 70 (20.58%), 55 (16.18%), 40
among all the patients (11.76%) and 15 (4.41%) patients had mild,
moderate, severe and very severe level of
Table 2: Association between socio-economic depression. 72 (21.18%), 80 (23.53%), and 48
status and depression and anxiety (14.12%) had mild, moderate and severe anxiety
Low Middle High score. A study by Sabita et al20 reported that 19.5%
P- pregnant women were having risk for antenatal
socio- socio- Socio-
Variables valu depression, of which the mild, moderate and
eco eco eco
e moderately severe levels of depression were
status status status
Severe 35 16 4 16.4%, 1.4% and 1.8% respectively. Gul et al21
0.00 reported that mild depression was present among
Depressio (63.64% (29.09% (7.27%
1 68 (32.1%), moderate depression in 64 (30.2%),
n n=55 ) ) )
Severe 32 13 3 severe depression in 24 (11.3%) and very severe
0.00 depression in 20 (9.4%) women. According to
Anxiety (66.67% (27.08% (6.25%
1 HAM-A scores, 70 (33%) of the participants scored
n=48 ) ) )
in normal range, 44 (20.8%) lied in mild anxiety
range, 62 (29.2%) lied in moderate anxiety while
DISCUSSION:
36 (17%) lied in severe anxiety range.
Depression and anxiety are the most frequent
depressive disorders found in pregnant women
In this study we found that patients with low
attending antenatal clinics and associated with
socioeconomic status had higher depression and
higher maternal and neonatal complications.13
anxiety rate. Overall 55 (16.18%) patients had
Many of factors contributing to increase the
severe and very severe depression among these 35
prevalence of depression and anxiety among
(63.64%) had low socio-economic status, 16
antennal women but the most important risk factor
(29.09%) had middle and 4 (7.27%) had high
is poverty/low-socioeconomic status. Many of

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socio-economic status, a significant association 9. Bhat NA, Hassan R, Shafiq M, Sheikh S.

was observed between severe depression and low Sociodemographic factors: a major predictor
socio-economic status with p-value <0.05. These of anxiety and depression among pregnant
results were comparable to many of previous women. Delhi Psychiatry J. 2015; 18(1):86–
studies in which low socio-economic status was 94.
significantly associated with severe depression and 10. Chandran M, Tharyan P, Muliyil J, Abraham
anxiety with p-value <0.05.22,23 Overall 48 S. Post-partum depression in a cohort of
(14.12%) patients had severe anxiety level, among women from a rural area of Tamil Nadu,
those 32 (66.67%) patients had low, 13 (27.08%) India. Incidence and risk factors. Br J
had middle and 3 (6.25%) had high socio-economic Psychiatr 2002; 181: 499–504.
status. A significant association was observed with 11. Mental health aspects of women’s
p-value <0.05. A study by Ali et al24 reported in reproductive health: A global review of the
their study that the most common contributing literature. Available from:
factor was low socioeconomic status (64.4%) a http://apps.who.int/iris/bitstream/10665/4384
second factor was no partner social support 6/1/9789241563567_eng.pdf. Accessed 3 Jan
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psychological consultation (13.5%) of antenatal 12. Nasreen HE, Kabir ZN, Forsell Y, Edhborg
depression. M. Prevalence and associated factors of
depressive and anxiety symptoms during
CONCLUSION: pregnancy. BMC Womens Health.
Depressive disorders such as depression and 2011;11:22.
anxiety can lead to severe maternal and perinatal 13. Witt WP, Street NW, Hagen EW, Wichmann
complications. We concluded that frequency of MA. The prevalence and determinants of
depressive disorders like depression and anxiety antepartum mental health problems among
was very high in pregnant women attending women in the USA: a nationally
antenatal clinic. We found that severe depression representative population-based study. Arch
and anxiety level has a significant association with Womens Ment Health. 2011; 13(5):425–37.
low socioeconomic status. 14. Mahboob S, Shah A, Bowen A, Afridi I,
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