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ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

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Research Article

Antenatal Depression; its Prevalence of Positive Screen and the Associating Risk Factors Including Labor and Neonatal Outcome

Author(s): Nurezwana Elias* and Sofiah Sulaiman

Volume 16, Issue 2, 2020

Page: [107 - 115] Pages: 9

DOI: 10.2174/1573404816666200131101943

Price: $65

Abstract

Background: Antenatal depression is often neglected and unrecognized. It is known to be associated with various unwanted outcomes for both mothers and babies.

Objective: This study aims to assess the prevalence of a positive screen for antenatal depression and its risk factors as well as the labour and neonatal outcomes.

Method: 265 pregnant women who received care from University Malaya Medical Centre were recruited in this study. They completed the Edinburgh Postnatal Depression Scale (EPDS) questionnaires twice; once during the antenatal period and once again during the postnatal period. Only 235 out of 265 data were analysed for the association between risk factors, labour and neonatal outcome. Postnatal data that were collected after 4-6 weeks of delivery were completed in 90 women.

Results: 41 women (17%) were found to have a positive screen and it has a significant positive correlation with postnatal EDPS score (r=0.919, p=0.00). After adjustment for confounders, preexisting medical illness is the only risk factor found to be associated with the positive screen group (OR 3.0, 95% CI1.11-8.46). The positive screen group is also associated with reduced neonatal birth weight (0R=0.998; 95%CI0.997-0.999), reduced cord pH (OR=0.000; 95%CI0.000-0.202) and increased blood loss at birth (0R=1.005; 95%CI1.001-1.009).

Conclusion: The positive screen group of antenatal depression is associated with few adverse pregnancy and neonatal outcomes. Therefore, a formal mental health assessment should be offered to all pregnant women who are found to have a positive screen of antenatal depression.

Keywords: Antenatal depression, postnatal depression, EPDS, pregnancy outcome, neonatal outcome.

Graphical Abstract

[1]
Segre LS, Davis WN. Postpartum Depression and Perinatal Mood Disorders in the DSM. Postpartum Support International 2013.
[2]
Misri S. Suffering in silence: the burden of perinatal depression. Can J Psychiatry 2007; 52(8): 477-8.
[http://dx.doi.org/10.1177/070674370705200801] [PMID: 17955908]
[3]
Antenatal and postnatal mental health Nice, February. 2016; pp.22-8.
[4]
Marques M, Pereira AT, Maia B, et al. 1229-What about antenatal depressive symptoms correlates/risk factors? Eur Psychiatry 2013; 28: 1.
[http://dx.doi.org/10.1016/S0924-9338(13)76307-7]
[5]
Rashid A, Mohd R. Poor social support as a risk factor for antenatal depressive symptoms among women attending public antennal clinics in Penang, Malaysia. Reprod Health 2017; 14(1): 144.
[http://dx.doi.org/10.1186/s12978-017-0404-4] [PMID: 29096646]
[6]
Finnbogadóttir H, Dykes AK, Wann-Hansson C. Prevalence and incidence of domestic violence during pregnancy and associated risk factors: A longitudinal cohort study in the south of Sweden. BMC Womens Health 2014; 14: 63.
[http://dx.doi.org/10.1186/1472-6874-14-63] [PMID: 24885532]
[7]
Howard LM, Oram S, Galley H, Trevillion K, Feder G. Domestic violence and perinatal mental disorders: a systematic review and meta-analysis. PLoS Med 2013; 10(5): e1001452
[http://dx.doi.org/10.1371/journal.pmed.1001452] [PMID: 23723741]
[8]
Ajinkya S, Jadhav PR, Srivastava NN. Depression during pregnancy: Prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai. Ind Psychiatry J 2013; 22(1): 37-40.
[http://dx.doi.org/10.4103/0972-6748.123615] [PMID: 24459372]
[9]
George C, Lalitha AR, Antony A, Kumar AV, Jacob KS. Antenatal depression in coastal South India: Prevalence and risk factors in the community. Int J Soc Psychiatry 2016; 62(2): 141-7.
[http://dx.doi.org/10.1177/0020764015607919] [PMID: 26443716]
[10]
Rafferty J, Mattson G, Earls MF, Yogman MW. Committee On Psychosocial Aspects Of Child And Family Health. Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice. Pediatrics 2019; 143(1): pii: e20183260
[http://dx.doi.org/10.1542/peds.2018-3260] [PMID: 30559118]
[11]
Kessler RC, McGonagle KA, Swartz M, Blazer DG, Nelson CB. Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence. J Affect Disord 1993; 29(2-3): 85-96.
[http://dx.doi.org/10.1016/0165-0327(93)90026-G] [PMID: 8300981]
[12]
WHO. Gender Disparities in Mental Health World 2001.
[13]
Parker G, Brotchie H. Gender differences in depression. Int Rev Psychiatry 2010; 22(5): 429-36.
[http://dx.doi.org/10.3109/09540261.2010.492391] [PMID: 21047157]
[14]
Goodwin RD, Gotlib IH. Gender differences in depression: the role of personality factors. Psychiatry Res 2004; 126(2): 135-42.
[http://dx.doi.org/10.1016/j.psychres.2003.12.024] [PMID: 15123392]
[15]
Cyranowski JM, Frank E, Young E, Shear MK. Adolescent onset of the gender difference in lifetime rates of major depression: a theoretical model. Arch Gen Psychiatry 2000; 57(1): 21-7.
[http://dx.doi.org/10.1001/archpsyc.57.1.21] [PMID: 10632229]
[16]
Whiteford HA, Degenhardt L, Rehm J, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 2013; 382(9904): 1575-86.
[http://dx.doi.org/10.1016/S0140-6736(13)61611-6] [PMID: 23993280]
[17]
Baxter AJ, Scott KM, Ferrari AJ, Norman RE, Vos T, Whiteford HA. Challenging the myth of an “epidemic” of common mental disorders: trends in the global prevalence of anxiety and depression between 1990 and 2010. Depress Anxiety 2014; 31(6): 506-16.
[http://dx.doi.org/10.1002/da.22230] [PMID: 24448889]
[18]
Bloch M, Schmidt PJ, Danaceau M, Murphy J, Nieman L, Rubinow DR. Effects of gonadal steroids on mood and emotion processing in women with a history of postpartum depression. Am J Psychiatry 2000; 157(6): 924-30.
[http://dx.doi.org/10.1176/appi.ajp.157.6.924] [PMID: 10831472]
[19]
Cohen LS, Altshuler LL, Harlow BL, et al. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA 2006; 295(5): 499-507.
[http://dx.doi.org/10.1001/jama.295.5.499] [PMID: 16449615]
[20]
Seth S, Lewis AJ, Galbally M. Perinatal maternal depression and cortisol function in pregnancy and the postpartum period: a systematic literature review. BMC Pregnancy Childbirth 2016; 16(1): 124.
[http://dx.doi.org/10.1186/s12884-016-0915-y] [PMID: 27245670]
[21]
Bloch M, Rubinow DR, Schmidt PJ, Lotsikas A, Chrousos GP, Cizza G. Cortisol response to ovine corticotropin-releasing hormone in a model of pregnancy and parturition in euthymic women with and without a history of postpartum depression. J Clin Endocrinol Metab 2005; 90(2): 695-9.
[http://dx.doi.org/10.1210/jc.2004-1388] [PMID: 15546899]
[22]
Wisner KL, Stowe ZN. Psychobiology of postpartum mood disorders. Semin Reprod Endocrinol 1997; 15(1): 77-89.
[http://dx.doi.org/10.1055/s-2008-1067970] [PMID: 9065980]
[23]
Magiakou MA, Mastorakos G, Rabin D, Dubbert B, Gold PW, Chrousos GP. Hypothalamic corticotropin-releasing hormone suppression during the postpartum period: implications for the increase in psychiatric manifestations at this time. J Clin Endocrinol Metab 1996; 81(5): 1912-7.
[PMID: 8626857]
[24]
Bloch M, Daly RC, Rubinow DR. Endocrine factors in the etiology of postpartum depression. Compr Psychiatry 2003; 44(3): 234-46.
[http://dx.doi.org/10.1016/S0010-440X(03)00034-8] [PMID: 12764712]
[25]
Bowen A, Muhajarine N. Antenatal depression. Can Nurse 2006; 102(9): 26-30.
[PMID: 17168096]
[26]
Lee AM, Lam SK, Sze Mun Lau SM, Chong CS, Chui HW, Fong DY. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 2007; 110(5): 1102-12.
[http://dx.doi.org/10.1097/01.AOG.0000287065.59491.70] [PMID: 17978126]
[27]
Leigh B, Milgrom J. Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry 2008; 8: 24.
[http://dx.doi.org/10.1186/1471-244X-8-24] [PMID: 18412979]
[28]
Gavin AR, Melville JL, Rue T, Guo Y, Dina KT, Katon WJ. Racial differences in the prevalence of antenatal depression. Gen Hosp Psychiatry 2011; 33(2): 87-93.
[http://dx.doi.org/10.1016/j.genhosppsych.2010.11.012] [PMID: 21596200]
[29]
Melville JL, Gavin A, Guo Y, Fan MY, Katon WJ. Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstet Gynecol 2010; 116(5): 1064-70.
[http://dx.doi.org/10.1097/AOG.0b013e3181f60b0a] [PMID: 20966690]
[30]
Klainin P, Arthur DG. Postpartum depression in Asian cultures: a literature review. Int J Nurs Stud 2009; 46(10): 1355-73.
[http://dx.doi.org/10.1016/j.ijnurstu.2009.02.012] [PMID: 19327773]
[31]
Belay YA, Moges NA, Hiksa FF, Arado KK, Liben ML. Prevalence of antenatal depression and associated factors among pregnant women attending antenatal care at Dubti Hospital: A case of pastoralist region in northeast Ethiopia. Depress Res Treat 2018; 2018: 1659089
[http://dx.doi.org/10.1155/2018/1659089] [PMID: 30906594]
[32]
Shah SM, Bowen A, Afridi I, Nowshad G, Muhajarine N. Prevalence of antenatal depression: comparison between Pakistani and Canadian women. J Pak Med Assoc 2011; 61(3): 242-6.
[PMID: 21465937]
[33]
Thompson O, Ajayi I. Prevalence of antenatal depression and associated risk factors among pregnant women attending antenatal clinics in Abeokuta North Local Government Area, Nigeria. Depress Res Treat 2016; 2016: 4518979
[http://dx.doi.org/10.1155/2016/4518979] [PMID: 27635258]
[34]
Abujilban SK, Abuidhail J, Al-Modallal H, Hamaideh S, Mosemli O. Predictors of antenatal depression among Jordanian pregnant women in their third trimester. Health Care Women Int 2014; 35(2): 200-15.
[http://dx.doi.org/10.1080/07399332.2013.817411] [PMID: 24020729]
[35]
Josefsson A, Berg G, Nordin C, Sydsjö G. Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand 2001; 80(3): 251-5.
[http://dx.doi.org/10.1034/j.1600-0412.2001.080003251.x] [PMID: 11207491]
[36]
Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 2004; 103(4): 698-709.
[http://dx.doi.org/10.1097/01.AOG.0000116689.75396.5f] [PMID: 15051562]
[37]
Fisher J, Cabral de Mello M, Patel V, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ 2012; 90(2): 139G-49G.
[http://dx.doi.org/10.2471/BLT.11.091850] [PMID: 22423165]
[38]
Rwakarema M, Premji SS, Nyanza EC, Riziki P, Palacios-Derflingher L. Antenatal depression is associated with pregnancy-related anxiety, partner relations, and wealth in women in Northern Tanzania: a cross-sectional study. BMC Womens Health 2015; 15: 68.
[http://dx.doi.org/10.1186/s12905-015-0225-y] [PMID: 26329331]
[39]
Rahman A, Iqbal Z, Harrington R. Life events, social support and depression in childbirth: perspectives from a rural community in the developing world. Psychol Med 2003; 33(7): 1161-7.
[http://dx.doi.org/10.1017/S0033291703008286] [PMID: 14580070]
[40]
World Health Organisation. Maternal mental health and child health and development in low and middle income countries 2008.
[41]
Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry 2016; 3(10): 973-82.
[http://dx.doi.org/10.1016/S2215-0366(16)30284-X] [PMID: 27650773]
[42]
Milgrom J, Gemmill AW, Bilszta JL, et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord 2008; 108(1-2): 147-57.
[http://dx.doi.org/10.1016/j.jad.2007.10.014] [PMID: 18067974]
[43]
Edwards B, Galletly C, Semmler-Booth T, Dekker G. Does antenatal screening for psychosocial risk factors predict postnatal depression? A follow-up study of 154 women in Adelaide, South Australia. Aust N Z J Psychiatry 2008; 42(1): 51-5.
[http://dx.doi.org/10.1080/00048670701739629] [PMID: 18058444]
[44]
Castro E Couto T, Martins Brancaglion MY, Nogueira Cardoso M, et al. What is the best tool for screening antenatal depression? J Affect Disord 2015; 178: 12-7.
[http://dx.doi.org/10.1016/j.jad.2015.02.003] [PMID: 25770478]
[45]
Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: A systematic review. J Affect Disord 2016; 191: 62-77.
[http://dx.doi.org/10.1016/j.jad.2015.11.014] [PMID: 26650969]
[46]
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782-6.
[http://dx.doi.org/10.1192/bjp.150.6.782] [PMID: 3651732]
[47]
Cox J, Holden J, Sagovsky R, Wisner K, Parry B, Piontek C. Edinburgh Postnatal Depression Scale. EDPS 2002.
[48]
Smith KF, Huber LR, Issel LM, Warren-Findlow J. The association between maternal depression during pregnancy and adverse birth outcomes: A retrospective cohort study of PRAMS participants. J Community Health 2015; 40(5): 984-92.
[http://dx.doi.org/10.1007/s10900-015-0022-4] [PMID: 25833420]
[49]
Andersson L, Sundström-Poromaa I, Wulff M, Aström M, Bixo M. Implications of antenatal depression and anxiety for obstetric outcome. Obstet Gynecol 2004; 104(3): 467-76.
[http://dx.doi.org/10.1097/01.AOG.0000135277.04565.e9] [PMID: 15339755]
[50]
Goedhart G, Snijders AC, Hesselink AE, van Poppel MN, Bonsel GJ, Vrijkotte TG. Maternal depressive symptoms in relation to perinatal mortality and morbidity: results from a large multiethnic cohort study. Psychosom Med 2010; 72(8): 769-76.
[http://dx.doi.org/10.1097/PSY.0b013e3181ee4a62] [PMID: 20668282]
[51]
Dole N, Savitz DA, Hertz-Picciotto I, Siega-Riz AM, McMahon MJ, Buekens P. Maternal stress and preterm birth. Am J Epidemiol 2003; 157(1): 14-24.
[http://dx.doi.org/10.1093/aje/kwf176] [PMID: 12505886]
[52]
Suri R, Altshuler L, Hellemann G, Burt VK, Aquino A, Mintz J. Effects of antenatal depression and antidepressant treatment on gestational age at birth and risk of preterm birth. Am J Psychiatry 2007; 164(8): 1206-13.
[http://dx.doi.org/10.1176/appi.ajp.2007.06071172] [PMID: 17671283]
[53]
Sjöström K, Thelin T, Valentin L, Marsál K. Do pre-, early, and mid-pregnancy life events influence gestational length? J Psychosom Obstet Gynaecol 1999; 20(3): 170-6.
[http://dx.doi.org/10.3109/01674829909075592] [PMID: 10497761]
[54]
Straub H, Adams M, Kim JJ, Silver RK. Antenatal depressive symptoms increase the likelihood of preterm birth. Am J Obstet Gynecol 2012; 207(4): 329.e1-4.
[http://dx.doi.org/10.1016/j.ajog.2012.06.033] [PMID: 22789523]
[55]
Yedid Sion M, Harlev A, Weintraub AY, Sergienko R, Sheiner E. Is antenatal depression associated with adverse obstetric and perinatal outcomes? J Matern Fetal Neonatal Med 2016; 29(6): 863-7.
[http://dx.doi.org/10.3109/14767058.2015.1023708] [PMID: 25777791]
[56]
Mochache K, Mathai M, Gachuno O, Vander Stoep A, Kumar M. Depression during pregnancy and preterm delivery: a prospective cohort study among women attending antenatal clinic at Pumwani Maternity Hospital. Ann Gen Psychiatry 2018; 17: 31.
[http://dx.doi.org/10.1186/s12991-018-0202-6] [PMID: 30061917]
[57]
Jarde A, Morais M, Kingston D, et al. Neonatal outcomes in women with untreated antenatal depression compared with women without depression: A systematic review and meta-analysis. JAMA Psychiatry 2016; 73(8): 826-37.
[http://dx.doi.org/10.1001/jamapsychiatry.2016.0934] [PMID: 27276520]
[58]
Bodén R, Lundgren M, Brandt L, Reutfors J, Andersen M, Kieler H. Risks of adverse pregnancy and birth outcomes in women treated or not treated with mood stabilisers for bipolar disorder: population based cohort study. BMJ 2012; 345: e7085
[http://dx.doi.org/10.1136/bmj.e7085] [PMID: 23137820]
[59]
Liu C, Cnattingius S, Bergström M, Östberg V, Hjern A. Prenatal parental depression and preterm birth: a national cohort study. BJOG 2016; 123(12): 1973-82.
[http://dx.doi.org/10.1111/1471-0528.13891] [PMID: 26786413]
[60]
Kadir AA, Nordin R, Ismail SB, Yaacob MJ, Wan Mustapha WMR. Validation of the malay version of edinburgh postnatal depression scale for postnatal women in Kelantan, Malaysia. Asia Pac Fam Med 2004; 3(1-2): 9-18.
[61]
Kit LK, Janet G, Jegasothy R. Incidence of postnatal depression in Malaysian women. J Obstet Gynaecol Res 1997; 23(1): 85-9.
[http://dx.doi.org/10.1111/j.1447-0756.1997.tb00811.x] [PMID: 9094824]
[62]
Ministry of Health Malaysia. Perinatal Care. Manual 3rd Edition. 2013; pp. 1-251.
[63]
Senturk V, Abas M, Berksun O, Stewart R. Social support and antenatal depression in extended and nuclear family environments in Turkey: a cross-sectional survey. BMC Psychiatry 2011; 11: 48.
[http://dx.doi.org/10.1186/1471-244X-11-48] [PMID: 21435209]
[64]
Chung TK, Lau TK, Yip AS, Chiu HF, Lee DT. Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med 2001; 63(5): 830-4.
[http://dx.doi.org/10.1097/00006842-200109000-00017] [PMID: 11573032]
[65]
Accortt EE, Cheadle AC, Dunkel Schetter C. Prenatal depression and adverse birth outcomes: an updated systematic review. Matern Child Health J 2015; 19(6): 1306-37.
[http://dx.doi.org/10.1007/s10995-014-1637-2] [PMID: 25452215]
[66]
Rahman A, Bunn J, Lovel H, Creed F. Association between antenatal depression and low birthweight in a developing country. Acta Psychiatr Scand 2007; 115(6): 481-6.
[http://dx.doi.org/10.1111/j.1600-0447.2006.00950.x] [PMID: 17498160]
[67]
Ibanez G, Charles MA, Forhan A, et al. EDEN Mother–Child Cohort Study Group. Depression and anxiety in women during pregnancy and neonatal outcome: data from the EDEN mother-child cohort. Early Hum Dev 2012; 88(8): 643-9.
[http://dx.doi.org/10.1016/j.earlhumdev.2012.01.014] [PMID: 22361259]
[68]
Grigoriadis S, VonderPorten EH, Mamisashvili L, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 2013; 74(4): e321-41.
[http://dx.doi.org/10.4088/JCP.12r07968] [PMID: 23656857]
[69]
Field T, Diego M, Hernandez-Reif M, et al. Chronic prenatal depression and neonatal outcome. Int J Neurosci 2008; 118(1): 95-103.
[http://dx.doi.org/10.1080/00207450601042144] [PMID: 18041608]
[70]
Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 2010; 67(10): 1012-24.
[http://dx.doi.org/10.1001/archgenpsychiatry.2010.111] [PMID: 20921117]
[71]
Alder J, Fink N, Bitzer J, Hösli I, Holzgreve W. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med 2007; 20(3): 189-209.
[http://dx.doi.org/10.1080/14767050701209560] [PMID: 17437220]
[72]
Eastwood J, Ogbo FA, Hendry A, Noble J, Page A. Early Years Research Group (EYRG). The impact of antenatal depression on perinatal outcomes in Australian women. PLoS One 2017; 12(1): e0169907
[http://dx.doi.org/10.1371/journal.pone.0169907] [PMID: 28095461]
[73]
Lancaster C1. Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 2010; 202(1): 5-14.
[http://dx.doi.org/10.1016/j.ajog.2009.09.007] [PMID: 20096252]
[74]
Faisal-Cury A, Menezes PR. Antenatal depression strongly predicts postnatal depression in primary health care. Br J Psychiatry 2012; 34(4): 446-50.
[http://dx.doi.org/10.1016/j.rbp.2012.01.003] [PMID: 23429816]
[75]
Gaillard A, Le Strat Y, Mandelbrot L, Keïta H, Dubertret C. Predictors of postpartum depression: prospective study of 264 women followed during pregnancy and postpartum. Psychiatry Res 2014; 215(2): 341-6.
[http://dx.doi.org/10.1016/j.psychres.2013.10.003] [PMID: 24370337]
[76]
Mohamad Yusuff AS, Tang L, Binns CW, Lee AH. Prevalence and risk factors for postnatal depression in Sabah, Malaysia: a cohort study. Women Birth 2015; 28(1): 25-9.
[http://dx.doi.org/10.1016/j.wombi.2014.11.002] [PMID: 25466643]

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