Abstract
Objective: To highlight the incidence of undiagnosed depression and evaluate its severity among pregnant Pakistani women and identify its risk factors.
Methodology: This cross-sectional study was conducted at Ziauddin University Hospital, Karachi from January 1, to July 31, 2016. All women attending the antenatal clinics for routine follow-up visits were included. Women who were already diagnosed with major depressive disorder (MDD) were excluded. All completed the standardized Patient Health Questionnaire – 9 (PHQ-9) for the screening of depression.
Results: Out of 1000 respondents, BMI was overweight for 40.4% of women and obese for 20.5%. There were 59.8% primigravida, 32.6% multigravida, 6.4% grand multigravida, and 1.2% great grand multigravida. In 24.8%, this pregnancy was unplanned. On PHQ-9, 411 had no to minimal depressive symptoms, 332 mild, 214 moderate and 43 had severe MDD. In primigravida, 32.9% had mild depression, in multigravida, 37.1% had mild and 37.7% had moderate depression, in grand multigravida, 31.3% reported severe depression, and in great grand multigravida, 66.7% had severe depression. An increased risk of depression was found in women with a family history of psychiatric illnesses, in those with an unplanned pregnancy, and in those with the previous history of stillbirth and miscarriages. Majority of women <21 years of age were mildly depressed and some >40 years were severely depressed.
Conclusion: The prevalence of depression among pregnant women is high and is usually mild. Risk factors were extremes of age, higher gravida, previous history of miscarriage and stillbirth, and unplanned pregnancy.
