Understanding the antepartum depressive symptoms and its risk factors among the pregnant women visiting public health facilities of Nepal

• Published in: PloS one 2019-04, Vol.14 (4), p.e0214992-e0214992
• Main Authors: Joshi, Deepak, Shrestha, Santoshi, Shrestha, Nipun
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alcoholic beverages; Analysis; Anxiety; Anxiety - epidemiology; Bivariate analysis; Childbirth & labor; Childrens health; Complications and side effects; Cross-Sectional Studies; Depression (Mood disorder); Depression, Postpartum - epidemiology; Domestic violence; Drinking (Alcoholic beverages); Fairness; Families & family life; Family; Female; Gender; Gender equality; Gender inequality; Gestational age; Health aspects; Health care; Health care facilities; Health Facilities; Health services; Home environment; Humans; Husband-wife relations; Internet; Interviews; Marriage and sex; Maternal & child health; Medicine and Health Sciences; Mental depression; Mental disorders; Mental health; Middle Aged; Miscarriage; Nepal - epidemiology; People and Places; Postpartum depression; Pregnancy; Pregnancy complications; Pregnant Women; Prenatal depression; Primary care; Primary health care; Psychiatric Status Rating Scales; Psychological aspects; Psychological factors; Public health; Qualitative analysis; Researchers; Risk analysis; Risk Factors; Signs and symptoms; Social Sciences; Symptoms; Systematic review; Tests; Well being; Women; Women's health; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0214992

Antepartum depression is a contributing factor for adverse maternal and perinatal outcome. The study aimed to assess the antepartum depressive symptoms in selected public health facilities of Nepal. This is a mixed-method cross-sectional study that included 143 pregnant women attending the antenatal checkup in four public health facilities of Kathmandu. Edinburgh Postnatal Depression Scale (EPDS) tool with cut-off score > = 10 was used to assess the antepartum depressive symptoms. Bivariate and multivariable analysis was carried out to identify factors associated with the depressive symptoms. Further semi-structured interviews were conducted with 12 pregnant women identified with the depressive symptoms. Of the total 143 pregnant women, 26 (18%, CI at 95% 12.6-25.5) reported depressive symptoms. Multivariable analysis reported higher odds of antepartum depressive-symptoms with health problem, early gestational age, sex preference, and spousal alcohol intake. Thematic analysis of qualitative data further revealed participants' apprehension on; birth outcome, a family expectation of male child, inadequate support from the family/husband and disturbed family environment. Notable proportion of pregnant women were reported with antepartum depressive symptoms. Women's perception on patriarchal values for childbirth was revealed to be important factor for the depressive symptoms. The study draws an attention to a need for screening for antepartum depression into primary health care system. Strengthening ongoing efforts on gender equity could contribute the psychological well-being of pregnant women.