ABSTRACT
Objective: To determine the prevalence and association of prenatal depression with socioeconomic, demographic and personal factors among pregnant women living in Kallar Syedan, Rawalpindi, Pakistan. Methods: Five hundred women in the second and third trimester of pregnancy, living in Kallar Syedan, a rural area of district Rawalpindi Pakistan, were included in the study. Depression was assessed using "Patient health questionnaire" (PHQ9) in Urdu, with a cut-off score of 10. Multi-dimensional scale of perceived social support (MSPSS) was used to assess perceived social support. Life Events and Difficulties Schedule (LEDS) were used to measure stressful life events in past 1 year. Tool to assess intimate partner violence (IPV) was based on WHO Multi Country Study on "Women's Health and Domestic Violence against Women." Results: Prevalence of prenatal depression was found to be 27%. Number of pregnancies was significantly associated with prenatal depression (p < 0.01). Women living in a joint family and those who perceived themselves as moderately satisfied or not satisfied with their life in the next 4 years were found to be depressed (p < 0.01, OR 6.9, CI 1.77-26.73). Depressive symptomatology in women who experienced more than five stressful life events in last 1 year was three times higher (p < 0.001, OR 3.2, CI 1.68-5.98) than in women with 1-2 stressful events. Women who were supported by their significant others or their family members had 0.9 times (p < 0.01, OR 0.9, CI 0.85-0.96) less chance of getting depressed. Pregnant women who were psychologically abused by their partners were 1.5 times more depressed (p < 0.05 CI 1.12-2.51). Odds of having depression was also high in women who had less mean score of MSSI (p < 0.05, OR 1.1, CI 1.01-1.09). Women who had suitable accommodation had 0.5 times less chance of having depression than others (p < 0.05, OR 0.5, CI 0.27-0.92). Conclusion: Over a quarter of the women in the study population reported prenatal depression, which were predicted predominantly by psychosocial variables.
ABSTRACT
This review was conducted to explore the bi-directional association of maternal depression with diet. This link is hypothesized because the mental health of pregnant women may adversely affect their nutritional intake; or inversely, that poor nutritional intake during pregnancy may cause mental health issues. Seven electronic databases were searched to retrieve relevant peer-reviewed articles published during 2000-2018. Primary research studies published in English that evaluated the relationship between maternal antenatal and postnatal depression with dietary intake were selected. We screened 1585 articles, of which 13 met the inclusion criteria. These included five cohort studies (including two birth cohorts) and eight cross-sectional studies representing a total of 12,742 participants altogether. Studies were divided into five groups depending on whether they analyzed all nutrients, micronutrients, dietary patterns, dietary behavior or intake of fish and vegetables. The studies exploring the association of depression with dietary patterns found a protective association of "Health Conscious", "Healthy" and "Brazilian" diet patterns with maternal depression. The group of studies which analyzed all nutrients, found an inverse relationship of the "Healthy Eating Index" with maternal depression. Deficiency of calcium, iron, and folate were also associated with maternal depression. Prenatal and early postpartum eating attitudes and BMI were found as predictors of depressive symptoms in the late post-partum period in a diet behavior study. It is important to identify modifiable lifestyle risk factors which may contribute to maternal depression. A limitations of our review is the absence of meta-analysis which was not possible due to heterogeneity of the studies.
