Psycho-social determinants of antenatal anxiety and depression in Pakistan: Is social support a mediator?
- Published
- Accepted
- Subject Areas
- Gynecology and Obstetrics, Psychiatry and Psychology, Public Health, Women's Health
- Keywords
- antenatal anxiety, antenatal depression, sex bias, gender discrimination, social psychology, determinants, social support
- Copyright
- © 2014 Waqas et al.
- Licence
- This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ PrePrints) and either DOI or URL of the article must be cited.
- Cite this article
- 2014. Psycho-social determinants of antenatal anxiety and depression in Pakistan: Is social support a mediator? PeerJ PrePrints 2:e463v2 https://doi.org/10.7287/peerj.preprints.463v2
Abstract
Introduction: Pregnancy is generally viewed as a time of fulfillment and joy, however, for many women, it can be a stressful event. In South Asia, it is associated with cultural stigmas revolving around gender discrimination, abnormal births and genetic abnormalities. It is also associated with several psychiatric problems in women, most notably, depression and anxiety.
Methodology: This cross sectional study was undertaken in four teaching hospitals in Lahore from February, 2014 to June, 2014. 500 Pregnant women presenting at the outdoors of obstetrics and gynecology department were interviewed. The questionnaire consisted of three sections: Demographics, Hospital anxiety and depression scale and social provision scale. Data was analyzed in SPSS v.20. Descriptive statistics were analyzed for demographics. Pearson Chi Square, Bivariate Correlations and linear regression were run to analyze associations of independent variables with scores on HAD scale and SPS.
Results: There were a total of 500 respondents. Mean age of respondents was 27.41 years (5.65). Anxiety levels of participants were categorized as Normal 145 (29%), borderline 110 (22%) and anxious 245 (49%). Depression levels were categorized as 218 (43.6%) normal, 123 (24.6%) borderline, and 159 (31.8%) depressed. Inferential analysis revealed that higher scores on HAD scale were significantly associated with lower scores on social provisions scale (SPS), rural background, history of harassment, abortion, C-sections and unplanned pregnancies (P < .05).
Social support also mediated the relationship between gender of previous offspring and scores on HAD scale. Women reporting higher numbers of female children were significantly associated with higher scores on HAD scale and lower on SPS scale. Whereas increasing number of male progeny were associated with low scores on depression subscale (P < .05).
Conclusion: Keeping in context the predominantly patriarchal socio-cultural setting, the predictors of antenatal anxiety and depression in Pakistan may differ from those of the developed countries. Rural women and working women showed higher levels of antenatal anxiety and depression, which contradicts studies from western countries. Our study revealed higher number of female progeny was associated with higher levels of depression and anxiety while male progeny had a protective influence. We, therefore, suggest that interventions designed to reduce antenatal anxiety and depression should take these unique factors, operating in developing countries and patriarchal societies, into account in their design and implementation.
Author Comment
This is an update of the original submission. Several revisions have been made in the Methods and Results sections.