740: Shining a light on Perinatal Depression: Predictors of antepartum depression in Pune, India

Abstract

Our objectives were to: (1) describe the prevalence of antepartum and postpartum depression; (2) identify predictors of both antepartum and postpartum depression; and (3) quantify adverse maternal and neonatal outcomes in women with antepartum depression. We conducted a prospective cohort study of pregnant women in Pune, India. Sociodemographics, medical and obstetric history were collected at baseline. PHQ-9 depression scale was administered during pregnancy and 6 months postpartum. Demographics and adverse maternal and neonatal outcomes of women with and without antepartum depressive symptoms were compared using chi-square. Logistic regression was used to determine predictors of both antepartum and postpartum depressive symptoms. Of 235 pregnant women enrolled, 136 (58%) reported at least one symptom of depression with 21 (15%) having moderate or severe depression scores (PHQ-9 score≥ 10). Compared to antepartum women, significantly fewer postpartum women reported depressive symptoms (20% vs. 58%, p< 0.001). Of 188 postpartum women, 34 (18%) had depressive symptoms prior to delivery, but only one had more severe depression scores postpartum. Intimate partner violence before or during pregnancy was predictive of both antepartum (OR: 6.23 (2.52-15.41), p=< 0.001) and postpartum depressive symptoms (OR: 4.47 (2.02-9.86), p=< 0.001). Personal financial instability, defined as recent homelessness, recent job loss or trouble paying the bills, was also predictive of both antepartum (OR: 6.29 (2.69-14.68), p< 0.001) and postpartum depression (OR: 3.90(1.81-8.42), p=0.001). The cohort overall experienced low rates of intrauterine fetal demise and (1%), hypertension (6%). Many Indian pregnant women in our study reported symptoms of depression. Most women with antepartum depression experienced improvement in their mood postpartum, which contrasts with patterns of perinatal depression in developed countries. Intimate partner violence and personal financial instability needs to be addressed before and during pregnancy in order to decrease depression in these settings.View Large Image Figure ViewerDownload Hi-res image Download (PPT)