Abstract
BACKGROUND: The association of mental health with parenthood is complex and varies across many social contexts. Previous studies place mothers with young children at a high-risk for depression. Therefore, the study aimed to understand the association of parity as a risk factor for maternal depression in a cross-sectional survey.
 
 METHOD: A total of 255 women were surveyed at two primary health care centers in Karachi, a Metropolitan city of Pakistan between May 2019 and July 2019 with an anonymously answered Public Health Questionnaire (PHQ) 9. The demographic characteristics and related variables were determined as potential correlates of vulnerability to maternal depression. Significant predictive factors associated with risk factors were analyzed by means of linear correlation and multiple regression analysis.
 
 RESULTS: The PHQ 9 score noted an 89.2% prevalence of depression in the study sample. Of those, 72.6% (0.001 p-value) were multiparous women (3-5 children). When analyzed within each individual parity category, grand-multiparous women (6 or more children) had the highest percentage of depression at 92.6% followed by multiparous women (2-5 children) at 90.6%.
 
 CONCLUSION: The result showed the greatest frequency of depression among multiparous women. However, grand multiparous unemployed women were at the highest risk of depression among low-income urban populations.
Highlights
Pakistan is the sixth most populous country in the world with a population of over 207 million people according to the census of 2017(Pakistan Bureau Of Statistics, 2017)
All our study participants belonged to the low- and lower middle socio-economic status based on their household income
Upon analyzing the frequency of depression in mothers, the highest number on women with depression was multiparous (Table 1). This being statistically significant and on further analysis, when we studied the prevalence of depression within each category of parity, we found that the women with 5 or more children (Grand multiparous) had 93.6% depression amongst them making it the highest among all categories (Table 2) with multi parity standing at 90.6% (Table 2)
Summary
Pakistan is the sixth most populous country in the world with a population of over 207 million people according to the census of 2017(Pakistan Bureau Of Statistics, 2017). Studies conducted in Pakistan over the past decade have set the prevalence range between 22% and a whopping 60% for anxiety and depression(Ahmed, Enam, Iqbal, Murtaza, & Bashir, 2016) These high rates coupled with an annual population growth rate of 2.4% (Pakistan Bureau Of Statistics, 2017) warrants a look at the mental health of the caretakers of the future generation(Niloufer Sultan Ali, Mahmud, Khan, & Ali, 2013; Gulamani, Shaikh, & Chagani, 2013; LeMasters et al, 2020; Maselko et al, 2016; Rahman, Lovel, Bunn, Iqbal, & Harrington, 2004). The study aimed to understand the association of parity as a risk factor for maternal depression in a cross-sectional survey
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