Abstract
BackgroundResearch on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers.MethodsWe used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS).ResultsPrevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband’s depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife’s depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers.ConclusionBoth ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.
Highlights
Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries
Nasreen et al BMC Psychiatry (2018) 18:195 (Continued from previous page). Both antepartum depressive symptoms (ADS) and antepartum anxiety symptoms (AAS) are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia
Expectant mothers were more educated than fathers in east coast, while no difference was observed in west coast
Summary
Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. Contemporary research findings, mostly from high-income countries, suggest that fathers are affected by depression during ante and postpartum period [2]. Recent research findings in high-income countries show that anxiety is more prevalent than depression among mothers during their perinatal period [1, 3]. Anxiety and depressive symptoms are more prevalent during pregnancy than postpartum period both in mothers [1, 4] and fathers [1, 5]. Meta-analysis indicates the mean weighted prevalence for maternal antepartum depressive symptoms (ADS) is 12% in high income countries [6] and about 20% in Asia [7]. Comorbid depressive and anxiety symptoms in mothers are common during pregnancy [1, 8], very few data are available about expectant fathers [1]
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