Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry

Shahnaz Barat,Simin Asadollahi,Mahsima Adnani,Maedeh Mollaalipour,Mahtab Zeynalzadeh,Banafshe Zarinkamar,Farzan Kheirkhah,Sajedeh Aligoltabar,Seyyedeh Mahboubeh Mirtabar,Alireza Azizi,Fatemeh Amirkhanloo,Seyedeh Shabnam Mehdinia,Zinatosadat Buzari,Angela Hamidia,Nooshin Fatery,Asieh Khodami,Faezeh Khorshidian,Azita Ghanbarpour,Mahbobeh Faramarzi,Fatemeh Basirat,Fatemeh Shafizade,Zahra Basirat,Davood Hosseini Talari,Shahla Yazdani Charati,Hoda Shirafkan,Fatemeh Nasiri Amiri ,R Khazaei ,Seddigheh Esmaelzadeh ,Mehrangiz Amiri ,A Kani ,Shahram Shahrokhi ,Zeinab Pahlavan

doi:10.1186/s12884-023-06024-3

Abstract

BackgroundPsychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum.MethodsA cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions.ResultsThe prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P < 0.001), as well as its three subscales: somatization (β = 1.355, P = 0.019), anxiety symptoms (β = 2.249, P < 0.001), and depressive symptoms (β = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (β = 1.344, P = 0.038) and the somatization subscale (β = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (β = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (β = 1.998, P = 0.012) and depressive symptoms (β = 1.949, P = 0.020).ConclusionThe high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.

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