Screening for antepartum anxiety and depression and their association with domestic violence among Egyptian pregnant women

Abstract

Greater attention has been paid recently to prenatal mental disorders and their association with exposure to domestic violence (DV) as both have serious reproductive consequences. The aim of this study was to screen for anxiety and/or depression among pregnant women, as well as identify the frequency and association of exposure to DV. This cross-sectional study was conducted in 2013 and included a systematic random sample of 376 pregnant women attending the antenatal care outpatient clinic at the largest university hospital in Egypt. Participants were interviewed using a structured questionnaire including three components: sociodemographic characteristics of the participants, the Hospital Anxiety and Depression Scale questionnaire (HADS), and the Hurt, Insulted, Threaten, Scream (HITS) inventory for screening for DV. Women who expressed simultaneous anxiety and depressive manifestations accounted for 63%, whereas 11.4% and 10.4% of them expressed only anxiety and only depression, respectively. Exposure to DV was detected in 30.6% of all participants, of whom 25.2% were physically hit by their husbands often to most of the time. Simultaneous anxiety and depression was independently associated with lifetime exposure to DV (odds ratio=3.27, 95% confidence interval: 1.28-8.34, P=0.013), whereas having a university-graduated husband was a protective factor from DV (odds ratio=0.22, 95% confidence interval: 0.64-0.75, P=0.01). Symptoms of anxiety and depression were highly reported among this sample of pregnant Egyptian women and were significantly associated with exposure to intimate partner violence. Screening of pregnant women for mental disorders associated with exposure to DV with provision of supportive mental health services, as well as interventions to reduce exposure to DV, should be considered for integration into antenatal care services.