Abstract
BackgroundAntenatal depression has become a common and serious problem, significantly affecting maternal and fetal health. However, evaluation and intervention methods for pregnant women in obstetric clinics are inadequate. This study aimed to determine the prevalence of and risk factors for depression among all pregnant women at their first attending antenatal care in the obstetrics clinic, a comprehensive teaching hospital, southwest of China.MethodsFrom June to December 2019, 5780 pregnant women completed online psychological assessments, and data from 5728 of the women were analyzed. The women were categorized into two groups according to the presence or absence of depression. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9), with a cutoff point of 10 for depression. Anxiety and somatic symptoms were measured by the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-15 (PHQ-15), respectively. Univariate analysis and binary logistic regression analysis were used to determine the association among antenatal depression, anxiety, somatic symptoms and participants’ characteristics.ResultsThe prevalence of antenatal depression among all the pregnant women at their first attending antenatal care was 16.3%, higher in the first trimester (18.1%). Anxiety symptoms (Mild anxiety AOR = 2.937; 95% CI: 2.448–3.524) and somatic symptoms (Mild somatic symptoms AOR = 3.938; 95% CI: 2.888–3.368) were major risk factors for antenatal depression among women and the risk increased more with the anxiety level or somatic symptoms level. Gestational weeks (second trimester AOR = 0.611; 95% CI: 0.483–0.773; third trimester AOR = 0.337; 95% CI: 0.228–0.498) and urban residence (AOR = 0.786; 95% CI: 0.652–0.947) were protective factors for antenatal depression among women.ConclusionsAbout one in six pregnant women would experience depression, and special attention should be paid to some risk factors (i.e., early pregnancy, anxiety symptoms, somatic symptoms, rural residence). Online psychological assessments might be a time-saving and convenient screening method for pregnant women in obstetric clinics.
Highlights
Depression has become a common public mental health problem, which would rank first in the world disease burden by 2030 [1]
All the women diagnosed with pregnancy by B-ultrasonography and registered to attending antenatal care at the Department of Obstetrics, the First Affiliated Hospital of Chongqing Medical University were required to complete online psychological assessments for free at their first attending antenatal care, but some pregnant women who insisted on refusing psychological assessment or were illiterate were excluded
The prevalence of antenatal depression at their first attending antenatal care in our study was 16.3%, which was equivalent to that reported in a recent meta-analysis [5], but relatively lower than estimates reported in most previous studies in China
Summary
Depression has become a common public mental health problem, which would rank first in the world disease burden by 2030 [1]. This problem is seriously affecting the mental health of the Chinese people [2]. Risk factors of antenatal depression are multifactorial including age of pregnant women, marital status, income, education, occupation, unplanned pregnancy, history of the previous mental disorder, complication during pregnancy, conflicts, social support, number of pregnancy, history of fetal loss, and relationship with husband [6, 7]. This study aimed to determine the prevalence of and risk factors for depression among all pregnant women at their first attending antenatal care in the obstetrics clinic, a comprehensive teaching hospital, southwest of China
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