Burden and risk factors for antenatal depression and its effect on preterm birth in South Asia: A population-based cohort study

Women experience high rates of depression, particularly during pregnancy and the postpartum periods. Using population-based data from Bangladesh and Pakistan, we estimated the burden of antenatal depression, its risk factors, and its effect on preterm birth. The study uses the following data: matern...

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Bibliographic Details
Published in:PloS one Vol. 17; no. 2; p. e0263091
Main Authors: Khanam, Rasheda, Applegate, Jennifer, Nisar, Imran, Dutta, Arup, Rahman, Sayedur, Nizar, Ambreen, Ali, Said Mohammed, Chowdhury, Nabidul Haque, Begum, Farzana, Dhingra, Usha, Tofail, Fahmida, Mehmood, Usma, Deb, Saikat, Ahmed, Salahuddin, Muhammad, Sajid, Das, Sayan, Ahmed, Saifuddin, Mittal, Harshita, Minckas, Nicole, Yoshida, Sachiyo, Bahl, Rajiv, Jehan, Fyezah, Sazawal, Sunil, Baqui, Abdullah H.
Format: Journal Article
Language:English
Published: United States Public Library of Science 07.02.2022
Public Library of Science (PLoS)
Subjects:
Adult
Asia - epidemiology
Bangladesh - epidemiology
Birth
Childrens health
Cohort analysis
Cohort Studies
Confidence intervals
Depression - complications
Depression - epidemiology
Diabetes
Education
Female
Gestation
Health risks
Health surveillance
Humans
Infant, Newborn
Infants (Premature)
Medical laboratories
Medicine and Health Sciences
Mental depression
Pakistan - epidemiology
Parity
Pediatrics
Population
Population studies
Population-based studies
Postpartum depression
Postpartum period
Pregnancy
Pregnancy Complications - epidemiology
Pregnancy Complications - psychology
Pregnancy Outcome - epidemiology
Pregnancy Outcome - psychology
Premature birth
Premature Birth - epidemiology
Prenatal Care - statistics & numerical data
Prenatal depression
Psychological aspects
Public health
Risk analysis
Risk Factors
Socioeconomics
Ultrasound
Womens health
Young Adult
Asia
Bangladesh
Pakistan
South Asia
United States > US
Tanzania
Maryland
Switzerland
Baltimore Maryland
Karachi Pakistan
India
ISSN:1932-6203, 1932-6203
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Summary:Women experience high rates of depression, particularly during pregnancy and the postpartum periods. Using population-based data from Bangladesh and Pakistan, we estimated the burden of antenatal depression, its risk factors, and its effect on preterm birth. The study uses the following data: maternal depression measured between 24 and 28 weeks of gestation using the 9-question Patient Health Questionnaire (PHQ-9); data on pregnancy including an ultrasound before 19 weeks of gestation; data on pregnancy outcomes; and data on woman's age, education, parity, weight, height, history of previous illness, prior miscarriage, stillbirth, husband's education, and household socioeconomic data collected during early pregnancy. Using PHQ-9 cutoff score of ≥12, women were categorized into none to mild depression or moderate to moderately severe depression. Using ultrasound data, preterm birth was defined as babies born <37 weeks of gestation. To identify risk ratios (RR) for antenatal depression, unadjusted and adjusted RR and 95% confidence intervals (CI) were calculated using log- binomial model. Log-binomial models were also used for determining the effect of antenatal depression on preterm birth adjusting for potential confounders. Data were analyzed using Stata version 16 (StataCorp LP). About 6% of the women reported moderate to moderately severe depressive symptoms during the antenatal period. A parity of ≥2 and the highest household wealth status were associated with an increased risk of depression. The overall incidence of preterm birth was 13.4%. Maternal antenatal depression was significantly associated with the risk of preterm birth (ARR, 95% CI: 1.34, 1.02-1.74). The increased risk of preterm birth in women with antenatal depression in conjunction with other significant risk factors suggests that depression likely occurs within a constellation of other risk factors. Thus, to effectively address the burden of preterm birth, programs require developing and providing integrated care addressing multiple risk factors.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0263091