Risk factors for antenatal depression: A review

Depression is the most prevalent mental disorder in pregnancy, and yet it is lessstudied than postpartum depression despite the consequences it may have onboth the pregnant woman and her offspring. Therefore, it would be important toknow which risk factors may favour the appearance of antenatal depression inorder to carry out appropriate prevention interventions. The aim of the presentreview was to identify the main risk factors of antenatal depression. We searchedin databases PubMed and PsycINFO for articles published about the factorsassociated with antenatal depression from January 2010 through December 2020.The literature review identified three main groups of antenatal depression riskfactors: sociodemographic, obstetric, and psychological. First, among thesociodemographic variables, the low level of studies and the economic incomeclearly stood out from the rest. Then, not having planned the pregnancy was themain obstetric variable, and finally, the main psychological risk factors werehaving a history of psychological disorders and/or depression as well aspresenting anxiety, stress, and/or low social support during pregnancy. Thisreview shows that the antenatal depression is affected by multiple factors. Mostcan be identified at the beginning of the pregnancy, and some are risk factorspotentially modifiable through appropriate interventions, such as psychologicalfactors. For this reason, it is important to carry out a good screening for depressionduring pregnancy and consequently, be able to prevent its appearance ortreat it if necessary.

Effect of Antenatal Depression on Fetal Growth Outcomes at the Jos University Teaching Hospital Jos, Plateau State, Nigeria

Background: Depression is the most prevalent psychiatric disorder in pregnancy and it is associated with psychosocial and obstetric factors. Studies have shown that pregnancy does not prevent women from becoming depressed;rather, it may be a time when depression occurs for the first time in some women. Antenatal depression has been identified as a risk factor for post natal depression, adverse obstetric outcomes, poorer neonatal outcomes and higher growth retardation in infants. Purpose: This study aimed to determine the fetal growth outcomes among depressed pregnant women in their third trimester attending antenatal clinic at the Jos University Teaching Hospital (JUTH), Jos, Plateau State, Nigeria. Method: A prospective cohort study design was used to assess 514 women who consented to the study (256 cases and 258 controls). A socio-demographic questionnaire was given to the women to fill out the study entry. Edinburgh Post Natal Depression Scale (EPDS) was used to screen for depression and MINI neuropsychiatric interviews were used to diagnose depression in those women found to be at risk of depression using the EPDS. Ultrasonography was used to determine the fetal weight in the third trimester of pregnancy. The birth weight of the babies born to the women was obtained from the birth register in the labor ward and the fetal growth rate was calculated from the estimated fetal weight on ultrasound scan in late pregnancy and the birth weight of babies. Result: The mean fetal weight in the third trimester for non-depressed women was slightly higher than in depressed women though the difference was not statistically significant (P = 0.431). The difference in the mean calculated fetal growth rate for fetuses of non-depressed women in the third trimester was statistically significantly higher than in depressed women (p = 0.000). Depressed women also had babies with lower birth weight than non-depressed women and the difference was statistically significant (p = 0.00).

Risk of Adverse Perinatal Outcomes and Antenatal Depression Based on the Zung Self-Rating Depression Scale

Objective:The aim of the study is to investigate the relationship between antenatal depression and adverse perinatal outcomes.Methods:This prospective cohort study enrolled pregnant women between gestational ages of 12-20 weeks to complete the Chinese version of the Zung Self-Rating Depression Scale(SDS)and followed them for delivery from September 2015 to September 2016.Participants were classified into mild,moderate,and severe depression groups according to the SDS scores.Logistic regression was performed to assess the association between antenatal depression and perinatal outcomes including preterm birth(PTB),cesarean section use,hypertension disorders,gestational diabetes,and thyroid diseases during pregnancy.An age-stratified analysis was performed.Results:A total of 4,663 pregnant women were analyzed.As a result,13.8%,1.7%,and 0.2%of women were classified as mild,moderate,and severe depression,respectively.Severely depressed mothers were at higher risk for PTB(adjusted odds ratio[OR]=11.31,95%confidence interval[CI]2.13-60.03),especially spontaneous PTB.Moderate-depressed women were at higher risk for hyperthyroidism during pregnancy(adjusted OR=3.67,95%CI 1.10-12.27),while women with mild depression tended to choose cesarean sections(OR=1.24,95%CI=1.04-1.49).Age-stratified analysis indicated an elevated risk of adverse outcomes associated with depression in women aged<25 years,but the association was not significant.Conclusions:Antenatal depression was associated with PTB,hyperthyroidism,and cesarean use.Studies with large sample sizes should verify the relationship between PTB and antenatal depression to avoid casual events.

Initiative to Improve the Health Outcomes of Those at Risk of Perinatal Depression: Referral Characteristics and Psychosocial Determinants

In Australia, perinatal depression affects 15% - 20% of pregnant women. Depression does not go away on its own, getting help at early stages shown to be effective in treating antenatal depression. Aim of this study is to assess and describe the screening of women through the antenatal clinic and measure the outcome of services provided (such as counselling, social assistance) for those at risk of depression, in a general hospital setting in an ethnically diverse part of Sydney, Australia. Data from 193 women were obtained through accessing the psychosocial and screening assessments completed at the antenatal clinic between 2007 and 2008. Data regarding patients’ psychosocial characteristics, referrals and interventions were also gathered from hospital records. Data revealed that 60.4% of women screened scored ≥10 on the Edinburgh Postnatal Depression Scale (EDPS) which is indicative of significant depressive symptomatology. Of these women, 39.4% went on to receive a formal diagnosis. Women who indicated that they had planned their pregnancies (47.2%) were significantly less likely to report having major worries and stressors over the last 12 months (p < 0.05) in comparison to those who indicated that their pregnancies were unplanned. Data showed while screening methods are effective, regrettably a high proportion of women, despite presenting with “at risk” symptomatology levels, do not engage in intervention programs. Further research is required to explore the barriers in accessing both screening and intervention services (particularly in a culturally diverse area such as this), and how services can improve processes and patient participation.