Journal of Education and Health Promotion

Psychological profiles of risk for antenatal depression and anxiety in Iranian sociocultural context

Document Type : Original Article

Authors

. Zahra Alipour
. Gholam Reza Kheirabadi 1
. Ahmad Ali Eslami 2
. Ashraf Kazemi

1 Behavioral Sciences Research Center, Isfahan University of Medical Sciences,

2 Department of Health Education and Promotion, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract
BACKGROUND AND AIM: Mental health issues including depression and anxiety are common
in pregnancy worldwide. This study aimed to identify factors associated with mental disorders in a
sample of Iranian pregnant women.
MATERIALS AND METHODS: A cross‑sectional study was conducted among pregnant women
referred to a prenatal‑care clinic in an urban area, Isfahan, Iran. The questionnaires in this study
included the General Health Questionnaire and additional structured questionnaires exploring
sociodemographic, obstetric, and economic risk factors and empowerment for decision‑making
regarding pregnancy, parenting, financial authority, trust, and confidence in health‑care staff.
Regression analysis was performed to assess the impact of the number of variables on the likelihood
of the presence of mental health problems.
RESULTS: Overall, 54.2% and 11.7% of the women had anxiety and depression, respectively. No
statistically significant associations were reported between anxiety and depression and obstetric
characteristics such as gestational age, parity, abortion, previous infertility, unwanted pregnancy,
and the screening test results . According to the logistic regression analysis, the predictors of
depression and anxiety were acknowledging psychological changes in pregnancy and empowerment
for decision‑making regarding pregnancy and parenting and financial authority (P < 0.05).
CONCLUSIONS: probably, women’s empowerment on becoming aware of psychological changes
during pregnancy and making decisions on pregnancy, parenting, and financial authority is the factor
affecting the mental health of pregnant women.

Keywords

Anxiety
depression
Iran
mental health
pregnancy
  1. World Health Organization. Maternal Mental Health and
    Child Health and Development in Low and Middle Income
    Countries: Report of the Meeting, Geneva, Switzerland,
    30 January‑01 February, 2008; 2008.
    2. Fisher J, Tran T, Duc Tran T, Dwyer T, Nguyen T, Casey GJ,
    et al. Prevalence and risk factors for symptoms of common
    mental disorders in early and late pregnancy in vietnamese
    women: A prospective population‑based study. J Affect Disord
    2013;146:213‑9.
    3. Rezaee R, Framarzi M. Predictors of mental health during
    pregnancy. Iran J Nurs Midwifery Res 2014;19:S45‑50.
    4. Sadeghi N, Azizi S, Molaeinezhad M. Anxiety status in pregnant
    mothers at third trimester of pregnancy and its related factors in
    referrals to Bandar Abbas Hospitals in 2012. Iran J Obstet Gynecol
    Infert 2014;17:8‑15.
    5. Alderdice F, McNeill J, Lynn F. A systematic review of systematic
    reviews of interventions to improve maternal mental health and
    well‑being. Midwifery 2013;29:389‑99.
    6. Hartmann JM, Mendoza‑Sassi RA, Cesar JA. Postpartum
    depression: Prevalence and associated factors. Cad Saude Publica
    2017;33:e00094016.
    7. Vigo D, Thornicroft G, Atun R. Estimating the true global burden
    of mental illness. Lancet Psychiatry 2016;3:171‑8.
    8. Davalos DB, Yadon CA, Tregellas HC. Untreated prenatal
    maternal depression and the potential risks to offspring: A review.
    Arch Womens Ment Health 2012;15:1‑4.
    9. FisherJ, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S,
    et al. Prevalence and determinants of common perinatal mental
    disorders in women in low‑ and lower‑middle‑income countries:
    A systematic review. Bull World Health Organ 2012;90:139G‑49.
    10. Roomruangwong C, Epperson CN. Perinatal depression in Asian
    women: Prevalence, associated factors, and cultural aspects. Asian
    Biomed 2011;5:179‑93.
    11. Herrman H, Saxena S, Moodie R, World Health Organization.
    Promoting Mental Health: Concepts, Emerging Evidence, Practice:
    A Report of the World Health Organization, Department of
    Mental Health and Substance Abuse in Collaboration with the
    Victorian Health Promotion Foundation and the University of
    Melbourne; 2005.
    12. Walker L, Verins I, MoodieR, Webster K. Responding to the Social
    and Economic Determinants of Mental Health: A Conceptual
    Framework for Action. Promot Mental Health; 2005. p. 89‑108.
    13. Forouzandeh N, Delaram M, Deris F. The quality of mental
    health status in pregnancy and it’s contributing factors on women
    visiting the health care centers of Shahrekord, (2001‑2002).
    J Reprod Infert 2003;4:146‑56.
    14. Noorbala A, Mohammad K. The validation of general health
    questionnaire‑28 as a psychiatric screening tool. Hakim Res J
    2009;11:47‑53.
    15. Faisal‑Cury A, Menezes P, Araya R, Zugaib M. Common mental
    disorders during pregnancy: Prevalence and associated factors
    among low‑income women in São Paulo, Brazil: Depression
    and anxiety during pregnancy. Arch Womens Ment Health
    2009;12:335‑43.
    16. Hartley M, Tomlinson M, Greco E, Comulada WS, Stewart J,
    le Roux I, et al. Depressed mood in pregnancy: Prevalence and
    correlates in two cape town peri‑urban settlements. Reprod Health
    2011;8:9.
    17. Felice E, Saliba J, Grech V, Cox J. Prevalence rates and psychosocial
    characteristics associated with depression in pregnancy and
    postpartum in Maltese women. J Affect Disord 2004;82:297‑301.
    18. Sawyer A, Ayers S, Smith H. Pre‑ and postnatal psychological
    wellbeing in Africa: A systematic review. J Affect Disord
    2010;123:17‑29.
    19. Lee AM, Lam SK, Sze Mun Lau SM, Chong CS, Chui HW,
    Fong DY, et al. Prevalence, course, and risk factors for antenatal
    anxiety and depression. Obstet Gynecol 2007;110:1102‑12.
    20. Biratu A, Haile D. Prevalence of antenatal depression and
    associated factors among pregnant women in Addis Ababa,
    Ethiopia: A cross‑sectional study. Reprod Health 2015;12:99.
    21. Shahmiry H, Momtazi S. The prevalence of depression and its
    relationship with personal characteristics in pregnant women.
    Med J Tabriz Univ Med Sci 2006;28:83‑6.
    22. Abuidhail J, Abujilban S. Characteristics of Jordanian depressed
    pregnant women: A comparison study. J Psychiatr Ment Health
    Nurs 2014;21:573‑9.
    23. Ratcliff BG, Sharapova A, Suardi F, Borel F. Factors associated with
    antenatal depression and obstetric complications in immigrant
    women in Geneva. Midwifery 2015;31:871‑8.
    24. Srinivasan N, Murthy S, Singh AK, Upadhyay V, Mohan SK,
    Joshi A, et al. Assessment of burden of depression during
    pregnancy among pregnant women residing in rural setting of
    Chennai. J Clin Diagn Res 2015;9:LC08‑12.
    25. Schmied V, Johnson M, Naidoo N, Austin MP, Matthey S, Kemp L,
    et al. Maternal mental health in Australia and New Zealand:
    A review of longitudinal studies. Women Birth 2013;26:167‑78.
    26. Agostini F, Neri E, Salvatori P, Dellabartola S, Bozicevic L,
    Monti F, et al. Antenatal depressive symptoms associated with
    specific life events and sources of social support among Italian
    women. Matern Child Health J 2015;19:1131‑41.
    27. Karmaliani R, Asad N, Bann CM, Moss N, Mcclure EM, Pasha O,
    et al. Prevalence of anxiety, depression and associated factors
    among pregnant women of Hyderabad, Pakistan. Int J Soc
    Psychiatry 2009;55:414‑24.
    28. Groves AK, Kagee A, Maman S, Moodley D, Rouse P. Associations
    between intimate partner violence and emotional distress among
    pregnant women in Durban, South Africa. J Interpers Violence
    2012;27:1341‑56.
    29. Marchesi C, Bertoni S, Maggini C. Major and minor depression
    in pregnancy. Obstet Gynecol 2009;113:1292‑8.
    30. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the
    women at risk of antenatal anxiety and depression: A systematic
    review. J Affect Disord 2016;191:62‑77.
    31. Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM,
    et al. Risk factors for depressive symptoms during pregnancy:
    A systematic review. Am J Obstet Gynecol 2010;202:5‑14.
  2. 32. Bergner A, Beyer R, Klapp BF, Rauchfuss M. Pregnancy after
    early pregnancy loss: A prospective study of anxiety, depressive
    symptomatology and coping. J Psychosom Obstet Gynaecol
    2008;29:105‑13.
    33. Gong X, Hao J, Tao F, Zhang J, Wang H, Xu R, et al. Pregnancy
    loss and anxiety and depression during subsequent pregnancies:
    Data from the C‑ABC study. Eur J Obstet Gynecol Reprod Biol
    2013;166:30‑6.
    34. Marston C. Report of a WHO Technical Consultation on Birth
    Spacing Geneva Switzerland, 13‑15 June 2005; 2007.
    35. Froozanfar S, Majlessi F, Rahimi FA, Pourreza A. Assessment
    of the relationship between empowerment and reproductive
    behavior. J Daneshvar Med 2012;18:1‑9.
    36. Jahdi F, Montazeri A, Balouchi M, Behboodi MZ. The impact of
    group prenatal care on pregnant women empowerment. Payesh
    2014;13:229‑34.
    37. Malhotra A, Schuler SR. Women’s empowerment as a variable
    in international development. Measuring Empowerment:
    Cross‑Disciplinary Perspectives.edited by Deepa Narayan: The
    world bank; 2005. p. 71‑88.
    38. Abada T, Tenkorang EY. Women’s autonomy and unintended
    pregnancies in the Philippines. J Biosoc Sci 2012;44:703‑18.
    39. Borghei NS, Taghipour A, Roudsari RL, Keramat A. Development
    and validation of a new tool to measure Iranian pregnant women’s
    empowerment. East Mediterr Health J 2016;21:897‑905.
    40. McIntosh CA, Finkle JL. The Cairo conference on population and
    development: A new paradigm? Population and Development
    Review 21, 1995; No 2: 223‑60.
    41. Abbott MW, Williams MM. Postnatal depressive symptoms
    among pacific mothers in Auckland: Prevalence and risk factors.
    Aust N Z J Psychiatry 2006;40:230‑8.
    42. Cunningham K, Ruel M, Ferguson E, Uauy R. Women’s
    empowerment and child nutritional status in South Asia:
    A synthesis of the literature. Matern Child Nutr 2015;11:1‑9.
    43. Cohen A, Raja S, Underhill C, Yaro BP, Dokurugu AY, De Silva M,
    et al. Sitting with others: Mental health self‑help groups in
    Northern Ghana. Int J Ment Health Syst 2012;6:1.
Journal of Education and Health Promotion
Volume 8, Issue 12
December 2018
Pages 1-7

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us