Prevalence of antenatal depression and associated risk factors among pregnant women attending antenatal clinics in Karachi, Pakistan

Objective: To highlight the incidence of undiagnosed depression and evaluate its severity among pregnant Pakistani women and identify its risk factors. Methodology: This cross-sectional study was conducted at Ziauddin University Hospital, Karachi from January 1, to July 31, 2016. All women attending the antenatal clinics for routine follow-up visits were included. Women who were already diagnosed with major depressive disorder (MDD) were excluded. All completed the standardized Patient Health Questionnaire – 9 (PHQ-9) for the screening of depression. Results: Out of 1000 respondents, BMI was overweight for 40.4% of women and obese for 20.5%. There were 59.8% primigravida, 32.6% multigravida, 6.4% grand multigravida, and 1.2% great grand multigravida. In 24.8%, this pregnancy was unplanned. On PHQ-9, 411 had no to minimal depressive symptoms, 332 mild, 214 moderate and 43 had severe MDD. In primigravida, 32.9% had mild depression, in multigravida, 37.1% had mild and 37.7% had moderate depression, in grand multigravida, 31.3% reported severe depression, and in great grand multigravida, 66.7% had severe depression. An increased risk of depression was found in women with a family history of psychiatric illnesses, in those with an unplanned pregnancy, and in those with the previous history of stillbirth and miscarriages. Majority of women 40 years were severely depressed. Conclusion: The prevalence of depression among pregnant women is high and is usually mild. Risk factors were extremes of age, higher gravida, previous history of miscarriage and stillbirth, and unplanned pregnancy.