Frequency of Antenatal Depressive Symptoms and Their Determinants among Pregnant Women Attending Antenatal Clinic at Northwest General Hospital
Antenatal Depressive Symptoms and Determinants among Pregnant Women
DOI:
https://doi.org/10.54393/pjhs.v7i10.4234Keywords:
Antenatal Depressive Symptoms, Risk Factors, Socioeconomic Factors, Antenatal ClinicAbstract
Antenatal depressive symptoms (ADS) are common and are associated with significant consequences for both mother and fetus. Its burden is particularly high in low- and middle-income countries, yet routine screening remains limited in Pakistan. Objectives: To determine the trimester-wise frequency of antenatal depressive symptoms and their determinants among pregnant women attending a tertiary care hospital in Peshawar through prospective follow-up across pregnancy. Methods: This prospective cohort study was conducted from 01 April 2024 to 01 December 2025 at Northwest General Hospital, Peshawar,.including a complete-case cohort of 384 pregnant women aged ≥15 years (435 screened at baseline). ADS, defined as a PHQ-9 score ≥5 (a screening threshold, not a diagnosis of depression), were assessed in all three trimesters. Data were analyzed using SPSS version 25.0. Descriptive statistics were applied, and associations were evaluated using Chi-square. Repeated measures ANOVA assessed changes in mean PHQ-9 scores across trimesters, and multivariable logistic regression was performed to identify independent predictors of third-trimester antenatal depressive symptoms. (p≤0.05). Results: frequency of ADS increased significantly from 19.3% in the first trimester to 34.4% in the second and 47.4% in the third trimester (p<0.001). Third-trimester ADS were more frequent among women with unplanned pregnancy (64.9%), miscarriage (65.1%), stillbirth (70.8%), non-supportive spouse (79.6%), prior depression (81.3%), and antenatal care dissatisfaction (72.1%) (p≤0.002). Independent predictors of third-trimester ADS included prior depression (AOR=4.5), non-supportive spouse (AOR=3.8), pregnancy complications (AOR=2.9), antenatal care dissatisfaction (AOR=2.6), low socioeconomic status (AOR=2.3), and unplanned pregnancy (AOR=2.1). Conclusions: Self-reported antenatal depressive symptoms are common and increase across pregnancy..Targeted identification of women with these risk factors, using a validated tool such as the PHQ-9 followed by clinical evaluation, may support timely psychosocial care; studies using diagnostic interviews are needed before routine screening is recommended.
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