Published online Aug 19, 2022. doi: 10.5498/wjp.v12.i8.1061
Peer-review started: October 4, 2021
First decision: December 12, 2021
Revised: January 8, 2022
Accepted: July 18, 2022
Article in press: July 18, 2022
Published online: August 19, 2022
Depression is a common problem in women in childbearing years due to burdens of motherhood and building a family. Few studies estimate the prevalence of antepartum depression compared to those in the postpartum period.
To estimate the prevalence and the severities of peripartum depression and major depressive disorder and their predictors.
This is a longitudinal observation study. It included 200 women scoring ≥ 13 with the Edinburgh Postpartum Depression Scale, indicating presence of symptoms of depression. They had a gestational age of ≥ 6 wk and did follow-ups until the 10th week to 12th weeks postpartum. Information of women's reactions to life circumstances and stressors during the current pregnancy were gathered from answers to questions of the designed unstructured clinical questionnaire. Severities of depression, anxiety, and parenting stress were determined by the Beck Depre-ssion Inventory, State-Trait Anxiety Inventory for Adults, and Parenting Stress Index-Short Form, respectively. Psychiatric interviewing was done to confirm the diagnosis of major depression. Measuring the levels of triiodothronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) was done in both antepartum and postpartum periods.
Out of 968 (mean age = 27.35 ± 6.42 years), 20.66% (n = 200) of the patients had clinically significant symptoms of depression and 7.44% had major depression. Previous premenstrual dysphoria, post-abortive depression, and depression unrelated to pregnancy and were reported in 43%, 8%, and 4.5% of the patients, respectively. Psychosocial stressors were reported in 15.5% of the patients. Antepartum anxiety and parenting stress were reported in 90.5% and 65% of the patients, respectively. Postpartum T3, T4, and TSH levels did not significantly differ from reference values. Regression analysis showed that anxiety trait was a predictor for antepartum (standardized regression coefficients = 0.514, t = 8.507, P = 0.001) and postpartum (standardized regression coefficients = 0.573, t = 0.040, P = 0.041) depression. Antepartum depression (standardized regression coefficients = -0.086, t = -2.750, P = 0.007), and parenting stress (standardized regression coefficients = 0.080, t = 14.34, P = 0.0001) were also predictors for postpartum depression.
Results showed that 20.66% of the patients had clinically significant symptoms of depression and 7.44% had major depression. Anxiety was a predictor for antepartum and postpartum depression. Antepartum depression and parenting stress were also predictors for postpartum depression.
Core Tip: The prevalence rates of depression and anxiety are higher in pregnant women compared to non-pregnant women because motherhood and family responsibilities represent additional burdens on pregnant woman. The prevalence rate of peripartum depression has been estimated to range from 5%-58% or even higher in different nations; however, meta-analyses studies from different countries and populations reported similar approximated prevalence rates for postpartum, as well as antepartum, depression, which is 10%-16.4%. A unified consensus has been made to use specific screening tools for determination of peripartum depression. The Edinburgh Postpartum Depression Scale is a commonly and widely used 10-item screening questionnaire with an estimated sensitivity of 75%-100% and a specificity of 76%-97%. Here, we estimated the prevalence of antepartum and postpartum depression for Egyptian women and determined their independent risk predictors.