Screening of antenatal depression in Pakistan: risk factors and effects on obstetric and neonatal outcomes

Introduction: To determine the frequency of probable antenatal depression (AD) in pregnant women in third trimester, assess the risk factors and its impact on obstetric and neonatal outcomes in a developing country. Methods: A prospective study conducted in a tertiary care hospital in Lahore from March 2007 to July 2007. Two hundred and thirteen pregnant women in the third trimester, attending the Gynecology Outpatient Clinic were recruited. They were assessed by a semistructured questionnaire to gather demographic details and various risk factors for AD. AD was assessed by Edinburgh Postnatal Depression Scale. All women were followed until delivery to determine their obstetric and neonatal outcomes. Results: Out of 213 women, 91 (42.7%) scored above the cut‐off for AD. More women with depression reported problems in their marriage, problems with parents/in laws, history of domestic violence, past history of psychiatric problems and history of postnatal depression. In the obstetric risk factors history of previous miscarriages, stillbirths, and complications in previous pregnancy reached statistical significance. Thirty‐seven (17.3%) women were lost to follow up. Women with AD had more obstetric complications during delivery. Babies of mothers with AD had significantly low birth weight, as well as low mean APGAR scores at 1 and 5 minutes following birth. Discussion: AD is a common problem in Pakistani Society. In view of the risk factors and adverse outcomes associated with depression during pregnancy, there is need for close liaison between Gynaecologists and Psychiatrists in managing these patients.