Prevalence of Depression and its Risk Factors in Antenatal

Women consulting at the Outpatient Department of the

UERMMMCIAclan Agbanlog Agoncillo, K Agoncillo, L Alianza

Ame Ancheta Ang Ping Ang, A Ang, V

Pregnancy is a time of joy and excitement..

Many studies are now stating that depression is becoming a common thing in pregnancy.

Depression is the psychopathological feeling of sadness due to a primary or secondary cause (Sadock and Sadock 2003), and it is common during pregnancy for women to succumb to feelings of loneliness, sadness, and guilt.

• Depression during pregnancy negatively affects fetal health (Bonari et al 2003), since the mother may have:

o poor appetiteo show suicidal or destructive behaviour and,o resort to vices that could lead to pre-term labor

and poorer APGAR scores (Berle et al 2005).

• Neonates born from depressed mothers have decreased serotonin and dopamine levels (Lundy et al 1999; Field et al 2003) and increased cortisol levels (Kean and Marsh 2007; Lundy et al 1999),

• Results in low birth weights and higher susceptibility to concurrent infections.

• Increased cortisol levels are also associated with predisposition of the child to increased insulin resistance (Philipps et al 1998).

• Moreover, it may affect the mother relationship to the child and have emotional cognitive and behavioural consequences.

SIGNIFICANCE of the STUDY

GENERAL OBJECTIVE

• This study is designed to determine the prevalence and pattern of occurrence of antenatal depression among Filipino women consulting at the UERMMMC Outpatient department from April to May of 2010.

SPECIFIC OBJECTIVES

• To determine the prevalence of antepartum depression of pregnant Filipino Women consulting at the OPD of UERMMMCI.

• To determine the association of the following identified risk factors associated with antenatal depression:

ₒ Ageₒ Marital statusₒ Social supportₒ Personal or family history of depressionₒ Socioeconomic statusₒ Substance abuse

METHODOLOGY

Descriptive cross sectional design

Population: all pregnant women, capable of reading and understanding the questionnaire, and who consulted at the UERMMMCI Department of

Obstetrics and Gynecology Outpatient Department between April 21 to May 28 2010.

Consent Form

Assisted questionnaire: demographic data, source of social support, history of psychiatric consult, problems with substance abuse and

Patient Health Questionnaire 9 (PHQ – 9)

PHQ – 9 was assessed :o 5-9 have minimal symptomso 10-14 could either have minor depression,

dysthymia, mild major depressiono 15-19 have moderately severe major depressiono 20-severe major depressiono ≥ 10 or those with suicidal ideation was

REFERRED

Data was then compiled and processed by STATA ver. 9.

RESULTS and DISCUSSION

Table 2. Summary of Crude Analysis of the Association Between Selected Independent Variables and Depression.

Independent Variable RR 95% CI p-value

Marital Status

Single 0.92 0.93-1.1 0.774

Married 0.91 - -

Age      

≤ 29 0.90 0.94-1.12 0.501

≥ 30 0.92 - -

Social Support b1b

With 0.92 - -

Without 1.00 1.02-1.16 0.765

Personal/Family History of Depression

With 1.00 1.05-1.14 0.602

Without 0.92 - -

Socioeconomic Status

Low 0.90 0.79-1.21 0.831

Adequate 0.92 - -

Substance Abuse

Yes 1.00 1.05-1.14 0.601

No 0.92 - -

Level of DifficultyWith 0.99 1.04-1.20 0.012

Without 0.89 - -

 Table3. Summary of Multiple Regression Analysis of the Association Between Selected Independent Variables and Depression

Independent Variable OR 95% CI p-value

Marital Status

Single 0.59 0.10-3.40 0.478

Married - - -

Age      

≤ 29 1.56 0.26-9.28 0.622

≥ 30 - - -

Economic Status

<PhP5,000.00 3.44 0.33-35.29 0.297

>PhP5,000.00 - - -

RESULTS• The percent of married and single parents among

the respondents were almost equal (52% and 47% respectively).

• INCOME: those earning above and below PhP10,000.00 have equal distribution, though among the respondents there is about 23% with earnings below PhP5,000.00 (below the minimum food level of PhP6,000 according to the NSCB) .

• 179 out of 195 : minimal signs to severe signs of depression based on their PHQ – 9 scores.

• 47% have minimal • 32% mild symptoms• 4% moderate to severe • 1% severe

Marital Status and Depression

• 52% Married individuals with depression

• 47%, Single with depression• 1% have consulted with a psychiatrist

Monthly Income and Depression• 50% belong to the group with monthly

earnings between PhP5,000-9,999 • 25% and PhP10,000-14,999 • 21% PhP1000-4,999 • 16% PhP15,000-20,000 • and those with monthly earnings

<PhP1,000 or >PhP20,000 with 5% each.

Substance Abuse and Depression1.6% of those with symptoms of depression were exposed to substance abuse.

Social Support and DepressionAmong those suffering from depression, the majority came from those who had support (96%) and those individuals with support, majority of them has no difficulty in functioning.

History of Psychiatric ConsultationOnly 3 individuals (1%) out of the 179 previously consulted a psychiatrist about their problems.

Depression and Trimester of Pregnancy 42% last trimester38% 2nd trimester14% 1st trimester

AGE 58%, 29 years oldLevel of Depression and Difficulty of

Functioning• Mild difficulty in functioning 21%• Minimal 8%• Moderate 6%• Moderately severe 2%• Severe , 0.5%

SUMMARY and CONCLUSION

• In April 21 to May 28, 2010,out of 195 participants, 179 presented with signs and symptoms of depression,

• Age range of 26-30, Married• Income: PhP5,000.00-9,000.00 and PhP10,000.00-

14,999.00. • History of Psychiatric Consultation 1%• Majority have minimal symptoms• Risk Factors were found insignificant, though in multiple

regression analysis: economic status (in terms: of adequacy of income) and age was found to have positive trending but were still statistically insignificant.

RECOMMENDATIONS• Longer duration and coverage of

study• Different Locations of study