Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia

Abstract

BackgroundResearch on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers.MethodsWe used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS).ResultsPrevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband’s depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife’s depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers.ConclusionBoth ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.

Motherhood in the Time of Coronavirus: The Impact of the Pandemic Emergency on Expectant and Postpartum Women’s Psychological Well-Being

“…Such figures are extremely relevant, especially if we consider that the highest possible threshold reported in the literature (i.e., 13 or above) has been used as the cut-off value for depression in the current study. When anxiety and depressive symptoms are compared, this study confirms that anxiety is usually more prevalent than depression among expectant mothers as already found in previous studies (Nasreen et al, 2018;van de Loo et al, 2018). However, while depression and anxiety symptoms are quite common among pregnant and postpartum women, the women in our sample were significantly more at risk for developing anxiety and depressive symptoms; these findings suggest that the pandemic and the measures adopted to fight its spread have had a negative impact on expectant and postpartum women' well-being, thus constituting an additional risk factor for this specific population.…”

“…Previous research on pregnant women has extensively studied the impact and prevalence of antenatal anxiety and depression reporting high rates of such conditions across various countries (Biaggi et al, 2016;Falah-Hassani et al, 2017;Nasreen et al, 2018;van de Loo et al, 2018). In this respect, although differences have been reported across studies due to the methodological approaches used, the prevalence of anxiety disorders among pregnant women has been found to be approximately 15% (Dennis et al, 2017).…”

Associations Between Fear of COVID-19, Mental Health, and Preventive Behaviours Across Pregnant Women and Husbands: An Actor-Partner Interdependence Modelling

“…Mental health problems during pregnancy have been reported to have detrimental consequences on the woman and her foetus (Field 2011;Rees et al 2019). Depression and anxiety are the most reported mental health problems among pregnant women (Nasreen et al 2018). The prevalence rate of depression among pregnant women of low-and lower-middle-income countries has been estimated to be 15.6% (Fisher et al 2012).…”

“…This usually occurs with other mental health problems and stressors or poor relationship quality with close family members including husbands (Johnson et al 2018). Although these previous studies mainly focused on pregnant women, few studies have simultaneously explored fathers' mental health when their wives are pregnant (Nasreen et al 2018;Wee et al 2011). Studies have shown that poor couple interaction or poor relationship quality also affects their mental health, such as anxiety or depression symptoms during pregnancy (Figueiredo et al 2018;Røsand et al 2012).…”

Circadian rhythm and its association with birth and infant outcomes: research protocol of a prospective cohort study

“…A valid Malay version of DASS-21 will be used in current study [16]. DASS-21 has been applied in past studies involving pregnant Asian women, including Malaysian pregnant women [17,31].…”