Social Determinants and Prevalence of Antenatal Depression among Women in Rural Bangladesh: A Cross-Sectional Study

Abstract

The prevalence of antenatal depression in Bangladesh ranges from 18 to 33%. Antenatal depression has negative impacts on the mother and child such as suicidal ideations, low birth weight, and impaired fetal development. This cross-sectional study aims to determine the prevalence and social determinants of antenatal depression in rural Sylhet, Bangladesh. Data were collected from 235 pregnant women between March and November 2021. The validated Bangla Edinburgh Postnatal Depression Scale was used to measure antenatal depressive symptoms (ADS). Background information was collected using a structured questionnaire including the Duke Social Support and Stress Scale, pregnancy choices, and WHO Intimate Partner Violence questions. Point-prevalence of antenatal depression was 56%. Intimate partner violence (IPV) before pregnancy (adjusted odds ratio (AOR) 10.4 [95% confidence interval (CI) 2.7–39.7]) and perceived husband’s male gender preference (AOR 9.9 [95% CI 1.6–59.6]) were significantly associated with increased odds of ADS among pregnant women. Increased family support was a significant protective factor for ADS (AOR 0.94 [95% CI 0.91–0.97]). Antenatal depression commonly occurs in rural Sylhet, Bangladesh, highlighting the need for improved screening and management within these settings. The findings suggest the need for community-based interventions for women with low family support and experiencing intimate partner violence, and educational programs and gender policies to tackle gender inequalities.

Prevalence and associated factors of antenatal depression in rural Bangladesh

“…While some studies have identified family support and a preference for the male gender within families as significant contributing factors to prenatal depression (12, 13), this particular study did not observe such associations. It suggests that with the progression of time, contemporary family members may be more attentive and supportive of pregnant mothers than in the past.…”

“…These two groups of women are more likely to be the victims of intimate partner violence (27). This study found intimate partner violence as a significant contributing factor to antenatal depression which is similar to the study conducted by Peltzer et al in Thailand and Insan et al in Bangladesh (12, 28).…”

“…However, in the case of unwanted pregnancies, the rates of mild and severe depression were higher (mild depression: 48.4%, severe depression: 8.8%). Out of the 91 women with a history of unintended pregnancies, 48.4% (44) reported mild depression, 13.2% (12) experienced moderate depression, and 8.8% (8) had severe depression. Additionally, 29.7% (27) showed no or minimal signs of depression.…”

“…The occurrence of depression during pregnancy in Bangladesh varies between 18% and 33% (12), which is not too small. A recent study, carried out in a rural sub-district in Matlab, involving pregnant women at their 34-35 weeks of pregnancy showed a 33% prevalence and the associated factors included an unsupportive husband or mother-in-law, domestic violence, and mental pressure for male gender preference of the family (13).…”

“…A recent study, carried out in a rural sub-district in Matlab, involving pregnant women at their 34-35 weeks of pregnancy showed a 33% prevalence and the associated factors included an unsupportive husband or mother-in-law, domestic violence, and mental pressure for male gender preference of the family (13). A recent cross-sectional study, conducted in rural Sylhet highlighted male gender preference of husband, low family support, and sexual violence as the main associated factors for developing antenatal depression (12).…”