Issue
Authors retain the copyright without restrictions for their published content in this journal. HSSR is a SHERPA ROMEO Green Journal.
Publishing License
This is an open-access article distributed under the terms of
PREVALENCE OF DEPRESSION AND ITS ASSOCIATED FACTORS DURING 2ND WAVE OF COVID-19 AMONG PREGNANT WOMEN IN A TERTIARY CARE HOSPITAL, LAHORE
Corresponding Author(s) : Quratulain Ahsan
Humanities & Social Sciences Reviews,
Vol. 9 No. 3 (2021): May
Abstract
Purpose of the study: Antenatal depression is a significant predictor for postnatal depression, and pregnant women with depressive symptoms have an increased risk of frequent non-scheduled medical and emergency visits. The purpose of this study is to evaluate the antenatal depression and its related factors and effects of the COVID-19 pandemic on the frequency of antenatal visits.
Methodology: A descriptive cross-sectional study was conducted from July to September 2020 with 220 pregnant women from the Gynae Outpatient Department at the Tertiary Care Hospital of Lahore. Women aged 18–45 years with no pregnancy-related complications were included. The Patient Health Questionnaire-9 tool was used to screen for antenatal depression, and a self-structured questionnaire was developed to explore depression-related factors.
Main Findings: Antenatal depression prevalence was found very high among pregnant women during the second wave of Covid-19 and pandemic did not affect regular antenatal visits of women.
Applications of this study: Mental disorders are associated with several individuals and societal factors, including feelings of insecurity and hopelessness, exposure to violence, physical ill health, and rapid social change. The existing pandemic situation, working from home, temporary unemployment, home-schooling of children, lack of contact and social support, it is important to look after mental and physical health especially women in pregnancy who can suffer from more severe mental health problems and can affect ANC visits that directly related to maternal and child health.
Novelty/Originality of this study: Depression in pregnancy is associated with severe complications and prevents patients from taking an active role in their healthcare. Women with depressive symptoms have an increased risk of frequent non-scheduled antenatal care (ANC) visits and emergency healthcare visits for pregnancy-related emergencies especially in the 2nd wave of COVID-19. It was very important to study the factors related to antenatal depression during this pandemic. Counselling and awareness may improve the physical and mental health of pregnant women.
Keywords
Download Citation
Endnote/Zotero/Mendeley (RIS)BibTeX
- Aamir, I. S. (2017). Prevalence of Depression among Pregnant Women Attending Antenatal Clinics in Pakistan. Acta Psychopathologica, 3(5), 3–7. https://doi.org/10.4172/2469-6676.100126 DOI: https://doi.org/10.4172/2469-6676.100126
- Abdulghani, H., & Alharbi, A. (2014). Risk factors associated with postpartum depression in the Saudi population. Neuropsychiatric Disease and Treatment, 10, 311. https://doi.org/10.2147/NDT.S57556 DOI: https://doi.org/10.2147/NDT.S57556
- Al-Hejji, Z., Al-Khudhair, M., Al-Musaileem, M., & Al-Eithan, M. (2019). Prevalence and associated risk factors of antenatal depression among women attending antenatal clinics in primary health care centers in the Ministry of Health in Al-Ahsa City, Saudi Arabia. Journal of Family Medicine and Primary Care, 8(12), 3900. https://doi.org/10.4103/jfmpc.jfmpc_724_19 DOI: https://doi.org/10.4103/jfmpc.jfmpc_724_19
- Alder, J., Fink, N., Bitzer, J., Hösli, I., & Holzgreve, W. (2007). Depression and anxiety during pregnancy: A risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. Journal of Maternal-Fetal and Neonatal Medicine, 20(3), 189-209. https://doi.org/10.1080/14767050701209560 DOI: https://doi.org/10.1080/14767050701209560
- Belay, Y. A., Moges, N. A., Hiksa, F. F., Arado, K. K., & Liben, M. L. (2018). Prevalence of Antenatal Depression and Associated Factors among Pregnant Women Attending Antenatal Care at Dubti Hospital: A Case of Pastoralist Region in Northeast Ethiopia. Depression Research and Treatment, 2018, 1–9. https://doi.org/10.1155/2018/1659089 DOI: https://doi.org/10.1155/2018/1659089
- Chowdhary, N., & Psychiatrist, C. (2014). Best Practice & Research Clinical Obstetrics and Gynaecology The content and delivery of psychological interventions for perinatal depression by non-specialist health workers in low and middle income countries : A systematic review. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 113–133. https://doi.org/10.1016/j.bpobgyn.2013.08.013 DOI: https://doi.org/10.1016/j.bpobgyn.2013.08.013
- Chen, J., Cross, W. M., Plummer, V., Lam, L., Sun, M., Qin, C., & Tang, S. (2019). The risk factors of antenatal depression: A cross-sectional survey. Journal of Clinical Nursing, 28(19–20), 3599–3609. https://doi.org/10.1111/jocn.14955 DOI: https://doi.org/10.1111/jocn.14955
- Dayan, F., Javadifar, N., Tadayon, M., Malehi, A. S., & Komeili Sani, H. (2018). The Relationship between Gestational Weight Gain and Postpartum Depression in Normal and Overweight Pregnant Women. Journal of Pregnancy, 2018, 1–6. https://doi.org/10.1155/2018/9315320 DOI: https://doi.org/10.1155/2018/9315320
- Fathi-Ashtiani, A., Ahmadi, A., Ghobari-Bonab, B., Azizi, M. P., & Saheb-Alzamani, S. M. (2015). Randomized Trial of Psychological Interventions to Preventing Postpartum Depression among Iranian First-time Mothers. International Journal of Preventive Medicine, 6(1),1-7. https://doi.org/10.4103/2008-7802.169078 DOI: https://doi.org/10.4103/2008-7802.169078
- Faisal-Cury, A., & Rossi Menezes, P. (2007). Prevalence of anxiety and depression during pregnancy in a private setting sample. Archives of Women’s Mental Health, 10(1), 25–32. https://doi.org/10.1007/s00737-006-0164-6 DOI: https://doi.org/10.1007/s00737-006-0164-6
- Field, T. (2017). Prenatal Depression Risk Factors, Developmental Effects and Interventions: A Review. Journal of Pregnancy and Child Health, 4(1), 1-25. https://doi.org/10.4172/2376-127X.1000301 DOI: https://doi.org/10.4172/2376-127X.1000301
- Gallis, J. A., Maselko, J., O’Donnell, K., Song, K., Saqib, K., Turner, E. L., & Sikander, S. (2018). Criterion-related validity and reliability of the Urdu version of the patient health questionnaire in a sample of community-based pregnant women in Pakistan. PeerJ, 6(7), 2-16. https://doi.org/10.7717/peerj.5185 DOI: https://doi.org/10.7717/peerj.5185
- Health, (2016). Ethnic Minorities and Mental Health: Guidelines for mental health services and staff on working with people from ethnic minority communities.
- Humayun, A., Haider, I. I., Imran, N., Iqbal, H., & Humayun, N. (2013). Antenatal depression and its predictors in Lahore, Pakistan. Eastern Mediterranean Health Journal, 19(4), 327–332. https://doi.org/10.2 6719/2013.19.4.327 DOI: https://doi.org/10.26719/2013.19.4.327
- Hussain, S. I. S. S. U. M. U. Y. S. (2020). Prevalence of antenatal depression and associated risk factors among pregnant women attending antenatal clinics in Karachi, Pakistan. Rawal Medical Journal, 45(2), 434–438.
- Jacob et al (2007). Mental health systems in countries: where are we now? Lancet, 370(9592), 1061-1077. https://doi.org/10.1016/S0140-6736(07)61241-0 DOI: https://doi.org/10.1016/S0140-6736(07)61241-0
- Javed, Khan, M. N. S., Nasar, A., & Rasheed, A. (2020). Mental healthcare in Pakistan. Taiwanese Journal of Psychiatry, 34(1), 6. DOI: https://doi.org/10.1097/01.ccm.0000726292.18727.28
- Jooma, R., Minhas, F. A., & Saxena, S. (2009). WHO-AIMS Report on Menal Health Institutes in Pakistan, 79–92.
- Karmaliani et al (2009). Prevalence of anxiety, depression and associated factors among pregnant women of Hyderabad, Pakistan. International Journal of Social Psychiatry, 55(5), 414–424. https://doi.org/1 0.1177/0020764008094645 DOI: https://doi.org/10.1177/0020764008094645
- Kotlar, B., Gerson, E., Petrillo, S., Langer, A., & Tiemeier, H. (2021). The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review. Reproductive Health. BioMed Central Ltd. https://doi.org/10.1186/s12978-021-01070-6 DOI: https://doi.org/10.21203/rs.3.rs-96736/v1
- Kaiyo-Utete, M., Dambi, J. M., Chingono, A., Mazhandu, F. S. M., Madziro-Ruwizhu, T. B., Henderson, C., Magwali, T., Langhaug, L., & Chirenje, Z. M. (2020). Antenatal depression: An examination of prevalence and its associated factors among pregnant women attending Harare polyclinics. BMC Pregnancy and Childbirth, 20(1), 197. https://doi.org/10.1186/s12884-020-02887-y DOI: https://doi.org/10.1186/s12884-020-02887-y
- Marcos-Nájera, R., RodrÃguez-Muñoz, M. de la F., Soto Balbuena, C., Olivares Crespo, M. E., Izquierdo Méndez, N., Le, H.-N., & Escudero Gomis, A. (2019). The Prevalence and Risk Factors for Antenatal Depression Among Pregnant Immigrant and Native Women in Spain. Journal of Transcultural Nursing : Official Journal of the Transcultural Nursing Society, 31(6), 564-575. https://doi.org/10.117 7/1043659619891234 DOI: https://doi.org/10.1177/1043659619891234
- Patel, V., & Kleinman, A. (2003). Poverty and common mental disorders in developing countries. Bulletin of the World Health Organization, 81(8), 609–615.
- Rahman, A., Khan, M. N., Hamdani, S. U., Chiumento, A., Akhtar, P., Nazir, H., Nisar, A., Masood, A., Din, I. U., Khan, N. A., Bryant, R. A., Dawson, K. S., Sijbrandij, M., Wang, D., & van Ommeren, M. (2019). Effectiveness of a brief group psychological intervention for women in a post-conflict setting in Pakistan: a single-blind, cluster, randomised controlled trial. The Lancet, 393(10182), 1733–1744. https://doi.org/10.1 016/S0140-6736(18)32343-2 DOI: https://doi.org/10.1016/S0140-6736(18)32343-2
- Rahman, A., Bunn, J., Lovel, H., & Creed, F. (2007). Association between antenatal depression and low birthweight in a developing country. Acta Psychiatrica Scandinavica, 115(6), 481–486. https://doi.org/10.1111/j.1600-0447.2006.00950.x DOI: https://doi.org/10.1111/j.1600-0447.2006.00950.x
- Rahman, Atif, Iqbal, Z., & Harrington, R. (2003). Life events, social support and depression in childbirth: Perspectives from a rural community in the developing world. Psychological Medicine, 33(7), 1161–1167. https://doi.org/10.1017/S0033291703008286 DOI: https://doi.org/10.1017/S0033291703008286
- Rathod et al (2017). Mental Health Service Provision in Low- and Middle-Income Countries. Health Services Insights, 10, 1–7. https://doi.org/10.1177/1178632917694350 DOI: https://doi.org/10.1177/1178632917694350
- Roozbeh, N., Nahidi, F., & Hajiyan, S. (2016). Barriers related to prenatal care utilization among women. Saudi Medical Journal, 37(12), 1319–1327. https://doi.org/10.15537/smj.2016.12.15505 DOI: https://doi.org/10.15537/smj.2016.12.15505
- Roshaidai Mohd Arifin, S., Cheyne, H., & Maxwell, M. (2018). Review of the prevalence of postnatal depression across cultures. AIMS Public Health, 5(3), 260–295. https://doi.org/10.3934/publichealth.2018.3.260 DOI: https://doi.org/10.3934/publichealth.2018.3.260
- Reid, K. M., & Taylor, M. G. (2015). Social support, stress, and maternal postpartum depression: A comparison of supportive relationships. Social Science Research, 54, 246–262. https://doi.org/10.1016/j.ss research.2015.08.009 DOI: https://doi.org/10.1016/j.ssresearch.2015.08.009
- Rich-Edwards et al (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology and Community Health, 60(3), 221–227. https://doi.org/10.1136/jech.2005.039370 DOI: https://doi.org/10.1136/jech.2005.039370
- Sarfraz, M., Tariq, S., Hamid, S., & Iqbal, N. (2015). Social and Societal Barriers in Utlization of Maternal Health Care Services in Rural Punjab, Pakistan. J Ayub Med Coll Abbottabad, 27(4), 843–849.
- Saeed, A., Raana, T., Saeed, A. M., & Humayun, A. (2016). Effect of antenatal depression on maternal dietary intake and neonatal outcome: A prospective cohort. Nutrition Journal, 15(1), 1–9. https://doi.org/10.11 86/s12937-016-0184-7
- Sleath, B., West, S., Tudor, G., Perreira, K., King, V., & Morrissey, J. (2005). Ethnicity and prenatal depression: Women’s experiences and perspectives on communicating about their emotions and feelings during pregnancy. Patient Education and Counseling, 58(1), 35–40. https://doi.org/10.1016/j.pec.2004.03.019 DOI: https://doi.org/10.1016/j.pec.2004.03.019
- Stein et al (2014). Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800-1819. https://doi.org/10.1016/S0140-6736(14)61277-0 DOI: https://doi.org/10.1016/S0140-6736(14)61277-0
- Straub, H., Adams, M., Kim, J. J., & Silver, R. K. (2012). Antenatal depressive symptoms increase the likelihood of preterm birth. American Journal of Obstetrics and Gynecology, 207(4), 329. https://doi.org/10.10 16/j.ajog.2012.06.033 DOI: https://doi.org/10.1016/j.ajog.2012.06.033
- The American College of Obstetricians and Gynecologist. (2018). Screening for Perinatal Depression. Replaces Committee Opinion, 132(757), 208–212. https://doi.org/10.1097/AOG.0000000000002927 DOI: https://doi.org/10.1097/AOG.0000000000002927
- Unicef. (2016). Maternal and Newborn Health Disparities (Pakistan).
- Uwambaye, P., Nyiringango, G., Musabwasoni, S. M. G., Husain, A., Nessa, K., & Razzaque, M. S. (2020). COVID-19 Pandemic: Adaptation in Antenatal Care for Better Pregnancy Outcomes. Frontiers in Global Women’s Health, 1, 1-7. https://doi.org/10.3389/fgwh.2020.599327 DOI: https://doi.org/10.3389/fgwh.2020.599327
- Wainberg et al (2017). Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective. Current Psychiatry Reports, 19(5), 28. https://doi.org/10.1007/s11920-017-0780-z DOI: https://doi.org/10.1007/s11920-017-0780-z
- Waqas, A., Raza, N., Lodhi, H. W., Muhammad, Z., Jamal, M., & Rehman, A. (2015). Psychosocial Factors of Antenatal Anxiety and Depression in Pakistan: Is Social Support a Mediator? PLOS ONE, 10(1), 1-14. https://doi.org/10.1371/journal.pone.0116510 DOI: https://doi.org/10.1371/journal.pone.0116510
- Williams et al (2016). Vitamin D levels and perinatal depressive symptoms in women at risk: A secondary analysis of the mothers, omega-3, and mental health study. BMC Pregnancy and Childbirth, 16(1), 1–9. https://doi.org/10.1186/s12884-016-0988-7 DOI: https://doi.org/10.1186/s12884-016-0988-7
- Woldetensay et al (2018). Validation of the Patient Health Questionnaire (PHQ-9) as a screening tool for depression in pregnant women: Afaan Oromo version. PLOS ONE, 13(2), 1-15. https://doi.org/10.137 1/journal.pone.0191782 DOI: https://doi.org/10.1371/journal.pone.0191782
References
Aamir, I. S. (2017). Prevalence of Depression among Pregnant Women Attending Antenatal Clinics in Pakistan. Acta Psychopathologica, 3(5), 3–7. https://doi.org/10.4172/2469-6676.100126 DOI: https://doi.org/10.4172/2469-6676.100126
Abdulghani, H., & Alharbi, A. (2014). Risk factors associated with postpartum depression in the Saudi population. Neuropsychiatric Disease and Treatment, 10, 311. https://doi.org/10.2147/NDT.S57556 DOI: https://doi.org/10.2147/NDT.S57556
Al-Hejji, Z., Al-Khudhair, M., Al-Musaileem, M., & Al-Eithan, M. (2019). Prevalence and associated risk factors of antenatal depression among women attending antenatal clinics in primary health care centers in the Ministry of Health in Al-Ahsa City, Saudi Arabia. Journal of Family Medicine and Primary Care, 8(12), 3900. https://doi.org/10.4103/jfmpc.jfmpc_724_19 DOI: https://doi.org/10.4103/jfmpc.jfmpc_724_19
Alder, J., Fink, N., Bitzer, J., Hösli, I., & Holzgreve, W. (2007). Depression and anxiety during pregnancy: A risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. Journal of Maternal-Fetal and Neonatal Medicine, 20(3), 189-209. https://doi.org/10.1080/14767050701209560 DOI: https://doi.org/10.1080/14767050701209560
Belay, Y. A., Moges, N. A., Hiksa, F. F., Arado, K. K., & Liben, M. L. (2018). Prevalence of Antenatal Depression and Associated Factors among Pregnant Women Attending Antenatal Care at Dubti Hospital: A Case of Pastoralist Region in Northeast Ethiopia. Depression Research and Treatment, 2018, 1–9. https://doi.org/10.1155/2018/1659089 DOI: https://doi.org/10.1155/2018/1659089
Chowdhary, N., & Psychiatrist, C. (2014). Best Practice & Research Clinical Obstetrics and Gynaecology The content and delivery of psychological interventions for perinatal depression by non-specialist health workers in low and middle income countries : A systematic review. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 113–133. https://doi.org/10.1016/j.bpobgyn.2013.08.013 DOI: https://doi.org/10.1016/j.bpobgyn.2013.08.013
Chen, J., Cross, W. M., Plummer, V., Lam, L., Sun, M., Qin, C., & Tang, S. (2019). The risk factors of antenatal depression: A cross-sectional survey. Journal of Clinical Nursing, 28(19–20), 3599–3609. https://doi.org/10.1111/jocn.14955 DOI: https://doi.org/10.1111/jocn.14955
Dayan, F., Javadifar, N., Tadayon, M., Malehi, A. S., & Komeili Sani, H. (2018). The Relationship between Gestational Weight Gain and Postpartum Depression in Normal and Overweight Pregnant Women. Journal of Pregnancy, 2018, 1–6. https://doi.org/10.1155/2018/9315320 DOI: https://doi.org/10.1155/2018/9315320
Fathi-Ashtiani, A., Ahmadi, A., Ghobari-Bonab, B., Azizi, M. P., & Saheb-Alzamani, S. M. (2015). Randomized Trial of Psychological Interventions to Preventing Postpartum Depression among Iranian First-time Mothers. International Journal of Preventive Medicine, 6(1),1-7. https://doi.org/10.4103/2008-7802.169078 DOI: https://doi.org/10.4103/2008-7802.169078
Faisal-Cury, A., & Rossi Menezes, P. (2007). Prevalence of anxiety and depression during pregnancy in a private setting sample. Archives of Women’s Mental Health, 10(1), 25–32. https://doi.org/10.1007/s00737-006-0164-6 DOI: https://doi.org/10.1007/s00737-006-0164-6
Field, T. (2017). Prenatal Depression Risk Factors, Developmental Effects and Interventions: A Review. Journal of Pregnancy and Child Health, 4(1), 1-25. https://doi.org/10.4172/2376-127X.1000301 DOI: https://doi.org/10.4172/2376-127X.1000301
Gallis, J. A., Maselko, J., O’Donnell, K., Song, K., Saqib, K., Turner, E. L., & Sikander, S. (2018). Criterion-related validity and reliability of the Urdu version of the patient health questionnaire in a sample of community-based pregnant women in Pakistan. PeerJ, 6(7), 2-16. https://doi.org/10.7717/peerj.5185 DOI: https://doi.org/10.7717/peerj.5185
Health, (2016). Ethnic Minorities and Mental Health: Guidelines for mental health services and staff on working with people from ethnic minority communities.
Humayun, A., Haider, I. I., Imran, N., Iqbal, H., & Humayun, N. (2013). Antenatal depression and its predictors in Lahore, Pakistan. Eastern Mediterranean Health Journal, 19(4), 327–332. https://doi.org/10.2 6719/2013.19.4.327 DOI: https://doi.org/10.26719/2013.19.4.327
Hussain, S. I. S. S. U. M. U. Y. S. (2020). Prevalence of antenatal depression and associated risk factors among pregnant women attending antenatal clinics in Karachi, Pakistan. Rawal Medical Journal, 45(2), 434–438.
Jacob et al (2007). Mental health systems in countries: where are we now? Lancet, 370(9592), 1061-1077. https://doi.org/10.1016/S0140-6736(07)61241-0 DOI: https://doi.org/10.1016/S0140-6736(07)61241-0
Javed, Khan, M. N. S., Nasar, A., & Rasheed, A. (2020). Mental healthcare in Pakistan. Taiwanese Journal of Psychiatry, 34(1), 6. DOI: https://doi.org/10.1097/01.ccm.0000726292.18727.28
Jooma, R., Minhas, F. A., & Saxena, S. (2009). WHO-AIMS Report on Menal Health Institutes in Pakistan, 79–92.
Karmaliani et al (2009). Prevalence of anxiety, depression and associated factors among pregnant women of Hyderabad, Pakistan. International Journal of Social Psychiatry, 55(5), 414–424. https://doi.org/1 0.1177/0020764008094645 DOI: https://doi.org/10.1177/0020764008094645
Kotlar, B., Gerson, E., Petrillo, S., Langer, A., & Tiemeier, H. (2021). The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review. Reproductive Health. BioMed Central Ltd. https://doi.org/10.1186/s12978-021-01070-6 DOI: https://doi.org/10.21203/rs.3.rs-96736/v1
Kaiyo-Utete, M., Dambi, J. M., Chingono, A., Mazhandu, F. S. M., Madziro-Ruwizhu, T. B., Henderson, C., Magwali, T., Langhaug, L., & Chirenje, Z. M. (2020). Antenatal depression: An examination of prevalence and its associated factors among pregnant women attending Harare polyclinics. BMC Pregnancy and Childbirth, 20(1), 197. https://doi.org/10.1186/s12884-020-02887-y DOI: https://doi.org/10.1186/s12884-020-02887-y
Marcos-Nájera, R., RodrÃguez-Muñoz, M. de la F., Soto Balbuena, C., Olivares Crespo, M. E., Izquierdo Méndez, N., Le, H.-N., & Escudero Gomis, A. (2019). The Prevalence and Risk Factors for Antenatal Depression Among Pregnant Immigrant and Native Women in Spain. Journal of Transcultural Nursing : Official Journal of the Transcultural Nursing Society, 31(6), 564-575. https://doi.org/10.117 7/1043659619891234 DOI: https://doi.org/10.1177/1043659619891234
Patel, V., & Kleinman, A. (2003). Poverty and common mental disorders in developing countries. Bulletin of the World Health Organization, 81(8), 609–615.
Rahman, A., Khan, M. N., Hamdani, S. U., Chiumento, A., Akhtar, P., Nazir, H., Nisar, A., Masood, A., Din, I. U., Khan, N. A., Bryant, R. A., Dawson, K. S., Sijbrandij, M., Wang, D., & van Ommeren, M. (2019). Effectiveness of a brief group psychological intervention for women in a post-conflict setting in Pakistan: a single-blind, cluster, randomised controlled trial. The Lancet, 393(10182), 1733–1744. https://doi.org/10.1 016/S0140-6736(18)32343-2 DOI: https://doi.org/10.1016/S0140-6736(18)32343-2
Rahman, A., Bunn, J., Lovel, H., & Creed, F. (2007). Association between antenatal depression and low birthweight in a developing country. Acta Psychiatrica Scandinavica, 115(6), 481–486. https://doi.org/10.1111/j.1600-0447.2006.00950.x DOI: https://doi.org/10.1111/j.1600-0447.2006.00950.x
Rahman, Atif, Iqbal, Z., & Harrington, R. (2003). Life events, social support and depression in childbirth: Perspectives from a rural community in the developing world. Psychological Medicine, 33(7), 1161–1167. https://doi.org/10.1017/S0033291703008286 DOI: https://doi.org/10.1017/S0033291703008286
Rathod et al (2017). Mental Health Service Provision in Low- and Middle-Income Countries. Health Services Insights, 10, 1–7. https://doi.org/10.1177/1178632917694350 DOI: https://doi.org/10.1177/1178632917694350
Roozbeh, N., Nahidi, F., & Hajiyan, S. (2016). Barriers related to prenatal care utilization among women. Saudi Medical Journal, 37(12), 1319–1327. https://doi.org/10.15537/smj.2016.12.15505 DOI: https://doi.org/10.15537/smj.2016.12.15505
Roshaidai Mohd Arifin, S., Cheyne, H., & Maxwell, M. (2018). Review of the prevalence of postnatal depression across cultures. AIMS Public Health, 5(3), 260–295. https://doi.org/10.3934/publichealth.2018.3.260 DOI: https://doi.org/10.3934/publichealth.2018.3.260
Reid, K. M., & Taylor, M. G. (2015). Social support, stress, and maternal postpartum depression: A comparison of supportive relationships. Social Science Research, 54, 246–262. https://doi.org/10.1016/j.ss research.2015.08.009 DOI: https://doi.org/10.1016/j.ssresearch.2015.08.009
Rich-Edwards et al (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology and Community Health, 60(3), 221–227. https://doi.org/10.1136/jech.2005.039370 DOI: https://doi.org/10.1136/jech.2005.039370
Sarfraz, M., Tariq, S., Hamid, S., & Iqbal, N. (2015). Social and Societal Barriers in Utlization of Maternal Health Care Services in Rural Punjab, Pakistan. J Ayub Med Coll Abbottabad, 27(4), 843–849.
Saeed, A., Raana, T., Saeed, A. M., & Humayun, A. (2016). Effect of antenatal depression on maternal dietary intake and neonatal outcome: A prospective cohort. Nutrition Journal, 15(1), 1–9. https://doi.org/10.11 86/s12937-016-0184-7
Sleath, B., West, S., Tudor, G., Perreira, K., King, V., & Morrissey, J. (2005). Ethnicity and prenatal depression: Women’s experiences and perspectives on communicating about their emotions and feelings during pregnancy. Patient Education and Counseling, 58(1), 35–40. https://doi.org/10.1016/j.pec.2004.03.019 DOI: https://doi.org/10.1016/j.pec.2004.03.019
Stein et al (2014). Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800-1819. https://doi.org/10.1016/S0140-6736(14)61277-0 DOI: https://doi.org/10.1016/S0140-6736(14)61277-0
Straub, H., Adams, M., Kim, J. J., & Silver, R. K. (2012). Antenatal depressive symptoms increase the likelihood of preterm birth. American Journal of Obstetrics and Gynecology, 207(4), 329. https://doi.org/10.10 16/j.ajog.2012.06.033 DOI: https://doi.org/10.1016/j.ajog.2012.06.033
The American College of Obstetricians and Gynecologist. (2018). Screening for Perinatal Depression. Replaces Committee Opinion, 132(757), 208–212. https://doi.org/10.1097/AOG.0000000000002927 DOI: https://doi.org/10.1097/AOG.0000000000002927
Unicef. (2016). Maternal and Newborn Health Disparities (Pakistan).
Uwambaye, P., Nyiringango, G., Musabwasoni, S. M. G., Husain, A., Nessa, K., & Razzaque, M. S. (2020). COVID-19 Pandemic: Adaptation in Antenatal Care for Better Pregnancy Outcomes. Frontiers in Global Women’s Health, 1, 1-7. https://doi.org/10.3389/fgwh.2020.599327 DOI: https://doi.org/10.3389/fgwh.2020.599327
Wainberg et al (2017). Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective. Current Psychiatry Reports, 19(5), 28. https://doi.org/10.1007/s11920-017-0780-z DOI: https://doi.org/10.1007/s11920-017-0780-z
Waqas, A., Raza, N., Lodhi, H. W., Muhammad, Z., Jamal, M., & Rehman, A. (2015). Psychosocial Factors of Antenatal Anxiety and Depression in Pakistan: Is Social Support a Mediator? PLOS ONE, 10(1), 1-14. https://doi.org/10.1371/journal.pone.0116510 DOI: https://doi.org/10.1371/journal.pone.0116510
Williams et al (2016). Vitamin D levels and perinatal depressive symptoms in women at risk: A secondary analysis of the mothers, omega-3, and mental health study. BMC Pregnancy and Childbirth, 16(1), 1–9. https://doi.org/10.1186/s12884-016-0988-7 DOI: https://doi.org/10.1186/s12884-016-0988-7
Woldetensay et al (2018). Validation of the Patient Health Questionnaire (PHQ-9) as a screening tool for depression in pregnant women: Afaan Oromo version. PLOS ONE, 13(2), 1-15. https://doi.org/10.137 1/journal.pone.0191782 DOI: https://doi.org/10.1371/journal.pone.0191782