Factors associated with perinatal depression in Pakistan

Abstract

There is little data on the burden of perinatal depression in Pakistan. This research aimed to provide estimates of the prevalence of perinatal depression, identify the risk factors, and understand the experiences and perceptions of perinatal depression in the Pakistani population. A systematic review and meta-analysis, two cross-sectional studies, and a qualitative study were conducted. A systematic review methodology was used to calculate estimates of the prevalence of perinatal depression in Pakistan. For the cross-sectional studies, recent parents completed a questionnaire, including the Edinburgh Postnatal Depression Scale and the Pittsburgh Sleep Quality Index. Qualitative interviews were conducted with recent parents about their experiences of perinatal depression. The meta-analysis estimated a pooled prevalence of maternal depression (30.0%-37.0%). Intimate partner violence, unintended pregnancy, poor relationship with spouse, and low-income were risk factors for perinatal depression. The maternal cross-sectional study reported that 35.2% and 34.3% of participants scored more than 12 on the EPDS during the antenatal and postnatal periods respectively. Intimate partner violence, sleep disturbance, adverse life events, and unplanned pregnancy were predictors of antenatal depression. Antenatal depression, financial hardship, and a lack of support were predictors of postnatal depression. The paternal cross-sectional study found that 23.5% of participants scored more than 10 on the EPDS during the postnatal period. A depressed spouse and own sleep disturbance were predictors of paternal depression. The qualitative study reported that a lack of understanding of perinatal mental health issues, disturbed sleep, emotional stressors, and financial burdens were stressors during the perinatal period. This research concludes that perinatal depression is prevalent in the Pakistani population and there is a need to raise awareness about perinatal depression in Pakistan