# Prevalence of Depression and Anxiety Disorders and Associated Psychosocial Risk Factors Among Pregnant Women Attending an Outpatient Clinic at a Tertiary Care Hospital

## TL;DR

This study found that nearly 17% of pregnant women at a hospital had depression, and 8% had anxiety, with factors like economic stress and marital issues playing a big role.

## Contribution

The study identifies specific psychosocial and obstetric risk factors for depression and anxiety in pregnant women in a low-resource setting.

## Key findings

- Depression was independently associated with factors like unplanned pregnancy, economic stress, and marital discord.
- Anxiety was strongly linked to unplanned pregnancy and economic stress.
- Over one in five pregnant women experienced depression or anxiety, highlighting the need for mental health screening during pregnancy.

## Abstract

Background

Pregnancy is a period of significant biological and psychosocial change that may predispose women to mental health disorders. Antenatal depression and anxiety are increasingly recognized as important public health concerns due to their adverse impact on maternal well-being, pregnancy outcomes, and offspring development. Despite this, these conditions often remain underdiagnosed in routine antenatal care, particularly in low- and middle-income settings. This study aimed to determine the prevalence of depressive and anxiety disorders among pregnant women attending a tertiary care outpatient clinic and to examine their association with selected sociodemographic, obstetric, psychosocial, and physiological factors.

Methods

A hospital-based cross-sectional study was conducted over two months in the obstetrics and gynaecology outpatient department of a tertiary care teaching hospital. A total of 180 antenatal women aged ≥18 years were enrolled. Data were collected using a semi-structured questionnaire covering sociodemographic details, obstetric history, psychosocial stressors, and physiological parameters. Depression and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-5 (SCID-5). Descriptive statistics were used to estimate prevalence, and bivariate and multivariable logistic regression analyses were performed to identify factors associated with depression and anxiety.

Results

Most were aged ≥25 years, 171 (95.0%), with more than half of the women being graduates, 105 (58.3%), and the majority were homemakers, 154 (85.6%). The prevalence of prenatal depression and anxiety was 31(17.2%) and 14(7.8%), respectively. On multivariable analysis, depression was independently associated with duration of marriage greater than five years (18/69, 26.1%; adjusted odds ratio (AOR) = 2.47, 95% CI: 1.10-5.55), unplanned pregnancy (9/24, 37.5%; AOR = 2.9, 95% CI: 1.1-7.8), presence of comorbidities (25/80, 31.3%; AOR = 4.8, 95% CI: 1.7-13.6), economic stress (20/31, 64.5%; AOR = 9.6, 95% CI: 3.6-25.4), work-related stress (18/27, 66.7%; AOR = 8.2, 95% CI: 3.1-21.6), and marital discord (19/25, 76.0%; AOR = 14.7, 95% CI: 4.9-43.8). Anxiety was independently associated with unplanned pregnancy (10/24, 41.7%; AOR = 9.8, 95% CI: 2.9-33.1), economic stress (9/30, 30.0%; AOR = 5.4, 95% CI: 1.6-18.3), and marital discord (6/25, 24.0%; AOR = 3.4, 95% CI: 1.0-11.9).

Conclusion

A substantial proportion of pregnant women experience depression and anxiety, largely driven by psychosocial stressors and certain obstetric factors. Integrating routine mental health screening and psychosocial support into antenatal care services is essential to improve maternal mental health and pregnancy outcomes.