Risk factors and co-morbid anxiety and depression in pregnancy in a tertiary hospital in southeast Nigeria

Abstract

Background: Anxiety and depression commonly co-exist, and as a consequence entails greater suffering, low quality of life and poor foetal outcome. Not many studies have determined the rate of co-occurrence of anxiety/depression, and the associated risk factors in pregnancy.

Methods: It was a cross sectional study of 200 consecutive attendees of antenatal clinic of a tertiary hospital using Sociodemographic, Obstetric questionnaires, Hospital Anxiety Depression Scale, Index of Marital Satisfaction, Big Five Personality Inventory, Brief Coping Scale and Oslo-3 Social Support Scale. Data collected were analyzed with Chi-square and Pearson’s correlation and multiple regression tests.

Results: Thirty-five (17.5%) out of two hundred participants had anxiety, 21/200 (10.5%) were depressed, while 9/200 (4.5%) were both depressed and anxious. Poor social support was predictive for depression (P=0.03, CI=-.43 to -.02). Poor marital satisfaction (P<0.001, CI=.04 to .10), neuroticism personality trait (P<001, CI=.08 to .28) were predictive for both depression and anxiety. Use of problem-based and emotion-based coping skills, positively correlated with having anxiety symptoms (r=0.150, P=0.03; r=0.159, P=0.02 respectively). No association was found between anxiety/depression and parity, unemployment, gestational age, past obstetrics and gynaecology history.

Conclusion: Clinicians should evaluate patients further when anxiety or depression is detected in pregnancy. The importance of good interpersonal relationship in the family, extended family and next-door neighbours should be emphasised.