Associations between symptoms of depression and sociodemographic factors and pregnancy-related complaints among pregnant women in urban and rural Nepal.

Abstract

Background: Maternal morbidities such as depression, pelvic girdle pain (PGP), low back pain (LBP) and pelvic organ prolapse (POP) appear to occur differently in developing countries. Nepal is a predominantly rural country with 44% of households living below the poverty line and strong emigrational tendencies among the male population. This leaves pregnant women exposed to higher workloads, which has been linked to PGP, LBP and POP. There is limited knowledge as to the adverse effects these factors may have on antenatal depression. Considering the maternal and neonatal risk-factors that have been associated with antenatal depression, such as premature birth, low birth weight and intrauterine growth restriction, it is important to understand and target the factors that may affect antenatal depression. Purpose: To investigate the impacts of sociodemographic factors and pregnancy-related complaints on symptoms of depression among pregnant women in Nepal. Material and methods: A cross sectional study using standardized condition-specific questionnaires with response from 1284 pregnant women who were attending antenatal check-ups in two hospitals in urban and rural Nepal. Multivariate logistic regression analysis was used to determine variables associated with symptoms of depression. Results: Twenty-two percent of the women presented with symptoms of depression, while 29% of the women with LBP and/or PGP showed symptoms of depression. Being housewife, having to fetch water and having symptoms of POP was associated with symptoms of depression, while women who live with their husband had lower odds of having depressive symptoms. For women with LBP and/or PGP, having symptoms of POP, moderate to high pain intensity and self-reported severe disability was associated with symptoms of depression, while women who live with their husband had lower odds of depressive symptoms. Conclusion: The results indicate that the experience of social support may act as a protective factor, while certain work load characteristics may involve adverse impacts on symptoms of depression. Furthermore, for pregnant women with LBP and/or PGP the results suggest that the presence of depressive symptoms may impact on the experience of pain intensity and disability or vice versa.