January 2010, Volume 60, Issue 1

Letter to the Editor

Depression during pregnancy: causes, risk factors and treatment

Madam, maternal mental health problems have emerged as great human, social and economic burden affecting mothers and their babies, families and societies. Women are twice more vulnerable to mental illness disorders than men, especially those in their childbearing age. Studies show that the prevalence of depression is 5% in non-pregnant and 8-10% in pregnant women, however, 13% women suffer from depression within one year of their deliveies.1
Depression is not merely feeling unwell, unhappy or down for a few days. It is a common mental disorder adversely affecting a person's mood, likes and dislikes, perceptions and feelings, sleep, appetite and concentration. When chronic, it can disrupt an individual's routine life interfering with his duties and responsibilities to his or her own self and society as a whole.
A woman presenting with persistent body and headache, feeling of worthlessness, disappointment and sorrow, sleeplessness, forgetfulness and loss of interest in activities previously enjoyed is suspected of suffering from depression and should consult a doctor.2
Depression is a multifactorial disorder with a genetic predisposition. It can be due to changes in brain chemistry, stressful life events or hormonal factors. A personal history of depression, young age, lack of support from loved ones, anxiety of pregnancy, complications of a previous pregnancy, marriage or monetary problems are some of its risk factors.2 It's association with premature deliveries and low birth weight babies have been established and it increases the risk of complications during and after pregnancy.2 A recent research emphasized upon the prevalence of Ante Natal depression amongst the less educated and socially deprived women.3
Commonly two types of treatments are available. Firstly, Talk therapy i.e. talking and counseling the patient and secondly Medicines, keeping in mind the risk factors of anti depressants during pregnancy.3
So as to prevent depression, women should be regularly screened in order to determine whether they are at risk or not keeping in mind the above mentioned risk factors A study was carried out employing the Edinburgh Post Natal Depression Scale during pregnancy and 7.7% women were found positive for depression during their ante partum period highlighting the importance of screening during pregnancy.4
In conclusion efforts should be made in order to improve education, awareness, and access of women to hospitals so that the burden of maternal health problem during pregnancy should be avoided.
Muhammad Owais Khan, Syed Muhammad Ali Saad
4th Year Student, Dow Medical College.

References

1.Online. Cited July 27 2009. Available from URL: http://www.who.int/mental_health/prevention/suicide/MaternalMH/en/.
2.Depression during and after pregnancy. (Online) (Cited July 28 2009). Available from URL: http://www.womenshealth.gov/FAQ/depression-pregnancy.cfm#b.
3.Husain M, Chaudhry I, Saeed Q, Khan S, Hassan Q, Husain N. Social stress and depression during pregnancy in women of a low income country; European Psychiatry 2009; 24: (Suppl 1) S622.
4.Kim J, Gordon T, La Porte L, Adams M, Kuendig J, Silver R. The utility of maternal depression screening in the third trimester. Am J Obstet Gynecol 2008; 199: 509.e1-509.e5.

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