Risk Factors for depressive symptoms during pregnancy in a sample of Iraqi women

Objective The aim of this study was to find the factors that may associate with and increase the negative affective states like depression and anxiety in a sample of depressed Iraqi women. Study Design A two phase longitudinal study including 215 randomly selected pregnant Iraqi women, depression during pregnancy was diagnosed in 80 case at phase one of the study by using Edinburgh Postnatal Depression Scale 1 (EPDS). Those were offered to phase two of the study which includes further questions about social, economic, psychological, medical, surgical and sexual and relationship conditions that may increase anxiety and depression status during pregnancy. Risks were calculated by percentage and 95% confidence interval. Results Prevalence of depression was (37.2 %). The depressed mothers were significantly more likely to be older >35 years pregnant women (43.75%), and received secondary education (38.75%) , most of them are teachers in primary or secondary schools , and of moderate to low income, they are multiparous with irregular ANC antenatal care , 60% of them had history of either primary or secondary infertility , 8.75 % had bleeding at early pregnancy and >42 % had history of previous miscarriage , all these factors contribute to large fear of losing the fetus that create emotional and psychological distress . > two thirds of them had poor marital relationship and > one third had history of domestic violence , > one forth had history of previous psychiatric disorders , about 77.5% had poor family and social support and about 18.75% had unplanned pregnancy. And lastly, one fifth of them had history of medical disease of pregnancy and 15% of them using different type of drugs during pregnancy. Conclusion Psychosocial assessment of pregnant women may facilitate early interventions to augment support networks, thereby reducing the risk of emotional distress. . The strongest risk factor was history of depression prior to pregnancy. Other associated factors were fear of childbirth, low SES, lack of social support and marital relationship difficulties. These factors and other factors that may be discovered during future studies set the stage for a next era of psychiatric and collaborative interdisciplinary research on pregnancy to reduce the burden of maternal stress, depression, and anxiety in the perinatal period. It is critical to identify the signs, symptoms, and diagnostic thresholds that warrant prenatal intervention and to develop efficient, effective and ecologically valid screening and intervention strategies to be used widely.