Prevalence and determinants of antepartum psychiatric disorders: A cross-sectional study in 25 villages of sarjapur PHC area, Bangalore Urban district

Abstract

Background: Antenatal psychiatric disorders are linked to adverse perinatal outcomes and postpartum depression, yet there is a paucity of rural community-based data in India. Objectives: The is to estimate the prevalence and identify determinants of antepartum psychiatric disorders among rural women. Methods: Pregnant women in the third trimester residing in 25 villages under Sarjapur Primary Health Centre, near Bangalore were included. The sample size was calculated as 150 and simple random sampling is done with probability proportional to the size of the village. Screening for antepartum psychiatric disorders and psychiatric symptoms was done using revised Clinical Interview Schedule. Chi-square test and Fischer's exact test was done for associating antepartum psychiatric disorders and independent co-variates. Adjusted odds ratios (AOR) were calculated with 95% confidence intervals, using multiple logistic regression. Results: The prevalence of antepartum psychiatric disorder was 15.3%. The most common psychiatric symptoms were somatic symptoms (43/3%), fatigue (37.3%), sleep problems (28%), and anxiety (22.7%). Poor relationship with in-laws (OR = 5.9 [1.48–50.71] P = 0.017), lower education (OR = 2.3 [1.04–7.80] P = 0.036), low socioeconomic status (P = 0.01) and recent adverse events (P = 0.01) were risk factors for antepartum psychiatric disorder. None of the women sought consultation or treatment for psychiatric symptoms and none were screened for antepartum psychiatric disorders during antenatal visits. Conclusion: A high burden of antepartum psychiatric disorders exists among rural women in our study. There is a need for screening, referral, and management of antepartum psychiatric disorders to be included as a part of routine antenatal care along with capacity building at the primary care level and utilization of existing platforms such as community women's groups for health education, sensitization, and de-stigmatization of antepartum psychiatric disorders.

Keywords

• antepartum psychiatric disorders
• clinical interview schedule-revised
• maternal mental health
• pregnant women
• rural