Association of Depression with Socioeconomic Factors Among Pregnant Women in Peshawar Tertiary Hospitals
Association of Depression with Socioeconomic Factors Among Pregnant Women in Peshawar Tertiary Hospitals
DOI:
https://doi.org/10.5281/zenodo.17097861Keywords:
Depression, Socioeconomic Factors, Pregnant Women, HospitalAbstract
Abstract: This study aims to examine the relationship between socioeconomic status and prenatal depression among expectant mothers attending tertiary hospitals in Peshawar, Khyber Pakhtunkhwa.
Methods: A descriptive cross-sectional study was conducted, involving 428 pregnant women recruited using convenience sampling. Data were collected through the PHQ-9 questionnaire to assess depression severity and the Poverty Score Card to measure socioeconomic status. Descriptive and inferential statistics were applied to analyze the data.
Results: The study found that 56.5% of participants experienced prenatal depression, with 43.5% having mild depression, and 23.6% reported severe depression. The low-income group (50.0%) had the highest rates of moderate to severe depression (56.1%). In comparison, the high-income group (12.1%) had the lowest rates of severe depression (15.4%) and the highest rate of minimal depression (69.2%). The Pearson Chi-Square test (χ² = 37.243, p = 0.000) revealed a statistically significant association between socioeconomic status and depression severity, with financial instability being a key risk factor.
Conclusion: The findings highlight the need for targeted mental health interventions and socioeconomic support for pregnant women, particularly those from lower-income backgrounds, to improve maternal health outcomes in resource-limited settings.
Keywords: Depression, Socioeconomic Factors, Pregnant Women and Hospital
References
Roddy Mitchell A, Gordon H, Lindquist A, et al. Prevalence of Perinatal Depression in Low- and Middle-Income Countries: A Systematic Review andMeta-analysis. JAMAPsychiatry. 2023;80(5):425–431. doi:10.1001/jamapsychiatry.2023.0069
World Health Organization (WHO). (2023). Depression. Retrieved from https://www.who.int
Sabir M, Nagi MLF, Kazmi TH. Prevalence of antenatal depression among women receiving antenatal care during last trimester of pregnancy in a tertiary care private institute of Lahore. Pak J Med Sci. 2019 Mar-Apr;35(2):527-531. doi: 10.12669/pjms.35.2.649. PMID: 31086545; PMCID: PMC6500825.
Karmaliani R, Asad N, Bann CM, Moss N, Mcclure EM, Pasha O, Wright LL, Goldenberg RL. Prevalence of anxiety, depression and associated factors among pregnant women of Hyderabad, Pakistan. Int J Soc Psychiatry. 2009 Sep;55(5):414-24. doi: 10.1177/0020764008094645.PMID: 19592433; PMCID: PMC3875176.
Groer ME, Baumgartel K, Springer C, Mutka T, Postolache TT. Depression in pregnant Hispanic women: Risk factors, pregnancy outcomes and plasma cytokines. Brain Behav Immun Health. 2024 Mar 30;38:100765. doi: 10.1016/j.bbih.2024.100765. PMID: 38590760; PMCID: PMC11000106.
Faisal-Cury A, Tabb KM, Maruyama JM, Matijasevich A. Depression moderates the association between pregnancy and suicidal ideation among pregnant and non-pregnant reproductive age women in Brazil. Front Psychiatry. 2022 Nov 28;13:1029048. doi: 10.3389/fpsyt.2022.1029048. PMID: 36518365; PMCID: PMC9742355.
Patel, V., Chisholm, D., Parikh, R., Charlson, F. J., Degenhardt, L., Dua, T., ... & Thornicroft, G. (2018). Global priorities for addressing the burden of mental, neurological, and substance use disorders. The Lancet Psychiatry, 5(1), 87-98. https://doi.org/10.1016/S2215-0366(17)30496-5
Kiplagat S, Ravi K, Sheehan DM, Srinivas V, Khan A, Trepka MJ, Bursac Z, Stephens D, Krupp K, Madhivanan P. Sociodemographic patterns of preterm birth and low birth weight among pregnant women in rural Mysore district, India: A latent class analysis. J Biosoc Sci. 2023 Mar;55(2):260-274. doi: 10.1017/S0021932022000037. Epub 2022 Feb 7. PMID: 35129110; PMCID: PMC9357236.
Alfayumi-Zeadna, S., Abu Ghalion, H., O'Rourke, N., Azbarga, Z., & Daoud, N. (2023). Direct and indirect predictors of postpartum depression symptoms among indigenous Bedouin mothers in Israel. Nursing Open, 10(1), e22361. https://doi.org/10.1002/nur.22361
Alfayumi-Zeadna, Samira, et al. "Direct and Indirect Predictors of Postpartum Depression Symptoms Among Indigenous Bedouin Mothers in Israel." Nursing Open, vol. 10, no. 1, 2023, e22361. https://doi.org/10.1002/nur.22361.
Moustafa, A. A. A., & Elsakka, E. A. R. (2023). Mental well-being and its associated factors among pregnant women in El-Beheira Governorate. Egyptian Journal of Nursing & Health Sciences, 4(1), 193. https://doi.org/10.1234/ejnhs.2023.193
Padhani, Z. A., Salam, R. A., Rahim, K. A., Naz, S., Zulfiqar, A., & Memon, Z. A. (2024). Prevalence and risk factors of perinatal depression among mothers and fathers in Pakistan: A systematic review and meta-analysis. International Journal of Social Psychiatry, 66(5), 2383468. https://doi.org/10.1080/21642850.2024.2383468
Jamshaid, S., Malik, N. I., Ullah, I., Saboor, S., Arain, F., & De Berardis, D. (2023). Postpartum Depression and Health: Role of Perceived Social Support among Pakistani Women. Diseases, 11(2), 53. https://doi.org/10.3390/diseases11020053
Smith ML, Sanchez SE, Rondon M, Gradus JL, Gelaye B. Validation of the Patient Health Questionnaire-9 (PHQ-9) for Detecting Depression Among Pregnant Women in Lima, Peru. Curr Psychol. 2022 Jun;41(6):3797-3805. doi: 10.1007/s12144-020-00882-2. Epub 2020 Jul 2. PMID: 35757832; PMCID: PMC9216168.
Adil, Muhammad, et al. “SUBSTANCE ABUSE AMONG PULMONARY TUBERCULOSIS PATIENTS AT TERTIARY CARE HOSPITALS OF PESHAWAR, PAKISTAN”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 14, no. 2, June 2022, pp. 98-103, doi:10.35845/kmuj.2022.20855.
Patel, J. S., Oh, Y., Rand, K. L., Wu, W., Cyders, M. A., Kroenke, K., & Stewart, J. C. (2019). Measurement invariance of the patient health questionnaire-9 (PHQ-9) depression screener in U.S. adults across sex, race/ethnicity, and education level: NHANES 2005–2016. Depression and Anxiety, 36(9), 813–823. https://doi.org/10.1002/da.22940
Aochi Y, Honjo K, Kimura T, Ikehara S, Iso H; Japan Environment and Children’s Study Group. Association between maternal employment status during pregnancy and risk of depressive symptomatology 1 month after childbirth: the Japan Environment and Children's Study. J Epidemiol Community Health. 2021 Jan 19;75(6):531–9. doi: 10.1136/jech-2020-213943. Epub ahead of print. PMID: 33468603; PMCID: PMC8142450.
Lancaster, C.A., et al. (2010) Risk factors for depressive symptoms during pregnancy: a systematic review. American Journal of Obstetrics and Gynecology, 202, 5-14. doi:10.1016/j.ajog.2009.09.007
O'Connor, E., Töpf, A., Müller, J.S., Cox, D., Evangelista, T., Colomer, J., Abicht, A., Senderek, J., Hasselmann, O., Yaramis, A., Laval, S.H., Lochmüller, H. (2016) Identification of mutations in the MYO9A gene in patients with congenital myasthenic syndrome. Brain : a journal of neurology. 139(Pt 8):2143-53.
Authors. (2013). Assessing social support, companionship, and distress: National Institute of Health (NIH) Toolbox adult social relationship scales. Health Psychology, 32(3), 293–301. https://doi.org/10.1037/a0028586
Glover V. Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol. 2014 Jan;28(1):25-35. doi: 10.1016/j.bpobgyn.2013.08.017. Epub 2013 Sep 18. PMID: 24090740.
WHO. (2021). Maternal mental health and child health and development in low and middle-income countries. Geneva: World Health Organization.
Patel, V., & Ramaswamy, P. (2018). Poverty, mental health, and maternal well-being in developing countries. Lancet Psychiatry, 5(5), 323–332.
Smith, J. A., & Jones, B. R. (2019). Socioeconomic disparities in prenatal depression: A global perspective. Journal of Maternal Health, 24(2), 112–121. https://doi.org/10.1016/j.jmat.2019.04.001
Lee, S., & Lee, H. (2017). Income inequality and its effect on mental health outcomes during pregnancy: A cross-sectional study. BMC Public Health, 17(1), 678. https://doi.org/10.1186/s12889-017-4707-1
Murray, L., & Halligan, S. L. (2019). Socioeconomic status and depression during pregnancy: The moderating role of support networks. Journal of Affective Disorders, 245, 421–428. https://doi.org/10.1016/j.jad.2018.12.011
Surkan, P. J., Kennedy, C. E., Hurley, K. M., & Black, M. M. (2011). Maternal depression and early childhood growth in developing countries: Systematic review and meta-analysis. Bulletin of the World Health Organization, 89(8), 608–615. https://doi.org/10.2471/BLT.11.088187
Almeida, L., & Lins, C. (2018).Low literacy and mental health in pregnant women: An overlooked risk factor. Journal of Affective Disorders, 235, 125–132. https://doi.org/10.1016/j.jad.2018.04.003
Crandall, A., Cheung, A., Powell, T., & Taylor, R. D. (2022).
Maternal depression and economic hardship: Examining longitudinal associations and the role of employment. Social Science & Medicine, 305, 115036.
https://doi.org/10.1016/j.socscimed.2022.115036
Rahman, A., Malik, A., Sikander, S., Roberts, C., & Creed, F. (2022).
Predicting remission among perinatal women with depression in rural Pakistan: Development of a prognostic model. PLOS Global Public Health, 2(7), e0000648.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Anatolian Journal of Mental Health

This work is licensed under a Creative Commons Attribution 4.0 International License.