Women's Health Nursing (여성건강간호학회지)

Korean Society of Women Health Nursing (한국여성건강간호학회)
권호 표지
DOI QR코드

DOI QR Code

Associated factors of depression in pregnant women in Korea based on the 2019 Korean Community Health Survey: a cross-sectional study

  • Kim, Eun Gyeong (Department of Nursing, Kunsan National University) ;
  • Park, Sook Kyoung (College of Nursing, Research Institute of Nursing Science, Jeonbuk National University) ;
  • Nho, Ju-Hee (College of Nursing, Research Institute of Nursing Science, Jeonbuk National University)
  • Received : 2021.12.07
  • Accepted : 2022.02.03
  • Published : 2022.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Various individual and social factors influence depression in pregnant women. The purpose of this study was to identify the influence of socioeconomic status, health behaviors, and health status on depression of pregnant women in Korea. Methods: This study analyzed data from the 2019 Korean Community Health Survey conducted from August to October 2019. A structural questionnaire with Patient Health Quetsionnaire-9 (PHQ-9), health behavior, health status, and psychological characteristics was used. The data of 1,096 pregnant women between the ages of 19 and 55 years were analyzed using descriptive statistics, independent-test and chi-square tests, and multiple regression. Results: The mean score of prenatal depression as measured by the PHQ-9 during pregnancy was 2.35 points out of 0 to 27 points. Low income (B=0.69, p<.001), low-education level (B=0.70, p<.001), skipping breakfast (B=0.34, p=.001), less than 8 hours of sleeping (B=0.26, p=.009), binge drinking during pregnancy (B=0.46, p=.001), and stress (B=1.89, p<.001) were significantly associated with increased depression scores. In contrast, depression scores significantly decreased as subjective health status (B=-0.59, p<.001) and subjective oral health status (B=-.17, p=.003) increased. Conclusion: Findings support the need for healthcare policies and clinical screening to alleviate prenatal depression, especially for pregnant women with low socioeconomic status, poor health behavior, poor health status, and high stress.

Keywords

References

  1. Dere SS, Varotariya JK, Ghildiyal RP, Sharma SA, Kaur DM. Antenatal preparedness for motherhood and its association with antenatal anxiety and depression in first time pregnant women from India. Ind Psychiatry J. 2019;28(2):255-261. https://doi.org/10.4103/ipj.ipj_66_19
  2. Allan C, Carrick-Sen D, Martin CR. What is perinatal well-being? A concept analysis and review of the literature. J Reprod Infant Psychol. 2013;31(4):381-398. https://doi.org/10.1080/02646838.2013.791920
  3. Sadock BJ, Sadock VA, Ruiz P. Synopsis of psychiatry: behavioral sciences clinical psychiatry. 11th ed. New York: Wolters Kluwer; 2015. p. 832.
  4. Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M. Depression and anxiety during pregnancy and six months postpartum: a follow-up study. Acta Obstet Gynecol Scand. 2006;85(8):937-944. https://doi.org/10.1080/00016340600697652
  5. Tomfohr-Madsen LM, Racine N, Giesbrecht GF, Lebel C, Madigan S. Depression and anxiety in pregnancy during COVID-19: a rapid review and meta-analysis. Psychiatry Res. 2021;300:113912. https://doi.org/10.1016/j.psychres.2021.113912
  6. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016;191:62-77. https://doi.org/10.1016/j.jad.2015.11.014
  7. Choi SK, Ahn SY, Shin JC, Jang DG. A clinical study of depressive symptoms during pregnancy. Korean J Obstet Gynecol. 2009;52(11):1102-1108.
  8. Kim M, Kim Y. The mediating effect of fatigue on the relationship between pregnancy stress and depression during the third trimester of pregnancy. J East-West Nurs Res. 2018;24(1):81-89. https://doi.org/10.14370/jewnr.2018.24.1.81
  9. Koh M, Ahn S, Kim J, Park S, Oh J. Pregnant women's antenatal depression and influencing factors. Korean J Women Health Nurs. 2019;25(1):112-113. https://doi.org/10.4069/kjwhn.2019.25.1.112
  10. Jahan N, Went TR, Sultan W, Sapkota A, Khurshid H, Qureshi IA, et al. Untreated depression during pregnancy and its effect on pregnancy outcomes: a systematic review. Cureus. 2021;13(8):e17251. https://doi.org/10.7759/cureus.17251
  11. Hagberg KW, Robijn AL, Jick S. Maternal depression and antidepressant use during pregnancy and the risk of autism spectrum disorder in offspring. Clin Epidemiol. 2018;10:1599-1612. https://doi.org/10.2147/CLEP.S180618
  12. Liu C, Cnattingius S, Bergstrom M, Ostberg V, Hjern A. Prenatal parental depression and preterm birth: a national cohort study. BJOG. 2016;123(12):1973-1982. https://doi.org/10.1111/1471-0528.13891
  13. Brummelte S, Galea LA. Postpartum depression: etiology, treatment and consequences for maternal care. Horm Behav. 2016;77:153-166. https://doi.org/10.1016/j.yhbeh.2015.08.008
  14. Pearson RM, Carnegie RE, Cree C, Rollings C, Rena-Jones L, Evans J, et al. Prevalence of prenatal depression symptoms among 2 generations of pregnant mothers: the Avon Longitudinal Study of Parents and Children. JAMA Netw Open. 2018;1(3):e180725. https://doi.org/10.1001/jamanetworkopen.2018.0725
  15. Recto P, Champion JD. Psychosocial risk factors for perinatal depression among female adolescents: a systematic review. Issues Ment Health Nurs. 2017;38(8):633-642. https://doi.org/10.1080/01612840.2017.1330908
  16. Eddy B, Poll V, Whiting J, Clevesy M. Forgotten fathers: postpartum depression in men. J Fam Issues. 2019;40(8):1001-1017. https://doi.org/10.1177/0192513X19833111
  17. Field T. Prenatal depression risk factors, developmental effects and interventions: a review. J Pregnancy Child Health. 2017;4(1):301. https://doi.org/10.4172/2376-127X.1000301
  18. Cho H, Ahn S. Do childbirth confidence, prenatal depression, childbirth knowledge, and spousal support influence childbirth fear in pregnant women? Korean J Women Health Nurs. 2020;26(4):358-366. https://doi.org/10.4069/kjwhn.2020.12.14
  19. Ma X, Wang Y, Hu H, Tao XG, Zhang Y, Shi H. The impact of resilience on prenatal anxiety and depression among pregnant women in Shanghai. J Affect Disord. 2019;250:57-64. https://doi.org/10.1016/j.jad.2019.02.058
  20. Baek SJ, Yun J, Nam JA, Seo EY, Kwon SY, Lee CH, et al. Antenatal depressive symptoms and associated risk factors among pregnant women. J Korean Neuropsychiatr Assoc. 2019;58(4):346-352. https://doi.org/10.4306/jknpa.2019.58.4.346
  21. Tsai SY, Lee PL, Gordon C, Cayanan E, Lee CN. Objective sleep efficiency but not subjective sleep quality is associated with longitudinal risk of depression in pregnant women: a prospective observational cohort study. Int J Nurs Stud. 2021;120:103966. https://doi.org/10.1016/j.ijnurstu.2021.103966
  22. Park SJ, Choi HR, Choi JH, Kim KW, Hong JP. Reliability and validity of the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Anxiety Mood. 2010;6(2):119-124.
  23. Kim EG, Park SK, Nho JH. Factors related to maternal oral health status: focus on pregnant and breastfeeding women. Healthcare (Basel). 2021;9(6):708. https://doi.org/10.3390/healthcare9060708
  24. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  25. Sidebottom AC, Harrison PA, Godecker A, Kim H. Validation of the Patient Health Questionnaire (PHQ)-9 for prenatal depression screening. Arch Womens Ment Health. 2012; 15(5):367-374. https://doi.org/10.1007/s00737-012-0295-x
  26. Sanchez SE, Friedman LE, Rondon MB, Drake CL, Williams MA, Gelaye B. Association of stress-related sleep disturbance with psychiatric symptoms among pregnant women. Sleep Med. 2020;70:27-32. https://doi.org/10.1016/j.sleep.2020.02.007
  27. Ter Kuile H, Finkenauer C, van der Lippe T, Kluwer ES. Changes in relationship commitment across the transition to parenthood: pre-pregnancy happiness as a protective resource. Front Psychol. 2021;12:622160. https://doi.org/10.3389/fpsyg.2021.622160
  28. Jo EM, Yoo H. Happiness among pregnant women: a concept analysis. Korean J Women Health Nur. 2016;22(3):128-138. https://doi.org/10.4069/kjwhn.2016.22.3.128
  29. Corbani IE, Rucci P, Iapichino E, Quartieri Bollani M, Cauli G, Ceruti MR, et al. Comparing the prevalence and the risk profile for antenatal depressive symptoms across cultures. Int J Soc Psychiatry. 2017;63(7):622-631. https://doi.org/10.1177/0020764017725543
  30. Ashley JM, Harper BD, Arms-Chavez CJ, LoBello SG. Estimated prevalence of antenatal depression in the US population. Arch Womens Ment Health. 2016;19(2):395-400. https://doi.org/10.1007/s00737-015-0593-1
  31. Kim EG. Analysis of drinking related to health behaviors during pregnancy: focus on community health survey data. J Korean Soc Matern Child Health. 2020;24(4):204-11. https://doi/org/10.21896/jksmch.2020.24.4.204
  32. Jeon BJ. Low fertility era and maternal health promotion. J Korea Contents Assoc. 2014;14(6):162-173. https://doi.org/10.5392/JKCA.2014.14.06.162
  33. Siu AL; US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, Grossman DC, Baumann LC, Davidson KW, et al. Screening for depression in adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(4):380-387. https://doi.org/10.1001/jama.2015.18392
  34. Zhan Y, Ma H, Feng Y, Wang Y, Wu S, Cai S, et al. Dietary patterns in relation to gestational depression and sleep disturbance in Chinese pregnant women. J Obstet Gynaecol Res. 2020;46(12):2618-2628. https://doi.org/10.1111/jog.14508
  35. Daley AJ, Macarthur C, Winter H. The role of exercise in treating postpartum depression: a review of the literature. J Midwifery Womens Health. 2007;52(1):56-62. https://doi.org/10.1016/j.jmwh.2006.08.017
  36. Sim SJ. Association between oral health behaviors and health related quality of life in Korean adults. Int J Clin Prev Dent. 2019;15(3):129-136. https://doi.org/10.15236/ijcpd.2019.15.3.129
  37. Watt MH, Eaton LA, Choi KW, Velloza J, Kalichman SC, Skinner D, et al. "It's better for me to drink, at least the stress is going away": perspectives on alcohol use during pregnancy among South African women attending drinking establishments. Soc Sci Med. 2014;116:119-125. https://doi.org/10.1016/j.socscimed.2014.06.048
  38. Omidvar S, Faramarzi M, Hajian-Tilak K, Nasiri Amiri F. Associations of psychosocial factors with pregnancy healthy life styles. PLoS One. 2018;13(1):e0191723. https://doi.org/10.1371/journal.pone.0191723
  39. Kim EJ, Park HJ. Expansion of health insurance coverage for prenatal care and its association with low birth weight and premature birth. J Korean Soc Matern Child Health. 2019;23(4):241-249. https://doi.org/10.21896/jksmch.2019.23.4.241