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Depression, sleep quality, and body image disturbances among pregnant women in India: a cross-sectional study

  • Kranti S. Kadam (Department of Psychiatry, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital) ;
  • Aditya R. Anvekar (Department of Psychiatry, Tata Memorial Hospital) ;
  • Vishnu B. Unnithan (Department of Nuclear Medicine, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital)
  • 투고 : 2023.01.23
  • 심사 : 2023.03.18
  • 발행 : 2023.10.31

초록

Background: Pregnancy is associated with a number of physical, emotional, and biological changes that can exacerbate maternal psychological disturbances, such as body image concerns and depression. Sleep disturbances during pregnancy can also have adverse impacts. This study aimed to determine the prevalence of depression, sleep disturbances, and body image concerns among pregnant women. The study also examined the relationship between these factors and pregnancy-related variables, such as bad obstetric history and whether the pregnancies were unplanned. Methods: A cross-sectional study of 146 pregnant patients was conducted at a tertiary care center over 15 months. The patients were administered the Beck Depression Inventory, Pittsburgh Sleep Quality Index, and Body Image Concern Inventory questionnaires. Contingency tables, Fisher exact test, and Spearman correlation were used to identify underlying relationships. Results: The prevalence of depression was 22.6%. Although body image disturbance was noted in only 2.7% of patients, 46.6% had poor sleep quality. Poor sleep was associated with primigravida status. Bad obstetric history and unplanned pregnancy were associated with depression. Depression was found to be significantly correlated with body image disturbances and poor sleep quality. Conclusion: Psychiatric disorders were prevalent during pregnancy. This study highlights the importance of screening for depression in pregnant patients. Counselling and caregiver education can be useful for mitigating psychological disturbances. Management of pregnancies by multidisciplinary teams that include psychiatrists could be immensely useful in improving the pregnancy experiences of patients.

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참고문헌

  1. Williams D. Pregnancy: a stress test for life. Curr Opin Obstet Gynecol 2003;15:465-71.  https://doi.org/10.1097/00001703-200312000-00002
  2. Van Mullem C, Tillett J. Psychiatric disorders in pregnancy. J Perinat Neonatal Nurs 2009;23:124-30.  https://doi.org/10.1097/JPN.0b013e3181a4bf3b
  3. Hegde SS, Pai KK, Sandeep K. Prevalence of antenatal depression and gender preference: a cross sectional study among Mangalore population, Karnataka, India. J Pharm Biomed Sci 2013;30:1011-4. 
  4. George C, Lalitha AR, Antony A, Kumar AV, Jacob KS. Antenatal depression in coastal South India: prevalence and risk factors in the community. Int J Soc Psychiatry 2016;62:141-7.  https://doi.org/10.1177/0020764015607919
  5. Varma D, Chandra PS, Thomas T, Carey MP. Intimate partner violence and sexual coercion among pregnant women in India: relationship with depression and post-traumatic stress disorder. J Affect Disord 2007;102:227-35.  https://doi.org/10.1016/j.jad.2006.09.026
  6. Yin X, Sun N, Jiang N, Xu X, Gan Y, Zhang J, et al. Prevalence and associated factors of antenatal depression: systematic reviews and meta-analyses. Clin Psychol Rev 2021;83:101932. 
  7. Oren DA, Wisner KL, Spinelli M, Epperson CN, Peindl KS, Terman JS, et al. An open trial of morning light therapy for treatment of antepartum depression. Am J Psychiatry 2002;159:666-9. https://doi.org/10.1176/appi.ajp.159.4.666
  8. Accortt EE, Cheadle AC, Dunkel Schetter C. Prenatal depression and adverse birth outcomes: an updated systematic review. Matern Child Health J 2015;19:1306-37.  https://doi.org/10.1007/s10995-014-1637-2
  9. Colten HR, Altevogt BM. Sleep disorders and sleep deprivation: an unmet public health problem. Washington (DC): National Academies Press; 2006. 
  10. Palagini L, Gemignani A, Banti S, Manconi M, Mauri M, Riemann D. Chronic sleep loss during pregnancy as a determinant of stress: impact on pregnancy outcome. Sleep Med 2014;15:853-9.  https://doi.org/10.1016/j.sleep.2014.02.013
  11. Kim Y, Wilkens LR, Schembre SM, Henderson BE, Kolonel LN, Goodman MT. Insufficient and excessive amounts of sleep increase the risk of premature death from cardiovascular and other diseases: the Multiethnic Cohort Study. Prev Med 2013;57:377-85.  https://doi.org/10.1016/j.ypmed.2013.06.017
  12. Wang H, Leng J, Li W, Wang L, Zhang C, Li W, et al. Sleep duration and quality, and risk of gestational diabetes mellitus in pregnant Chinese women. Diabet Med 2017;34:44-50.  https://doi.org/10.1111/dme.13155
  13. Mehta UJ, Siega-Riz AM, Herring AH. Effect of body image on pregnancy weight gain. Matern Child Health J 2011;15:324-32.  https://doi.org/10.1007/s10995-010-0578-7
  14. Brown A, Rance J, Warren L. Body image concerns during pregnancy are associated with a shorter breast feeding duration. Midwifery 2015;31:80-9.  https://doi.org/10.1016/j.midw.2014.06.003
  15. Adewuya AO, Ola BA, Aloba OO. Prevalence of major depressive disorders and a validation of the Beck Depression Inventory among Nigerian adolescents. Eur Child Adolesc Psychiatry 2007;16:287-92.  https://doi.org/10.1007/s00787-006-0557-0
  16. Ibeneme SC, Nwosu AO, Ibeneme GC, Bakare MO, Fortwengel G, Limaye D. Distribution of symptoms of post-stroke depression in relation to some characteristics of the vulnerable patients in socio-cultural context. Afr Health Sci 2017;17:70-8.  https://doi.org/10.4314/ahs.v17i1.10
  17. Amaricai E, Poenaru DV. The post-stroke depression and its impact on functioning in young and adult stroke patients of a rehabilitation unit. J Ment Health 2016;25:137-41.  https://doi.org/10.3109/09638237.2015.1022251
  18. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.  https://doi.org/10.1016/0165-1781(89)90047-4
  19. Ghadakzadeh S, Ghazipour A, Khajeddin N, Karimian N, Borhani M. Body Image Concern Inventory (BICI) for identifying patients with BDD seeking rhinoplasty: using a Persian (Farsi) version. Aesthetic Plast Surg 2011;35:989-94.  https://doi.org/10.1007/s00266-011-9718-8
  20. Littleton HL, Axsom D, Pury CL. Development of the body image concern inventory. Behav Res Ther 2005;43:229-41.  https://doi.org/10.1016/j.brat.2003.12.006
  21. Littleton H, Breitkopf CR. The Body Image Concern Inventory: validation in a multiethnic sample and initial development of a Spanish language version. Body Image 2008;5:381-8.  https://doi.org/10.1016/j.bodyim.2008.06.004
  22. Pajulo M, Savonlahti E, Sourander A, Helenius H, Piha J. Antenatal depression, substance dependency and social support. J Affect Disord 2001;65:9-17.  https://doi.org/10.1016/S0165-0327(00)00265-2
  23. Humayun A, Haider II, Imran N, Iqbal H, Humayun N. Antenatal depression and its predictors in Lahore, Pakistan. East Mediterr Health J 2013;19:327-32.  https://doi.org/10.26719/2013.19.4.327
  24. Kadam KS, Anvekar S, Angane AY, Unnithan VB. The silent survivor: a cross-sectional study of domestic violence, perceived stress, coping strategies, and suicidal risk in the wives of patients with alcohol use disorder. Indian J Soc Psychiatry 2022;38:188-94.  https://doi.org/10.4103/ijsp.ijsp_98_20
  25. Roomruangwong C, Kanchanatawan B, Sirivichayakul S, Maes M. High incidence of body image dissatisfaction in pregnancy and the postnatal period: associations with depression, anxiety, body mass index and weight gain during pregnancy. Sex Reprod Healthc 2017;13:103-9. 
  26. Kadam KS, Bagal RP, Angane AY, Ghorpade GS, Anvekar AR, Unnithan VB. A cross-sectional study of quality of life, psychiatric illness, perceived social support, suicidal risk and selfesteem among patients with burns. J Family Med Prim Care 2021;10:432-8.  https://doi.org/10.4103/jfmpc.jfmpc_1604_20
  27. Spatuzzi R, Vespa A, Lorenzi P, Miccinesi G, Ricciuti M, Cifarelli W, et al. Evaluation of social support, quality of life, and body image in women with breast cancer. Breast Care (Basel) 2016;11:28-32.  https://doi.org/10.1159/000443493
  28. Zeng K, Li Y, Yang R. The mediation role of psychological capital between family relationship and antenatal depressive symptoms among women with advanced maternal age: a cross sectional study. BMC Pregnancy Childbirth 2022;22:488. 
  29. Duke CH, Williamson JA, Snook KR, Finch KC, Sullivan KL. Association between fruit and vegetable consumption and sleep quantity in pregnant women. Matern Child Health J 2017;21:966-73.  https://doi.org/10.1007/s10995-016-2247-y
  30. Oboro OF, Ebulue V, Oboro VO, Ohenhen V, Oyewole A, Akindele R, et al. The magnitude and determinants of depressive symptoms amongst women in early pregnancy in Southern Nigeria: a cross-sectional study. S Afr J Psychiatr 2022;28:1691. 
  31. Okun ML, Tolge M, Hall M. Low socioeconomic status negatively affects sleep in pregnant women. J Obstet Gynecol Neonatal Nurs 2014;43:160-7.  https://doi.org/10.1111/1552-6909.12295
  32. Wyatt S, Ostbye T, De Silva V, Lakmali P, Long Q. Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study. BMC Pregnancy Childbirth 2021;21:758. 
  33. Martinez-Galiano JM, Hernandez-Martinez A, Rodriguez-Almagro J, Delgado-Rodriguez M, Gomez-Salgado J. Relationship between parity and the problems that appear in the postpartum period. Sci Rep 2019;9:11763. 
  34. Bassi M, Delle Fave A, Cetin I, Melchiorri E, Pozzo M, Vescovelli F, et al. Psychological well-being and depression from pregnancy to postpartum among primiparous and multiparous women. J Reprod Infant Psychol 2017;35:183-95.  https://doi.org/10.1080/02646838.2017.1290222
  35. Chen YH, Huang JP, Au HK, Chen YH. High risk of depression, anxiety, and poor quality of life among experienced fathers, but not mothers: a prospective longitudinal study. J Affect Disord 2019;242:39-47. 
  36. Fekadu Dadi A, Miller ER, Mwanri L. Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: a systematic review and meta-analysis. PLoS One 2020;15:e0227323. 
  37. Moreau C, Bonnet C, Beuzelin M, Blondel B. Pregnancy planning and acceptance and maternal psychological distress during pregnancy: results from the National Perinatal Survey, France, 2016. BMC Pregnancy Childbirth 2022;22:162. 
  38. Goyal D, Gay CL, Lee KA. Patterns of sleep disruption and depressive symptoms in new mothers. J Perinat Neonatal Nurs 2007;21:123-9.  https://doi.org/10.1097/01.JPN.0000270629.58746.96
  39. Wolfson AR, Crowley SJ, Anwer U, Bassett JL. Changes in sleep patterns and depressive symptoms in first-time mothers: last trimester to 1-year postpartum. Behav Sleep Med 2003;1:54-67.  https://doi.org/10.1207/S15402010BSM0101_6
  40. Cash TF. The treatment of body image disturbances. In: Thompson J, editor. Body image, eating disorders, and obesity: an integrative guide for assessment and treatment. Washington (DC): American Psychological Association; 1996. p. 83-107.