Presentation at the Global Maternal Newborn Health Conference, October 20, 2015
This longitudinal study examined the relationship of psychological distress with birth outcomes among pregnant women from Peshawar, Pakistan. A total of 230 pregnant women who attended antenatal care between September 2011 and December 2012, were enrolled. Psychological symptoms were assessed using Depression, Anxiety and Stress scales (DASS-42). Respondents were dichotomized into psychologically distressed (with DAS symptoms) and non-distressed groups (without DAS symptoms) based on the cut-off values for each set of symptoms of depression, anxiety and stress. Data on relevant confounding factors as dietary intake, emotional support, demographic-socioeconomic characteristics and maternal anthropometry (mid upper arm circumference (MUAC) and gestational weight gain) were collected using pre-tested questionnaires and standard procedures. After delivery, new born physical measurements (birth weight, length and head circumferences) were measured. A total of 45% (n=104) of the respondents reported mild to severe symptoms of psychological distress. Among the total births, 2%, 21% and 22% were stillbirth, pre-term (<37 weeks) and low birth weight (LBW) babies respectively. Overall, compared to women without DAS symptoms, distressed women had a tendency to deliver preterm (28% vs 16%, p=0.035) and low birth weight babies (<2500 g) (32% vs 15%, p=0.024). In regression models, antenatal psychological distress predicted lower birth-weight, controlling for confounders; however no differences were evident in means birth length and head circumference among the groups. Our study concluded that women with DAS symptoms during pregnancy are at the risk of delivering low birth weight babies.