Prevalence of Depression and its Risk Factors in Antenatal Women consulting at the Outpatient Department of the UERMMMCI Aclan Agbanlog Agoncillo, K Agoncillo, L Alianza Ame Ancheta Ang Ping Ang, A Ang, V

Pregnancy is a time of joy and excitement.. Many studies are now stating that depression is becoming a common thing in pregnancy. Depression is the psychopathological feeling of sadness due to a primary or secondary cause (Sadock and Sadock 2003), and it is common during pregnancy for women to succumb to feelings of loneliness, sadness, and guilt.

Depression during pregnancy negatively affects fetal health (Bonari et al 2003), since the mother may have: o poor appetite o show suicidal or destructive behaviour and, o resort to vices that could lead to pre-term labor and poorer APGAR scores (Berle et al 2005).

Neonates born from depressed mothers have decreased serotonin and dopamine levels (Lundy et al 1999; Field et al 2003) and increased cortisol levels (Kean and Marsh 2007; Lundy et al 1999), Results in low birth weights and higher susceptibility to concurrent infections. Increased cortisol levels are also associated with predisposition of the child to increased insulin resistance (Philipps et al 1998). Moreover, it may affect the mother relationship to the child and have emotional cognitive and behavioural consequences.

SIGNIFICANCE of the STUDY

GENERAL OBJECTIVE This study is designed to determine the prevalence and pattern of occurrence of antenatal depression among Filipino women consulting at the UERMMMC Outpatient department from April to May of 2010.

SPECIFIC OBJECTIVES

To determine the prevalence of antepartum depression of pregnant Filipino Women consulting at the OPD of UERMMMCI. To determine the association of the following identified risk factors associated with antenatal depression:  Age  Marital status  Social support  Personal or family history of depression  Socioeconomic status  Substance abuse

METHODOLOGY

Descriptive cross sectional design Population: all pregnant women, capable of reading and understanding the questionnaire, and who consulted at the UERMMMCI Department of Obstetrics and Gynecology Outpatient Department between April 21 to May Consent Form

Assisted questionnaire: demographic data, source of social support, history of psychiatric consult, problems with substance abuse and Patient Health Questionnaire 9 (PHQ – 9)

PHQ – 9 was assessed : o 5-9 have minimal symptoms o could either have minor depression, dysthymia, mild major depression o have moderately severe major depression o 20-severe major depression o ≥ 10 or those with suicidal ideation was REFERRED Data was then compiled and processed by STATA ver. 9.

RESULTS and DISCUSSION

Table 2. Summary of Crude Analysis of the Association Between Selected Independent Variables and Depression. Independent VariableRR95% CIp-value Marital Status Single Married Age ≤ ≥ Social Support b1b With Without Personal/Family History of Depression With Without Socioeconomic Status Low Adequate Substance Abuse Yes No Level of Difficulty With Without0.89--

Table3. Summary of Multiple Regression Analysis of the Association Between Selected Independent Variables and Depression Independent VariableOR95% CIp-value Marital Status Single Married--- Age ≤ ≥ Economic Status <PhP5, >PhP5,

RESULTS The percent of married and single parents among the respondents were almost equal (52% and 47% respectively). INCOME: those earning above and below PhP10, have equal distribution, though among the respondents there is about 23% with earnings below PhP5, (below the minimum food level of PhP6,000 according to the NSCB).

179 out of 195 : minimal signs to severe signs of depression based on their PHQ – 9 scores. 47% have minimal 32% mild symptoms 4% moderate to severe 1% severe

Marital Status and Depression 52% Married individuals with depression 47%, Single with depression 1% have consulted with a psychiatrist

Monthly Income and Depression 50% belong to the group with monthly earnings between PhP5,000-9,999 25% and PhP10,000-14,999 21% PhP1000-4,999 16% PhP15,000-20,000 and those with monthly earnings PhP20,000 with 5% each.

Substance Abuse and Depression 1.6% of those with symptoms of depression were exposed to substance abuse. Social Support and Depression Among those suffering from depression, the majority came from those who had support (96%) and those individuals with support, majority of them has no difficulty in functioning. History of Psychiatric Consultation Only 3 individuals (1%) out of the 179 previously consulted a psychiatrist about their problems.

Depression and Trimester of Pregnancy 42% last trimester 38% 2 nd trimester 14% 1 st trimester AGE 58%, 29 years old Level of Depression and Difficulty of Functioning Mild difficulty in functioning 21% Minimal 8% Moderate 6% Moderately severe 2% Severe, 0.5%

SUMMARY and CONCLUSION

In April 21 to May 28, 2010,out of 195 participants, 179 presented with signs and symptoms of depression, Age range of 26-30, Married Income: PhP5, , and PhP10, , History of Psychiatric Consultation 1% Majority have minimal symptoms Risk Factors were found insignificant, though in multiple regression analysis: economic status (in terms: of adequacy of income) and age was found to have positive trending but were still statistically insignificant.

RECOMMENDATIONS Longer duration and coverage of study Different Locations of study