Antenatal anxiety and depression: Frequency and correlates during the COVID-19 pandemic in Pakistan

Context: Mental health ailments like anxiety and depression are common during the antenatal period. Uncertainty during COVID-19 pandemic has markedly increased its prevalence in the general population. Pregnancy, being emotionally and physically exhausting, makes mothers more susceptible to developing mental disorders like anxiety and depression. Aims: To investigate prevalence and associated risk factors of antenatal anxiety and depression among women in Karachi, Pakistan. Settings and Design: This cross-sectional study was conducted in the department of obstetrics and gynecology during May 2020 till May 2021. Methods and Material: The study explored anxiety, depression, and associated factors in pregnant women attending antenatal clinics at a tertiary care hospital located in Karachi, Pakistan, during the COVID-19 pandemic by using the hospital anxiety and depression scale (HADS) as a screening tool. Statistical Analysis: Data was entered in SPSS version 21 for statistical analysis. Results: A total of 390 patients were enrolled in the study with mean age of 28.06 +/- 4.52 years. Mean week of pregnancy at the time of enrolment into the study was 32.7 +/- 3.1. Prevalence of anxiety and depression was 46.7% and 33.1%, respectively. On multivariable analysis, polyhydramnios was a risk factor of anxiety, whereas low income and unplanned pregnancy were substantially linked to depression. Fear of visiting doctor was a common risk factor for both anxiety and depression. Conclusion: In a catastrophe like the COVID-19 pandemic, attempts to address heightened anxiety during antenatal visits will undoubtedly benefit maternal and fetal mental health. As a response, strategies to manage high anxiety symptoms should be taken into consideration.