Waqas Ahmed, Raza Nahal, Lodhi Haneen Wajid, Muhammad Zerwah, Jamal Mehak, Rehman Abdul
CMH-Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt, Pakistan.
Allama Iqbal Medical College, Lahore, Pakistan.
PLoS One. 2015 Jan 28;10(1):e0116510. doi: 10.1371/journal.pone.0116510. eCollection 2015.
Pregnancy is generally viewed as a time of fulfillment and joy; however, for many women it can be a stressful event. In South Asia it is associated with cultural stigmas revolving around gender discrimination, abnormal births and genetic abnormalities.
This cross-sectional study was done at four teaching hospitals in Lahore from February, 2014 to June, 2014. A total of 500 pregnant women seen at hospital obstetrics and gynecology departments were interviewed with a questionnaire consisting of three sections: demographics, the Hospital Anxiety and Depression Scale (HADS) and the Social Provisions Scale (SPS). Pearson's chi-squared test, bivariate correlations and multiple linear regression were used to analyze associations between the independent variables and scores on the HADS and SPS.
Mean age among the 500 respondents was 27.41 years (5.65). Anxiety levels in participants were categorized as normal (145 women, 29%), borderline (110, 22%) or anxious (245, 49%). Depression levels were categorized as normal (218 women, 43.6%), borderline (123, 24.6%) or depressed (159, 31.8%). Inferential analysis revealed that higher HADS scores were significantly associated with lower scores on the SPS, rural background, history of harassment, abortion, cesarean delivery and unplanned pregnancies (P < .05). Social support (SPS score) mediated the relationship between the total number of children, gender of previous children and HADS score. Women with more daughters were significantly more likely to score higher on the HADS and lower on the SPS, whereas higher numbers of sons were associated with the opposite trends in the scores (P < .05).
Because of the predominantly patriarchal sociocultural context in Pakistan, the predictors of antenatal anxiety and depression may differ from those in developed countries. We therefore suggest that interventions designed and implemented to reduce antenatal anxiety and depression should take into account these unique factors.
怀孕通常被视为一个充满成就感和喜悦的时期；然而，对许多女性来说，这可能是一个压力重重的事件。在南亚，它与围绕性别歧视、异常分娩和基因异常的文化耻辱感相关联。
这项横断面研究于2014年2月至2014年6月在拉合尔的四家教学医院进行。对在医院妇产科就诊的500名孕妇进行了问卷调查，问卷由三个部分组成：人口统计学、医院焦虑抑郁量表（HADS）和社会支持量表（SPS）。使用Pearson卡方检验、双变量相关性分析和多元线性回归来分析自变量与HADS和SPS得分之间的关联。
500名受访者的平均年龄为27.41岁（5.65）。参与者的焦虑水平被分类为正常（145名女性，29%）、临界（110名，22%）或焦虑（245名，49%）。抑郁水平被分类为正常（218名女性，43.6%）、临界（123名，24.6%）或抑郁（159名，31.8%）。推断性分析显示，较高的HADS得分与较低的SPS得分、农村背景、骚扰史、流产史、剖宫产史和意外怀孕显著相关（P < 0.05）。社会支持（SPS得分）介导了子女总数、前子女性别与HADS得分之间的关系。女儿较多的女性在HADS上得分显著更高，在SPS上得分更低，而儿子数量较多则与得分的相反趋势相关（P < 0.05）。
由于巴基斯坦主要是父权制的社会文化背景，产前焦虑和抑郁的预测因素可能与发达国家不同。因此，我们建议设计和实施的减少产前焦虑和抑郁的干预措施应考虑到这些独特因素。
