Depression, perceived stress, and resilience among pregnant woman in two maternity hospitals Karachi, Pakistan

Women during pregnancy are at a higher risk of developing stress and depression. One of the factors leading to stress and depression is low resilience in the face of life stressors. This study aimed to estimate the prevalence of perceived stress and depression and their association with resilience and other covariates among pregnant women, in two maternity hospitals of Karachi, Pakistan. Methods: An analytical cross-sectional study design was employed to achieve the study objectives. A total of 440 pregnant women were recruited using consecutive sampling. Data was collected using a structured questionnaire: EPDS for antenatal depression, PSS for perceived stress, and RS-l4 for level of resilience. Data was analyzed by using descriptive and inferential statistics. Multiple linear regression was applied to determine factors associated with perceived stress, whereas the factors associated with antenatal depression were analyzed using Cox proportional algorithm in software Stata version 12. Study Findings: The prevalence of antenatal depression was found to be 57% among pregnant women. Quality of sleep; employment status; interaction between levels of resilience, perceived stress score, social support score; and an interaction between complication in current pregnancy and domestic violence were found to be significantly associated variables with antenatal depression at the level of multivariable analysis. The estimated mean perceived stress score was found to be 18.77 (SD+ 6.33). The factors associated with perceived stress were: domestic violence, complication in current pregnancy, mode of delivery, gestational age, relationship with husband and in-laws, history of postnatal depression, resilience, socio-economic status, social support, past history ofpsychiatric illness and sleep pattern during pregnancy; substance use, and number of stressful life events. Approximately, 41% participants were found to have low resilience levels. There was an inverse relationship of resilience score with depression scores and perceived stress scores, whereas, a positive relationship was found between the perceived stress scores and depression scores. Conclusion: The study findings suggest high levels of depression pregnant women recruited in this stud and perceived stress among y. It can be stated, with reasonable conviction, that women who are less resilient are more likely to develop depressive symptoms. Moreover, women who reported low social support, low resilience, and high perceived stress were found to be more inclined to feel depressed. These findings draw attention towards the immediate need for mental health screening program s to be conducted for pregnant women, and the initiation of treatment and support programs integrated into antenatal services. Moreover, governmentally imposed interventions are required for the sustained mental well-being of the pregnant women in the country