Physical and psychological morbidities among selected antenatal females in Kegalle district of Sri Lanka: A cross sectional study

J Obstet Gynaecol. 2017 Oct;37(7):849-854. doi: 10.1080/01443615.2017.1306697. Epub 2017 Apr 11.

Abstract

While motherhood is often a positive and satisfying experience, for some women, it is linked with suffering and ill-health. A woman should be able to feel physically and mentally content during pregnancy. Discomforts in pregnancy may be considered as insignificant by the physician. Therefore, the objective of this study was to determine physical and psychological morbidities among primigravid antenatal females in the Kegalle District, Sri Lanka. A sample of 1017 second and third trimester primigravid antenatal females selected by a two-stage probability proportional to size cluster sampling method, were assessed for physical and psychological problems. Data analysis was done using SPSS 16 package and associations were found using Chi square test with p values. The presence of any physical health problem during the preceding 14 days was reported by 75.7% (95% CI 73.0-78.2) of females though each individual physical problem was reported by less than or around one-third. Prevalence of psychological distress and depression was 22.7% (95% CI 20.2-25.4) and 10.4% (95% CI 8.7-12.4), respectively. The self-rated health was very good in 24.7% and good in 55.9%. Older employed females had significantly higher physical problems. It is concluded that although the self-rated wellbeing during pregnancy is high, the presence of physical and psychological ill-health is substantial. Impact statement Pregnancy is a time of intense physical change and is associated with emotional upheaval in many women. Obstetric morbidity is defined as morbidity in a woman who has been pregnant regardless of the site or the duration of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. It is classified into three categories namely; direct, indirect and psychological obstetric morbidity. For one maternal death, there can be between 9 and 16 females with obstetric morbidity depending on the level of development of a country. As a country with good health indicators, this study was conducted to determine physical and psychological problems among primigravid antenatal females in the Kegalle District,p Sri Lanka to improve service quality further. The presence of any physical health problem during the preceding 14 days was reported by a quarter of females and backache, fatigue, body aches, psychological distress, urinary incontinence and headache was commonly reported individual problems. Older employed females had significantly higher physical problems. Though trivial for health workers, physical and psychological problems are prevalent. These should be actively sought and remedied by health workers to improve the quality of life.

Keywords: EPDS; GHQ-30; Pregnant; physical problems.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Chi-Square Distribution
  • Cluster Analysis
  • Cross-Sectional Studies
  • Depression / epidemiology*
  • Diagnostic Self Evaluation
  • Female
  • Humans
  • Morbidity
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / psychology
  • Pregnancy Trimester, Second / psychology*
  • Pregnancy Trimester, Third / psychology*
  • Prevalence
  • Sri Lanka / epidemiology
  • Stress, Psychological / epidemiology*
  • Young Adult