Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry

Shahnaz Barat; Azita Ghanbarpour; Seyyedeh Mahboubeh Mirtabar; Farzan Kheirkhah; Zahra Basirat; Hoda Shirafkan; Angela Hamidia; Faezeh Khorshidian; Davood Hosseini Talari; Zeynab Pahlavan; Sedigheh Esmaelzadeh; Zinatosadat Buzari; Mahtab Zeynalzadeh; Shahla Yazdani Charati; Fatemeh Shafizade; Mahsima Adnani; Fatemeh Amirkhanloo; Maedeh Mollaalipour; Atieh Chale Kani; Mania Amiri; Razieh Khazaei; Seyedeh Shabnam Mehdinia; Fatemeh Basirat; Simin Asadollahi; Asieh Khodami; Alireza Azizi; Fatemeh Nasiri-Amiri; Nooshin Fatery; Shirin Shahrokhi; Banafshe Zarinkamar; Sajedeh Aligoltabar; Mahbobeh Faramarzi

doi:10.1186/s12884-023-06024-3

Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry

BMC Pregnancy Childbirth. 2023 Nov 14;23(1):793. doi: 10.1186/s12884-023-06024-3.

Authors

Shahnaz Barat^#¹, Azita Ghanbarpour^#², Seyyedeh Mahboubeh Mirtabar³, Farzan Kheirkhah⁴, Zahra Basirat¹, Hoda Shirafkan⁵, Angela Hamidia⁴, Faezeh Khorshidian⁴, Davood Hosseini Talari⁴, Zeynab Pahlavan⁶, Sedigheh Esmaelzadeh¹, Zinatosadat Buzari¹, Mahtab Zeynalzadeh¹, Shahla Yazdani Charati¹, Fatemeh Shafizade², Mahsima Adnani², Fatemeh Amirkhanloo², Maedeh Mollaalipour², Atieh Chale Kani², Mania Amiri², Razieh Khazaei², Seyedeh Shabnam Mehdinia², Fatemeh Basirat², Simin Asadollahi², Asieh Khodami², Alireza Azizi⁴, Fatemeh Nasiri-Amiri⁶, Nooshin Fatery⁷, Shirin Shahrokhi⁸, Banafshe Zarinkamar⁹, Sajedeh Aligoltabar¹⁰, Mahbobeh Faramarzi¹¹

Affiliations

¹ Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
² Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
³ Research Clinical Psychology, Student Research Committee, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
⁴ Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
⁵ Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
⁶ Department of Midwifery, School of Nursing and Midwifery,Infertility and Reproductive Health Research Center, Reproductive Health, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
⁷ Midwifery, Clinical Research Development Unit of Rohani Hospital, Health Research, Institute, Babol University of Medical Sciences, Babol, Iran.
⁸ Clinical Psychology, Student Reasearch Committee, Behshahr Azad University, Behshahr, Iran. shirin.sh2225@gmail.com.
⁹ Clinical Psychology, Clinical Research Development Unit of Shahid Yahya Nejad, Health Research Institute, Babol University of Medical Sciences, HospitalBabol, Iran.
¹⁰ Midwifery, Student Reasearch Committee, Babol University of Medical Sciences, Babol, Iran.
¹¹ Department of General Courses, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. mahbob330@yahoo.com.

^# Contributed equally.

Abstract

Background: Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum.

Methods: A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions.

Results: The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P < 0.001), as well as its three subscales: somatization (β = 1.355, P = 0.019), anxiety symptoms (β = 2.249, P < 0.001), and depressive symptoms (β = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (β = 1.344, P = 0.038) and the somatization subscale (β = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (β = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (β = 1.998, P = 0.012) and depressive symptoms (β = 1.949, P = 0.020).

Conclusion: The high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.

Keywords: Anxiety Depression; Distress; Postpartum; Pregnancy; Psychological; Risk factors.

MeSH terms

Anxiety / epidemiology
Anxiety / psychology
Child
Cross-Sectional Studies
Depression / epidemiology
Depression, Postpartum* / psychology
Female
Humans
Infant
Iran / epidemiology
Mental Health
Postpartum Period / psychology
Pregnancy
Pregnancy, High-Risk
Psychological Distress*
Stress, Psychological / psychology

Grants and funding

724134620/Babol University of Medical Sciences