Muscat: Omani women have a high rate of being afflicted by possible depression during pregnancy, a groundbreaking new study published in the latest issue of the Sultan Qaboos University Medical Journal has revealed. The study is the first investigation into antenatal depression in Oman.
The researchers studied 959 pregnant Omani women who were attending local primary care health centres in Muscat. They used the Edinburgh Postnatal Depression Scale questionnaire to measure symptoms of depression in the study group.
According to the questionnaire responses, almost a quarter of these women (24.3 per cent) had antenatal depression, a rate higher than what is reported in other Arab and developed countries around the world, including Jordan, Morocco, Turkey, Australia and the UK.
“It was an issue of concern that our study showed such a high prevalence of possible antenatal depression in Oman,” commented Dr Mohammed Al Azri, the study’s lead researcher and an Associate Professor in the Family Medicine and Public Health department of Sultan Qaboos University.
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“If this form of depression is not diagnosed early on, these women suffer and their babies could also suffer,” he added.
In pregnant women, antenatal depression is known to increase the risk of pre-eclampsia—a serious pregnancy complication characterized by high blood pressure which can lead to early labour and delivery. Other complications of depression during pregnancy include Caesarean section births, spontaneous preterm births, suicidal thoughts and the development of post-natal depression
For the babies, antenatal depression has been associated with slower foetal activity, low birth weight, admission to the neonatal care unit and sudden infant death. If the depression continues after birth, these babies may receive insufficient physical and psychological care from their mothers. Their older siblings may also suffer from the secondary effects of maternal depression.
The researchers found that the main factors associated with antenatal depression were unplanned pregnancies and marital conflict. In order to combat these issues in Oman, Dr Al Azri recommends that women should be provided with ample education about contraception and pregnancy planning. He also suggests that counselling services be provided for married couples experiencing problems within their marriage.
Dr Al Azri is concerned that antenatal depression often goes undiagnosed in Oman. “This could be for many reasons, including a lack of awareness on the part of the attending physicians that this is a common problem, a lack of experience in diagnosing antenatal depression and a lack of medical guidelines and tools to diagnose the condition. Also, women might not be willing to talk about psychological or personal problems with their doctor,” he explained.
The study concluded that significant changes need to be made within Oman’s public health system in order to identify those affected by antenatal depression so they can be treated as soon as possible.
“Screening for the presence of antenatal depression should be included as a routine part of antenatal care,” affirmed Dr Al Azri.
“Sufficient support should be provided to all those affected women, including counselling services. Also, women with severe forms of this depression, who are not responding to counselling, should be referred to psychologists or psychiatrists as appropriate.”
Dr. Al Azri pointed out that there are limitations to this study. For example, the study data was gathered via a questionnaire and the women were not clinically diagnosed with antenatal depression by a qualified psychiatrist, meaning the true rate of antenatal depression may have been under- or over-estimated. Although the Edinburgh Postnatal Depression Scale used in this study is known as a reliable and sensitive indicator of ante- and post-natal depression, there may still be cultural differences which could have affected the results. In addition, some of the women included in the study may have had pre-existing undiagnosed depression.
The symptoms of antenatal depression include a significant lack of energy, tearfulness, chronic anxiety, emotional detachment and feelings of isolation, guilt or suicide. “Any pregnant women experiencing these symptoms should talk to their doctor about this as soon as possible,” urged Dr Al Azri.