Antenatal Care Status in Pregnant Women and Evaluation of Relationship Between Antenatal Care and Depression Symptoms
Objective: The aim of our study is to determine the antenatal care status of pregnant women in the last trimester and to determine whether there is a relationship between antenatal care parameters and depression sypmtoms.
Methods: The study was cross-sectional and was performed between September 201 and January 2019 at the Department of Obstetrics and Gynecology of Farabi Hospital, Karadeniz Technical University, Faculty of Medicine. The study included 135 last trimester pregnant women who were admitted to the outpatient clinic, did not have any chronic disease, did not get pregnant with assisted reproductive techniques and had not had major depression before. Beck Depression Scale (BDS) and a questionnaire consisting of 52 questions, which was prepared based on the prenatal care management guide of the Ministry of Health and assesses the antenatal care status and socio-demographic characteristics of the participants, was applied with the face-to-face interview technique. Each “yes” response to the questions asked about antenatal care receiving status was scored as “1 point” and every “no” response was scored as “0 point” and “consulting score” over 15 points and “procedures score” over 24 points were calculated.
Results: The mean age of the participants was 30,2±5,4 years. 98.5% (n = 133) of the pregnant women came to the doctor in the first 14 weeks. Only 2 pregnant women had less than 4 visits. 72,6% (n = 98) of pregnant women had a sufficient number of visits. The average counseling score of the pregnant women was 7.8 ± 4.1 and the mean of the procedures score was 18.6 ± 2.6. The most consulted subject was the use of medication with 79.3% (n = 107) and the subject with the least consultancy was oral and dental health with 25.9% (n = 35). All of the pregnant women had urine and blood analysis and ultrasonography (usg). The least procedure was breast examination with 10.4% (n = 14). It was observed that 27.4% (n = 37) of the pregnant women had depression symptoms. While there was no statistically significant relationship between BDS score and total number of visits (p = 0.843), counseling score (p = 0.108) and the number of procedures score (p = 0.166), a significant relationship was found between thinking of receiving adequate care and BDS score (p = 0.026).
Conclusion: In our study, we found that most of the pregnant women received adequate antenatal care in terms of the number of procedures and visits, but that they could not receive the counseling services adequately and there is a significant relationship between thinking that she received adequate care and symptoms of depression. This may lead to primary care physicians who are responsible for the pregnancy. In this respect, studies and projects are needed to develop antenatal care services.
- Akın A, Özvarış Ş. Türkiye’de Doğum Öncesi Bakım Hizmetlerinden Yararlanma. Eds: Akın A. Türkiye’de Ana Sağlığı, Aile Planlaması Hizmetleri ve İsteyerek Düşükler, Türkiye Nüfus ve Sağlık Araştırması-1998 İleri Analiz Sonuçları. Ankara, Hacettepe Üniversitesi Türkiye Aile Sağlığı ve Planlaması Vakfı UNFPA; 2002.
- Alkema L, Chou D, Hogan D. et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. The Lancet. 2016;387(10017):462-74.
- İsmet K, Rudolf S, Oona C. Ulusal Anne Ölümleri Çalışması 2005. Hacettepe Üniversitesi Nüfus Etütleri Enstitüs, Ankara, NEE-HÜ. 2005;6(02).
- Öztürk MO. Ruh Sağlığı ve Bozuklukları. 8. basım. Ankara, Feryal Matbaası. 2001;266-296.
- Kessler RC. Epidemiology of women and depression. Journal of affective disorders. 2003;74(1):5-13.
- Woody C, Ferrari A, Siskind D, Whiteford H, Harris M. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders. 2017;219:86-92.
- Mersha A, Abebe S, Sori L, Abegaz T. Prevalence and Associated Factors of Perinatal Depression in Ethiopia: A Systematic Review and Meta-Analysis. Depression research and treatment. 2018;2018:Article ID 1813834.
- Bakanlığı TS. Doğum öncesi bakım yönetim rehberi. Ankara, Turkey: TC Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü. 2009.
- Erbil N, Oruç H, Karabulut A. Gebelikte depresyon ve etkileyen faktörlerin belirlenmesi. Turkiye Klinikleri Journal of Gynecology and Obstetrics. 2009;19(2):67-74.
- Çatak B, İkiışık H, Kartal S, Öner C, Seğmen Ö. İstanbul’da doğum öncesi bakım hizmetlerinin değerlendirilmesi: toplum tabanlı bir araştırma. Perinatoloji Dergisi. 2012;20(3):126-34.
- ERBAŞ G. İstanbul İli Gaziosmanpaşa İlçesinde Doğum Öncesi Bakım Hizmetlerinin Değerlendirilmesi. istanbul üniversitesi tıp fakültesi. 2016.
- Karaçam Z, Ançel G. Depression, anxiety and influencing factors in pregnancy: a study in a Turkish population. Midwifery. 2009;25(4):344-56.
- Golbasi Z, Kelleci M, Kisacik G, Cetin A. Prevalence and correlates of depression in pregnancy among Turkish women. Maternal and child health journal. 2010;14(4):485-91.
- Bakanlığı S. Türkiye Halk Sağlığı Kurumu Kadın ve Üreme Sağlığı Daire Başkanlığı Doğum Öncesi Bakım Yönetim Rehberi. Sağlık Bakanlığı Yayın. 2014(924):1-32.
- Pediatrics AAo. American College of Obstetricians and Gynecologists. Guidelines for perinatal care. Elk Grove Village (IL). 147: AAP Washington, DC.; 2002.
- Organization WH. WHO recommendations on antenatal care for a positive pregnancy experience: World Health Organization; 2016.
- Çatak B, Öner C, Oğuz İ, Gülay M, Özbek R, Baştürk S. Doğum öncesi bakım hizmetlerinin sahada izlemi ve değerlendirilmesi: Bursa örneği. Türkiye Aile Hekimliği Dergisi. 2014;18(2):63-9.
- Yucel U, Ciceklioglu M, Ocek ZA. Prenatal Care Utilization Level of Pregnant Women Living inThree Different Neighborhoods of Izmir’s Bornova District. TAF Preventive Medicine Bulletin. 2015;14(5):370-7.
- Kıssal A, Kartal B. Bir üniversite hastanesinde doğum yapan kadınların doğum öncesi bakım içeriğinin değerlendirilmesi. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi.5(1):36-42.
- Temizer M. Oğuzeli merkez aile sağlığı merkezine kayıtlı 2014 yılında canlı doğum yapmış annelerin doğum öncesi bakım hizmeti alma durumlarının değerlendirilmesi (tez). Gaziantep Üniversitesi. 2015.
- Kuğu N, Akyüz G. Gebelikte ruhsal durum. CÜ Tıp Fakültesi Dergisi. 2001;23(1):61-4.
- Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstetrics & Gynecology. 2005;106(5):1071-83.
- Kessler RC, Nelson CB, McGonagle KA, Liu J, Swartz M, Blazer DG. Comorbidity of DSM–III–R major depressive disorder in the general population: results from the US National Comorbidity Survey. The British journal of psychiatry. 1996;168(S30):17-30.