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LETTER TO THE EDITOR
Year : 2019  |  Volume : 8  |  Issue : 2  |  Page : 151-152

Will screening for antenatal anxiety and depression improve neonatal outcome?


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth, Kancheepuram, Tamil Nadu, India

Date of Submission12-Mar-2019
Date of Acceptance22-Mar-2019
Date of Web Publication30-Jul-2019

Correspondence Address:
Dr. Kalaivani Annadurai
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth, Kancheepuram District, Thiruporur - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JDRNTRUHS.JDRNTRUHS_41_19

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How to cite this article:
Sundarrajan IB, Annadurai K, Bobhate P. Will screening for antenatal anxiety and depression improve neonatal outcome?. J NTR Univ Health Sci 2019;8:151-2

How to cite this URL:
Sundarrajan IB, Annadurai K, Bobhate P. Will screening for antenatal anxiety and depression improve neonatal outcome?. J NTR Univ Health Sci [serial online] 2019 [cited 2019 Aug 23];8:151-2. Available from: http://www.jdrntruhs.org/text.asp?2019/8/2/151/263637



Sir,

Pregnancy is a time of happiness and expectations for every woman. Moreover, it is also a period of challenges and stress as a result of psychosocial and physiological changes due to pregnancy. Anxiety and depression are the most common psychiatric illnesses encountered in antenatal women which often goes unnoticed. So, it is a challenging task to identify the antenatal women who are at higher risk of developing anxiety and depression. The most common factors which have been identified for antenatal anxiety and depression were lack of support from spouse and family, history of physical or emotional abuse, unwanted or unplanned pregnancy, bad obstetric outcome, and family history of mental health disorders.[1]

Although screening for anxiety and depression in antenatal women has been recommended in clinical setup, various challenges such as lack of availability of adequate number of psychiatrists, lack of awareness on mental health illness among general population and the stigma associated with it, lack of affordable services and treatment are hampering in getting earlier diagnosis and follow-up of mental health disorders. Even though a variety of scales are available for diagnosing anxiety and depression in general population, validity of these scales is still questionable for usage among antenatal women. As antenatal period is a stressful state with various physiological and psychological changes taking place in a woman, it will increase the likelihood of false-positive results on screening.[2]

Maternal anxiety and depression have adverse effects on the neonate. The immediate effects are low birth weight and preterm delivery. Moreover, the long-term effects were noted in cognition, motor, and behaviors of children born to antenatal mothers with untreated anxiety and depression. These changes were observed not only in the early life of new born but also persists throughout their development. The child born to such mothers is also at higher chance of developing severe mental health issues in their latter part of life and this becomes a vicious cycle.[3]

Screening for anxiety and depression during pregnancy and its early intervention seems to be the most rewarding strategy in minimizing the effect on fetus. Antenatal screening is feasible even in low-resource settings with minimal funds and manpower, as this is a period when antenatal woman comes frequently in contact with the health care facility.[4] Early initiation of cognitive behavior therapy among antenatal women with anxiety and depression shows promising results in tackling this issue, and thereby improving the birth outcome and a healthy baby.[5]

To conclude, further research focusing on anxiety and depression in antenatal period is the need of the hour for developing validated tools for screening. Integration of mental health services to general health care through capacity building of primary health care personnel in administering the screening techniques as a part of routine antenatal check-ups should be advocated for a safe motherhood.

Acknowledgment

The authors are very thankful to Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth for supporting the study.

Financial support and sponsorship

Nil.

Conflicts of interest

The authors declare no conflicts of interest.



 
  References Top

1.
Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: A systematic review. J Affect Disord 2016;191:62-77.  Back to cited text no. 1
    
2.
Nasreen HE, Kabir ZN, Forsell Y, Edhborg M. Low birth weight in offspring of women with depressive and anxiety symptoms during pregnancy: Results from a population based study in Bangladesh. BMC Public Health 2010;10:515.  Back to cited text no. 2
    
3.
Schetter CD, Tanner L. Anxiety, depression and stress in pregnancy: Implications for mothers, children, research, and practice. Curr Opin Psychiatry 2012;25:141.  Back to cited text no. 3
    
4.
Austin MP. Antenatal screening and early intervention for “perinatal” distress, depression and anxiety: where to from here?. Archives of Women's Mental Health. 2004;7:1-6. Available from: https://link.springer.com/article/10.1007/s00737-003-0034-4. [Last Accessed on 2019 Apr 11].  Back to cited text no. 4
    
5.
Austin MP, Frilingos M, Lumley J, Hadzi-Pavlovic D, Roncolato W, Acland S, et al. Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: A randomised controlled trial. J Affect Disord 2008;105:35-44.  Back to cited text no. 5
    




 

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