ASSOCIATION OF ANTENATAL DEPRESSION AND HOUSEHOLD FOOD INSECURITY AMONG PREGNANT WOMEN: A CROSS-SECTIONAL STUDY FROM SLUMS OF LAHORE

Authors

  • Hafsa Ayyub Health Services Academy, Islamabad http://orcid.org/0000-0003-1712-0941
  • Mariyam Sarfraz Health Services Academy, Islamabad
  • Khizran Mir Health Services Academy, Islamabad
  • Fakiha tus Salam Health Services Academy

Abstract

Background: Pregnant women are more likely to develop antenatal depression due to multiple factors including sickness and death of close family member, unwanted pregnancy, unplanned pregnancy, economic and relationship difficulties. Food insecurity is a major issue in low resource settings, especially in developing countries. Malnourishment in pregnant women along with antenatal depression can lead to adverse effect on growth of foetus and can lead to adverse pregnancy outcomes. The aim of this study was to determine an association between food insecurity and antenatal depression among pregnant women living in slum settlements of Lahore. Method: A community based, cross-sectional study was conducted in slum settlements of district Lahore, with a sample of 367 pregnant women. Antenatal depression and household food insecurity was measured using Edinburgh Postnatal Depression Scale (EPDS) and Household food insecurity access scale (HFIAS). Data was entered and analysed in SPSS-20.0. Chi-square and multivariate logistic regression analysis was used to estimate effect of food insecurity on antenatal depression among pregnant women.  Results: Prevalence of antenatal depression was 39.5% among pregnant women. Majority of the sample, i.e., 46% were food insecure. In an adjusted model, multivariate logistic regression showed existence of strong association between food insecurity and antenatal depression (AOR=2.58, 95%, CI: 1.64–4.075) in women surveyed. Conclusion: Study results show strong association between food insecurity and antenatal depression. Findings also suggest the need of an effective intervention at community level to combat food insecurity and antenatal depression in marginalized populations.Keywords: Food insecurity; Antenatal; Slums; Nutrition; Pregnancy; Developing Country; Pakistan

Author Biographies

Hafsa Ayyub, Health Services Academy, Islamabad

Health Services Academy, Student

Mariyam Sarfraz, Health Services Academy, Islamabad

Department of Public Health, Assistant Professor

Khizran Mir, Health Services Academy, Islamabad

Health Services Academy, Student

Fakiha tus Salam, Health Services Academy

Health Services Academy, Student

References

World Food Program. What causes Hunger? [Internet]. [cited 2016 July 22]. Available from: http://www.wfp.org/hunger/causes

MDG Monitor. Eradicate Extreme Poverty and Hunger. [Internet]. MDG Monitor. 2015 [cited 2016 Jul 24]. Available from: http://www.mdgmonitor.org/mdg-1-eradicate-poverty-hunger/

WHO. Millennium Development Goals (MDGs) [Internet]. World Health Organization; 2015 [cited 2016 Jul 24]. Available from: http://www.who.int/mediacentre/factsheets/fs290/en/

McGuire S. FAO, IFAD, WFP. The State of Food Insecurity in the World 2015: Meeting the 2015 international hunger targets: taking stock of uneven progress. Rome: FAO, 2015. Adv Nutr 2015;6(5):623–4.

United Nations Standing Committee on Nutrition. Sixth report on the world nutrition situation. [Internet]. Switzerland; 2016 [cited 2016 Jul 24]. Available from: http://www.unscn.org/files/Publications/RWNS6/report/SCN_report.pdf

UN. Department of Economic and Social Affairs, Population Division. World urbanization prospects: the 2014 revision. 2014.

Faye O, Baschieri A, Falkingham J, Muindi K. Hunger and food insecurity in Nairobi’s slums: an assessment using IRT models. J Urban Health 2011;88(Suppl 2):235–55.

What is food insecurity? Feeding Texas. [Internet]. [cited 2016 Jul 24]. Available from: http://www.feedingtexas.org/learn/food-insecurity/

Williamson CS. Nutrition in pregnancy. Nutr Bull 2006;31(1):28–59.

López-Cano LA, Restrepo-Mesa SL. A group of pregnant teenagers’ perceptions regarding their pregnancy accompanied by food insecurity. Rev Salud Pública (Bogotá) 2014;16(1):76–87.

Carmichael SL, Yang W, Herring A, Abrams B, Shaw GM. Maternal food insecurity is associated with increased risk of certain birth defects. J Nutr 2007;137(9):2087–92.

WHO. Mental Health: A Call for Action by World Health Ministers. [Internet]. Geneva; 2001 [cited 2016 Jul 23]. Available from: http://www.who.int/mental_health/advocacy/en/Call_for_Action_MoH_Intro.pdf

WHO. Depression. [Internet]. World Health Organization; 2016 [cited 2016 Jul 25]. Available from: http://www.who.int/mediacentre/factsheets/fs369/en/

World Food Program. WFP Pakistan Country Brief. [Internet]. [cited 2016 Jul 25]. Available from: http://documents.wfp.org/stellent/groups/public/documents/ep/wfp272142.pdf?_ga=1.57009903.412424498.14880248460

Azeem MM, Mugera AW, Schilizzi S. Living on the edge: Household vulnerability to food-insecurity in the Punjab, Pakistan. Food Policy 2016;64:1–13.

Humayun A, Haider II, Imran N, Iqbal H, Humayun N. Antenatal depression and its predictors in Lahore, Pakistan. East Mediterr Health J 2013;19(4):327–32.

Waqas A, Raza N, Lodhi HW, Muhammad Z, Jamal M, Rehman A. Psychosocial factors of antenatal anxiety and depression in Pakistan: is social support a mediator? PLoS One 2015;10(1):e0116510.

Saeed A, Raana T, Saeed AM, Humayun A. Effect of antenatal depression on maternal dietary intake and neonatal outcome: a prospective cohort. Nutr J 2016;15(1):64.

Imran N, Haider II. Screening of antenatal depression in Pakistan: risk factors and effects on obstetric and neonatal outcomes. Asia-Pacific Psychiatry 2010;2(1):26–32.

Planning Commision Government of Pakistan. National Nutrition Survey 2011. [Internet]. [cited 2016 Jul 28]. Available from: https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/NNS%202011.pdf

Coates J, Swindale A, Bilinsky P. Household Food Insecurity Access Scale (HFIAS) for Measurement of Household Food Access: Indicator Guide (vol 3). Washington DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development; 2007.

Laerd Statistics. Cronbach’s Alpha in SPSS Statistics - procedure, output and interpretation of the output using a relevant example. [Internet]. [cited 2016 Jul 29]. Available from: https://statistics.laerd.com/spss-tutorials/cronbachs-alpha-using-spss-statistics.php

Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782–6.

Shah SM, Bowen A, Afridi I, Nowshad G, Muhajarine N. Prevalence of antenatal depression: comparison between Pakistani and Canadian women. J Pak Med Assoc 2011;61(3):242–6.

Mir S, Karmaliani R, Hatcher J, Asad N, Sikander S. Prevalence and risk factors contributing to depression among pregnant women in district Chitral, Pakistan. J Pak Psych Soc 2012;9(1):28–36.

Bavle AD, Chandahalli AS, Phatak AS, Rangaiah N, Kuthandahalli SM, Nagendra PN. Antenatal Depression in a Tertiary Care Hospital. Indian J Psychol Med 2016;38(1):31–5.

Agampodi SB, Agampodi TC. Antenatal Depression in Anuradhapura, Sri Lanka and the Factor Structure of the Sinhalese Version of Edinburgh Post Partum Depression Scale among Pregnant Women. PloS One 2013;8(7):e69708.

Nasreen HE, Kabir ZN, Forsell Y, Edhborg M. Prevalence and associated factors of depressive and anxiety symptoms during pregnancy: a population based study in rural Bangladesh. BMC Womens Health 2011;11:22.

Connelly CD, Hazen AL, Baker-Ericzén MJ, Landsverk J, Horwitz SM. Is screening for depression in the perinatal period enough? The co-occurrence of depression, substance abuse, and intimate partner violence in culturally diverse pregnant women. J Womens Health (Larchmt) 2013;22(10):844–52.

Jayasuriya V, Wijewardena K, Axemo P. Intimate partner violence against women in the capital province of Sri Lanka: prevalence, risk factors, and help seeking. Violence Against Women 2011;17(8):1086–102.

Rahman M, Nakamura K, Seino K, Kizuki M. Intimate partner violence and chronic undernutrition among married Bangladeshi women of reproductive age: are the poor uniquely disadvantaged? Eur J Clin Nutr 2013;67(3):301–7.

Zakar R, Nasrullah M, Zakar MZ AH, Ali H. The association of intimate partner violence with unintended pregnancy and pregnancy loss in Pakistan. Int J Gynaecol Obstet 2016;133(1):26–31.

Yanikkerem E, Ay S, Piro N. Planned and unplanned pregnancy: Effects on health practice and depression during pregnancy. J Obstet Gynaecol Res 2013;39(1):180–7.

Golbasi Z, Kelleci M, Kisacik G, Cetin A. Prevalence and correlates of depression in pregnancy among Turkish women. Matern Child Health J 2010;14(4):485–91.

Khan MN, Chiumento A, Dherani M, Bristow K, Sikander S, Rahman A. Psychological distress and its associations with past events in pregnant women affected by armed conflict in Swat, Pakistan: a cross sectional study. Confl Health 2015;9:37.

Cankorur VS, Abas M, Bersun O, Stewart R. Social Support and the incidence and persistence of depression between antenatal and postnatal examinations in Tukey: A cohort study. BMC Open 2015;5(4):e006456.

Shakeel N, Eberhard-Gran M, Sletner L, Slinning K, Martisen EW, Holm I, et al. A prospective cohort study of depression in pregnancy, prevalence and risk factors in a multi-ethnic population. BMC Pregnancy Childbirth 2015;15:5.

Chinnakali P, Upadhyay RP, Shokeen D, Singh K, Kaur M, Singh AK, et al. Prevalence of household-level food insecurity and its determinants in an urban resettlement colony in north India. J Health Popul Nutr 2014;32(2):227–36.

Agarwal S, Sethi V, Gupta P, Jha M, Agnihotri A, Nord M. Experiential household food insecurity in an urban underserved slum of North India. Food Secur 2009;1(3):239–50.

Maitra C, Rao DSP. Poverty-Food Security Nexus: Evidence from a Survey of Urban Slum Dwellers in Kolkata. World Dev 2015;72:308–25.

Vuong TN, Gallegos D, Ramsey R. Household food insecurity, diet, and weight status in a disadvantaged district of Ho Chi Minh City, Vietnam: a cross-sectional study. BMC Public Health 2015;15:232.

Osei A, Pandey P, Spiro D, Nielson J, Shrestha R, Talukder Z, et al. Household food insecurity and nutritional status of children aged 6 to 23 months in Kailali District of Nepal. Food Nutr Bull 2010;31(4):483–94.

Published

2018-09-17