Risk Factors and Prevalence of Antenatal Psychiatric Symptoms: A Cross-Sectional Study in an Underprivileged Urban Setting
DOI:
https://doi.org/10.51957/Healthline_835_2026Keywords:
Antenatal psychiatric symptoms, Urban underprivileged setting, Maternal mental health, Risk factors, PrevalenceAbstract
Introduction: Antenatal psychiatric symptoms (APS) adversely affect maternal-foetal outcomes, yet risk factors remain under-researched in India’s underprivileged urban communities. Objectives: We assessed the prevalence and associated risk factors of APS in an urban primary care setting. Methods: This cross-sectional study was conducted at a government maternity hospital in South India. Women >= 18 years, with gestation < 24 weeks, were screened for APS using Patient Health Questionnaire 9, Generalised Anxiety Disorder 7 and World Health Organisation's Alcohol, Smoking, and Substance Involvement Screening Test, respectively. Descriptive statistics were used for clinical variables. Multivariable logistic regression was used for risk factors associated with APS. Results: Prevalence of APS was 13.4%. History of self-harm attempts and spouse being a daily wage labourer were associated with APS. Conclusion: APS is prevalent in urban, underprivileged backgrounds. Mental health screening during pregnancy is vital, especially for those with history of self-harm.
References
1. Kalra H, Tran TD, Romero L, Chandra P, Fisher J. Prevalence and determinants of antenatal common mental disorders among womenin India: a systematic review and meta-analysis. Arch Womens Ment Health. 2021;24(1):29–53. doi:10.1007/s00737-020-01024-0 DOI: https://doi.org/10.1007/s00737-020-01024-0
2. Dadi AF, Miller ER, Mwanri L. Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis. PLOS ONE. 2020;15(1):e0227323. doi:10.1371/journal.pone.0227323 DOI: https://doi.org/10.1371/journal.pone.0227323
3. Antenatal and postnatal mental health: clinical management and service guidance. Free Download [Internet]. [cited 2026 May 11]. Available from: https://www.nice.org.uk/guidance/cg192
4. Vianna P, Bauer ME, Dornfeld D, Chies JAB. Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids.
Medical Hypotheses. 2011;77(2):188–91. doi:10.1016/j.mehy.2011.04.007 DOI: https://doi.org/10.1016/j.mehy.2011.04.007
5. Khetan M, Dhankhar R, Verma S, Arora S, Sangwan RK, Huda RK, et al. Barriers and facilitators for high-risk pregnancy care: a qualitative study on the perspective of pregnant women of rural Rajasthan. Reprod Health. 2026;23:43. doi:10.1186/s12978-025-02233-5 DOI: https://doi.org/10.1186/s12978-025-02233-5
6. Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R. Impact of Maternal Depression on Infant Nutritional Status and Illness: A Cohort Study. Arch Gen Psychiatry. 2004 ;61(9):946–52. doi:10.1001/archpsyc.61.9.946 DOI: https://doi.org/10.1001/archpsyc.61.9.946
7. Priyadarshini U, Rao AP, Dash S. Recommendations for maternal mental health policy in India. J Public Health Policy. 2023 Mar;44(1):90–101. doi:10.1057/s41271-022-00384-4 DOI: https://doi.org/10.1057/s41271-022-00384-4
8. Choedon T, Sethi V, Killeen SL, Ganjekar S, Satyanarayana V,Ghosh S, et al. Integrating nutrition and mental health screening, risk identification and management in prenatal health programs in
India. Int J Gynaecol Obstet. 2023;162(3):792–801. doi:10.1002/ijgo.14728 DOI: https://doi.org/10.1002/ijgo.14728
9. G.N.N. Sathyanath A, Jayanna K, Priya GLP. Prevalence and determinants of postpartum depression among rural and urban women in South India: a comparative cross-sectional study. International Journal Of Community Medicine And Public Health. 2026 ;13(4):1994–9. doi:10.18203/2394-6040.ijcmph20261045 DOI: https://doi.org/10.18203/2394-6040.ijcmph20261045
10. Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90(2):139G-149G. doi:10.2471/BLT.11.091850. DOI: https://doi.org/10.2471/BLT.11.091850
11. Thomas S, Ekstrand M, Thomas T, Srinivasan K. Feasibility of training primary healthcare workers to identify antenatal depression. Glob Ment Health (Camb). 2023 ;10:e57. doi:10.1017/gmh.2023.48 DOI: https://doi.org/10.1017/gmh.2023.48
12. Patient Health Questionnaire (PHQ) Screeners. Free Download [Internet]. [cited 2025 Oct 17]. Available from: https://www.phqscreeners.com/select-screener/
13. Lotlikar S, Chandra P, Desai G, Quantius SM, Venkataraman L, Vijayakumar M. Exploring the acceptability, feasibility and utility of a digital tool for self-reporting perinatal anxiety and depression in urban obstetric and paediatric clinics in India. Digit Health. 2025;11:20552076251314101. doi:10.1177/20552076251314101 DOI: https://doi.org/10.1177/20552076251314101
14. World Health Organization. Guidelines for the identification and management of substance use and substance use disorders in pregnancy [Internet]. Geneva: World Health Organization; 2014 [cited 2024 Jul 21]. Available from: https://iris.who.int/handle/10665/107130
15. Thomas S, Srinivasan K, Heylen E, Ekstrand ML. Correlates of Social support in individuals with a diagnosis of Common Mental Disorders and Non Communicable Medical Diseases in rural South India. Soc Psychiatry Psychiatr Epidemiol. 2021 ;56(9):1623–31. doi:10.1007/s00127-020-01997-4 DOI: https://doi.org/10.1007/s00127-020-01997-4
16. George M, Johnson AR, Sulekha T. Incidence of Postpartum Depression and Its Association With Antenatal Psychiatric Symptoms: A Longitudinal Study in 25 Villages of Rural South arnataka. Indian J Psychol Med. 2022 Jan;44(1):37–44. doi:10.1177/0253717621991061 DOI: https://doi.org/10.1177/0253717621991061
17. Sahoo S, Gill G, Sikka P, Nehra R. Antenatal depression and anxiety in Indian women: A systematic review. Ind Psychiatry J. 2023;32(2):222–33. doi:10.4103/ipj.ipj_156_22 DOI: https://doi.org/10.4103/ipj.ipj_156_22
18. Lukose A, Ramthal A, Thomas T, Bosch R, Kurpad AV, Duggan C, et al. Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women. Matern Child Health J. 2014 Jan;18(1):161–70. doi:10.1007/s10995-013-1249-2 DOI: https://doi.org/10.1007/s10995-013-1249-2
19. Nath A, Venkatesh S, Balan S, Metgud CS, Krishna M, Murthy GVS. The prevalence and determinants of pregnancy-related anxiety amongst pregnant women at less than 24 weeks of pregnancy in Bangalore, Southern India. Int J Womens Health. 2019 Apr 10;11:241–8. doi:10.2147/IJWH.S193306 PubMed PMID: 31114392 DOI: https://doi.org/10.2147/IJWH.S193306
20. Pradhan R, Dandsena RS, Singh S, Ghosal S, Bhattacharya D, Kanungo S, et al. Prevalence and factors associated with tobacco use among pregnant and breastfeeding mothers in India: insights from the National Family Health Survey-5 (2019–21). Front Public Health. 2025;13. doi:10.3389/fpubh.2025.1495522 DOI: https://doi.org/10.3389/fpubh.2025.1495522
21. National Family Health Survey 5 [Internet]. [cited 2026 May 10]. Available from: https://www.nfhsiips.in/nfhsuser/nfhs5.php
22. Bijjal SS, Ganiger FB, Mugali JD, Shaikh M, Purad V, Anirudh B. A Descriptive Review on Perinatal Deliberate Self-harm: An Untraversed Mental Health Domain. Journal of Psychiatry Spectrum. 2023;2(1):16. doi:10.4103/jopsys.jopsys_52_22 DOI: https://doi.org/10.4103/jopsys.jopsys_52_22
23. Bedaso A, Adams J, Peng W, Sibbritt D. The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis. Reprod Health. 2021;18(1):162. doi:10.1186/s12978-021-01209-5 DOI: https://doi.org/10.1186/s12978-021-01209-5
24. Caroline D, Izzati D, Purwanto B, Fitriana F. Occupation of The Husband is a Risk Factor for Psychological Problems Among Pregnant Immigrant Women in East Belitung, Indonesia. Jurnal Psikiatri Surabaya. 2025;14(1):50–6. doi:10.20473/jps.v14i1.57382 DOI: https://doi.org/10.20473/jps.v14i1.57382
Downloads
Published
License
Copyright (c) 2026 Bhuvaneshwari Sethuraman, Avita R Johnson, Systla Rukmini, John Michael Raj A, Ramakrishna Goud B, Anupama N Shetty (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Articles in "Healthline Journal" are Open Access articles. The license permits use, distribution and reproduction in any medium for non-commercial purposes only, provided the original work and source is properly cited, and the new creations are licensed under the identical terms.
How to Cite
