“PREVALENCE OF PRENATAL DEPRESSION

IN DIFFERENT TRIMESTERS”

RESEARCH PROJECT ON

What is Depression? A state of low mood, feelings of sadness, anxiety and anger that can affect the person’s physical and mental state.

SIGNS & SYMPTOMS OF DEPRESSION

NEUROTRASNMITTORS THAT REGULATES MOOD AND BEHAVIOR

REDUCED LEVEL OF NOREPINEPHRINE, DOPAMINE AND

SEROTONIN CAUSES:•Insomnia•Anxiety•Lethargy•Loss of concentration•Aggressive Behavior•Attention deficit problem•Sadness•Suicidal thoughts

ROLE OF HORMONES IN CAUSING DEPRESSION

ESTROGENFemale steroid hormone and makes a woman more susceptible to stress, anxiety and depression when it’s level is low.

CORTISOL

PRENATAL DEPRESSIONDepression related to child bearing

can occur during pregnancy is called “Prenatal Depression”

or “Antenatal Depression”

REASONS:•Poor maternal care•Family relationship problems•Financial problems•Abnormal levels of female hormones

BIOLOGICAL CAUSES OF PRENATAL DERPESSION

Fluctuations in female reproductive hormones affect the neurochemical pathway which leads to prenatal depression.

Other functions of Progesterone beside maintainingthe pregnancy is to regulate the female’s mood, sleep, aggressive behavior and anxiety

EFFECTS OF DEPRESSIONON:

•Mother: At high risk on postpartum depression, premature labor, GIT problems, psychosis, deprived health conditions•Fetus and child: Low birth weight, premature baby, cardiovascular problems, depression.

INTERVENTIONS•Psychotherapy•Medications Selective Serotonin Reuptake Inhibitors Vitamin B8, sedatives.• Yoga, exercise, good environmental conditions.

NOTE THATOnly SSRI’s are considered to be the most safest drug which can be taken in prenatal

depression,

SAMPLE TOOL: ZUNG SELF RATING DEPRESSION SCALE

SAMPLE SIZE: 1ST Trimester: 50 women 2nd Trimester: 50 women 3rd Trimester: 50 women

SADNESS

•Low levels of Estrogen and Progesterone•During pregnancy elevated levels of Corticotropin Releasing Hormone remains unbind which causes sadness (Florio et al., 2003).•Workload, joint family, being multiparous.

LOSS OF INTEREST

Loss of pleasure and interest in daily activitiesduring the period of pregnancy is due to the tired feeling and body ache (Gelder et al., 2005).

SUICIDAL THOUGHTS

Absent in most of the females, while some experienced mild and moderate feeling due to family problems and severe depression.The rate of suicide in gestational period is low(Levery et al., 2004).

CRY FEELING

Gestational Pre-eclampsia(gestational hypertension) occurs which can lead to Cry feeling and sadness during pregnancy (Sharma et al., 2003)

FEEL IRRITATED

Irritation feeling during pregnancy is due to the decreased level of mood regulating hormones estrogen and progesterone (Macqueen et al., 2003).

AVOID BEING SOCIAL

Changes in female’s body make them to feel that they don't look attractive in her own eyes and in others eyes. Pregnant women who are depressed avoid social functions and social gatherings (Murray et al., 2003).

FATIGUE/TIRED FEELING

Fatigue in 1st trimester is because a large amount of energy is required for building life support system and as females enters the second trimester fatigue subsides (Campbell et al., 2004). Fatigue again starts in third trimester because the fetus puts pressure and load on the body (Kiserud et al., 2004)

MOOD SWINGS

Mood swings are mostly experienced during the first trimester and then again in the third trimester when the body prepares for birth (Peter et al., 2004). Mood changes during pregnancy are caused by physical stresses, fatigue, metabolic changes, variations in hormones such as estrogen and progesterone that has effect on brain and causing depression (Morrison et al., 2006)

APPETITE CHANGES

The reason of loss of appetite during third trimester is due to the increased level of progesterone which relaxes stomach & intestinal muscles that leads to Gastro esophageal Reflux Disease (GERD) and ultimately loss of appetite (Niebyl et al., 2010)

ANXIETY DUE TO WEIGHT GAIN

Weight gain in pregnancy is related to fetal growth and this weight is attributed to additional blood volume, weight of the uterus, placental weight, weight of the fetus and extra fluid during the period of pregnancy (Feig et al., 1995).

Females reported backache in first and most of the females reported it in third trimester. Backache and pelvic pain was reported most because the fetus puts pressure on lower back, abdominal muscles and pelvis.

BODY PAIN

Sleep in gestational women is interrupted by fetal movements/physical discomfort and increases if a woman is depressed (Hiscock et al., 2001). There’s poor sleep quality, decreased sleep efficiency, increased wakefulness, in third trimester of pregnancy (Saletu et al., 2001)

IMPROPER SLEEP

Hence our study and all the statistics shows that females feel the most depressed in “THIRD TRIMESTER”.Another study was done by Bennet and his associates in 2004 which shows the prevalence of depression in third trimester.

MEAN LEVELS OF DEPRESSION AMONG THREE TRIMESTERS

It is found in those women who face daily challenges, being multiparous, and low family support. Physiological reasons include the altered hormonal levels, fetal development which puts load on the female’s body leads to pain, anxiety, morning sickness, appetite changes, insomnia and severe depression.

PRESENTED BY:Sammar Naseem Siddiqui

BS Research ProjectDepartment of Physiology

QUESTIONS ?