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Association of gender disadvantage factors and gender preference with antenatal depression in women: a cross-sectional study from rural Maharashtra

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Abstract

Purpose

Maternal depression is a major public health problem in low- and middle-income countries including India. Very few studies have assessed association of various risk factors with antenatal depression in rural Indian women, especially the effect of marital conflict, gender disadvantage and gender preference on antenatal depression. This paper describes the prevalence of probable antenatal depression in rural Maharashtra, a state in the western part of India and specifically assesses the association of marital and gender disadvantage factors and gender preference for a male child with antenatal depression.

Methods

Primary Health Centre-based cross-sectional survey of antenatal women in rural Maharashtra was carried out. The outcome of interest was a probable diagnosis of depression in antenatal women which was measured using the Edinburgh postnatal depression scale (EPDS). Data were analyzed using simple and multiple logistic regression.

Results

302 women in their antenatal period were included in this study. The outcome of antenatal depression (EPDS > 12) was found in 51 women (16.9%, 95% CI 12.6–21.1%). Feeling pressurized to deliver a male child was strongly associated with the outcome of antenatal depression (adjusted odds ratio (OR): 3.0; 95% CI 1.4–6.5). Unsatisfactory reaction of in-laws to dowry (adjusted OR 11.2; 95% CI 2.4–52.9) and difficult relationship with in-laws (adjusted OR 5.3; 95% CI 2.4–11.6) were also significantly associated with antenatal depression.

Conclusions

Our findings demonstrate that antenatal depression in rural women of Western Maharashtra is associated with gender disadvantage factors, especially related to preference for a male child. The agenda to improve maternal mental health should be ultimately linked to address the broader social development goals and gender empowerment.

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Acknowledgements

This work was supported by financial assistance from the Indian Council of Medical Research for MD (Doctor of Medicine) thesis. Authors would like to acknowledge all pregnant women who provided their valuable time to participate in this study. Authors would also like to thank Dr. Ghopal, In-Charge Medical Officer, Kolhar PHC and the staff of Kolhar PHC and all sub-centres for their support. Authors are indebted to Prof. Deepak Phalke, Head of Department of Preventive and Social Medicine, Rural Medical College, Pravara Institute of Medical Sciences, Loni and Dr. Uttara Ramchandra Shidhaye for their valuable guidance during the course of this study.

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Shidhaye, P., Shidhaye, R. & Phalke, V. Association of gender disadvantage factors and gender preference with antenatal depression in women: a cross-sectional study from rural Maharashtra. Soc Psychiatry Psychiatr Epidemiol 52, 737–748 (2017). https://doi.org/10.1007/s00127-017-1380-2

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