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Social environment and depression among pregnant women in urban areas of Pakistan: Importance of social relations

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  • Kazi, Ambreen
  • Fatmi, Zafar
  • Hatcher, Juanita
  • Kadir, Muhammad Masood
  • Niaz, Unaiza
  • Wasserman, Gail A.

Abstract

Aspects of the social environment, including social conditions (socio-economic status, household situations, chronic illnesses) and social relations (attitude and behaviors of relations) are major determinants of depression among women. This study evaluates the relative power of social relations and social conditions in predicting depression among pregnant women in Pakistan. In the qualitative phase of the study, social environmental determinants were identified through literature search, and experts' opinions from psychologists, psychiatrists, gynecologists, sociologists and researchers. Along with this, 79 in-depth interviews were conducted with pregnant women drawn from six hospitals (public and private) and two communities in Karachi, Pakistan. Identified determinants of depression were grouped into themes of social conditions and social relations and pregnancy-related concerns. In the study's quantitative phase, the relative power of the identified themes and categories, based on their scores for predicting depression (determined by the Center for Epidemiological Studies--Depression Scale (CES-D scale)), was determined through multivariate linear regression. Social environmental determinants of pregnant women were described under the themes and categories of (1) social relations: involving husband, in-laws and children; (2) social conditions: involving the economy, illness, life events, household work, environmental circumstances and social problems; and (3) pregnancy-related concerns i.e. symptoms of pregnancy, changes during pregnancy, dependency and concern for unborn baby. Multivariate analysis found that among these themes, social relations and pregnancy-related concerns were significantly associated with total CES-D scores. Among the categories besides increasing age and less education, husband, in-laws, household work and pregnancy symptoms were significantly associated with total CES-D scores. The study highlights the importance of social relations compared to social conditions for determining depression in pregnant women.

Suggested Citation

  • Kazi, Ambreen & Fatmi, Zafar & Hatcher, Juanita & Kadir, Muhammad Masood & Niaz, Unaiza & Wasserman, Gail A., 2006. "Social environment and depression among pregnant women in urban areas of Pakistan: Importance of social relations," Social Science & Medicine, Elsevier, vol. 63(6), pages 1466-1476, September.
    • Handle: RePEc:eee:socmed:v:63:y:2006:i:6:p:1466-1476
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    References listed on IDEAS

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    1. Bobak, Martin & Pikhart, Hynek & Hertzman, Clyde & Rose, Richard & Marmot, Michael, 1998. "Socioeconomic factors, perceived control and self-reported health in Russia. A cross-sectional survey," Social Science & Medicine, Elsevier, vol. 47(2), pages 269-279, July.
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    1. Mayston, Rosie & Frissa, Souci & Tekola, Bethlehem & Hanlon, Charlotte & Prince, Martin & Fekadu, Abebaw, 2020. "Explanatory models of depression in sub-Saharan Africa: Synthesis of qualitative evidence," Social Science & Medicine, Elsevier, vol. 246(C).
    2. Sathyanarayanan Doraiswamy & Anupama Jithesh & Sonia Chaabane & Amit Abraham & Karima Chaabna & Sohaila Cheema, 2020. "Perinatal Mental Illness in the Middle East and North Africa Region—A Systematic Overview," IJERPH, MDPI, vol. 17(15), pages 1-20, July.
    3. Rozina Karmaliani & Nargis Asad & Carla M. Bann & Nancy Moss & Elizabeth M. Mcclure & Omrana Pasha & Linda L. Wright & Robert L. Goldenberg, 2009. "Prevalence of Anxiety, Depression and Associated Factors Among Pregnant Women of Hyderabad, Pakistan," International Journal of Social Psychiatry, , vol. 55(5), pages 414-424, September.
    4. Ahmed Waqas & Nahal Raza & Haneen Wajid Lodhi & Zerwah Muhammad & Mehak Jamal & Abdul Rehman, 2015. "Psychosocial Factors of Antenatal Anxiety and Depression in Pakistan: Is Social Support a Mediator?," PLOS ONE, Public Library of Science, vol. 10(1), pages 1-14, January.
    5. Armaan A Rowther & Asiya K Kazi & Huma Nazir & Maria Atiq & Najia Atif & Nida Rauf & Abid Malik & Pamela J Surkan, 2020. "“A Woman Is a Puppet.” Women’s Disempowerment and Prenatal Anxiety in Pakistan: A Qualitative Study of Sources, Mitigators, and Coping Strategies for Anxiety in Pregnancy," IJERPH, MDPI, vol. 17(14), pages 1-19, July.

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