Assessment of prenatal depression among pregnant nurses in Punjab, Pakistan: A cross-sectional study

Prenatal depression is a significant public health concern that substantially affects both maternal and fetal well-being. While information on postpartum depression is widely available, research addressing prenatal depression, particularly among pregnant working women, remains limited.

This study aimed to identify general and occupation-specific stressors, along with factors associated with prenatal depression, such as shift work, professional responsibilities, and work-related environments among pregnant nurses.

This cross-sectional study was conducted using data collected from 101 pregnant nurses employed at various secondary and tertiary hospitals across Punjab between September 2022 and August 2023. Participants, who were between 8 and 28 weeks of gestation, provided information through a structured and validated questionnaire.

The study revealed a notably high prevalence of prenatal depressive symptoms among pregnant nurses, with 59 % scoring above the clinical threshold and 42.6 % (95 % CI: 33.2 %-52.6 %) meeting screening criteria. The mean depression score was 10.23 (SD = 4.72), with 14.85 % experiencing severe depression, 36.63 % experiencing mild depression, and 48.51 % falling within the normal range. Several factors were significantly associated with higher depression scores, including: poor spousal relationship (β = -0.59, p = 0.004), family history of depression (β = 0.43, p = 0.001), higher pregnancy-related stress (β = 0.42, p = 0.001), lower social support (β = -0.31, p = 0.003) and lower maternal-fetal attachment (β = -0.19, p = 0.033). Additional occupational and clinical contributors included lack of financial stability (β = 3.12; 95 % CI: 1.43-4.81; p = 0.001), working 10 hours per day (β = 2.87; 95 % CI: 1.11-4.63; p = 0.002), irregular prenatal check-ups (β = 2.45; 95 % CI: 0.79-4.11; p = 0.004), and presence of medical comorbidities (β = 2.91; 95 % CI: 1.27-4.55; p = 0.001).

These findings accentuate the need for a robust support system and targeted mental health interventions for pregnant nurses. Implementing stress management programs, routine screening for prenatal depression, and accessible counseling services may help mitigate the adverse effects of prenatal depression among pregnant nurses and other working women.