Depressive, anxiety symptoms and their co-occurrence among women seeking antenatal care in Bangladesh

Anxiety and depression are significant concerns among antenatal women in Bangladesh. Despite the critical need for tailored mental health care in health facilities, studies on these symptoms in this demographic remain lacking. Therefore, our study aimed to assess the levels, distribution, and associated factors of depressive and anxiety symptoms and their co-occurrence among women seeking antenatal care at a public healthcare facility in Bangladesh. We conducted a cross-sectional study between May 2024, and June 2024, among women seeking antenatal care (ANC) care in Durgapur Upazila Health Complex, a primary-level public health facility in Bangladesh. Among 640 women who received ANC care, 638 participated in the study. Depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9), and anxiety symptoms were assessed by the Generalized Anxiety Disorder-7 (GAD-7). Bivariate and multivariable logistic regression were conducted to determine factors contributing to depressive and anxiety symptoms. About 39% of participants had depressive symptoms and 50% had anxiety symptoms, with 26% experiencing both simultaneously. No participants had severe overall depressive or anxiety symptoms. PHQ-9 data indicated half experienced daily fatigue, while GAD-7 data showed over half experienced daily nervousness and two-fifths had daily fears. Women in the second and third trimesters had 43% (aOR: 0.57, 95% CI: 0.36-0.89) and 58% (aOR: 0.42, 95% CI: 0.24-0.71) lower odds of depressive symptoms compared to those in the first trimester respectively. Women with 11 years or more education had 40% (aOR: 0.60, 95% CI: 0.38-0.94) lower odds of anxiety. Additionally, women in the second and third trimesters had 40% (aOR: 0.60, 95% CI: 0.37-0.97) and 49% (aOR: 0.59, 95% CI: 0.29-0.91) lower likelihood of co-occurrence compared to those in the first trimester and women with 6-10 years of education had 48% (aOR: 0.52, 95% CI: 0.34-0.79) and those with 11 or more years had 52% (aOR: 0.48, 95% CI: 0.29-0.81) lower likelihood of co-occurring depressive and anxiety symptoms compared to women with 5 years or less education. Our study found a high prevalence of depressive and anxiety symptoms among antenatal care seekers, with notable co-occurrence of these conditions. Given these findings, there is an urgent need for targeted mental health support for these women, especially those in their first trimester and those with limited education.