الفهرس 
Chapter 1 definition and types of maternal depressionOnly 14 pages are availabe for public view
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Abstract
Depression is generally associated with significant work and family impairment. Perinatal depression has adverse effects not only on the mother herself, but also may have a negative impact upon her significant relationships, including with her infant, and on the cognitive, emotional and behavioral development of the child. Although depression is frequently missed by primary care providers, there has been a recent increase in public awareness of postnatal depression. Yet antenatal depression is equally important. Depression in the perinatal period warrants the same attention as at any other time in the life cycle. The aim of this study is to determine the risk factors of maternal depression, and/or anxiety and the effect of pregnancy loss as a risk factor for maternal depression, and/or anxiety. The study is a case control nested in cross-sectional study was conducted FHCs of El fayum city. The sample size was calculated as 200 women which increased to 220 to avoid dropout during the actual work. The sample were taken from women attending the selected family health centers for antenatal care during the period of the study. The studied females were subjected to scales (EPDS) and (DASS21) for detection of anxiety and/or depression. After detection of depression in all participants, there were divided into two groups: Group (A): women having depression and/or anxiety (considered as a case group (No.50). Group (B): women haven’t any psychological problems (considered as a control group (No.170). Both groups were subjected to antenatal questionnaire that was designed to collect data to determine the risk factors as follows: i. Data related to current pregnancy and reproductive history. ii. Data related to the mental health of women before and during pregnancy and postpartum to study the risk factors of depression and/or anxiety: - Presence of previous history of psychiatric illness including (antenatal and postnatal depression). - Presence of family history of previous psychiatric illness (including antenatal depression and postnatal depression). - Family dynamic events: including lack of social support (such as relations between their husbands, mothers, friends and mother in law) and Stressful life events (such as death of any relatives, financial problems and change home) (Mohammad et al., 2011). By the end of the study, the recorded data of all the studied females were tabulated for statistical analysis. Socio-demographic characteristics of the participant females in the current study including age, educational level and occupation was not statistically significant in the development of antenatal and postpartum depression. The effect of a previous obstetric history as a risk factor of maternal depression showed that history of stillbirth , abortion or miscarriage had statistically significant results and considered as an important risk factors; where 78% of the depressed women had a previous obstetric history compared to 42% of the control group,14% of the depressed cases had a previous history of stillbirth compared with 0% of controls and 52% of the depressed cases had a previous history of abortion compared with 6% of controls. Study of the psychological risk factors showed that presence of previous history of psychiatric illness (including antenatal and postnatal depression to the women or one of her family members) was associated with the presence of depression as 36% of depressed cases have a history of previous psychiatric illness compared to 10% only of controls . Lack of social support that presented from changing the relationships between woman and her family members especially her husband and her mother-in-law significantly associated with increased risk of depressive symptoms during pregnancy as 34% of the depressed cases had a history of changing relationships compared with 8% of the controls. Also the study showed Stressful life events (such as death of any relatives, change home) were significantly associated with an increase in depressive symptoms as 84% of depressed cases had a history of stressful life events in the last year compared to 44% of the controls which was highly significant. Study of risk factors among depressed group showed that women who had history of abortion or miscarriage reported as 65.4% had mild depression, 15.4% had moderate and 19.2% have severe depression. Also 68.7% of cases had history of previous caesarian section scored mild depression while 25% scored moderate depression and 6.3% scored severe depression. Social history was important as a significant risk factor in scoring the level of depression where 67% of cases reported a history of changing relationships scored severe depression while 29.4% scored moderate depression and 5.9% scored mild degree of depression.