Syeda Rabia, Nazia Hakeem, Saima Aziz, Hira Afreen.
Coping strategies in women with anxiety and depression during prenatal period.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;22(03):191-9.

Objective: To determine the frequency and association of coping strategies with different levels of anxiety and depression. Methods: A cross-sectional study was carried out in private hospitals of Karachi, from January to May 2017. Data was collected from pregnant women willing to participate in the study by using non-probability convenient sampling. A questionnaire was used to gather socio-demographic and obstetric data after informed consent from pregnant women. Hospital anxiety and depression scale (HADS) was used to identify different levels of anxiety and depression. Coping strategies were assessed by using brief inventory results which were assessed on SPSS 16. Results: Study group included 400 women between the ages of 18 to 38 years with a mean age of 27.08 ± 4.074. The adaptive strategies were used by 23.3% of the study group. Maladaptive strategies were adopted by 17.9% of women and 58.9% were using both adaptive and maladaptive strategies. There was a significant association of adaptive strategies and women appearing normal on HADS scale (p-value= 0.000, OR= .077) whereas there was negative association with maladaptive strategies and normal behaviour (p-value= 0.032, OR= 1.747). Women with borderline anxiety were using only combination of both types of strategies. Women using maladaptive strategies were having significant association with abnormal level of anxiety (p-value= 0.000, OR= 3.369) with borderline depression (p-value= 0.012, OR= .420) and abnormal depression (p-value= 0.000, OR= -6.657). Active coping (OR 5.952 and 6.679), instrumental (OR 4.138 and 6.679), planning (OR 10.300 and 6.646),) and positive reframing (OR 1.735 and 3.765) were protective for abnormal anxiety and abnormal depression. Religious practices were protective for abnormal anxiety only (OR= 4.289). Conclusion: Adaptive strategies are associated with normal mental status and are protective for anxiety and depression whereas maladaptive strategies are the risk factors for anxiety and depression. Pregnant women should be encouraged to adopt adaptive strategies to reduce the adverse outcome associated with anxiety and depression. Keywords: Prenatal education, coping behaviour, anxiety, depression, prenatal care.

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