Prevalence and determinants of antenatal depression among pregnant women in the remote Garamchashma Valley, District Chitral, Pakistan: a facility-based analytical cross-sectional study

Abstract Background Pregnancy represents a period of increased psychological vulnerability, with antenatal depression posing significant risks to both maternal and fetal well-being. In Pakistan, the prevalence of this condition is reported to be substantially higher than global estimates. Despite this burden, evidence from remote areas remains limited. This study aimed to determine the prevalence of antenatal depression and its associated risk factors in the remote Garamchashma Valley of District Chitral, Pakistan. Methods An analytical cross-sectional study was conducted at health centres in the Garamchashma Valley, Chitral, Pakistan. A total of 155 pregnant women were recruited using consecutive sampling. A structured questionnaire was used to assess sociodemographic, obstetric, and psychosocial factors. The Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) were used to screen for depression, with a cut-off score of ≥ 10. Data were analysed using Pearson’s Chi-square test, Fisher’s exact test, and multivariable binary logistic regression. Results The prevalence of antenatal depression was 34.2% (PHQ-9) and 40% (EPDS). In multivariable logistic regression, male child preference was the strongest independent predictor of antenatal depression (PHQ-9 AOR 4.22, p = 0.003; EPDS AOR 3.67, p = 0.008)