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Globally, including Indonesia, pregnant women are vulnerable population to experience symptoms of anxiety and depression. If these two symptoms are not identified and treated during pregnancy, it will have an impact on maternal and child health, such as suicide, pre-eclampsia, postpartum depression, premature, and low birth weight. Therefore, screening for symptoms of anxiety and depression in pregnant women is very important. However, Indonesia does not yet have instruments and protocols for screening symptoms of anxiety and depression in pregnant women in antenatal care (ANC) both conventionally and the use of digital technology. In fact, Indonesia already has a mental health assessment policy in ANC since July, 2021 and is currently carrying out a digital health transformation to improve the quality of health services. This study aimed to develop a screening system for symptoms of anxiety and depression in pregnant women based on an expert system in ANC.
The study consists of three stages. Phase 1 tested the validity and reliability of the Indonesian version of the Edinburgh Postnatal Depression Scale (EPDS) instrument on 125 pregnant women online through the dissemination of Google forms. Phase 2 assessed the screening ability of EPDS instrument compared to MINI-International Neuropsychiatric Interview (MINI) instrument as gold standard in 298 pregnant women. This 2nd phase was carried out in Depok City (Beji, Cipayung, Jati Jajar, and Pancoran Mas public health centre). The MINI assessment was carried out online by two trained enumerators. The 3rd stage was carried out by developing a prototype of an anxiety and depression symptom screening system based on expert system. Statistical analysis at stage 1 employed various types of validity and reliability tests. The 2nd stage was carried out to test sensitivity and specificity. The 3rd stage was evaluated on the accuracy of the expert system and the feasibility of the prototype.
This study produced an Indonesian version of the EPDS instrument that was proven to be valid and reliable for use in the population of pregnant women. This instrument had a sensitivity and specificity of > 90% for screening for symptoms of pregnancy anxiety and depression. The proportion of accuracy in expert systems was > 90%. Pregnant women state that this prototype was easy, short assessment time, and useful to use.
The prototype based on expert system called BMoms, was feasible and able to be carried out for screening symptoms of anxiety and depression in pregnant women in ANC. The BMoms prototype can be further developed into a ready and appropriate application so that it becomes an innovative solution for mental health screening in pregnant women.
Non-communicable diseases (NCDs) have become a leading cause of morbidity and mortality in the world. Metabolic syndrome is a group of clinical symptoms that can increase the risk of developing NCDs, especially cardiovascular disease and type 2 diabetes mellitus. The results of Riskesdas analysis found that the prevalence of metabolic syndrome in Indonesia went from 10.8% (2013) to 24.4% (2018). Office employees are often associated with sedentary behavior so that the chances of developing metabolic syndrome are higher. The objective of this study is to determine the prevalence and the factors associated with metabolic syndrome among Regional Device Organizations (OPDs) employees of Depok City Government in 2022. This cross-sectional study included secondary data from the result of health screening of Depok City Government employees in 2022. A total of 1,128 respondents from 21 OPDs were included in this study. Prevalence of metabolic syndrome was 33.2%. Bivariate analysis shows that the variables that were statistically significant with the metabolic syndrome included age, sex, BMI, family history of PTM, total cholesterol level, total-cholesterol-to-HDL ratio, and physical activity. In multivariate analysis, variables found to have significant association with metabolic syndrome were age, BMI, and total-cholesterol-to-HDL ratio.