Prevalence of antenatal depression and associated factors among pregnant women in Addis Ababa, Ethiopia: a cross-sectional study

Reproductive Health

Demewoz Haile²  Abera Biratu¹ 

[1] Department of Nursing, College of Medicine and Health sciences, Madwalabu University, Bale Goba, Ethiopia;Department of Reproductive Health, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia

关键词: Ethiopia;    Low income countries;    Mental health;    Maternal health;    Depression;    Antenatal care;   

Others  :  1231211
DOI  :  10.1186/s12978-015-0092-x

 received in 2015-06-05, accepted in 2015-10-26,  发布年份 2015

【 摘 要 】

Background

The World Health Organization identifies depressive disorders as the second leading cause of global disease burden by 2020. However, there is a paucity of studies which examined the associated factors of antenatal depression in low-income countries. This study aimed to determine the prevalence of antenatal depression and associated factors among pregnant women in Addis Ababa, Ethiopia.

Methods

A cross-sectional study was employed among 393 pregnant women attending antenatal care service in Addis Ababa public health centers, Ethiopia from April 12–26, 2012. The Edinburgh Postnatal Depression Scale (EPDS) was used to detect depressive symptoms. Descriptive statistics and logistic regression were used in the statistical analysis.

Results

Prevalence of antenatal depression was 24.94 % (95 % CI: 20.85–29.30 %). In the final multivariable model, those pregnant women who have previous history of depression were nearly three times at higher odds of having antenatal depression as compared to pregnant women who have no history of depression [AOR = 2.57(95 % CI: 1.48–4.48 )]. Those pregnant women having unplanned pregnancy were nearly three times at higher odds to develop depression as compared to pregnant women whose pregnancy was planned [AOR = 2.78(95 % CI: 1.59–4.85)]. The odd of developing antenatal depression was 89 % higher in those pregnant women who experienced lack of baby’s father support [AOR = 1.89(95 % CI: 1.06–3.36)]. Education level, community’s support, and partner’s feeling on current pregnancy were not significantly associated factors with antenatal depression in the final multivariable model.

Conclusion

Although clinical confirmation for antenatal depression is not conducted, one quarter of the pregnant women attending antenatal care were depressed in Addis Ababa based on EPDS. Unplanned pregnancy, experiencing lack of baby’s father support and previous history of depression were factors independently associated with antenatal depression. Promotion of family planning and integration of mental health service with existing maternal health care as well as strengthening the referral system among public health centers were the recalled interventions to prevent antenatal depression in Addis Ababa Public Health Centers.

【 授权许可】

   
2015 Biratu and Haile.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Pillay B, Cassimjee M. Anxiety and depression in an urban general practice. J Anxiety Depress. 2000; 3(2):4-5.
• [2]World Health Organization (WHO). DEPRESSION: A Global Public Health Concern. 2012. Available at http://www.who.int/mental_health/management/depression/who_paper_depression_wfmh_2012.pdf. Accessed May 11, 2012.
• [3]Evans J, Heron J, Francomb H, Oke S, Golding J. Cohort study of depressed mood during pregnancy and after childbirth. BMJ. 2001; 323:257-260.
• [4]Fatoye FO, Adeyemi AB, Oladimeji B. Emotional distress and its correlates among Nigerian women in late pregnancy. J Obstet Gynecol. 2004; 24:504-509.
• [5]Gotlib IH, Whiffen VE, Mount JH, Milne K, Cordy NI. Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum. J Consult Clin Psychol. 1989; 57(2):269-274.
• [6]O’Keane V, Marsh MS. Depression during pregnancy. BMJ. 2007; 334:1003-1005.
• [7]Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol. 2004; 103(4):698-709.
• [8]Fisher J, Mello MC, Patel V, Rahman A, Tran T, Holton S, Holmes W. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012; 90(2):139G-149G.
• [9]Nasreen HE, Kabir ZN, Forsell Y, Edhborg M. Prevalence and associated factors of depressive and anxiety symptoms during pregnancy: a population based study in rural bangladesh. BMC Womens Health. 2011; 11:22. BioMed Central Full Text
• [10]Rahman A, Iqbal Z, Harrington R. Life events, social support and depression in childbirth: perspectives from a rural community in the developing world. Psychol Med. 2003; 33:1161-1167.
• [11]Faisal-Cury A, Menezes P, Araya R, Zugaib M. Common mental disorders during pregnancy: prevalence and associated factors among low-income women in São Paulo, Brazil. Arch Women Ment Health. 2009; 120:335-343.
• [12]Hartley M, Tomlinson M, Greco E, Comulada WS, Stewart J, Roux I, Mbewu N, Rotheram-Borus MJ. Depressed mood in pregnancy: prevalence and correlates in two Cape Town peri-urban settlements. Reprod Health. 2011; 8:9. BioMed Central Full Text
• [13]Manikkam L, Burns JK. Antenatal depression and its risk factors: an urban prevalence study in KwaZulu-Natal. S Afr Med J. 2012; 102(12):940-944.
• [14]Kaaya SF, Mbwambo JK, Kilonzo GP, Van Den Borne H, Leshabari MT, Fawzi MC, Schaalma H. Socio-economic and partner relationship factors associated with antenatal depressive morbidity among pregnant women in Dar es Salaam, Tanzania. Tanzan J Health Res. 2010; 12(1):23-35.
• [15]Alder J, Fink V, Bitzer J, Hosli I, Holzgreve W. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Med. 2007; 20:189-209.
• [16]Kazi A, Fatmi Z, Hatcher J, Kadir MM, Niaz U, Wasserman GA. Social environments and depression among pregnant women in urban areas of Pakistan: Importance of social relations. Soc Sci Med. 2006; 63:1466-1476.
• [17]Hart R, McMahon CA. Mood state and psychological adjustment to pregnancy. Arch Womens Ment Health. 2006; 9:329-337.
• [18]Sawyer A, Ayers S, Smith H. Pre and postnatal psychological well being in Africa: a systematic review. J Affect Disord. 2010; 123(1-3):17-29.
• [19]Koubovec D, Geerts L, Odendaal HJ, Stein DJ, Vythilingum B. Effects of psychological stress on fetal development and pregnancy outcome. Curr Psychiatry Rep. 2005; 7:274-280.
• [20]Rahman A, Bunn J, Lovel H, Creed F. Association between antenatal depression and low birth weight in a developing country. Acta Psychiatr Scand. 2007; 115:481-486.
• [21]Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010; 67(10):1012-24.
• [22]Stewart RC, Umar E, Kauye F, Bunn J, Vokhiwa M, Fitzgerald M, Tomenson B, Rahman A, Creed F. Maternal common mental disorder and infant growth--a cross-sectional study from Malawi. Matern Child Nutr. 2008; 4(3):209-219.
• [23]Rondó PHC, Ferreira RF, Nogueira F, Ribeiro MCN, Lobert N, Artes R. Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr. 2003; 57:266-272.
• [24]Evans J, Heron J, Patel RR, Wiles N. Depressive symptoms during pregnancy and low birth weight at term. Br J Psychiatry. 2007; 191:84-85.
• [25]Wisner KL, Sit DK, Hanusa BH, Moses-Kolko EL, Bogen DL, Hunker DF, Perel JM, Jones-Ivy S, Bodnar LM, Singer LT. Major depression and antidepressant treatment: impact on pregnancy and neonatal outcomes. Am J Psychiatry. 2009; 166(5):557-566.
• [26]Field T, Diego M, Hernandez-Reif M. Prenatal depression effects on the fetus and newborn: a review. Infant Behav Dev. 2006; 29(3):445-455.
• [27]Hanlon C, Medhin G, Alem A, Araya M, Abdulahi A, Hughes M, Tesfaye M, Wondimagegn D, Patel V, Prince M. Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale. J Affect Disord. 2008; 108:251-262.
• [28]Tesfaye M, Hanlon C, Wondimagegn D, Alem A. Detecting postnatal common mental disorders in Addis Ababa, Ethiopia: validation of the Edinburgh Postnatal Depression Scale and Kessler Scales. J Affect Disord. 2010; 122(1-2):102-108.
• [29]Dibaba Y, Fantahun M, Hindin MJ. The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: evidence from rural Southwestern Ethiopia. BMC Pregnancy Childbirth. 2013; 13:135. BioMed Central Full Text
• [30]Summary and Statistical Report of the 2007 Population and Housing Census, Population Census Commission. Federal Democratic Republic of Ethiopia, Addis Ababa; 2007.
• [31]Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh Postnatal Depression Scale (EPDS). J Reprod Infant Psychol. 1990; 8:99-106.
• [32]Gibson J, McKenzie-McHarg K, Shakespeare J, Price J, Gray R. A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatr Scand. 2009; 119:350-364.
• [33]Senturk V, Abas M, Berksun O, Stewart R. Social support and antenatal depression in extended and nuclear family environments in Turkey: a cross-sectional survey. BMC Psychiatry. 2011; 11:48. BioMed Central Full Text
• [34]Wissart J, Parshad O, Kulkarni S. Prevalence of pre- and postpartum depression in Jamaican women. BMC Pregnancy Childbirth. 2005; 5:15. BioMed Central Full Text
• [35]Hickey CA, Cliver S, Goldenberg RL, McNeal SF, Hoffman HJ. Relationship of psychosocial status to low prenatal weight gain among non‐obese black and white women delivering at term. Obstet Gynaecol. 1995; 86:177-183.
• [36]Karmaliani R, Asad N, Bann C, Moss N, Mcclure EM, Pasha O, Wright LL, Goldenberg RL. Prevalence of anxiety, depression and associated factors among pregnant women of Hyderabad, Pakistan. Int J Soc Psychiatry. 2009; 55:414-424.
• [37]Silva RA, Jansen K, Souza LDM, Moraes IGS, Tomasi E, Silva Gdel G, Dias MS, Pinheiro RT. Depression during pregnancy in the Brazilian public health care system. Rev Bras Psiquiatr. 2010; 32(2):139-144.
• [38]Rich-Edwards JW, Kleinman K, Abrams A, Harlow BL, Thomas J, McLaughlin TJ, Joffe H, Gillman MW. Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. J Epidemiol Community Health. 2006; 60:221-227.
• [39]Bunevicius R, Kusminskas L, Bunevicius A, Nadisaukiene RJ, Jureniene K, Pop VJ. Psychosocial risk factors for depression during pregnancy. Acta Obstet Gynecol Scand. 2009; 88(5):599-605.
• [40]Johanson R, Chapman G, Murray D, Johnson I, Cox J. The North Staffordshire Maternity Hospital prospective study of pregnancy-associated depression. J Psychosom Obstet Gynaecol. 2000; 21(2):93-97.
• [41]Dayan J, Creveuil C, Dreyfus M, Herlicoviez M, Baleyte J-M, O'Keane V. Developmental model of depression apply to prenatal depression: role of present and past life events, past emotional disorders and pregnancy stress. PLoS One. 2010; 5(9):e12942.
• [42]Rahman A, Fisher J, Bower P, Luchters S, Tran T, Yasamy MT, Saxena S, Waheed W. Interventions for common perinatal mental disorders in women in low-and middle-income countries: a systematic review and meta-analysis. Bull World Health Organ. 2013; 91:593-601.