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

Biratu A, Haile D - Reprod Health (2015)

Bottom Line: The World Health Organization identifies depressive disorders as the second leading cause of global disease burden by 2020.The Edinburgh Postnatal Depression Scale (EPDS) was used to detect depressive symptoms.Descriptive statistics and logistic regression were used in the statistical analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, College of Medicine and Health sciences, Madwalabu University, Bale Goba, Ethiopia. abe_birr@yahoo.com.

ABSTRACT

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 24.9 % (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.

No MeSH data available.


Related in: MedlinePlus

Conceptual framework of antenatal depression and associated factors
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Fig1: Conceptual framework of antenatal depression and associated factors

Mentions: The Edinburgh Postnatal Depression Scale (EPDS) [31] has been used to detect depressive symptoms. The EPDS is a 10 item questionnaire, scored from 0 up to 3 (higher score indicating more depressive symptoms), that has been validated for detecting depression in ante partum and postpartum samples in many countries. The instrument was validated in public health centers in Addis Ababa for postpartum use and showed sensitivity of 84.6 % and specificity of 77.0 % at the cutoff score 7/8 [28]. The cutoff point of EDPS among pregnant women is usually higher than postpartum women [32]. Like other similar studies conducted abroad and in Ethiopia, we used EPDS cutoff point of 13 to identify pregnant women with depressive symptom [29, 33]. Those pregnant women who scored 13 and above were categorized as depressed women while pregnant women who scored below 13 were considered as non depressed women [29]. Partner’s feeling on current pregnancy can be defined as pregnant women feeling about the feeling of her partners regarding the current pregnancy. It was measured by asking the pregnant women to rate whether her partner feels happy or not happy on the current pregnancy. Baby’s father support was measured by asking the pregnant women feeling about the partners support to the health of the fetus and continuation of the pregnancy. Community support is measured by asking the pregnant women feeling about the emotional support of the community. The explanatory variables: baby’s father support (poor vs good), partner’s feeling on current pregnancy (happy vs unhappy), community support (poor vs good), and substance use history (yes vs no) were collected by a structured questionnaire. Socio-demographic characteristics and obstetric variables: trimester (first, second and third), having previous pregnancy (yes vs no), previous pregnancy & labor complication (yes vs no), previous history of stillbirth (yes vs no) , previous history of abortion (yes vs no), is the current pregnancy planned (yes vs no), previous ANC follow up (no follow up , sometimes, regular) and current pregnancy complication (yes vs no) were also collected by a structured questionnaire. The conceptual framework is presented in Fig. 1.Fig. 1


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

Biratu A, Haile D - Reprod Health (2015)

Conceptual framework of antenatal depression and associated factors
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4627391&req=5

Fig1: Conceptual framework of antenatal depression and associated factors
Mentions: The Edinburgh Postnatal Depression Scale (EPDS) [31] has been used to detect depressive symptoms. The EPDS is a 10 item questionnaire, scored from 0 up to 3 (higher score indicating more depressive symptoms), that has been validated for detecting depression in ante partum and postpartum samples in many countries. The instrument was validated in public health centers in Addis Ababa for postpartum use and showed sensitivity of 84.6 % and specificity of 77.0 % at the cutoff score 7/8 [28]. The cutoff point of EDPS among pregnant women is usually higher than postpartum women [32]. Like other similar studies conducted abroad and in Ethiopia, we used EPDS cutoff point of 13 to identify pregnant women with depressive symptom [29, 33]. Those pregnant women who scored 13 and above were categorized as depressed women while pregnant women who scored below 13 were considered as non depressed women [29]. Partner’s feeling on current pregnancy can be defined as pregnant women feeling about the feeling of her partners regarding the current pregnancy. It was measured by asking the pregnant women to rate whether her partner feels happy or not happy on the current pregnancy. Baby’s father support was measured by asking the pregnant women feeling about the partners support to the health of the fetus and continuation of the pregnancy. Community support is measured by asking the pregnant women feeling about the emotional support of the community. The explanatory variables: baby’s father support (poor vs good), partner’s feeling on current pregnancy (happy vs unhappy), community support (poor vs good), and substance use history (yes vs no) were collected by a structured questionnaire. Socio-demographic characteristics and obstetric variables: trimester (first, second and third), having previous pregnancy (yes vs no), previous pregnancy & labor complication (yes vs no), previous history of stillbirth (yes vs no) , previous history of abortion (yes vs no), is the current pregnancy planned (yes vs no), previous ANC follow up (no follow up , sometimes, regular) and current pregnancy complication (yes vs no) were also collected by a structured questionnaire. The conceptual framework is presented in Fig. 1.Fig. 1

Bottom Line: The World Health Organization identifies depressive disorders as the second leading cause of global disease burden by 2020.The Edinburgh Postnatal Depression Scale (EPDS) was used to detect depressive symptoms.Descriptive statistics and logistic regression were used in the statistical analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, College of Medicine and Health sciences, Madwalabu University, Bale Goba, Ethiopia. abe_birr@yahoo.com.

ABSTRACT

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 24.9 % (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.

No MeSH data available.


Related in: MedlinePlus