Predicting postnatal depressive symptoms in a prospective cohort study in Rwanda: the impact of poor maternal social support.

Journal: Frontiers in global women's health

Volume: 4

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Mental Health Nursing, College of Medicine and Health Sciences, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda. Department of Psychology, York University, Toronto, ON, Canada. School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda. School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.

Abstract summary 

Postnatal depression is a significant public health issue that demands attention, and recent evidence indicates that rates are relatively high in low-income countries such as Rwanda. However, lack of social support is recognized as a potential risk factor for postnatal depressive symptoms. This study sought to explore the influence of poor maternal social support on postnatal depressive symptoms in a sample of women in Rwanda.A prospective cohort research design was conducted with women recruited from four different health centers in Rwanda's Southern Province. A sample of 396 pregnant women accessing antenatal care services was recruited at the baseline from their late second term or later, then followed up after giving birth. The dropout rate was 21.46%; thus, the data of 311 women were analyzed. The outcome variable was the presence of depressive symptoms (Edinburgh Postnatal Depression Scale (EPDS) (≥12 cut-off score), while predictor variables included maternal social support measured using a modified Maternal Social Support Scale (MSSS), perceived health status, socio-demographic information (marital status, wealth class, age, education, occupation), negative life events, gestational and obstetric information (parity, pregnancy intention, age at birth, children given birth, and mode of delivery). Univariate and multivariate analyses were performed.From a sample of 311 participants, over a quarter (20.9%) had elevated postnatal depressive symptoms (EPDS ≥ 12 scores). Elevated scores were predicted by poor perceived health status; respondents reporting neither poor nor good (AOR=0.28, CI = 0.11; 0.72, = 0.007) or good health (AOR=0.14, CI = 0.05; 0.37, = 0.001) were less likely to be affected. Poor maternal social support was also linked with postnatal depressive symptoms; poor partner support (AOR=4.22; CI = 1.44; 12.34; = 0.009) was associated with high risk, while good friend support (AOR = 0.47, CI = 0.23; 0.98, = 0.04) was a significant protector. Additionally, violence or negative life events were also independent predictors of postnatal depressive symptoms (AOR: 2.94, CI: 1.37-6.29, = 0.005).Postnatal depressive symptoms were found to affect one in five Rwandan women. However, good maternal social support can be a strong protector. Early interventions targeting mothers in the postnatal period and strengthened social support networks for women at risk should be developed.

Authors & Co-authors:  Umuziga Providence M PM Gishoma Darius D Hynie Michaela M Nyirazinyoye Laetitia L Nsereko Etienne E

Study Outcome 

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Statistics
Citations :  Shrivastava SR, Shrivastava PS, Ramasamy J. Antenatal and postnatal depression: a public health perspective. J Neurosci Rural Pract. (2015) 6(1):116–9. 10.4103/0976-3147.143218
Authors :  5
Identifiers
Doi : 1113483
SSN : 2673-5059
Study Population
Women,Mothers
Mesh Terms
Other Terms
Rwanda;edinburgh postnatal depression scale;maternal social support scale;mental health;postnatal depression
Study Design
Cohort Study
Study Approach
Country of Study
Rwanda
Publication Country
Switzerland