Antenatal depressive symptoms and perinatal complications: a prospective study in rural Ethiopia.

Journal: BMC psychiatry

Volume: 17

Issue: 1

Year of Publication: 2018

Affiliated Institutions:  Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. tesera@gmail.com. Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. Department of Obstetrics and Gynecology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. Department of Psychiatry and Mental Health, Perinatal Mental Health Project, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa.

Abstract summary 

Antenatal depressive symptoms affect around 12.3% of women in in low and middle income countries (LMICs) and data are accumulating about associations with adverse outcomes for mother and child. Studies from rural, low-income country community samples are limited. This paper aims to investigate whether antenatal depressive symptoms predict perinatal complications in a rural Ethiopia setting.A population-based prospective study was conducted in Sodo district, southern Ethiopia. A total of 1240 women recruited in the second and third trimesters of pregnancy were followed up until 4 to 12 weeks postpartum. Antenatal depressive symptoms were assessed using a locally validated version of the Patient Health Questionnaire (PHQ-9) that at a cut-off score of five or more indicates probable depression. Self-report of perinatal complications, categorised as maternal and neonatal were collected by using structured interviewer administered questionnaires at a median of eight weeks post-partum. Multivariate analysis was conducted to examine the association between antenatal depressive symptoms and self-reported perinatal complications.A total of 28.7% of women had antenatal depressive symptoms (PHQ-9 score ≥ 5). Women with antenatal depressive symptoms had more than twice the odds of self-reported complications in pregnancy (OR=2.44, 95% CI: 1.84, 3.23), labour (OR= 1.84 95% CI: 1.34, 2.53) and the postpartum period (OR=1.70, 95% CI: 1.23, 2.35) compared to women without these symptoms. There was no association between antenatal depressive symptoms and pregnancy loss or neonatal death.Antenatal depressive symptoms are associated prospectively with self-reports of perinatal complications. Further research is necessary to further confirm these findings in a rural and poor context using objective measures of complications and investigating whether early detection and treatment of depressive symptoms reduces these complications.

Authors & Co-authors:  Bitew Tesera T Hanlon Charlotte C Kebede Eskinder E Honikman Simone S Fekadu Abebaw A

Study Outcome 

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Statistics
Citations :  Hendrick V. Evaluation of mental health and depression during pregnancy. Psychopharmacol Bull. 1998;34:297–299.
Authors :  5
Identifiers
Doi : 301
SSN : 1471-244X
Study Population
Women
Mesh Terms
Adult
Other Terms
Antenatal depressive symptoms;Ethiopia;Perinatal complications;Prospective study;Rural and low income
Study Design
Cross Sectional Study
Study Approach
Country of Study
Ethiopia
Publication Country
England