Clinical and Obstetric Risk Factors for Postnatal Depression in HIV Positive Women: A Cross Sectional Study in Health Facilities in Rural KwaZulu-Natal.

Nontokozo Lilian Mbatha,Kebogile Elizabeth Mokwena,Sphiwe Madiba

doi:10.3390/ijerph17228425

Abstract

Postnatal depression (PND) remains underdiagnosed and undertreated in different socio-economic backgrounds in South Africa. This study determined the prevalence of and clinical and obstetric risk factors for PND symptoms among HIV positive women in health facilities in a rural health district in South Africa. The Edinburgh Postnatal Depression Scale was used to measure PND from 386 women who had delivered a live infant. More than half (58.5%) tested HIV positive during the current pregnancy. The prevalence of PND symptoms was 42.5%. Logistic regression analysis yielded significant associations between clinical and obstetric variables of pre-term baby (p-value < 0.01), baby health status p-value < 0.01), baby hospitalization, (p-value < 0.01), and knowing the baby’s HIV status (p-value = 0.047). Maternal variables associated with PND were level of education (p-value < 0.01), monthly income (p-value < 0.01), and source of income (p-value = 0.05). At multivariate analysis, none of the clinical and obstetrical risk factors were independently associated with the PND. The high prevalence of PND symptoms underscore the need to integrate routine screening for PND in prevention of mother to child transmission of HIV programmes to enable early diagnosing and treatment of PND.

Highlights

Maternal mental health problems continue to present a public health challenge.The mental ill-health of women of childbearing age and related factors are increasingly affecting the women’s quality of life [1]
In a study conducted in South Africa among people living with HIV (PLHIV), the results indicated that 22% of PLHIV were severely depressed [14]
The current study prevalence falls within the range of prior prevalence estimates reported in sub-Saharan Africa and South Africa (42.2–49.3%), such as a prevalence of depressive symptoms of 43% reported by Kakyo et al [45] in a rural district in Uganda

Summary

Introduction

Maternal mental health problems continue to present a public health challenge. The mental ill-health of women of childbearing age and related factors are increasingly affecting the women’s quality of life [1]. The prevalence of depression in women in low and middle-income countries (LMICs) is estimated at 15–57% [2,3,4]. Postnatal depression (PND), in particular, is a maternal health phenomenon which occurs frequently among women who have recently given birth [5]. A systematic review reported a prevalence of PND of 19.8% from studies conducted in LMICs [5]. PND has long-term negative physical and psychological consequences for both the mother and the child. PND can lead to chronic depression and disruptions of family and marital relationships

Methods

Results

Discussion

Conclusion