Abstract
BackgroundThe disability associated with depression and its impact on maternal and child health has important implications for public health policy. While the prevalence of postnatal depression is high, there are no prevalence data on antenatal depression in South Africa. The purpose of this study was to determine the prevalence and correlates of depressed mood in pregnancy in Cape Town peri-urban settlements.MethodsThis study reports on baseline data collected from the Philani Mentor Mothers Project (PMMP), a community-based, cluster-randomized controlled trial on the outskirts of Cape Town, South Africa. The PMMP aims to evaluate the effectiveness of a home-based intervention for preventing and managing illnesses related to HIV, TB, alcohol use and malnutrition in pregnant mothers and their infants. Participants were 1062 pregnant women from Khayelitsha and Mfuleni, Cape Town. Measures included the Edinburgh Postnatal Depression Scale (EPDS), the Derived AUDIT-C, indices for social support with regards to partner and parents, and questions concerning socio-demographics, intimate partner violence, and the current pregnancy. Data were analysed using bivariate analyses followed by logistic regression.ResultsDepressed mood in pregnancy was reported by 39% of mothers. The strongest predictors of depressed mood were lack of partner support, intimate partner violence, having a household income below R2000 per month, and younger age.ConclusionsThe high prevalence of depressed mood in pregnancy necessitates early screening and intervention in primary health care and antenatal settings for depression. The effectiveness and scalability of community-based interventions for maternal depression must be developed for pregnant women in peri-urban settlements.Trial registrationClinicalTrials.gov: NCT00972699.
Highlights
The disability associated with depression and its impact on maternal and child health has important implications for public health policy
Mental health is neglected in the national policies of many low and middle income (LAMI) countries [3], and is of critical public health significance because of its intergenerational impact on infants and children as a result of its impact on disease burden and child health
Other studies have not found an association between depression during pregnancy and adverse obstetric outcomes [14,15], while a recent review has shown that women with depression during pregnancy are at increased risk for pre-term birth and low birth weight [16]
Summary
The disability associated with depression and its impact on maternal and child health has important implications for public health policy. Despite its high prevalence and known correlation with poverty [2], data for low and middle income (LAMI) countries is limited. Mental health is neglected in the national policies of many LAMI countries [3], and is of critical public health significance because of its intergenerational impact on infants and children as a result of its impact on disease burden and child health. Though less well documented than postpartum depression, depression in pregnancy is associated with adverse child outcomes. Other studies have not found an association between depression during pregnancy and adverse obstetric outcomes [14,15], while a recent review has shown that women with depression during pregnancy are at increased risk for pre-term birth and low birth weight [16]. Research from Ethiopia has found Common Mental Disorders (CMD) in pregnancy, which are characterised by depressive, anxious, panic and somatic symptoms, to be associated with prolonged labour (of more than 24 hours), delayed initiation of breastfeeding, and more diarrhoeal episodes [20]
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