Abstract
BackgroundPreterm birth occurs among 9.6% of births worldwide and is the leading cause of long-term neurodevelopmental disabilities among children and also responsible for 28% of neonatal deaths. No single etiological factor is responsible for preterm birth, but various risk factors have been identified. Prior studies have reported that compromised maternal mental health occurring during pregnancy may lead to various adverse obstetric outcomes.ObjectiveTo determine whether antenatal depression is significantly associated with preterm delivery in a low resource hospital sample from the suburbs of Nairobi.Methods292 women attending the antenatal clinic at Pumwani Maternity Hospital in Nairobi meeting the study criteria were recruited. The Edinburgh Postnatal Depression Scale was administered to screen for depression. A clinical cutoff score of 10 and above was regarded as possible depression. Thereafter, a clinical interview together with the Patient Health Questionnaire-9 was administered to evaluate the participants on DSM-V criteria for major depressive disorder. Only 255 of the women were successfully followed-up to delivery with an attrition rate of 12.7%. Records of gestation at delivery and birth weight were collected at second contact.Data analysisPreterm birth was associated with various demographic, psychosocial and medical variables. Relative risks were estimated via log binomial regression analysis to determine whether depression was a risk factor for preterm birth.ResultsOf the 255 participants, 98(38.4%) found to have depressive symptoms and 27(10.7%) delivered preterm. The risk of delivering preterm was 3.8 times higher among those with depressive symptoms.ConclusionThere is a positive association between antenatal depression and preterm delivery. This highlights the importance of screening for mental health disorders in the antenatal period as a means to reduce adverse obstetric outcomes.
Highlights
Preterm birth occurs among 9.6% of births worldwide and is the leading cause of long-term neurodevelopmental disabilities among children and responsible for 28% of neonatal deaths
Preterm birth is an adverse obstetric outcome in Kenya that has been the national focus in efforts to reduce neonatal mortality rate (Kenya Vision 2030, Ministry of Health)
Women who are depressed during pregnancy have a 3.8 times higher risk of delivering preterm than those who are not depressed
Summary
Preterm birth occurs among 9.6% of births worldwide and is the leading cause of long-term neurodevelopmental disabilities among children and responsible for 28% of neonatal deaths. Preterm birth contributes to 28% of all neonatal mortalities and continues to be an economic healthcare burden, putting the surviving children at a seven times higher risk of various morbidities [3, 4]. It is the leading cause of long-term neurodevelopmental disabilities [5]. Adolescent pregnancies, being of African ethnicity, short birth spacing intervals and underweight prepregnancy weights have been shown to moderately predispose women to preterm labor [6]. Pre-eclampsia, a condition where high blood pressure occurs in pregnancy accompanied by other symptoms potentially leads to early induction of labor or early cesarean section delivery thereby preterm birth [6]
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