Prevalence and associated risk factors of antenatal depression among Brazilian pregnant women: A population-based study

Abstract

• Antenatal depression (AD) is a common maternal mental health disorder that affects women globally and is considered a public health concern, especially in developing countries. • Overall, there is a lack of population-based studies assessing the prevalence and the relationship between sociodemographic and obstetric variables with AD. • Among 22.621 women (18–49 years old) from the Brazilian National Health Survey (PNS−2013) there was 800 pregnant women. The AD prevalence was 11.4% (95%CI: 8.5% - 14.9%). • AD was associated with lower education, a non-white skin color and living alone. • In Brazil, AD is prevalent and its associated with a vulnerable sociodemographic profile. An equitable mental health assistance for pregnant women should consider risks factors such as race, education and partner status. Antenatal depression is frequently prevalent but results may vary among studies. We aim to estimate the prevalence of antenatal depression and its associated sociodemographic and obstetric risk factors. We used data from the Brazilian National Survey (PNS 2013), a population-based study, with complex and probabilistic sampling method. Of the 22.445 women at reproductive age (18 to 49 years old) participants in the PNS 2013, there were 800 women reported being pregnant at the time of interview. All participants answered the Patient Health Questionnaire-9 (PHQ-9) and a questionnaire with sociodemographic, obstetric and clinical data. Pregnant women with a PHQ-9 score ≥ 10 were classified as “Depressed”. All variables were categorized. Logistic regression models were performed to obtain crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI) for the association between explanatory variables and antenatal depression. Among 800 pregnant women, 95 (11.4%; 95%CI: 8.5%:14.9%) were classified as depressed. In the adjusted analysis, the following variables were associated with higher risk of AD: an elementary school degree (adjusted OR 5.22, 95% CI 2.10:12.9), a non-white skin color (aOR 2.67, 95% CI 1.44 - 4.94) and living alone (aOR 2.16, 95% CI 1.12:4.18). In Brazil, antenatal depression is prevalent and its associated with a vulnerable sociodemographic profile. An equitable mental health assistance for pregnant women should consider risks factors such as race, education and partner status.