Abstract
BackgroundDepression in pregnancy has adverse health outcomes for mothers and children. The magnitude and risk factors of maternal depression during pregnancy is less known in developing countries. This study examines the association between pregnancy intention, social support and depressive symptoms in pregnancy in Ethiopia.MethodsData for this study comes from a baseline survey conducted as part of a community- based cohort study that involved 627 pregnant women from a Demographic Surveillance Site (DSS) in Southwestern Ethiopia. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms during pregnancy. Data on depressive symptoms, pregnancy intention, social support and other explanatory variables were gathered using an interviewer-administered structured questionnaire. The association between independent variables and depressive symptom during pregnancy was assessed using multivariable logistic regression.ResultsThe prevalence of depressive symptoms during pregnancy was 19.9% (95% CI, 16.8-23.1), using EPDS cut off point of 13 and above. The mean score on the EPDS was 8, ranging from 0 to 25 (SD ±5.4). Women reporting that the pregnancy was unwanted were almost twice as likely to experience depressive symptoms compared with women with a wanted pregnancy. (Adjusted Odds Ratio (AOR) = 1.96, 95% Confidence Interval (CI) 1.04-3.69) Women who reported moderate (AOR = 0.27; 95% CI 0.14-0.53) and high (AOR = 0.23, 95% CI 0.11-0.47) social support during pregnancy were significantly less likely to report depressive symptoms. Women who experienced household food insecurity and intimate partner physical violence during pregnancy were also more likely to report depressive symptoms.ConclusionAbout one in five pregnant women in the study area reported symptoms of depression. While unwanted pregnancy increases women’s risk of depression, increased social support plays a buffering role from depression. Thus, identifying women’s pregnancy intention and the extent of social support they receive during antenatal care visits is needed to provide appropriate counseling and improve women’s mental health during pregnancy.
Highlights
Depression in pregnancy has adverse health outcomes for mothers and children
Antenatal depression is a predictor of postnatal depression--women who are depressed during pregnancy have a higher risk of developing depression during the postpartum period [8,9]
Overall, our study found a high level of depressive symptoms among pregnant women in the study area
Summary
The magnitude and risk factors of maternal depression during pregnancy is less known in developing countries. This study examines the association between pregnancy intention, social support and depressive symptoms in pregnancy in Ethiopia. Mental health problems, such as depression, rank among the top causes of disability among women worldwide; they still remain inconspicuous as a component of reproductive health care [1]. Several studies have shown that depression, anxiety, and stress in pregnancy are risk factors for adverse outcomes for women and children. A study from Ethiopia found that antenatal common mental disorders such as depression, anxiety and somatic symptoms are associated with prolonged labor, delayed initiation of breast feeding and more diarrheal episodes for infants [7]. Antenatal depression is a predictor of postnatal depression--women who are depressed during pregnancy have a higher risk of developing depression during the postpartum period [8,9]
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