Journal Article

Antenatal depressive symptoms and perinatal complications: a prospective study in rural Ethiopia

Kebede, Eskinder, Fekadu, Abebaw, Bitew, Tesera, Honikman, Simone, Hanlon, Charlotte

2017

Overview

Background Antenatal depressive symptoms affect around 12.3% of women in in low and middle income countries (LMICs) and data are accumulating about associations with adverse outcomes for mother and child. Studies from rural, low-income country community samples are limited. This paper aims to investigate whether antenatal depressive symptoms predict perinatal complications in a rural Ethiopia setting. Methods A population-based prospective study was conducted in Sodo district, southern Ethiopia. A total of 1240 women recruited in the second and third trimesters of pregnancy were followed up until 4 to 12 weeks postpartum. Antenatal depressive symptoms were assessed using a locally validated version of the Patient Health Questionnaire (PHQ-9) that at a cut-off score of five or more indicates probable depression. Self-report of perinatal complications, categorised as maternal and neonatal were collected by using structured interviewer administered questionnaires at a median of eight weeks post-partum. Multivariate analysis was conducted to examine the association between antenatal depressive symptoms and self-reported perinatal complications. Result A total of 28.7% of women had antenatal depressive symptoms (PHQ-9 score ≥ 5). Women with antenatal depressive symptoms had more than twice the odds of self-reported complications in pregnancy (OR=2.44, 95% CI: 1.84, 3.23), labour (OR= 1.84 95% CI: 1.34, 2.53) and the postpartum period (OR=1.70, 95% CI: 1.23, 2.35) compared to women without these symptoms. There was no association between antenatal depressive symptoms and pregnancy loss or neonatal death. Conclusion Antenatal depressive symptoms are associated prospectively with self-reports of perinatal complications. Further research is necessary to further confirm these findings in a rural and poor context using objective measures of complications and investigating whether early detection and treatment of depressive symptoms reduces these complications.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V
• Subject: Adult / Alcohol use / Depression - diagnosis / Depression - psychology / Depression, Mental / Depression, Postpartum - diagnosis / Depression, Postpartum - psychology / Diagnosis / Ethiopia / Female / Health aspects / Health risk assessment / Humans / Life Change Events / Medicine / Medicine & Public Health / Mental depression / Mental disorders / Mood disorders / Multivariate analysis / Neonates / Parturition - psychology / Population studies / Postpartum / Postpartum Period - psychology / Pregnancy / Pregnancy complications / Pregnancy Complications - diagnosis / Pregnancy Complications - psychology / Pregnancy Trimester, Third - psychology / Pregnant women / Prenatal depression / Prospective Studies / Psychiatry / Psychological aspects / Psychotherapy / Research Article / Rural Population / Surveys and Questionnaires / Womens health / Young Adult