A cross-sectional study of depression among women attending antenatal clinics in Blantyre district, Malawi

Abstract

BackgroundPregnancy is a period associated with major psychological and social changes in the life of a woman and can be associated with anxiety and depression.AimTo describe demographic, clinical and risk profile of antenatal depression among pregnant women attending antenatal clinics in Blantyre district, Malawi.SettingThe study was conducted in eight antenatal clinics in Blantyre district, Malawi.MethodsA cross-sectional study of 480 randomly selected pregnant women attending antenatal clinics was conducted. Prevalence was determined using the Edinburgh Postnatal Depression Scale (EPDS) which was validated against a sub-sample using the Mini International Neuropsychiatric Interview. The risk factors of depression were assessed using the Pregnancy Risk Questionnaire. Data were analysed using descriptive statistics, Pearson chi-square test and binary logistic regression.ResultsPrevalence of antenatal depression using the EPDS was 19% (95% CI 15.5% – 22.5%, n = 91) and was comparable to the Mini International Neuropsychiatric Interview (25.8% [95% CI = 17.5–34], n = 25). The key risk factors that predicted antenatal depression were: ‘being distressed by anxiety or depression for more than 2 weeks during this pregnancy’ (OR = 4.1 [2.1–7.9], p ≤ 0.001); ‘feeling that a relationship with partner is not an emotionally supportive one’ (OR = 3.5 [1.4–8.4], p = 0.01); ‘having major stresses, changes or losses in the course of this pregnancy’ (OR = 3.2 [1.7–6.2], p = 0.01); ‘feeling that father was critical of her when growing up’ (OR = 3.2 [1.4–7.6], p = 0.01); and ‘having history of feeling miserable or depressed for ≥2 weeks before this pregnancy’ (OR = 2.4 [1.3–4.4], p = 0.01).ConclusionThis study confirmed the high-prevalence rate of depression in this group and illustrated that antenatal depression was associated with being distressed by anxiety or depression; support from partner; major stresses during pregnancy; and history of feeling miserable or depressed before pregnancy. This study also found a history of poor relationship between pregnant women and their fathers during childhood.

Antenatal depression: an examination of prevalence and its associated factors among pregnant women attending Harare polyclinics

“…In Zimbabwe, recent studies have also shown that intimate partner violence is a risk factor for depression in the perinatal period [22,39]. Unlike other studies in LMICs [5,12,13,17,18,21,40], we did not find any significant associations of antenatal depression with HIV, maternal age, educational level, history of obstetric complications, social support and gravidity. This may be due to methodological differences.…”

“…Factors associated with antenatal depression, such as intimate partner violence (IPV), experiencing a negative life event, and marital status, are relational. This is consistent with other regional studies [12][13][14][15][16][17][18][19][20][21][22][23]. In Zimbabwe, recent studies have also shown that intimate partner violence is a risk factor for depression in the perinatal period [22,39].…”

“…depression in women from Sub-Saharan Africa ranges from 20 to 49% [5,[12][13][14][15][16][17][18][19][20][21][22][23]. These prevalence variations can be explained by several reasons.…”

Prevalence and Correlates of Prenatal Depression, Anxiety and Suicidal Behaviours in the Volta Region of Ghana

“…Evidence suggests that prenatal depression and anxiety rates are lower in high-income countries and relatively higher among pregnant women in low and middle-income countries [ 3 , 4 , 5 , 6 ]. For example, studies conducted in some Sub-Saharan African (SSA) countries found similar patterns of prenatal depression rates; Malawi-19% [ 7 ], Ethiopia-23% and 26% pooled prevalence [ 8 ] and Nigeria-24% [ 9 ]. However, there are some discrepancies in the prevalence rates in low-income and high-income countries (LMICs) as a systematic review, including studies from thirty high-, middle- and low-income countries, found the prevalence of prenatal anxiety and depression to be less than 10% with no country-specific differences [ 10 ].…”

Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi

“…Depression is a serious health problem affecting pregnant women during all stages of their pregnancy [ 1 ]. In Malawi, major depressive disorders (10.7% to 25.8%) are prevalent among pregnant women [ 2 , 3 ]. These figures fall within prevalence rates range of depressive disorders during pregnancy (8.3% to 41%) reported in sub-Saharan Africa [ 4 ].…”