A population survey of prevalence rates of antenatal depression in the Irish obstetric services using the Edinburgh Postnatal Depression Scale (EPDS)

Abstract

Ireland has the second-highest birth rate in Europe and poorly developed perinatal psychiatry services. There are no screening services for antenatal depression and no data available on prevalence rates of depression among women attending the Irish obstetric services. The aim of this study was to assess the prevalence rates of depression during pregnancy in a population sample in Ireland using the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool. Pregnant women during all stages of pregnancy were recruited from five maternity hospitals throughout the Republic of Ireland. Approximately 5000 EPDS questionnaires were collected. Information on the participant's age, gestational week, gravidity, parity, and level of education attained was also collected. A score of > 12 was used as a measure of probable depression. Overall, 15.8% of pregnant women scored > 12 in the EPDS. There was a significant association between gestational week and rates of depression, with increasing rates occurring with advancing pregnancy (p < 0.001). Overall, higher socioeconomic groups were over-represented in the sample although we replicated the well-established findings of higher EPDS scores in women with lower educational attainment (p < 0.005). This study demonstrates that prevalence rates of probable antenatal depression are high among women attending the obstetric services in Ireland and highlight the importance of increasing awareness of antenatal depression. These high rates of antenatal depression may be related to certain conditions that are specific to an Irish setting: the absence of screening for depression in the context of grossly under-resourced perinatal psychiatry services. These findings provide indirect confirmatory evidence for the need for streamlined mental health services within reproductive health services.

The Prevalence of and Factors Associated With Antenatal Depression Among All Pregnant Women Attending the Obstetrics Clinic for the First Time in A Comprehensive Teaching Hospital

“…The incidence of antenatal depression in our study was significantly lower than that reported in low-and middle-income areas, such as Africa, where the incidence was 26.3% [6] , but the prevalence reported in our study might be slightly higher than that reported in high-income countries, such as Ireland [28] . This discrepancy in prevalence between countries might be due to the differences in depression screening tool, culture, study methodology, study population, socio-economic and socio-demographic variations.…”

Profiles and characteristics of clinical subtypes of perinatal depressive symptoms: A latent class analysis

“…Consistent with previous studies (Silverman et al, ), among women with no depression history, younger age was associated with increased risk of depressive symptoms, even though the young women were generally prepared for their forthcoming delivery. However, because of their youth and the frightening delivery experience, young women are relatively likely to experience severe depression (Jairaj et al, ; Melville, Gavin, Guo, Fan, & Katon, ). Moreover, compared with 26‐34‐year‐old women (reference group), older women (≥35 years old) were more likely to belong to Classes 3 and 4, which were associated with the presence of physio‐somatic symptoms.…”

“…In a study of non-pregnant women of reproductive age, low levels of education increased the risk of depression (Nguyen, Weiss, Beydoun, & Kancherla, 2017). Education can increase knowledge of the details of gestation and delivery and thereby reduce fear of childbirth and the risk of perinatal depression (Jairaj et al, 2018;Marcus, Flynn, Blow, & Barry, 2003).…”

Adverse Childhood Experiences and Changing Levels of Psychosocial Distress Scores across Pregnancy in Kenyan Women

“…A nationally representative household survey reports 32% of females and 18% of males having experienced sexual violence, while 66% of females and 73% of males experienced physical violence [19]. In other LMIC, the prevalence of antenatal depression ranges from 18% to 25% [20][21][22], while that in high-income countries is much lower and spans 6% to 16% [23,24]. A study in South Africa found that maternal childhood trauma predicted greater maternal depressive symptoms and more negative child outcomes within the first six months post-partum [25].…”