Depressed mood in pregnancy: Prevalence and correlates in two Cape Town peri-urban settlements

Abstract

BackgroundThe disability associated with depression and its impact on maternal and child health has important implications for public health policy. While the prevalence of postnatal depression is high, there are no prevalence data on antenatal depression in South Africa. The purpose of this study was to determine the prevalence and correlates of depressed mood in pregnancy in Cape Town peri-urban settlements.MethodsThis study reports on baseline data collected from the Philani Mentor Mothers Project (PMMP), a community-based, cluster-randomized controlled trial on the outskirts of Cape Town, South Africa. The PMMP aims to evaluate the effectiveness of a home-based intervention for preventing and managing illnesses related to HIV, TB, alcohol use and malnutrition in pregnant mothers and their infants. Participants were 1062 pregnant women from Khayelitsha and Mfuleni, Cape Town. Measures included the Edinburgh Postnatal Depression Scale (EPDS), the Derived AUDIT-C, indices for social support with regards to partner and parents, and questions concerning socio-demographics, intimate partner violence, and the current pregnancy. Data were analysed using bivariate analyses followed by logistic regression.ResultsDepressed mood in pregnancy was reported by 39% of mothers. The strongest predictors of depressed mood were lack of partner support, intimate partner violence, having a household income below R2000 per month, and younger age.ConclusionsThe high prevalence of depressed mood in pregnancy necessitates early screening and intervention in primary health care and antenatal settings for depression. The effectiveness and scalability of community-based interventions for maternal depression must be developed for pregnant women in peri-urban settlements.Trial registrationClinicalTrials.gov: NCT00972699.

Suicide ideation, depression and HIV among pregnant women in rural South Africa

“…Interestingly, three suicidal women had no current or prior depression and one suicidal woman reported a prior depression but no current depression, raising the possibility, as has been postulated in some reports [2,4], that for some women depression and suicide ideation may be independent phe-nomena. We found no significant association between unplanned pregnancies and suicide ideation, as has been shown in other research in pregnancy in South Africa [8,9], however, rates of unplanned pregnancies were pervasive in this sample, and substantial qualitative data supports the notion that for suicidal women an unplanned pregnancy, together with either partner or family conflict over the unplanned nature of the pregnancy, was a significant psychosocial stressor which frequently triggered suicide ideation. Partner conflict and intimate partner violence are strongly associated with antenatal depression in this region [9,15] and with both antenatal depression and suicide ideation in other LMICs [6,7,27,32] .…”

“…Thus, suicide ideation may be a feature of a depressed woman's response to an HIV diagnosis during pregnancy, since depression is frequently associated with negative thinking, poor problem solving and poor health perceptions [9,42].…”

“…In that study researchers found a significant association between probable depression and suicide ideation with risk factors including: being single and without support, being HIVpositive, having an unplanned pregnancy and a past history of depression. The link between antenatal depression and suicide ideation is important since in many Southern African settings the burden of antenatal depression is between 30% -47% [8][9][10][11] and risks are compounded by multiple factors including: HIV, with up to 43% of pregnant women in the worst affected areas testing HIV-positive [12], high rates of unplanned pregnancies [13] and intimate partner violence [14,15]. Suicide ideation among pregnant women in LMICs represents an important global mental health concern, in particular in HIV epidemic settings.…”

Assessment of anxiety and depression levels of pregnant women with hyperemesis gravidarum in a case-control study

“…The condition generally requires frequent visits to the emergency room and sometimes repeated hospitalization for intravenous hydration. Recently published studies have found that the point prevalence of depression ranges from 8.5% to 39.0% at different times during pregnancy and from 6.5% to 12.9% at different times during the first year postpartum, which are both slightly higher than the depression frequency in non-pregnant women (3)(4)(5). HG is currently conceptualized as a biological illness with an unknown pathophysiological cause.…”

Prevalência de sinais e sintomas e conhecimento sobre doenças sexualmente transmissíveis

“…(9)(10)(11) In Brazil, no study was identified with this emerging social group. Identifying factors related to the vulnerability of this population for STDs can assist health professionals in the development of interventions to prevent and control these infections among this segment of the population that is, because of its condition of dispersion and urban segregation, is at the margins of public health services.…”