Depression during pregnancy and preterm delivery: a prospective cohort study among women attending antenatal clinic at Pumwani Maternity Hospital

Abstract

BackgroundPreterm birth occurs among 9.6% of births worldwide and is the leading cause of long-term neurodevelopmental disabilities among children and also responsible for 28% of neonatal deaths. No single etiological factor is responsible for preterm birth, but various risk factors have been identified. Prior studies have reported that compromised maternal mental health occurring during pregnancy may lead to various adverse obstetric outcomes.ObjectiveTo determine whether antenatal depression is significantly associated with preterm delivery in a low resource hospital sample from suburbs of Nairobi.Methods292 women attending the antenatal clinic at Pumwani Maternity Hospital in Nairobi meeting the study criteria were recruited. The Edinburgh Postnatal Depression Scale was administered to screen for depression. A clinical cutoff score of 10 and above was regarded as possible depression. Thereafter, a clinical interview together with the Patient Health Questionnaire-9 was administered to evaluate the participants on DSM-V criteria for major depressive disorder. Only 255 of the women were successfully followed-up to delivery with an attrition rate of 12.7%. Records of gestation at delivery and birth weight were collected at second contact.Data analysisPreterm birth was associated with various demographic, psychosocial and medical variables. Relative risks were estimated via log binomial regression analysis to determine whether depression was a risk factor for preterm birth.ResultsOf the 255 participants, 98(38.4%) found to have depressive symptoms and 27(10.7%) delivered preterm. The risk of delivering preterm was 3.8 times higher among those with depressive symptoms.ConclusionThere is a positive association between antenatal depression and preterm delivery. This highlights the importance of screening for mental health challenges in the antenatal period as a means to reduce adverse obstetric outcomes.

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.…”

“…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.…”

Determinants of preterm birth among mothers who gave birth in East Africa: systematic review and meta-analysis

“…Presence of periodontal disease (AOR 2.32; 95%CI: 1.33-4.27) [34] and periodontitis (at least three sites from different teeth with clinical attachment loss greater than or equal to4 mm [85] was significantly associated with PTB. Maternal depression increased the probability of having PTB (ARR 4.13; 95% CI: 2.82-17.42) [65]. Hematocrit level < 33 (AOR 7.2; 95% CI: 3.1-16.8) [63] and presence of chronic illness (AOR 4.5; 95% CI: 2, 10.2) [63] were found to be significantly associated with PTB.…”

“…, 11 from Ethiopia[52][53][54][55][56][57][58][59][60][61][62][63], 6 from Kenya[5,54,[64][65][66][67], 7 from Malawi [4, 6, 68-72], 3 from Sudan [10, 73, 74], 3 from Zambia [75-77],3 from Zimbabwe [78-80], 2 from Uganda [7, 81], 2 from Mozambique[82,83], 1 from Rwanda[84], and 1 from Madagascar[85]. Twenty five studies were done by cohort study design[33, 35, 36, 39, 41, 43, 45-50, 59, 61, 65-68, 70, 75, 77, 80, 83-85], 9 studies by case control study design[7,10,37,38,53,55,57,73,79] and 24 studies by cross sectional study design[4-6, 34, 40, 42, 44, 51, 52, 54, 56, 58, 60, 62, 64, 69, 71, 72, 74, 76, 78, 81, 82] (Table 1).…”

Correction to: Depression during pregnancy and preterm delivery: a prospective cohort study among women attending antenatal clinic at Pumwani Maternity Hospital

“…Following the publication of the original article [ 1 ], the authors reported the following typesetting errors:…”