Determinants of Depression, Anxiety, and Stress among Pregnant Women Attending Tertiary Hospitals in Urban Centers, Nigeria

Abstract

Most times, pregnancy is considered a joyous event, but it also heightens a woman’s emotional and psychological state. Globally, some women suffer mental disorders, especially in developing nations. In Nigeria, there is evidence for a high prevalence of depression, anxiety, and stress during pregnancy. Therefore, this study aimed to estimate the severity and factors associated with depression, anxiety, and stress among pregnant women in Port Harcourt, Nigeria. A facility-based cross-sectional survey was carried out in the two tertiary hospitals in Port Harcourt city between September and October 2022 using the Depression Anxiety and Stress Scale-21 (DASS-21). Univariate, bivariate, and multivariate analyses were performed using STATA 16. The proportional odds model (POM) was used, and the statistical significance was set at p ≤ 0.05. A total of 413 respondents participated in the study, of whom 9.5%, 26.6%, and 17.3% had at least moderate depression, anxiety, and stress, respectively. Marital status, educational levels, and employment status were significantly associated with depression. Marital status, religion, and trimester were significantly associated with anxiety, while age, marital status, educational level, religion, income, trimester, and previous abortions/miscarriages were significantly related to stress. This study showed evidence of moderate-to-extremely severe anxiety, stress, and depression, as well as factors associated with these disorders. Our findings have implications for strengthening mental health policies as they pertain to antenatal care.

Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries

“…Given that generalized anxiety disorder was reported across 184 studies, we were able to further interrogate the prevalence of this disorder across important subgroups (Figure 3). While investigating generalized anxiety by country income status, we found a higher prevalence among studies performed in lower-middle–income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109) compared with low-income countries (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961). Upper-middle–income countries had the lowest prevalence (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496).…”

“…Generalized anxiety disorder (including anxiety not specified) was the most commonly reported anxiety disorder, examined by 184 of 203 studies (90.6%) . The pooled point prevalence for generalized anxiety disorder was 22.2% (95% CI, 19.4%-25.0%; n = 173 553).…”

“…Our search identified 10 617 studies; 1231 full texts were reviewed, and of these, 203 studies were included (Figure 1; eTable 2 in Supplement 1). Cumulatively, outcomes were reported for 212 318 perinatal women (from conception to 12 months post birth) from 33 LMICs. The prevalence estimates of 6 anxiety and related disorders were reported: generalized anxiety disorder, social anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, and adjustment disorder.…”

“…The majority of studies reported the prevalence of generalized anxiety antenatally (150 [81.5%]). Among these, the pooled point prevalence was 23.9% (95% CI, 20.5%-27.4%; n = 149 485).…”

Depression and Perceived Stress among Perinatal Women Living with HIV in Ibadan, Nigeria

“…Sub-Saharan Africa (SSA) accounts for 71% of the global population of people living with HIV (PLWH) 2 , with a prevalence rate of 1.4% in Nigeria making it the third most HIV-burdened country 2 . The burden of HIV in Nigeria is the highest among the female adult population and a known predisposition of maternal mortality with an estimated prevalence of 26.4% among pregnant cohorts 3,4 .…”