Prevalence and determinants of antenatal depression in Ethiopia: A systematic review and meta-analysis

Abstract

Background Maternal depression is the most prevalent psychiatric disorder during pregnancy, can alter fetal development and have a lasting impact on the offspring's neurological and behavioral development. However, no review has been conducted to report the consolidated magnitude of antenatal depression (AND) in Ethiopia. Therefore, this review aimed to systematically summarize the existing evidence on the epidemiology of AND in Ethiopia. Methods Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of AND from three electronic databases (PubMed, EMBASE, and SCOPUS). We used predefined inclusion criteria to screen identified studies. A qualitative and quantitative analysis was employed. Heterogeneity across the studies was evaluated using Q and the I² test. Publication bias was assessed by funnel plot and Egger’s regression test. Results In this review, a total of 193 studies were initially identified and evaluated. Of these, five eligible articles were included in the final analysis. In our meta-analysis, the pooled prevalence of AND in Ethiopia was 21.28% (95% CI; 15.96–27.78). The prevalence of AND was highest in the third trimester of pregnancy at 32.10% and it was 19.13% in the first trimester and 18.86% in the second trimester of pregnancy. The prevalence of AND was 26.48% and 18.28% as measured by Beck depression inventory (BDI) and the Edinburgh Postnatal Depression Scale (EPDS), respectively. Moreover, the prevalence of AND was 15.50% for the studies conducted in the community setting and it was 25.77% for the studies conducted in the institution-based setting. In our qualitative synthesis, we found that those pregnant women who had a history of stillbirth, complications during pregnancy, previous history of depression, no ANC follow-up, irregular ANC follow-up, not satisfied by ANC follow-up, and monthly income <1500 Ethiopian birr were linked with a greater risk of developing ANC. We also found that those women who experienced partner violence during pregnancy, food insecurity, medium and low social support, and those who were unmarried, age group 20–29, house wives and farmers were associated with a higher risk of developing ANC. Conclusion and recommendations Our meta-analysis found that the pooled prevalence of AND in Ethiopia was 21.28%. The prevalence of AND was high in the third trimester of pregnancy as compared to the first and second trimesters of pregnancy. The prevalence of AND was high in studies conducted using BDI than EPDS. Studies on the magnitude of AND as well as the possible determinants in each trimester of pregnancy with representative sample size are recommended. Screening of depression in a pregnant woman in perinatal setting might be considered backed by integration of family planning and mental health services. The use of validated and a standard instrument to assess AND is warranted. S...

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].…”

“…The high prevalence rate in this study is comparable to other LMICs [12,13,16,17]. In South Africa, for example, the prevalence of antenatal depression ranges from 20 to 49% [19,21,23,38].…”

“…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.…”

“…Studies investigating HIVpositive, pregnant women reported higher prevalence of antenatal depression [20][21][22]; HIV infection typically increases the risk of depression up to four times [24,25]. Secondly, pregnancy stage influences prevalence estimates; depression occurrence is trimester-dependent with the burden being greater in the third trimester [13,26]. Thirdly, tools used to evaluate depression can also explain maternal depression disparities [27].…”