Biratu Abera, Haile Demewoz
Department of Nursing, College of Medicine and Health sciences, Madwalabu University, Bale Goba, Ethiopia.
Department of Reproductive Health, College of Medicine and Health sciences, Bahir Dar University, P.Box 79, Bahir Dar, Ethiopia.
Reprod Health. 2015 Oct 30;12:99. doi: 10.1186/s12978-015-0092-x.
The World Health Organization identifies depressive disorders as the second leading cause of global disease burden by 2020. However, there is a paucity of studies which examined the associated factors of antenatal depression in low-income countries. This study aimed to determine the prevalence of antenatal depression and associated factors among pregnant women in Addis Ababa, Ethiopia.
A cross-sectional study was employed among 393 pregnant women attending antenatal care service in Addis Ababa public health centers, Ethiopia from April 12-26, 2012. The Edinburgh Postnatal Depression Scale (EPDS) was used to detect depressive symptoms. Descriptive statistics and logistic regression were used in the statistical analysis.
Prevalence of antenatal depression was 24.9 % (95 % CI: 20.85-29.30 %). In the final multivariable model, those pregnant women who have previous history of depression were nearly three times at higher odds of having antenatal depression as compared to pregnant women who have no history of depression [AOR = 2.57(95 % CI: 1.48-4.48 )]. Those pregnant women having unplanned pregnancy were nearly three times at higher odds to develop depression as compared to pregnant women whose pregnancy was planned [AOR = 2.78(95 % CI: 1.59-4.85)]. The odd of developing antenatal depression was 89 % higher in those pregnant women who experienced lack of baby's father support [AOR = 1.89(95 % CI: 1.06-3.36)]. Education level, community's support, and partner's feeling on current pregnancy were not significantly associated factors with antenatal depression in the final multivariable model.
Although clinical confirmation for antenatal depression is not conducted, one quarter of the pregnant women attending antenatal care were depressed in Addis Ababa based on EPDS. Unplanned pregnancy, experiencing lack of baby's father support and previous history of depression were factors independently associated with antenatal depression. Promotion of family planning and integration of mental health service with existing maternal health care as well as strengthening the referral system among public health centers were the recalled interventions to prevent antenatal depression in Addis Ababa Public Health Centers.
世界卫生组织认定，到2020年，抑郁症将成为全球疾病负担的第二大主要成因。然而，在低收入国家，针对产前抑郁症相关因素的研究却很匮乏。本研究旨在确定埃塞俄比亚亚的斯亚贝巴孕妇中产前抑郁症的患病率及相关因素。
2012年4月12日至26日，在埃塞俄比亚亚的斯亚贝巴公共卫生中心接受产前护理服务的393名孕妇中开展了一项横断面研究。采用爱丁堡产后抑郁量表（EPDS）来检测抑郁症状。统计分析采用描述性统计和逻辑回归。
产前抑郁症的患病率为24.9%（95%置信区间：20.85 - 29.30%）。在最终的多变量模型中，有抑郁症既往史的孕妇患产前抑郁症的几率比无抑郁症病史的孕妇高出近三倍[AOR = 2.57(95%置信区间：1.48 - 4.48)]。与计划怀孕的孕妇相比，意外怀孕的孕妇患抑郁症的几率高出近三倍[AOR = 2.78(95%置信区间：1.59 - 4.85)]。在那些缺乏孩子父亲支持的孕妇中，患产前抑郁症的几率高出89%[AOR = 1.89(95%置信区间：1.06 - 3.36)]。在最终的多变量模型中，教育水平、社区支持以及伴侣对当前怀孕的感受并非产前抑郁症的显著相关因素。
尽管未对产前抑郁症进行临床确诊，但基于EPDS，在亚的斯亚贝巴，四分之一接受产前护理的孕妇患有抑郁症。意外怀孕、缺乏孩子父亲的支持以及抑郁症既往史是与产前抑郁症独立相关的因素。推广计划生育、将心理健康服务与现有的孕产妇保健相结合以及加强公共卫生中心之间的转诊系统，是亚的斯亚贝巴公共卫生中心预防产前抑郁症时被提及的干预措施。
