Department of Food Science Nutrition and Technology, University of Nairobi, Nairobi, 00625, Kenya.
Department of Psychiatry, College of Health Sciences, University of Nairobi, Nairobi, 00100, Kenya.
F1000Res. 2020 Dec 21;9:1495. doi: 10.12688/f1000research.27434.3. eCollection 2020.
Prepartum depression is common among pregnant women and has not been studied much in low and middle-income countries. Evidence shows that mental illnesses are prevalent in urban than in rural areas. The study objective was to determine the magnitude of prepartum depression, risk factors, and real-life experiences of depression among pregnant women. A mixed-method cross-sectional study was conducted. It included 262 pregnant women attending antenatal clinics in two public health facilities in urban low-income settlement Nairobi, Kenya. Edinburgh Postnatal Depression Scale (EPDS) with cut-off >13 was used to classify clinical depressive illness. Further, a focus group discussion was conducted with 20 women identified with depression. Univariable analysis with Odd's Ratio was used to test associations. Variables with a p<0.05 in multivariable regression were considered significant. Out of the 262 women, 33.6% were found to have clinical depression as indicated by EPDS score of >13. Women's gestational age was statistically significantly associated with prepartum depression [OR 4.27 (95% C.I. 2.08 - 8.79), ]. Income level ≤ 5000 KES was statistically significantly associated with prepartum depression [OR 3.64 (95% C.I.1.25 -10.60), ]. Further, thematic analysis of qualitative indicated that poverty, lack of social support, domestic violence, and unfriendly health care were major contributors to prepartum depression. Significant numbers of pregnant women were found to experience depression. This prevalence rate indicates a high disease burden of women who live with depression, which is not diagnosed because screening of depression is not done in primary health care centers. This study calls for a need and consideration for screening for perinatal depression in primary health care facilities, mainly in resource-poor areas. Interventions targeting means of resolving conflicts in families are highly needed. Such steps would help achieve key sustainable development goals where maternal and child health remains key priority.
产前抑郁症在孕妇中很常见，但在中低收入国家研究得还不多。有证据表明，精神疾病在城市比在农村更为普遍。本研究旨在确定孕妇产前抑郁症的严重程度、危险因素以及抑郁的实际经历。本研究采用混合方法的横断面研究。它包括在肯尼亚内罗毕低收入城市住区的两家公立卫生机构的产前诊所就诊的 262 名孕妇。使用爱丁堡产后抑郁量表（EPDS），截断值>13 用于分类临床抑郁障碍。此外，对 20 名被诊断为抑郁症的女性进行了焦点小组讨论。采用单变量分析和优势比（Odd's Ratio）来检验相关性。多变量回归中 p 值<0.05 的变量被认为具有统计学意义。在 262 名妇女中，33.6%的妇女根据 EPDS 评分>13 被诊断为患有临床抑郁症。妇女的妊娠年龄与产前抑郁症呈统计学显著相关[OR 4.27（95%置信区间 2.08-8.79）]。收入水平≤5000 KES 与产前抑郁症呈统计学显著相关[OR 3.64（95%置信区间 1.25-10.60）]。此外，定性的主题分析表明，贫困、缺乏社会支持、家庭暴力和不友好的医疗保健是产前抑郁症的主要原因。相当数量的孕妇被发现患有抑郁症。这一流行率表明，生活在抑郁症中的妇女的疾病负担很高，而由于初级保健中心没有进行抑郁症筛查，这些妇女的抑郁症并没有得到诊断。这项研究呼吁有必要在初级保健设施中进行围产期抑郁症筛查，特别是在资源匮乏的地区。迫切需要针对解决家庭冲突的干预措施。这些措施将有助于实现可持续发展目标，其中孕产妇和儿童健康仍然是重点。
