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在埃塞俄比亚西北部,抑郁症仍是孕妇群体中一个被忽视的公共卫生问题。

Depression remains a neglected public health problem among pregnant women in Northwest Ethiopia.

作者信息

Beyene Getnet Mihretie, Azale Telake, Gelaye Kassahun Alemu, Ayele Tadesse Awoke

机构信息

Department of psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Arch Public Health. 2021 Jul 12;79(1):132. doi: 10.1186/s13690-021-00649-6.

Abstract

BACKGROUND

Antenatal depression is highly prevalent but a neglected public health problem in low income countries. It has serious effects on the general health of women, birth outcomes and child health. However, there has been limited substantial evidence on the prevalence and predictors of antenatal depression in Ethiopia. This lack of evidence potentiates the consequences of the problem and can limit the attention to intervention. Thus, this study aimed to assess the prevalence and potential predictors of antenatal depression at Debre Tabor and Woreta towns, Northeast Ethiopia.

METHODS

A community-based cross-sectional study was employed on 548 pregnant women recruited by a cluster sampling method. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). The List of Threatening Experiences Questionnaire (LTE-Q), the Oslo-3 Social Support Scale (OSSS-3), Intimate Partner Violence (IPV) Scale and Fast Alcohol Screening Test (FAST) were also used to measure stressful events, social support, intimate partner violence (IPV) and hazardous alcohol use respectively. Bivariable and multivariable logistic regression analyses were carried out to identify factors associated with antenatal depression.

RESULTS

The prevalence of antenatal depression was found to be 24.45% (95% CI: 21.20, 28.30%). Being single (AOR =3.32, 95% CI = 1.36, 8.09); fear of pregnancy complication (AOR = 3.84, 95% CI = 1.53,9.62); history of chronic illness (AOR = 8.14, 95% CI = 2.14, 30.91); unplanned pregnancy (AOR = 2.99, 95% CI = 1.36,6.55); history of stillbirth (AOR = 3.56, 95% CI = 1.23, 10.29),one or more negative life events (AOR = 4.06, 95% CI = 1.71, 9.66) and intimate partner violence (AOR = 3.91, 95% CI = 1.65, 9.26) were factors significantly associated with antenatal depression.

CONCLUSION

Nearly a quarter of pregnant women suffer from depressive symptoms during pregnancy. Being single; fear of pregnancy complication; history of chronic illness; unplanned pregnancy; history of stillbirth; one or more negative life events and intimate partner violence were important predictors of antenatal depression in this study. Health care workers should consider addressing these risk factors during a routine antenatal care. Also, integrating early screening, detection, and treatment of antenatal depression into routine antenatal care is warranted to improve the quality of life of pregnant women and pregnancy outcomes as well.

摘要

背景

产前抑郁症在低收入国家极为普遍,但却是一个被忽视的公共卫生问题。它对女性的整体健康、分娩结局和儿童健康都有严重影响。然而,关于埃塞俄比亚产前抑郁症的患病率和预测因素,目前确凿的证据有限。这种证据的缺乏加剧了该问题的后果,并可能限制对干预措施的关注。因此,本研究旨在评估埃塞俄比亚东北部德布雷塔博尔镇和沃雷塔镇产前抑郁症的患病率及潜在预测因素。

方法

采用基于社区的横断面研究,通过整群抽样方法招募了548名孕妇。使用爱丁堡产后抑郁量表(EPDS)测量抑郁症状。还使用威胁性经历问卷清单(LTE-Q)、奥斯陆-3社会支持量表(OSSS-3)、亲密伴侣暴力(IPV)量表和快速酒精筛查测试(FAST)分别测量应激事件、社会支持、亲密伴侣暴力(IPV)和有害酒精使用情况。进行双变量和多变量逻辑回归分析以确定与产前抑郁症相关的因素。

结果

发现产前抑郁症的患病率为24.45%(95%置信区间:21.20,28.30%)。单身(调整后比值比[AOR]=3.32,95%置信区间=1.36,8.09);对妊娠并发症的恐惧(AOR=3.84,95%置信区间=1.53,9.62);慢性病病史(AOR=8.14,95%置信区间=2.14,30.91);意外怀孕(AOR=2.99,95%置信区间=1.36,6.55);死产史(AOR=3.56,95%置信区间=1.23,10.29);一个或多个负面生活事件(AOR=4.06,95%置信区间=1.71,9.66)以及亲密伴侣暴力(AOR=3.91,95%置信区间=1.65,9.26)是与产前抑郁症显著相关的因素。

结论

近四分之一的孕妇在孕期患有抑郁症状。单身;对妊娠并发症的恐惧;慢性病病史;意外怀孕;死产史;一个或多个负面生活事件以及亲密伴侣暴力是本研究中产前抑郁症的重要预测因素。医护人员在常规产前检查期间应考虑解决这些风险因素。此外,将产前抑郁症的早期筛查、检测和治疗纳入常规产前检查中,对于改善孕妇的生活质量和妊娠结局也是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f44e/8273995/957d31809632/13690_2021_649_Fig1_HTML.jpg

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