Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Consortium for Advanced Research in Africa (CARTA), Nairobi, Kenya.
BMC Pregnancy Childbirth. 2022 Mar 18;22(1):219. doi: 10.1186/s12884-022-04549-7.
Antepartum depression is the most common mental health disorder in pregnancy and it is also a risk factor for adverse perinatal outcomes. Low and middle income countries like Nigeria bear a higher burden of antepartum depression compared with high income countries. Prioritizing mental health issues among pregnant women is crucial to achieving the Sustainable Development Goals. We determined the prevalence, associated factors and perinatal outcomes of antepartum depression among pregnant women in Ibadan, Nigeria.
A prospective cohort study was conducted among 1745 pregnant women enrolled early in pregnancy (≤ 20 weeks) at four comprehensive obstetric facilities within Ibadan metropolis. Antepartum depression was ascertained during the third trimester using the Edinburg Postpartum Depression Scale ≥ 12. The primary exposure was antepartum depression and the outcome variables were the perinatal outcomes. The associated factors assessed included sociodemographic, obstetric, psychological, and lifestyle characteristics. Bi-variate logistic and Poisson regression analyses were used to assess the factors and relative risk for perinatal outcomes of antepartum depression.
The prevalence of antepartum depression was 14.1%. The significant factors associated with APD after adjusting for confounders were: high income (≥ 20, 000) which was protective (AOR) = 0.59; 95% CI: (0.40 - 0.88); p-value: 0.010] and perceived stress increased the odds of APD in a monotonic fashion: moderate stress [AOR = 2.39; 95% CI: (1.01 - 5.7); p-value: 0.047], high stress [AOR = 6.43; 95% CI: (2.28 - 18.2); p-value: < 0.001]. Preterm delivery was the only significant perinatal outcome [Relative Risk (RR) = 1.66; 95% CI (1.14 - 2.39); p-value = 0.007]. Depression did not increase the risk of having low birth weight babies (p = 0.513), macrosomia (p = 0.894), birth asphyxia (p = 0.317), and caesarean section (p = 0.298).
APD was prevalent among our study population. The significant factors identified in this study can be targeted to reduce the occurrence of APD among pregnant women in Nigeria through appropriate social and public health interventions which include APD screening, counselling, and the provision of emotional support for pregnant women during antenatal care.
产前抑郁症是妊娠期间最常见的心理健康障碍，也是围产期不良结局的一个风险因素。像尼日利亚这样的中低收入国家与高收入国家相比，产前抑郁症的负担更高。优先考虑孕妇的心理健康问题对于实现可持续发展目标至关重要。我们旨在确定尼日利亚伊巴丹孕妇产前抑郁症的患病率、相关因素和围产期结局。
在伊巴丹大都市的四家综合性产科机构，对 1745 名妊娠早期（≤20 周）的孕妇进行了前瞻性队列研究。在妊娠晚期使用爱丁堡产后抑郁量表（Edinburg Postpartum Depression Scale）≥12 分来确定产前抑郁症。主要暴露因素是产前抑郁症，结局变量是围产期结局。评估的相关因素包括社会人口统计学、产科、心理和生活方式特征。采用双变量逻辑回归和泊松回归分析来评估产前抑郁症的围产期结局的相关因素和相对风险。
产前抑郁症的患病率为 14.1%。在调整混杂因素后，与 APD 相关的显著因素包括：高收入（≥20,000）具有保护作用（OR）=0.59；95%CI：（0.40-0.88）；p 值：0.010]和感知压力呈单调递增方式增加 APD 的几率：中度压力[OR=2.39；95%CI：（1.01-5.7）；p 值：0.047]，高压力[OR=6.43；95%CI：（2.28-18.2）；p 值：<0.001]。早产是唯一显著的围产期结局[相对风险（RR）=1.66；95%CI（1.14-2.39）；p 值：0.007]。抑郁不会增加低出生体重儿（p=0.513）、巨大儿（p=0.894）、出生窒息（p=0.317）和剖宫产（p=0.298）的风险。
在我们的研究人群中，APD 较为普遍。本研究确定的显著因素可以通过适当的社会和公共卫生干预措施来减少尼日利亚孕妇产前抑郁症的发生，这些干预措施包括 APD 筛查、咨询以及在产前保健期间为孕妇提供情感支持。
