Department of Primary Health Care Sciences, Mental Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
African Mental Health Research Initiative (AMARI), Research Support Centre, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
PLoS One. 2023 Jul 7;18(7):e0270873. doi: 10.1371/journal.pone.0270873. eCollection 2023.
Antenatal depression is highly prevalent and is associated with negative birth and neonatal outcomes. However, the mechanisms and causality behind these associations remain poorly understood as they are varied. Given the variability in whether associations are present, there is need to have context-specific data to understand the complex factors that go into these associations. This study aimed to assess the associations between antenatal depression and birth and neonatal outcomes among women attending maternity care in Harare, Zimbabwe.
We followed 354 pregnant women in second or third trimester, attending antenatal care services in two randomly selected clinics in Harare, Zimbabwe. Antenatal depression was assessed using the Structured Clinical Interview for DSM-IV. Birth outcomes included birth weight, gestational age at delivery, mode of delivery, Apgar score, and initiation of breastfeeding within one-hour postdelivery. Neonatal outcomes at six weeks postdelivery included infant's weight, height, illness, feeding methods and maternal postnatal depressive symptoms. The association between antenatal depression and categorical and continuous outcomes were assessed by logistic regression and point-biserial correlation coefficient, respectively. Multivariable logistic regression determined the confounding effects on statistically significant outcomes.
Prevalence of antenatal depression was 23.7%. It was associated with low birthweight [AOR = 2.30 (95% CI: 1.08-4.90)], exclusive breastfeeding [AOR = 0.42 (95%CI: 0.25-0.73)] and postnatal depressive symptoms [AOR = 4.99 (95%CI: 2.81-8.85)], but not with any other birth or neonatal outcomes measured.
The prevalence of antenatal depression in this sample is high with significant associations demonstrated for birth weight, maternal postnatal depressive symptoms and infant feeding methods Effective management of antenatal depression is thus crucial to the promotion of maternal and child health.
产前抑郁症的发病率很高，与不良的分娩和新生儿结局有关。然而，由于这些关联的机制和因果关系各不相同，因此人们对这些关联背后的机制和因果关系仍知之甚少。鉴于这些关联是否存在的可变性，需要有特定于背景的数据来了解导致这些关联的复杂因素。本研究旨在评估津巴布韦哈拉雷的两家随机选择的诊所的产妇保健中心就诊的孕妇中产前抑郁症与分娩和新生儿结局之间的关联。
我们对 354 名处于第二或第三孕期的孕妇进行了随访，这些孕妇在津巴布韦哈拉雷的两家随机选择的诊所接受产前保健服务。使用 DSM-IV 结构化临床访谈评估产前抑郁症。分娩结局包括出生体重、分娩时的胎龄、分娩方式、阿普加评分以及分娩后 1 小时内开始母乳喂养。在分娩后 6 周时，新生儿结局包括婴儿的体重、身高、疾病、喂养方式和产妇产后抑郁症状。通过逻辑回归和点二项相关系数分别评估产前抑郁与分类和连续结局之间的关联。多变量逻辑回归确定了对统计学显著结局的混杂影响。
产前抑郁症的患病率为 23.7%。它与低出生体重[OR=2.30（95%CI：1.08-4.90）]、纯母乳喂养[OR=0.42（95%CI：0.25-0.73）]和产后抑郁症状[OR=4.99（95%CI：2.81-8.85）]有关，但与其他任何分娩或新生儿结局无关。
该样本中产前抑郁症的患病率很高，与出生体重、产妇产后抑郁症状和婴儿喂养方式存在显著关联。有效管理产前抑郁症对于促进母婴健康至关重要。
