Prevalence of postpartum depression and associated factors among women in Mbarara and Rwampara districts of south-western Uganda

The Influence of Personality Traits on Postpartum Depression: A Systematic Review Based on the NEO-FFI Scale

Postpartum depression (PPD) is a significant global health concern with profound implications for mothers, families, and societies. This systematic review aims to synthesize current research findings to understand better how personality traits, as assessed by the NEO Five-Factor Inventory (NEO-FFI), contribute to the development and progression of PPD. Conducted in January 2024, this review searched major databases like PubMed, PsycINFO, and Scopus up to December 2023, focusing on the NEO-FFI's role in evaluating PPD. Following PRISMA guidelines, studies were selected based on strict criteria, including the exclusive use of NEO-FFI for personality assessment and a focus on postpartum women. A total of seven studies were included after a rigorous two-step screening process, and their data were qualitatively synthesized. The review covered a total of 4172 participants, with a prevalence of clinically significant postpartum depression symptoms ranging from 10.6% to 51.7%. Notably, Neuroticism emerged as a significant predictor of PPD, with odds ratios ranging from 1.07 (95% CI: 0.96-1.20) in some studies to as high as 1.87 (95% CI: 1.53-2.27) in others. In contrast, traits like Extraversion and Conscientiousness generally showed protective effects, with lower scores associated with reduced PPD risk. For instance, Extraversion scores correlated negatively with PPD risk (Beta = -0.171) in one study. However, the impact of other traits such as Openness and Agreeableness on PPD risk was less clear, with some studies indicating negligible effects. The review highlights Neuroticism as a consistent and significant predictor of PPD risk, with varying impacts from other personality traits. The findings suggest potential pathways for targeted interventions in maternal mental health care, emphasizing the need for comprehensive personality evaluations in prenatal and postnatal settings.

Long-term effects on depressive symptoms among Ugandan mothers - Findings from a follow-up of a cluster-randomized education trial in a rural low-resource setting

INTRODUCTION

Depression is increasingly affecting mothers in poor countries such as Uganda. Various interventions have been implemented to tackle this problem, but their sustainability is under-researched. Here we present follow-up data on maternal depression six years after a cluster-randomized controlled maternal education trial in rural Uganda.

METHODS

The intervention lasted six months and consisted of nutrition, hygiene, sanitation and child stimulation education, delivered to 511 mothers of 6 to 8 months' old children. Six years later we assessed maternal depressive symptoms using two psychometric tools; the Beck Depression Inventory II (BDI-II) and Center for Epidemiologic Studies Depression scale (CESD).

RESULTS

For this follow-up study, data was available from 307/511 (60 %) mothers. Intention-to-treat analyses adjusting for clustering showed that the intervention mothers had non-significantly less depression symptoms (absolute score difference - 2; 95 % CI -5 to 0; p = 0.07) on BDI-II, and borderline significantly less depression symptoms (absolute score difference - 3; 95 % CI -5 to 0; p = 0.05) on CES-D compared to the controls. For categorized depression scores, the control mothers had significantly higher proportion of women classified in the worse depression categories for both BDI-II and CESD. We did not find any baseline characteristics associated with maternal depression.

LIMITATIONS

The BDI-II and CES-D tools are both self-reported and we cannot rule out the possibility of social desirability bias in reporting of depression symptoms.

CONCLUSION

Six years after the maternal education trial, some benefits on maternal mental health were sustained. More studies are warranted on sustainability and scale-up of such interventions.

Postpartum pain and the risk of postpartum depression: A meta-analysis of observational studies

OBJECTIVE

This meta-analysis of observational studies aimed to derive a more precise estimation of the relationship between postpartum pain and postpartum depression (PPD).

METHODS

A systematic literature search was completed in the following databases from inception to September 26, 2022: PubMed, Embase, and Web of Science. Quality evaluation of each study was achieved through Newcastle-Ottawa scale (NOS) assessment. Heterogeneity across studies was evaluated by Cochran's Q test and I2 test. Pooled estimates of odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were analyzed using fixed-effects model or random-effects model, according to heterogeneity. Subgroup analysis, sensitivity analysis, and Egger's test were also performed.

RESULTS

From the identified 1884 articles, a total of 8 studies involving 3973 participants were included in the final meta-analysis. Seven of the 8 studies were evaluated as high-quality, with NOS scores ≥7. A significant heterogeneity was observed (I2  = 66.5%, p = 0.004) among eight studies. Therefore, the performed random-effect model suggested a significant association between postpartum pain and PPD risk (OR 1.29, 95% CI 1.10-1.52, p = 0.002). However, the subgroup analyses did not define the source of heterogeneity. Moreover, the sensitivity analysis showed the stability of the pooled results, but the significant publication bias was identified (p = 0.009). The trim and fill method was performed and resulted in an OR of 1.14 (95% CI 0.95-1.37, p = 0.162).

CONCLUSIONS

This meta-analysis found a potential association between postpartum pain and PPD. Further researches are needed to provide more robust evidences.

Unplanned pregnancy and risk of peripartum depression: a prospective cohort study in Saudi pregnant women attending antenatal care clinic

Background

Few studies have been conducted on unintended pregnancies and peripartum depression in Saudi Arabia. This study aimed to evaluate the relationship between unplanned pregnancies and peripartum depression among pregnant women in Jeddah, Saudi Arabia.

Methods

This prospective cohort study included pregnant women attending an antenatal care clinic in 2021. The London Measure of Unplanned Pregnancy was used to assess the prevalence of unplanned pregnancy, and the Edinburgh Postnatal Depression Scale (EPDS) was used to assess antenatal and postnatal depression.

Results

A total of 236 participants were included, of which 25.8% had unplanned pregnancies, 36.0% had ambivalent pregnancies, and 38.1% had planned pregnancies. EPDS results revealed that 77.5% and 73.35% of the females were negative for antenatal and postnatal depression, respectively. A history of stressful events (P=0.001), husband (P=0.020), and family support (P=0.007) was significantly associated with antenatal EPDS score, whereas age (P=0.005), type of delivery (P=0.019), and family support (P=0.031) were significantly associated with the postnatal score.

Conclusion

Unplanned pregnancies may affect the perinatal mental health of women. We demonstrated the importance of family or husbands' support for women with perinatal depression. In addition, our research showed that pregnancy at an early age is a risk factor for postnatal depression. Therefore, these women should be closely monitored not only during their pregnancy but also during the first postpartum year.

Validating the Edinburgh Postnatal Depression Scale Against the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition for Use in Uganda

Background

The Edinburgh Postnatal Depression Scale (EPDS) is a widely acknowledged screening tool for postpartum depression (PPD) globally, but its validation in Uganda has been lacking. This study aimed to assess the EPDS's accuracy as a PPD screening tool in Uganda compared to the Mini-International Neuropsychiatric Interview (MINI 7.0.2) based on the DSM-5.

Methods

This was a descriptive cross-sectional study conducted at a referral hospital and two peri-urban primary care postpartum clinics in rural southwestern Uganda. We enrolled 287 mothers aged 18 to 49 at their six-week postpartum visit. The EPDS was used for initial screening, and the MINI 7.0.2 was employed for clinical diagnosis. The study used the Runyankore-Rukiga language version of the EPDS and collected data from November 11, 2019, to June 10, 2020, with the MINI 7.0.2 as the reference standard.

Results

The overall PPD prevalence was 29.5%, as opposed to 26.5% with EPDS and MINI 7.0.2 DSM-5 criteria (p = 0.239). The EPDS demonstrated a sensitivity of 86.8%, specificity of 92.1%, positive predictive value of 80.5%, and negative predictive value of 94.9%. A cutoff score of ≥10 was found to be the most effective acceptable point after drawing the AUC of ROC and determining the most appropriate point using Youden's index. The area under the ROC curve, indicating the scale's overall performance against MINI 7.0.2, was 0.89 for Bwizibwera HCIV, 0.97 for Kinoni HCIV, and 0.84 for MRRH. In conclusion, the EPDS can effectively screen for postpartum depression in southwestern Uganda using a cutoff score of ≥10. It exhibits strong diagnostic performance in correctly identifying PPD in postpartum mothers.

Intimate partner violence and antenatal care utilization predictors in Uganda: an analysis applying Andersen's behavioral model of healthcare utilization

BACKGROUND

Optimal utilization of antenatal care (ANC) services improves positive pregnancy experiences and birth outcomes. However, paucity of evidence exists on which factors should be targeted to increase ANC utilization among women experiencing intimate partner violence (IPV) in Uganda.

OBJECTIVE

To determine the independent association between IPV exposure and ANC utilization as well as the predictors of ANC utilization informed by Andersen's Behavioral Model of Healthcare Utilization.

METHODS

We analyzed 2016 Uganda Demographic and Health Survey data that included a sample of 1,768 women with children aged 12 to 18 months and responded to both ANC utilization and IPV items. Our outcome was ANC utilization, a count variable assessed as the number of ANC visits in the last 12 months preceding the survey. The key independent variable was exposure to any IPV form defined as self-report of having experienced physical, sexual and/or emotional IPV. Covariates were grouped into predisposing (age, formal education, religion, problem paying treatment costs), enabling (women's autonomy, mass media exposure), need (unintended pregnancy, parity, history of pregnancy termination), and healthcare system/environmental factors (rural/urban residence, spatial accessibility to health facility). Poisson regression models tested the independent association between IPV and ANC utilization, and the predictors of ANC utilization after controlling for potential confounders.

RESULTS

Mean number of ANC visits (ANC utilization) was 3.71 visits with standard deviation (SD) of ± 1.5 respectively. Overall, 60.8% of our sample reported experiencing any form of IPV. Any IPV exposure was associated with lower number of ANC visits (3.64, SD ± 1.41) when compared to women without IPV exposure (3.82, SD ± 1.64) at p = 0.013. In the adjusted models, any IPV exposure was negatively associated with ANC utilization when compared to women with no IPV exposure after controlling for enabling factors (Coef. -0.03; 95%CI -0.06,-0.01), and healthcare system/environmental factors (Coef. -0.06; 95%CI -0.11,-0.04). Predictors of ANC utilization were higher education (Coef. 0.27; 95%CI 0.15,0.39) compared with no education, high autonomy (Coef. 0.12; 95%CI 0.02,0.23) compared to low autonomy, and partial media exposure (Coef. 0.06; 95%CI 0.01,0.12) compared to low media exposure.

CONCLUSION

Addressing enabling and healthcare system/environmental factors may increase ANC utilization among Ugandan women experiencing IPV. Prevention and response interventions for IPV should include strategies to increase girls' higher education completion rates, improve women's financial autonomy, and mass media exposure to improve ANC utilization in similar populations in Uganda.

Treatment of Perinatal Depression and Correlates of Treatment Response Among Pregnant Women Living with HIV in Uganda

INTRODUCTION

Perinatal depression is common among women living with HIV, but depression care is limited in low-resource settings. We examined (1) characteristics of women receiving Problem Solving Therapy (PST) versus antidepressant therapy (ADT), (2) treatment response by modality, and (3) correlates of treatment response.

METHODS

This analysis used data from 191 Ugandan women in the intervention arm of a cluster randomized controlled trial of task-shifted, stepped-care depression treatment for pregnant women living with HIV (PWLWH). Treatment response was defined as scoring < 5 on the nine-item Patient Health Questionnaire (PHQ-9). Bivariate analysis and multivariable logistic regression were used to examine characteristics of women by treatment group and correlates of treatment response.

RESULTS

Of 134 participants with depression, 129 (96%) were treated: 84 (65%) received PST and 45 (35%) received ADT. Severe depression at treatment initiation was more common in those receiving ADT (28.9% versus 4.8%, Fischer's Exact Test < 0.001). Treatment response was higher for PST (70/84; 83.3%) than ADT (30/45; 66.7%; p = .03). ADT side effects were rare and minor; no infants had serious congenital defects. Of 22 participants (19%) who did not respond to treatment, only five received intensified management. Social support and interpersonal violence were associated with treatment response (adjusted odds ratio, [aOR] = 3.06, 95% CI = 1.08-8.66 and aOR = 0.64, 95% CI = 0.44-0.93).

DISCUSSION

Both depression treatment modalities yielded high response rates in Ugandan PWLWH; ADT was well-tolerated. Our results highlight a need to build capacity to implement the stepped-care protocol for non-responders and screen for social support and interpersonal violence.

Postpartum depression and associated factor among mothers attending public health centers of Yeka sub city, addis ababa Ethiopia

Postpartum depression (PPD) is a major public health concern that affects both the mother's health and the development of the child.Postpartum depression is defined by the American Psychiatric Association (APA) as the development of a Major Depressive Episode (MDE) within four weeks of birth. The rate of postpartum depression statistics is lacking in developing countries. This indicates that the data can be much higher if diagnosed and reported.There for this study assessed the magnitude of postpartum depression and its associated factors among mothers attending selected public health center of Yeka sub city, Addis Ababa, Ethiopia.

Method and materials

An institutional-based cross-sectional approach was conducted from December 2021 to January 2022 among 454 postpartum women. A single population proportion equations was used to calculate the sample size for this investigation.A multi-stage sampling method was applied based on the health center they are attending.One of the eleven sub-cities in Addis Abeba, Ethiopia, was chosen for this procedure using a simple random selection technique. Furthermore, four health centers from the selected sub-city were chosen using simple random selection.For data collection, structured questioners were utilised.The Edinburgh Postnatal Depression Scale, also known as the EPDS, was used to assess participants' postpartum depression. The data was validated, coded, and entered into Epi-data before being exported to SPSS for analysis. Bivariable and multivariable logistic regression were used. P-values less than 0.05 were deemed statistically significant.

Result

The overall prevalence of postpartum depression was 23.8 % [95 % CI (20-27.8)].Being single [AOR = 7.4, 95 % CI (4.2-12.9)], having complications during pregnancy [AOR = 2.1, 95 % CI (1.16-3.82)], Bottle feeding immediately after birth [AOR = 0.3, 95 % CI (0.13-0.66)], and having low perceived psycho-social support [AOR = 3.5, 95 % CI (1.4-8.5)] were significantly associated with postpartum depression.

Conclusion and recommendation

The current study found that post postpartum depression is highly prevalent among women. As a result, we recommend that to have regular screening, follow up and mental health care in postnatal periods of pregnancy. Because the period following childbirth is stressful, especially for new mothers, emotional and psychosocial support should be provided both in the community and in health care settings. Keywords:Postpartum depression, Women, Edinburgh Postnatal Depression Scale (EPDS),Ethiopia.

Stressors and Maladaptive Coping Mechanisms Associated with Elevated Perinatal Depressive Symptoms and Suicidality Among Women Living with HIV in Uganda

BACKGROUND

Perinatal depression is highly prevalent among women living with HIV and contributes to nonadherence to the PMTCT (prevention of mother-to-child transmission) care continuum. We examined correlates of elevated depressive symptoms and suicidality in this population.

METHOD

Baseline data from 391 Ugandan women enrolled in a cluster randomized controlled trial of a depression care intervention were analyzed. Adult women with confirmed sero-positive HIV status were eligible if their gestation period was ≤ 32 weeks, and they had a Patient Health Questionnaire (PHQ-9) score ≥ 5. Correlates of elevated depressive symptoms (PHQ-9 > 9) and moderate-to-severe suicidal ideation (more than half of the days in the prior 2 weeks) were assessed using bivariate and multivariate logistic regression models, controlling for clustering within study sites by using a random effects specification (with study site as the random effect), as well as age and education.

RESULTS

The mean PHQ-9 score was 12.7 (SD = 5.1); 267 (68.3%) participants had elevated depressive symptoms, and 51 (13.0%) reported moderate-to-severe suicidality. In multiple logistic regression analysis, perceived provider stigma of childbearing [OR (95% CI) = 1.81 (1.16, 2.84)], greater use of negative problem-solving [OR (95% CI) = 1.09 (1.04, 1.15)], and lower general social support [OR (95% CI) = 0.50 (0.30, 0.82)] were correlated with elevated depression symptoms, while moderate-to-severe suicidal ideation was correlated with greater experience of physical interpersonal violence (IPV) and greater use of negative problem-solving.

CONCLUSIONS

Programs aimed at improving provider support for the childbearing needs of persons living with HIV, supporting women who are experiencing IPV, and helping women to develop effective problem-solving skills and social supports may reduce symptoms of perinatal depression and help optimize PMTCT care outcomes.

TRIAL REGISTRATION

Clinicaltrials.gov NCT03892915 (registered March 21, 2019).

Preventing Perinatal Depression: Cultural Adaptation of the Mothers and Babies Course in Kenya and Tanzania

Pregnant women and mothers in sub-Saharan Africa are at high risk for perinatal depression, warranting a need to develop culturally tailored interventions to prevent perinatal depression. This paper documents the process of adapting an evidence-based preventive intervention developed in the United States, the Mothers and Babies Course (MBC), to fit the contexts of rural pregnant women and mothers of young children in Kenya and Tanzania using the updated Framework for Reporting Adaptations and Modifications-Enhanced (FRAME). Data from informant interviews and field observations from the planning and implementation phases were used to make adaptations and modifications of the MBC for perinatal women through the eight aspects of FRAME. Follow-up field visits and reflection meetings with case managers and intervention participants indicated that the adapted version of the MBC was well accepted, but fidelity was limited due to various implementation barriers. The FRAME provided an optimal structure to outline the key adaptations and modifications of a preventive intervention intended to maximize engagement, delivery, and outcomes for high-risk perinatal women in rural settings.

Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross-sectional study

OBJECTIVE

This study aimed at assessing factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City.

DESIGN

A cross-sectional study.

SETTINGS

The study was conducted in health facilities offering ANC services in Lira City, Northern Uganda.

PARTICIPANTS

The study was among 368 pregnant mothers attending their first ANC in the three selected facilities (Lira Regional Referral Hospital, Ober Health Center IV and Pentecostal Assembly of God Mission Health Center IV) in Lira City.

PRIMARY AND SECONDARY OUTCOME MEASURES

Level of first ANC attendance within 12 weeks of pregnancy and associated factors.

RESULTS

Early ANC attendance was 36.1%. Women who were: unmarried (adjusted OR (aOR): 0.40, 95% CI: 0.16 to 0.99), took >2 hours to reach a health facility (aOR: 0.21, 95% CI: 0.07 to 0.62), or not visited by village health teams or healthcare workers at home (aOR: 0.33, 95% CI: 0.12 to 0.92) were less likely to attend their first ANC early. On the other hand, women who were: not knowing first that ANC guides parents on infant care (aOR: 2.22, 95% CI: 1.06 to 4.67); pregnant without consent of spouse (aOR: 4.29, 95% CI: 1.75 to 10.55); attending ANC from a private facility (aOR: 2.89, 95% CI: 1.27 to 6.15); and having two to three healthcare workers present at the ANC clinic (aOR: 1.79, 95% CI: 1.03 to 3.13) were more likely to attend ANC early.

CONCLUSIONS

Despite the fact that the WHO recommends that all women begin ANC within 12 weeks after conception, Lira City in Northern Uganda had a low overall incidence of timely ANC initiation. Being unmarried, distance to reach a health facility, and being visited by village health teams or healthcare workers at home were all linked to timely ANC commencement. As a result, intervention efforts should concentrate on the highlighted determinants in order to promote ANC initiation in Lira City, Northern Uganda. This can be accomplished by providing information and education to the community on the timing and necessity of ANC in Northern Uganda.

Predicting postnatal depressive symptoms in a prospective cohort study in Rwanda: the impact of poor maternal social support

Background

Postnatal depression is a significant public health issue that demands attention, and recent evidence indicates that rates are relatively high in low-income countries such as Rwanda. However, lack of social support is recognized as a potential risk factor for postnatal depressive symptoms. This study sought to explore the influence of poor maternal social support on postnatal depressive symptoms in a sample of women in Rwanda.

Method

A prospective cohort research design was conducted with women recruited from four different health centers in Rwanda's Southern Province. A sample of 396 pregnant women accessing antenatal care services was recruited at the baseline from their late second term or later, then followed up after giving birth. The dropout rate was 21.46%; thus, the data of 311 women were analyzed. The outcome variable was the presence of depressive symptoms (Edinburgh Postnatal Depression Scale (EPDS) (≥12 cut-off score), while predictor variables included maternal social support measured using a modified Maternal Social Support Scale (MSSS), perceived health status, socio-demographic information (marital status, wealth class, age, education, occupation), negative life events, gestational and obstetric information (parity, pregnancy intention, age at birth, children given birth, and mode of delivery). Univariate and multivariate analyses were performed.

Results

From a sample of 311 participants, over a quarter (20.9%) had elevated postnatal depressive symptoms (EPDS ≥ 12 scores). Elevated scores were predicted by poor perceived health status; respondents reporting neither poor nor good (AOR = 0.28, CI = 0.11; 0.72, p = 0.007) or good health (AOR = 0.14, CI = 0.05; 0.37, p = 0.001) were less likely to be affected. Poor maternal social support was also linked with postnatal depressive symptoms; poor partner support (AOR = 4.22; CI = 1.44; 12.34; p = 0.009) was associated with high risk, while good friend support (AOR = 0.47, CI = 0.23; 0.98, p = 0.04) was a significant protector. Additionally, violence or negative life events were also independent predictors of postnatal depressive symptoms (AOR: 2.94, CI: 1.37-6.29, p = 0.005).

Conclusion

Postnatal depressive symptoms were found to affect one in five Rwandan women. However, good maternal social support can be a strong protector. Early interventions targeting mothers in the postnatal period and strengthened social support networks for women at risk should be developed.

Maternal mental health screening and management by health workers in southwestern Uganda: a qualitative analysis of knowledge, practices, and challenges

BACKGROUND

Maternal mental health (MMH) problems, such as perinatal depression, maternal anxiety, suicide ideation and puerperal psychosis among others, have a significant impact on maternal morbidity and mortality, as well as the health and development of children. One in every four pregnant women and one in every five postpartum women in low-income countries, suffer from maternal mental health (MMH) problems. Despite this, MMH screening, diagnosis, and reporting remain scanty in Uganda. Consequently, this study aimed to investigate the knowledge, practices, and impediments that maternity care workers face when screening and managing women with maternal mental health disorders in health facilities in south-western Uganda.

METHODS

In-depth interviews were conducted with 22 health-care professionals who work in maternity care departments in primary and tertiary healthcare facilities in southwestern Uganda to investigate their medical knowledge, clinical practices, and challenges related to the screening and management of maternal mental health problems. Using qualitative content analysis, distinct categories and subcategories were found.

RESULTS

Medical staff especially midwives lacked specialized training in screening and managing women with maternal mental health problems They screened and managed MMH problems solely based on history and physical examination, and they referred nearly every mother displaying signs of mental illness because they felt ill-prepared to handle them. On the other hand, medical staff with some level of specialized training in mental health particularly staff working in mental health units, were more likely to use a mental health screening tool in addition to history and physical examination; and to treat any women exhibiting signs and symptoms of maternal mental problems without referring them. Lack of in-service training on maternal mental health, poorly coordinated referral systems, reluctance of mentally ill to visit medical facilities, scarcity of mental health specialists, and shortage of relevant medications were identified as the major challenges. Age, experience level, or gender had no effect on screening or management practices.

CONCLUSIONS

The results suggest that specialized training in mental health, and particularly maternal mental health, is essential for the effective screening and management of maternal mental health conditions in South Western Uganda.

Prevalence and associated factor of postpartum depression among mothers living with HIV at an urban postnatal clinic in Uganda

BACKGROUND

Postpartum depression among mothers living with HIV is a significant public health problem due to its effects on engagement in care, HIV disease progression, and an increased risk of mother-to-child transmission of HIV.

OBJECTIVE

The objective of this study was to determine the prevalence and factors associated with postpartum depression among mothers living with HIV.

DESIGN

The study employed a cross-sectional quantitative research design.

METHODS

In this cross-sectional survey, we consecutively recruited 290 participants among mothers attending postnatal, immunization, and family planning clinics at an urban clinic in Uganda. Using an interviewer-administered questionnaire, we collected data on socio-demographics, obstetric, and HIV-related characteristics. Postpartum depression was assessed using the Patient Health Questionnaire version 9. We classified participants with Patient Health Questionnaire version 9 scores of ⩾10 as having postpartum depression. We conducted logistic regression to examine the association between postpartum depression and independent variables.

RESULTS

The prevalence of postpartum depression was 15.9%. After controlling for other variables, participants who reported poor male partner support were more likely to experience postpartum depression compared to those who had good partner support (adjusted odds ratio = 4.52, confidence interval = 2.31-8.84, p value < 0.001).

CONCLUSION

Mothers living with HIV should be routinely assessed for the presence of depression and male partner support. Health care providers of HIV-infected women should design strategies to promote male partner support for better maternal, infant, and HIV treatment outcomes.

Prevalence of and sociodemographic factors associated with antenatal depression among women in Limpopo Province, South Africa

Background. Pregnancy-related depression is a common psychiatric disorder and a major public health concern in both developed and developing countries, but the disorder receives little attention and few resources, particularly in developing countries.Objectives. To assess the prevalence of antenatal depression and its sociodemographic risk factors among pregnant women in Limpopo Province, South Africa.Methods. This was a cross-sectional descriptive study conducted in a district hospital from 8 March to 12 April 2021. Consecutive women attending antenatal care services during the data collection period were included in the study. The Edinburgh Postnatal Depression Scale was used to assess depression symptoms.Results. The prevalence of antenatal depression was 31% (95% confidence interval 26.1 - 36.3). Being unmarried, being a smoker, being without financial support from a partner, having a violent partner and having a less-educated partner were significant predictors of antenatal depression in these women.Conclusion. Nearly one-third of the pregnant women in our study had depressive symptoms. The important predictors of antenataldepression included being unmarried, smoking, lack of financial support from a partner, intimate partner violence and having a lesseducated partner. These findings may help healthcare workers to identify women at risk early, so that support can be offered during pregnancy and childbirth.

Women's empowerment, maternal depression, and stress: Evidence from rural Burkina Faso

Objective

Though there is a wide array of evidence that women's empowerment is associated with more positive health and nutritional outcomes for women and children, evidence around the relationship with mental health or subjective well-being remains relatively limited. The objective of this paper is to explore this relationship in longitudinal data from rural Burkina Faso.

Methods

We analyze the association between empowerment measured using the project-level Women's Empowerment in Agriculture Index (pro-WEAI), and two additional outcomes of interest: stress (measured using the SRQ-20) and maternal depression (measured using the Edinburgh scale for post-partum depression). The analysis employs both cross-sectional specifications and panel specifications conditional on individual fixed effects.

Results

We find evidence of substantial negative correlations between the empowerment score and maternal stress and depression measured using both continuous and binary variables. This relationship seems to be particularly driven by self-efficacy and respect among household members, where higher scores have negative associations with depression and stress that are both large in magnitude and precisely estimated.

Conclusion

Enhanced mental health may be another channel for a positive effect of empowerment on women's welfare.

The impact of obesity-related neuroinflammation on postpartum depression: A narrative review

Obesity is currently one of the most serious health problems, affecting 13% of the world's adult population. Obesity is characterized by persistent low-grade chronic inflammation that assumes systemic proportions and triggers several associated metabolic diseases. Furthermore, obesity has been associated with an increased occurrence of central disorders such as impaired cognitive function, reward system dysfunction, and depression. In summary, there is a quantitative reduction in the release of neurotransmitters in depression. Postsynaptic cells capture lower concentrations of neurotransmitters, which leads to a functional reduction in the central nervous system (CNS). Globally, approximately 15-65% of women experience depressive symptoms during pregnancy, depending on their location. Depressive symptoms persist in some women, leading to postpartum depression (PPD). Thus, obesity may be considered a risk factor for PPD development. This study aimed to synthesize studies on the impact of obesity-related neuroinflammation and PPD. We conducted a narrative review of the relevant literature. The search was performed in electronic databases, specifically PubMed, selecting articles in English published from 2014 to 2021 using the narrative review methodology.

Magnitude and Determinant Factors of Postpartum Depression Among Mothers Attending Their Postnatal and Vaccination Services at Public Health Institutions of Addis Ababa, Ethiopia

Background

The postpartum period is known as a high-risk period for the onset of different maternal mental health problems. Globally, 10–20% of postnatal mothers suffer from depressive symptoms. This study aimed to assess the magnitude and determinant factors of postpartum depression among mothers attending their postnatal and vaccination services at public health institutions in Addis Ababa, Ethiopia.

Methodology

Health institution-based cross-sectional study was conducted among 461 postnatal mothers attending public health institutions in Addis Ababa from 15 May 2021 to 15 July 2021. A multistage sampling technique was employed to select the public health institutions and a systematic random sampling method was used to get selected, postnatal mothers. Epidata version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. P-value ≤ 0.05 was used as a cut point of statistical significance in multivariable binary logistic regression.

Results

From total postnatal mothers 91(19.7%) of them had postpartum depression. Occupational status [AOR = 3.39, 95% CI: 1.04, 8.15], marital status [AOR = 2.69, 95% CI =1.33, 5.45], income management [AOR = 3.76, 95% CI: 1.53, 8.21], sex of baby [AOR = 5.07, 95% CI: 1.24, 20.69], history of child death [AOR = 6.93, 95% CI: 2.67, 15.79], unplanned pregnancy [AOR = 3.08, 95% CI: 1.65, 7.93], negative life event [AOR = 2.39, 95% CI: 1.03, 5.39], substance use during pregnancy [AOR = 6.23, 95% CI: 2.72, 20.05], history of depression [AOR = 5.08, 95% CI: 1.79, 14.39], and marriage satisfaction [AOR = 6.37, 95% CI: 2.63, 14.29] were determinant factors of postpartum depression.

Conclusion

The prevalence of postpartum depression in this study is high compared to national findings. Occupational status, marital status, income management, sex of baby, history of child death, unplanned pregnancy, negative life event, substance use during pregnancy, history of depression, and marital satisfaction were determinant factors of postpartum depression. The ministry of health should integrate mental health services with existing maternal health care services. It would be better if all healthcare professionals working in the maternal and child health unit will routinely screen postpartum depressive symptoms and link them to mental health services.

Lived experiences of Ugandan women who had recovered from a clinical diagnosis of postpartum depression: a phenomenological study

BACKGROUND

Postpartum depression affects a significant proportion of women of childbearing age. The birth of a newborn baby is normally considered a joyful event, inhibiting mothers from expressing their depressive feelings. If the condition is not well understood and managed, mothers with postpartum depression are likely to experience suicidal ideation or even commit suicide. This study explored lived experiences of women who had recovered from a clinical diagnosis of postpartum depression in southwestern Uganda.

METHODS

This phenomenological study adopted the explorative approach through in-depth interviews as guided by the biopsychosocial model of depression. It was conducted in Mbarara Regional Referral Hospital, Bwizibwera Health Centre IV and Kinoni Health Centre IV located in Mbarara and Rwampara districts, southwestern Uganda. Data were collected from 30 postpartum mothers who were purposively selected, between 9th December 2019 and 25th September 2020. We analyzed this work using thematic data analysis and this was steered by the Colaizzi's six-step phenomenological approach of inquiry.

RESULTS

The findings were summarized into five major themes: 1) somatic experiences including insomnia and headache, breast pain, poor breast milk production, weight loss and lack of energy; 2) difficulties in home and family life including overwhelming domestic chores, lack of social support from other family members, fighting at home and financial constraints due to COVID-19 pandemic; 3) negative emotions including anger, self-blame, despondency and feelings of loneliness and regrets of conceiving or marriage; 4) feelings of suicide, homicide and self-harm including suicidal ideation and attempt, homicidal ideations and attempt and feelings of self-harm and 5) coping with postpartum depression including spirituality, termination of or attempt to leave their marital relationships, acceptance, counselling and seeking medical treatment, perseverance.

CONCLUSION AND RECOMMENDATIONS

Suicidal and homicidal thoughts are important parts of the postpartum depression experience, and these may put the lives of the mothers, their spouses and their babies at a great risk. Poor relationship quality, intimate partner violence and lack of financial resources contribute significantly to the negative emotional experiences of mothers with PPD.