Depressive symptoms and associated factors among pregnant women attending antenatal care at Comprehensive Specialized Hospitals in Northwest Ethiopia, 2022: an institution-based cross-sectional study

Prevalence of depression and associated factors among critically ill pregnant women in Palestine

BACKGROUND

Depression during pregnancy poses significant challenges for both the mother and fetus, especially in cases where pregnancy complications become life-threatening. Recognizing the prevalence and risk factors associated with prenatal depression in critically ill pregnant women is essential, particularly in resource-limited settings like Palestine.

METHODS

A cross-sectional study was conducted among 304 critically ill pregnant women in eight Palestinian hospitals between January and March 2024. Data were collected through the Clinically Useful Depression Outcome Scale (CUDOS) and analyzed using SPSS Version 25. Descriptive statistics and multiple regression were applied to identify significant factors associated with depression severity.

RESULTS

The study found high levels of prenatal depression, with a mean CUDOS score of 55.72. Frequent crying (51%) and persistent fatigue (42.4% always, 41.1% sometimes) were common symptoms. Financial instability (p = 0.003), history of miscarriage (p = 0.005), unintended pregnancies (p = 0.001), and residing in rented housing (p = 0.004) were significant predictors, explaining a substantial variance in depression scores (adjusted R² = 0.56, p < 0.001).

CONCLUSIONS

These results underscore the importance of routine mental health evaluations for critically ill pregnant women. Early detection and targeted interventions can improve outcomes for both mothers and their babies, offering essential insights for healthcare providers and policymakers.

PRACTICE IMPLICATIONS

Incorporating mental health screening and support within maternal care programs in Palestine can help mitigate depression among high-risk pregnant women, improving maternal and fetal health outcomes.

Depression and anxiety among pregnant women during COVID 19 pandemic in Ethiopia: a systematic review and meta-analysis

Background

Coronavirus Disease-19 pandemic had an adverse impact on the mental health of the public worldwide, but the problem is worst among pregnant women due to social distancing policies and mandatory lockdown, including prenatal care services. As a result, the prevalence of depression and anxiety could increase during the pandemic, particularly among pregnant women. Thus, the purpose of this review is to determine the magnitude of depression and anxiety and contributing factors among pregnant women during the pandemic in Ethiopia.

Methods

Web of Science, Since Direct, PubMed, Google Scholar, and African Journals Online were the electronic databases searched, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed in this review. The Newcastle-Ottawa Critical Appraisal Checklist was used to assess the quality of the included studies. A predefined data extraction sheet developed in Excel was used to extract the data. The pooled prevalence of anxiety and depression was determined by a random effect model meta-analysis.

Results

4,269 and 1,672 pregnant women were involved in depression and anxiety studies, respectively. The pooled prevalence of depression and anxiety among pregnant women during the COVID-19 pandemic in Ethiopia was 24.7% (95% CI: 18.52-30.87) and 35.19% (95% CI: 26.83-43.55), respectively. Single marital status (AOR = 2.22, 95% CI: 1.07-3.37), poor social support (AOR = 2.7, 95% CI: 1.06-4.35), unplanned pregnancies (AOR = 2.17, 95% CI: 1.34-3.0), and unsatisfied marital status (AOR = 2.16, 95% CI: 1.17-3.14) were risk factors for depression. Violence against intimate partners (AOR = 2.87, 95% CI: 1.97-3.77) and poor social support (AOR = 1.98, 95% CI: 1.24-2.71) were risk factors for anxiety.

Conclusion

One-fourth and nearly one-third of pregnant women had depression and anxiety, respectively, during COVID-19 pandemic in Ethiopia. Single or unsatisfied marital status and unplanned pregnancies were risk factors for depression. Poor social support was significantly associated with depression and anxiety. Pregnant women who experienced violence against intimate partners had higher anxiety. After COVID-19 pandemic, mental health interventions are essential for reducing depression and anxiety.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=527148, PROSPERO (CRD42024527148).

Perinatal depression and associated factors in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Perinatal depression is a significant public health issue affecting one in four women globally. It occurs at a critical time of a woman's life; affecting her relationships with family, and child's emotional, behavioral, and cognitive development. Considering the burden of the problem to the whole family, this systematic review and meta-analysis was conducted to estimate the pooled prevalence of perinatal depression and its determinants in Ethiopia to provide up-to-date evidence at a national level.

METHODS

All observational studies conducted on perinatal depression in Ethiopia were included based on the selection criteria. Data was extracted using Microsoft Excel and then exported to STATA version-11 for analysis. The random-effects model was employed to estimate the pooled effect size of perinatal depression and its determinants with 95% confidence intervals. Funnel plots analysis and Egger regression tests were conducted to check the publication bias. Sub-group and sensitivity analyses were also performed.

RESULTS

This systematic review and meta-analysis included thirty studies and the pooled prevalence of perinatal depression in Ethiopia was 24.29% (95% CI (21.98, 26.59)). According to the subgroup analysis, the pooled prevalence of antenatal depression and others (postnatal and perinatal depression) was 24.24% and 24.52% respectively. Regarding determinants of perinatal depression, having unplanned pregnancy [OR = 3.04 (2.2, 4.2)], intimate partner violence [OR = 3.09(2.14, 4.46)], poor social support [OR = 3.3(2.38, 4.57)], and a history of depression [OR = 3.68(2.45, 5.52)] were significantly associated with depression.

CONCLUSION AND RECOMMENDATION

This study showed that the pooled prevalence of perinatal depression in Ethiopia was found to be high. To ensure the mental health of both the mother and child, health professionals should routinely screen perinatal women for depression giving special focus for those with a history of depression and managing them accordingly.

A comparative study of antenatal depression among urban and rural pregnant women in Gimbi District, Oromia, Ethiopia

Background

Antenatal depression (AND) is a form of clinical depression that can be caused by stress and worries that can bring pregnancy to more severe levels. It has negative impacts on women, the family, and the community at large. The comparative study of antenatal depression among rural and urban pregnant women was less studied in Ethiopia and in this study area in particular.

Objective

The objective of the study was to compare the prevalence of antenatal depression and its associated factors among pregnant women in Gimbi rural and urban residents in Ethiopia in 2023.

Methods

A community-based comparative cross-sectional study design was used from 1 February to 30 March 2023. A systematic random sampling method was used to select study participants. Data were collected using pretested interviewer-administered structured questionnaires. Binary logistic regression analysis was used to identify factors associated with antenatal depression. Variables with a p-value of 0.25 or less in the bi-variable logistic regression model were candidates for a multi-variable logistic regression model.

Results

The prevalence of antenatal depression was 56 (21.5%), 95% CI: [16.9-25.5] among rural participants and 50 (19.2%) [95%] CI: [14.6-23.8] among urban participants. Having complications during pregnancy (AOR: 4.92, 95% CI: 1.35, 17.88), ever had depression (AOR: 3.20, 95% CI: 1.30, 7.85), consuming alcohol (AOR: 3.78, 95% CI: 1.24, 11.49), and educational status (can read and write) (AOR: 2.14, 95% CI:1.05, 4.67) were factors associated with antenatal depression among urban mothers, while no antenatal care follow-up (AOR: 6.6, 95% CI: 2.63, 16.85), unplanned pregnancy (AOR: 4.51, 95% CI:1.10, 1.86), and having complications during pregnancy (AOR: 2.77, 95% CI: 1.30, 5.92) were factors associated with antenatal depression among rural mothers.

Conclusion

The prevalence of antenatal depression among rural mothers was higher than the prevalence of antenatal depression among urban mothers in the Gimbi district. Having complications during pregnancy, ever had depression, consuming alcohol, and educational status were associated factors with antenatal depression among urban mothers; having complications during pregnancy, unplanned pregnancy, and no ANC follow-up were factors associated with antenatal depression among rural mothers. Therefore, quality family planning and ANC services should be provided for the women to reduce unplanned pregnancies and experience complication-free pregnancy periods.

The effects of a mindfulness-based stress reduction program and deep relaxation exercises on pregnancy-related anxiety levels: A randomized controlled trial

AIM

The present study aimed to examine the effects of a mindfulness-based stress reduction (MBSR) program and deep relaxation exercises on pregnancy-related anxiety levels.

MATERIALS AND METHODS

This randomized parallel-group controlled trial was conducted with 95 pregnant women (MBSR: n = 32, deep relaxation exercises: n = 31, control: n = 32) between 1 August and 15 October 2022 with pregnant women who were registered at the pregnancy outpatient clinics of a hospital in the Southeastern Anatolia Region of Türkiye. CONSORT guidelines were followed in our study. The participants in the MBSR group were given an eight-session MBSR program, consisting of two sessions per week for 4 weeks, whereas the participants in the deep relaxation exercises group were asked to do exercises at home with deep relaxation videos four times a week for 4 weeks. The participants in the control group received only routine prenatal care.

RESULTS

The mean PRAQ-R2 Fear of Giving Birth subscale scores of the participants in the MBSR and deep relaxation exercises groups after the intervention were lower than that of the participants in the control group. Additionally, the mean total PRAQ-R2, PRAQ-R2 Worries about Bearing a Physically or Mentally Handicapped Child subscale and PRAQ-R2 Concern about One's Own Appearance subscale scores of the participants in the MBSR group were found to be significantly lower than the scores of those in the deep relaxation exercises and control groups (p < 0.001).

CONCLUSION

The MBSR program is an effective method for reducing pregnancy-related anxiety levels. Additionally, deep relaxation exercises are alternative practices for reducing the fear of giving birth among pregnant women.

TRIAL REGISTRATION

NCT05447000.

Prevalence and factors associated with antenatal depressive symptoms across trimesters: a study of 110,584 pregnant women covered by a mobile app-based screening programme in Shenzhen, China

BACKGROUND

Antenatal depression is a significant public health issue affecting pregnant women both globally and in China. Using data from a mobile app-based screening programme, this study explored the prevalence and factors associated with antenatal depressive symptoms across different trimesters in Shenzhen.

METHODS

A retrospective cross-sectional study was conducted on pregnant women who gave birth in any hospital in Shenzhen between July 2021 and May 2022 and underwent depression screening using an official maternal and infant health mobile app at least once during pregnancy. Depressive symptoms were evaluated using the 9-item Patient Health Questionnaire (PHQ-9), with cut-off scores of 5 and 10 for mild and high level of symptoms, respectively. The prevalence for each trimester was determined by calculating the proportion of women scoring 5 or higher. A variety of sociodemographic, obstetric, psychological, and lifestyle factors were assessed for their association with depressive symptoms. Chi-square test and multivariate logistic regression were performed to identify significant predictors.

RESULTS

A total of 110,584 pregnant women were included in the study, with an overall prevalence of depressive symptoms of 18.0% and a prevalence of high-level symptoms of 4.2%. Depressive symptoms were most prevalent in the first trimester (10.9%) and decreased in the second (6.2%) and third trimesters (6.3%). Only a small proportion (0.4%) of women showed persistent depressive symptoms across all trimesters. Anxiety symptoms in early pregnancy emerged as the most significant predictor of depressive symptoms. Other factors linked to an increased risk throughout pregnancy include lower marital satisfaction, living with parents-in-law, experience of negative life events, as well as drinking before and during pregnancy. Factors associated with a reduced risk throughout pregnancy include multiparity and daily physical activity.

CONCLUSIONS

This large-scale study provides valuable insights into the prevalence and factors associated with antenatal depressive symptoms in Shenzhen. The findings underscore the need for targeted interventions for high-risk groups and the integration of mental health care into routine antenatal services. Continuous, dynamic monitoring of depressive symptoms for pregnant women and ensuring at-risk women receive comprehensive follow-up and appropriate psychological or psychiatric care are crucial for effectively addressing antenatal depression and improving maternal and infant health outcomes.