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Antenatal depressive symptoms and perinatal complications: a prospective study in rural Ethiopia

  • Bitew, Tesera1, 2
  • Hanlon, Charlotte1, 3
  • Kebede, Eskinder4
  • Honikman, Simone5
  • Fekadu, Abebaw1, 6, 7
  • 1 Addis Ababa University, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa, Ethiopia , Addis Ababa (Ethiopia)
  • 2 Debre Markos University, Department of Psychology, Institute of Education and Behavioral Sciences, Debre Markos, Ethiopia , Debre Markos (Ethiopia)
  • 3 King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, Health Services and Population Research Department, London, UK , London (United Kingdom)
  • 4 Addis Ababa University, Department of Obstetrics and Gynecology, College of Health Sciences, Addis Ababa, Ethiopia , Addis Ababa (Ethiopia)
  • 5 University of Cape Town, Department of Psychiatry and Mental Health, Perinatal Mental Health Project, Alan J Flisher Centre for Public Mental Health, Cape Town, South Africa , Cape Town (South Africa)
  • 6 King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, London, UK , London (United Kingdom)
  • 7 Addis Ababa University, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia , Addis Ababa (Ethiopia)
Published Article
BMC Psychiatry
Springer (Biomed Central Ltd.)
Publication Date
Aug 22, 2017
DOI: 10.1186/s12888-017-1462-4
Springer Nature


BackgroundAntenatal depressive symptoms affect around 12.3% of women in in low and middle income countries (LMICs) and data are accumulating about associations with adverse outcomes for mother and child. Studies from rural, low-income country community samples are limited. This paper aims to investigate whether antenatal depressive symptoms predict perinatal complications in a rural Ethiopia setting.MethodsA population-based prospective study was conducted in Sodo district, southern Ethiopia. A total of 1240 women recruited in the second and third trimesters of pregnancy were followed up until 4 to 12 weeks postpartum. Antenatal depressive symptoms were assessed using a locally validated version of the Patient Health Questionnaire (PHQ-9) that at a cut-off score of five or more indicates probable depression. Self-report of perinatal complications, categorised as maternal and neonatal were collected by using structured interviewer administered questionnaires at a median of eight weeks post-partum. Multivariate analysis was conducted to examine the association between antenatal depressive symptoms and self-reported perinatal complications.ResultA total of 28.7% of women had antenatal depressive symptoms (PHQ-9 score ≥ 5). Women with antenatal depressive symptoms had more than twice the odds of self-reported complications in pregnancy (OR=2.44, 95% CI: 1.84, 3.23), labour (OR= 1.84 95% CI: 1.34, 2.53) and the postpartum period (OR=1.70, 95% CI: 1.23, 2.35) compared to women without these symptoms. There was no association between antenatal depressive symptoms and pregnancy loss or neonatal death.ConclusionAntenatal depressive symptoms are associated prospectively with self-reports of perinatal complications. Further research is necessary to further confirm these findings in a rural and poor context using objective measures of complications and investigating whether early detection and treatment of depressive symptoms reduces these complications.

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