A cross-sectional study of depression among women attending antenatal clinics in Blantyre district, Malawi

Background: Pregnancy is a period associated with major psychological and social changes in the life of a woman and can be associated with anxiety and depression. Aim: To describe demographic, clinical and risk profile of antenatal depression among pregnant women attending antenatal clinics in Blantyre district, Malawi. Setting: The study was conducted in eight antenatal clinics in Blantyre district, Malawi. Methods: A cross-sectional study of 480 randomly selected pregnant women attending antenatal clinics was conducted. Prevalence was determined using the Edinburgh Postnatal Depression Scale (EPDS) which was validated against a sub-sample using the Mini International Neuropsychiatric Interview. The risk factors of depression were assessed using the Pregnancy Risk Questionnaire. Data were analysed using descriptive statistics, Pearson chi-square test and binary logistic regression. Results: Prevalence of antenatal depression using the EPDS was 19% (95% CI 15.5% ­ 22.5%, n= 91) and was comparable to the Mini International Neuropsychiatric Interview (25.8%[95%CI=17.5­34], n=25). The key risk factors that predicted antenatal depression were: 'being distressed by anxiety or depression for more than 2 weeks during this pregnancy'(OR=4.1 [2.1­7.9], p≤ 0.001); 'feeling that a relationship with partner is not an emotionally supportive one' (OR=3.5 [1.4­8.4], p=0.01); 'having major stresses, changes or losses in the course of this pregnancy' (OR=3.2 [1.7­6.2], p=0.01); 'feeling that father was critical of her when growing up' (OR=3.2 [1.4­7.6], p=0.01); and 'having history of feeling miserable or depressed for ≥ 2 weeks before this pregnancy' (OR=2.4 [1.3­4.4], p=0.01). Conclusion: This study confirmed the high-prevalence rate of depression in this group and illustrated that antenatal depression was associated with being distressed by anxiety or depression; support from partner; major stresses during pregnancy; and history of feeling miserable or depressed before pregnancy. This study also found a history of poor relationship between pregnant women and their fathers during childhood