ABSTRACT
Background: With the rising incidence of Maternal deaths due to suicide as evident from reports of Kerala state confidential review of maternal deaths, there is a felt need for screening for depression in study antenatal population. Though there have been various screening tools used, a simplified tool validated in study population was not used in study antenatal women till now. The objective of this study was to estimate the prevalence of depression among antenatal women admitted in the department of obstetrics and gynecology, Government Medical College, Thrissur and also to study the risk factors associated with depression in the study population.Methods: A questionnaire based cross sectional observational study was conducted among 100 antenatal women in their third trimester. PHQ-9 questionnaire was used to screen for depression and the information regarding risk factors was collected from the patient, her caregivers and from clinical records. Data analysis was done using EPI-INFO/SPSS software.Results: Prevalence of depression among hospitalized mothers: 53%. Most cases (70%) had: mild depression (PHQ Score: 5-9). Only very few (2%) of them had severe depression (PHQ score: more than 20). 9% had: moderately severe depression (PHQ score: 15-19). 19% had: moderate depression (PHQ score: 10-14). Statistically significant risk factors identified in this study were fetal gender preference, anxiety about labour process, anxiety about labour pain, anxiety about making the baby a part of their life and anxiety about baby’s health.Conclusions: The prevalence of depression among hospitalized mothers using PHQ-9 scale is high (53%). Screening for depression was found to be feasible and can be made a part of routine antenatal care so that appropriate interventions can be provided to improve maternal mental health and thereby prevent the maternal mortality occurring due to suicides.
ABSTRACT
Depression is a debilitating mood and mental disorder affecting approximately 13% of postpartum mothers worldwide with a prevalence of 25%-60% in low and middle income countries. The prevalence is yet to be published in Cameroon. Aim: This study was carried out to determine the prevalence, severity and risk factors of depression among postpartum mothers in Limbe Health District (LHD), Cameroon. Study Design: It was a cross-sectional, analytic community-based survey. A non- probability convenient sampling method was used to recruit four hundred participants in eight communities in the LHD. Postpartum mothers with infants aged 1-12 months constituted the study population. Data collected using the Patient Health Questionnaire-9 (PHQ-9) and a structured questionnaire was analyzed using Epi-Info version 3.5.4. A p-value of less than 0.05 was considered statistically significant for variables. Results: The prevalence of depression among participants was 61.8% based on PHQ-9 depression scale. The severity of depression varied from mild 54.7%, moderate 43.3% to severe2.0%. Socio-demographic factors associated with depression were: unemployment [OR=2.02;95% CI:(1.35-3.86), p=0.002], unsatisfactory support or assistance for care of baby [OR = 4.89; 95% CI: 2.25-10.612), p = < 0.001], marital conflict [OR = 0.44; 95%CI: (0.23-0.82), p = 0.009] and serious financial problems [OR = 0.31; 95% CI: (0.18-0.54), p =0.002]. Unplanned pregnancy was the only obstetric factor associated with depression [OR=2.02; 95% CI: (1.24-3.29), p= 0.004]. Conclusion: The prevalence of depression among postpartum mothers in the LHD was high. Unemployment, unsatisfactory assistance for child care, marital conflicts, financial difficulties and unplanned pregnancy were risk factors for postpartum depression.