Abstract
Introduction
This study aimed to investigate the prevalence, severity, and factors associated with antenatal depression among women receiving antenatal care at Mubende Regional Referral Hospital (MRRH) in Uganda. Antenatal depression is a critical concern for maternal and child well-being, as it is associated with adverse outcomes such as preterm birth, abortion, low birth weight, and impaired maternal-infant bonding. Despite several international guidelines recommending routine screening for antenatal depression, local Ugandan guidelines often overlook this essential aspect of maternal care.
Methods
A cross-sectional study involving 353 pregnant women utilized the Patient Health Questionnaire 9 (PHQ-9) to assess antenatal depression. Participants were categorized as having antenatal depression if their total PHQ-9 score was ≥ 5 and met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for either major or minor depression. Psychosocial demographic and obstetric characteristics were recorded. Logistic regression analysis identified factors linked to antenatal depression.
Results
The burden of antenatal depression was notably high, affecting 37.68% of the participants. Among those with antenatal depression, the majority exhibited mild symptoms 94 (70.68%). The significant factors associated with antenatal depression, revealed by multivariate analysis, included younger age (≤ 20 years), older age (≥ 35 years), history of domestic violence, alcohol use, gestational age, history of abortion, history of preeclampsia, and unplanned pregnancies.
Conclusion
This study revealed a significantly high prevalence of antenatal depression, emphasizing its public health importance. Most cases were classified as mild, emphasizing the importance of timely interventions to prevent escalation. The identified risk factors included age, history of domestic violence, alcohol use, first-trimester pregnancy, abortion history, previous preeclampsia, and unplanned pregnancy.
Similar content being viewed by others
Explore related subjects
Find the latest articles, discoveries, and news in related topics.Introduction
Background
Antenatal depression is characterized by a nonpsychotic depressed mood disorder lasting two weeks or more, marked by feelings of low mood, loss of interest in previously enjoyable activities, low self-esteem, guilt, low energy, and suicidal thoughts, occurring during pregnancy [1]. Various stressors during pregnancy, such as unintended pregnancy [2, 3], pregnancy complications [4], chronic disease [5], previous mental illness [6], fear of childbirth [7], gestational age [8], and maternal age [9], increase the risk of developing depression.
Depression during pregnancy elevates maternal noradrenaline and cortisol levels, reducing uterine blood flow and leading to adverse obstetric and neonatal outcomes. These outcomes include spontaneous abortion, hypertensive disorders, antepartum hemorrhage, intrauterine growth restriction, prematurity, low birth weight, low Apgar scores, neonatal intensive care unit admissions, and postnatal depression [10,11,12]. Antenatal depression is also associated with risky behaviors such as substance abuse (e.g., alcoholism and smoking), reduced healthcare service uptake, poor appetite, and suicide, further compromising fetal and maternal well-being [6].
Despite being the most prevalent mental health problem during pregnancy, antenatal depression often goes undetected and untreated, potentially leading to adverse obstetric and neonatal outcomes [11, 13, 14]. In Uganda, previous studies have reported a high prevalence of antenatal depression (35.8%) [15]. However, maternal and child health programs in the country primarily focus on improving the nutritional and physical well-being of mothers, neglecting their mental health needs.
Current perinatal care guidelines established by the American College of Obstetricians and Gynecologists advocate routine screening for depression for all pregnancies [16]. Other international standards, such as the World Health Organization (WHO) [17], National Institute for Health and Care Excellence (NICE) [18], and (RCOG) [19], also advocate for the use of consistent, validated tests to screen for antenatal depression during antenatal care. However, local clinical guidelines in Uganda lack a standard protocol for screening for antenatal depression [20]. This absence of screening as part of standard antenatal care may contribute to increased prevalence, inadequate detection and treatment, and serious consequences for both mothers and babies.
Given the importance of maternal mental health, this study aimed to provide evidence on the prevalence, severity, and factors associated with antenatal depression among women attending antenatal care at Mubende Regional Referral Hospital (MRRH).
Specific objectives:
-
To determine the prevalence of antenatal depression among women attending antenatal care at Mubende Regional Referral Hospital.
-
To determine the factors associated with antenatal depression among women attending antenatal care at Mubende Regional Referral Hospital.
Materials and methods
Study design
Cross-sectional study.
Study setting
This study was conducted during August 2023 in the antenatal care section of MRRH, a publicly funded tertiary healthcare center situated in the Mubende town council, Kyaterekera Parish, Mubende district in Uganda's central region.
Eligibility criteria
Inclusion criteria
All pregnant women who were attending antenatal care at MRRH during the study period.
Exclusion criteria
Women who experienced obstetric emergencies or medical illnesses such as eclampsia, ruptured ectopic, or epilepsy, for whom urgent attention was needed. Women who had a severe mental health problem associated with lack of insight and therefore couldn't respond to the interviewer-administered questionnaire. For example, schizophrenia and bipolar affective disorder. Women who were receiving psychiatric treatment and/or antidepressant medications.
Study procedure
At the beginning of each antenatal care clinic session, the researcher delivered an educational talk outlining the study's objectives, inclusion and exclusion criteria, and potential benefits. A consecutive sampling procedure was then employed. Research assistants obtained a list of eligible women attending the clinic each day and approached each woman to participate in the study. Women who agreed to participate were provided with appropriate privacy and confidentiality. The researcher and two research assistants administered a structured questionnaire to each participant individually, away from the hearing of others. Informed consent was obtained from all participants in the language they understood before administering the questionnaire. The participants were required to respond to each question they were asked about individually.
Study variables and instruments
Data on psychosocial demographic factors and obstetric factors were collected using interviewer-administered questionnaires, while data on the prevalence and severity of antenatal depression were collected using the Patient Health Questionnaire-9 (PHQ-9).
The PHQ-9 is a self-reported tool consisting of nine items widely used for screening depressive symptoms experienced over the past two weeks [21]. It has been validated for perinatal research in Africa, specifically in Ethiopia [22], and in primary healthcare settings in Uganda [23]. The nine items of the PHQ-9 directly align with the diagnostic criteria for major depressive disorder outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) [24].
Each item represents a set of symptoms and is scored on a Likert scale based on the frequency of symptoms experienced over the past two weeks, ranging from 0 (not at all), 1 (several days), 2 (more than half the days), and 3 (nearly every day). The total PHQ-9 score ranges from 0 to 27, indicating the severity of depressive symptoms.
In this study, women who scored 5 or higher on the PHQ-9 and met the DSM-IV criteria for either major or minor depression on the questionnaire were categorized as having antenatal depression.
The DSM-IV criteria for major depression require the presence of five or more depressive symptoms experienced for more than half the days for at least 2 weeks, with at least one of these symptoms being a depressed mood or loss of interest in previously enjoyable activities. Conversely, the criteria for minor depression require the presence of at least two but fewer than five depressive symptoms experienced for more than half the days for at least 2 weeks, with at least one of these symptoms being a depressed mood or loss of interest in previously enjoyable activities [25].
Consistent with research conducted elsewhere in Africa [26, 27] and in Uganda [23, 28], we categorized depression into mild (PHQ score 5–9), moderate (PHQ score 10–14), or severe (PHQ score > 15) depression. It is important to note that the term "depression" in this context does not denote a clinical diagnosis but rather the outcome of a screening procedure in an epidemiological study with the properties mentioned earlier. In low-resource settings in Africa, the PHQ-9 has demonstrated superiority over other common depression screening measures, exhibiting better test–retest reliability than the Edinburgh Postnatal Depression Scale (EPDS) and better criterion validity than either the EPDS or the Self-Reporting Questionnaire-20 (SRQ-20) [29].
Data quality control
To guarantee that the questionnaires were appropriate, simple English was used, and the use of technical terms was limited. The questionnaires were translated into Luganda and back-translated for accuracy. Translated questionnaires were read to English-naive participants. The researcher monitored the data collection process, and immediate cross-checking of completed questionnaires was conducted to ensure accuracy and completeness.
Sample size calculation
The sample size was estimated using the statistical equation proposed by Kish Leslie (1965): \(n=\frac{{Z}^{2}PQ}{{D}^{2}}\)
Where \(n\) = desired sample size, \(Z\)= the standard normal deviation at the 95% confidence level, \(Z\)=1.96, and \(P\) = proportion of the target population estimated to have the specific characteristic (female attending antenatal care who has antenatal depression). which was found to be 35.8% in Uganda [15]. \(Q\)= (1- \(P\)) = proportion of the population without the characteristic. \(D\) = precision of the study (the degree of accuracy desired). In this case, \(D\) = 5% was used.
By substituting the given values into the equation, the sample size \((n)\) was calculated to be 353.
Data analysis
Objective one involved summarizing the prevalence of antenatal depression as frequency and percentage with 95% confidence intervals. The severity of antenatal depression was categorized based on PHQ-9 scores. Objective two assessed factors associated with antenatal depression using binary logistic regression. Statistical significance was set at a p-value less than 0.05. Results were presented through pie charts, tables, bar graphs, and discussion for effective interpretation.
Results
Study conduct and participant selection
This study was conducted in the antenatal care unit of the MRRH during the timeframe encompassing August 2023. A total of 509 women were given an educational talk by the researcher regarding the study’s objectives, inclusion and exclusion criteria, and benefits. Women who met the exclusion criteria or did not provide consent were excluded from participation. The study flow is shown in Fig. 1.
Descriptive statistics for participant characteristics
Table 1 presents the psychosocial demographic characteristics of the participants.
Table 2 presents the obstetric characteristics of the research population.
Prevalence of antenatal depression
Table 3 illustrates that of the 353 participants, 133 (37.68%) were classified as having depression, while 220 (62.32%) were identified as not having depression.
Severity of antenatal depression
Figure 2 illustrates the distribution of antenatal depression severity among women with antenatal depression. Out of the 133 participants with antenatal depression, 94 (70.68%) had mild depression, 29 (21.80%) had moderate depression, and 10 (7.52%) had severe depression.
Factors associated with antenatal depression:
Table 4 presents the results of a multivariate analysis examining the relationships between various participant characteristics and antenatal depression. The data included both unadjusted (crude) and adjusted odds ratios (ORs) along with 95% confidence intervals (CIs) for each characteristic.
Discussion
Objective 1: The prevalence of antenatal depression
It was determined to be 37.68%. This aligns with the worldwide prevalence range of 15 to 65%, as reported by Dadi and colleagues [4]. The joint prevalence of antenatal depression across 173 studies and 182 reports evaluated by systematic review and meta-analysis performed by Yin and colleagues was 20.7%, while the pooled prevalence of major antenatal depression across 72 studies and 79 reports was 15.0% [30]. The prevalence of antenatal depression in our study was higher than the worldwide average prevalence, and this disparity may be attributed to Uganda’s transition from a low- to a lower-middle-income country [31], and the prevalence of antenatal depression is significantly higher in low- or lower-middle-income countries [32].
Our findings also exceed the pooled prevalence of 27.01% for sub-Saharan Africa reported by Dadi and colleagues [1]. This variance might be due to cultural distinctions across various countries and the utilization of alternative assessment tools for antenatal depression other than the PHQ-9 in some studies.
The prevalence observed in this study is consistent with previous research conducted in Kenya, where the prevalence was 36% [33]. However, these findings are higher than those in Tanzania, where the prevalence was 11.5% [34], and in Rwanda, where it was 26.6% [35]. This discrepancy could be attributed to the fact that Tele and colleagues [33], as in our study, utilized the PHQ-9 as an assessment tool, whereas Ngocho and colleagues [34] and Umuziga and colleagues [35] used the Edinburgh Postnatal Depression Scale (EPDS). Different assessment tools may yield different prevalence rates due to variations in the way antenatal depression is measured.
The prevalence depicted aligns with results from northern Uganda, where it was reported as 35.8% [15]. However, this prevalence is notably higher than the 13% reported in a study conducted in Kamuli, Eastern Uganda [36]. This variation arises because the Kamuli study only considered moderate and severe depression [36].
The study findings also revealed that 70.68% of the participants with depression had mild symptoms, 21.80% had moderate symptoms, and 7.52% had severe symptoms. This emphasizes the importance of timely and targeted interventions to address the psychological needs of pregnant women and prevent the escalation of depression.
Objective 2: Factors associated with antenatal depression among women attending antenatal care at MRRH
Younger women (≤ 20 years) and older women (≥ 35 years) were more likely to experience antenatal depression. These findings align with studies conducted in the Netherlands [37], Vietnam [38], and Uganda [39], suggesting that age plays a significant role in antenatal depression risk. Younger women may face challenges in coping with the demands of pregnancy and impending motherhood, while older women may have unique life circumstances and reproductive histories that contribute to depression [9, 33].
A history of domestic violence was strongly associated with antenatal depression, which is consistent with the findings of studies from South Asia [3], Bangalore [40], Zimbabwe [41], and Kenya [33]. These findings emphasize the detrimental effects of psychological and emotional abuse on maternal mental health during pregnancy. Addressing intimate partner violence and providing support to affected women are critical steps in preventing and managing antenatal depression.
Consistent with the findings of studies conducted in Ethiopia [27] and Kenya [33], alcohol use during pregnancy was significantly associated with antenatal depression. This highlights the potential exacerbation of maternal mental health concerns due to alcohol consumption. Health-care providers should prioritize alcohol screening and intervention during antenatal care to safeguard both maternal and fetal well-being.
Being in the first trimester of pregnancy was associated with antenatal depression. This aligns with the findings of studies from China and Kenya [42], indicating that early pregnancy may be characterized by heightened anxiety and mood fluctuations. Early identification and support for women in these situations are essential to prevent or manage antenatal depression.
A history of abortion was found to be significantly associated with antenatal depression in our study, which is consistent with findings from research conducted in Kenya [13]. This association suggested that previous experiences of abortion can have lasting emotional and psychological impacts on pregnant women.
Unplanned pregnancies were associated with higher odds of experiencing antenatal depression, which is consistent with the findings of other studies from the Netherlands [37], South Asia [3], Ethiopia [6], and Kenya [13]. These findings highlight the stress and uncertainty that unplanned pregnancies can cause. Integrating mental health screening and intervention programs tailored to women with unplanned pregnancies may alleviate the burden of antenatal depression.
In our study, a previous history of preeclampsia showed a moderate association with antenatal depression, although this association did not initially reach statistical significance in the unadjusted analysis. However, after implementing adjustments, the association became statistically significant, highlighting its relevance. These findings align with research from Canada [43], which suggested that a history of preeclampsia may increase the risk of experiencing depression.
Conclusions
A significant prevalence of antenatal depression among pregnant women at MRRH was observed, emphasizing its importance as a public health concern.
Most cases of depression were classified as mild, followed by moderate and severe. This highlights the importance of appropriate and timely interventions to prevent further escalation of antenatal depression.
The identified associated factors included age, history of domestic violence, alcohol use, first-trimester pregnancy, abortion history, previous preeclampsia, and unplanned pregnancy.
Study limitations
However, it is essential to acknowledge certain limitations of this study. The lack of data on physical activity and chronic infectious diseases may limit the generalizability of our results since both physical activity [44] and chronic infectious diseases have been linked to an increased prevalence of depression during pregnancy and the postpartum period [32].
The study's cross-sectional design limits its ability to establish causal relationships between the identified factors and antenatal depression. A longitudinal approach would have been useful for causal inference.
Areas for further research
Longitudinal studies that follow pregnant women from early pregnancy to postpartum can provide valuable insights into the trajectory of antenatal depression and its long-term impacts on maternal and child health. Randomized controlled trials evaluating the effectiveness of different interventions for preventing and treating antenatal depression can provide evidence-based guidelines for clinical practice. Studies evaluating the integration of mental health services into routine antenatal care and assessing the feasibility and acceptability of such services are needed.
Recommendations
We recommend integrating mental health screening and interventions into routine antenatal care to support pregnant women's well-being and maternal-child health. Antenatal care should include screening and intervention for domestic violence and substance abuse.
Availability of data and materials
The datasets used during the current study are available from the corresponding author upon request. Musa Kasujja via email: musakasujja2@gmail.com.
Abbreviations
- AAP:
-
American Academy of Pediatrics
- ACOG:
-
American College of Obstetricians and Gynecologists
- EPDS:
-
Edinburgh Postnatal Depression Scale
- MRRH:
-
Mubende Regional Referral Hospital
- PHQ 9:
-
Patient Health Questionnaire- 9
References
Dadi AF, Wolde HF, Baraki AG, Akalu TY. Epidemiology of antenatal depression in Africa: A systematic review and meta-analysis. BMC Pregnancy Childbirth. 2020;20(1):1–13.
Tuthill EH, Reynolds CME, McKeating A, O’Malley EG, Kennelly MM, Turner MJ. Maternal obesity and depression reported at the first antenatal visit. Ir J Med Sci. 2022;191(3):1241–50. Available from: https://doi.org/10.1007/s11845-021-02665-5
Insan N, Weke A, Forrest S, Rankin J. Social determinants of antenatal depression and anxiety among women in South Asia : A systematic review & meta-analysis. 2022;1–25. Available from: https://doi.org/10.1371/journal.pone.0263760
Dadi AF, Miller ER, Bisetegn TA, Mwanri L. Global burden of antenatal depression and its association with adverse birth outcomes: An umbrella review. BMC Public Health. 2020;20(1):173.
Aktas S, Calik KY. Factors affecting depression during pregnancy and the correlation between social support and pregnancy depression. Iran Red Crescent Med J. 2015;17(9):e16640.
Dadi AF, Miller ER, Woodman R, Bisetegn TA, Mwanri L. Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: Application of structural equation model. BMC Pregnancy Childbirth. 2020;20(1):1–15.
Jamal BA, Dastgir G, Khan MS, Iqbal N, Benish R, Khan AM, et al. Antenatal depression: Prevalence predictors and frequently employed coping strategies. Pakistan J Med Heal Sci. 2018;12(2):432–6.
Alenko A, Dejene S, Girma S. Sociodemographic and obstetric determinants of antenatal depression in jimma medical center, southwest ethiopia: Facility based case–control study. Int J Womens Health. 2020;12:557–65.
Acheanpong K, Pan X, Kaminga AC, Liu A. Prevalence and risk factors of prenatal depression among pregnant women attending antenatal clinic at Adventist Hospital, Bekwai Municipality, Ghana. Med (United States). 2022;101(10):E28862.
Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. The Lancet Psychiatry. 2016;3(10):973–82. Available from: https://linkinghub.elsevier.com/retrieve/pii/S221503661630284X
Hue MT, Van Nguyet NH, Nha PP, Vu NT, Duc PM, Van Trang NT, et al. Factors associated with antenatal depression among pregnant women in Vietnam: A multisite cross-sectional survey. Heal Psychol Open. 2020;7(1):2055102920914076.
Li H, Yu X, Qiang W, Lu M, Jiang M, Hou Y, et al. A longitudinal cohort study of gestational diabetes mellitus and perinatal depression. BMC Pregnancy Childbirth. 2022;22(1):1–10. Available from: https://doi.org/10.1186/s12884-022-04667-2
Tiki T, Taye K, Duko B. Prevalence and factors associated with depression among pregnant mothers in the West Shoa zone, Ethiopia: A community-based cross-sectional study. Ann Gen Psychiatry. 2020;19(1):1–7. Available from: https://doi.org/10.1186/s12991-020-00275-6
Li Xxiu, Gao R, Dai X, Liu H, Zhang J, Liu X, et al. The association between symptoms of depression during pregnancy and low birth weight:a prospective study. BMC Pregnancy Childbirth. 2020;20(1):147.
Natamba BK, Achan J, Arbach A, Oyok TO, Ghosh S, Mehta S, et al. Reliability and validity of the center for epidemiologic studies-depression scale in screening for depression among HIV-infected and -uninfected pregnant women attending antenatal services in northern Uganda: A cross-sectional study. BMC Psychiatry. 2014;14(1):1–8.
American Academy of Peadiatrics, American College of Obstetricians and Gynecologists. Guidelines for Perinatal Care. In: Kilpatrick SJ, Papile LA, Macones GA, editors. 8th ed. Washington, DC: American Academy of Pediatrics; 2017. p. 183–5. [cited 2024 Mar 22]. https://publications.aap.org/aapbooks/book/522/Guidelines-for-Perinatal-Care.
World Health Organization. Guide for integration of perinatal mental health in maternal and child health services. 2022. 66 p. Available from: https://www.who.int/publications/i/item/9789240057142
NICE. Antenatal And Postnatal Mental Health: Clinical Management and Service Guidance. NICE guideline 192. NICE Clin Guidel. 2020;(December 2014). Available from: http://www.nice.org.uk/nicemedia/live/11004/30433/30433.pdf%5Cnguidance.nice.org.uk/cg45
Russell K, Ashley A, Chan G, Gibson G, Jones R. Maternal Mental Health – Women’s Voices. R Collage Obstet Ginaecologists. 2017;1–58. Available from: https://www.rcog.org.uk/globalassets/documents/patients/information/maternalmental-healthwomens-voices.pdf
Ministry of Health Uganda. Uganda Clinical Guidelines. J Pharm Pract Res. 2020;6(3):486. Available from: www.health.go.ug
Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.
Woldetensay YK, Belachew T, Tesfaye M, Spielman K, Biesalski HK, Kantelhardt EJ, et al. Validation of the Patient Health Questionnaire (PHQ-9) as a screening tool for depression in pregnant women: Afaan Oromo version. PLoS ONE. 2018;13(2):1–15.
Nakku JEM, Rathod SD, Kizza D, Breuer E, Mutyaba K, Baron EC, et al. Validity and diagnostic accuracy of the Luganda version of the 9-item and 2-item Patient Health Questionnaire for detecting major depressive disorder in rural Uganda. Glob Ment Heal. 2016 [cited 2022 Dec 3];3(20):1–8. Available from: https://doi.org/10.1017/gmh.2016.14
First MB, Gibbon M, Spitzer RL, Williams JBW, Benjamin LS. Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Washington, DC: American Psychiatric Press, Inc.; 1997.
Bell CC. DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. JAMA. 1994 Sep 14;272(10):828–9. Available from: https://doi.org/10.1001/jama.1994.03520100096046
Bitew T, Hanlon C, Kebede E, Honikman S, Fekadu A. Antenatal depressive symptoms and perinatal complications: A prospective study in rural Ethiopia. BMC Psychiatry. 2017;17(1):1–12.
Borie YA, Siyoum M, Tsega A, Anbese G. Maternal Depression and Associated Factors Among Pregnant Women Attending Ante Natal Care, Southern Ethiopia: Cross-Sectional Study. Front Public Heal. 2022;10(June):1–5.
Nakku JEM, Nalwadda O, Garman E, Honikman S, Hanlon C, Kigozi F, et al. Group problem solving therapy for perinatal depression in primary health care settings in rural Uganda: an intervention cohort study. BMC Pregnancy Childbirth. 2021;21(1):1–12.
Weobong B, Akpalu B, Doku V, Owusu-Agyei S, Hurt L, Kirkwood B, et al. The comparative validity of screening scales for postnatal common mental disorder in Kintampo. Ghana J Affect Disord. 2009;113(1–2):109–17.
Yin X, Sun N, Jiang N, Xu X, Gan Y, Zhang J, et al. Prevalence and associated factors of antenatal depression: Systematic reviews and meta-analyses. Clin Psychol Rev. 2021;83:101932. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0272735820301203
Campos NG, Sharma M, Clark A, Kim JJ, Resch SC. Resources required for cervical cancer prevention in low- and middle-income countries. PLoS ONE. 2016;11(10):1–20.
Roddy Mitchell A, Gordon H, Lindquist A, Walker SP, Homer CSE, Middleton A, et al. Prevalence of Perinatal Depression in Low- and Middle-Income Countries. JAMA Psychiatry. 2023 May 1;80(5):425. Available from: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2802140
Tele A, Kathono J, Mwaniga S, Nyongesa V, Yator O, Gachuno O, et al. Prevalence and risk factors associated with depression in pregnant adolescents in Nairobi, Kenya. J Affect Disord Reports. 2022;10(November 2021):100424. Available from: https://doi.org/10.1016/j.jadr.2022.100424
Ngocho JS, Minja LM, Mwamba RN, Knettel BA, Kisigo GA, Mmbaga BT, et al. Prevalence and predictors of depression among women attending antenatal care in Moshi , Tanzania : a cross ‑ sectional study. BMC Pregnancy Childbirth. 2022;3:1–8. Available from: https://doi.org/10.1186/s12884-022-04917-3
Umuziga MP, Gishoma D, Hynie M, Nyirazinyoye L. Antenatal depressive symptoms in rwanda: rates, risk factors, and social support. BMC Pregnancy Childbirth. 2022;22(1):1–9. Available from: https://doi.org/10.1186/s12884-022-04522-4
Nalwadda O, Wamala R, Nakku J. Population Ass. Antenatal Depression in a Rural District in Uganda : findings from a. 2015. [cited 2020 Mar 22]. Available from: https://paa2019.populationassociation.org/abstracts/190663.
Muskens L, Boekhorst MGBM, Kop WJ, van den Heuvel MI, Pop VJM, Beerthuizen A. The association of unplanned pregnancy with perinatal depression: a longitudinal cohort study. Arch Womens Ment Health. 2022;25(3):611–20. Available from: https://doi.org/10.1007/s00737-022-01225-9
Sidhu G, Sidhu T, Kaur P, Lal D, Sangha N. Evaluation of peripartum depression in females. Int J Appl Basic Med Res. 2019;9(4):201. Available from: www.ijabmr.org
Nakku JEM, Nakasi G, Mirembe F. Postpartum major depression at six weeks in primary health care: Prevalence and associated factors. Afr Health Sci. 2006;6(4):207–14.
Sheeba B, Nath A, Metgud CS, Krishna M, Venkatesh S, Vindhya J, et al. Prenatal depression and its associated risk factors among pregnant women in Bangalore: A hospital based prevalence study. Front Public Heal. 2019;7:1–9.
Kaiyo-Utete M, Dambi JM, Chingono A, Mazhandu FSM, Madziro-Ruwizhu TB, Henderson C, et al. Antenatal depression: An examination of prevalence and its associated factors among pregnant women attending Harare polyclinics. BMC Pregnancy Childbirth. 2020;20(1):1–8.
Huang X, Wang Y, Wang Y, Guo X, Zhang L, Wang W, et al. Prevalence and factors associated with trajectories of antenatal depression: a prospective multi-center cohort study in Chengdu, China. BMC Pregnancy Childbirth. 2023;23(1):1–10. Available from: https://doi.org/10.1186/s12884-023-05672-9.
Auger N, Low N, Paradis G, Ayoub A, Fraser WD. Preeclampsia and the longitudinal risk of hospitalization for depression at 28 years. Soc Psychiatry Psychiatr Epidemiol. 2021 [cited 2023 Sep 7];56(3):429–36. Available from: https://link.springer.com/article/https://doi.org/10.1007/s00127-020-01920-x
Petrovic D, Perovic M, Lazovic B, Pantic I. Association between walking, dysphoric mood and anxiety in late pregnancy: A cross-sectional study. Psychiatry Res. 2016;246:360–3. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0165178116309532
Acknowledgements
We appreciate all patients who agreed to participate in the study.
Guarantor: Musa Kasujja
Funding
The study received no grants.
Author information
Authors and Affiliations
Contributions
MK was the principal investigator, designed the study, collected and analyzed the data, and wrote a draft of the manuscript. SO, NS, and SN, were involved in the discussion and conclusions drawn from the study results. LB, JK, and UI were the supervisors of the study.
Corresponding author
Ethics declarations
Ethics approval and consent to participate
Ethical approval and clearance for this study were obtained from the Bishop Stuart University Research Ethics Committee (BSU-REC) (Ref No: BSU-REC-2023–130). Administrative permission was obtained from the management of MRRH and the head of the antenatal care clinic. Informed consent was obtained from all study participants before conducting interviews.
Consent for publication
Not applicable to this study.
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Kasujja, M., Omara, S., Senkungu, N. et al. Factors associated with antenatal depression among women attending antenatal care at Mubende Regional Referral Hospital: a cross-sectional study. BMC Women's Health 24, 195 (2024). https://doi.org/10.1186/s12905-024-03031-0
Received:
Accepted:
Published:
DOI: https://doi.org/10.1186/s12905-024-03031-0