Original Research

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

Genesis Chorwe-Sungani, Jennifer Chipps
South African Journal of Psychiatry | Vol 24 | a1181 | DOI: https://doi.org/10.4102/sajpsychiatry.v24i0.1181 | © 2018 Genesis Chorwe-Sungani, Jennifer Chipps | This work is licensed under CC Attribution 4.0
Submitted: 30 November 2017 | Published: 26 November 2018

About the author(s)

Genesis Chorwe-Sungani, Kamuzu College of Nursing, University of Malawi, Malawi
Jennifer Chipps, School of Nursing, University of the Western Cape, South Africa


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Abstract

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 = 17.5–34], 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 [2.1–7.9], p≤ 0.001); ‘feeling that a relationship with partner is not an emotionally supportive one’ (OR = 3.5 [1.4–8.4], p = 0.01); ‘having major stresses, changes or losses in the course of this pregnancy’ (OR = 3.2 [1.7–6.2], p = 0.01); ‘feeling that father was critical of her when growing up’ (OR = 3.2 [1.4–7.6], p = 0.01); and ‘having history of feeling miserable or depressed for ≥2 weeks before this pregnancy’ (OR = 2.4 [1.3–4.4], 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.


Keywords

Antenatal; depression; low resource settings; risk factors; pregnancy

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