妊娠与儿童健康杂志

抽象的

Antepartum Risk Factors for Postpartum Depression: A Follow up Study among Urban Women Living in Nairobi, Kenya

Linnet Ongeri, Phelgona Otieno, Jane Mbui, Elizabeth Juma and Muthoni Mathai

Introduction: Longitudinal studies that assess antepartum risk factors and outcome in the postpartum period can help provide a wealth of information in understanding maternal depression. In addition to collecting information on prevalence and correlates of antepartum depression, such studies reveal postpartum outcomes of depression as well as its risk factors while avoiding recall bias, a limitation frequently seen in cross sectional postpartum studies. Methodology: We consecutively recruited 188 adult women residing in an urban, resource poor setting and attending maternal and child health clinics in 2 major public hospitals in Nairobi, Kenya. A translated Kiswahili EPDS was used to screen for depressive symptoms at baseline assessment in the 3rd trimester and a follow up assessment at 6-10 weeks post-partum. A different questionnaire was administered at baseline to collect information on potential socio demographic and clinical antepartum risk variables. Study results: At a cut off of 13 or more on the EPDS, our study found a prevalence of 18% for antepartum depression. Associated correlates of antepartum depression were partner current alcohol use and partner wanting current pregnancy. Out of the 171 women we followed up at 6-12 weeks postpartum, 21% were found to have postpartum depression. Antenatal depression and conflict with partner were the strongest independent predictors of postpartum depression. In the adjusted analysis, the risk of having postpartum depression is increased six-fold in the presence of antepartum depression and ten times in the presence of conflict with partner. Conclusion: High rates of perinatal depression among women residing in Africa underscore the need for addressing this public health burden. Despite the comparably little emphasis on antenatal depression, antenatal depressive symptoms appear to be as common as postnatal depressive symptoms. Depression screening and psychosocial support that especially addresses conflict resolution during pregnancy should therefore be targeted for future interventions.