Socio-economic and partner relationship factors associated with antenatal depressive morbidity among pregnant women in Dar es Salaam, Tanzania

• Published in: Tanzania journal of health research Vol. 12; no. 1
• Main Authors: Kaaya, S.F, Mbwambo, J.K, Kilonzo, G.P, Van Den Borne, H, Leshabari, M.T, Smith Fawzi, M.C, Schaalma, H
• Format: Journal Article
• Language: English
• Published: Health User's Trust Fund (HRUTF) 05-04-2011
• Subjects: pregnancy, depression, socio-economic adversity, Tanzania
• ISSN: 1821-6404

Depression during pregnancy may negatively influence social
functioning, birth outcomes and postnatal mental health. A
cross-sectional analysis of the baseline survey of a prospective study
was undertaken with an objective of determining the prevalence and
socio-demographic factors associated with depressive morbidity during
pregnancy in a Tanzanian peri-urban setting. Seven hundred and eighty
seven second to third trimester pregnant women were recruited at
booking for antenatal care at two primary health care clinics. Prenatal
structured interviews assessed socio-economic, quality of partner
relationships and selected physical health measures. Depressive
symptoms were measured at recruitment and three and eight months
postpartum using the Kiswahili version of the Hopkins Symptom
Checklist. Completed antenatal measures available for 76.2%
participants, showed a 39.5% prevalence of depression. Having a
previous depressive episode (OR 4.35, P<0.01), low (OR 2.18,
P<0.01) or moderate (OR 1.86, P=0.04) satisfaction with ability to
access basic needs, conflicts with the current partner (OR 1.89,
P<0.01), or booking earlier for antenatal care (OR 1.87, P=0.02)
were independent predictors of antenatal depression in the logistic
regression model; together explaining 21% of variance in depression
scores. Attenuation of strength of multivariate associations suggests
confounding between the independent risk factors and socio-demographic
and economic measures. In conclusion, clinically significant depressive
symptoms are common in mid and late trimester antenatal clinic
attendees. Interventions for early recognition of depression should
target women with a history of previous depressive episodes or low
satisfaction with ability to access basic needs, conflict in partner
relationships and relatively earlier booking for antenatal care.
Findings support a recommendation that antenatal services consider
integrating screening for depression in routine antenatal care.