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Background: Depression during pregnancy, the most prevalent mental health problem, can alter fetal development and has important consequences on the offspring’s physical and mental health. Evidence suggests increasing rates of prevalence of depression in low-income settings such as Ethiopia. However, there are a few studies on the topic with inconsistent results. Therefore, the aim of this study was to investigate the prevalence of antenatal depression and its correlates among pregnant women in Ethiopia. Methods: A community-based cross-sectional study was conducted in the West Shoa zone, Oromia regional state, Ethiopia, from February 20, 2018, to March 20, 2018. Pregnant women were recruited by using cluster sampling techniques. Data on socio-demographic, obstetric, and psychosocial characteristics were collected by interviewer-administered questionnaire. Patient Health Questionnaire (PHQ-9) was used to assess depression during pregnancy. Bivariable and multivariable logistic regression analyses were fitted to identify correlates of depression. The level of statistical significance was declared at p value < 0.05. Results: The mean age (± SD) of the pregnant women was 28.41 ± 5.9 years. The prevalence of depression during pregnancy was 32.3%. When we adjusted for possible confounding variables in the final model; those pregnant mothers with an average monthly income of less than 500 (18 USD) Ethiopian birr [AOR = 3.19, 95% CI (1.47, 6.96)], unplanned pregnancy [AOR = 1.52, 95% CI (1.04, 2.21)] and having history of abortion [AOR = 5.13, 95% CI (2.42, 10.85)] have higher odds of depression when compared to their counterparts. Conclusion: The prevalence of depression during pregnancy was high. Strengthening the counseling service as well as increasing access and availability of modern contraceptive methods may reduce the rates of unplanned pregnancy in Ethiopia and this, in turn, plays a significant role in alleviating a resultant depression. Further, the integration of mental health services with existing maternal health care as well as strengthening the referral system among public health centers was warranted to minimize antenatal depression in the West Shoa zone health facilities.
A community-based cross-sectional study was employed. The study was conducted in the West Shoa zone, Oromia regional state, Ethiopia. The west Shoa zone has a total of 23 woredas (districts) including Ambo town. The projected population of the West Shoa zone is about 2.6 million (1.3 million men and 1.3 women) population. During the study period, there were 26, 7399 pregnant women with 17, 9160 of which are in the 2nd and 3rd trimester of pregnancy. The assessment was conducted from February 20, 2018, to March 20, 2018. Single population proportion formula was used to calculate the sample size using the magnitude of depression in pregnant mothers in Ethiopia, 31.1% [23], with a 95% confidence interval, 5% of margin error and with the calculated design effect of 2.5. A cluster sampling technique was employed to select three woredas, such as Jeldu, Ambo, and Bako out of 23 woredas. Health extension workers of each woreda listed pregnant mothers using the non-identifying registration code. We have used this registration as a sampling frame to recruit the study participants. A total of 874 pregnant mothers who were in the second or third trimester of pregnancy, lived and currently living in the study area for at least the preceding 1 year were recruited for the study. Those with hearing or cognitive impairment to the extent of impairing capacity to communicate adequately and unable to give informed consent to take part in the study were excluded from the study. Data were collected by trained data collectors. The presence of antenatal depression was assessed by the Patient Health Questionnaire item nine (PHQ-9). This scale has been validated to use among pregnant women in the community setting with the minimum cut-off point of 8 or more suggest depression [24]. This is a highly reliable scale with a sensitivity of 80.8% and a specificity of 79.5% to assess depression. Its reliability coefficient, Cronbach’s alpha, and 1-week test–retest were 0.84 and 0.98, respectively. Perceived stress scale was also used in the study. It is a 10-item Likert scale; each item has 5 possible responses measuring the frequency of perceived stress over the last month [25, 26]. These 10 items are to assess stress due to events, feeling out of control, and feeling rushed or short on time. It has been used in different studies conducted in Ethiopia. It was highly reliable in our study with Cronbach’s alpha of 0.92. We have used the Ethiopian Demographic and Health Survey (EDHS) of 2016 formats to assess other pregnancy-related information (like previous stillbirth, spontaneous abortion, neonatal and infant mortality, and comorbid medical conditions, actual antenatal visits and birth preparedness) [27]. A score of 8 or more in the Patient Health Questionnaire item nine (PHQ-9) was considered depression in this study [24]. The scores above mean in perceived stress scale were considered perceived stress in this study [25, 26]. It is the ending of a pregnancy by removal or expulsion of an embryo or fetus before it can survive outside the uterus. In this study, it includes spontaneous abortion and induced abortion. The Statistical Package for Social Science (SPSS) version 21.0 was used for data analysis. Pregnant mothers’ socio-demographic, economic and obstetric characteristics were described using the statistics of frequency and percentage distributions. Further, bivariate logistic regression analysis was conducted to identify correlates of antenatal depression. Variables with a p-value < 0.25 during bivariate analysis were entered into a multivariate logistic regression analysis to identify potential confounders. Then, adjusted OR was calculated using multivariate logistic regression analysis and the level of significance of association was determined. Significance level was declared at < 0.05.
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