Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study

Abstract Background There is a high prevalence of antenatal depression in low-or-middle-income countries, but information about risk factors in these settings is still lacking. The purpose of this study is to measure the prevalence of and explore risk factors associated with antenatal depressive sym...

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Autores principales:	Sage Wyatt, Truls Ostbye, Vijitha De Silva, Prabodha Lakmali, Qian Long
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Depression Mental health Antenatal care Obstetric health Sri Lanka Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/2fbe280164cd4682ba54252c6e655c9d
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spelling	oai:doaj.org-article:2fbe280164cd4682ba54252c6e655c9d2021-11-14T12:32:34ZPredictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study10.1186/s12884-021-04239-w1471-2393https://doaj.org/article/2fbe280164cd4682ba54252c6e655c9d2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12884-021-04239-whttps://doaj.org/toc/1471-2393Abstract Background There is a high prevalence of antenatal depression in low-or-middle-income countries, but information about risk factors in these settings is still lacking. The purpose of this study is to measure the prevalence of and explore risk factors associated with antenatal depressive symptoms in Galle, Sri Lanka. Methods This study used a mixed-method approach. The quantitative portion included 505 pregnant women from Galle, Sri Lanka, with health record data, responses to psychometric questionnaires (MSPSS and PRAQ-R2), and antenatal depression screening (EPDS). The qualitative portion included interviews with public health midwives about their experiences and routine clinical practices with women with antenatal depressive symptoms. Results Prevalence of antenatal depressive symptoms was 7.5%, highest in women over the age of 30 (13.0%, OR = 3.88, 95%CI = 1.71 – 9.97), with diabetes (21.9%, OR = 3.99, 95%CI = 1.50 – 9.56), or pre-eclampsia in a previous pregnancy (19.4%, OR = 3.32, 95%CI = 1.17 – 8.21). Lower prevalence was observed in the primiparous (3.3%, OR = 0.29, 95%CI = 0.12 – 0.64) employed outside the home (3.6%, OR = 0.33, 95%CI = 0.13 – 0.72), or upper-middle class (2.3%, OR = 0.17, 95%CI = 0.04 – 0.56). Anxiety levels were elevated in depressed women (OR = 1.13, 95%CI = 1.07 – 1.20), while perceived social support was lower (OR = 0.91, 95%CI = 0.89 – 0.93). After multivariable adjustment, only parity (OR = 0.20, 95%CI 0.05 – 0.74) and social support from a “special person” (OR = 0.94, 95%CI = 0.77 – 0.95) remained significantly associated with depressive symptoms. Qualitative findings also identified antenatal health problems and poor social support as risk factors for depressive symptoms. They also identified different contributing factors to poor mental health based on ethnicity, higher stress levels among women working outside the home, and misinformation about health conditions as a cause of poor mental health. Conclusions Prevalence of antenatal depressive symptoms in Galle is lower than the recorded prevalence in other regions of Sri Lanka. Risk factors for antenatal depressive symptoms were identified on biological, psychological, and social axes. These variables should be considered when developing future guidelines for mental health and obstetric treatment in this context.Sage WyattTruls OstbyeVijitha De SilvaPrabodha LakmaliQian LongBMCarticleDepressionMental healthAntenatal careObstetric healthSri LankaGynecology and obstetricsRG1-991ENBMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Depression Mental health Antenatal care Obstetric health Sri Lanka Gynecology and obstetrics RG1-991
spellingShingle	Depression Mental health Antenatal care Obstetric health Sri Lanka Gynecology and obstetrics RG1-991 Sage Wyatt Truls Ostbye Vijitha De Silva Prabodha Lakmali Qian Long Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study
description	Abstract Background There is a high prevalence of antenatal depression in low-or-middle-income countries, but information about risk factors in these settings is still lacking. The purpose of this study is to measure the prevalence of and explore risk factors associated with antenatal depressive symptoms in Galle, Sri Lanka. Methods This study used a mixed-method approach. The quantitative portion included 505 pregnant women from Galle, Sri Lanka, with health record data, responses to psychometric questionnaires (MSPSS and PRAQ-R2), and antenatal depression screening (EPDS). The qualitative portion included interviews with public health midwives about their experiences and routine clinical practices with women with antenatal depressive symptoms. Results Prevalence of antenatal depressive symptoms was 7.5%, highest in women over the age of 30 (13.0%, OR = 3.88, 95%CI = 1.71 – 9.97), with diabetes (21.9%, OR = 3.99, 95%CI = 1.50 – 9.56), or pre-eclampsia in a previous pregnancy (19.4%, OR = 3.32, 95%CI = 1.17 – 8.21). Lower prevalence was observed in the primiparous (3.3%, OR = 0.29, 95%CI = 0.12 – 0.64) employed outside the home (3.6%, OR = 0.33, 95%CI = 0.13 – 0.72), or upper-middle class (2.3%, OR = 0.17, 95%CI = 0.04 – 0.56). Anxiety levels were elevated in depressed women (OR = 1.13, 95%CI = 1.07 – 1.20), while perceived social support was lower (OR = 0.91, 95%CI = 0.89 – 0.93). After multivariable adjustment, only parity (OR = 0.20, 95%CI 0.05 – 0.74) and social support from a “special person” (OR = 0.94, 95%CI = 0.77 – 0.95) remained significantly associated with depressive symptoms. Qualitative findings also identified antenatal health problems and poor social support as risk factors for depressive symptoms. They also identified different contributing factors to poor mental health based on ethnicity, higher stress levels among women working outside the home, and misinformation about health conditions as a cause of poor mental health. Conclusions Prevalence of antenatal depressive symptoms in Galle is lower than the recorded prevalence in other regions of Sri Lanka. Risk factors for antenatal depressive symptoms were identified on biological, psychological, and social axes. These variables should be considered when developing future guidelines for mental health and obstetric treatment in this context.
format	article
author	Sage Wyatt Truls Ostbye Vijitha De Silva Prabodha Lakmali Qian Long
author_facet	Sage Wyatt Truls Ostbye Vijitha De Silva Prabodha Lakmali Qian Long
author_sort	Sage Wyatt
title	Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study
title_short	Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study
title_full	Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study
title_fullStr	Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study
title_full_unstemmed	Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study
title_sort	predictors and occurrence of antenatal depressive symptoms in galle, sri lanka: a mixed-methods cross-sectional study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/2fbe280164cd4682ba54252c6e655c9d
work_keys_str_mv	AT sagewyatt predictorsandoccurrenceofantenataldepressivesymptomsingallesrilankaamixedmethodscrosssectionalstudy AT trulsostbye predictorsandoccurrenceofantenataldepressivesymptomsingallesrilankaamixedmethodscrosssectionalstudy AT vijithadesilva predictorsandoccurrenceofantenataldepressivesymptomsingallesrilankaamixedmethodscrosssectionalstudy AT prabodhalakmali predictorsandoccurrenceofantenataldepressivesymptomsingallesrilankaamixedmethodscrosssectionalstudy AT qianlong predictorsandoccurrenceofantenataldepressivesymptomsingallesrilankaamixedmethodscrosssectionalstudy
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Predictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study

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