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      Common Mental Disorder and Associated Factors among Women Attending Antenatal Care Follow-Up in North Wollo Public Health Facilities, Amhara Region, Northeast Ethiopia: A Cross-Sectional Study

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          Abstract

          Introduction

          Common mental health disorders (CMD) during pregnancy are a public health concern because of the implications for the mother and infant's health during pregnancy and after birth. The prevalence and factors related to common mental disorders vary globally. Therefore, this study assessed the magnitude and factors associated with common mental disorder among pregnant women attending ANC follow-up in North Wollo Zone, Northeast Ethiopia.

          Methods

          An institutional-based cross-sectional study was conducted in North Wollo, Amhara Region, Northeast Ethiopia. A multistage sampling technique was used to select 777 study participants. The common mental disorder was assessed by using SRQ-20. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Logistic regression analysis was done to identify the independent variables associated with common mental disorders. Independent variables with a p value less than 0.05 were considered significantly associated with CMD.

          Results

          The magnitude of CMD was 18.1% (95% CI: 15.5, 21.0). Factors significantly associated with CMD were the educational level of participants (AOR = 0.17, 95% CI: 0.06, 0.48), husband's educational status (AOR = 11.13, 95%: 4.18, 29.66), unplanned pregnancy (AOR = 2.54, 95% CI: 1.26, 5.09), self-reported complication on the current pregnancy (AOR = 0.11, 95% CI: 0.05, 0.21), self-reported complication during the previous delivery (AOR = 3.38, 95% CI: 1.39, 8.18), undernutrition (AOR = 2.19, 95%: 1.26, 3.81), high psychosocial risk (AOR = 20.55, 95% CI: 9.69, 43.59), having a legal issue (AOR = 2.06, 95%: 1.12, 3.79), and relationship problem (AOR = 7.22, 95% CI: 3.59, 14.53). Conclusions and Recommendation. One in five pregnant women has common mental disorder. Educational status of the participants and their spouses, unplanned pregnancy, self-reported complication during current and previous pregnancy, psychosocial risk, and legal and relationship problems were the main determinants of common mental disorders. Therefore, screening pregnant women for mental disorders and provision of necessary mental health services are recommended to minimize the adverse health outcome of CMD during pregnancy.

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          Most cited references42

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          Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review.

          Jane Fisher, Meena Cabral de Mello, Vikram Patel … (2012)
          To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low- and lower-middle-income countries. Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Thirteen papers covering 17 low- and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8%) countries, and on disorders in the postnatal period, for 17 (15%). Weighted mean prevalence was 15.6% (95% confidence interval, CI: 15.4-15.9) antenatally and 19.8% (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95% CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95% CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95% CI: 0.3-0.9). CPMDs are more prevalent in low- and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.
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            A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction.

            Nancy Grote, Jeffrey A Bridge, Amelia Gavin … (2010)
            Maternal depressive symptoms during pregnancy have been reported in some, but not all, studies to be associated with an increased risk of preterm birth (PTB), low birth weight (LBW), and intrauterine growth restriction (IUGR). To estimate the risk of PTB, LBW, and IUGR associated with antenatal depression. We searched for English-language and non-English-language articles via the MEDLINE, PsycINFO, CINAHL, Social Work Abstracts, Social Services Abstracts, and Dissertation Abstracts International databases (January 1980 through December 2009). We aimed to include prospective studies reporting data on antenatal depression and at least 1 adverse birth outcome: PTB (<37 weeks' gestation), LBW (<2500 g), or IUGR (<10th percentile for gestational age). Of 862 reviewed studies, 29 US-published and non-US-published studies met the selection criteria. Information was extracted on study characteristics, antenatal depression measurement, and other biopsychosocial risk factors and was reviewed twice to minimize error. Pooled relative risks (RRs) for the effect of antenatal depression on each birth outcome were calculated using random-effects methods. In studies of PTB, LBW, and IUGR that used a categorical depression measure, pooled effect sizes were significantly larger (pooled RR [95% confidence interval] = 1.39 [1.19-1.61], 1.49 [1.25-1.77], and 1.45 [1.05-2.02], respectively) compared with studies that used a continuous depression measure (1.03 [1.00-1.06], 1.04 [0.99-1.09], and 1.02 [1.00-1.04], respectively). The estimates of risk for categorically defined antenatal depression and PTB and LBW remained significant when the trim-and-fill procedure was used to correct for publication bias. The risk of LBW associated with antenatal depression was significantly larger in developing countries (RR = 2.05; 95% confidence interval, 1.43-2.93) compared with the United States (RR = 1.10; 95% confidence interval, 1.01-1.21) or European social democracies (RR = 1.16; 95% confidence interval, 0.92-1.47). Categorically defined antenatal depression tended to be associated with an increased risk of PTB among women of lower socioeconomic status in the United States. Women with depression during pregnancy are at increased risk for PTB and LBW, although the magnitude of the effect varies as a function of depression measurement, country location, and US socioeconomic status. An important implication of these findings is that antenatal depression should be identified through universal screening and treated.
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              Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale.

              Abdulreshid Abdulahi, Charlotte Hanlon, Martin Prince … (2008)
              The cultural validity of instruments to detect perinatal common mental disorders (CMD) in rural, community settings has been little-investigated in developing countries. Semantic, content, technical, criterion and construct validity of the Edinburgh Postnatal Depression Scale (EPDS) and Self-Reporting Questionnaire (SRQ) were evaluated in perinatal women in rural Ethiopia. Gold-standard measure of CMD was psychiatric assessment using the Comprehensive Psychopathological Rating Scale (CPRS). Community-based, convenience sampling was used. An initial validation study (n=101) evaluated both EPDS and SRQ. Subsequent validation was of SRQ alone (n=119). EPDS exhibited poor validity; area under the receiver operating characteristic (AUROC) curve of 0.62 (95%CI 0.49 to 0.76). SRQ-20 showed better validity as a dimensional scale, with AUROC of 0.82 (95%CI 0.68 to 0.96) and 0.70 (95%CI 0.57 to 0.83) in the two studies. The utility of SRQ in detecting 'cases' of CMD was not established, with differing estimates of optimal cut-off score: three and above in Study 1 (sensitivity 85.7%, specificity 75.6%); seven and above in Study 2 (sensitivity 68.4%, specificity 62%). High convergent validity of SRQ as a dimensional measure was demonstrated in a community survey of 1065 pregnant women. Estimation of optimal cut-off scores and validity coefficients for detecting CMD was limited by sample size. EPDS demonstrated limited clinical utility as a screen for perinatal CMD in this rural, low-income setting. The SRQ-20 was superior to EPDS across all domains for evaluating cultural equivalence and showed validity as a dimensional measure of perinatal CMD.
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                Author and article information

                Contributors
                Henok Kumsa:
                ORCID: https://orcid.org/0000-0003-0403-4382
                Journal
                Journal ID (nlm-ta): Depress Res Treat
                Journal ID (iso-abbrev): Depress Res Treat
                Journal ID (publisher-id): drt
                Title: Depression Research and Treatment
                Publisher: Hindawi
                ISSN (Print): 2090-1321
                ISSN (Electronic): 2090-133X
                Publication date Collection: 2024
                Publication date (Electronic): 21 March 2024
                Volume: 2024
                Electronic Location Identifier: 8828975
                Affiliations
                1Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
                2Department of Midwifery, School of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
                3Department of Public Health, School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
                4Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
                5School of Medicine, College of Health Science, Woldia University, Woldia, Ethiopia
                6College of Health Science, Woldia University, Woldia, Ethiopia
                7Amhara National Regional State Public Health Institute, Bahir Dar, Ethiopia
                8Ethiopian Public Health Institute, Addis Ababa, Ethiopia
                Author notes

                Academic Editor: Janusz K. Rybakowski

                Author information
                https://orcid.org/0000-0003-3043-1816
                https://orcid.org/0000-0003-0403-4382
                https://orcid.org/0000-0002-8616-0034
                https://orcid.org/0000-0003-4084-4761
                https://orcid.org/0000-0003-4505-1285
                https://orcid.org/0000-0002-5073-6767
                https://orcid.org/0000-0003-0144-4968
                Article
                DOI: 10.1155/2024/8828975
                PMC ID: 10978072
                PubMed ID: 38549566
                SO-VID: f17177f6-0d2c-4bf4-97e0-5f91aa79bfa8
                Copyright © Copyright © 2024 Amanuel Addisu et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 28 November 2022
                Date revision received : 4 May 2023
                Date accepted : 7 March 2024
                Funding
                Funded by: Woldia University
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Neurology
                Data availability:
                ScienceOpen disciplines: Neurology

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