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First trimester antenatal depression and anxiety: prevalence and associated factors in an urban population in Soweto, South Africa

Part of: Advancing the DOHaD Agenda in Africa DOHaD on International Women's Day 2020

Published online by Cambridge University Press:  07 September 2017

S. Redinger ,
S. A. Norris ,
R. M. Pearson ,
L. Richter  and
T. Rochat
S. Redinger
Affiliation:
MRC/Developmental Pathways to Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa DST-NRF Centre of Excellence in Human Development, University of Witwatersrand, Johannesburg, South Africa Human and Social Development Research Programme, Human Sciences Research Council, Durban, South Africa
S. A. Norris
Affiliation:
MRC/Developmental Pathways to Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Stellenbosch Institute of Advanced Study, University of Stellenbosch, Stellenbosch, South Africa
R. M. Pearson
Affiliation:
School of Social and Community Medicine, Centre for Academic Mental Health, Bristol University, Bristol, UK
L. Richter
Affiliation:
DST-NRF Centre of Excellence in Human Development, University of Witwatersrand, Johannesburg, South Africa
T. Rochat*
Affiliation:
MRC/Developmental Pathways to Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Human and Social Development Research Programme, Human Sciences Research Council, Durban, South Africa Department of Psychiatry, University of Oxford, Oxford, UK
*
*Address for correspondence: Dr T. Rochat, Human Science Research Council, 5th Floor, The Atrium, 430 Peter Mokaba Ridge Road, Durban 4001, South Africa. (Email [email protected])
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Abstract

Depression and anxiety in the antenatal period are of public health concern given potential adverse effects for both mother and infant. Both are under-researched in the first trimester of pregnancy, especially in Africa. We examine the prevalence of first trimester antenatal depression and anxiety in a cohort of South African women and investigate associated risk factors. Data were collected from 946 women (2014–2016) in the Soweto First 1000 Days Cohort, a prospective pregnancy cohort in Soweto, South Africa. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale with a score of ⩾13 indicating probable depression. Anxiety was assessed using the short form of the State-Trait Anxiety Index with a score ⩾12 indicating probable anxiety. Prevalence of antenatal depression was 27% [95% confidence interval (CI) 24.2–29.8] and anxiety 15.2% (95% CI 12.9–17.5). Factors associated with antenatal depression and anxiety were predominantly relationship- and family-centred. Women who perceived that their partner made life harder for them had three-fold increased odds for depression [(odds ratio (OR) 3.33 [2.28–4.85] P<0.001], whereas those with family stressors had almost double the odds for depression (OR 1.78 [1.22–2.59] P=0.003) and anxiety (OR 1.75 [1.44–2.69] P=0.0011). Antenatal depression and anxiety are common in the first trimester of pregnancy, and partner and family relationship stressors are central. Longitudinal analysis is needed to determine if this is a phase of adjustment to pregnancy or onset of persistent symptomology. Early intervention may have secondary preventative effects and should involve the partner and family.

Keywords

antenatalanxietydepressionSouth Africa
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 9 , Issue 1: Themed Issue: DOHaD AFRICA , February 2018 , pp. 30 - 40
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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2017 

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