A cross-sectional study of depression among women attending antenatal clinics in Blantyre district, Malawi

Pregnancy is a period associated with major psychological and social changes in the life of a woman and can be associated with anxiety and depression.

To describe demographic, clinical and risk profile of antenatal depression among pregnant women attending antenatal clinics in Blantyre district, Malawi.

The study was conducted in eight antenatal clinics in Blantyre district, Malawi.

A cross-sectional study of 480 randomly selected pregnant women attending antenatal clinics was conducted. Prevalence was determined using the Edinburgh Postnatal Depression Scale (EPDS) which was validated against a sub-sample using the Mini International Neuropsychiatric Interview. The risk factors of depression were assessed using the Pregnancy Risk Questionnaire. Data were analysed using descriptive statistics, Pearson chi-square test and binary logistic regression.

Prevalence of antenatal depression using the EPDS was 19% (95% CI 15.5% - 22.5%, n = 91) and was comparable to the Mini International Neuropsychiatric Interview (25.8% [95% CI = 17.5-34], n = 25). The key risk factors that predicted antenatal depression were: 'being distressed by anxiety or depression for more than 2 weeks during this pregnancy' (OR = 4.1 [2.1-7.9], p ≤ 0.001); 'feeling that a relationship with partner is not an emotionally supportive one' (OR = 3.5 [1.4-8.4], p = 0.01); 'having major stresses, changes or losses in the course of this pregnancy' (OR = 3.2 [1.7-6.2], p = 0.01); 'feeling that father was critical of her when growing up' (OR = 3.2 [1.4-7.6], p = 0.01); and 'having history of feeling miserable or depressed for ≥2 weeks before this pregnancy' (OR = 2.4 [1.3-4.4], p = 0.01).

This study confirmed the high-prevalence rate of depression in this group and illustrated that antenatal depression was associated with being distressed by anxiety or depression; support from partner; major stresses during pregnancy; and history of feeling miserable or depressed before pregnancy. This study also found a history of poor relationship between pregnant women and their fathers during childhood.