E-Screening for Prenatal Depression in Kampala, Uganda Using the Edinburgh Postnatal Depression Scale: Survey Results

Perinatal depression remains a substantial public health challenge, often overlooked or incorrectly diagnosed in numerous low-income nations.

The goal of this study was to establish statistical baselines for the prevalence of perinatal depression in Kampala and understand its relationship with key demographic variables.

We employed an Android-based implementation of the Edinburgh Postnatal Depression Scale (EPDS) to survey 12,913 women recruited from 7 government health facilities located in Kampala, Uganda. We used the standard EPDS cutoff, which classifies women with total scores above 13 as possibly depressed and those below 13 as not depressed. The χ2 test of independence was used to determine the most influential categorical variables. We further analyzed the most influential categorical variable using odds ratios. For continuous variables such as age and the weeks of gestation, we performed a simple correlation analysis.

We found that 21.5% (2783/12,913, 95% CI 20.8%-22.3%) were possibly depressed. Respondents' relationship category was found to be the most influential variable (χ21=806.9, P<.001; Cramer's V=0.25), indicating a small effect size. Among quantitative variables, we found a weak negative correlation between respondents' age and the total EPDS score (r=-0.11, P<.001). Similarly, a weak negative correlation was also observed between the total EPDS score and the number of previous children of the respondent (r=-0.07, P<.001). Moreover, a weak positive correlation was noted between weeks of gestation and the total EPDS score (r=0.02, P=.05).

This study shows that demographic factors such as spousal employment category, age, and relationship status have an influence on the respondents' EPDS scores. These variables may serve as proxies for latent factors such as financial stability and emotional support.