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Depression in pregnancy: A multinational prospective cohort study.

Alexandra Roddy Mitchell1, Farhat-Ul-Ain Ahmed2, Catherine Cluver3

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Approximately 1 in 6 women in Pakistan and South Africa experience depression during pregnancy. Importantly, this study found no association between depression in pregnancy and adverse infant outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Mental Health
  • Global Health

Background:

  • Depression during pregnancy poses risks to both mothers and infants.
  • Prevalence estimates for antenatal depression vary significantly in low- and middle-income countries (LMICs).

Purpose of the Study:

  • To prospectively determine the prevalence of depression in pregnancy in two LMICs.
  • To investigate the association between antenatal depression and adverse pregnancy outcomes.

Main Methods:

  • A multinational prospective cohort study conducted in Pakistan and South Africa (2021-2023).
  • The Edinburgh Postnatal Depression Scale (EPDS) was used to screen women (20-34 weeks gestation).
  • Bayesian modeling adjusted for EPDS sensitivity and specificity to estimate prevalence.

Main Results:

  • 1537 women were recruited; adjusted prevalence of depression in pregnancy was 17.1% (95% CrI 13.3%-21.1%).
  • Prevalence differed by country: 10.8% in Pakistan (95% CrI 7.7%-14.3%) and 25.9% in South Africa (95% CrI 20.8%-31.1%).
  • No significant associations were found between EPDS scores (≥11) and spontaneous preterm birth, low birthweight, or neonatal unit admission.

Conclusions:

  • One in six women in the study experienced depression in pregnancy.
  • Antenatal depression was not linked to increased adverse pregnancy outcomes in this cohort.
  • Provides robust prevalence data for antenatal depression in LMICs, crucial for maternal mental health initiatives.