Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia.
BMC Pregnancy Childbirth
; 17(1): 206, 2017 Jun 29.
Article
em En
| MEDLINE
| ID: mdl-28662641
ABSTRACT
BACKGROUND:
Uptake of delivery and postnatal care remains low in Low and Middle-Income Countries (LMICs), where 99% of global maternal deaths take place. However, the potential impact of antenatal depression on use of institutional delivery and postnatal care has seldom been examined. This study aimed to examine whether antenatal depressive symptoms are associated with use of maternal health care services.METHODS:
A population-based prospective study was conducted in Sodo District, Southern Ethiopia. Depressive symptoms were assessed during pregnancy with a locally validated, Amharic version of the Patient Health Questionnaire (PHQ-9). A cut off score of five or more indicated possible depression. A total of 1251 women were interviewed at a median of 8 weeks (4-12 weeks) after delivery. Postnatal outcome variables were institutional delivery care utilization, type of delivery, i.e. spontaneous or assisted, and postnatal care utilization. Multivariate logistic regression was used to examine the association between antenatal depressive symptoms and the outcome variables.RESULTS:
High levels of antenatal depressive symptoms (PHQ score 5 or higher) were found in 28.7% of participating women. Nearly two-thirds, 783 women (62.6%), delivered in healthcare institutions. After adjusting for potential confounders, women with antenatal depressive symptoms had increased odds of reporting institutional birth [adjusted Odds Ratio (aOR) =1.42, 95% Confidence Interval (CI) 1.06, 1.92] and increased odds of reporting having had an assisted delivery (aOR = 1.72, 95% CI 1.10, 2.69) as compared to women without these symptoms. However, the increased odds of institutional delivery among women with antenatal depressive symptoms was associated with unplanned delivery care use mainly due to emergency reasons (aOR = 1.62, 95% CI 1.09, 2.42) rather than planning to deliver in healthcare institutions.CONCLUSION:
Improved detection and treatment of antenatal depression has the potential to increase planned institutional delivery and reduce perinatal complications, thus contributing to a reduction in maternal morbidity and mortality.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
10_ODS3_salud_sexual_reprodutiva
/
2_ODS3
/
5_ODS3_mortalidade_materna
/
6_ODS3_enfermedades_notrasmisibles
Problema de saúde:
10_sexual_health_reproductive_rights
/
2_cobertura_universal
/
2_mortalidade_materna
/
2_salud_sexual_reprodutiva
/
5_Complications_during_labor_delivery
/
5_maternal_care
/
6_mental_health_behavioral_disorders
Assunto principal:
Aceitação pelo Paciente de Cuidados de Saúde
/
Parto Obstétrico
/
Depressão
/
Países em Desenvolvimento
/
Instalações de Saúde
/
Complicações do Trabalho de Parto
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
BMC Pregnancy Childbirth
Assunto da revista:
OBSTETRICIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Etiópia