Antenatal depressive symptoms and perinatal complications: a prospective study in rural Ethiopia

BMC Psychiatry. 2017 Aug 22;17(1):301. doi: 10.1186/s12888-017-1462-4.


Background: Antenatal depressive symptoms affect around 12.3% of women in in low and middle income countries (LMICs) and data are accumulating about associations with adverse outcomes for mother and child. Studies from rural, low-income country community samples are limited. This paper aims to investigate whether antenatal depressive symptoms predict perinatal complications in a rural Ethiopia setting.

Methods: A population-based prospective study was conducted in Sodo district, southern Ethiopia. A total of 1240 women recruited in the second and third trimesters of pregnancy were followed up until 4 to 12 weeks postpartum. Antenatal depressive symptoms were assessed using a locally validated version of the Patient Health Questionnaire (PHQ-9) that at a cut-off score of five or more indicates probable depression. Self-report of perinatal complications, categorised as maternal and neonatal were collected by using structured interviewer administered questionnaires at a median of eight weeks post-partum. Multivariate analysis was conducted to examine the association between antenatal depressive symptoms and self-reported perinatal complications.

Result: A total of 28.7% of women had antenatal depressive symptoms (PHQ-9 score ≥ 5). Women with antenatal depressive symptoms had more than twice the odds of self-reported complications in pregnancy (OR=2.44, 95% CI: 1.84, 3.23), labour (OR= 1.84 95% CI: 1.34, 2.53) and the postpartum period (OR=1.70, 95% CI: 1.23, 2.35) compared to women without these symptoms. There was no association between antenatal depressive symptoms and pregnancy loss or neonatal death.

Conclusion: Antenatal depressive symptoms are associated prospectively with self-reports of perinatal complications. Further research is necessary to further confirm these findings in a rural and poor context using objective measures of complications and investigating whether early detection and treatment of depressive symptoms reduces these complications.

Keywords: Antenatal depressive symptoms; Ethiopia; Perinatal complications; Prospective study; Rural and low income.

MeSH terms

  • Adult
  • Depression / diagnosis*
  • Depression / psychology
  • Depression, Postpartum / diagnosis*
  • Depression, Postpartum / psychology
  • Ethiopia
  • Female
  • Humans
  • Life Change Events
  • Parturition / psychology
  • Postpartum Period / psychology*
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / psychology
  • Pregnancy Trimester, Third / psychology
  • Prospective Studies
  • Rural Population
  • Surveys and Questionnaires
  • Young Adult