THE EFFECT OF ANTENATAL DEPRESSION ON BIRTH OUTCOMES: A PROSPECTIVE COHORT STUDY IN BENCH-SHEKO ZONE, SOUTHWEST REGION, ETHIOPIA, 2022

Abstract

Introduction: Depression is the most common mental illness during pregnancy. Its prevalence is much higher in pregnant populations relative to general female populations, often due to hormonal changes during pregnancy time. Women with a previous history of either perinatal or non-perinatal major depression disorder are more likely to relapse during pregnancy. However, the impact of prenatal depression on adverse birth outcome has not sufficiently been addressed by previous literatures. Therefore, this study was intended to investigate the impact of mothers’ prenatal depression during pregnancy on adverse birth outcome among pregnant women in Bench-Sheko Zone, Southwest, Ethiopia, 2022. Objective: To investigate the impact of mothers’ antenatal depression on adverse birth outcome at public health institutions in Bench-Sheko Zone, Southwest, Ethiopia, 2022. Methods: Institutional based prospective cohort study was conducted from January 01/2022 to August 01/2022. Participants were assigned to either exposed or none-exposed group based on their exposure status to prenatal depression during pregnancy and followed starting from their 2nd ANC contact until childbirth. During the course of the follow-up relevant information was taken at three phases: at the time of enrolment, at the third visit, and immediately after delivery to assess for adverse birth outcome. The collected data was entered in to Epi data version 3.1 and analyzed using SPSS for windows version 20. Descriptive statistics was used to describe the study population in relation to socio-demographic and other relevant variables. Binary logistic regression was carried out to detect the association of different independent variables with the dependent variable. Independent variables having P<0.20 on the binary logistic regression analysis was considered as candidates for the final multivariable binary logistic regression. Then variables at p-value <0.05 with 95% confidence level was considered as statistically significant. Result: From the total anticipated participants, 450(90%) completed the follow-up. According to the finding, pregnant women in exposed group were 2.76 times more likely to encounter adverse birth outcome (stillbirth, low birth weight or pre-tem birth) compared with pregnant women in none-exposed group AOR=2.76: 95% CI; [1.35, 5.63]. Besides being exposed to prenatal depression, other variables such as: if husband doesn’t support the current pregnancy [AOR= 2.17: 95% CI; 1.06, 4.44], if women had previous adverse birth outcomes history [AOR= 2.41: vi | P a g e 95% CI; [1.19, 4.90] and having 2nd visit MUAC measurement of <23cm [AOR= 3.60: 95% CI; [1.62, 7.98] also demonstrated strong association with the adverse birth outcome. Conclusion and recommendation: This prospective cohort study showed that women who had antenatal depression were associated with risk increasing of adverse birth outcomes. It further revealed that poor partner support during the current pregnancy, women had previous adverse birth outcomes and having 2nd visit MUAC measurement of <23cm were found to be strong predictors of adverse birth outcome. Thus, from this research finding, it’s evident that incorporating depression assessment tool in routine antenatal care could help for prompt detection and management of prenatal depression thereby prevent possible adverse birth outcomes.