Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia
| dc.contributor.author | Bitew, Tesera | |
| dc.contributor.author | Hanlon, Charlotte | |
| dc.contributor.author | Kebede, Eskinder | |
| dc.contributor.author | Honikman, Simone | |
| dc.contributor.author | Onah, Michael N | |
| dc.contributor.author | Fekadu, Abebaw | |
| dc.date.accessioned | 2017-07-03T11:58:32Z | |
| dc.date.available | 2017-07-03T11:58:32Z | |
| dc.date.issued | 2017-06-29 | |
| dc.date.updated | 2017-07-02T03:15:16Z | |
| dc.description.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. | |
| dc.identifier.apacitation | Bitew, T., Hanlon, C., Kebede, E., Honikman, S., Onah, M. N., & Fekadu, A. (2017). Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia. <i>BMC Pregnancy and Childbirth</i>, http://hdl.handle.net/11427/24681 | en_ZA |
| dc.identifier.chicagocitation | Bitew, Tesera, Charlotte Hanlon, Eskinder Kebede, Simone Honikman, Michael N Onah, and Abebaw Fekadu "Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia." <i>BMC Pregnancy and Childbirth</i> (2017) http://hdl.handle.net/11427/24681 | en_ZA |
| dc.identifier.citation | Bitew, T., Hanlon, C., Kebede, E., Honikman, S., Onah, M. N., & Fekadu, A. (2017). Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural EthiopiaBMC Pregnancy and Childbirth, 17(1):206. | |
| dc.identifier.ris | TY - Journal Article AU - Bitew, Tesera AU - Hanlon, Charlotte AU - Kebede, Eskinder AU - Honikman, Simone AU - Onah, Michael N AU - Fekadu, Abebaw AB - 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. DA - 2017-06-29 DB - OpenUCT DO - 10.1186/s12884-017-1383-8 DP - University of Cape Town J1 - BMC Pregnancy and Childbirth LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia TI - Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia UR - http://hdl.handle.net/11427/24681 ER - | en_ZA |
| dc.identifier.uri | http://dx.doi.org/10.1186/s12884-017-1383-8 | |
| dc.identifier.uri | http://hdl.handle.net/11427/24681 | |
| dc.identifier.vancouvercitation | Bitew T, Hanlon C, Kebede E, Honikman S, Onah MN, Fekadu A. Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia. BMC Pregnancy and Childbirth. 2017; http://hdl.handle.net/11427/24681. | en_ZA |
| dc.language.iso | en | |
| dc.publisher | BioMed Central | |
| dc.publisher.department | Department of Psychiatry and Mental Health | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights | This article is distributed under the terms of the Creative Commons Attribution 4.0 International License | |
| dc.rights.holder | The Author(s). | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
| dc.source | BMC Pregnancy and Childbirth | |
| dc.source.uri | https://bmcpregnancychildbirth.biomedcentral.com/ | |
| dc.subject.other | Antenatal depressive symptoms | |
| dc.subject.other | Delivery care use | |
| dc.subject.other | Postnatal care use | |
| dc.subject.other | Assisted delivery | |
| dc.subject.other | Planned institutional delivery | |
| dc.subject.other | Ethiopia | |
| dc.title | Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia | |
| dc.type | Journal Article | |
| uct.type.filetype | Text | |
| uct.type.filetype | Image | |
| uct.type.publication | Research | en_ZA |
| uct.type.resource | Article | en_ZA |