Major depression among pregnant women attending a tertiary teaching hospital in Northern Uganda assessed using DSM-V criteria
Background Major depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the prevalence and associated factors of MD among pregnant women in Uganda. We assessed the magnitude and factors associated with MD among preg...
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| Published in: | BMC pregnancy and childbirth Vol. 25; no. 1; pp. 504 - 10 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
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London
BioMed Central
26.04.2025
Springer Nature B.V BMC |
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| ISSN: | 1471-2393, 1471-2393 |
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| Abstract | Background
Major depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the prevalence and associated factors of MD among pregnant women in Uganda. We assessed the magnitude and factors associated with MD among pregnant women attending antenatal care (ANC) at a large teaching hospital in Northern Uganda.
Methods
Between June and August 2023, we enrolled pregnant women aged 18 years or older attending ANC clinic at Gulu Regional Referral Hospital in Northern Uganda. Data were collected using a validated semi-structured questionnaire. MD was evaluated using DSM-V criteria and was defined as having (1) at least two weeks of either persistent low mood or excessive sadness, (2) plus additional symptoms from the MD diagnostic criterion A, for a total of at least five MD symptoms, and (3) the symptoms caused significant distress or problem and significantly altered behaviour or functionality. Modified Poisson regression analyses with robust standard errors was constructed to evaluate for factors independently associated with major depression. Adjusted prevalence ratio (aPR) whose 95% confidence interval (CI) did not include the null value (0) or
p
< 0.05 was considered statistically significant.
Results
We enrolled 329 participants, with a mean age of 26.1± 5.5 years. Overall, 29.8% (
n
= 98) had MD; 37 (11.2%) mild, 49 (14.9%) moderate, and 12 (3.6%) severe MD. Having a co-wife (aPR: 1.64, 95% CI:1.09–2.45,
p
= 0.016), an arranged marriage (aPR: 1.56, 95% CI: 1.02–2.42,
p
= 0.042), partner’s income in second quartile (aPR: 2.14, 95% CI: 1.29–3.54,
p
= 0.003), experiencing physical violence (aPR: 1.75, 95% CI: 1.09–3.81,
p
= 0.019), controlling behaviours from partner (aPR: 3.60, 95% CI: 1.79–7.26,
p
< 0.001), and planned pregnancy (aPR: 0.53%, 955 CI: 0.35–0.81,
p
= 0.003) were independently associated with MD.
Conclusion
Major Depression affects nearly one-third of pregnant women in Northern Uganda. Major Depression is more prevalent among women with co-wives, in arranged marriages, with unplanned pregnancies, whose partners had low income, who experienced physical violence or controlling behaviours from a partner. These findings highlight the urgent need for targeted interventions, including prevention, screening, and treatment services for Major Depression within Antenatal Care clinics. Implementing such measures is crucial to improving maternal, foetal, and neonatal health outcomes in the region. |
|---|---|
| AbstractList | Abstract Background Major depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the prevalence and associated factors of MD among pregnant women in Uganda. We assessed the magnitude and factors associated with MD among pregnant women attending antenatal care (ANC) at a large teaching hospital in Northern Uganda. Methods Between June and August 2023, we enrolled pregnant women aged 18 years or older attending ANC clinic at Gulu Regional Referral Hospital in Northern Uganda. Data were collected using a validated semi-structured questionnaire. MD was evaluated using DSM-V criteria and was defined as having (1) at least two weeks of either persistent low mood or excessive sadness, (2) plus additional symptoms from the MD diagnostic criterion A, for a total of at least five MD symptoms, and (3) the symptoms caused significant distress or problem and significantly altered behaviour or functionality. Modified Poisson regression analyses with robust standard errors was constructed to evaluate for factors independently associated with major depression. Adjusted prevalence ratio (aPR) whose 95% confidence interval (CI) did not include the null value (0) or p < 0.05 was considered statistically significant. Results We enrolled 329 participants, with a mean age of 26.1± 5.5 years. Overall, 29.8% (n = 98) had MD; 37 (11.2%) mild, 49 (14.9%) moderate, and 12 (3.6%) severe MD. Having a co-wife (aPR: 1.64, 95% CI:1.09–2.45, p = 0.016), an arranged marriage (aPR: 1.56, 95% CI: 1.02–2.42, p = 0.042), partner’s income in second quartile (aPR: 2.14, 95% CI: 1.29–3.54, p = 0.003), experiencing physical violence (aPR: 1.75, 95% CI: 1.09–3.81, p = 0.019), controlling behaviours from partner (aPR: 3.60, 95% CI: 1.79–7.26, p < 0.001), and planned pregnancy (aPR: 0.53%, 955 CI: 0.35–0.81, p = 0.003) were independently associated with MD. Conclusion Major Depression affects nearly one-third of pregnant women in Northern Uganda. Major Depression is more prevalent among women with co-wives, in arranged marriages, with unplanned pregnancies, whose partners had low income, who experienced physical violence or controlling behaviours from a partner. These findings highlight the urgent need for targeted interventions, including prevention, screening, and treatment services for Major Depression within Antenatal Care clinics. Implementing such measures is crucial to improving maternal, foetal, and neonatal health outcomes in the region. Background Major depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the prevalence and associated factors of MD among pregnant women in Uganda. We assessed the magnitude and factors associated with MD among pregnant women attending antenatal care (ANC) at a large teaching hospital in Northern Uganda. Methods Between June and August 2023, we enrolled pregnant women aged 18 years or older attending ANC clinic at Gulu Regional Referral Hospital in Northern Uganda. Data were collected using a validated semi-structured questionnaire. MD was evaluated using DSM-V criteria and was defined as having (1) at least two weeks of either persistent low mood or excessive sadness, (2) plus additional symptoms from the MD diagnostic criterion A, for a total of at least five MD symptoms, and (3) the symptoms caused significant distress or problem and significantly altered behaviour or functionality. Modified Poisson regression analyses with robust standard errors was constructed to evaluate for factors independently associated with major depression. Adjusted prevalence ratio (aPR) whose 95% confidence interval (CI) did not include the null value (0) or p < 0.05 was considered statistically significant. Results We enrolled 329 participants, with a mean age of 26.1± 5.5 years. Overall, 29.8% ( n = 98) had MD; 37 (11.2%) mild, 49 (14.9%) moderate, and 12 (3.6%) severe MD. Having a co-wife (aPR: 1.64, 95% CI:1.09–2.45, p = 0.016), an arranged marriage (aPR: 1.56, 95% CI: 1.02–2.42, p = 0.042), partner’s income in second quartile (aPR: 2.14, 95% CI: 1.29–3.54, p = 0.003), experiencing physical violence (aPR: 1.75, 95% CI: 1.09–3.81, p = 0.019), controlling behaviours from partner (aPR: 3.60, 95% CI: 1.79–7.26, p < 0.001), and planned pregnancy (aPR: 0.53%, 955 CI: 0.35–0.81, p = 0.003) were independently associated with MD. Conclusion Major Depression affects nearly one-third of pregnant women in Northern Uganda. Major Depression is more prevalent among women with co-wives, in arranged marriages, with unplanned pregnancies, whose partners had low income, who experienced physical violence or controlling behaviours from a partner. These findings highlight the urgent need for targeted interventions, including prevention, screening, and treatment services for Major Depression within Antenatal Care clinics. Implementing such measures is crucial to improving maternal, foetal, and neonatal health outcomes in the region. Major depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the prevalence and associated factors of MD among pregnant women in Uganda. We assessed the magnitude and factors associated with MD among pregnant women attending antenatal care (ANC) at a large teaching hospital in Northern Uganda.BACKGROUNDMajor depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the prevalence and associated factors of MD among pregnant women in Uganda. We assessed the magnitude and factors associated with MD among pregnant women attending antenatal care (ANC) at a large teaching hospital in Northern Uganda.Between June and August 2023, we enrolled pregnant women aged 18 years or older attending ANC clinic at Gulu Regional Referral Hospital in Northern Uganda. Data were collected using a validated semi-structured questionnaire. MD was evaluated using DSM-V criteria and was defined as having (1) at least two weeks of either persistent low mood or excessive sadness, (2) plus additional symptoms from the MD diagnostic criterion A, for a total of at least five MD symptoms, and (3) the symptoms caused significant distress or problem and significantly altered behaviour or functionality. Modified Poisson regression analyses with robust standard errors was constructed to evaluate for factors independently associated with major depression. Adjusted prevalence ratio (aPR) whose 95% confidence interval (CI) did not include the null value (0) or p < 0.05 was considered statistically significant.METHODSBetween June and August 2023, we enrolled pregnant women aged 18 years or older attending ANC clinic at Gulu Regional Referral Hospital in Northern Uganda. Data were collected using a validated semi-structured questionnaire. MD was evaluated using DSM-V criteria and was defined as having (1) at least two weeks of either persistent low mood or excessive sadness, (2) plus additional symptoms from the MD diagnostic criterion A, for a total of at least five MD symptoms, and (3) the symptoms caused significant distress or problem and significantly altered behaviour or functionality. Modified Poisson regression analyses with robust standard errors was constructed to evaluate for factors independently associated with major depression. Adjusted prevalence ratio (aPR) whose 95% confidence interval (CI) did not include the null value (0) or p < 0.05 was considered statistically significant.We enrolled 329 participants, with a mean age of 26.1± 5.5 years. Overall, 29.8% (n = 98) had MD; 37 (11.2%) mild, 49 (14.9%) moderate, and 12 (3.6%) severe MD. Having a co-wife (aPR: 1.64, 95% CI:1.09-2.45, p = 0.016), an arranged marriage (aPR: 1.56, 95% CI: 1.02-2.42, p = 0.042), partner's income in second quartile (aPR: 2.14, 95% CI: 1.29-3.54, p = 0.003), experiencing physical violence (aPR: 1.75, 95% CI: 1.09-3.81, p = 0.019), controlling behaviours from partner (aPR: 3.60, 95% CI: 1.79-7.26, p < 0.001), and planned pregnancy (aPR: 0.53%, 955 CI: 0.35-0.81, p = 0.003) were independently associated with MD.RESULTSWe enrolled 329 participants, with a mean age of 26.1± 5.5 years. Overall, 29.8% (n = 98) had MD; 37 (11.2%) mild, 49 (14.9%) moderate, and 12 (3.6%) severe MD. Having a co-wife (aPR: 1.64, 95% CI:1.09-2.45, p = 0.016), an arranged marriage (aPR: 1.56, 95% CI: 1.02-2.42, p = 0.042), partner's income in second quartile (aPR: 2.14, 95% CI: 1.29-3.54, p = 0.003), experiencing physical violence (aPR: 1.75, 95% CI: 1.09-3.81, p = 0.019), controlling behaviours from partner (aPR: 3.60, 95% CI: 1.79-7.26, p < 0.001), and planned pregnancy (aPR: 0.53%, 955 CI: 0.35-0.81, p = 0.003) were independently associated with MD.Major Depression affects nearly one-third of pregnant women in Northern Uganda. Major Depression is more prevalent among women with co-wives, in arranged marriages, with unplanned pregnancies, whose partners had low income, who experienced physical violence or controlling behaviours from a partner. These findings highlight the urgent need for targeted interventions, including prevention, screening, and treatment services for Major Depression within Antenatal Care clinics. Implementing such measures is crucial to improving maternal, foetal, and neonatal health outcomes in the region.CONCLUSIONMajor Depression affects nearly one-third of pregnant women in Northern Uganda. Major Depression is more prevalent among women with co-wives, in arranged marriages, with unplanned pregnancies, whose partners had low income, who experienced physical violence or controlling behaviours from a partner. These findings highlight the urgent need for targeted interventions, including prevention, screening, and treatment services for Major Depression within Antenatal Care clinics. Implementing such measures is crucial to improving maternal, foetal, and neonatal health outcomes in the region. BackgroundMajor depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the prevalence and associated factors of MD among pregnant women in Uganda. We assessed the magnitude and factors associated with MD among pregnant women attending antenatal care (ANC) at a large teaching hospital in Northern Uganda.MethodsBetween June and August 2023, we enrolled pregnant women aged 18 years or older attending ANC clinic at Gulu Regional Referral Hospital in Northern Uganda. Data were collected using a validated semi-structured questionnaire. MD was evaluated using DSM-V criteria and was defined as having (1) at least two weeks of either persistent low mood or excessive sadness, (2) plus additional symptoms from the MD diagnostic criterion A, for a total of at least five MD symptoms, and (3) the symptoms caused significant distress or problem and significantly altered behaviour or functionality. Modified Poisson regression analyses with robust standard errors was constructed to evaluate for factors independently associated with major depression. Adjusted prevalence ratio (aPR) whose 95% confidence interval (CI) did not include the null value (0) or p < 0.05 was considered statistically significant.ResultsWe enrolled 329 participants, with a mean age of 26.1± 5.5 years. Overall, 29.8% (n = 98) had MD; 37 (11.2%) mild, 49 (14.9%) moderate, and 12 (3.6%) severe MD. Having a co-wife (aPR: 1.64, 95% CI:1.09–2.45, p = 0.016), an arranged marriage (aPR: 1.56, 95% CI: 1.02–2.42, p = 0.042), partner’s income in second quartile (aPR: 2.14, 95% CI: 1.29–3.54, p = 0.003), experiencing physical violence (aPR: 1.75, 95% CI: 1.09–3.81, p = 0.019), controlling behaviours from partner (aPR: 3.60, 95% CI: 1.79–7.26, p < 0.001), and planned pregnancy (aPR: 0.53%, 955 CI: 0.35–0.81, p = 0.003) were independently associated with MD.ConclusionMajor Depression affects nearly one-third of pregnant women in Northern Uganda. Major Depression is more prevalent among women with co-wives, in arranged marriages, with unplanned pregnancies, whose partners had low income, who experienced physical violence or controlling behaviours from a partner. These findings highlight the urgent need for targeted interventions, including prevention, screening, and treatment services for Major Depression within Antenatal Care clinics. Implementing such measures is crucial to improving maternal, foetal, and neonatal health outcomes in the region. Major depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the prevalence and associated factors of MD among pregnant women in Uganda. We assessed the magnitude and factors associated with MD among pregnant women attending antenatal care (ANC) at a large teaching hospital in Northern Uganda. Between June and August 2023, we enrolled pregnant women aged 18 years or older attending ANC clinic at Gulu Regional Referral Hospital in Northern Uganda. Data were collected using a validated semi-structured questionnaire. MD was evaluated using DSM-V criteria and was defined as having (1) at least two weeks of either persistent low mood or excessive sadness, (2) plus additional symptoms from the MD diagnostic criterion A, for a total of at least five MD symptoms, and (3) the symptoms caused significant distress or problem and significantly altered behaviour or functionality. Modified Poisson regression analyses with robust standard errors was constructed to evaluate for factors independently associated with major depression. Adjusted prevalence ratio (aPR) whose 95% confidence interval (CI) did not include the null value (0) or p < 0.05 was considered statistically significant. We enrolled 329 participants, with a mean age of 26.1± 5.5 years. Overall, 29.8% (n = 98) had MD; 37 (11.2%) mild, 49 (14.9%) moderate, and 12 (3.6%) severe MD. Having a co-wife (aPR: 1.64, 95% CI:1.09-2.45, p = 0.016), an arranged marriage (aPR: 1.56, 95% CI: 1.02-2.42, p = 0.042), partner's income in second quartile (aPR: 2.14, 95% CI: 1.29-3.54, p = 0.003), experiencing physical violence (aPR: 1.75, 95% CI: 1.09-3.81, p = 0.019), controlling behaviours from partner (aPR: 3.60, 95% CI: 1.79-7.26, p < 0.001), and planned pregnancy (aPR: 0.53%, 955 CI: 0.35-0.81, p = 0.003) were independently associated with MD. Major Depression affects nearly one-third of pregnant women in Northern Uganda. Major Depression is more prevalent among women with co-wives, in arranged marriages, with unplanned pregnancies, whose partners had low income, who experienced physical violence or controlling behaviours from a partner. These findings highlight the urgent need for targeted interventions, including prevention, screening, and treatment services for Major Depression within Antenatal Care clinics. Implementing such measures is crucial to improving maternal, foetal, and neonatal health outcomes in the region. |
| ArticleNumber | 504 |
| Author | Blasich, Nozuko P. Ochola, Henry Pebolo, Pebalo Francis Ouma, Simple Bongomin, Felix Okot, Jerom Aeku, Michael Job |
| Author_xml | – sequence: 1 givenname: Jerom surname: Okot fullname: Okot, Jerom email: Okotayolijerome@gmail.com organization: Faculty of Medicine, Gulu University – sequence: 2 givenname: Henry surname: Ochola fullname: Ochola, Henry organization: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine – sequence: 3 givenname: Nozuko P. surname: Blasich fullname: Blasich, Nozuko P. organization: Academic Affairs, Research and Quality Assurance National Health Laboratory Service – sequence: 4 givenname: Michael Job surname: Aeku fullname: Aeku, Michael Job organization: Faculty of Medicine, Gulu University – sequence: 5 givenname: Pebalo Francis surname: Pebolo fullname: Pebolo, Pebalo Francis organization: Department of Sexual and Reproductive Health, Gulu University – sequence: 6 givenname: Felix surname: Bongomin fullname: Bongomin, Felix organization: Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Department of Internal Medicine, Gulu Regional Referral Hospital – sequence: 7 givenname: Simple surname: Ouma fullname: Ouma, Simple organization: Department of Public Health, Gulu University, The AIDS Support Organization |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40287620$$D View this record in MEDLINE/PubMed |
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| Keywords | Pregnancy Major depression Antenatal care |
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Major depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on... Major depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the... BackgroundMajor depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of evidence on the... Abstract Background Major depression (MD) during pregnancy complicates maternal and neonatal outcomes. Despite its significant impact, there is a lack of... |
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| SubjectTerms | Adolescent Adult Age Alcohol Antenatal care Cross-Sectional Studies Data collection Depressive Disorder, Major - diagnosis Depressive Disorder, Major - epidemiology Diagnostic and Statistical Manual of Mental Disorders Education Female Gynecology HIV Hospitals Hospitals, Teaching Human immunodeficiency virus Humans Major depression Marriage Maternal and Child Health Medicine Medicine & Public Health Mental depression Mental disorders Mental health Obstetrics Personal relationships Pregnancy Pregnancy Complications - diagnosis Pregnancy Complications - epidemiology Pregnancy Complications - psychology Pregnant People - psychology Prenatal Care Prevalence Questionnaires Reproductive Medicine Risk Factors Sample size Surveys and Questionnaires Teaching hospitals Tertiary Care Centers - statistics & numerical data Uganda - epidemiology Variables Violence Womens health Young Adult |
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| Title | Major depression among pregnant women attending a tertiary teaching hospital in Northern Uganda assessed using DSM-V criteria |
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