Factors associated with depression symptoms among pregnant adolescent girls and young women at Kawempe National Referral Hospital, Uganda

Abstract

Introduction: Depression symptoms are among the most prevalent mental health problems that occur during pregnancy, affecting about one in four women worldwide. Maternal depression symptoms is of public health concern among pregnant Adolescent Girls and Young Women, and is often undiagnosed and untreated during antenatal period. Circumstances of persistent physical and psychosocial stress among these young women is related to the occurrence of depression symptoms, with resultant negative health-related behaviours and conditions that impact pregnancy outcomes; with other effects manifesting later during childhood development. Objectives: To determine the prevalence and factors associated with depression symptoms among pregnant adolescent girls and young women (AGYW) attending antenatal clinics. Methods: A cross-sectional study was conducted at Kawempe National Referral Hospital, Kampala antenatal clinics for a period of two months. Quantitative study approaches were employed among pregnant women aged 15 – 24 years. PHQ-9 questionnaire was used to measure depression symptoms; a score of ≥8 was considered for depression symptoms. Systematic random sampling technique was used to select eligible study participants until a sample size of 366 participants was achieved. Data was analysed using STATA version 14, and multivariate modified Poisson regression analysis was used to determine factors at p-value < 0.05, that are associated with depression symptoms among pregnant AGYW. Results: The prevalence of depression symptoms among pregnant AGYW was 19.1%. Factors associated with depression symptoms were found to include; gravidity ≥ 3 (PrR 1.9, 95% CI [1.19-3.32]), low partner support (PrR 2.2, 95% CI [1.27-3.98]), Intimate Partner Violence (PrR 2.8, 95% CI [1.55-4.93]) and having suffered from subjective COVID-19 symptoms (PrR 2.3, 95% CI [1.37-3.89]). The prevalence rate of depression symptoms was lower among pregnant AGYW house-wives and those self-employed/ businesses owners, compared to those in formal employment (PrR 0.5, 95% CI [0.26-0.87]) and (PrR 0.4, 95% CI [0.21-0.80]) respectively. Conclusion: Depression symptoms are common among pregnant AGYW attending antenatal clinics, and being self-employed or a housewife was found to be protective. The factors significantly associated with depression symptoms among pregnant AGYW included; being pregnant for the third or more times, Low partner support, experiencing Intimate Partner Violence and having a history of suffering from subjective symptoms of COVID-19.