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Antenatal Depression: Prevalence and Determinants in a High-Risk Sample of Women in Saskatoon

Pregnancy is often portrayed as a happy time for the woman and her family. In reality, many women struggle with negative emotions and moods that can have deleterious effects on the mother, the fetus, and the growing family. Depression is an increasing, worldwide problem, with women in their childbearing years and those of low socioeconomic status the most vulnerable. <p>This study explores depression, as determined by the Edinburgh Postnatal Depression Scale (EPDS), in a high-risk sample of pregnant women enrolled in two prenatal programs in Saskatoon, Saskatchewan, Canada. A prevention and population health approach has been used to identify potential determinants and implications of antenatal depression. The data analyzed in this study were from the first cross-sectional portion of a longitudinal, epidemiological study of depression in pregnancy into the postpartum. Women were invited to participate in the study at their first prenatal visit. Data were collected by program staff. <p>The prevalence of depression in this sample of 402 high-risk women was 29.5%, which is similar to other studies of inner-city, low income, and minority women elsewhere in the world. In the final model, antenatal depression was associated with a history of depression, moods going up and down, current smoking status, high levels of stressors, and social support.<p>Factor analysis of the EPDS revealed three underlying factors: Anxiety, Depression, and Self-harm thoughts. The anxiety factor explained most of the variance in the overall EPDS scores in this sample of women. A history of problems with mood fluctuations was significantly associated with anxiety and depression subscales and self-harm. Significantly more women aged 21 and under experienced anxiety, and more Aboriginal women experienced depressive symptoms and self-harm thoughts. Twenty percent of women reported self-harm thoughts in the preceding seven days. Depressed, Aboriginal, and single women, and women who use alcohol were most at risk for self-harm thoughts. <p>The level of depressive symptoms in this sample of women represents a significant public and mental health problem in women already challenged by inequities in their life circumstances. We need to develop public health policy that will support screening and identification of women with depression. Interventions at the primary, secondary, and tertiary levels of prevention can help to improve the health of women struggling with antenatal depression, promote the optimal intrauterine environment for their unborn children, and reduce the intergenerational transmission of depression.

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:SSU.etd-08282007-153141
Date30 August 2007
CreatorsHauser Bowen, Angela N
ContributorsMuhajarine, Nazeem, Stewart, Norma, Reeder, Bruce, Baetz, Marilyn, Maslany, George
PublisherUniversity of Saskatchewan
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
LanguageEnglish
Detected LanguageEnglish
Typetext
Formatapplication/pdf
Sourcehttp://library.usask.ca/theses/available/etd-08282007-153141/
Rightsunrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Saskatchewan or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report.

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