The prevalence of and risk factors for perinatal depression among woman in the Knysna and Bitou sub-district : a cross sectional observational study
Thesis (MFamMed)--Stellenbosch University, 2019.
ENGLISH SUMMARY : Background: Perinatal depressive symptoms occur in women during pregnancy, around childbirth and within one year after delivery. Women in low middle income countries (LMICs) are at risk, screening is poor and the prevalence in the Southern Cape region of South Africa is unknown. Aim and objectives: The aim of the study is to determine the prevalence of and risk factors associated with perinatal depressive symptoms among women in the Knysna and Bitou sub-districts. The objectives are to compare antenatal and postnatal depressive symptoms, to evaluate associated risk factors and compare the effect of multiple versus single risk factors. Methods: A descriptive cross sectional study design was used. Women aged 18 and above were sampled over a period of 10 months. Participation was voluntary and signed informed consent was obtained. Each participant completed the validated Edinburgh Postnatal Depression Scale (EPDS) and a risk factor assessment questionnaire. All documentation was available in Afrikaans, English and isiXhosa. A positive score for perinatal depressive symptoms was 13 or more. Referral for optional counselling or management was done as needed. Results: In this study, the prevalence of perinatal depressive symptoms was high at 40.6%. The prevalence was similar for antenatal and postnatal groups with 40% and 40.5% respectively. Significant risk factors present among both groups were: no social support, use of alcohol and tobacco, race and a known or previous diagnosis of depression. More than one of the identified risk factors were present in 28.8% of depressed participants. Conclusion: Perinatal depression risk in the Knysna/Bitou sub-districts, as found using the EPDS screening tool, is high. Both antenatal and postnatal groups showed similar prevalence. Risk factors in this population were lack of social support, substance use, race and a current or previous diagnosis of depression; with the majority of participants having one risk factor. Prevalence was similar for those with no risk factors and two or more risk factors. The results highlight the need for effective screening of all antenatal and postnatal women.
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