Background

Antenatal depression is associated with adverse maternal and infant well-being. However, compared to postpartum depression, it has been less frequently explored globally or in Jamaica. This study aimed to determine the prevalence of, and factors associated with, antenatal depressive symptoms among Jamaican women in order to inform policy and build interventions that could improve their management and reduce their negative consequences.

Methods

This secondary analysis of data from the second Jamaican Birth Cohort Study (JA-Kids Birth Cohort) included 3,517 women enrolled during pregnancy. Information was extracted from interviewer-administered questionnaires which recorded social, demographic, medical and obstetric information during pregnancy. The Edinburgh Postnatal Depression scale (EPDS) was used to screen for depression, with scores ≥13 considered indicative of a high likelihood of depression. Bivariate analysis examined associations between depressive symptoms and: age, income, financial difficulties, perceived social support, perceived partner infidelity, previous child-bearing unions and children with the current partner. Obstetric factors were also explored and included gravidity, prior adverse pregnancy outcome and complications from previous pregnancies. Variables that predicted the likelihood of depression based on an EPDS cut score of 13 were evaluated using logistic regression.

Results

One in five participants (19.6%; 95% CI 18.3–20.9%) had a high likelihood of antenatal depression (EPDS ≥13). Significant predictors of high depressive symptom severity included four indicators of poor perceived social and partner support [ORs (95% CI) ranged from: 1.61 (1.07–2.43); p = 0.024 to 3.14(1.69–5.84); p< 0.001], perceived partner infidelity [1.86 (1.36, 2.54); p<0.001], exposure to violence [2.36 (1.66–3.38); p<0.001] and financial difficulties [1.39 (1.07, 1.80); p = 0.013].

Conclusions

Women’s perceived social and partner support were strongly associated with depressive symptom severity. Within the Jamaican cultural context of unstable reproductive unions, efforts are needed to involve fathers in the antenatal care process to strategically improve the psychological well-being of new mothers which may positively influence long term developmental outcomes for their babies.

中文翻译：

---

与有限的知觉伴侣和其他社会支持相关的牙买加产前抑郁症状的横断面研究

背景

产前抑郁症与母婴健康不良有关。但是，与产后抑郁症相比，在全球范围内或在牙买加，它的探索频率都较低。这项研究旨在确定牙买加妇女产前抑郁症状的患病率及其相关因素，以便为制定政策和制定干预措施提供信息，以改善她们的管理并减少她们的负面影响。

方法

来自第二个牙买加出生队列研究（JA-Kids Birth Cohort）的数据的次要分析包括3,517名在怀孕期间入组的妇女。从访调员管理的调查表中提取信息，这些调查表记录了怀孕期间的社会，人口，医学和产科信息。爱丁堡产后抑郁量表（EPDS）用于筛查抑郁症，得分≥13被认为表明了抑郁症的可能性很高。双变量分析检查了抑郁症状与以下之间的关联：年龄，收入，经济困难，感知到的社会支持，感知到的伴侣不忠，以前的育儿联盟以及与当前伴侣的孩子。还探讨了产科因素，包括妊娠率，先前的不良妊娠结局和先前妊娠的并发症。

结果

五分之一的参与者（19.6％； 95％的CI为18.3-20.9％）发生产前抑郁的可能性很高（EPDS≥13）。抑郁症状严重程度的重要预测因素包括不良社交和伴侣支持的四个指标[OR（95％CI），范围从：1.61（1.07–2.43）；p = 0.024至3.14（1.69-5.84）；p <0.001]，感觉伴侣的不忠[1.86（1.36，2.54）; p <0.001]，遭受暴力侵害[2.36（1.66-3.38）；p <0.001]和财务困难[1.39（1.07，1.80）；p = 0.013]。

结论

妇女对社交和伴侣的支持与抑郁症状的严重程度密切相关。在牙买加不稳定的生殖联盟的文化背景下，需要努力使父亲参与产前保健过程，以战略性地改善新母亲的心理健康，这可能对婴儿的长期发育结果产生积极影响。