A comparative study of postpartum anxiety and depression in mothers with pre-term births in Kenya
Joyce Mutua, Pius Kigamwa, Pauline Ng'ang'a, Albert Tele, Manasi Kumar
Abstract
Comorbid anxiety and depression and its precursors such as stress associated with neonatal care in hospital, survival of the baby, social support and maternal family dynamics are understudied in sub-Saharan Africa. We studied comorbid postpartum anxiety and depression among mothers of preterm infants receiving intensive care in newborn unit at Kenyatta National Hospital, and mothers of full-term healthy infants attending a health center in Nairobi. A comparative cross-sectional study design was used to recruit 172 mother-infant dyads; 86 full-term mothers and 86 with pre-term deliveries. Self-reported socio-demographic questionnaire, Edinburgh Postnatal Depression Scale, Kessler's 10 and Patient Health Questionnaire-4 were used to screen for levels of depression, psychological distress and anxiety. Multivariate logistic regression was used to assess the independent predictors of comorbid depression and anxiety. From 35.1% who screened positive for anxiety 75% (n = 45) were mothers with pre-term babies and of 43 (25%) who screened positive for comorbid depression and anxiety, 83.7% (n = 36) were mothers with pre-term babies. We found that the risk of comorbid depression and anxiety were 6 times more among the mothers with pre-term birth as compared to full term births (p = 0.002), 4.76 times more (p = 0.043) among mothers who reported IPV and 5.95 more (p < 0.001) times among mothers who reported psychological distress. We found higher proportions of depression, anxiety, and general distress in mothers who delivered pre-term. Risk factors like IPV and poor mental health should be addressed in postpartum mothers regardless of full term or preterm births status, as a fundamental right.