title: Prevalence and determinants of antenatal depression among pregnant women in a predominantly rural population in Ghana: the DON population-based study.
abstract: BACKGROUND
  While depression during pregnancy is one of the strongest risk factors for postnatal depression, it has been comparatively little studied, particularly in sub-Saharan Africa.
  
  
  METHODS
  Cohort study nested within 4-weekly surveillance of all women of reproductive age to identify pregnancies and collect data on births and deaths in the Kintampo Health Research Centre study area of Ghana. Women were screened for depression during pregnancy using the Patient Health Questionnaire to ascertain DSM-IV major or minor depression. Information on demographic factors, indicators of social and economic disadvantage, and previous obstetric history were also collected which were examined using logistic regression; effect sizes reported as relative risks with 95% confidence intervals.
  
  
  RESULTS
  21,135 pregnant women were screened of whom 20,920 (98.9%) had complete data on potential determinants. 2086 (9.9%, 95% CI: 9.5%-10.3%) had AND. Determinants of AND were: maternal age 30+ years (relative risk [RR], 1.16 (1.06-1.27); never married ([RR] 1.34, (1.14-1.58); lower wealth quintile ([RR], 1.30 (1.13-1.50); unplanned pregnancy ([RR], 1.55 (1.43-1.69); previous pregnancy loss ([RR], 1.30 (1.18-1.43).
  
  
  CONCLUSIONS
  We did not assess women for physical health during pregnancy, and lacked information on some potentially relevant psychosocial factors.
  
  
  CONCLUSIONS
  Prevalence of antenatal depression, applying clinical criteria, is similar to that seen in high income countries. Factors related to chronic social and economic disadvantage are among the most important co-determinants. Population-level interventions that address these problems among women of reproductive age may be the most effective strategy for reducing the prevalence and impact of depression in pregnancy.
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P.O. Box 200, Kintampo, Brong-Ahafo Region, Ghana; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK. Electronic address: bkweobong@gmail.com.
authors.forename: Benedict
authors.initials: B
authors.lastname: Weobong
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK.
authors.forename: Seyi
authors.initials: S
authors.lastname: Soremekun
authors.affiliation: Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Augustinus Ha
authors.initials: AH
authors.lastname: Ten Asbroek
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P.O. Box 200, Kintampo, Brong-Ahafo Region, Ghana.
authors.forename: Seeba
authors.initials: S
authors.lastname: Amenga-Etego
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P.O. Box 200, Kintampo, Brong-Ahafo Region, Ghana.
authors.forename: Samuel
authors.initials: S
authors.lastname: Danso
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P.O. Box 200, Kintampo, Brong-Ahafo Region, Ghana; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK.
authors.forename: Seth
authors.initials: S
authors.lastname: Owusu-Agyei
authors.affiliation: Health Services and Population Research Department, Institute of Psychiatry, King׳s College, London.
authors.forename: Martin
authors.initials: M
authors.lastname: Prince
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK.
authors.forename: Betty R
authors.initials: BR
authors.lastname: Kirkwood
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence; D012424:Rural Population; D055815:Young Adult
keywords: Antenatal; Depression; Determinants; Pregnancy; Sub-Saharan Africa