Effects of antenatal depression on adverse birth outcomes among women attending antenatal care at Jimma University Medical Center, Ethiopia: a prospective cohort study

Abstract

Existing evidence indicated an increasing burden of antenatal depression on adverse birth outcomes in low- and middle-income countries. However, the evidence regarding the effect of antenatal depression on adverse birth outcomes is not well understood in the study area. Therefore, this study aimed to determine the effect of antenatal depression on adverse birth outcomes at Jimma University Medical Center, Southwest Ethiopia. A facility-based prospective cohort study was conducted among 255 pregnant women at Jimma University Medical Center from May to September 2023. A convenient sampling technique was employed to select study subjects. Adverse birth outcomes were measured by having one or more negative newborn outcomes. Antenatal depression was assessed using the Edinburgh Postpartum Depression Scale. A pretested, interviewer-administered, structured questionnaire was used to collect the data. A bivariable and multivariable log-binomial model was used to examine the association between antenatal depression and adverse birth outcomes. A statistically significant association was declared at a P value less than 0.05. Results In this study, the estimated cumulative incidence of adverse birth outcomes was 53% and 29% among women with and without antenatal depression, respectively. The proportion of antenatal depression was 20%. Physically inactive women (ARR = 1.54;95%CI:1.22,1.94), exposed to tobacco (ARR = 2.64;95%CI:1.90,3.67), chronic medical illness (ARR = 2.14; 95%CI:1.68,2.72), induced labor (ARR = 1.47; 95%CI:1.17,1.85), and antenatal depression (ARR = 1.58; 95%CI:1.26, 1.95) were the predictors of the risk of adverse birth outcomes. The incidence of adverse birth outcomes among women with and without depression at Jimma University Medical Center was 53% and 29%, respectively. Physically inactive women, exposed to tobacco, chronic medical illness, induced labor, and particularly antenatal depression, were statistically significantly associated with newborn adverse birth outcomes. Thus, to minimize the incidence of adverse birth outcomes, early anticipation, screening, and management of antenatal depression are recommended during antenatal care follow-up.