Prevalence of prenatal and postpartum depression and associated factors among HIV-infected women in public primary care in rural South Africa: a longitudinal study

Karl Peltzer, Violeta J. Rodriguez, Tae Kyoung Lee, Deborah Jones

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2 Citations (Scopus)

Abstract

This study aimed to assess the longitudinal prevalence of prenatal and postnatal depression and associated factors among HIV-infected women in rural South Africa. In a longitudinal, cluster-randomized, prevention of mother to child transmission (PMTCT) intervention trial, 681 HIV-infected prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited in 2015 by consecutive sampling at 8–24 weeks pregnancy and followed up at 32 weeks prenatally, and 6 and 12 months postpartum (retention rate = 59.2%). Results indicate that at baseline, 48.7% of the women screened positive for depression (scores of ≥13 on the “Edinburgh Postnatal Depression Scale 10”), while postnatally (at 12 months) the prevalence was 35.6%. Mothers who did not have depression before or after were 205 (50.1%), those who had depression before and after were 58 (14.4%), those who had depression only before were 81 (20.1%), and those who had depression only after were 59 (14.6%). In multinominal logistic regression analyses, less education and physical and psychological intimate partner violence were associated with sustained perinatal depression. Participation in the PMTCT intervention was associated with remitting depression while alcohol use was associated with the onset of postnatal depression. Using generalized linear mixed models in longitudinal analyses, psychological partner violence, lack of male involvement during pregnancy and non-adherence to antiretroviral treatment were associated with depression. In conclusion, a high pre- and postnatal prevalence of depression was found highlighting the utility of interventions to address prevention and treatment of perinatal depression.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
DOIs
StateAccepted/In press - Mar 28 2018

Fingerprint

Postpartum Depression
South Africa
Longitudinal Studies
Primary Health Care
longitudinal study
HIV
Depression
Mothers
Psychology
Community Health Centers
Pregnancy
Physical Education and Training
pregnancy
Violence
violence
Postpartum Period
Linear Models
Logistic Models
Regression Analysis
Alcohols

Keywords

  • Antenatal care
  • depression
  • HIV
  • longitudinal study
  • postnatal care
  • South Africa

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health

Cite this

@article{2f0085eb056c4ce7ae3a461e8044f009,
title = "Prevalence of prenatal and postpartum depression and associated factors among HIV-infected women in public primary care in rural South Africa: a longitudinal study",
abstract = "This study aimed to assess the longitudinal prevalence of prenatal and postnatal depression and associated factors among HIV-infected women in rural South Africa. In a longitudinal, cluster-randomized, prevention of mother to child transmission (PMTCT) intervention trial, 681 HIV-infected prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited in 2015 by consecutive sampling at 8–24 weeks pregnancy and followed up at 32 weeks prenatally, and 6 and 12 months postpartum (retention rate = 59.2{\%}). Results indicate that at baseline, 48.7{\%} of the women screened positive for depression (scores of ≥13 on the “Edinburgh Postnatal Depression Scale 10”), while postnatally (at 12 months) the prevalence was 35.6{\%}. Mothers who did not have depression before or after were 205 (50.1{\%}), those who had depression before and after were 58 (14.4{\%}), those who had depression only before were 81 (20.1{\%}), and those who had depression only after were 59 (14.6{\%}). In multinominal logistic regression analyses, less education and physical and psychological intimate partner violence were associated with sustained perinatal depression. Participation in the PMTCT intervention was associated with remitting depression while alcohol use was associated with the onset of postnatal depression. Using generalized linear mixed models in longitudinal analyses, psychological partner violence, lack of male involvement during pregnancy and non-adherence to antiretroviral treatment were associated with depression. In conclusion, a high pre- and postnatal prevalence of depression was found highlighting the utility of interventions to address prevention and treatment of perinatal depression.",
keywords = "Antenatal care, depression, HIV, longitudinal study, postnatal care, South Africa",
author = "Karl Peltzer and Rodriguez, {Violeta J.} and Lee, {Tae Kyoung} and Deborah Jones",
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N2 - This study aimed to assess the longitudinal prevalence of prenatal and postnatal depression and associated factors among HIV-infected women in rural South Africa. In a longitudinal, cluster-randomized, prevention of mother to child transmission (PMTCT) intervention trial, 681 HIV-infected prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited in 2015 by consecutive sampling at 8–24 weeks pregnancy and followed up at 32 weeks prenatally, and 6 and 12 months postpartum (retention rate = 59.2%). Results indicate that at baseline, 48.7% of the women screened positive for depression (scores of ≥13 on the “Edinburgh Postnatal Depression Scale 10”), while postnatally (at 12 months) the prevalence was 35.6%. Mothers who did not have depression before or after were 205 (50.1%), those who had depression before and after were 58 (14.4%), those who had depression only before were 81 (20.1%), and those who had depression only after were 59 (14.6%). In multinominal logistic regression analyses, less education and physical and psychological intimate partner violence were associated with sustained perinatal depression. Participation in the PMTCT intervention was associated with remitting depression while alcohol use was associated with the onset of postnatal depression. Using generalized linear mixed models in longitudinal analyses, psychological partner violence, lack of male involvement during pregnancy and non-adherence to antiretroviral treatment were associated with depression. In conclusion, a high pre- and postnatal prevalence of depression was found highlighting the utility of interventions to address prevention and treatment of perinatal depression.

AB - This study aimed to assess the longitudinal prevalence of prenatal and postnatal depression and associated factors among HIV-infected women in rural South Africa. In a longitudinal, cluster-randomized, prevention of mother to child transmission (PMTCT) intervention trial, 681 HIV-infected prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited in 2015 by consecutive sampling at 8–24 weeks pregnancy and followed up at 32 weeks prenatally, and 6 and 12 months postpartum (retention rate = 59.2%). Results indicate that at baseline, 48.7% of the women screened positive for depression (scores of ≥13 on the “Edinburgh Postnatal Depression Scale 10”), while postnatally (at 12 months) the prevalence was 35.6%. Mothers who did not have depression before or after were 205 (50.1%), those who had depression before and after were 58 (14.4%), those who had depression only before were 81 (20.1%), and those who had depression only after were 59 (14.6%). In multinominal logistic regression analyses, less education and physical and psychological intimate partner violence were associated with sustained perinatal depression. Participation in the PMTCT intervention was associated with remitting depression while alcohol use was associated with the onset of postnatal depression. Using generalized linear mixed models in longitudinal analyses, psychological partner violence, lack of male involvement during pregnancy and non-adherence to antiretroviral treatment were associated with depression. In conclusion, a high pre- and postnatal prevalence of depression was found highlighting the utility of interventions to address prevention and treatment of perinatal depression.

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