Prevalence and correlates of depression among pregnant adolescents in primary maternal care in Nigeria

Household food insecurity and symptoms of anxiety and depression during pregnancy: Systematic review and meta-analysis

Household food insecurity (HFI) has been related to adverse maternal-child health outcomes and mental health worsening during pregnancy. Few studies evaluated the temporal association between HFI and anxiety and depressive symptoms in pregnant women, and this association remains not completely understood. This study aimed to systematically review the association between HFI and symptoms of depression and anxiety in pregnant individuals. The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (CRD42022373615). Systematic searches were conducted on 10 electronic databases and grey literature. Two researchers independently conducted the study selection, data extraction process, and the risk of bias assessment. Random-effects meta-analysis models were used, and I2 > 40% indicated high heterogeneity across studies. Eighteen articles were included for the systematic review, comprising n = 27,882, and a total of 18,987 pregnant individuals aged between 14 and 45 years were included in the meta-analysis. The prevalence of HFI reported in studies ranged from 12.6% to 62.1% (n = 17). The prevalence of depressive and anxiety symptoms ranged from 18% to 49% (n = 11) and 23% to 34% (n = 2), respectively. HFI during pregnancy was associated with increased odds of experiencing symptoms of depression [(OR: 2.52; 95% CI: 2.11-3.02), I2 = 73.23%]. The quality of evidence was very low due to high heterogeneity. Our findings highlighted the association between HFI and depression symptoms during pregnancy. Findings from this study suggest the importance of assessing HFI and mental health during pregnancy.

Psychosocial Factors Associated With Perinatal Anxiety and Perinatal Depression Among Adolescents: A Rapid Review

The current review examined the influence of psychosocial factors on adolescents' perinatal anxiety (PA) and perinatal depression (PND) across geographical regions. Three databases were searched for articles published between 2017 and 2022 and 15 articles were reviewed. We categorized factors into social, cultural, and environmental domains. Social factors included adolescent caregiver trust/attachment, social support, perceived social support, trauma/poly-traumatization, and peer solidarity. Cultural factors included feelings of shame, marital satisfaction, partner's rejection of pregnancy, lack of parental involvement in care, parenting stress, childhood household dysfunction, and adverse childhood events. Environmental factors included neighborhood support, food insecurity, domestic violence, going to church, going out with friends, and sources for obtaining information. Routine assessment of psychosocial factors among perinatal teens is crucial to identify those at higher risk for PA and PND. Further research is necessary to examine the influence of cultural and environmental factors on PA, PND, and perinatal outcomes among adolescents. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 13-22.].

Depressive symptomatology in pregnant adolescents: considerations for care

PURPOSE OF REVIEW

Adolescents who are pregnant experience higher levels of depressive symptoms than nonpregnant peers and pregnant adults. Clinicians caring for youth are often the first point of clinical contact for pregnant adolescents but report low confidence in assessing and treating reproductive health concerns. In the current review, we outline risk factors for depressive symptoms among pregnant adolescents and provide guidance on best practices in assessment and treatment of depressive symptoms in this pediatric sub-population.

RECENT FINDINGS

Depressive symptoms are persistent across pregnancy. In adolescents, they are linked to greater risk of suicidal ideation, suicidal behavior, and nonsuicidal self-injury. Risk factors for prenatal depressive symptoms among adolescents include lower levels of income, history of depression, exposure to childhood maltreatment and/or recent abuse, and/or lifetime exposure to racial/ethnic discrimination. These risk factors likely interact with each other.

SUMMARY

Clinicians should assess carefully for depressive symptoms in all pregnant adolescents using a standardized, validated measure supplemented by thoughtful clinical interviewing. Clinicians can educate adolescents on the distinction between symptoms of pregnancy versus symptoms of depression. We encourage clinicians to increase their comfort in providing psychopharmacological treatment, consulting with colleagues in psychiatry, and referring adolescents for psychopharmacological treatment and therapy as needed.

Suicidal Risk and Depression in Pregnant Women in Times of Pandemic

PURPOSE

Pregnancy is a risk period for the development of mental disorders. About 10% of pregnant women worldwide experience a mental disorder, mainly depression, and this percentage has been aggravated by the COVID-19 pandemic. This study aims to understand the impact of COVID-19 on the mental health of pregnant women.

METHODS

Three hundred and one pregnant women in the week 21.85 ± 9.9 were recruited through social media and pregnant women forums from September 2020 to December 2020. A multiple-choice questionnaire was administered to evaluate the sociodemographic characteristics of the women, the care provided, and different aspects related to COVID-19. A Beck Depression Inventory was also delivered.

RESULTS

Of the pregnant women 23.5% had seen or had considered seeing a mental health professional during pregnancy. Predictive models using multivariate logistic regression found that this fact was associated with an increased risk of depression (OR = 4.22; CI 95% 2.39-7.52; P < 0.001). Among women with moderate-severe depression, it was associated with an increased risk of having suicidal thoughts (OR = 4.99; CI 95% 1.11-27.9; P = 0.044) and age was found to be a protective variable (OR = 0.86; CI 95% 0.72-0.98; P = 0.053).

CONCLUSIONS

The COVID-19 pandemic represents a major mental health challenge for pregnant women. Despite the decrease in face-to-face visits, there are opportunities for health professionals to identify the existence of psycho-pathological alterations and suicidal ideation by asking the patient if she is seeing or considering seeing a mental health professional. Therefore, it is necessary to develop tools for early identification to ensure correct detection and care.

Prevalence and risk factors associated with depression in pregnant adolescents in Nairobi, Kenya

Background

Adolescent parenthood can be associated with a range of adverse outcomes for young mothers such as depression, substance abuse, and posttraumatic stress disorder. Identification of depression and understanding risk factors among pregnant adolescents is important for development of appropriate interventions and programs focused on adolescent mental health. This paper reports on the findings of the prevalence of depression and its associated risk factors among pregnant adolescents in Nairobi, Kenya.

Methods

We recruited 153 pregnant adolescent (14-18 years) who were accessing maternal health services in one of two Nairobi County primary health care facilities in the cross-sectional survey conducted in 2021. The Patient Health Questionnaire 9 was used to screen for depression. Multivariate Stepwise linear regression modelling was used to identify key predictors of depression.

Results

Using a cut off of 10 and above on PHQ-9, we found that 43.1% of the respondents were depressed. Depressive symptoms in were independently associated with being in school, experience of intimate partner violence, substance use within the family and having experienced pressure to use substances by family or peers.

Limitations

Cross-sectional by design and the applications of our findings are limited to settings that are similar to our study population. The PHQ-9 used has not been psychometrically validated locally in this sample.

Conclusion

We found a high prevalence of depressive symptoms among respondents. These risk factors identified merit further investigation. Comprehensive mental health screening needs to be integrated in primary and community health services on the possible presence of depression.

Adolescent perinatal mental health in South Asia and Sub-Saharan Africa: A systematic review of qualitative and quantitative evidence

Despite the contribution of mental ill-health to perinatal morbidity and mortality, the experiences of adolescent girls and young women (AGYW) in low- and middle-income countries remain overlooked. This review explores potential intersecting vulnerabilities for perinatal mental health to identify the prevalence, risk factors, interventions, and implications for health services and future research. We searched mixed-methods English-language studies in four databases (MEDLINE, PsycInfo, Global Health, Embase) published between January 1, 2000 and April 30, 2022 reporting age-disaggregated data on the prevalence, risk factors, and interventions for AGYW's mental health during pregnancy through one year postpartum (quantitative) and/or the mental health experiences of AGYW in the perinatal period (qualitative). Our search yielded 3205 results, of which 48 met the inclusion criteria. Both regions observe a paucity of robust evidence and intervention evaluations, particularly South Asia. While meta-analysis was infeasible due to study heterogeneity, quantitative studies do identify individual-level risk factors for perinatal depression. Qualitative studies emphasise stigma's impact, among other societal-level social risk factors, on diverse perinatal mental health outcomes of importance to AGYW themselves. Rigorous evaluations of interventions are lacking bar two protocols with forthcoming results. Evidence gaps persist concerning prevalence of outcomes beyond depression and implications of AGYW's perinatal experiences including pregnancy/perinatal loss and obstetric and postpartum complications. High-quality research, including comparable prevalence and multi-method evidence identifying risk and protective factors and promising interventions is urgently needed to improve adolescent wellbeing in the perinatal period. A key strength of this review is our assessment of available evidence for both regions. In doing so, we address a critical blind spot of prior reviews that focused either on adult perinatal mental health in low- and middle-income countries, or on AGYW perinatal mental health in high-income settings but neglected the intersection of these potential vulnerabilities for these high-burden, low-resource contexts.