Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation model
Abstract Background Various forms of life stressors have been implicated as causes of antenatal depression. However, there is a lack of understanding of which forms of stress lead to antenatal depression and through what mechanisms. Modeling stress processes within a theoretical model framework can...
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doaj-63254a56f6a44329934ec1d5504f9c9c2020-11-25T02:50:25ZengBMCBMC Pregnancy and Childbirth1471-23932020-03-0120111510.1186/s12884-020-02859-2Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation modelAbel Fekadu Dadi0Emma R. Miller1Richard Woodman2Telake Azale Bisetegn3Lillian Mwanri4Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarCollege of Medicine and Public health, Discipline of Public health, Flinders UniversityCollege of Medicine and Public health, Center for Epidemiology and BiostatisticsDepartment of Health promotion and Behavioral sciences, Institute of Public Health, College of Medicine and Health Sciences, University of GondarCollege of Medicine and Public health, Discipline of Public health, Flinders UniversityAbstract Background Various forms of life stressors have been implicated as causes of antenatal depression. However, there is a lack of understanding of which forms of stress lead to antenatal depression and through what mechanisms. Modeling stress processes within a theoretical model framework can enhance an understanding of the mechanisms underlying relationships between stressors and stress outcomes. This study used the stress process model framework to explore the causal mechanisms underlying antenatal depression in Gondar, Ethiopia. Methods Questionnaires, using an Online Data collection Kit (ODK) tool were administered face-to-face in 916 pregnant women in their second and third trimesters. Pregnant women were included from six randomly selected urban districts in Gondar, Ethiopia during June and August 2018. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depression. A Structural Equation Model (SEM) was employed to explore the direct, indirect, and total effect of stressors and mediators of antenatal depression. Result Sixty-three participants (6.9%) reported symptoms of depression. Of these, 16 (4.7%) and 47 (8.1%) were in their second and third trimesters, respectively. The SEM demonstrated several direct effects on antenatal depression scores including unplanned pregnancy (standardized β = 0.15), having a history of common mental health disorder (standardized β = 0.18) and fear of giving birth to the current pregnancy (standardized β = 0.29), all of which were associated with a higher depression score. Adequate food access for the last 3 months (standardized β = − 0.11) was associated with decreased depression score. Social support (β = − 0.21), marital agreement (β = − 0.28), and partner support (β = −.18) appeared to partially mediate the link between the identified stressors and the risk of antenatal depression. Conclusion Both direct and indirect effects contributed to higher antenatal depression score in Ethiopian women. The three psychosocial resources namely marital agreement, social and partner support, mediated reduced antenatal depression scores. Early screening of antenatal depression and enhancing the three psychosocial resources would help to improve maternal resilience.http://link.springer.com/article/10.1186/s12884-020-02859-2Antenatal depressionPregnant mothersStructural equation modelingStressor |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Abel Fekadu Dadi Emma R. Miller Richard Woodman Telake Azale Bisetegn Lillian Mwanri |
spellingShingle |
Abel Fekadu Dadi Emma R. Miller Richard Woodman Telake Azale Bisetegn Lillian Mwanri Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation model BMC Pregnancy and Childbirth Antenatal depression Pregnant mothers Structural equation modeling Stressor |
author_facet |
Abel Fekadu Dadi Emma R. Miller Richard Woodman Telake Azale Bisetegn Lillian Mwanri |
author_sort |
Abel Fekadu Dadi |
title |
Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation model |
title_short |
Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation model |
title_full |
Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation model |
title_fullStr |
Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation model |
title_full_unstemmed |
Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation model |
title_sort |
antenatal depression and its potential causal mechanisms among pregnant mothers in gondar town: application of structural equation model |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2020-03-01 |
description |
Abstract Background Various forms of life stressors have been implicated as causes of antenatal depression. However, there is a lack of understanding of which forms of stress lead to antenatal depression and through what mechanisms. Modeling stress processes within a theoretical model framework can enhance an understanding of the mechanisms underlying relationships between stressors and stress outcomes. This study used the stress process model framework to explore the causal mechanisms underlying antenatal depression in Gondar, Ethiopia. Methods Questionnaires, using an Online Data collection Kit (ODK) tool were administered face-to-face in 916 pregnant women in their second and third trimesters. Pregnant women were included from six randomly selected urban districts in Gondar, Ethiopia during June and August 2018. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depression. A Structural Equation Model (SEM) was employed to explore the direct, indirect, and total effect of stressors and mediators of antenatal depression. Result Sixty-three participants (6.9%) reported symptoms of depression. Of these, 16 (4.7%) and 47 (8.1%) were in their second and third trimesters, respectively. The SEM demonstrated several direct effects on antenatal depression scores including unplanned pregnancy (standardized β = 0.15), having a history of common mental health disorder (standardized β = 0.18) and fear of giving birth to the current pregnancy (standardized β = 0.29), all of which were associated with a higher depression score. Adequate food access for the last 3 months (standardized β = − 0.11) was associated with decreased depression score. Social support (β = − 0.21), marital agreement (β = − 0.28), and partner support (β = −.18) appeared to partially mediate the link between the identified stressors and the risk of antenatal depression. Conclusion Both direct and indirect effects contributed to higher antenatal depression score in Ethiopian women. The three psychosocial resources namely marital agreement, social and partner support, mediated reduced antenatal depression scores. Early screening of antenatal depression and enhancing the three psychosocial resources would help to improve maternal resilience. |
topic |
Antenatal depression Pregnant mothers Structural equation modeling Stressor |
url |
http://link.springer.com/article/10.1186/s12884-020-02859-2 |
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