Association of Antenatal Depression with Anemia and Adherence to Iron-Folic AcidSupplement among Pregnant Women Attending Antenatal Care Services at Health Centers in Yeka Sub-City, Addis Ababa, Ethiopia, 2019
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Date
2019-10
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Addis Ababa University
Abstract
Background: Depression affects a large proportion of the global population. It is reported to
affect about a quarter of pregnant women in Ethiopia. Some studies indicate that anemia might
bea risk factor for depression. This underscores the need for an iron-folic acid supplement
(IFAS). IFAS adherence by pregnant women is however not satisfactory. Studies again implicate
that depression might affect adherence to IFAS. Nevertheless, thispotential vicious cycleis not a
well-explored area of research. The objective of this study is therefore to assess the association
of antenatal depression with anemia and adherence to IFAS among pregnant women attending
antenatal care (ANC) at selected health centers.
Methods: a facility-based cross-sectional study was conducted among pregnant women who
attended ANC service in Yeka sub-city, Addis Ababa. A total of 406 pregnant women were
recruited in the study. Patient health questionnaire (PHQ-9), a validated tool in Ethiopia, was
used to assess antenatal depression. IFAS adherence was assessed using pill count method.
Bivariableand subsequent multivariable logistic regression were employed for data analysis.
Results: it was found that anemic pregnant mothers had an increased odds of having antenatal
depression [AOR=2.63; 95% CI (1.13, 6.14)] compared to non-anemic mothers. Having financial
hardship, whether current pregnancy is planned and emotional abuse from an intimate partner
also significantly associated with antenatal depression. Antenatal depression at cut-off (PHQ-
9≥5) failed to show statistically significant association with IFAS adherence. Major depression
(PHQ-9≥10) was however found to be significantly associated with adherence to IFAS
[AOR=1.97; 95% CI (1.09, 3.56)] in pregnant women. Besides, factors significantly associated
with IFAS adherence were parity, knowledge of the use of IFAS and current pregnancy
complication.
Conclusion: the study revealed a significant association that exists between two important public
health problems, anemia and antenatal depression; and the association between antenatal
depression and IFAS adherence. Further investigation of these associations is a warranted area of
future studies. In the meantime, putting these underlying determinants into consideration is
beneficial as they might complicate diagnosis and have a negative impact on treatment outcomes.
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Keywords
Antenatal Deprssion , Anemia , Iron-Folic Acid, Pregnant Women ,Antenatal Care Services , Health Centers