Probable perinatal depression and social support among women enrolled in Malawi's Option B+ Program: A longitudinal analysis
Malawi's PMTCT Option B+ program has expanded the reach of ART services among pregnant and breastfeeding women, but retention in lifelong HIV care remains challenging. Given that depression can undermine retention, it is important to understand how depression changes over the perinatal period,...
Saved in:
Published in | Journal of affective disorders Vol. 306; pp. 200 - 207 |
---|---|
Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Netherlands
Elsevier B.V
01.06.2022
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Malawi's PMTCT Option B+ program has expanded the reach of ART services among pregnant and breastfeeding women, but retention in lifelong HIV care remains challenging. Given that depression can undermine retention, it is important to understand how depression changes over the perinatal period, varies across treatment and retention groups, and could be buffered by social support.
Data are from an observational study conducted among women enrolled in Malawi's PMTCT Option B+ program. We used multilevel generalized linear models to estimate the odds of probable depression by time, treatment and retention group, and social support. Probable depression was assessed with the Edinburgh Postnatal Depression Scale and Patient Health Questionnaire-9.
Of 468 women, 15% reported probable depression at antenatal enrollment and prevalence differed across newly diagnosed individuals, second line therapy users, and previous defaulters (18%, 21%, 5%, p = 0.001). Odds of probable perinatal depression decreased over time (OR per month: 0.87, 95% CI: 0.82–0.92) but were higher among those newly diagnosed (OR: 3.25, 95% CI: 1.59–6.65) and on second line therapy (OR: 3.39, 95% CI: 1.44–7.99) as compared to previous defaulters. Odds of probable postpartum depression were lower for participants with high social support (OR: 0.19, 95% CI: 0.09–0.39).
Lack of diagnostic psychiatric evaluation precludes actual diagnosis of depression.
Probable depression varied across the perinatal period and across treatment and retention groups. Social support was protective for postpartum depression among all participants. Depression screening and provision of social support should be considered in PMTCT programs.
•Probable depression was higher in the antenatal period than the postpartum period.•Probable depression varied across treatment and retention groups.•Social support was protective for postpartum depression among all participants.•Lack of diagnostic psychiatric evaluation precluded actual diagnosis of depression.•Depression screening and social support should be considered in PMTCT programs. |
---|---|
Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 NLB and MAS led the conception, design, and writing of the paper. NLB did the analyses and interpretation for the paper. BJH, BLD, MM, ANJ, KK, MBC, MCH and the S4 Study Team were involved in the data collection and study management of the parent study. MCH acquired funding for and designed the parent study. All authors have reviewed the paper, provided comments and edits to the manuscript, and have read and approved the final manuscript. CONTRIBUTIONS |
ISSN: | 0165-0327 1573-2517 |
DOI: | 10.1016/j.jad.2022.03.017 |