Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women
Abstract Background Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20–25% of pregnant and postpartum women in low- and middle-income countries. The wide accessibility of mobile phones allows mobile h...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-09-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-05039-6 |
| _version_ | 1811208705160511488 |
|---|---|
| author | Alyssa D. Hummel Keshet Ronen Amritha Bhat Brenda Wandika Esther M. Choo Lusi Osborn Maneesh Batra John Kinuthia Manasi Kumar Jennifer A. Unger |
| author_facet | Alyssa D. Hummel Keshet Ronen Amritha Bhat Brenda Wandika Esther M. Choo Lusi Osborn Maneesh Batra John Kinuthia Manasi Kumar Jennifer A. Unger |
| author_sort | Alyssa D. Hummel |
| collection | DOAJ |
| description | Abstract Background Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20–25% of pregnant and postpartum women in low- and middle-income countries. The wide accessibility of mobile phones allows mobile health (mHealth) interventions to be considered a solution to identify perinatal depression and provide appropriate referrals for treatment. This study, nested in a larger SMS communication project, examined the prevalence and correlates of perinatal depression, determined the association between antenatal depression and infant morbidity and mortality, and compared SMS communication patterns between women with and without perinatal depression. Methods This was a prospective longitudinal cohort study of pregnant women seeking antenatal services at two public sector health clinics in Kenya. SMS messages were sent to participants with educational content related to their pregnancy and infant health and two-way SMS communication occurred with a nurse. Sociodemographic and obstetric characteristics, SMS messaging behaviors, infant health status, and depressive symptoms were assessed by a standardized questionnaire administered at enrollment (30–36 weeks gestation) and follow-up (14 weeks postpartum). Generalized estimating equation (GEE) with Poisson link was used to evaluate correlates of perinatal depressive symptoms, infant outcomes, and frequency of SMS messaging. Results Of the 572 women with complete follow-up information, 188 (32.9%) screened positive for elevated depressive symptoms (≥10 by EPDS scale) at some time point during pregnancy or postpartum. The strongest predictors of any depressive symptoms included interpersonal abuse during pregnancy, fewer years of schooling, and maternal unemployment. Antenatal depressive symptoms were associated with an increased risk of infant illness or hospitalization (RR = 1.12, 95% CI: 1.11, 1.13). Women with antenatal or persistent perinatal depressive symptoms sent fewer SMS messages during the study period than their counterparts without depression. Conclusions Prevalence of elevated perinatal depressive symptoms was high in this cohort of Kenyan women. Our findings highlight the importance of screening perinatal women for experiences of symptoms of depression as well as abuse. Differences in messaging frequency between women with vs. without depressive symptoms presents an opportunity to provide more tailored support for those perinatal depression. |
| first_indexed | 2024-04-12T04:26:06Z |
| format | Article |
| id | doaj.art-d34151a4c19742868359ed6440655677 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-12T04:26:06Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-d34151a4c19742868359ed64406556772022-12-22T03:48:04ZengBMCBMC Pregnancy and Childbirth1471-23932022-09-0122111610.1186/s12884-022-05039-6Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan womenAlyssa D. Hummel0Keshet Ronen1Amritha Bhat2Brenda Wandika3Esther M. Choo4Lusi Osborn5Maneesh Batra6John Kinuthia7Manasi Kumar8Jennifer A. Unger9University of WashingtonUniversity of WashingtonUniversity of WashingtonKenyatta National HospitalUniversity of WashingtonKenyatta National HospitalUniversity of WashingtonKenyatta National HospitalUniversity of NairobiDepartment of Obstetrics and Gynecology, Warren Alpert Medical School Brown University, Women and Infants HospitalAbstract Background Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20–25% of pregnant and postpartum women in low- and middle-income countries. The wide accessibility of mobile phones allows mobile health (mHealth) interventions to be considered a solution to identify perinatal depression and provide appropriate referrals for treatment. This study, nested in a larger SMS communication project, examined the prevalence and correlates of perinatal depression, determined the association between antenatal depression and infant morbidity and mortality, and compared SMS communication patterns between women with and without perinatal depression. Methods This was a prospective longitudinal cohort study of pregnant women seeking antenatal services at two public sector health clinics in Kenya. SMS messages were sent to participants with educational content related to their pregnancy and infant health and two-way SMS communication occurred with a nurse. Sociodemographic and obstetric characteristics, SMS messaging behaviors, infant health status, and depressive symptoms were assessed by a standardized questionnaire administered at enrollment (30–36 weeks gestation) and follow-up (14 weeks postpartum). Generalized estimating equation (GEE) with Poisson link was used to evaluate correlates of perinatal depressive symptoms, infant outcomes, and frequency of SMS messaging. Results Of the 572 women with complete follow-up information, 188 (32.9%) screened positive for elevated depressive symptoms (≥10 by EPDS scale) at some time point during pregnancy or postpartum. The strongest predictors of any depressive symptoms included interpersonal abuse during pregnancy, fewer years of schooling, and maternal unemployment. Antenatal depressive symptoms were associated with an increased risk of infant illness or hospitalization (RR = 1.12, 95% CI: 1.11, 1.13). Women with antenatal or persistent perinatal depressive symptoms sent fewer SMS messages during the study period than their counterparts without depression. Conclusions Prevalence of elevated perinatal depressive symptoms was high in this cohort of Kenyan women. Our findings highlight the importance of screening perinatal women for experiences of symptoms of depression as well as abuse. Differences in messaging frequency between women with vs. without depressive symptoms presents an opportunity to provide more tailored support for those perinatal depression.https://doi.org/10.1186/s12884-022-05039-6Perinatal depressionmHealth interventionSMS messagingKenya |
| spellingShingle | Alyssa D. Hummel Keshet Ronen Amritha Bhat Brenda Wandika Esther M. Choo Lusi Osborn Maneesh Batra John Kinuthia Manasi Kumar Jennifer A. Unger Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women BMC Pregnancy and Childbirth Perinatal depression mHealth intervention SMS messaging Kenya |
| title | Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women |
| title_full | Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women |
| title_fullStr | Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women |
| title_full_unstemmed | Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women |
| title_short | Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women |
| title_sort | perinatal depression and its impact on infant outcomes and maternal nurse sms communication in a cohort of kenyan women |
| topic | Perinatal depression mHealth intervention SMS messaging Kenya |
| url | https://doi.org/10.1186/s12884-022-05039-6 |
| work_keys_str_mv | AT alyssadhummel perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen AT keshetronen perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen AT amrithabhat perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen AT brendawandika perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen AT esthermchoo perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen AT lusiosborn perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen AT maneeshbatra perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen AT johnkinuthia perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen AT manasikumar perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen AT jenniferaunger perinataldepressionanditsimpactoninfantoutcomesandmaternalnursesmscommunicationinacohortofkenyanwomen |