Socio-ecological factors associated with probable depression among pregnant and parenting adolescent girls: findings from a cross-sectional study in Burkina Faso and Malawi.

Publisher: BioMed Central Country of Publication: England NLM ID: 101224380 Publication Model: Electronic Cited Medium: Internet ISSN: 1742-4755 (Electronic) Linking ISSN: 17424755 NLM ISO Abbreviation: Reprod Health Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2004-

Parenting* ; Depression*/epidemiology ; Depression*/etiology; Pregnancy ; Adolescent ; Female ; Humans ; Burkina Faso/epidemiology ; Malawi/epidemiology ; Cross-Sectional Studies

Background: Pregnant and parenting adolescent girls are at risk of poor mental health because of stigma and social exclusion. Despite one in four girls starting childbearing by the age of 19 in Africa, no study, to the best of our knowledge, has examined the multi-layered factors (individual, family, friends, and neighborhood-related factors) associated with depressive symptoms among pregnant and parenting girls in Africa. Our study contributes to addressing this gap by examining the socio-ecological factors associated with depression symptoms among pregnant and parenting adolescent girls.
Methods: Our study adopted a cross-sectional design. Between March and September 2021, we interviewed 980 pregnant and parenting adolescent girls in Ouagadougou, Burkina Faso, and 669 in Blantyre, Malawi. We recruited pregnant and parenting adolescent girls in randomly selected urban and rural enumeration areas in Burkina Faso (n = 71) and Malawi (n = 66). We assessed depressive symptoms using the Patient Health Questionnaire (PHQ-9), which generated an overall score of 27. We considered a score of 10 or more as probable depression. We also obtained information on individual, family, friends, and neighborhood characteristics. We employed logistic regression models to examine the significant factors associated with probable depression among pregnant and parenting adolescent girls.
Results: The prevalence of probable depression was 18.8% and 14.5% in Burkina Faso and Malawi, respectively. At the individual level, having secondary education was significantly associated with a lower likelihood of probable depression in Malawi (AOR: 0.47; 95% CI 0.27-0.82) but not in Burkina Faso. At the family level, denying paternity (AOR: 3.14; 95% CI 1.34-7.11 in Malawi) and no parental support (AOR: 2.08; 95% CI 1.22-3.55 in Burkina Faso) were associated with higher odds of probable depression. At the community level, perceived neighborhood safety was associated with a lower likelihood of probable depression in Malawi (AOR: 0.74; 95% CI 0.61-0.89) and Burkina Faso (AOR: 0.81; 95% CI 0.73-0.90). Having a safety net within the community was associated with lower odds of probable depression in Burkina Faso (AOR: 0.87; 95% CI 0.78-0.96) but not in Malawi.
Conclusion: Depressive symptoms are common among pregnant and parenting adolescents, suggesting the need to screen them regularly for depression during antenatal and postnatal visits. Factors associated with depression among pregnant and parenting girls operate at multiple levels suggesting a need for multilevel interventions that address all areas of vulnerabilities.
(© 2023. The Author(s).)

Lancet Child Adolesc Health. 2022 Aug;6(8):582-592. (PMID: 35750063)
J Affect Disord. 2021 Jan 15;279:473-483. (PMID: 33126078)
Ann Gen Psychiatry. 2018 Dec 20;17:53. (PMID: 30598688)
Soc Ment Health. 2015 Jul;5(2):145-161. (PMID: 27840772)
Depress Res Treat. 2020 Jan 21;2020:5364521. (PMID: 32411457)
Soc Sci Med. 2020 Feb;246:112740. (PMID: 31864176)
Issues Ment Health Nurs. 2017 Aug;38(8):633-642. (PMID: 28650677)
Stud Fam Plann. 2021 Dec;52(4):557-570. (PMID: 34766351)
AIDS Behav. 2021 Jul;25(7):2094-2107. (PMID: 33452658)
MCN Am J Matern Child Nurs. 2016 Jan-Feb;41(1):31-6; quiz E3-4. (PMID: 26474475)
Matern Child Health J. 2015 Oct;19(10):2187-94. (PMID: 25691461)
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211053750. (PMID: 34905994)
J Psychosom Obstet Gynaecol. 2021 Dec;42(4):356-360. (PMID: 32131669)
Nat Hum Behav. 2019 Apr;3(4):346-353. (PMID: 30971786)
BMJ. 2019 Apr 9;365:l1476. (PMID: 30967483)
World Psychiatry. 2007 Oct;6(3):168-76. (PMID: 18188442)
Asian J Psychiatr. 2018 Feb;32:147-150. (PMID: 29274541)
Drug Alcohol Depend. 2014 Nov 1;144:102-10. (PMID: 25236890)
PLoS One. 2019 Aug 16;14(8):e0221053. (PMID: 31419238)
J Adolesc Health. 2021 Jul;69(1S):S5-S15. (PMID: 34217460)
J Affect Disord. 2006 Nov;96(1-2):89-93. (PMID: 16857265)
J Interpers Violence. 2021 May;36(9-10):NP5060-NP5083. (PMID: 30160637)
Glob Soc Welf. 2018 Mar;5(1):11-27. (PMID: 29744286)
Arch Pediatr Adolesc Med. 2002 Dec;156(12):1216-22. (PMID: 12444833)
CMAJ. 2012 Feb 21;184(3):E191-6. (PMID: 22184363)
Pediatrics. 2014 Jan;133(1):114-22. (PMID: 24298010)
SSM Popul Health. 2019 Jan 28;7:100368. (PMID: 30766911)
AIDS Care. 2019 Jan;31(1):95-104. (PMID: 30241443)
J Interpers Violence. 2021 Nov;36(21-22):NP12016-NP12040. (PMID: 31789083)
Nervenarzt. 2019 Mar;90(3):243-250. (PMID: 30643954)
Glob Ment Health (Camb). 2018 Nov 19;5:e38. (PMID: 30637111)
J Psychosom Obstet Gynaecol. 2018 Sep;39(3):168-175. (PMID: 28574297)
Glob Public Health. 2022 Aug-Sep;17(9):2125-2138. (PMID: 34569422)
Glob Public Health. 2020 Jun;15(6):865-876. (PMID: 31994453)
Sex Reprod Health Matters. 2019 Dec;27(1):1571304. (PMID: 31533558)
J Interpers Violence. 2022 Aug;37(15-16):NP13560-NP13580. (PMID: 33832374)
Can J Psychiatry. 2019 Apr;64(4):285-293. (PMID: 30978142)
J Community Psychol. 2019 Jun;47(5):1000-1013. (PMID: 30999386)
AIDS Care. 2019 Jan;31(1):117-124. (PMID: 30304947)
J Child Adolesc Ment Health. 2017 May;29(1):11-26. (PMID: 28287023)
Psychiatry J. 2018 Oct 15;2018:6865085. (PMID: 30410921)
Lancet. 2011 Jun 18;377(9783):2093-102. (PMID: 21652063)
SSM Popul Health. 2020 Nov 04;12:100689. (PMID: 33204810)
BMC Psychiatry. 2018 May 18;18(1):136. (PMID: 29776353)
BMC Womens Health. 2018 Jun 15;18(1):96. (PMID: 29902989)
Afr J Prim Health Care Fam Med. 2020 May 28;12(1):e1-e9. (PMID: 32501029)
Soc Sci Med. 2008 Mar;66(6):1334-45. (PMID: 18234406)
Dtsch Arztebl Int. 2017 Feb 24;114(8):121-127. (PMID: 28302261)
Reprod Health. 2020 May 14;17(1):65. (PMID: 32410710)
Am J Orthopsychiatry. 2016 Jan;86(1):61-8. (PMID: 26460697)

12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; 12103 Styrelsen för Internationellt Utvecklingssamarbete; No. 109813 - 001 International Development Research Centre

Keywords: Adolescent mothers; Depression; Mental health; Pregnant and parenting adolescents; Socio-ecological model

Date Created: 20230307 Date Completed: 20230309 Latest Revision: 20230310

20240104

PMC9990966

10.1186/s12978-023-01588-x

36882850