Antenatal depressive symptoms among pregnant women: Evidence from a Southern Brazilian population-based cohort study

Background: Surveillance of antenatal depression in low and middle-income countries (LMIC) is still limited. Identification of women at high risk of antenatal depression is urgently needed to plan appropriate interventions. The aim of the present study was to identify predictors and correlates of antenatal depression among Brazilian women. Methods: All women living in the urban area of the city of Pelotas, Southern Brazil, with confirmed pregnancy and estimated delivery date between 1 January and 31 December 2015, were invited to take part in the study. Eligible pregnant women were recruited from health services. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) by face-to-face interviews. A cutoff-point of 13 or more defined antenatal depression. Outcomes: Information on antenatal depression was available for 4130 women. Mean and median EPDS scores were 7.6 (SD 5) and 7, respectively. The prevalence of antenatal depression was 16% (95%CI 14.9-17.1). After adjustment for potential confounders, low maternal education, older age, non-white skin color, not living with a partner, unplanned pregnancy, alcohol consumption during pregnancy, higher number of children and a history of depression were found to be associated with antenatal depression. Interpretation: Antenatal depression prevalence is higher among Brazilian women than women from high-income countries but similar to other LMIC populations. Our study identifies relevant predictors and correlates that may be considered potential targets to plan intervention strategies for disease management in the context of a middle-income country