PREVALENCE AND CORRELATES OF PERINATAL DEPRESSION AMONG ADOLESCENTS AND YOUNG ADULTS IN WESTERN AREA, SIERRA LEONE

Abstract

Background: Perinatal depression includes depressive episodes that occur during pregnancy, around child birth or within the first year of the postpartum period. Studies have established that the prevalence of perinatal depression among adolescents and young adults is relatively high, with rates ranging from 16% to 44%, depending on the characteristics of the sample, the type of instrument used to assess depressive symptoms, and other bio psychosocial reasons. A number of studies have proven that adolescents and young adults who are mothers are at a higher risk of developing depression and depressive symptoms when compared to older adult mothers and non-pregnant/parenting adolescents. Pregnancy in adolescents and young adult is associated with serious mental health consequences. Unfortunately, like in many other sub-Saharan countries, mental healthcare services in Sierra Leone are poorly developed, and the situation is much worse for child and adolescent mental healthcare. Methodology: This was a cross sectional study. Therefore the objective of the study was to examine the prevalence and correlates of perinatal depression among adolescents and young adults in Freetown, Sierra Leone. A sample of 288 pregnant adolescents and young adults aged 14-21 years old were recruited into the study from three maternity centres: Princess Christian Maternity Hospital and Aberdeen Women Centre in the Western Area urban and Waterloo Community Health Centre in the Western Area rural. The Edinburgh Postnatal Depression Scale was used to measure depression with a cut off score of equal or greater than 12. The Global School Health Questionnaire was adapted to assess socio-demographic characteristics, and the Multidimensional Scale of Perceived Social Support was used to assess respondents’ level of social support received. Participatory Ranking Methodology (PRM) was used to determine the stressful life events pregnant adolescents and young adults encounter. The Statistical Package for the Social Sciences(SPSS) version 20 was used to analyze the data. The Chi-square was used to test the association between perinatal depression and correlates, and multiple logistic regressions was used to identify independent factors associated with perinatal depression. The level of significance for all tests was at 5% (p<0.05). Stressful life events were analyzed using PRM, and this included the following three steps: Piling of responses Calculation of average ranking Account of each responses mentioned by participants Results: The overall mean age of the participants was 18.6±1.7 years. Higher proportions (44.4%) of the respondents were aged between 18-19 years, whilst the least proportion (23.3%) of the respondents was within the age range of 14-17 years. Islam was the predominant religion identified (79.9%), and two-thirds (66.7%) of the respondents had secondary school education, while 17.4% had no formal education. The prevalence of perinatal depression among pregnant adolescents and young adults was 29.5%. Socio-demographic correlates such as family type, person respondent lived with and marital status were identified as significant correlates of perinatal depression (p<0.001). There was a statistically significant association between perinatal depression and respondents perceived social support (p<0.001). Amongst the stressful life events mentioned by participants who were depressed, "Being out of school and Lack of support from partner (father)" were ranked the highest of all the stressful events. Conclusions: This study revealed a high prevalence of perinatal depression among young persons aged 14-21 years in Freetown, Sierra Leone. There was a significant relationship between perinataldepression, low perceived social support, and stressful life events among the study participants. Efforts should be made to establish support groups for pregnant adolescents and young adults, as well as schemes that ensure that these women are able to return to school or are engaged in some form of skills acquisition after delivery. Services providing mental health care should be incorporated in primary health care centres especially in the routine ANC services in Sierra Leone