In multivariable logistic regression analysis, the significant independent predictors of APD included:
- Maternal age 30–49 years (Adjusted OR: 3.2, 95% CI: 1.5–6.8, p=0.003)
- Bad health status before pregnancy (Adjusted OR: 4.1, 95% CI: 1.9–8.6, p<0.001)
- Not being happy about being pregnant (Adjusted OR: 5.3, 95% CI: 2.6–10.9, p<0.001)
- Having had complications during pregnancy (Adjusted OR: 2.8, 95% CI: 1.3–5.9, p=0.008)
- History of stressful life events during pregnancy (Adjusted OR: 6.7, 95% CI: 3.2–14.1, p<0.001)
These findings suggest that psychosocial and medical factors play a significant role in the development of APD among pregnant women in latent labor.
Conclusion and Implications
This study highlights that 8.2% of pregnant women in latent labor in rural southwestern Uganda experience antepartum depression, which is relatively lower than previous estimates in Uganda (19–27%). However, the factors contributing to APD remain critical concerns that require improved antenatal care with mental health integration. Given that stressful life events and lack of emotional preparedness for pregnancy are strong predictors, non-pharmacological interventions, such as counseling, social support programs, and routine mental health screening, should be integrated into antenatal care to improve maternal and neonatal outcomes.
Recommendations
- Routine Screening for APD: Implement mental health assessments in antenatal clinics using validated tools like the M.I.N.I 7.0.2.
- Psychosocial Support Programs: Establish peer support groups, counseling services, and family involvement to help women cope with pregnancy-related stress.
- Health Education on Mental Health: Provide information about APD symptoms, risk factors, and coping strategies during antenatal visits.
- Integration of Mental Health into Maternal Care: Train healthcare providers in early identification and management of APD using non-pharmacological approaches.
- Further Research: Conduct longitudinal studies to assess the impact of APD on postpartum depression and infant outcomes.
This study underscores the urgent need for comprehensive maternal mental health interventions in Uganda and similar low-resource settings to improve both maternal well-being and neonatal health.
