Abstract
BACKGROUND: Few studies have examined the point prevalence and incidence of perinatal mental disorders among the general population of pregnant women and no prior studies have investigated these in adolescent mothers. This study aimed to fill this gap by estimating the point prevalence and incidence of depressive and generalized anxiety symptoms, and their associated factors from pregnancy to 3 months post-delivery. METHODS: A longitudinal study was conducted among 533 adolescent pregnant women in their second trimester. A convenience sampling strategy was used to recruit participants from preselected antenatal clinics in Mwanza, Tanzania from 5th August 2023 to 30th June 2024. We used the Edinburgh Postnatal Depression Scale (EPDS) to assess depressive symptoms and the Generalized Anxiety Disorder - 7 (GAD-7) scale to screen for generalized anxiety symptoms. The Screening was done in the second trimester of pregnancy (T1), the third trimester (T2), four weeks postpartum (T3) and three months post-delivery (T4). RESULTS: The point prevalence of both depressive and generalized anxiety symptoms decreased from the second trimester of pregnancy (T1) to 3 months post-delivery (T4). The point prevalence of depressive symptoms fell from 20.64% (95% CI, 0.17-0.24) at T1 to 9.90% (95% CI, 0.07-0.12) at T4, while the point prevalence of generalized anxiety symptoms fell from 22.33% (95% CI, 0.19-0.26) at T1 to 10.48% (95% CI, 0.08-0.13) at T4. In contrast, the incidence of both depressive and anxiety symptoms increased from recruitment (T1) through to 3 months post-delivery. Specifically, the incidence of depressive symptoms rose from 9.00% (95% CI, 0.07-0.12) at T2 to 11.89% (95% CI, 0.07-0.12) at T4, while the incidence of generalized anxiety symptoms rose from 7.20% (95% CI, 0.05-0.10) at T2 to 10.81% (95% CI, 0.06-0.11) at T4. At all-time points, being classified as displaying depressive symptoms was highly associated with being classified as displaying symptoms of anxiety. CONCLUSIONS: There was an increase in incidence in depressive and anxiety symptoms in adolescent women from the second trimester of pregnancy to three months post-delivery, but a decrease in point prevalence. These findings support the importance of integrating mental health services into existing antenatal and postnatal care services for adolescent women.