Pregnant women’s attitudes, awareness and knowledge about perinatal depression

Abstract

Background: Perinatal depression (PD) is an important public health problem that is associated with high maternal morbidity and mortality, and negative long-term consequences for children and families. Globally, around 12% of women are affected, either during pregnancy or in the first year after childbirth. In Malta, the condition is also common with point prevalence rates of around 15% and 9% for antenatal and postnatal depression respectively. Research on PD and more specifically on attitudes, awareness and knowledge about PD is scarce, especially within the local context. Literature suggeststhat these three variables may be influenced by various socio-demographic and clinical variables, ultimately impacting on women’s help-seeking intentions. This study follows the recently launched Maltese Mental Health Strategy which also hints at the local perinatal mental health scenario. It aims to explore the attitudes, awareness and knowledge of PD among pregnant Maltese women seeking routine antenatal care at Mater Dei Hospital. Methodology: A cross-sectional paper-based quantitative survey was conducted between April and July 2019. The study utilised an already established research tool, the Perinatal Depression Monitor, which was adapted to the local population and then subjected to psychometric testing. A convenience sample of 404 pregnant women were recruited for the study with the booking midwives acting as intermediaries in the distribution of the questionnaire. The data collected was analysed using statistical software. Descriptive data was generated and univariate and multivariate regression analyses were conducted. Results: The study participants generally held positive attitudes towards PD and screening measures that identify this condition. A multivariate linear regression model indicated that the main predictors of such attitudes were parity (p-value: 0.006), gestational age (p-value: 0.017), level of education (p-value:<0.001), and marital status (p-value: 0.018). Awareness of PD among the sample appeared high. 79.8% of participants were able to recognise the term PD, yet there seemed to be a marked difference in the unprompted awareness of antenatal and postnatal depression. Conversely, prompted awareness of PD was high, although some groups of participants presented higher awareness of postnatal PD than others. Despite being aware, most participants were unable to correctly define PD or estimate its prevalence rate, suggesting some important gaps in the participants’ level of knowledge. Non-pharmacological treatment options were the most frequently cited treatment option, with most participants claiming they would choose help from a doctor, especially those who had training in health (p-value: 0.021) or mental health (p-value: 0.0017). However, if personally affected by the condition, the majority claimed they would resort for help from family and friends, except for those with lower levels of education (p-value: 0.005) and those not gainfully employed (p-value: 0.007) who claimed they would seek no help at all. Conclusion: Notwithstanding its limitations, this research provides an important snapshot of Maltese pregnant women’s attitudes, awareness and knowledge about PD. The study findings are particularly valuable to policy makers in the development of targeted education and awareness campaigns, in the drawing up of pathways for community and mental health practices, and in future maternal health services planning.