A comparative study of postpartum anxiety and depression in mothers with pre-term births in Kenya

Introduction: Comorbid anxiety and depression and its precursors such as stress associated with neonatal care in hospital, survival of the baby, social support and maternal family dynamics are understudied in sub-Saharan Africa. We studied comorbid postpartum anxiety and depression among mothers of preterm infants receiving intensive care in newborn unit at Kenyatta National Hospital, and mothers of full-term healthy infants attending a health center in Nairobi. Method: A comparative cross-sectional study design was used to recruit 172 mother-infant dyads; 86 full-term mothers and 86 with pre-term deliveries. Self-reported socio-demographic questionnaire, Edinburgh Postnatal Depression Scale, Kessler's 10 and Patient Health Questionnaire-4 were used to screen for levels of depression, psychological distress and anxiety. Multivariate logistic regression was used to assess the independent predictors of comorbid depression and anxiety. Results: From 35.1% who screened positive for anxiety 75% (n = 45) were mothers with pre-term babies and of 43 (25%) who screened positive for comorbid depression and anxiety, 83.7% (n = 36) were mothers with pre-term babies. We found that the risk of comorbid depression and anxiety were 6 times more among the mothers with pre-term birth as compared to full term births (p = 0.002), 4.76 times more (p = 0.043) among mothers who reported IPV and 5.95 more (p < 0.001) times among mothers who reported psychological distress. Conclusion: We found higher proportions of depression, anxiety, and general distress in mothers who delivered pre-term. Risk factors like IPV and poor mental health should be addressed in postpartum mothers regardless of full term or preterm births status, as a fundamental right.