Depression and its psychosocial risk factors in pregnant Kenyan adolescents: A cross-sectional study in a community health Centre of Nairobi

Background: Adolescent pregnancies within urban resource-deprived settlements predispose young girls to adverse mental health and psychosocial adversities, notably depression. Depression in sub-Saharan Africa is a leading contributor to years lived with disability (YLD). The study's objective was to determine the prevalence of depression and related psychosocial risks among pregnant adolescents reporting at a maternal and child health clinic in Nairobi, Kenya. Methods: A convenient sample of 176 pregnant adolescents attending antenatal clinic in Kangemi primary healthcare health facility participated in the study. We used PHQ-9 to assess prevalence of depression. Hierarchical multivariate linear regression was performed to determine the independent predictors of depression from the psychosocial factors that were significantly associated with depression at the univariate analyses. Results: Of the 176 pregnant adolescents between ages 15-18 years sampled in the study, 32.9% (n=58) tested positive for a depression diagnosis using PHQ-9 using a cut-off score of 15+. However on multivariate linear regression, after various iterations, when individual predictors using standardized beta scores were examined, having experienced a stressful life event (B=3.27, P=0.001, β =0.25) explained the most variance in the care giver burden, followed by absence of social support for pregnant adolescents (B=-2.76, P=0.008, β=-0.19), being diagnosed with HIV/AIDS (B=3.81, P=0.004, β =0.17) and being young (B=2.46, P=0.038, β =0.14). Conclusion: Depression is common among pregnant adolescents in urban resource-deprived areas of Kenya and is correlated with well-documented risk factors such as being of a younger age and being HIV positive. Interventions aimed at reducing or preventing depression in this population should target these groups and provide support to those experiencing greatest stress.