Prevalence and correlates of depressive and anxiety symptoms among pregnant women from an urban informal settlement in Nairobi, Kenya: a community-based cross-sectional study

Purpose: Previous research, largely from the Global North, reports high rates of common mental health disorders among women in the antenatal period, but there is paucity of such data in contexts like Kenya. This study investigated the prevalence and correlates of depressive and anxiety symptoms among pregnant women in an urban informal settlement in Kenya’s capital – Nairobi. Methods: An analysis of baseline cross-sectional data from a pilot cluster randomized trial of an integrated early childhood development programme. Participants were pregnant women in their third pregnancy trimester (N = 249), residing in an urban informal settlement in Nairobi County. Mental health measures [(Patient health questionnaire (PHQ-9) and generalized anxiety disorder scale (GAD-7)] were administered alongside other sociodemographic, pregnancy, and health-related questionnaires. Linear regression analysis was performed to investigate correlates of antenatal depressive and anxiety symptoms. Results: Participant’s mean age was 27.5 years (SD = 5.6). The prevalence of antenatal depressive and anxiety symptoms was 26.9% (95%CI: 21.4–32.4) and 6.4% (95%CI: 3.4–9.4), based on the PHQ-9 and GAD-7 cut-off scores of ≥ 10 respectively. Being married was a significant correlate for decreased depressive and anxiety symptoms. Higher levels of education (secondary or tertiary), history of three or more previous pregnancies, and an experience of moderate-to-extreme pain were significant correlates for elevated depressive symptoms. Similarly, tertiary level of education, history of four or more previous pregnancies, and experiencing pain were significant correlates for elevated anxiety symptoms for the pregnant women. Participants reporting feeling unwell had significantly higher anxiety symptom scores. Conclusion: In this setting, correlates of antenatal depressive and anxiety symptoms cut across demographic, pregnancy and health-related factors with implications for targeted interventions. Findings point to the need for screening of depression and anxiety as part of routine antenatal care. Further research is needed to understand these contextual correlates. Trial registration: This study was part of the integrated early childhood development pilot cluster randomised control trial, retrospectively registered in the Pan African Clinical Trial Registry on 26/03/2021, registration number PACTR202103514565914.