Predictive statistical model for the factors associated with prenatal depression among pregnant adolescents in Maha Sarakham province, Thailand

Abstract

Background: The rate of adolescent pregnancy has steadily increased in Thailand over the years and depression is considered an important psychological problem in many pregnant adolescents. The aims of this study were to determine the proportion of pregnant adolescents with depressive symptoms and to identify a predictive statistical model for the factors related to prenatal depression among adolescents at antenatal care clinics in 10 community health centers in Maha Sarakham Province. Methods: A cross-sectional study was conducted in 230 randomly selected participants who were pregnant adolescents who volunteered to participate in the research, those aged ≤19 years, and had an estimated gestational age of ≤18 weeks. Those with severe obstetrics complications or a psychiatric disorder were excluded. The subjects were asked to complete a demographic questionnaire and the Thai version of the Edinburgh Postnatal Depression Scale. The mean age of participants was 17.0 (±1.4) years. Results: Overall, 43.9% of the adolescents had a cut off score of ≥11, suggestive of prenatal depressive symptoms. Multivariate analysis identified that pregnant adolescents at a primary school education level were 6.5 times more likely to experience depression symptoms than those with a diploma. Those who were emotionally supported by their husband or partner compared to relatives had a five times higher chance of presenting depressive symptoms, and those with a perceived bad relationship with their husband or partner seven times higher. The model was well-calibrated (goodness-of-fit test, p = 0.675) and had high discriminative power (ROC curve = 0.73 (95%CI = 0.67 to 0.79). Conclusions: More attention is needed to reduce the known problems with pregnant adolescents and to ensure they continue with their education. Lastly, public education to support mental health initiatives for individuals and families should be encouraged.