Antepartum depression among women attending antenatal care in the third trimester in Conakry, Guinea: Findings from the MISPOD study

• Pregnant and postpartum women are more vulnerable to poor mental health conditions. • The significant association between symptoms suggestive of antepartum depression and worries about feeding the family underscores the need for context-appropriate and pro-poor interventions to address food insecurity and women’s financial empowerment. • In light of the extremely limited availability of both integrated and specialised mental health services in Guinea, the high prevalence of antepartum depressive symptoms in our study warrants the need for further studies to explore opportunities and approaches for integrating preventive, promotive, and curative mental health services. Depression in pregnancy (antepartum depression) is a common mental health condition associated with multiple adverse outcomes. Despite high prevalence in sub-Saharan African countries, there is a critical evidence gap on its prevalence in Guinea. We aimed to estimate the prevalence of symptoms suggestive of antepartum depression among women seeking antenatal care (ANC) in urban Guinea and to identify factors associated with it. As baseline of a longitudinal mixed methods study, we surveyed 417 pregnant women at ≥28 weeks gestation seeking ANC at 22 selected health facilities in Conakry and screened them using the Edinburgh Postnatal Depression Scale, with a score of 11 or higher indicating symptoms suggestive of depression. We used bivariate and multivariable logistic regression to identify factors associated with symptoms suggestive of antepartum depression. The prevalence of symptoms suggestive of antepartum depression was 34.5 % (95 % CI: 30.1–39.2). Women who worried 'sometimes' (aOR 3.10; 95 % CI: 1.83, 5.29) and 'very often' (aOR 5.69; 95 % CI: 2.72, 11.91) about feeding their family in the last weeks before the survey were more likely to have symptoms suggestive of antepartum depression than those who ‘never’ worried. Women who attended ANC at private health facilities were less likely to have symptoms suggestive of antepartum depression compared with those who attended ANC at public facilities (aOR 0.34; 95 % CI: 0.16, 0.69). The high prevalence of antepartum depressive symptoms in Conakry highlights the need to integrate mental health services into routine maternal healthcare and address socioeconomic determinants of perinatal mental health.