Prevalence and associated factors of symptoms of depression, anxiety and stress in pregnant women in Mozambique: a cross-sectional study

Abstract Background Mental disorders represent a major public health burden worldwide, disproportionately affecting women in low- and middle-income countries. The perinatal period is a time of increased biological, psychological, and social vulnerability, heightening the risk of depressive, anxiety, and stress symptoms. Despite the high relevance, data on maternal mental health in Mozambique remain scarce. Methods A cross-sectional study was conducted in two health centers in Maputo. Pregnant women aged ≥ 18 years were systematically recruited. Psychological symptoms were assessed using the DASS-21. Prevalence ratios for depressive, anxiety, and stress symptoms were estimated using Poisson regression with robust variance. Results Clinically significant symptoms (moderate to extremely severe) were observed in 38.9% of participants for depression, 57.6% for anxiety, and 14.4% for stress. Additional factors significantly associated with symptoms included household composition, marital status, family history of mental illness, occupational status, religion, and family planning practices. Conclusions The findings highlight substantial psychosocial and structural vulnerabilities among pregnant women in Maputo. Systematic screening integrated into prenatal care, policies addressing economic and occupational insecurity, and further research exploring protective factors and culturally relevant interventions are warranted.