Integration of Mental Health-Nutrition Counseling for Perinatal Women in Primary Care.

Abstract

Background: Nutrition deficiencies during pregnancy may expose women to the risk of maternal depression. The objective of this study was to identify nutritional factors associated with maternal depression among pregnant women in urban low-income Nairobi Kenya.

Methods: A cross-sectional study that recruited 262 pregnant women aged18 to 44, attending antenatal clinics in two public health facilities. Depression Scale assessed maternal depression. Nutritional status assessed by anthropometrics. The 24-hour recall determined dietary intake. Brain food essentials assessed through questionnaires. Odd's Ratio tested the associations. All characteristics with p < 0.001 in bivariate analysis were considered in multivariate model. Variables with p < 0.05 were significant.

Results: Out of 262 women, 33.6 % (95% CI 27.9-40.7) had depression illness indicated by EPDS >13. About 32.1 % of the women had a BMI <22.8 kg/m 2, and 9.9% had MUAC >23cm. About 32.1 % and 9.9% of the women had a BMI <22.8 kg/m 2, and MUAC >23cm, respectively. The study established a statistically significant association between poor nutrition (MUAC) and maternal depression (p < 0.001) and also between maternal depression and inadequate intake of brain essential (p = 0.002). Maternal depression was significantly associated with income (p< 0.001). In multivariate analysis, the main predictor of maternal depression was poor nutrition (p< 0.004).

Conclusion: Findings suggest the need for assessment of women's dietary intake and early screening of maternal depression during prenatal period. The study recommends better integration of nutritional and mental health care of perinatal women in primary health care.