The causal effect of stressors on antenatal common mental disorders among pregnant mothers in Dabat district Northwest, Ethiopia: A generalized structural equation model approach

Abstract

Antenatal mental health is a crucial but overlooked and neglected element of maternal and infant health care. Various factors have been associated with triggering mental illness during pregnancy. It is essential to explore the stressors and mediators that play a role in causing these health issues and understand how they interact. Therefore, this study aimed to analyze the causal association between stressors and factors influencing mental disorders using the stress process model. A community-based cross-sectional survey was conducted among pregnant women at Dabat Health and Demographic Surveillance Site Northwest, Ethiopia, in June and August 2022. This study aimed to measure common mental disorders in pregnant women using Self-Reported Questionnaire-20 and explore the causal association with stressors variables. A Generalized Structural Equation Model was used to evaluate the effect of stressors and mediators on common antenatal mental disorders. This model, known for its ability to understand the complex relationship between environmental exposures, emotional responses, and cognitive appraisals, was used to evaluate the impact of stressors and mediators on common antenatal mental disorders. The study included 872 pregnant women, of which 114 (13.1%) (95% CI: 10.07, 15.4) reported experiencing symptoms of common antenatal mental disorders. Lack of antenatal care(β=1.4), unplanned pregnancy(β=0.85), and intimate partner violence (β=0.87), all of which were associated with a higher antenatal common mental disorder score. A family history of mental disorders (β=-0.11) was associated with a decreased antenatal common mental disorder score. Moreover, social support (β=-0.19), life-threatening events (β=0.93), and stress-coping mechanisms (β=0.12) appeared to mediate the link between the identified stressors and antenatal common mental disorders. This study highlights the association between psychosocial factors and antenatal mental health, underlining the urgent need for a holistic approach to prenatal care that includes mental well-being. Integrating support systems and stress-coping mechanisms is crucial for improving maternal health outcomes.