Effects of Marital Status and Social Support on Antenatal Depression: A Meta-Analysis


  • Meita Tyas Nugrahaeni Master’s Program in Public Health, Universitas Sebelas Maret
  • Hanung Prasetya Health Polytechnics Ministry of Health Surakarta
  • Bhisma Murti Master’s Program in Public Health, Universitas Sebelas Maret




Background: Pregnancy is a period of increased vulnerability to depression incidence, especially if the pregnancy is accompanied by additional demands. Antenatal depression is depression that occurs during pregnancy characterized by certain symptoms, namely anxiety, distress, confusion, and excessive fear. The study aims to estimate the effect size of marital status and social support on the incidence of antenatal depression in pregnant women. Subjects and Method: The study used systematic review and meta-analysis with PICO, Popula­tion: pregnant women; Intervention: marital status and strong social support; Comparison: unmarried marital status and weak social support. Outcome: antenatal depression. The articles used were obtained from several databases namely Google Scholar, Pubmed, SpringerLink, and Science Direct. The article search keywords were "Antenatal Depression" AND "Marital Status" AND "Social Support" AND "Pregnant Women". The inclusion criteria for the articles were full-text articles in English using cross-sectional observational study design, published between 2012 and 2022, the study subject was pregnant women, and the size of the association was presented in adjusted Odds ratio (aOR). The data were analyzed using Review Manager app (RevMan 5.3). Results: A total of 17 cross-sectional articles originated from Asia and Africa including Qatar, Thailand, China, Ethiopia, Tanzania, Nigeria, and Rwanda for systematic review and meta-analysis with a total population of 8,723 pregnant women. Pregnant women with unmarried marital status could contribute to the worsening condition of pregnant women that generated antenatal dep­res­sion (aOR= 2.76; 95% CI= 1.75 to 4.36; p< 0.0001).  Meanwhile, pregnant women with weak social sup­port could contribute to the worsening of the condition of pregnant women that generated antenatal depression (aOR= 2.22; 95% CI= 1.42 to 3.46; p= 0.005). Conclusion: Marital status and social support can improve the prevention of antenatal dep­res­sion in pregnant women. Keywords: marital status, social support, pregnant women, antenatal depression. Correspondence: Meita Tyas Nugrahaeni. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: meitatyas04@gmail.com. Mobile: +628­597­4825459.

Author Biography

Hanung Prasetya, Health Polytechnics Ministry of Health Surakarta

Study Program of Acupuncture


Akincigil A, Munch S, Niemczyk KC (2010). Predictors of maternal depression in the first year postpartum: Marital status and mediating role of relationship quality. Soc. Work Health Care, 49(3): 227–244. Doi: 10.1080/0098138090-3213055

Ayele S, Alemayehu M, Fikadu E, Tarekegn GE (2021). Prevalence and associated factors of depression among pregnant mothers who had intimate partner violence during pregnancy attending antenatal care at gondar university hospital northwest Ethiopia in 2020. BioMed Res. Int., 21(89): 1–9. Doi: 10.1155/2021/9965289

Bedaso A, Adams J, Peng W, Sibbritt D (2021). The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis. Reprod. Health, 18(162): 1–23. Doi: 10.1186/-s12978-021-01209-5

Belete AH, Assega MA, Abajobir AA, Belay YA, Tariku MK (2019). Prevalence of antenatal depression and associated factors among pregnant women in aneded woreda, north west wthiopia: a community based cross-sectional study. BMC Res. Notes, 12(713): 1–6. Doi: 10.1186/s13104-019-4717-y

Biratu A, Haile D (2015). Prevalence of antenatal depression and associated factors among pregnant women in Addis Ababa, Ethiopia: a cross-secti-onal study. Reprod. Health, 12(99): 1–8. Doi: 10.1186/s12978-015-0092-x

Bisetegn TA, Mihretie G, Muche T (2016). Prevalence and predictors of depres¬si-on among pregnant women in Debre-tabor town, northwest ethiopia. PLoS One, 11(9): 1–10. Doi: 10.1371/journal.pone.0161108

CEBM (2014). Critical appraisal of a cross-sectional study (Survey) appraisal questions. https://www-.cebma.org/-wpcontent/uploads/Critical-Appraisal-Questions-for-a-Cross SectionalStudy-july-2014.pdf

Dadi AF, Miller ER, Bisetegn TA, Mwanri L (2020a). Global burden of antenatal depression and its association with adverse birth outcomes : an umbrella review. BMC, 20(173): 1–16. Doi: 10.1186/s12¬889-020-8293-9

Dadi AF, Miller ER, Woodman R, Bisetegn TA, Mwanri L (2020b). Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: Application of structural equation model. BMC Pregnancy Childbirth, 20(168): 1–15. Doi: 10.1186/s12884-020-02859-2

Dadi AF, Wolde HF, Baraki AG, Akalu TY (2020c). Epidemiology of antenatal dep¬ression in Africa : a systematic review and meta-analysis. BMC Pregnancy Childbirth, 20(251): 1–13. Doi: 10.1186/s12884-020-02929-5 (2020)

Dın ZU, Ambreen S, Iqbal Z, Iqbal M, Ahmad S (2016). Determinants of antenatal psychological distress in Pakistan women. Noro Psikiyatr. Ars., 53(2): 152–157. Doi: 10.5152/npa.2015.10235

Duko B, Ayano G, Bedaso A (2019). Depression among pregnant women and associated factors in hawassa city, ethi¬opia: an institution- based cross-sectional study. Reprod. Health, 16(25): 1–6. Doi: 10.1186/s12978-019-0685-x

Keliyo ET, Jibril MK, Wodajo GT (2021). Prevalence of antenatal depression and associated factors among preg¬nant women attending antenatal care at health institutions of Faafan Zone, Somali Region, Eastern Ethiopia. Dep-ress. Res. Treat., 21(2): 1–8. Doi: 10.1155/2021/2523789

Kimbui E, Kuria M, Yator O, Kumar M (2018). A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention work. Ann. Gen. Psychiatry, 17(53), 1–15. Doi: 10.-1186/s12991-018-0222-2

Lodebo M, Birhanu D, Abdu S, Yohannes T (2020). Magnitude of antenatal dep-res¬sion and associated factors among pregnant women in west badewacho woreda, Ahmadiyya zone, south Ethiopia: community-based cross-sectional study. Depress. Res. Treat, 20(2), 1–11. Doi: 10.1155/2020/2950536

Luthar S, Cicchetti D, Becker B (2010). Beyond marital status: the quality of the mother-father relationship and its influence on reproductive health behaviors and outcomes among unmarried low-income pregnant women. Matern. Child Health J., 14(5): 543–562. Doi: 10.1007/s10995-009-0509-7.Beyond

Manongi R, Rogathi J, Sigalla G, Mushi D, Rasch V, Gammeltoft T, Meyrowitsch DW (2020). The association between intimate partner violence and signs of depression during pregnancy in Kilimanjaro Region, Northern Tanzania. J. Interpers. Violence, 17(23): 1–15. Doi: 10.1177/0886260517724256

Massae AF, Larsson M, Leshabari S, Mbekenga C, Pembe AB, Svanberg AS (2021). Predictors of fear of childbirth and depressive symptoms among pregnant women: a cross-sectional survey in Pwani region, Tanzania. BMC Pregnancy Childbirth, 21(704): 1–13. Doi: 10.1186/s12884-021-04169-7

Naja S, Al Kubaisi N, Singh R, Abdalla H, Bougmiza I (2021). Screening for antenatal depression and its determinants among pregnant women in qa-tar: revisiting the biopsychosocial model. BMC Pregnancy Childbirth, 21 (330): 1–12. Doi: 10.1186/s12884-021-03793-7

Oboro OF, Ebulue V, Oboro VO, Ohenhen V, Oyewole A, Akindele R, Ala O, Oye-niran O, Isawumi A, Afolabi B (2022). The magnitude and determinants of depressive symptoms amongst wo¬men in early pregnancy in Southern Nigeria: a cross-sectional study. S. Afr. J. Psychiatry, 22(28): 1–8. Doi: 10.4102/sajpsychiatry.v28i0.1691

Rwakarema M, Premji SS, Nyanza EC, Riziki P, Palacios-Derflingher L (2015). Antenatal depression is associated with pregnancy-related anxiety, partner relations, and wealth in women in Northern Tanzania: A cross-sectional study. BMC Women’s Health, 15(1): 1–10. Doi: 10.1186/s12905-015-0225

Thompson O, Ajayi IO (2016). Prevalence of antenatal depression and associated risk factors among pregnant wo¬men attending antenatal clinics in Abeokuta North local government area, Nigeria. Depress. Res. Treat, 16(4): 1–15. Doi: 10.1155/2016/4518979

Tuksanawes P, Kaewkiattikun K, Kerdcha-roen N (2020). Prevalence and associated factors of antenatal depressive symptoms in pregnant women living in an Urban Area of Thailand. Int. J. Women’s Health, 20(12): 849–858. Doi: 10.2147/IJWH.S278872

Umuziga MP, Gishoma D, Hynie M, Nyirazinyoye L (2022). Antenatal depressive symptoms in Rwanda: rates, risk factors, and social support. BMC Pregnancy and Childbirth, 22(1): 1–9. Doi: 10.1186/s12884-022-04522-4

Yu Y, Zhu X, Xu H, Hu Z, Zhou W, Zheng B, Yin S (2020). Prevalence of depres¬sion symptoms and its influencing factors among pregnant women in late pregnancy in urban areas of Hengyang city, Hunan province, china: a cross-sectional study. BMJ Open, 10(9): 1–10. Doi: 10.1136/bmjopen-2020-038511

Zelalem ED, Asaye MM, Mihret MS (2020). Antenatal depression and its correlates on northwestern Ethiopian women: a community-based cross-sectional study. Pan Afr. Med. J., 36 (239): 1–13. Doi: 10.11604/pamj.2020.-36.239.19890

Zeng Y, Cui Y, Li J (2015). Prevalence and predictors of antenatal depressive symptoms among Chinese women in their third trimester: a cross- sec¬tional survey. BMC Psychiatry, 15(66): 1–7. Doi: 10.1186/s12888-015-0452-7







Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 > >>