Epidemiology of depressive and anxiety symptoms among pregnant women attending antenatal care in a rural area of Ghana

Depressive and anxiety symptoms are among the most common non-psychotic mental health problems during pregnancy and represent a significant public health concern. We described their epidemiology among rural pregnant women in Ghana. We conducted a cross-sectional survey among 259 pregnant women attending selected health facilities in the Builsa North Municipality. Symptoms of anxiety and depression were assessed using the Generalised Anxiety Disorder 2-item (GAD-2) questionnaire and Patient Health Questionnaire-9 (PHQ-9), respectively. Data on sociodemographic characteristics, pregnancy-related factors, and psychosocial/relational factors, including partner and family support, and exposure to psychological intimate partner violence, were also collected. Logistic regression analysis was performed in StataNow 18 SE to identify independent factors associated with anxiety, depression, and co-occurring symptoms. Of 259 respondents, 45.2% (95% CI: 39.2–51.3) reported depressive symptoms, 22.8%(95% CI: 18.0–28.3) reported anxiety symptoms, and 19.7% (95% CI: 15.3–25.0) had co-occurring symptoms. Higher rates were observed among women aged 35–49 years, those lacking intimate partner support, and those exposed to psychological intimate partner violence (IPV). Women aged 35–49 years had nearly threefold higher odds of reporting anxiety (aOR = 2.94; 95% CI: 1.19, 7.31) and co-occurring symptoms (aOR = 2.91; 95% CI: 1.12, 7.52) compared to those aged 15–24 years. Lack of intimate partner support was associated with fourfold higher odds of depressive symptoms (aOR = 4.00; 95% CI: 1.53, 10.50). Experiencing psychological IPV increased the odds of anxiety symptoms (aOR = 3.03; 95% CI: 1.32, 6.97), depressive symptoms (aOR = 5.25; 95% CI: 2.62, 10.52), and their co-occurrence (aOR = 3.30; 95% CI: 1.30, 8.38). There is a substantial burden of anxiety and depressive symptoms among pregnant women in rural Ghana, which are associated with maternal age, partner support, and exposure to psychological IPV. Integrating mental health and IPV screening in routine antenatal care services is essential.