This was a cross-sectional, prospective, descriptive, and analytical study conducted from 1 June to 30 August 2022 at the prenatal care unit of Abass Ndao Hospital in Dakar, Senegal. Pregnant women were recruited during routine antenatal checkups.

Inclusion criteria:

Exclusion criteria:

Data were collected using a structured questionnaire that captured the following:

Four standardised and validated tools were used:

All tools were administered in French or Wolof by trained midwives during the prenatal consultations.

Statistical analyses were performed using SPSS version 21.0. Descriptive statistics were calculated for all sociodemographic and clinical variables of the study participants. A bivariate analysis using chi-squared and t-tests was performed to identify potential associations between explanatory variables and depressive symptoms (EPDS ≥ 10).

Significant variables were entered into a multivariate logistic regression model to identify the independent predictors of antenatal depression. The results are expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Statistical significance was set at p < 0.05.

A total of 100 pregnant women participated in this study. The mean age was 26.6 years (SD ± 6.08), with the majority (72%) aged between 18 and 29. Most participants were married (97%), lived in urban areas (68%), and reported a medium socioeconomic status (63%).

Participants were further classified by age, education level, and occupation; details are provided in Table 1 .

According to the EPDS, 27 participants (27%) scored ≥ 10, indicating probable antenatal depression, as illustrated in Figure 1 .

Figure 1 illustrates the distribution of EPDS scores in the study population. Most scores fell below the clinical threshold, but a significant proportion exceeded it, indicating potential depressive symptoms.

When stratified by trimester, 30.7% of women in the first trimester, 26.3% in the second trimester, and 25.0% in the third trimester screened positive for antenatal depression. Although the difference was not statistically significant (p = 0.78), it suggests a potentially higher vulnerability to depressive symptoms in early pregnancy.

Depressive symptoms (EPDS ≥ 10) were significantly associated with the following factors:

These variables were included in the multivariate regression models.

Multivariate analysis revealed six independent predictors significantly associated with antenatal depression (EPDS ≥ 10). The table below summarises the results (see Table 2 ).

Women with a personal history of psychiatric disorders were more than five times more likely to experience antenatal depression than those without. Similarly, low social support and stressful life events substantially increased the risk.

A positive association was observed between pregnancy-specific anxiety and depressive symptoms, as depicted in Figure 2 , which shows the correlation between EPDS and PRAQ scores.

Low perceived social support emerged as one of the strongest independent predictors of antenatal depression (aOR = 4.5).

Women with low perceived support had notably higher EPDS scores, as shown in Figure 3 .

This is in line with numerous studies demonstrating the protective role of emotional, practical, and informational support during pregnancy [9] [12] . In the Senegalese context, urbanisation, social isolation, and relationship conflicts can decrease traditional family-based support systems, thus increasing psychological vulnerability.

Intimate partner violence (IPV), reported by 8% of participants and associated with a 2.5-fold increase in the risk of depression, remains a largely underestimated factor in antenatal mental health. Several African studies, such as those by Hartley et al. [13] and Djidonou et al. [14] , have highlighted a similar link between IPV and depression during pregnancy. Screening tools such as the WAST should be routinely implemented in antenatal visits, especially in settings where IPV is stigmatised or hidden.

Moreover, our findings suggest possible effects of interaction between social support, IPV, and stressful events. For example, women reporting both low social support and exposure to violence exhibited the highest EPDS scores, indicating a network of mutually reinforcing psychosocial risks. These results align with stress-diathesis models and advocate for multifactorial approaches to mental health screening.

Recent stressful or traumatic life events (e.g., bereavement, job loss, relationship conflict) were also strongly associated with depressive symptoms (aOR = 3.2). This finding reinforces the role of acute stressors in the initiation or exacerbation of depressive episodes during pregnancy. Similar results have been reported in South Africa and Pakistan, where women facing financial instability or domestic conflict are at an increased risk of perinatal mental disorders [4] [13] .

Pregnancy-specific anxiety (measured by PRAQ-R2) was significantly associated with depressive symptoms, supporting the hypothesis of a bidirectional relationship between anxiety and depression during the perinatal period [9] . This specific form of anxiety is characterised by fears about the health of the baby, pain from delivery, and bodily changes, and is a relevant predictor of emotional distress during pregnancy [15] .

As expected, personal psychiatric history was the strongest individual predictor of antenatal depression (aOR = 5.15). This finding supports the existing literature, which consistently shows that women with previous episodes of depression or anxiety are more susceptible to recurrence during pregnancy [3] [12] . This highlights the importance of obtaining a thorough mental health history early in the prenatal care process.

Finally, low socioeconomic status was associated with a higher risk of depression (aOR = 1.6). Financial hardship, unemployment, housing insecurity, and limited healthcare access are known to contribute to maternal psychological distress [5] [16] .

The intercorrelations between psychosocial variables are displayed in Figure 4 , highlighting the strongest links with EPDS scores.

This study has several limitations. First, the cross-sectional design limits causal inference. Although associations between psychosocial factors and antenatal depression were identified, the temporal direction cannot be established.

Second, the use of six predictors in the logistic regression model on a sample of 100 participants may raise concerns of statistical overfitting. Given that only 27 participants had EPDS scores ≥10, the model may exceed the commonly recommended 10 events per variable rule. This limitation should be considered when interpreting the multivariate findings, and replication in larger samples is needed.

Third, the use of self-reported measures, while validated, may have introduced social desirability bias, especially in culturally sensitive domains such as intimate partner violence.

Lastly, the generalisability of findings is limited to urban pregnant women attending a tertiary hospital in Dakar. Rural populations and non-attending pregnant women were not represented.