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Asante HA, Boyetey ST, Essaw E, Nyame CA, Mante B, Dziwornu L, Okyere P. Prevalence and factors associated with antepartum depression among adolescent women in the assin north district of Ghana: a cross-sectional study. BMC Womens Health 2024; 24:276. [PMID: 38711102 DOI: 10.1186/s12905-024-03111-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/23/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Globally, depression is a leading cause of disease-related disability among women. In low-and-middle-income countries (LMICs), the prevalence rate of antepartum depression is estimated to range between 15% and 57% and even higher in adolescent antepartum women. Although a number of studies have shown that depression is common in adolescent pregnancies and has a prevalence rate between 28% and 67% among adolescent mothers, there currently exists no literature on depression among adolescent pregnant women in Ghana. The study aimed to determine the prevalence of antepartum depression and identify the factors associated with it among pregnant adolescent women. METHODS A quantitative cross-sectional study design was adopted by randomly recruiting 220 adolescent pregnant women visiting antenatal clinics in five selected health facilities in five communities in the Assin North District of Ghana. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS). Data analysis was performed using Stata version 14. Both descriptive and inferential analyses were performed. A chi-square analysis was conducted to identify the association between independent and dependent variables. A multivariate logistic regression analysis was carried out to identify the independent variables that were significantly associated with the dependent variable. In all analyses, p-values ≤ 0.05 were deemed statistically significant at a 95% confidence interval. RESULTS The results indicated prevalence of depression was 38.6% using the EPDS cut-off ≥ 13. Respondents who were cohabiting were less likely to experiencing antepartum depression compared to those who were single (AOR = 0.36, 95% CI: 0.20-0.64, p = 0.001). Also, Respondents who had completed Junior High School had a lower likelihood of experiencing antepartum depression compared to those who had no formal education (AOR = 0.19, 95% CI: 0.05-0.76, p = 0.019). Respondents who perceived pregnancy-related items to be costly had higher odds of experiencing antepartum depression (AOR = 2.05, 95% CI: 1.02-4.12, p = 0.042). Lastly, adolescent pregnant women who reported that pregnancy-related items are costly were likely to experience antepartum depression compared to those who did not report such costs (AOR = 2.12, 95% CI: 1.20-3.75, p < 0.001). CONCLUSION The results of this study highlight the importance of a multi-pronged strategy for combating antepartum depression in adolescents and improving the overall health and well-being of pregnant adolescents. Considering that adolescence is a transitional period occasioned by several bio-psycho-social challenges, setting up systems to ensure that young girls are motivated and supported to stay in school will enhance their economic prospects and improve their standards of life while providing psycho-social support will benefit their health and general well-being.
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Affiliation(s)
- Hannah Amoquandoh Asante
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Shadrach Tetteh Boyetey
- Department of Health Policy, Management and Economics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ebenezer Essaw
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Christopher Amoah Nyame
- Department of Occupational and Environmental Health and Safety, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bertha Mante
- Department of Real Estate and Land Management, University for Development Studies, Tamale, Ghana
| | - Louisa Dziwornu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Paul Okyere
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Panolan S, Thomas M B. Prevalence and associated risk factors of postpartum depression in India: A comprehensive review. J Neurosci Rural Pract 2024; 15:1-7. [PMID: 38476432 PMCID: PMC10927066 DOI: 10.25259/jnrp_584_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/14/2023] [Indexed: 03/14/2024] Open
Abstract
Postpartum depression (PPD) is a psychological illness that affects women following delivery. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), PPD is a serious form of depression that begins four weeks following birth and continues for one year. Pregnancy and the period after delivery can be hazardous for women. Mothers undergo significant biological, emotional, financial, and societal changes during this time. Some women are predisposed to mental health disorders such as melancholy and worry. Many postpartum women do not acknowledge the seriousness of their condition, and many depressed mothers go untreated. Untreated PPD is harmful to both the mother and the newborn. The exact cause of PPD is unclear; however, hormonal fluctuations during pregnancy and childbirth, genetic susceptibility, birth trauma as well as psychosocial and demographic factors may serve as potential risk factors. The objective of this study is to determine the prevalence and risk factors of PPD in India. The review evaluates English language literature on PPD using Scopus, PubMed, and Google Scholar databases searched electronically between 2000 and 2022. The keywords "postpartum depression," or "postnatal depression," and "prevalence," and "causes," and "risk factors," or "predisposing factors," or "predictive factors" were used to search the database. The prevalence of PPD varies in different geographical regions and study settings. In India, the overall prevalence of PPD is 22%. However, the greatest prevalence was in the southern regions (26%; 95% confidence interval [CI]: 19-32) and the lowest in the northern regions (15%; 95% CI: 10-21). This study outlines the burden of PPD in India. Comprehensive intervention programs should be implemented to address the disease at a national level. The national authorities should incorporate PPD screening in the National Mental Health Program and emphasize health promotion activities.
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Affiliation(s)
- Sajna Panolan
- School of Public Health, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - Benson Thomas M
- School of Public Health, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India
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The Impact of Maternal Depression and Parent-Child Interactions on Risk of Parasitic Infections in Early Childhood: A Prospective Cohort in Benin. Matern Child Health J 2021; 26:1049-1058. [PMID: 34850311 PMCID: PMC9023386 DOI: 10.1007/s10995-021-03317-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/16/2022]
Abstract
Objectives Maternal depression occurs in 13–20% of women from low-income countries, which is associated with negative child health outcomes, including diarrheal disease. However, few studies have investigated its impact on child risk of infectious disease. We studied the impacts of maternal depressive symptoms and parent–child interactions, independently, on the risk of Plasmodium falciparum malaria and soil-transmitted helminth infection in Beninese children. Methods Our population included mothers and children enrolled in a clinical trial during pregnancy (MiPPAD) in Benin. The Edinburgh Postnatal Depression Scale (EPDS) assessed maternal depressive symptoms and the home observation measurement of the environment (HOME) assessed parent–child interactions. Blood and stool sample analyses diagnosed child malaria and helminth infection at 12, 18, and 24 months. Negative binomial and Poisson regression models with robust variance tested associations. Results Of the 302 mother–child pairs, 39 (12.9%) mothers had depressive symptoms. Median number of malaria episodes per child was 3 (0–14) and 29.1% children had at least one helminth infection. Higher EPDS scores were associated with lower HOME scores; relative risk (RR) 0.97 (95% confidence interval (CI) 0.95, 0.99), particularly with lower acceptance, involvement, and variety subscales; RR 0.92 (95% CI 0.85, 0.99), RR 0.82 (95% CI 0.77, 0.88), RR 0.93 (95% CI 0.88, 0.99), respectively. However, neither exposure was associated with risk of parasitic infection in children. Conclusions for Practice Maternal depressive symptoms are associated with poor parent–child interactions, particularly acceptance of behavior, involvement with children, and variety of interactions, but these exposures do not independently impact risk of parasitic infection in children.
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Pierce M, Hope HF, Kolade A, Gellatly J, Osam CS, Perchard R, Kosidou K, Dalman C, Morgan V, Di Prinzio P, Abel KM. Effects of parental mental illness on children's physical health: systematic review and meta-analysis. Br J Psychiatry 2020; 217:354-363. [PMID: 31610824 DOI: 10.1192/bjp.2019.216] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Children of parents with mental disorder face multiple challenges. AIMS To summarise evidence about parental mental disorder and child physical health. METHOD We searched seven databases for cohort or case-control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive-compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620). RESULTS Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04-1.26), asthma (OR = 1.26, 95% CI 1.12-1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74-3.73; diarrhoea: OR = 2.16, 95% CI 1.65-2.84). Evidence was inconclusive for obesity and other atopic disorders. CONCLUSIONS Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations. DECLARATION OF INTEREST None.
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Affiliation(s)
- Matthias Pierce
- Research Fellow, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Holly F Hope
- Research Associate, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Adekeye Kolade
- Research Assistant, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Judith Gellatly
- Research Fellow, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Cemre Su Osam
- PhD Student, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Reena Perchard
- Clinical Research Fellow, Division of Developmental Biology & Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Kyriaki Kosidou
- Senior Consultant, Department of Public Health Sciences, Division Public Health Epidemiology, Karolinska Institutet, Stockholm; and Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Christina Dalman
- Professor of Psychiatric Epidemiology and Research Group Leader, Department of Public Health Sciences, Division Public Health Epidemiology, Karolinska Institutet, Stockholm; and Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Vera Morgan
- Winthrop Professor and Head, Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, University of Western Australia, Australia
| | - Patricia Di Prinzio
- Research Fellow, Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, University of Western Australia, Australia
| | - Kathryn M Abel
- Professor of Psychological Medicine and Director, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
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Lillie M, Gallis JA, Hembling J, Owusu RK, Ali M, Abubakr-Bibilazu S, Aborigo R, Adam H, McEwan E, Awoonor-Williams JK, Baumgartner JN. Prevalence and Correlates of Depression Among Pregnant Women Enrolled in a Maternal and Newborn Health Program in Rural Northern Ghana: a Cross-sectional Survey. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2020; 7:131-140. [PMID: 32509505 PMCID: PMC7252621 DOI: 10.1007/s40609-020-00170-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Women in many sub-Saharan African countries are at elevated risk of depression during pregnancy. However, there are still gaps in the estimates of antenatal depression and associated risk factors in very low-resource settings such as Northern Ghana. This study describes the prevalence of depression among rural pregnant women, participating in a maternal and child health program, in Ghana, and examines associated risk factors for depression. Pregnant women who were registered for group-based maternal and child health community programs were recruited for study participation from 32 communities in two rural districts in Northern Ghana (n = 374). Baseline surveys were conducted and depression was assessed using the Patient Health Questionnaire (PHQ-9). Bivariate and multivariable analyses used a modified Poisson and generalized estimating equations (GEE) model. Of the women in our study population, 19.7% reported symptoms indicative of moderate to severe depression (PHQ-9 score ≥ 10), with 14.1% endorsing suicidal ideation in the last 2 weeks. Bivariate analyses revealed that lower hopefulness, moderate and severe hunger, experiences of emotional, physical, and/or sexual intimate partner violence (IPV), and insufficient social support from female relatives were associated with symptoms indicating moderate to severe depression. In the multivariable analyses, low hopefulness, household hunger, emotional IPV, physical and/or sexual IPV, and insufficient female relative support remained significantly associated with depression. Antenatal depression is associated with unmet basic needs and safety. Perinatal mental health programming must take an ecological perspective and address personal, familial, and community-level factors.
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Affiliation(s)
| | - John A. Gallis
- Duke Department of Biostatistics and Bioinformatics, Durham, NC USA
| | - John Hembling
- Catholic Relief Services Head Quarters, Baltimore, MD USA
| | | | - Mohammed Ali
- Catholic Relief Services Country Office, Tamale, Ghana
| | | | | | - Haliq Adam
- Catholic Relief Services Country Office, Tamale, Ghana
| | - Elena McEwan
- Catholic Relief Services Head Quarters, Baltimore, MD USA
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Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. ACTA ACUST UNITED AC 2020; 15:1745506519844044. [PMID: 31035856 PMCID: PMC6492376 DOI: 10.1177/1745506519844044] [Citation(s) in RCA: 425] [Impact Index Per Article: 106.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: The postpartum period represents the time of risk for the emergence of
maternal postpartum depression. There are no systematic reviews of the
overall maternal outcomes of maternal postpartum depression. The aim of this
study was to evaluate both the infant and the maternal consequences of
untreated maternal postpartum depression. Methods: We searched for studies published between 1 January 2005 and 17 August 2016,
using the following databases: MEDLINE via Ovid, PsycINFO, and the Cochrane
Pregnancy and Childbirth Group trials registry. Results: A total of 122 studies (out of 3712 references retrieved from bibliographic
databases) were included in this systematic review. The results of the
studies were synthetized into three categories: (a) the maternal
consequences of postpartum depression, including physical health,
psychological health, relationship, and risky behaviors; (b) the infant
consequences of postpartum depression, including anthropometry, physical
health, sleep, and motor, cognitive, language, emotional, social, and
behavioral development; and (c) mother–child interactions, including
bonding, breastfeeding, and the maternal role. Discussion: The results suggest that postpartum depression creates an environment that is
not conducive to the personal development of mothers or the optimal
development of a child. It therefore seems important to detect and treat
depression during the postnatal period as early as possible to avoid harmful
consequences.
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Affiliation(s)
- Justine Slomian
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Germain Honvo
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Patrick Emonts
- 2 Department of Obstetrics and Gynaecology, CHU Liège, Liège, Belgium
| | - Jean-Yves Reginster
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.,3 Department of Sport Science, University of Liège, Liège, Belgium
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Zhu QY, Huang DS, Lv JD, Guan P, Bai XH. Prevalence of perinatal depression among HIV-positive women: a systematic review and meta-analysis. BMC Psychiatry 2019; 19:330. [PMID: 31666033 PMCID: PMC6822469 DOI: 10.1186/s12888-019-2321-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 10/14/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Increasing attention has been paid to differences in the prevalence of perinatal depression by HIV status, although inconsistent results have been reported. The aim of this systematic review and meta-analysis was to assess the relationship between perinatal depression and HIV infection. A comprehensive meta-analysis of comparative studies comparing the prevalence of antenatal or postnatal depression between HIV-infected women and HIV-negative controls was conducted. METHODS Studies were identified through PubMed/Medline, Scopus, Web of Science, Cochrane Library, Embase and PsycINFO, and the reading of complementary references in August 2019. Subgroup analyses were performed for anticipated explanation of heterogeneity using methodological quality and pre-defined study characteristics, including study design, geographical location and depression screening tools for depression. The overall odds ratio (OR) and mean prevalence of each group were calculated. RESULTS Twenty-three studies (from 21 publications), thirteen regarding antenatal depression and ten regarding postnatal depression were included, comprising 3165 subjects with HIV infection and 6518 controls. The mean prevalence of antenatal depressive symptoms in thirteen included studies was 36% (95% CI: 27, 45%) in the HIV-positive group and 26% (95% CI: 20, 32%) in the control group. The mean prevalence of postnatal depressive symptoms in ten included studies was 21% (95% CI: 14, 27%) in the HIV-positive group and 16% (95% CI: 10, 22%) in the control group. Women living with HIV have higher odds of antenatal (OR: 1.42; 95% CI: 1.12, 1.80) and postnatal depressive symptoms (OR: 1.58; 95% CI: 1.08, 2.32) compared with controls. Publication bias and moderate heterogeneity existed in the overall meta-analysis, and heterogeneity was partly explained by the subgroup analyses. CONCLUSIONS Women with HIV infection exhibit a significantly higher OR of antenatal and postnatal depressive symptoms compared with controls. For the health of both mother and child, clinicians should be aware of the significance of depression screening before and after delivery in this particular population and take effective measures to address depression among these women.
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Affiliation(s)
- Qi-Yu Zhu
- 0000 0000 9678 1884grid.412449.eDepartment of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122 China
| | - De-Sheng Huang
- 0000 0000 9678 1884grid.412449.eDepartment of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122 China ,0000 0000 9678 1884grid.412449.eDepartment of Mathematics, School of Fundamental Sciences, China Medical University, Shenyang, China
| | - Jian-Da Lv
- 0000 0000 9678 1884grid.412449.eDepartment of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122 China
| | - Peng Guan
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Xing-Hua Bai
- grid.412636.4Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China
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Saeed N, Wemakor A. Prevalence and determinants of depression in mothers of children under 5 years in Bole District, Ghana. BMC Res Notes 2019; 12:373. [PMID: 31262347 PMCID: PMC6604414 DOI: 10.1186/s13104-019-4399-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/22/2019] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Depression in mothers is a risk factor for poor health, and pregnancy and child outcomes. The objective of the present study was to determine the prevalence of depression and identify its determinants in mothers of children under 5 years in Bole District, Ghana. RESULTS We conducted an analytical cross-sectional study consisting of 244 mothers (mean age 28.7 ± 6.29 years) in Bole District, Ghana. Edinburgh Postnatal Depression Scale was used to screen for depression and the determinants of depression were identified using logistic regression analysis. The prevalence of depression in this study population was 16.8% (95% confidence interval 12.1-22.0%). The independent determinants of depression were marital status, occupation, lighting source and type of cooking fuel. Being currently unmarried (p < 0.001), and using lighting sources other than electricity (p = 0.004) were associated with higher risk of depression while being employed in other occupations (p = 0.001), and not cooking with firewood (p = 0.008) were associated with lower risk of depression. In this study population, the prevalence of depression was relatively high in mothers and was associated with marital status, occupation, lighting source and cooking fuel. Interventions to prevent and treat depression in women should include strategies to improve their socio-economic status and living conditions.
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Affiliation(s)
- Nawaf Saeed
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Anthony Wemakor
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.
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Wemakor A, Iddrisu H. Maternal depression does not affect complementary feeding indicators or stunting status of young children (6-23 months) in Northern Ghana. BMC Res Notes 2018; 11:408. [PMID: 29941023 PMCID: PMC6019211 DOI: 10.1186/s13104-018-3528-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/20/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Maternal depression may affect child feeding practice which is an important determinant of child nutritional status. The objective of this study was to explore the association between maternal depression and WHO complementary feeding indicators [minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)] or stunting status of children (6-23 months) in Tamale Metropolis, Ghana. A community-based cross-sectional study was carried out involving 200 mother-child pairs randomly sampled from three communities in Tamale Metropolis, Ghana. RESULTS The prevalence of MDD, MMF, and MAD were 56.5, 65.0, and 44.0% respectively and 41.0% of the children sampled were stunted. A third of the mothers (33.5%) screened positive for depression. Maternal depression did not influence significantly MDD (p = 0.245), MMF (p = 0.442), and MAD (p = 0.885) or children's risk of stunting (p = 0.872). In conclusion maternal depression and child stunting are prevalent in Northern Ghana but there is a lack of evidence of an association between maternal depression and child feeding practices or nutritional status in this study population. Further research is needed to assess the effect of maternal depression on feeding practices and growth of young children.
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Affiliation(s)
- Anthony Wemakor
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, Ghana
| | - Habib Iddrisu
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, Ghana
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Association between maternal depression and risk of infant diarrhea: a systematic review and meta-analysis. Public Health 2018; 159:78-88. [DOI: 10.1016/j.puhe.2018.01.036] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/24/2018] [Accepted: 01/31/2018] [Indexed: 11/20/2022]
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Ahun MN, Aboud FE, Aryeetey R, Colecraft E, Marquis GS. Child development in rural Ghana: Associations between cognitive/language milestones and indicators of nutrition and stimulation of children under two years of age. Canadian Journal of Public Health 2018; 108:e578-e585. [PMID: 29356667 DOI: 10.17269/cjph.108.5875] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/03/2017] [Accepted: 09/23/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Two studies aimed to assess the provision of nutrition and psychosocial stimulation in the home and to examine associations between mental development and nutrition and stimulation using a validated measure of development milestones. METHODS The first study consisted of secondary analyses on health and nutrition data from 1081 mother-child pairs (the children aged 0-12 months) and their households in Ghana's Eastern Region. For the second study, the Ghana Milestones Measure, consisting of items assessing cognitive and language development, was used to assess child development in a subsample (N = 330) of Study 1 participants one year later (children 10-24 months of age). This measure was mother-reported and had been validated in a separate community in Ghana. Correlation and linear regression analyses were used to analyze the data. RESULTS Family assets and maternal education were identified as key factors of the family context. Both variables were positively associated with preventive health practices (r = 0.08 to 0.13, p < 0.0001 to 0.01), and dietary diversity (r = 0.15, p = 0.0001 to 0.0006), and negatively associated with maternal depressive symptoms (r = -0.19 to -0.12, p < 0.0001). Taller children had higher receptive (standardized beta = 0.16; p = 0.04) and expressive (0.21; 0.003) language, but not cognitive (0.15; 0.07) milestone scores, and psychosocial stimulation was positively associated with all three milestones (receptive = 0.13, p = 0.01; expressive = 0.21, p < 0.0001; and cognitive = 0.24, p < 0.0001). CONCLUSION Our study provides the first validated measure of children's language and cognitive development in Ghana, finding associations with nutrition and stimulation. The Ghana Milestones Measure can be used to assess and help promote children's mental development.
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Affiliation(s)
- Marilyn N Ahun
- Department of Psychology, McGill University, Montreal, QC (at time of study; currently a PhD candidate, Department of Social and Preventive Medicine, University of Montreal, Montreal, QC).
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Okronipa H, Adu-Afarwuah S, Lartey A, Ashorn P, Vosti SA, Young RR, Dewey KG. Maternal supplementation with small-quantity lipid-based nutrient supplements during pregnancy and lactation does not reduce depressive symptoms at 6 months postpartum in Ghanaian women: a randomized controlled trial. Arch Womens Ment Health 2018; 21:55-63. [PMID: 28698916 PMCID: PMC5762799 DOI: 10.1007/s00737-017-0752-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 06/19/2017] [Indexed: 01/19/2023]
Abstract
We examined the impact on depression at 6 months postpartum of maternal supplementation with small-quantity lipid-based nutrient supplement (SQ-LNS) compared to supplementation with iron and folic acid (IFA) or multiple micronutrients (MMN). In this partially double-blinded randomized controlled trial, pregnant women ≤20 weeks gestation (n = 1320) were recruited from antenatal clinics and randomly assigned to receive either (1) SQ-LNS during pregnancy and for 6 months postpartum, or (2) IFA during pregnancy only, or (3) MMN during pregnancy and for 6 months postpartum. Maternal depressive symptoms were measured at 6 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Women who scored 12 or more on the EPDS were considered to show symptoms of depression. One thousand one hundred fifty-one women were included in this analysis (LNS = 382, IFA = 387 and MMN = 382). Characteristics of the three groups were similar at baseline, and there were no significant differences between women who were included in the analysis (n = 1151) and those who were not (n = 169). At 6 months postpartum, 13% of the women overall showed symptoms of depression, and this did not differ by group (LNS = 13.1%, IFA = 11.2% and MMN = 14.7%. P = 0.36). The median (25, 75 percentile) EPDS score did not differ by group (LNS 4.0 (1.0, 8.0), IFA 4.0 (1.0, 8.0), MMN 5.0 (2.0, 9.0), P transformed = 0.13). Adjustment for covariates did not alter these findings. Maternal supplementation with SQ-LNS compared to MMN or IFA did not affect postnatal depressive symptoms in this sample of Ghanaian women.
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Affiliation(s)
- Harriet Okronipa
- Program in International and Community Nutrition, Department of Nutrition, University of California, 3135 Meyer Hall, One Shields Avenue, Davis, CA, 95616, USA. .,Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana.
| | - Seth Adu-Afarwuah
- 0000 0004 1937 1485grid.8652.9Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana
| | - Anna Lartey
- 0000 0004 1937 1485grid.8652.9Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana
| | - Per Ashorn
- 0000 0001 2314 6254grid.5509.9Center for Child Health Research, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Stephen A. Vosti
- 0000 0004 1936 9684grid.27860.3bDepartment of Agricultural and Resource Economics, University of California, Davis, CA USA
| | - Rebecca R. Young
- 0000 0004 1936 9684grid.27860.3bProgram in International and Community Nutrition, Department of Nutrition, University of California, 3135 Meyer Hall, One Shields Avenue, Davis, CA 95616 USA
| | - Kathryn G. Dewey
- 0000 0004 1936 9684grid.27860.3bProgram in International and Community Nutrition, Department of Nutrition, University of California, 3135 Meyer Hall, One Shields Avenue, Davis, CA 95616 USA
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Stewart RC, Ashorn P, Umar E, Dewey KG, Ashorn U, Creed F, Rahman A, Tomenson B, Prado EL, Maleta K. The impact of maternal diet fortification with lipid-based nutrient supplements on postpartum depression in rural Malawi: a randomised-controlled trial. MATERNAL & CHILD NUTRITION 2017; 13:e12299. [PMID: 27060705 PMCID: PMC6866218 DOI: 10.1111/mcn.12299] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 12/18/2015] [Accepted: 01/04/2016] [Indexed: 01/31/2023]
Abstract
Perinatal depression is highly prevalent in low-and-middle-income countries and has been linked to poor child health. Suboptimal maternal nutrition may be a risk factor for perinatal depression. In this randomised-controlled trial conducted in rural Malawi, we set out to test the hypothesis that women taking a fatty acid-rich lipid-based nutrient supplement (LNS) would have fewer depressive symptoms postpartum than those taking iron-folate (IFA) or multiple-micronutrient (MMN) capsules. Women were recruited from antenatal clinics and randomised to receive LNS or MMN during pregnancy and for 6 months postpartum, or IFA during pregnancy only. Maternal depressive symptoms were measured using validated translations of the Self Reporting Questionnaire (SRQ) and Edinburgh Postnatal Depression Scale (EPDS), antenatally (SRQ only) and at 6 months postpartum (SRQ and EPDS). Analysis was by modified intention to treat. One thousand three hundred and ninety one women were randomised (LNS = 462, MMN = 466, IFA = 463). The groups were similar across a range of baseline variables. At 6 months postpartum, 1078 (77.5%) had SRQ completed; mean (SD) scores were LNS 1.76(2.73), MMN 1.92(2.75), IFA 1.71(2.66), P = 0.541. One thousand and fifty seven (76.0%) had EPDS completed; mean (SD) scores were LNS 5.77(5.53), MMN 5.43(4.97), IFA 5.52(5.18), P = 0.676. There were no statistically significant differences between the groups on SRQ or EPDS scores (continuous or dichotomised) in unadjusted or adjusted models. In conclusion, fortification of maternal diet with LNS compared with MMN or IFA did not reduce postnatal depressive symptoms in this study.
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Affiliation(s)
- Robert C. Stewart
- Manchester Mental Health and Social Care NHS Trust, ManchesterUK and Institute of Brain, Behaviour and Mental Health, University of ManchesterUK
| | - Per Ashorn
- Department for International HealthUniversity of Tampere School of Medicine, Finland and Department of Pediatrics, Tampere University HospitalFinland
| | - Eric Umar
- Department of Community Health, College of MedicineUniversity of MalawiMalawi
| | | | - Ulla Ashorn
- Department for International HealthUniversity of Tampere School of MedicineFinland
| | - Francis Creed
- Institute of Brain, Behaviour and Mental HealthUniversity of ManchesterUK
| | - Atif Rahman
- Institute of Psychology, Health and SocietyUniversity of LiverpoolUK
| | - Barbara Tomenson
- Biostatistics Unit, Institute of Population HealthUniversity of ManchesterUK
| | | | - Ken Maleta
- Department of Community Health, College of MedicineUniversity of MalawiMalawi
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14
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Wemakor A, Mensah KA. Association between maternal depression and child stunting in Northern Ghana: a cross-sectional study. BMC Public Health 2016; 16:869. [PMID: 27557725 PMCID: PMC4997709 DOI: 10.1186/s12889-016-3558-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 08/19/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Stunting indicates failure to attain genetic potential for height and is a well-documented indicator for poor growth. Depression is common in women of reproductive age and women's mental health problems may affect the growth of young children. We examined the association between maternal depression and stunting in mother-child pairs attending Child Welfare Clinic (CWC) in Northern Ghana. METHODS An analytical cross-sectional study was performed involving mothers (15-45 years) and their children (0-59 months) who attended CWC at Bilpeila Health Centre, Tamale, Ghana. Socio-demographic data were collected using a semi-structured questionnaire, maternal depression was measured using Centre for Epidemiological Studies Depression Screening Scale, and anthropometry was conducted on children following standard procedures. The association between maternal depression and child stunting was examined in logistic regression adjusting for potential confounders. RESULTS Prevalence rates of child stunting and maternal depression were estimated at 16.1 and 27.8 % respectively in Northern Ghana. Mothers with depression when compared with those without depression tended to be younger, be currently unmarried, belong to the poorest household wealth tertile, and were more likely to have low birth weight babies, so these characteristics were adjusted for. In an adjusted multivariate logistic regression model, children of depressed mothers were almost three times more likely to be stunted compared to children of non-depressed mothers (Adjusted OR = 2.48, 95 % CI 1.29-4.77, p = 0.0011). CONCLUSIONS There is a high prevalence of depression among mothers in Northern Ghana which is associated with child stunting. Further studies are needed to identify the determinants of maternal depression and to examine its association with child stunting to inform nutrition programming.
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Affiliation(s)
- Anthony Wemakor
- School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, N/R, Ghana.
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15
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Kaaya S, Garcia ME, Li N, Lienert J, Twayigize W, Spiegelman D, Smith Fawzi MC. Association of maternal depression and infant nutritional status among women living with HIV in Tanzania. MATERNAL & CHILD NUTRITION 2016; 12:603-13. [PMID: 25382710 PMCID: PMC6240341 DOI: 10.1111/mcn.12154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Antenatal and post-natal depression has demonstrated a significant burden in sub-Saharan Africa, with rates ranging from 10% to 35%. However, perinatal women living with HIV in Tanzania have reported an even greater prevalence of depression (43-45%). The primary goal of this study was to examine the relationship between maternal depression and infant malnutrition among women living with HIV. The design was a retrospective cohort study within the context of a randomised controlled trial among women living with HIV and their infants. Within this trial, 699 mother-child pairs were analysed for the present study. Although antenatal depression was not associated with infant malnutrition and post-natal depression was negatively associated [relative risk (RR = 0.80, P = 0.04], cumulative depression demonstrated a positive association with infant wasting (RR = 1.08, P < 0.01) and underweight (RR = 1.03, P < 0.01) after controlling for confounding factors. Variation in the association between depression and infant nutritional status was observed for episodic vs. chronic depression. These findings suggest that providing evidence-based services for persistent depression among women living with HIV may have an effect on infant malnutrition. In addition, other positive outcomes may be related to infant cognitive development as well as HIV disease prognosis and survival among women.
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Affiliation(s)
- Sylvia Kaaya
- School of MedicineMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Maria E. Garcia
- Department of MedicineUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Nan Li
- Department of Global Health and PopulationHarvard School of Public HealthBostonMassachusettsUSA
| | - Jeffrey Lienert
- Department of Global Health and Social MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - William Twayigize
- Department of Global Health and Social MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - Donna Spiegelman
- Department of EpidemiologyHarvard School of Public HealthBostonMassachusettsUSA
| | - Mary C. Smith Fawzi
- Department of Global Health and Social MedicineHarvard Medical SchoolBostonMassachusettsUSA
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16
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Factors are not the same for risk of stopping exclusive breast-feeding and introducing different types of liquids and solids in HIV-affected communities in Ghana. Br J Nutr 2016; 116:115-25. [PMID: 27149980 DOI: 10.1017/s0007114516001707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Exclusive breast-feeding (EBF) for 6 months supports optimal infant growth, health and development. This paper examined whether maternal HIV status was associated with EBF and other infant feeding practices. Pregnant women were enrolled after HIV counselling, and their babies were followed up for up to 1 year. Data on household socio-economics and demographics, maternal characteristics and infants' daily diet were available for 482 infants and their mothers (150 HIV-positive (HIV-P), 170 HIV-negative (HIV-N) and 162 HIV-unknown (HIV-U)). Survival analyses estimated median EBF duration and time to introduction of liquids and foods; hazards ratios (HR) used data from 1-365 and 1-183 d, adjusting for covariates. Logistic regression estimated the probability of EBF for 6 months. Being HIV-P was associated with a shorter EBF duration (139 d) compared with HIV-N (163 d) and HIV-U (165 d) (P=0·004). Compared with HIV-N, being HIV-P was associated with about a 40 % higher risk of stopping EBF at any time point (HR 1·39; 95 % CI 1·06, 1·84; P=0·018) and less than half as likely to complete 6 months of EBF (adjusted OR 0·42; 95 % CI 0·22, 0·81; P=0·01). Being HIV-P tended to be or was associated with a higher risk of introducing non-milk liquids (HR 1·34; 95 % CI 0·98, 1·83; P=0·068), animal milks (HR 2·37; 95 % CI 1·32, 4·24; P=0·004) and solids (HR 1·56; 95 % CI 1·10, 2·22; P=0·011) during the first 6 months. Weight-for-age Z-score was associated with EBF and introducing formula. Different factors (ethnicity, food insecurity, HIV testing strategy) were associated with the various feeding behaviours, suggesting that diverse interventions are needed to promote optimal infant feeding.
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17
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Household Food Insecurity is Associated with Respiratory Infections Among 6-11-Month Old Infants in Rural Ghana. Pediatr Infect Dis J 2015; 34:821-5. [PMID: 25961890 DOI: 10.1097/inf.0000000000000743] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To determine the relationship between household food insecurity (HHFI) and symptoms of respiratory infections among infants in rural Ghana. METHODS The study was cross-sectional. The outcome variables were symptoms of respiratory infections (cough and nasal discharge) in infants. HHFI was measured using a 15-item modified U.S. Department of Agriculture (USDA) household food security module. Households were classified as food insecure if they had an affirmative answer for at least 1 item. Associations were examined using multiple logistic regression analysis. Data were collected in 32 communities located in 3 rural subdistricts in the Upper Manya Krobo district of the Eastern region of Ghana. The sample included 367 infants aged 6-11 months who attended a community-based growth monitoring session. RESULTS Overall, 20.5% of households reported experiencing food insecurity in the last month. Compared with infants in food secure households, infants living in food insecure households were about twice as likely to experience cough (adjusted odds ratio: 2.25, 95% confidence intervals: 1.25, 4.04) and nasal discharge (adjusted odds ratio: 1.87, 95% confidence intervals: 1.05, 3.36). CONCLUSION Infants living in food insecure households are at an increased risk of respiratory tract morbidity. Interventions that address HHFI might be important to improve infant health in rural Ghana.
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Scorza P, Owusu-Agyei S, Asampong E, Wainberg ML. The expression of perinatal depression in rural Ghana. ACTA ACUST UNITED AC 2015; 8:370-381. [PMID: 26539247 DOI: 10.1080/17542863.2015.1037849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In low- and middle-income countries, perinatal depression (PND) has been associated with poor infant health outcomes, including frequency of infant diarrheal episodes, preterm delivery and low birth weight, and discontinuation or problems breastfeeding. Yet little is known about the awareness or expression of PND depression in Ghana. A total of 12 in-depth key-informant interviews were conducted with women who had experienced PND within the previous two-and-a-half years. Three focus-group discussions were conducted with new mothers (n = 11), grandmothers (n = 8), and fathers (n = 9) for contextual and supporting information. 'Thinking too much' was the term most commonly used to describe PND. The women saw their distress as caused largely by poverty, lack of social support, and domestic problems. Women sought help through family and religious organizations, rather than through medical services. Problems producing breast milk or breastfeeding were nearly universal complaints and suggest significant effects on infant health in the study area. These results present evidence to support the increasing consensus that depression presents in similar and disabling ways across cultures and contexts. This formative qualitative data is required to tailor depression prevention or treatment interventions to this particular socio-cultural context.
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Affiliation(s)
- Pamela Scorza
- School of Public Health, University of Ghana, Legon, Ghana
| | | | | | - Milton L Wainberg
- Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York, USA
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19
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Weobong B, Ten Asbroek AH, Soremekun S, Danso S, Owusu-Agyei S, Prince M, Kirkwood BR. Determinants of postnatal depression in rural ghana: findings from the don population based cohort study. Depress Anxiety 2015; 32:108-19. [PMID: 24272979 DOI: 10.1002/da.22218] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 10/27/2013] [Accepted: 10/28/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Risk factors for postnatal depression (PND), one of the most pervasive complications of child bearing, are poorly understood in Africa. A recent systematic review of 31 studies found that the strongest predictors are social and economic disadvantage and gender-based factors; only six of these studies were community based, and almost all were in South Asia. METHODS Cohort study nested within 4 weekly surveillance of all women of reproductive age to identify pregnancies and collect data on births and deaths in the Kintampo Health Research Centre study area of Ghana. Women were screened for depression during pregnancy and after birth using the Patient Health Questionnaire to ascertain DSM-IV major or minor depression. Information was collected on determinants relating to the mother, birth, and baby, which were examined using logistic regression; effect sizes reported as relative risks with 95% confidence intervals. RESULTS Thirteen thousand nine hundred and twenty nine women were screened both during pregnancy and after birth, of whom 13,360 (95.9%) had complete data on potential determinants. Two hundred and fifty five (3.8%, 95% CI: 3.5%, 4.1%) had PND. Antenatal depression (AND) was the strongest determinant accounting for 34.4% of PND cases. Other determinants were season of delivery, peripartum/postpartum complications, newborn ill health, still birth, or neonatal death. Common determinants were observed for onset and persistent depression. CONCLUSIONS Although most AND resolves in this setting, more than a third of women with PND also had AND. Adverse birth- and baby-related outcomes are the other main determinants. We recommend that programs detect and treat depression during pregnancy and provide support to women with adverse birth outcomes.
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Gold KJ, Spangenberg K, Wobil P, Schwenk TL. Depression and risk factors for depression among mothers of sick infants in Kumasi, Ghana. Int J Gynaecol Obstet 2012; 120:228-31. [PMID: 23228821 DOI: 10.1016/j.ijgo.2012.09.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 09/11/2012] [Accepted: 11/13/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the prevalence of and risk factors for depression in a high-risk population of mothers of ill newborns in Ghana. METHODS Semi-structured interviews were conducted with women who had a hospitalized newborn at a tertiary teaching hospital in Kumasi, Ghana. Surveys included information on maternal demographics, pregnancy and delivery, interpersonal violence, and social support. Postpartum depression was measured with the Patient Health Questionnaire (PHQ)-9. Bivariable analysis was conducted using analysis of variance, χ(2), and Fisher exact tests; multivariable analysis was performed using multinomial logistic regression. RESULTS In total, 153 women completed the survey. Fifty (32.7%) had PHQ-9 scores of 5-9, indicating mild depression; 42 (27.4%) had PHQ-9 scores of 10-14, indicating moderate depression; and 15 (9.8%) had scores of 15 or higher, indicative of moderate/severe depression. History of interpersonal violence with current partner predicted depression. CONCLUSION Mothers of sick infants in Ghana are at high risk for symptoms of clinical depression. This is of critical importance because maternal depression affects infant health outcomes and may be particularly important for mothers of sick infants.
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Affiliation(s)
- Katherine J Gold
- Department of Family Medicine, University of Michigan, Ann Arbor, MI 48104-1213, USA.
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21
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Lartey A, Marquis GS, Mazur R, Perez-Escamilla R, Brakohiapa L, Ampofo W, Sellen D, Adu-Afarwuah S. Maternal HIV is associated with reduced growth in the first year of life among infants in the Eastern region of Ghana: the Research to Improve Infant Nutrition and Growth (RIING) Project. MATERNAL AND CHILD NUTRITION 2012; 10:604-16. [PMID: 22905700 DOI: 10.1111/j.1740-8709.2012.00441.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Children of HIV-infected mothers experience poor growth, but not much is understood about the extent to which such children are affected. The Research to Improve Infant Nutrition and Growth (RIING) Project used a longitudinal study design to investigate the association between maternal HIV status and growth among Ghanaian infants in the first year of life. Pregnant women in their third trimester were enrolled into three groups: HIV-negative (HIV-N, n = 185), HIV-positive (HIV-P, n = 190) and HIV-unknown (HIV-U, n = 177). Socioeconomic data were collected. Infant weight and length were measured at birth and every month until 12 months of age. Weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) z-scores were compared using analysis of covariance. Infant HIV status was not known as most mothers declined to test their children's status at 12 months. Adjusted mean WAZ and LAZ at birth were significantly higher for infants of HIV-N compared with infants of HIV-P mothers. The prevalence of underweight at 12 months in the HIV-N, HIV-P and HIV-U were 6.6%, 27.5% and 9.9% (P < 0.05), respectively. By 12 months, the prevalence of stunting was significantly different (HIV-N = 6.0%, HIV-P = 26.5% and HIV-U = 5.0%, P < 0.05). The adjusted mean ± SE LAZ (0.57 ± 0.11 vs. -0.95 ± 0.12; P < 0.005) was significantly greater for infants of HIV-N mothers than infants of HIV-P mothers. Maternal HIV is associated with reduce infant growth in weight and length throughout the first year of life. Children of HIV-P mothers living in socioeconomically deprived communities need special support to mitigate any negative effect on growth performance.
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Affiliation(s)
- Anna Lartey
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
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