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Wyunn KM, Than Wai ZZ, Ei Swe KE, Inthaphatha S, Nishino K, Yamamoto E. Factors associated with postpartum depression among Myanmar women in Yangon: A cross-sectional study. Heliyon 2024; 10:e33425. [PMID: 39040339 PMCID: PMC11261082 DOI: 10.1016/j.heliyon.2024.e33425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
Background Postpartum depression (PPD) is non-psychotic depressive illness after childbirth, and PPD affects the health and social status of mothers and their children. This study aims to identify the prevalence of suspected PPD and associated factors among women in Yangon, Myanmar. Methods This is a cross-sectional study of 552 women at 6-8 weeks postpartum who visited at North Okkalapa General and Teaching Hospital for postnatal care from September to October 2022. Socio-demographic factors, obstetric and infant factors, family support, and medical history were collected using a structured questionnaire. Myanmar version of the Edinburgh Postnatal Depression Scale (EPDS) was used for screening PPD, and all women were divided into suspected PPD (EPDS ≥10) and non-suspected PPD (EPDS <10). Chi-square and Fisher's exact tests were used to compare the characteristics of women between suspected PPD and non-suspected PPD. Logistic regression analysis was preformed to identify the factors associated with suspected PPD. Results The mean age of the 552 women was 27.9 years and 176 women (31.9 %) were categorized into suspected PPD. Factors associated with suspected PPD were living in a nuclear family (adjusted odds ratio (AOR) = 2.04, 95 % confidence interval (CI) 1.10-3.77), feeling insufficient income (AOR = 2.15, 95 % CI 1.09-4.25), unplanned pregnancy (AOR = 2.76, 95 % CI 1.47-5.16), less than eight ANC visits (AOR = 3.29, 95 % CI 1.74-6.23), low birth weight of the last baby (AOR = 5.69, 95 % CI 1.17-27.71), insufficient support from partners (AOR = 11.28, 95 % CI 5.62-22.63), parents (AOR = 3.83, 95 % CI 2.08-7.04), and parents-in-law (AOR = 2.00, 95 % CI 1.06-3.76), and depressive symptoms during the last pregnancy (AOR = 3.08, 95 % CI 1.52-6.26). Conclusion The prevalence of suspected PPD was 31.9 % among 6-8-week postpartum women in Yangon. Strengthening maternal health programs and providing education about postpartum psychiatric problems is essential to improve maternal psychological well-being.
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Affiliation(s)
- Kaung Myat Wyunn
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Medical Services, Ministry of Health, Nay Pyi Taw, Myanmar
| | | | - Khin Ei Ei Swe
- North Okkalapa General and Teaching Hospital, Yangon, Myanmar
| | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Asian Satellite Campuses Institute, Nagoya University, Nagoya, Japan
| | - Kimihiro Nishino
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Yenealem B, Negash M, Madoro D, Molla A, Nenko G, Nakie G, Getnet B. Prevalence and associated factors of maternal depression among mothers of children with undernutrition at comprehensive specialized hospitals in Northwest Ethiopia in 2023: a cross-sectional study. Front Psychiatry 2024; 15:1400293. [PMID: 39022759 PMCID: PMC11252023 DOI: 10.3389/fpsyt.2024.1400293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/03/2024] [Indexed: 07/20/2024] Open
Abstract
Background Malnutrition is one of the most significant child health problems in developing countries, accounting for an estimated 53% of child deaths per year. Depression is the leading cause of disease-related disability in women and adversely affects the health and well-being of mothers and their children. Studies have shown that maternal depression has an impact on infant growth and nutritional status. However, evidence is scarce regarding the relationship between maternal depression and child malnutrition. Objectives The general objective of this study was to assess the prevalence and associated factors of maternal depression among mothers of undernourished children at comprehensive specialized hospitals in Northwest Ethiopia in 2023. Methods An institution-based cross-sectional study was conducted among 465 participants. Outcome variables were assessed using a Patient Health Questionnaire-9 (PHQ-9). Data were analyzed using SPSS-25. Bivariate and multivariable logistic regression analyses were conducted. Variables with a p-value less than 0.05 were considered statistically significant with a corresponding 95% confidence interval (CI). Results The prevalence of maternal depression among mothers of children with undernutrition was 36.4% (95% CI = 32%-41%). According to a multivariate analysis, lack of maternal education (adjusted odds ratio [AOR] = 2.872, 95% CI = 1.502-5.492), unemployment (AOR = 2.581, 95% CI = 1.497-4.451), poor social support (AOR = 2.209, 95% CI = 1.314-3.713), perceived stigma (AOR = 2.243, 95% CI = 1.414-3.560), and stunting (AOR = 1.913, 95% CI = 1.129-3.241) were factors significantly associated with maternal depression. Conclusion The overall prevalence of maternal depression was higher among mothers of children with undernutrition. This higher prevalence was associated with several factors, including lack of education, unemployment, poor social support, high perceived stigma, and stunted physical growth in the children themselves. To decrease maternal depression, we can address these factors by increasing the level of maternal education and employment opportunities, strengthening social support systems, reducing stigma, and providing interventions to reduce stunting.
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Affiliation(s)
- Biazin Yenealem
- Department of Psychiatry, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Misrak Negash
- Department of Psychiatry, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Derebe Madoro
- Department of Psychiatry, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Alemayehu Molla
- Department of Psychiatry, College of Health and Medical Science, Injibara University, Injibara, Ethiopia
- School of Health, Faculty of Medicine and Health Science, University of New England, Armidale, NSW, Australia
| | - Goshu Nenko
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Berhanie Getnet
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Bua A, Moirano G, Pizzi C, Rusconi F, Migliore E, Richiardi L, Popovic M. Maternal antenatal mental health and its associations with perinatal outcomes and the use of healthcare services in children from the NINFEA birth cohort study. Eur J Pediatr 2024; 183:2769-2781. [PMID: 38564067 DOI: 10.1007/s00431-024-05525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
To investigate the associations between maternal mental health disorders before and during pregnancy and perinatal outcomes and child healthcare utilization between 6 and 18 months of age. Among the 6814 mother-child pairs from the Italian Internet-based NINFEA birth cohort, maternal depression, anxiety, and sleep disorders diagnosed by a physician before and during pregnancy were assessed through self-reported questionnaires completed during pregnancy and 6 months after delivery. Perinatal outcomes (preterm birth, birth weight, small for gestational age, congenital anomalies, and neonatal intensive care unit (NICU)) and children's healthcare utilization (emergency department (ED) visits, hospitalizations, and outpatient visits) were reported by mothers at 6 and 18 months postpartum. We used regression models adjusted for maternal age, education, parity, country of birth, region of delivery, and household income. Maternal mental health disorders were not associated with perinatal outcomes, except for depression, which increased the risk of offspring admission to NICU, and anxiety disorders during pregnancy, which were associated with preterm birth and lower birth weight. Children born to mothers with depression/anxiety disorders before pregnancy, compared to children of mothers without these disorders, had an increased odds of a visit to ED for any reason (odds ratio (ORadj) = 1.26, 95% confidence interval (CI): 1.02-1.54), of an ED visit resulting in hospitalization (ORadj = 1.75, 95%CI: 1.27-2.42), and of planned hospital admissions (ORadj = 1.55, 95%CI: 1.01-2.40). These associations with healthcare utilization were similar for mental disorders also during pregnancy. The association pattern of maternal sleep disorders with perinatal outcomes and child healthcare utilization resembled that of maternal depression and/or anxiety disorders with these outcomes. Conclusion: Antenatal maternal mental health is a potential risk factor for child-health outcomes and healthcare use. Early maternal mental health interventions may help to promote child health and reduce healthcare costs. What is Known: • Poor maternal mental health affects pregnancy outcomes and child health, and children of mothers with mental health conditions tend to have increased healtcare utilization. • Parents with poor mental health often face challenges in caring for their children and have less parenting self-efficacy, which could potentially lead to frequent medical consultations for minor health issues. What is New: • Maternal pre-pregnancy mental disorders were not associated with preterm birth, low birth weight, SGA, and congenital anomalies, except for depression, which increased the risk of offspring admission to NICU. Anxiety disorders during pregnancy were associated with lower birth weight and an increased odds of preterm birth. • Maternal depression and/or anxiety and sleep disorders, both before and during pregnancy, were associated with an increase in children's healthcare utilization between 6 and 18 months of life.
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Affiliation(s)
- Adriana Bua
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
| | - Franca Rusconi
- Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | - Enrica Migliore
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- CPO Piemonte, Turin, Italy
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Choedon T, Sethi V, Killeen SL, Ganjekar S, Satyanarayana V, Ghosh S, Jacob CM, McAuliffe FM, Hanson MA, Chandra P. Integrating nutrition and mental health screening, risk identification and management in prenatal health programs in India. Int J Gynaecol Obstet 2023; 162:792-801. [PMID: 36808738 DOI: 10.1002/ijgo.14728] [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: 09/05/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023]
Abstract
Pregnancy is a period of major physiologic, hormonal, and psychological change, increasing the risk of nutritional deficiencies and mental disorders. Mental disorders and malnutrition are associated with adverse pregnancy and child outcomes, with potential long-standing impact. Common mental disorders during pregnancy are more prevalent in low- and middle-income countries (LMICs). In India, studies suggest the prevalence of depression is 9.8%-36.7% and of anxiety is 55.7%. India has seen some promising developments in recent years such as increased coverage of the District Mental Health Program; integration of maternal mental health into the Reproductive and Child Health Program in Kerala; and the Mental Health Care Act 2017. However, mental health screening and management protocols have not yet been established and integrated into routine prenatal care in India. A five-action maternal nutrition algorithm was developed and tested for the Ministry of Health and Family Welfare, aiming to strengthen nutrition services for pregnant women in routine prenatal care facilities. In this paper, we present opportunities and challenges for integration of maternal nutrition and mental health screening and a management protocol at routine prenatal care in India, discuss evidence-based interventions in other LMICs including India, and make recommendations for public healthcare providers.
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Affiliation(s)
| | - Vani Sethi
- UNICEF Regional office for South Asia, Kathmandu, Nepal
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Sundarnag Ganjekar
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | | | | | - Chandni Maria Jacob
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Mark A Hanson
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Prabha Chandra
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
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Bhusal CK, Bhattarai S, Shrestha A, Sharma HR. Depression and Its Determinants among Postpartum Mothers Attending at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Rupandehi, Nepal. Int J Pediatr 2023; 2023:1331641. [PMID: 37538262 PMCID: PMC10396550 DOI: 10.1155/2023/1331641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Abstract
Background Postpartum depression is a serious mental health issue linked to maternal morbidity and negative effects for infant's normal growth, development, and well-being. This study is aimed at assessing the prevalence and factors associated with postpartum depression among mothers attending a tertiary hospital in Nepal. Methods A hospital-based cross-sectional study was conducted among 173 postpartum mothers (<6 weeks postdelivery) who were receiving care either at the postnatal ward or immunization clinic of Universal College of Medical Sciences and Teaching Hospital in Bhairahawa, Rupandehi district, Nepal. The study was carried out from October 2020 to February 2021 by using purposive sampling technique for selecting respondents. The variables that showed significant association with the dependent variable having p value < 0.05 in bivariate analysis were entered into multivariate logistic regression model to find the final associated factors. Results The prevalence of postpartum depression was 20.2% among mothers attending a tertiary hospital in Nepal. The mean age of the respondents was 24.77 ± 3.47. Factors such as mothers having female child (AOR = 6.39, CI = 1.54 - 26.46), unplanned pregnancy (AOR = 10.08, CI = 2.91 - 34.94), pregnancy-induced health problems (AOR = 9.68, CI: 3.51-26.64) were associated with an increased risk of postpartum depression. Similarly, mothers having formal education (AOR = 0.28, CI: 0.08-0.91), whose spouses have secondary and above education (AOR = 0.16, CI: 0.03-0.85), and who have ≥4 ANC visits (AOR = 0.15, CI = 0.05 - 0.40) were significantly associated but have a protective effect with postpartum depression. Conclusions Sex of newborn, mother's and spouse's education, intention of pregnancy, ANC visits, and pregnancy-induced health problems were found to be significantly associated with postpartum depression. Hence, specific health education program regarding maternal and child health integrating mental health should be provided to pregnant women, mothers, and their husbands, focusing on gender discrimination. Similarly specific orientation program should be provided to local health worker about the importance of planned pregnancy, in order to reduce pregnancy related health problems during ANC visits and to mothers after their delivery to reduce further chances of postpartum depression.
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Affiliation(s)
- Chet Kant Bhusal
- Department of Community Medicine, Universal College of Medical Sciences and Teaching Hospital Affiliated to Tribhuvan University, Bhairahawa, Rupandehi, Nepal
| | - Sigma Bhattarai
- Department of Nursing, Universal College of Medical Sciences and Teaching Hospital Affiliated to Tribhuvan University, Bhairahawa, Rupandehi, Nepal
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6
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Ricci H, Nakiranda R, Malan L, Kruger HS, Visser M, Ricci C, Faber M, Smuts CM. Association between maternal postpartum depressive symptoms, socioeconomic factors, and birth outcomes with infant growth in South Africa. Sci Rep 2023; 13:5696. [PMID: 37029213 PMCID: PMC10080513 DOI: 10.1038/s41598-023-32653-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/30/2023] [Indexed: 04/09/2023] Open
Abstract
This study aimed to investigate the association between maternal postpartum depressive symptoms, household demographic, socioeconomic, and infant characteristics with infant physical growth, and how these factors correlate to determine latent factors. This study was based on the baseline data of a 6-month randomised controlled trial aimed at providing an egg a day to infants aged 6 to 9-months from a low socioeconomic community in South Africa. Information collected on household demographic, socioeconomic, and infant characteristics was by face-to-face structured interviews, and trained assessors took anthropometric measurements. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess maternal postpartum depressive symptoms. The analysis was based on 428 mother-infant pairs. Total EPDS score and its subscales score were not associated with stunting or underweight risk. However, a three- to four-fold increased risk of stunting and underweight, respectively was observed for premature birth. Low birthweight was associated with an estimated six-fold increased risk of underweight and stunting. Being female was associated with about 50% reduced risk of stunting and underweight. In conclusion, more robust studies are needed to substantiate these findings, with more awareness creation on the consequences of LBW and prematurity on the physical growth of infants from resource-limited settings.
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Affiliation(s)
- Hannah Ricci
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa.
- North-West University (Africa Unit for Transdisciplinary Health Research (AUTHeR)), Potchefstroom, South Africa.
| | - Regina Nakiranda
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
| | - Linda Malan
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
| | - Herculina S Kruger
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
| | - Marina Visser
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
| | - Cristian Ricci
- North-West University (Africa Unit for Transdisciplinary Health Research (AUTHeR)), Potchefstroom, South Africa
| | - Mieke Faber
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
- South African Medical Research Council (Non-Communicable Diseases Research Unit), Tygerberg, South Africa
| | - Cornelius M Smuts
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
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van Immerzeel TD, Diagne M, Deme/Ly I, Murungi AE, Diouf S, Kerac M, Grijalva-Eternod CS, Day LT. Implementing a Care Pathway for small and nutritionally at-risk infants under six months of age: A multi-country stakeholder consultation. MATERNAL & CHILD NUTRITION 2023; 19:e13455. [PMID: 36373777 PMCID: PMC9749585 DOI: 10.1111/mcn.13455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/07/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022]
Abstract
Nutritional vulnerability under the age of 6 months is prevalent in low- and middle-income countries with 20.1% infants underweight, 21.3% wasted and 17.6% stunted in a recent review. A novel Care Pathway for improved management of small and nutritionally at-risk infants under 6 months and their mothers (MAMI) has recently been developed to provide outpatient care at large coverage. We aimed to investigate stakeholders' views on the feasibility of its implementation and to identify barriers and enablers. This was an early stage formative mixed-methods study: an online survey plus in-depth interviews with country-level stakeholders in nutrition and child health from different geographical regions and stakeholder groups. 189 stakeholders from 42 countries responded to the online survey and 14 remote interviews were conducted. Participants expressed an urgent need for improved detection and care for small and nutritionally at-risk infants under 6 months. Whilst they considered the MAMI Care Pathway feasible and relevant, they noted it was largely unknown in their country. The most mentioned implementation barriers were: community-specific needs and health care seeking barriers, health workers' lack of competence in breastfeeding counselling and the absence of a validated anthropometric screening method. Possible enablers for its implementation were: patients' preference for outpatient care, integrating the MAMI care pathway into existing maternal and child health programmes and the possibility of a local pilot project. Adaptation to the local context was considered crucial in further scale-up.
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Affiliation(s)
- Tabitha D van Immerzeel
- Department for Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Indou Deme/Ly
- University Cheick Anta Diop, Dakar, Senegal.,Centre Hospitalier National D'Enfants Albert Royer, Dakar, Senegal
| | | | | | - Marko Kerac
- Department for Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK.,Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK
| | - Carlos S Grijalva-Eternod
- Department for Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Louise T Day
- Department for Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK.,Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK
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8
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Marlow M, Skeen S, Hunt X, Sundin P, Weiss RE, Mofokeng S, Makhetha M, Cluver L, Sherr L, Tomlinson M. Depression, anxiety, and psychological distress among caregivers of young children in rural Lesotho: Associations with food insecurity, household death and parenting stress. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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9
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Bai Y, Abulitifu R, Wang D. Impact of an Early Childhood Development Intervention on the Mental Health of Female Caregivers: Evidence from a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11392. [PMID: 36141665 PMCID: PMC9516973 DOI: 10.3390/ijerph191811392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/26/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Investing in early childhood development is an effective way to enhance human capital accumulation. Caregivers' mental health is one of the most important factors influencing children's development. Previous studies have found that mental health issues in caregivers are widespread all over the world, especially in low- and middle-income countries. In this study, we explored the effects of the "Integrated Program for Early Childhood Development" on the mental health of female caregivers in Southwest China through a randomized intervention trial, with infants aged 5-25 months and their caregivers as the target subjects. The heterogeneity of the effects of different characteristics of the caregivers and the mechanism of the intervention effect were also analyzed. Primary caregivers were provided comprehensive early development interventions for the children in the treatment group via bi-weekly home visiting activities and monthly family group activities. The results showed that the prevalence of depression, anxiety, and stress symptoms among female caregivers in this rural area were 32%, 42%, and 30%, respectively. Whether the child was breastfed, parent's age, parent's education level, primary caregiver type, the ratio of the number of months the mother was at home full time to the child's age, the grandmother's rearing ability, and the family asset index were the factors influencing the mental health of female caregivers. The intervention significantly increased the proportion of depressive symptoms in 28% of the grandmothers. It significantly reduced the anxiety symptoms of daughters-in-law not from the local town, while the social interactions of both local and non-local daughters-in-law were significantly improved.
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Affiliation(s)
- Yu Bai
- School of Economics, Minzu University of China, Beijing 100081, China
- China Institute for Vitalizing Border Areas and Enriching the People, Beijing 100081, China
| | - Reyila Abulitifu
- School of Economics, Minzu University of China, Beijing 100081, China
| | - Dan Wang
- School of Economics, Minzu University of China, Beijing 100081, China
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Jhawar S, Gupta SD, Das A. Perinatal Depression as a Growing Mental Health Concern: A Systematic Review. JOURNAL OF HEALTH MANAGEMENT 2022. [DOI: 10.1177/09720634221109313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mental health today, is a rising concern the world over. In order to focus prevention strategies and treatment options, it is important to study the types, and attributes, of illnesses under mental health. Among all types, depression is found to be the major contributor to the global burden of this disease and it is found to affect more women than men. Among women, perinatal depression is a serious and highly prevalent form of depression that affects women of childbearing age. Perinatal depression comprises of antenatal depression (AD) and postnatal depression (PD). AD is a precursor of PD and while it negatively impacts the health of the woman herself, it also has potential adverse effects on the health and socio-psychological development of the new born. Research from low- and middle-income countries (LMICs) finds prevalence of AD at 25.8%, and of PD at 19.7%. In spite of this, while studies on PD are available, studies and understanding of AD are limited and have not received the desired attention of the scientific community. Various global and local organisations have done policy advocacy on mental health, and to some extent within this framework, on perinatal depression, however, focus is still required in the LMICs for strengthening health systems for prevention and treatment.
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Affiliation(s)
- Sheenu Jhawar
- IIHMR University (Indian Institute of Health Management Research), Jaipur, Rajasthan, India
| | - S. D. Gupta
- IIHMR University (Indian Institute of Health Management Research), Jaipur, Rajasthan, India
| | - Arindam Das
- IIHMR University (Indian Institute of Health Management Research), Jaipur, Rajasthan, India
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Jhawar S, Gupta SD, Das A. Maternal depression: Technology enabled self screening in real time. Health Care Women Int 2022; 43:1449-1463. [DOI: 10.1080/07399332.2022.2037603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sheenu Jhawar
- Apex Hospitals P L, Jaipur India
- ACE Vision Health Consultants P L, Jaipur, India
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12
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Mutahi J, Larsen A, Cuijpers P, Peterson SS, Unutzer J, McKay M, John-Stewart G, Jewell T, Kinuthia J, Gohar F, Lai J, Wamalwa D, Gachuno O, Kumar M. Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review. EClinicalMedicine 2022; 44:101289. [PMID: 35198916 PMCID: PMC8851289 DOI: 10.1016/j.eclinm.2022.101289] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/11/2022] [Accepted: 01/18/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Pregnant adolescent girls and young women (AGYW, aged 12-24 years) are at high risk for mental health problems, particularly in the Sub-Saharan African (SSA) region. METHODS We performed a systematic review of mental health studies among pregnant AGYW in SSA published between January 1, 2007 and December 31, 2020 in PubMed, Embase, CINAHL, PsycInfo, and Global Index Medicus following PRISMA guidelines (PROSPERO: CRD42021230980). We used Bronfenbrenner's bioecological model to frame and synthesize results from included studies. FINDINGS Our search yielded 945 articles from which 18 studies were included (N = 8 quantitative, N = 9 qualitative, N = 1 case report). The most frequently studied mental health problem was depression (N = 9 studies); the most frequently utilized measurement tool was the Edinburgh Postnatal Depression Scale (N = 3). Studies reported life course factors, individual, microsystem, exosystem, macrosystem, and chronosystem-level factors associated with mental health problems. Gaps in mental health service delivery for pregnant AGYW included lack of confidentiality, judgmental healthcare worker attitudes, and lack of services tailored to their unique needs. INTERPRETATION Gaps remain in research and services for mental health among pregnant AGYW in SSA. Integration of mental health services within school, community, and healthcare settings that are tailored to pregnant AGYW could strengthen health systems within SSA. FUNDING Author contributions were supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (F31HD101149 to AL) and the Fogarty International Center (K43TW010716 to MK). The funding agencies had no role in the writing of the manuscript or the decision to submit it for publication. The project itself was not funded.
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Affiliation(s)
- Joan Mutahi
- Department of Psychiatry, College of Health Sciences, University of Nairobi, 00100 (19676), Nairobi, Kenya
| | - Anna Larsen
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherland
| | | | - Jurgen Unutzer
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Mary McKay
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, United States
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Teresa Jewell
- University of Washington Libraries, Seattle, WA, United States
| | - John Kinuthia
- Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Fatima Gohar
- United Nations Children's Fund (UNICEF), New York, NY, United States
| | - Joanna Lai
- United Nations Children's Fund (UNICEF), New York, NY, United States
| | - Dalton Wamalwa
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Onesmus Gachuno
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
| | - Manasi Kumar
- Department of Psychiatry, College of Health Sciences, University of Nairobi, 00100 (19676), Nairobi, Kenya
- Brain and Mind Institute, Aga Khan University, Kenya
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Myo T, Hong SA, Thepthien BO, Hongkrailert N. Prevalence and Factors Associated with Postpartum Depression in Primary Healthcare Centres in Yangon, Myanmar. Malays J Med Sci 2021; 28:71-86. [PMID: 34512132 PMCID: PMC8407790 DOI: 10.21315/mjms2021.28.4.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 03/11/2021] [Indexed: 11/08/2022] Open
Abstract
Background Postpartum depression (PPD) can have serious consequences on both the mother and infant. Despite the higher prevalence, there are limited numbers of studies on PPD in low-and middle-income countries, like Myanmar. This study aimed to explore the prevalence and associated factors of PPD in primary healthcare settings in Myanmar. Methods This cross-sectional online study was conducted with 220 mothers under 6 months postpartum in April–May 2020 and who registered in public health centres in Kungyangone Township, Yangon, Myanmar. The postpartum depression was measured with the Edinburgh postpartum depression scale (EPDS, ≥ 13 scores). Independent variables included sociodemographic factors, obstetric and infant factors, psychosocial factors (social support and social media usage), health services utilisation and accessibility factors. Chi-square tests and multiple logistic regression were performed. Results Overall prevalence of depressive symptoms in 220 women under 6 months postpartum was 31.8% (95% confidence interval [CI]: 25.9, 37.3). In multiple logistic regression, unplanned pregnancy (adjusted odds ratio [AOR]: 2.946), less than four times antenatal care (ANC) visits (AOR: 2.518), travel time more than 1 h to reach health centres (AOR: 3.068) and birth interval more than 5 years (AOR: 4.594) were more likely to be associated with PPD, while preterm delivery (AOR: 0.091) was inversely associated. Conclusion This study showed the relatively high prevalence of PPD and the strong association with preterm delivery, pregnancy intention, breastfeeding status, birth interval as well as frequency of ANC received and travel time to health centre. It may suggest that maternal mental health services should be integrated with existing maternal and child health (MCH) services for early detection and prevention of depression symptoms with promotion of MCH services utilisation and improved accessibility among mothers in primary healthcare setting.
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Affiliation(s)
- Theigi Myo
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Seo Ah Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Bang-On Thepthien
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Nate Hongkrailert
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
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Tran LM, Nguyen PH, Naved RT, Menon P. Intimate partner violence is associated with poorer maternal mental health and breastfeeding practices in Bangladesh. Health Policy Plan 2021; 35:i19-i29. [PMID: 33165581 PMCID: PMC7649668 DOI: 10.1093/heapol/czaa106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 12/03/2022] Open
Abstract
Exposure to intimate partner violence (IPV) can have profound adverse consequences on maternal and child health. This study aimed to: (1) identify factors associated with IPV during pregnancy and postpartum in Bangladesh; and (2) assess the associations between IPV and maternal mental health and breastfeeding practices. We used data from a cross-sectional survey of 2000 mothers with children <6 months in four districts in Bangladesh. We applied multivariable logistic regression models to examine factors associated with IPV and structural equation modelling to assess the inter-relationships between IPV, maternal common mental disorders (CMD, measured by Self-reporting Questionnaire ≥7) and breastfeeding practices. Overall, 49.7% of mothers experienced violence during the last 12 months and 28% of mothers had high levels of CMD. Only 54% of women reported early initiation of breastfeeding and 64% reported exclusive breastfeeding. Women were more likely to experience IPV if living in food-insecure households, being of low socio-economic status, having low autonomy or experiencing inequality in education compared with husbands (OR ranged from 1.6 to 2.8). Women exposed to IPV were 2–2.3 times more likely to suffer from high levels of CMD and 28–34% less likely to breastfeed their babies exclusively. The indirect path (the indirect effects of IPV on breastfeeding through CMD) through maternal CMD accounted for 14% of the relationship between IPV on breastfeeding practice. In conclusion, IPV is pervasive in Bangladesh and is linked to increased risks of CMD and poor breastfeeding practices. Integrating effective interventions to mitigate IPV, along with routine maternal and child health services and involving men in counselling services, could help both to reduce exposure to IPV among women and to contribute to better health outcomes for women and children.
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Affiliation(s)
- Lan Mai Tran
- Alive &Thrive, FHI360,18 Ly Thuong Kiet Street, Hanoi, Vietnam
| | - Phuong Hong Nguyen
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA
| | - Ruchira Tabassum Naved
- Health System and Population Studies Division, ICDDR, GPO Box 128, Dhaka 1000, Bangladesh
| | - Purnima Menon
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA
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Association between high pre-pregnancy body mass index and antenatal depression: A study among pregnant women of upper socio-economic strata in North-West Delhi, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Concha N, Jovchelovitch S. Grandmothers: Central scaffolding sources impacting maternal and infant feeding practices in Colombia. MATERNAL & CHILD NUTRITION 2021; 17 Suppl 1:e13162. [PMID: 34241952 PMCID: PMC8269147 DOI: 10.1111/mcn.13162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 01/03/2023]
Abstract
A growing body of evidence highlights that maternal and child nutrition programmes need to extend beyond the mother-child dyad by adopting a family systems approach, particularly in the Global South. Guided by a sociocultural and community psychology understanding of health, the paper explores factors identifying grandmothers as central resources for nutrition programmes. The study was conducted in a Colombian urban periphery applying a qualitative longitudinal design (prenatal and postpartum). It is based on interviews with adolescent mothers and mothers in their 20s (n = 35 at T1; n = 21 at T2), grandmothers (n = 15 at T1; n = 12 at T2) and community/public stakeholders (n = 17). Many of the participants live in low-income households headed by grandmothers, who adjust feeding practices to the extent of their economic capacity. Findings reveal grandmothers play a central role in decision-making and in enabling a holistic support system for the dyad. This is defined as grandmothers' scaffolding; it covers nutrition advice, breastfeeding and infant feeding, cultural practices, caregiving and maternal mental health. The study helps build the evidence-base for the transferability of a family systems approach to Global South regions by using sociocultural and community psychology concepts to fortify the rationale for including grandmothers in maternal and child nutrition programmes. It argues for the need to continue raising the visibility of key actors like grandmothers and for nutrition programmes to align themselves more flexibly with the needs of families experiencing poverty.
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Affiliation(s)
- Natalia Concha
- Department of Psychological and Behavioural ScienceThe London School of Economics and Political ScienceLondonUK
| | - Sandra Jovchelovitch
- Department of Psychological and Behavioural ScienceThe London School of Economics and Political ScienceLondonUK
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Mishkin K, Maqsood SS, Ahmed HM. Antenatal Depression Symptoms Among Pregnant Women Seeking Health Services in Erbil, Iraq. Matern Child Health J 2021; 25:1043-1049. [PMID: 33905065 DOI: 10.1007/s10995-021-03142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Maternal depression, which includes depression in the prenatal and postpartum periods, is estimated to affect between 10 and 20% of women globally but the rate is higher in the Middle East. Research focused on maternal depression in Iraq is limited to one study focused on postpartum depression. This paper identifies the prevalence and factors associated with antenatal depression among pregnant Iraqi women. METHODS Women seeking maternal health services at primary health centers were invited to participate. Data were collected by trained midwifery students in Erbil, Iraq. Responses to the PHQ-2 PRIME-MD depression questions were used to identify depressive symptoms. Chi-square and logistic regression analyses were used to analyze findings. RESULTS Of the 179 participants, 86 (48%) reported depressive symptoms. In bivariate analysis, antenatal depression was associated with gestational age (p = 0.03), first prenatal visit in the second trimester (p = 0.003), loss of appetite (p = 0.003), not having help at home (p = 0.03), and use of prenatal vitamins (p = 0.002). Gravida approached significance (p = 0.07). In adjusted analysis, women reporting loss of appetite were more likely to report depressive symptoms (OR = 3.09, 95% CI: 1.47-6.51). DISCUSSION Consistent with other research from the region, nearly half the women reported depressive symptoms. Because lack of appetite is associated with depressive symptoms, women reporting loss of appetite should be prioritized for depression screening in time-constrained settings.
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Affiliation(s)
- Kathryn Mishkin
- Department of Health Policy, Management, Behavior, University at Albany, Albany, NY, USA.
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Food security mediates the decrease in women's depressive symptoms in a participatory nutrition-sensitive agroecology intervention in rural Tanzania. Public Health Nutr 2021; 24:4682-4692. [PMID: 33706829 DOI: 10.1017/s1368980021001014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate if food security mediated the impact of a nutrition-sensitive agroecology intervention on women's depressive symptoms. DESIGN We used annual longitudinal data (four time points) from a cluster-randomised effectiveness trial of a participatory nutrition-sensitive agroecology intervention, the Singida Nutrition and Agroecology Project. Structural equation modelling estimation of total, natural direct and natural indirect effects was used to investigate food security's role in the intervention's impact on women's risk of probable depression (Center for Epidemiologic Studies Depression Scale > 17) across 3 years. SETTING Rural Singida, Tanzania. PARTICIPANTS 548 food insecure, married, smallholder women farmers with children < 1 year old at baseline. RESULTS At baseline, one-third of the women in each group had probable depression (Control: 32·0 %, Intervention: 31·9 %, P difference = 0·97). The intervention lowered the odds of probable depression by 43 % (OR = 0·57, 95 % CI: 0·43, 0·70). Differences in food insecurity explained approximately 10 percentage points of the effects of the intervention on odds of probable depression (OR = 0·90, 95 % CI: 0·83, 0·95). CONCLUSIONS This is the first evidence of the strong, positive effect that lowering food insecurity has on reducing women's depressive symptoms. Nutrition-sensitive agricultural interventions can have broader impacts than previously demonstrated, i.e. improvements in mental health; changes in food security play an important causal role in this pathway. As such, these data suggest participatory nutrition-sensitive agroecology interventions have the potential to be an accessible method of improving women's well-being in farming communities.
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Okunola TO, Awoleke JO, Olofinbiyi B, Rosiji B, Olubiyi AO, Omoya S. Predictors of postpartum depression among an obstetric population in South-Western Nigeria. J Reprod Infant Psychol 2021; 40:420-432. [PMID: 33641549 DOI: 10.1080/02646838.2021.1886259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Perinatal maternal depression is the most common mood disturbance associated with pregnancy. It has grave consequences on both maternal health and wellbeing of offsprings, albeit usually neglected in low- and middle-income countries.Objective: To evaluate the relationship between antenatal depression(APD) and postpartum depression(PPD) and predictors of postpartum depression among an obstetric population in South-western Nigeria.Methods: This was a prospective longitudinal cohort study involving272 pregnant women recruited between 34 and 36 weeks of pregnancy and followed up to till 6 weeks after delivery. Edinburgh Postnatal Depression Scale (EPDS) questionnaires were administered to collect data. Data were analysed with SPSS version 23.A p-value < 0.05 was taken as statistically significant.Results: The prevalences of antepartum and postpartum depression were 6.3%, (95% CI 3.4%-9.2%) and 8.8% (95% CI 5.4%-12.1%) respectively. The Spearman correlation coefficient for antepartum EPDS and postpartum EPDS scores was 0.52, p < 0.001.The predictors of postpartum depression were antepartum depression (adjusted OR 10.6, 95% CI 8.33-48.60, p < 0.001), puerperal sepsis (adjusted OR 4.33, 95% CI 3.89-8.69, p = 0.03), domestic violence (adjusted OR 3.40, 95% CI 1.94-15.67, p = 0.01) and age group 25-34 years (adjusted OR 0.11, 95% CI 0.02-0.75, p = 0.02), and household income $1671-$3330 (adjusted OR 0.10, 95% CI 0.02-0.56, p = 0.01).Conclusion: There was a positive association between the antenatal EPDS and postnatal EPDS scores. Screening for maternal depression should be considered in prenatal period. Further studies are necessary to explore the novel finding of predictive role of puerperal sepsis in PPD.
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Affiliation(s)
| | - Jacob Olumuyiwa Awoleke
- Department of Obstetrics and Gynaecology, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
| | - Babatunde Olofinbiyi
- Department of Obstetrics and Gynaecology, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
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Singh DR, Sunuwar DR, Adhikari S, Singh S, Karki K. Determining factors for the prevalence of depressive symptoms among postpartum mothers in lowland region in southern Nepal. PLoS One 2021; 16:e0245199. [PMID: 33481863 PMCID: PMC7822291 DOI: 10.1371/journal.pone.0245199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022] Open
Abstract
Background Postpartum depression is the most common mental health problem among women of childbearing age in resource-poor countries. Poor maternal mental health is linked with both acute and chronic negative effects on the growth and development of the child. This study aimed to assess the prevalence and factors associated with depressive symptoms among postpartum mothers in the lowland region in southern Nepal. Methods A hospital-based analytical cross-sectional study was conducted from 1st July to 25th August 2019 among 415 randomly selected postpartum mothers attending the child immunization clinic at Narayani hospital. The postpartum depressive symptoms were measured using the validated Nepalese version of the Edinburg Postnatal Depression Scale (EPDS). The data were entered into EpiData software 3.1v and transferred into Stata version 14.1 (StataCorp LP, College Station, Texas) for statistical analyses. To identify the correlates, backward stepwise binary logistic regression models were performed separately for the dichotomized outcomes: the presence of postpartum depressive symptoms. The statistical significance was considered at p-value <0.05 with 95% confidence intervals (CIs). Results Among the total 415 study participants, 33.7% (95% CI: 29.2–38.5%) of postpartum mothers had depressive symptoms. Study participant’s whose family monthly income <150 USD compared to ≥150 USD (aOR = 13.76, 95% CI: 6.54–28.95), the husband had migrated for employment compared to not migrated (aOR = 8.19, 95% CI:4.11–15.87), nearest health facility located at more than 60 minutes of walking distance (aOR = 4.52, 95% CI: 2.26–9.03), delivered their last child by cesarean section compared to normal (vaginal) delivery (aOR = 2.02, 95% CI: 1.12–3.59) and received less than four recommended antenatal care (ANC) visits (aOR = 2.28, 95% CI:1.25–4.15) had higher odds of depressive symptoms. Participants who had planned pregnancy (aOR = 0.44, 95% CI: 0.25–0.77) were associated with 56% lower odds of depressive symptoms. Conclusions One-third of the mothers suffered from postpartum depressive symptoms. The participant’s husband migrated for employment, family income, distance to reach a health facility, delivery by cesarean section, not receiving recommended ANC visits, and plan of pregnancy were independent predictors for postpartum depressive symptoms. The study results warranted the urgency for clinical diagnosis of PPD and implementation of preventive package in study settings. Mental health education to pregnant women during ANC visits and proper counseling during the antepartum and postpartum period can also play a positive role in preventing postpartum depression.
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Affiliation(s)
- Devendra Raj Singh
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
- Research and Innovation Section, Southeast Asia Development Actions Network (SADAN), Lalitpur, Nepal
- Research Section, Swadesh Development Foundation (SDF), Province-2, Siraha, Nepal
- * E-mail:
| | - Dev Ram Sunuwar
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
- Department of Nutrition and Dietetics, Armed Police Force Hospital, Kathmandu, Nepal
| | - Shraddha Adhikari
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
| | - Sunita Singh
- Central Department of Home Science, Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Kshitij Karki
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
- Group for Technical Assistance, Lalitpur, Nepal
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Abdullahi AT, Farouk ZL, Imam A. Common mental disorders in mothers of children attending out-patient malnutrition clinics in rural North-western Nigeria: a cross-sectional study. BMC Public Health 2021; 21:185. [PMID: 33478451 PMCID: PMC7818054 DOI: 10.1186/s12889-021-10227-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/12/2021] [Indexed: 01/28/2023] Open
Abstract
Background Children with uncomplicated severe acute malnutrition are managed routinely within out-patient malnutrition treatment programs. These programs do not offer maternal mental health support services, despite maternal mental health playing a significant role in the nutritional status of children. Additionally, the burden of maternal Common Mental Disorders (CMDs) is poorly described among mothers of children attending these programs. This study thus determined the burden and risk factors for maternal CMDs among children attending out-patient malnutrition clinics in rural North-western Nigeria. Methods We conducted a cross-sectional study among 204 mothers of children with severe acute malnutrition who attending eight out-patient malnutrition clinics in Jigawa, North-western Nigeria. We used the World Health Organization Self-Reporting Questionnaire-20 (WHO SRQ-20) screening tool, a recognised and validated proxy measure for CMDs to identify mothers with CMDs. The prevalence of maternal CMDs was determined by identifying the proportion of mothers with SRQ scores of ≥8. Risk factors for CMD were determined using multivariable logistic regression. Results Maternal CMD prevalence in children attending these facilities was high at 40.7%. Non-receipt of oral polio vaccine (OPV) (AOR 6.23, 95%CI 1.85 to 20.92) increased the odds for CMD. While spousal age above 40 (AOR 0.95, 95%CI 0.90 to 0.99) and long years spent married (AOR 0.92, 95%CI 0.85 to 0.98) decreased the odds for CMD. Conclusions Our findings indicate maternal CMD burden is high in out-patient malnutrition clinics in North-western Nigeria. Maternal mental health services would need to be integrated into the community management of acute malnutrition programs to provide more holistic care, and possibly improve long-term outcomes after discharge from these programs.
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Affiliation(s)
- Aminu T Abdullahi
- Department of Psychiatry, Bayero University Kano, Kano, Nigeria.,Department of Psychiatry, Aminu Kano Teaching Hospital, PMB 3452, Kano, Nigeria
| | - Zubaida L Farouk
- Center for Infectious Diseases Research, Bayero University Kano, Kano, Nigeria.,Department of Paediatrics, Aminu Kano Teaching Hospital, PMB 3452, Kano, Nigeria
| | - Abdulazeez Imam
- Department of Vaccines and Immunity, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, P.O. Box 273, Atlantic Boulevard, Fajara, Gambia.
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Mental Health Issues among Caregivers of Young Children in Rural China: Prevalence, Risk Factors, and Links to Child Developmental Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010197. [PMID: 33383869 PMCID: PMC7796073 DOI: 10.3390/ijerph18010197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/15/2020] [Accepted: 12/26/2020] [Indexed: 11/16/2022]
Abstract
Previous research has found that there are high rates of mental health problems among caregivers in rural China and that caregiver mental health may be a significant predictor of developmental delays among infants and toddlers in these rural areas. In this paper, we use data from a survey of 986 caregiver-child pairs in rural China to examine the risk factors of caregiver mental health and measure the association between caregiver mental health and child development outcomes. To conduct the empirical analysis, we assess caregiver mental health using the Depression Anxiety Stress Scales-21 (DASS-21) questionnaire and measure child developmental outcomes using the Bayley Scales of Infant and Toddler Developmental Third Edition (Bayley-III). The results show that 32% of caregivers have depressive symptoms, 42% have anxiety symptoms, and 30% have symptoms of stress. The data also demonstrate that caregiver identity and age as well as different measures of socioeconomic status (SES) (characterized by caregiver education, father’s education, and household wealth) are all significantly linked to symptoms of caregiver mental health problems. The analysis shows that caregiver depression, anxiety, and/or stress are significantly associated with lower early childhood development (ECD) outcomes in all areas measured (cognition, language, social-emotion, and motor skills). The heterogeneous analysis demonstrates that there are differences in the effects of caregiver mental health problems on ECD among households are from families that are endowed with different levels of SES. On the basis of the findings the study concludes that policymakers should pay more attention to caregiver mental health problems in order to improve child developmental outcomes in rural China. The study cannot, however, draw casual conclusions and cannot rule out the possibility of recall bias when measuring caregiver mental health, which may limit the external validity of the findings.
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Tomlinson M, Chaudhery D, Ahmadzai H, Rodríguez Gómez S, Rodríguez Gómez C, van Heyningen T, Chopra M. Identifying and treating maternal mental health difficulties in Afghanistan: A feasibility study. Int J Ment Health Syst 2020; 14:75. [PMID: 33133235 PMCID: PMC7592367 DOI: 10.1186/s13033-020-00407-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022] Open
Abstract
Background The disproportionately high burden of mental disorders in low- and middle-income countries, coupled with the overwhelming lack of resources, requires an innovative approach to intervention and response. This study evaluated the feasibility of delivering a maternal mental health service in a severely-resource constrained setting as part of routine service delivery. Methods This exploratory feasibility study was undertaken at two health facilities in Afghanistan that did not have specialist mental health workers. Women who had given birth in the past 12 months were screened for depressive symptoms with the PHQ9 and invited to participate in a psychological intervention which was offered through an infant feeding scheme. Results Of the 215 women screened, 131 (60.9%) met the PHQ9 criteria for referral to the intervention. The screening prevalence of postnatal depression was 61%, using a PHQ9 cut-off score of 12. Additionally, 29% of women registered as suicidal on the PHQ9. Several demographic and psychosocial variables were associated with depressive symptoms in this sample, including nutritional status of the infant, anxiety symptoms, vegetative and mood symptoms, marital difficulties, intimate partner violence, social isolation, acute stress and experience of trauma. Of the 47 (65%) women who attended all six sessions of the intervention, all had significantly decreased PHQ9 scores post-intervention. Conclusion In poorly resourced environments, where the prevalence of postnatal depression is high, a shift in response from specialist-based to primary health care-level intervention may be a viable way to provide maternal mental health care. It is recommended that such programmes also consider home-visiting components and be integrated into existing infant and child health programmes. Manualised, evidence-based psychological interventions, delivered by non-specialist health workers, can improve outcomes where resources are scarce.
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Affiliation(s)
- Mark Tomlinson
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa.,School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Deepika Chaudhery
- World Bank, Health, Nutrition and Population Global Practice, South Asia Region, Kabul, Afghanistan
| | - Habibullah Ahmadzai
- World Bank, Health, Nutrition and Population Global Practice, South Asia Region, Kabul, Afghanistan
| | - Sofía Rodríguez Gómez
- Mental Health and Care Practices, Gender and Protection Department, Action Against Hunger, Kabul, Afghanistan
| | - Cécile Rodríguez Gómez
- Mental Health and Care Practices, Gender and Protection Department, Action Against Hunger, Kabul, Afghanistan
| | - Thandi van Heyningen
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Jyothi Kantipudi S, Kannan GK, Viswanathan S, Ranganathan S, Menon J, Ramanathan S. Antenatal Depression and Generalized Anxiety Disorder in a Tertiary Hospital in South India. Indian J Psychol Med 2020; 42:513-518. [PMID: 33354075 PMCID: PMC7735237 DOI: 10.1177/0253717620928440] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/31/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Antenatal depression is associated with several adverse maternal outcomes, perinatal outcomes, lower academic achievements in adolescence, and future mental health problems for the mothers. Early identification and effective treatment of depression in antenatal women can also improve perinatal outcomes. AIM This study aims to understand the prevalence of antenatal depression and anxiety disorder, along with associated factors, among antenatal women attending the outpatient clinic of the obstetrics department in a tertiary care hospital. METHODS A cross-sectional design was employed for determining the prevalence, while a case-control framework was used for analysis of the associated factors. Semi-structured sociodemographic pro forma, Patient Health Questionnaire (PHQ-9) Tamil version, and Generalised Anxiety Disorder (GAD-7) Tamil version were administered to antenatal women after obtaining informed consent. Those who scored above 10 points on the PHQ-9 or above 9 points on the GAD-7 were interviewed using the Mini-International Neuropsychiatric Interview (MINI) diagnostic interview schedule, by a psychiatrist, for confirming the diagnosis. RESULTS In our sample, 22% of the participants were diagnosed with depression, and 23% with generalized anxiety disorder (GAD). Twenty-eight participants (13.4%) had both depression and GAD. Antenatal depression was associated with alcohol use in the spouse (P < 0.015), physical violence (P < 0.026), low perceived social support from the in-laws (P < 0.039), and pressure to have a male child (0.001). Antenatal GAD was associated with low perceived social support from the in-laws (P < 0.039) and pressure to have a male child (P < 0.041). CONCLUSION The occurrence of depression and generalized anxiety disorder is high in antenatal women. Our study identified relevant psychosocial factors that may be potential targets to develop effective interventions.
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Affiliation(s)
| | - G K Kannan
- Mind Space Clinic, Chennai, Tamil Nadu, India
| | - Sushma Viswanathan
- Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - Sumathi Ranganathan
- Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - Jayakumar Menon
- Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - Sathianathan Ramanathan
- Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
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Marco PL, Valério ID, Zanatti CLDM, Gonçalves H. Systematic review: Symptoms of parental depression and anxiety and offspring overweight. Rev Saude Publica 2020; 54:49. [PMID: 32491095 PMCID: PMC7234214 DOI: 10.11606/s1518-8787.2020054001731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/22/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To evaluate the existing literature on the association between parents' depression and anxiety and their influence on their children's weight during childhood, identifying possible mechanisms involved in this association. METHODS A systematic search of the literature was conducted in the PubMed, PsycINFO and SciELO databases, using the following descriptors: (maternal OR mother* OR parent* OR paternal OR father) AND ("common mental disorder" OR "mental health" OR "mental disorder" OR "depressive disorder" OR depress* OR anxiety OR "anxiety disorder") AND (child* OR pediatric OR offspring) AND (overweight OR obes* OR "body mass index" OR BMI). A total of 1,187 articles were found after peer selection. RESULTS In total, 16 articles that met the inclusion criteria were selected for the review. Most of them investigated depressive symptoms and only three, symptoms of maternal anxiety. The evaluated studies suggested a positive association between symptoms of maternal depression and higher risk of childhood obesity. The results diverged according to the chronicity of depressive symptoms (episodic or recurrent depression) and income of the investigated country (high or middle income). Mechanisms were identified passing by quality of parenthood, affecting behaviors related to physical activity and child-feeding, as mediators of the association. CONCLUSIONS We conclude there is evidence of a positive relationship between the occurrence of maternal symptoms of depression and anxiety and childhood obesity. It is emphasized the need for a better understanding on the effect of depressive symptoms and the contextual factors involved in this relationship so that effective intervention strategies can be implemented.
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Affiliation(s)
- Paula Lobo Marco
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Inaê Dutra Valério
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Christian Loret de Mola Zanatti
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
- Universidade Federal do Rio Grande. Faculdade de Medicina. Programa de Pós-graduação em Saúde Pública. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Helen Gonçalves
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
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Shawahna R, Hattab S, Al-Shafei R, Tab’ouni M. Prevalence and factors associated with depressive and anxiety symptoms among Palestinian medical students. BMC Psychiatry 2020; 20:244. [PMID: 32429889 PMCID: PMC7236464 DOI: 10.1186/s12888-020-02658-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/11/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Co-existence of depression and anxiety can be associated with severe detrimental consequences to the physical, mental and social wellbeing of the affected populations. This study was conducted to determine prevalence of depressive and anxiety symptoms among Palestinian medical students and to investigate associations between sociodemographic factors of the students with depressive and anxiety symptoms. METHODS This study was conducted in a cross-sectional observational design using a questionnaire in the period between September 2018 and April 2019 in a major university in the West Bank of Palestine. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II) and anxiety symptoms were assessed using the Beck Anxiety Inventory (BAI). The questionnaire also collected the sociodemographic characteristics of the students. Reliability of the questionnaire was tested using the test re-test method. A total of 425 medical students were invited to participate in the study. RESULTS Of those invited, 286 students completed the questionnaire, giving a response rate of 67.3%. More than half (56.6%) of the students had minimal depression, 20.3% had mild depression, 14.0% had moderate depression, 9.1% had severe depression, 23.4% had no anxiety, 29.7% had mild to moderate anxiety, 25.5% had moderate to severe anxiety, and 21.3% had severe anxiety. Multiple linear regression analysis showed that academic stage (p-value < 0.01), Grade Point Average (p-value < 0.01), mental health status (p-value < 0.001), ever attempted suicide (p-value < 0.05), and religious commitment (p-value < 0.01) were predictors of BDI-II scores. Multiple linear regression analysis showed that academic stage (p-value < 0.05) and mental health status (p-value < 0.001) were predictors of BAI scores. CONCLUSIONS Depressive and anxiety symptoms were prevalent among Palestinian medical students in a major university in the West Bank of Palestine. Interventions might be designed to improve self-rated mental health of medical students in their academic years, ameliorate study conditions, and provision of counseling services to improve spirituality might be effective in reducing symptoms of depression and anxiety among medical students in Palestine. Future studies are still needed to investigate if these interventions could be useful in reducing depressive and anxiety symptoms among Palestinian medical students.
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Affiliation(s)
- Ramzi Shawahna
- grid.11942.3f0000 0004 0631 5695Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building 19, P.O. Box 7, Nablus, Palestine ,grid.11942.3f0000 0004 0631 5695An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine
| | - Suhaib Hattab
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building 19, P.O. Box 7, Nablus, Palestine.
| | - Rami Al-Shafei
- grid.11942.3f0000 0004 0631 5695Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mahmoud Tab’ouni
- grid.11942.3f0000 0004 0631 5695Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Khadka R, Hong SA, Chang YS. Prevalence and determinants of poor sleep quality and depression among postpartum women: a community-based study in Ramechhap district, Nepal. Int Health 2020; 12:125-131. [PMID: 31294785 PMCID: PMC7057136 DOI: 10.1093/inthealth/ihz032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 03/03/2019] [Accepted: 06/13/2019] [Indexed: 11/13/2022] Open
Abstract
Background Due to the limited number of studies in low- and middle-income countries (LMICs), this study aimed to identify the prevalence and determinants of postpartum poor maternal sleep and depression. Methods This cross-sectional study was conducted with 380 women who were 2–12 months postpartum in March and April 2017 in Ramechhap district, Nepal. Multiple logistic regression was used to identify the associated factors. Results The prevalence of poor sleep quality and depression was 28.2% and 18.7%, respectively. Poor sleep quality was associated with having an occupation (in government or business, odds ratio [OR] 6.69; in agriculture/labour, OR 15.5), a male infant (OR 2.37), home delivery (OR 2.17), mental illness during pregnancy (OR 5.87), complications after delivery (OR 5.58) and postpartum depression (OR 2.86). Meanwhile, postpartum depression was associated with having no post-natal care (OR 98.7), living in a nuclear family (OR 48.5), living in a rural area (OR 26.6), having a male infant (OR 4.61), having complications after delivery (OR 21.9), introducing complementary foods before 6 months of age (OR 4.71) and having poor sleep quality (OR 3.20). Conclusions A relatively high prevalence of depression and poor sleep quality were found. The close positive association between poor sleep quality and depression suggests the need for early identification and support for women at risk of poor sleep quality and depression in Nepal.
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Affiliation(s)
- Roshan Khadka
- Karnali College of Health Sciences, Gaushala, Battisputali, Kathmandu, Nepal.,ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Seo Ah Hong
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.,Institute for Health and Society, Hanyang University, Seoul, Republic of Korea
| | - Yan-Shing Chang
- King's College London, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, London, UK
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King C, Khanijahani A. Unmet health care needs among children of mothers exposed to violence. CHILD ABUSE & NEGLECT 2020; 101:104363. [PMID: 31982842 DOI: 10.1016/j.chiabu.2020.104363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/23/2019] [Accepted: 01/09/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Existing literature shows that maternal exposure to violence has negative consequences on the health and behavioral outcomes of their children, but how it affects unmet child healthcare needs is unknown. OBJECTIVES To examine associations between maternal violence exposure and unmet child healthcare needs in vulnerable families. PARTICIPANTS AND SETTING We used data from the third and fifth years of Fragile Families and Child Wellbeing Study, a birth cohort study of urban children born between 1998 and 2000 n = 2848. METHODS Mothers completed a self-reported questionnaire or interview. Maternal violence exposure was measured through direct (victim) and indirect (witness) exposure. Unmet child healthcare needs was operationalized through: not having seen a doctor when needed, not having a well-child visit in the past year, and never had a dental check-up. RESULTS In adjusted logistic regression models, children of mothers who were victims of violence were more likely to not have seen a doctor when needed (odds ratio = 3.36, p < 0.01), not have a well-child visit in the past year (odds ratio = 2.50, p < 0.01), and never have a dental check-up (odds ratio = 1.54, p < 0.01). There was no association between maternal witnessing violence and unmet child healthcare needs. CONCLUSIONS In this study of urban children, having a mother who was a victim of violence was associated with unmet healthcare needs. These findings underscore the need to invest in efforts to reduce the prevalence of violence. Such efforts would reduce unmet child healthcare needs in vulnerable families.
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Affiliation(s)
- Christian King
- Department of Health Management and Informatics, University of Central Florida, DPAC 402G, 528 W Livingston St., Orlando, FL, 32801, United States.
| | - Ahmad Khanijahani
- Duquesne University, Rangos School of Health Sciences, United States
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Emerson JA, Caulfield LE, Kishimata EM, Nzanzu JP, Doocy S. Mental health symptoms and their relations with dietary diversity and nutritional status among mothers of young children in eastern Democratic Republic of the Congo. BMC Public Health 2020; 20:225. [PMID: 32054476 PMCID: PMC7020353 DOI: 10.1186/s12889-019-8092-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/16/2019] [Indexed: 11/22/2022] Open
Abstract
Background In developing countries, maternal mental health problems have been linked to sub-optimal child feeding practices and child underweight and stunting, but little is known about how maternal mental health is associated with mothers’ own diets and nutritional status. The objective of the study was to investigate the association between mental health symptoms and diet and nutritional status of mothers of young children in South Kivu, DR Congo. Methods Participants were 828 mothers of young children enrolled in a larger, quasi-experimental study evaluating a multi-year food security and nutrition project. The present analysis was conducted with cross-sectional data collected from 2015 to 2016. We assessed symptoms of anxiety and depression using the Hopkins Symptom Checklist-25 (HSCL-25) and post-traumatic stress disorder (PTSD) with the Harvard Trauma Questionnaire (HTQ), using a four-point Likert scale. Mean scale scores were calculated ranging from one to four. A variable was created for high distress (participants scoring in the upper quartile of both measures). Dietary diversity scores were calculated from the number of food groups (range zero to ten) consumed the previous day, identified from an open recall. Nutritional status was measured by body mass index (BMI) and underweight (BMI < 18.5 kg/m2, or mid-upper arm circumference < 23 cm for pregnant women). Bivariate and multivariate (adjusting for parent study intervention group, education, age, health, parity, livelihoods zone, and territory of origin) regression analyses were conducted. Results Maternal mental health measures were positively and statistically significantly associated with higher dietary diversity scores in adjusted analyses (HSCL-25: ß= 0.18, p = 0.002, HTQ: ß= 0.12, p = 0.029, High Distress: ß= 0.47, p < 0.001). Mental health symptoms were not significantly associated with BMI (HSCL-25: ß = − 0.04, p = 0.824; HTQ: ß = 0.02, p = 0.913; High distress: ß= − 0.02, p = 0.938) or underweight (HSCL 25: OR = 0.91, p = 0.640; HTQ: OR = 1.03, p = 0.866; High distress: OR = 0.78, p = 0.489). Conclusions More severe maternal mental health symptoms were associated with higher dietary diversity but not nutritional status, and the reasons for these findings are not clear from available data. More research is needed to identify underlying factors that could influence mental health symptomatology and diet quality among food insecure and extremely resource-limited populations.
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Affiliation(s)
- Jillian A Emerson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA.
| | - Laura E Caulfield
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
| | | | - Jean-Pierre Nzanzu
- Adventist Development and Relief Agency, Uvira, South Kivu, Democratic Republic of Congo
| | - Shannon Doocy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
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Ransing R, Kukreti P, Deshpande S, Godake S, Neelam N, Raghuveer P, Mahadevaiah M, Kataria D, Patil S, Puri M, Padma K. Perinatal depression-knowledge gap among service providers and service utilizers in India. Asian J Psychiatr 2020; 47:101822. [PMID: 31710947 DOI: 10.1016/j.ajp.2019.10.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Lack of access to perinatal mental health (PMH) services is a significant public health problem in India. Barriers to accessing PMH services include the stigma, non-availability of services, poor knowledge, negative perception, attitude among perinatal women (PWs) and service providers. The present study attempted to examine the knowledge gap regarding perinatal depression (PD) among service providers [Nursing providers (NPs), Medical Practitioners (MPs)] and service utilizers (PWs). METHODS This cross-sectional study was conducted in two tertiary care teaching hospitals of India, one in a major metro and the other in a rural area. PWs, MPs and NPs were assessed for knowledge about PD using a semi-structured proforma and Perinatal Depression Monitor. RESULTS Among the 270 PWs, 8.51% were knowledgeable (PWA) and 91.49% were ignorant (PWB) about depression. PWB group were low educated (n = 140, 56.68%), and unemployed (n = 207, 83.80%) with lower family income [(≤₹10,356 per month), n = 170, 68.28%)]. There was knowledge discrepancy among NPs, MPs and PWA group in terms of a) PD is a normal part of pregnancy (agree- NPs = 71.52%, MPs = 10.00%, PWA-17.39%), b)biological causes of PD (agree- NPs = 45.23%, MPs = 70.00%, PWA = 26.03%) and c)antidepressant medications for PD (useful- NPs = 23.80%, MPs = 70.00%, PWA = 21.73%). Majority of the respondents agreed that all women should be screened for depression during pregnancy (NPs = 34.78%, MPs = 80.95%, PWA = 95.00%) and postpartum periods (NPs = 34.78%, MPs = 76.19%, PWA = 90.00%). CONCLUSIONS Low PD literacy among the PWs, misconception about aetiology and management among the NPs could be major barrier for delivery and utilisation of PD services. Thus, there is an urgent need to improve PD literacy among PWs and NPs.
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Affiliation(s)
- Ramdas Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical college
| | - Prerna Kukreti
- Lady Hardinge Medical College, Department of Psychiatry, C-604 Shaheed Bhagat Singh, Road, DI, India.
| | - Smita Deshpande
- Department of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, Banga Bandhu Sheikh Mujib Road, New Delhi 110001
| | - Shashwati Godake
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Ratnagiri
| | - Neelam Neelam
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi
| | | | - Mahesh Mahadevaiah
- Department of Psychiatry, Dharwad institute of Mental Health and Neurosciences (DIMHANS)
| | - Dinesh Kataria
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi
| | - Suvarna Patil
- Department of Medicine, BKL Walawalkar Rural Medical College
| | - Manju Puri
- Department of Obstetrics and Gynecology, Lady Hardinge Medical College
| | - Kumari Padma
- Department of Psychiatry, BKL Walawalkar Rural Medical College
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Wedderburn CJ, Evans C, Yeung S, Gibb DM, Donald KA, Prendergast AJ. Growth and Neurodevelopment of HIV-Exposed Uninfected Children: a Conceptual Framework. Curr HIV/AIDS Rep 2019; 16:501-513. [PMID: 31732866 PMCID: PMC6920255 DOI: 10.1007/s11904-019-00459-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE OF REVIEW The population of HIV-exposed uninfected (HEU) children is expanding rapidly, and over one million HEU infants are born each year globally. Several recent studies have reported that HEU children, particularly in low- and middle-income countries, are at risk of poor outcomes, including impaired growth and neurodevelopment. However, the reasons for poor clinical outcomes amongst HEU children remain unclear. RECENT FINDINGS We summarise the findings from recent large studies that have characterised growth and neurodevelopment in HEU children, identified risk factors and explored underlying mechanistic pathways. We propose a conceptual framework to explain how exposure to HIV and antiretroviral therapy (ART) may lead to adverse growth and neurodevelopment in uninfected children, and review the available evidence and research gaps. We propose that HEU children are affected both indirectly, through the augmentation of universal risk factors underlying poor growth and neurodevelopment, and directly through HIV/ART-specific pathways, which ultimately may converge through a series of common pathogenic mechanisms. In the era of universal ART, a better understanding of these pathways is crucial to inform future prevention and intervention strategies.
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Affiliation(s)
- Catherine J Wedderburn
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Ceri Evans
- Blizard Institute, Queen Mary University of London, London, UK.
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.
| | - Shunmay Yeung
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Diana M Gibb
- MRC Clinical Trials Unit, University College London, London, UK
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Andrew J Prendergast
- Blizard Institute, Queen Mary University of London, London, UK
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
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Upadhyay AK, Singh A, Singh A. Association between unintended births and risk of postpartum depression: Evidence from Ethiopia, India, Peru and Vietnam. SSM Popul Health 2019; 9:100495. [PMID: 31650000 PMCID: PMC6804781 DOI: 10.1016/j.ssmph.2019.100495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/05/2019] [Accepted: 10/03/2019] [Indexed: 12/29/2022] Open
Abstract
Previous studies have shown that unintended births adversely affect birth outcomes, child health and cognitive development in developing countries. However, only a few studies have examined the association between unintended births and risk of postpartum depression (PPD) in these countries. The study uses data from the first wave of Young Lives Study (YLS) conducted in 2002 in Ethiopia, India, Peru and Vietnam to examine the association between birth intention and the risk of PPD. Bivariate and multivariable logistic regressions are used to examine the association. Bivariate result indicates that the risk of PPD was substantially higher among mothers who reported an unintended birth as compared to mothers who reported an intended birth in each country. Results from multivariable logistic regression models indicate that unintended births were associated with higher risk of PPD in pooled data (odds ratio: 1.46, 95%CI. 1.29, 1.66), Ethiopia (odds ratio: 1.99, 95% CI. 1.58,2.50), and Peru (odds ratio: 1.29, 95% CI. 1.04, 1.59) compared with mothers having an intended birth. Results suggest that reducing unintended births might help in reducing the incidence of PPD among mothers in these countries. One of the most cost-effective interventions for reducing the incidence of unintended births is the availability of effective family planning programme.
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Affiliation(s)
| | - Abhishek Singh
- International Institute for Population Sciences, Mumbai, India
| | - Ashish Singh
- SJM School of Management, Indian Institute of Technology Bombay, India
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Manjrekar S, Patil S. Perception and Attitude toward Mental Illness in Antenatal Mothers in Rural Population of Southern India: A Cross-Sectional Study. J Neurosci Rural Pract 2019; 9:473-477. [PMID: 30271036 PMCID: PMC6126298 DOI: 10.4103/jnrp.jnrp_535_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Mental health disorders globally are on a rise due to various reasons. Gender differences have been one of the reasons. Pregnancy is a stressful event in mothers and it can either exacerbate preexisting mental illness or can give rise to other mental health disorders. Studies have shown that women residing in rural areas are at higher risk of developing mental health problems. Mental health problems have detrimental effects in post-partum period. Most of the complications can be prevented if psychiatric symptoms are detected in early part of pregnancy and if women are aware of these symptoms. Aim: To find the awareness, attitude and perception towards mental illness in antenatal mothers residing in rural area of India. Setting and Design: It's a descriptive cross sectional study conducted at primary health care centers. Methods and Materials: Total of 300 antenatal mothers attending primary health care centers were recruited into the study after a written informed consent was obtained. Statistical Analysis: Basic socio demographic data were collected and a semi structured questionnaire was designed. The participants were interviewed according to the questionnaire. Data collected was analyzed using SPSS software. Results and Conclusion: The mean age of the study participants was 24+5. Of the 300 study participants more than 90% were unaware that mental illness can occur during pregnancy and only around 07% could agree say that it can occur in pregnancy. There is poor awareness of mental health problems amongst pregnant women residing in rural part of southern India. The reasons for the same are lack of awareness, low levels of education, lower socio economic status, cultural beliefs and practices, lack of mental health services and stigma associated with mental illness. There is no routine screening for mental health problems during antenatal visits. If done otherwise could bring down adverse maternal outcome.
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Affiliation(s)
- Shivani Manjrekar
- Department of Community Medicine, USM-KLE IMP, Belagavi, Karnataka, India
| | - Sandeep Patil
- Department of Psychiatry, J.N. Medical College, KLE University, Belagavi, Karnataka, India
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Maharlouei N, Alibeigi H, Rezaianzadeh A, Keshavarz P, Raeisi Shahraki H, Nemati H, B Lankarani K. The relationship between maternal mental health and communication skills in children in Shiraz, Iran. Epidemiol Health 2019; 41:e2019035. [PMID: 31319652 PMCID: PMC6759496 DOI: 10.4178/epih.e2019035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 07/19/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Child development is a significant issue in global public health, and maternal mental health (MMH) can have a remarkable effect on children’s development of communication skills. We aimed to investigate the association between MMH and communication skills in a sample of Iranian children. METHODS This study was conducted in Shiraz, Iran during 2016. In total, 640 mothers who lived in Shiraz and were registered in the Fars Birth Cohort (FBC) study were invited to attend the FBC clinic with their children. A trained physician evaluated MMH using the General Health Questionnaire (GHQ). Additionally, a trained nurse assessed the children’s communication development status using the Ages and Stages Questionnaire for 60-month old children. RESULTS The majority of the mothers were homemakers (82.8%) and had high school diplomas (38.9%). The mothers’ mean age was 33.7±4.6 years. Seventy-nine (12.3%) children had delayed communication skills, but no significant association was found between children’s communication skills and the mothers’ total GHQ score (p=0.43). In total, 493 mothers (77.0%) had abnormal somatic symptoms, 497 (77.7%) had abnormal anxiety/insomnia, 337 (52.7%) had social dysfunction, and 232 (36.3%) suffered from depression. Logistic regression indicated that after adjusting for confounders, the odds of delayed communication skills were 3-fold higher among the children of mothers with abnormal somatic symptoms than among other children (p=0.01). CONCLUSIONS The study results confirmed that MMH had a significant impact on children’s communication skills. Moreover, maternal abnormal somatic symptoms exerted the strongest impact on the development of communication skills in 5-yearold children.
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Affiliation(s)
- Najmeh Maharlouei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Alibeigi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pedram Keshavarz
- Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hamid Nemati
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran B Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Sikander S, Ahmad I, Bates LM, Gallis J, Hagaman A, O’Donnell K, Turner EL, Zaidi A, Rahman A, Maselko J. Cohort Profile: Perinatal depression and child socioemotional development ; the Bachpan cohort study from rural Pakistan. BMJ Open 2019; 9:e025644. [PMID: 31061029 PMCID: PMC6502044 DOI: 10.1136/bmjopen-2018-025644] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/20/2018] [Accepted: 03/08/2019] [Indexed: 01/03/2023] Open
Abstract
PURPOSE This is a prospective pregnancy-birth cohort designed to investigate the effects of depression on socioemotional development of children. Perinatal depression is a risk factor for poor child development and for many it has a recurring chronic course. Thus, the exposure to depression can continue through the early years of the child with detrimental developmental outcomes. PARTICIPANTS Between October 2014 and February 2016, we recruited 1154 pregnant women from a rural subdistrict of Pakistan. Data include longitudinal and repeated measures of maternal psychosocial measures and child growth, cognitive and socioemotional measures. Follow-up include mother-child dyad assessments at 3rd, 6th, 12th, 24th and 36th months of child age. All these follow-ups are community based at the household level. We have competed baseline assessment. FINDINGS TO DATE Of the eligible dyads, we followed 885 (76.6%), 929 (91%) and 940 (93.3%) at 3, 6 and 12 months post-childbirth. We include a subsample mother-child dyad DNA and inflammatory biomarkers, 73 and 104, respectively. FUTURE PLANS While we continue to do 24-month and 36-month follow-up assessments, we plan to follow these mother-child dyads up to the age of 7-8 years with some children being exposed to at least 1 year of school environment. Investigators interested in learning more about the study can contact (jmaselko@unc.edu) and (siham.sikander@hdrfoundation.org).
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Affiliation(s)
- Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan
- Public Health, Health Services Academy, Islamabad, Pakistan
| | - Ikhlaq Ahmad
- Human Development Research Foundation, Islamabad, Pakistan
| | - Lisa M Bates
- Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - John Gallis
- Biostatistics, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Ashley Hagaman
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Karen O’Donnell
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Elizabeth Louise Turner
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Ahmed Zaidi
- Human Development Research Foundation, Islamabad, Pakistan
| | - Atif Rahman
- Child Mental Health Unit, University of Liverpool, Liverpool, UK
| | - Joanna Maselko
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Sheeba B, Nath A, Metgud CS, Krishna M, Venkatesh S, Vindhya J, Murthy GVS. Prenatal Depression and Its Associated Risk Factors Among Pregnant Women in Bangalore: A Hospital Based Prevalence Study. Front Public Health 2019; 7:108. [PMID: 31131270 PMCID: PMC6509237 DOI: 10.3389/fpubh.2019.00108] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/11/2019] [Indexed: 01/17/2023] Open
Abstract
Background: Depression is the commonest psychological problem that affects a woman during her perinatal period worldwide. The risk of prenatal depression increases as the pregnancy progresses and clinically significant depressive symptoms are common in the mid and late trimester. There is a paucity of research on depression during the prenatal period in India. Given this background, the present study aimed to assess the prevalence of prenatal depression and its associated risk factors among pregnant women in Bangalore, Southern India. Methods: The study was nested within an on-going cohort study. The study participants included 280 pregnant women who were attending the antenatal clinic at Jaya Nagar General Hospital (Sanjay Gandhi Hospital) in Bangalore. The data was collected by using a structured questionnaire which included. Edinburgh Postnatal Depression Scale (EPDS) to screen for prenatal depression. Results: The proportion of respondents who screened positive for prenatal depression was 35.7%. Presence of domestic violence was found to impose a five times higher and highly significant risk of developing prenatal depression among the respondents. Pregnancy related anxiety and a recent history of catastrophic events were also found to be a positive predictors of prenatal depression. Conclusion: The high prevalence of prenatal depression in the present study is suggestive of its significance as a public health problem. Health care plans therefore can include screening and diagnosis of prenatal depression in the antenatal care along with other health care facilities provided.
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Affiliation(s)
- B. Sheeba
- Research Assistant, Indian Institute of Public Health Hyderabad, Public Health of Foundation of India, Bangalore, India
| | - Anita Nath
- Wellcome Trust DBT India Alliance, Intermediate Fellow in Clinical and Public Health, Indian Institute of Public Health Hyderabad, Public Health Foundation of India, Hyderabad, India
| | - Chandra S. Metgud
- Professor, Department of Community Medicine, Pt. Jawahar Lal Nehru Memorial Medical College, Belgavi, India
| | | | - Shubhashree Venkatesh
- Research Assistant, Indian Institute of Public Health Hyderabad, Public Health of Foundation of India, Bangalore, India
| | - J. Vindhya
- Research Assistant, Indian Institute of Public Health Hyderabad, Public Health of Foundation of India, Bangalore, India
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Nath A, Venkatesh S, Balan S, Metgud CS, Krishna M, Murthy GVS. The prevalence and determinants of pregnancy-related anxiety amongst pregnant women at less than 24 weeks of pregnancy in Bangalore, Southern India. Int J Womens Health 2019; 11:241-248. [PMID: 31114392 PMCID: PMC6489575 DOI: 10.2147/ijwh.s193306] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: A pregnant woman undergoes physiological as well as psychological changes during this phase of life during which anxiety is a commonly faced mental condition. There is sufficient evidence on the association of pregnancy specific anxiety with adverse pregnancy outcomes. Studies on anxiety during pregnancy from low and middle income countries are limited. Methods: This study included 380 pregnant women, having a confirmed pregnancy of less than 24 weeks without any obstetric complication, who were availing of antenatal care at a public sector hospital in Bangalore city. Pregnancy-related thoughts (PRT) scale was used to screen for anxiety. Details pertaining to sociodemographic data, obstetric history, psychosocial factors including social support, marital discord, domestic violence, consanguinity, history of catastrophic events, history of mental illness, current presence of depression and anxiety was obtained by means of electronic data capture using an Android-based App. Results: Out of 380 pregnant women, 195 (55.7%) were found to have pregnancy-related anxiety. Lower socioeconomic status, low social support and depression emerged as significant determinants of anxiety. Conclusion: The prevalence of anxiety was fairly high in the study population and isp therefore an important public health concern. Pregnancy-related anxiety must be identified early during routine antenatal care to prevent any untoward pregnancy outcomes.
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Affiliation(s)
- Anita Nath
- Indian Institute of Public Health Hyderabad-Bangalore Campus, Public Health Foundation of India, Bangalore, Karnataka, India
| | - Shubhashree Venkatesh
- Indian Institute of Public Health Hyderabad-Bangalore Campus, Public Health Foundation of India, Bangalore, Karnataka, India
| | - Sheeba Balan
- Indian Institute of Public Health Hyderabad-Bangalore Campus, Public Health Foundation of India, Bangalore, Karnataka, India
| | - Chandra S Metgud
- Department of Community Medicine, J.N. Medical College, KLE University, Belgavi, Karnataka, India
| | | | - Gudlavalleti Venkata Satyanarayana Murthy
- Indian Institute of Public Health Hyderabad, Public Health Foundation of India, Hyderabad, Telangana, India
- Department of Clinical Research, International Center for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
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Sharmin KN, Sarwar N, Mumu SJ, Taleb DA, Flora MS. Postnatal depression and infant growth in an urban area of Bangladesh. Midwifery 2019; 74:57-67. [PMID: 30927633 DOI: 10.1016/j.midw.2019.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 02/20/2019] [Accepted: 03/17/2019] [Indexed: 01/05/2023]
Abstract
Postnatal depression (PND) has been a common depressive mental disorder among the mothers in a low-income country like Bangladesh where stunting, underweight and wasting are prevalent among infants. The present prospective cohort study was carried out among 297 non-depressed and 103 depressed mothers (ages 18-36 years) to find the association between post natal depression and growth of infants. Data were collected by face to face interview through semi-structured questionnaires and anthropometric measurements were taken with proper anthropometric techniques and calibrated instruments. Postnatal depression was assessed by the Edinburgh Postnatal Depression Scale and infants' physical growth was assessed by Z score of weight, length and Mid-Upper Arm Circumference (MUAC). The overall prevalence of post natal depression was found 22% [95% CI, 21.71-30.29]. Infants of depressed mothers were found iller in comparison with the infants of non-depressed mothers (p < 0.001) which could result in growth retardation of infants. According to the MUAC level, infants of depressed mothers were more at risk of malnutrition (p < 0.001). Early detection of postpartum depression, implementation of interventions, prevention or treatment of maternal depressive disorders and effective strategies will not only ameliorate the impact of PND among mothers but also facilitates infant growth.
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Affiliation(s)
- Kazi Nazira Sharmin
- Department of Applied Food Science and Nutrition, Chittagong Veterinary and Animal Sciences University (CVASU), Chittagong, Bangladesh.
| | - Nazmul Sarwar
- Department of Food Processing and Engineering, Chittagong Veterinary and Animal Sciences University (CVASU), Chittagong, Bangladesh
| | - Shirin Jahan Mumu
- Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Dr Abu Taleb
- Department of Community Medicine, Bangladesh Institute of Health Sciences (BIHS), Dhaka, Bangladesh
| | - Meerjady Sabrina Flora
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, Bangladesh
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Abstract
OBJECTIVE To determine whether children exposed to a greater variety of acts of parent-to-child physical and psychological maltreatment will be at greater risk of consuming obesogenic foods at a higher frequency. DESIGN Survey research using a longitudinal panel design. SETTING In-home interviews with primary caregivers in twenty large US cities.ParticipantsA national sample of at-risk children and their families who participated in the Fragile Families and Child Wellbeing Study (FFCWS). RESULTS Child maltreatment emerged as a statistically significant (P<0·01) and robust predictor of obesogenic food consumption, in both cross-sectional and longitudinal analyses. Child maltreatment also consistently emerged as one of the strongest predictors of obesogenic food consumption in these models. Ancillary analyses indicated that physical maltreatment plays a particularly important role in these associations. CONCLUSIONS A major implication of the present study is that child maltreatment prevention efforts should be reflected in interventions that seek to diminish unhealthy eating practices among children. Multi-professional teams can work together on obesity prevention not only via education but also by considering the interconnectedness of obesogenic food consumption and experiences of maltreatment.
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Zhang S, Dang R, Yang N, Bai Y, Wang L, Abbey C, Rozelle S. Effect of Caregiver's Mental Health on Early Childhood Development across Different Rural Communities in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112341. [PMID: 30360569 PMCID: PMC6265717 DOI: 10.3390/ijerph15112341] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/14/2018] [Accepted: 10/16/2018] [Indexed: 12/03/2022]
Abstract
Previous research has found that there are high rates of developmental delays among infants and toddlers in rural areas of China. Caregiver mental health problems might be one significant predictor of developmental delays among infants and toddlers, as has been found in other areas of the world. One way that the mental health of caregivers could affect early childhood development is through its effect on parenting practices. In this study, we used data from four major subpopulations of rural China to measure the correlation of caregiver mental health problems with the developmental outcomes of infants and toddlers. To do so, the study used the Bayley Scales of Infant Development III (BSID III) to examine the rates of developmental delays among 2514 rural infants/toddlers aged 6–30 months old. The results of the testing demonstrate that 48% of the sample’s infants/toddlers have cognitive delays; 52% have language delays; 53% have social-emotional delays; and 30% have motor delays. The data collection team also assessed caregiver mental health by using the Depression Anxiety Stress Scales (DASS-21) questionnaire. According to the findings, 39% of caregivers in the sample have symptoms of at least one kind of mental health problem (depression, anxiety, or stress). We also found that most caregivers do not engage in positive parenting practices, while a significant share of caregivers engage in negative parenting practices. The statistical analysis found that showing signs of mental health problems is significantly and negatively associated with infant/toddler developmental outcomes. The study also found that caregivers who show signs of mental health problems are significantly less likely to engage in interactive parenting practices. The study confirms that society needs to pay more attention to caregiver mental health problems in order to improve infant/toddler developmental outcomes in rural China and increase human capital accumulation in China as a whole.
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Affiliation(s)
- Siqi Zhang
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Ruirui Dang
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Ning Yang
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Yu Bai
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Lei Wang
- Center for Experimental Economics of Education, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
- International Business School, Shaanxi Normal University, Xi'an 710069, Shaanxi, China.
| | - Cody Abbey
- Rural Education Action Project, Stanford University, Stanford, CA 94305, USA.
| | - Scott Rozelle
- Rural Education Action Project, Stanford University, Stanford, CA 94305, USA.
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Woldetensay YK, Belachew T, Biesalski HK, Ghosh S, Lacruz ME, Scherbaum V, Kantelhardt EJ. The role of nutrition, intimate partner violence and social support in prenatal depressive symptoms in rural Ethiopia: community based birth cohort study. BMC Pregnancy Childbirth 2018; 18:374. [PMID: 30219050 PMCID: PMC6139168 DOI: 10.1186/s12884-018-2009-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 09/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression during pregnancy has far-reaching adverse consequences on mothers, children and the whole family. The magnitude and determinants of prenatal depressive symptoms in low-resource countries are not well established. This study aims to describe the prevalence of prenatal depressive symptoms and whether it is associated with maternal nutrition, intimate partner violence and social support among pregnant women in rural Ethiopia. METHODS This study is based on the baseline data from a large prospective, community-based, birth cohort study conducted in the South Western part of Ethiopia from March 2014 to March 2016. A total of 4680 pregnant women were recruited between 12 and 32 weeks of gestation. Depressed mood was assessed using the Patient Health Questionnaire (PHQ-9) scale and a cut off of ≥8 was taken to define prenatal depressive symptoms. Data collection was conducted electronically on handheld tablets and submitted to a secured server via an internet connection. Bivariate and multivariate logistic regression analyses were computed using IBM SPSS version 20 software. RESULT The community based prevalence of depressive symptoms during pregnancy was 10.8% (95%Confidence Interval (CI): 9.92-11.70). Adjusting for confounding variables, moderate household food insecurity (OR 1.74; 95% CI: 1.31-2.32), severe household food insecurity (OR 7.90; 95% CI: 5.87-10.62), anaemia (OR = 1.30; 95% CI: 1.04-1.61) and intimate partner violence (OR 3.08; 95% CI: 2.23-4.25) were significantly associated with prenatal depressive symptoms. On the other hand, good social support from friends, families and husband reduced the risk of prenatal depressive symptoms by 39% (OR 0.61; 95% CI: 0.50-0.76). CONCLUSION Prenatal depressive symptomatology is rather common during pregnancy in rural Ethiopia. In this community based study, household food insecurity, anaemia and intimate partner violence were significantly associated with prenatal depressive symptoms. Good maternal social support from friends, families and spouse was rather protective. The study highlights the need for targeted screening for depression and intimate partner violence during pregnancy. Policies aimed at reducing household food insecurity, maternal anaemia and intimate partner violence during pregnancy may possibly reduce depression.
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Affiliation(s)
- Yitbarek Kidane Woldetensay
- Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany. .,Food Security Center, University of Hohenheim, Stuttgart, Germany. .,Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia.
| | - Tefera Belachew
- Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Hans Konrad Biesalski
- Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany.,Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Shibani Ghosh
- Tufts University, Freidman School of Nutrition Science and Policy, Boston, USA
| | - Maria Elena Lacruz
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther University, Halle, Germany
| | - Veronika Scherbaum
- Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany.,Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Eva Johanna Kantelhardt
- Department of Gynecology, Faculty of Medicine, Martin-Luther University, Halle, Germany.,Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther University, Halle, Germany
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Haithar S, Kuria MW, Sheikh A, Kumar M, Vander Stoep A. Maternal depression and child severe acute malnutrition: a case-control study from Kenya. BMC Pediatr 2018; 18:289. [PMID: 30176822 PMCID: PMC6120093 DOI: 10.1186/s12887-018-1261-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 08/20/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Depression is the leading cause of disease-related disability in women and adversely affects the health and well-being of mothers and their children. Studies have shown maternal depression as a risk factor for poor infant growth. Little is known about the situation in Sub-Saharan Africa. The aim of our study was to examine the association between maternal depression and severe acute malnutrition in Kenyan children aged 6-60 months. METHODS A matched case-control study was conducted in general paediatric wards at the Kenyatta National Hospital. The cases were children admitted with severe acute malnutrition as determined by WHO criteria. The controls were age and sex-matched children with normal weight admitted in the same wards with acute ailments. Mothers of the cases and controls were assessed for depression using the PHQ-9 questionnaire. Child anthropometric and maternal demographic data were captured. Logistic regression analyses were used to compare the odds of maternal depression in cases and controls, taking into account other factors associated with child malnutrition status. RESULTS The prevalence of moderate to severe depression among mothers of malnourished children was high (64.1%) compared to mothers of normal weight children (5.1%). In multivariate analyses, the odds of maternal depression was markedly higher in cases than in controls (adjusted OR = 53.5, 95% CI = 8.5-338.3), as was the odds of having very low income (adjusted OR = 77.6 95% CI = 5.8-1033.2). CONCLUSIONS Kenyan mothers whose children are hospitalized with malnutrition were shown in this study to carry a significant mental health burden. We strongly recommend formation of self-help groups that offer social support, counseling, strategies to address food insecurity, and economic empowerment skills for mothers of children hospitalized for malnourishment.
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Affiliation(s)
- S. Haithar
- Department of Psychiatry, College of Health Sciences, University of Nairobi, P.O. Box 103140, Nairobi, 00101 Kenya
| | - M. W. Kuria
- Research Department of Clinical, Health and Educational Psychology, University College London, London, WC1E 7HB UK
| | - A. Sheikh
- Department of Clinical Medicine and Therapeutics, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, 00202 Kenya
| | - M. Kumar
- Department of Psychiatry, College of Health Sciences, University of Nairobi, P.O. Box 103140, Nairobi, 00101 Kenya
- Research Department of Clinical, Health and Educational Psychology, University College London, London, WC1E 7HB UK
| | - A. Vander Stoep
- Psychiatry & Behavioral Sciences and Epidemiology, 6200 NE 74th Street, Suite 210, Seattle, WA 88115-1538 USA
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Nguyen PH, Friedman J, Kak M, Menon P, Alderman H. Maternal depressive symptoms are negatively associated with child growth and development: Evidence from rural India. MATERNAL AND CHILD NUTRITION 2018; 14:e12621. [PMID: 29770998 PMCID: PMC6175434 DOI: 10.1111/mcn.12621] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 04/08/2018] [Accepted: 04/10/2018] [Indexed: 12/31/2022]
Abstract
Maternal depression has been suggested as a risk factor for both poor child growth and development in many low‐ and middle‐income countries, but the validity of many studies is hindered by small sample sizes, varying cut‐offs used in depression diagnostics, and incomplete control of confounding factors. This study examines the association between maternal depressive symptoms (MDSs) and child physical growth and cognitive development in Madhya Pradesh, India, where poverty, malnutrition, and poor mental health coexist. Data were from a baseline household survey (n = 2,934) of a randomized controlled trial assessing an early childhood development programme. Multivariate linear and logistic regression analyses were conducted, adjusting for socio‐economic factors to avoid confounding the association of mental health and child outcomes. MDS (measured using the Center for Epidemiologic Studies Short Depression Scale) was categorized as low, medium, and high in 47%, 42%, and 10% of mothers, respectively. The prevalence of child developmental delay ranged from 16% to 27% for various development domains. Compared with children of mothers with low MDS, those of high MDS mothers had lower height‐for‐age, weight‐for‐age, and weight‐for‐height z‐scores (0.22, 0.21, and 0.15, respectively), a higher rate of stunting and underweight (~1.5 times), and higher rate of developmental delay (partial adjusted odds ratio ranged from 1.3–1.8 for different development domains and fully adjusted odds ratio = 1.4 for fine motor). Our results—that MDS is significantly associated with both child undernutrition and development delay—add to the call for practical interventions to address maternal depression to simultaneously address multiple outcomes for both women and children.
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Affiliation(s)
| | | | | | - Purnima Menon
- International Food Policy Research Institute, Washington, DC, USA
| | - Harold Alderman
- International Food Policy Research Institute, Washington, DC, USA
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Perinatal Depression and Associated Factors among Mothers in Southern Ethiopia: Evidence from Arba Minch Zuria Health and Demographic Surveillance Site. PSYCHIATRY JOURNAL 2018; 2018:7930684. [PMID: 29854717 PMCID: PMC5954952 DOI: 10.1155/2018/7930684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/21/2018] [Accepted: 03/15/2018] [Indexed: 11/18/2022]
Abstract
Background. Perinatal depression is a serious mental health problem that can negatively affect the lives of women and children. The adverse consequences of perinatal depression in high-income countries also occur in low-income countries. Objective. To assess the perinatal depression and associated factors among mothers in Southern Ethiopia. Methods. A community based cross-sectional study was conducted among selected 728 study participants in Arba Minch Zuria HDSS. A pretested questionnaire was used to collect the data. Data were analyzed using STATA version 12 software. Descriptive statistical methods were used to summarize the characteristics of the mothers. Bivariate and multivariable logistic regression was used for analysis. Results. The prevalence of perinatal depression among the study period was 26.7%. In the final multivariable logistic regression, monthly income AOR (95% C.I): 4.2 (1.9, 9.3), parity [AOR (95% C.I): 0.14 (0.03, 0.65)], pregnancy complications AOR (95% C.I): 5 (2.5, 10.4), husband smoking status [AOR (95% C.I): 4.12 (1.6, 10.6)], history of previous depression AOR (95% C.I): 2.7 (1.54, 4.8), and family history of psychiatric disorders were the independent factors associated with perinatal depression. Conclusion. The study showed a high prevalence of perinatal depression among pregnant mothers and mothers who have less than a one-year-old child.
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Black MM, Merseth KA. First 1000 Days and Beyond: Strategies to Achieve the Sustainable Development Goals. DEVELOPMENTAL SCIENCE AND SUSTAINABLE DEVELOPMENT GOALS FOR CHILDREN AND YOUTH 2018. [DOI: 10.1007/978-3-319-96592-5_5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Levine A, Weissbecker I, Roshania R, Cavallera V, Mallow M, Leichner A, Antigua J, Gao J. Integrating psychosocial support at Ebola treatment units in Sierra Leone and Liberia. INTERVENTION-INTERNATIONAL JOURNAL OF MENTAL HEALTH PSYCHOSOCIAL WORK AND COUNSELLING IN AREAS OF ARMED CONFLICT 2018. [DOI: 10.4103/intv.intv_8_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Designing and Implementing an Early Childhood Health and Development Program in Rural, Southwest Guatemala: Lessons Learned and Future Directions. Adv Pediatr 2017; 64:381-401. [PMID: 28688599 DOI: 10.1016/j.yapd.2017.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nguyen PH, DiGirolamo AM, Gonzalez-Casanova I, Pham H, Hao W, Nguyen H, Truong TV, Nguyen S, Harding KB, Reinhart GA, Martorell R, Ramakrishnan U. Impact of preconceptional micronutrient supplementation on maternal mental health during pregnancy and postpartum: results from a randomized controlled trial in Vietnam. BMC Womens Health 2017; 17:44. [PMID: 28623904 PMCID: PMC5473979 DOI: 10.1186/s12905-017-0401-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 06/08/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Micronutrient malnutrition has been associated with maternal depressive symptoms (MDS), but little is known about the effects of preconceptional micronutrient supplementation. This paper examined the effects of preconceptional micronutrient supplementation on MDS during pregnancy and postpartum. METHODS We used data from a double-blind controlled trial (PRECONCEPT) in which 5011 Vietnamese women were randomized to receive weekly supplements containing either a) multiple micronutrients (MM) b) iron and folic acid (IFA) or c) folic acid (FA) until conception (n = 1813). Maternal mental health was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline (preconception), and the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy and 3 months postpartum. Elevated MDS was defined as EPDS score ≥ 4. All group comparisons were done using ANOVA or chi-square tests of proportions intention to treat and per protocol analyses (women consumed supplements ≥26 weeks before conception). We also conducted stratified analyses by preconception CES-D scores, underweight, or anemia status using generalized linear models. RESULTS Baseline CES-D scores were similar across treatment groups. The proportion of women experiencing elevated MDS was 11.3, 8.1 and 4.9% at first, second and third trimesters of pregnancy, respectively, and 3.6% at 3 mo postpartum. Mean EPDS scores at first (1.5 ± 2.7), second (1.1 ± 2.4), and third trimester of pregnancy (0.7 ± 2.0) and early postpartum (0.6 ± 1.8) were low and did not differ by treatment group. However, among women in the highest tertile of CES-D scores at preconception, mean EPDS scores in the first and second trimesters of pregnancy were lower in the MM and IFA groups compared to FA only (P < 0.05). CONCLUSIONS Weekly preconceptional micronutrient supplements containing iron did not improve depression measures relative to folic acid alone among all women, but may have benefitted women who were at risk for depression. TRIAL REGISTRATION The trial was registered retrospectively at ClinicalTrials.Gov as NCT01665378 on August 13, 2012.
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Affiliation(s)
- Phuong H. Nguyen
- International Food Policy Research Institute, Washington, DC USA
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | | | | | - Hoa Pham
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Wei Hao
- Emory University, Atlanta, GA USA
| | - Hieu Nguyen
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Truong V. Truong
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Son Nguyen
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | | | - Gregory A. Reinhart
- The Mathile Institute for the Advancement of Human Nutrition, Dayton, OH USA
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Shidhaye P, Shidhaye R, Phalke V. Association of gender disadvantage factors and gender preference with antenatal depression in women: a cross-sectional study from rural Maharashtra. Soc Psychiatry Psychiatr Epidemiol 2017; 52:737-748. [PMID: 28393283 DOI: 10.1007/s00127-017-1380-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 03/27/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE Maternal depression is a major public health problem in low- and middle-income countries including India. Very few studies have assessed association of various risk factors with antenatal depression in rural Indian women, especially the effect of marital conflict, gender disadvantage and gender preference on antenatal depression. This paper describes the prevalence of probable antenatal depression in rural Maharashtra, a state in the western part of India and specifically assesses the association of marital and gender disadvantage factors and gender preference for a male child with antenatal depression. METHODS Primary Health Centre-based cross-sectional survey of antenatal women in rural Maharashtra was carried out. The outcome of interest was a probable diagnosis of depression in antenatal women which was measured using the Edinburgh postnatal depression scale (EPDS). Data were analyzed using simple and multiple logistic regression. RESULTS 302 women in their antenatal period were included in this study. The outcome of antenatal depression (EPDS > 12) was found in 51 women (16.9%, 95% CI 12.6-21.1%). Feeling pressurized to deliver a male child was strongly associated with the outcome of antenatal depression (adjusted odds ratio (OR): 3.0; 95% CI 1.4-6.5). Unsatisfactory reaction of in-laws to dowry (adjusted OR 11.2; 95% CI 2.4-52.9) and difficult relationship with in-laws (adjusted OR 5.3; 95% CI 2.4-11.6) were also significantly associated with antenatal depression. CONCLUSIONS Our findings demonstrate that antenatal depression in rural women of Western Maharashtra is associated with gender disadvantage factors, especially related to preference for a male child. The agenda to improve maternal mental health should be ultimately linked to address the broader social development goals and gender empowerment.
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Affiliation(s)
- Pallavi Shidhaye
- Division of Clinical Sciences, National AIDS Research Institute, Indian Council of Medical Research, Pune, India
| | - Rahul Shidhaye
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India. .,CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht, The Netherlands. .,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Vaishali Phalke
- Public Health Foundation of India, 19, Rishi Nagar, Char Imli, Bhopal, Madhya Pradesh, India
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