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Matte-Gagné C, Bernier A, Thériault-Couture F, Tarabulsy GM. Paternal and Maternal Depressive Symptoms and Sensitivity: Links with Trajectories of Socioemotional Problems in Toddlerhood. Res Child Adolesc Psychopathol 2024; 52:1261-1273. [PMID: 38700809 DOI: 10.1007/s10802-024-01200-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 07/31/2024]
Abstract
Parental depressive symptoms and sensitivity have well-documented consequences for children; however, studies considering both parents are still scarce. This longitudinal study aimed to investigate the respective roles of paternal and maternal depressive symptoms and sensitivity in predicting the development of child socioemotional problems during toddlerhood. We also investigated the buffering role of each parent's sensitivity in the associations between the other parent's depressive symptoms and toddlers' socioemotional problems. The sample consisted of 140 Canadian families who were visited in their homes when children were around 13 (T1), 19 (T2), and 27 (T3) months of age. At T1, both parents' sensitivity was assessed from observations of parent-child interactions at home and each parent reported on his or her own depressive symptoms. At T1, T2, and T3, maternal and paternal perceptions of their toddler's socioemotional problems were assessed and aggregated. Growth curve analyses revealed that paternal and maternal depressive symptoms as well as paternal sensitivity were unique and persistent predictors of child socioemotional problems and that sensitive fathering acted as a buffer in the context of maternal depressive symptoms. This study highlights the importance of considering both parents when studying risk and protective factors for young children's socioemotional problems.
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Affiliation(s)
- Célia Matte-Gagné
- School of Psychology, Laval University, 2325 Des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
| | - Annie Bernier
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | | | - George M Tarabulsy
- School of Psychology, Laval University, 2325 Des Bibliothèques, Quebec, QC, G1V 0A6, Canada
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2
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Mazza M, Brisi C, Veneziani G, Lisci FM, Sessa I, Balocchi M, Rossi S, Di Stasio E, Marano G, Abate F, Anesini MB, Boggio G, Ciliberto M, De Masi V, Falsini C, Marzo EM, Avallone C, Serio A, Gonsalez Del Castillo A, Kotzalidis GD, Chieffo DPR, Lanzone A, Scambia G, Lai C, Sani G. A Network Analysis of Perinatal Depression, Anxiety, and Temperaments in Women in the First, Second, and Third Trimesters of Pregnancy. J Clin Med 2024; 13:3957. [PMID: 38999520 PMCID: PMC11242710 DOI: 10.3390/jcm13133957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 06/27/2024] [Accepted: 07/04/2024] [Indexed: 07/14/2024] Open
Abstract
Background/Objectives: Although depression and anxiety are found to be affected by temperaments, little research has studied these relationships in pregnancy. The present study explored the associations among perinatal depression (PD), anxiety dimensions (state, trait, and generalized anxiety disorder (GAD)), and temperaments between women in the three trimesters of pregnancy through a network analysis approach. Moreover, differences in the severity of PD and anxiety between women in the three trimesters were evaluated. Methods: Women in first (N = 31), second (N = 184), and third (N = 54) trimesters of pregnancy were recruited in the present cross-sectional study. The network analysis included PD, anxiety dimensions, and temperaments. Three network models were estimated, and ANOVAs evaluated the differences in the severity of PD and anxiety, including trimesters as a between-subject factor. Results: PD and GAD were the nodes most strongly connected across the three groups. Cyclothymic, depressive, and anxious temperaments were most frequently associated with PD and GAD. Hyperthymic temperament was in the periphery of the three networks. Lastly, women in the first trimester had the highest severity of PD and GAD. Conclusions: PD and GAD showed the strongest associations. Anxiety dimensions had positive associations with PD and GAD, suggesting their role as possible risk factors. Temperaments were differently associated within the network between the three groups. Clinical interventions during pregnancy should target the central variables, considering their direct and indirect relationships.
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Affiliation(s)
- Marianna Mazza
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Caterina Brisi
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giorgio Veneziani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli 1, 00185 Rome, Italy
| | - Francesco Maria Lisci
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilenia Sessa
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Marta Balocchi
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Sara Rossi
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Enrico Di Stasio
- Department of Basic Biotechnological Sciences, Intensive Care and Perioperative Clinics Research, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe Marano
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesca Abate
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Benedetta Anesini
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gianluca Boggio
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Michele Ciliberto
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Valeria De Masi
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Cecilia Falsini
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ester Maria Marzo
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Carla Avallone
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Annamaria Serio
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | | | - Georgios Demetrios Kotzalidis
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | | | - Antonio Lanzone
- Department of Gynaecology and Obstetrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanni Scambia
- Department of Gynaecology and Obstetrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Carlo Lai
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli 1, 00185 Rome, Italy
| | - Gabriele Sani
- Unit of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Loncarevic A, Maybery MT, Barbaro J, Dissanayake C, Green J, Hudry K, Iacono T, Slonims V, Varcin KJ, Wan MW, Wray J, Whitehouse AJO. Parent-Child Interactions May Help to Explain Relations Between Parent Characteristics and Clinically Observed Child Autistic Behaviours. J Autism Dev Disord 2024; 54:2742-2756. [PMID: 37209200 DOI: 10.1007/s10803-023-05914-x] [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] [Accepted: 01/21/2023] [Indexed: 05/22/2023]
Abstract
The importance of supporting parent-child interactions has been noted in the context of prodromal autism, but little consideration has been given to the possible contributing role of parental characteristics, such as psychological distress. This cross-sectional study tested models in which parent-child interaction variables mediated relations between parent characteristics and child autistic behaviour in a sample of families whose infant demonstrated early signs of autism (N = 103). The findings suggest that associations between parent characteristics (psychological distress; aloofness) and child autistic behaviours may be mediated by the child's inattentiveness or negative affect during interactions. These findings have important implications in developing and implementing interventions in infancy which target the synchrony of parent-child interaction with the goal to support children's social communication development.
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Affiliation(s)
- Antonina Loncarevic
- CliniKids, Telethon Kids Institute, Nedlands, WA, Australia.
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia.
| | - Murray T Maybery
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Josephine Barbaro
- Cooperative Research Centre for Living with Autism, Long Pocket, Indooroopilly, QLD, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Cheryl Dissanayake
- Cooperative Research Centre for Living with Autism, Long Pocket, Indooroopilly, QLD, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Kristelle Hudry
- Cooperative Research Centre for Living with Autism, Long Pocket, Indooroopilly, QLD, Australia
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Teresa Iacono
- Living with Disability Research Centre, College of Science, Health, and Engineering, Victoria, Australia
| | - Vicky Slonims
- Children's Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Evelina London Children's Hospital, Kings College London, London, UK
| | - Kandice J Varcin
- CliniKids, Telethon Kids Institute, Nedlands, WA, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Brisbane, QLD, Australia
| | - Ming Wai Wan
- Perinatal Mental Health and Parenting Research Unit, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - John Wray
- Child and Adolescent Health Service, Child Development Service, West Perth, WA, Australia
| | - Andrew J O Whitehouse
- CliniKids, Telethon Kids Institute, Nedlands, WA, Australia
- Cooperative Research Centre for Living with Autism, Long Pocket, Indooroopilly, QLD, Australia
- University of Western Australia, Crawley, WA, Australia
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McCann JK, Freire S, de Oliveira CVR, Ochieng M, Jeong J. Father involvement is a protective factor for maternal mental health in Western Kenya. SSM - MENTAL HEALTH 2024; 5:100318. [PMID: 38910840 PMCID: PMC11192501 DOI: 10.1016/j.ssmmh.2024.100318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Abstract
Depression is a major global health concern especially among mothers of young children in low- and middle-income countries (LMICs). While various risk and protective factors have been well-established, the role of fathers in potentially mitigating maternal depression remains understudied. This study aimed to investigate the association between father involvement and maternal depressive symptoms in rural Western Kenya. We used cross-sectional baseline data collected in February-March 2023 from a cluster-randomized controlled trial evaluating the effectiveness of a community-based parenting program for improving early childhood development. Primary caregivers with children 0-18 months of age were enrolled into the trial across 51 villages in Nyamira and Vihiga counties. We analyzed data from 413 mothers who were in a relationship with a male partner (i.e., father of the young child). Maternal depressive symptoms were measured using the CESD-10. Father involvement was reported using a multidimensional measure of men's engagement in childcare activities, household chores, early learning activities, and affection towards their child. We used multilevel regression models to estimate the adjusted associations between father involvement (overall score and by specific domains) and maternal depressive symptoms. We also conducted exploratory subgroup analyses to assess whether this association differed by child age. Overall, greater father involvement was associated with fewer maternal depressive symptoms. Specifically, fathers' engagement in household chores and childcare activities had the strongest protective associations. Exploratory subgroup analyses revealed larger associations for mothers with younger children under 6 months. Our findings suggest that father involvement is a protective factor for maternal mental health. Engaging fathers in early childhood interventions and encouraging men's involvement in caregiving activities may potentially benefit maternal well-being.
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Affiliation(s)
- Juliet K. McCann
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Silvana Freire
- Steinhardt School of Culture, Education and Human Development, New York University, New York, USA
| | | | | | - Joshua Jeong
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA
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5
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Axinn WG, Banchoff E, Ghimire DJ, Scott KM. Parental depression and their children's marriage timing: The long-term consequences of parental mental disorders. Soc Sci Med 2024; 347:116745. [PMID: 38460272 PMCID: PMC11131349 DOI: 10.1016/j.socscimed.2024.116745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/05/2024] [Accepted: 02/29/2024] [Indexed: 03/11/2024]
Abstract
Although decades of research documents powerful associations between parents' characteristics and their children's marital behaviors, the role of parental mental health has largely been ignored, despite the high prevalence of mental disorders and their strong potential to shape multiple dimensions of family life. Many studies examine other consequences of mothers' mental disorders, particularly for young children, but rarely do studies investigate the consequences of fathers' mental disorders, especially the potential for long-term consequences. We construct a theoretical framework for the study of intergenerational influences on family formation behaviors, integrating parental mental health, and emphasizing the potential for father's disorders to shape their children's lives. To investigate these associations, we use new intergenerational panel data featuring clinically validated diagnostic measures of parental mental health for both mothers and fathers, assessed independently. Results demonstrate that fathers' major depressive disorder is associated with significantly earlier marriage timing among sons. These important new findings provide insights into key priorities for social research on family formation processes and intergenerational influences across many domains.
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Affiliation(s)
- William G Axinn
- Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA.
| | - Emma Banchoff
- Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA
| | - Dirgha J Ghimire
- Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA
| | - Kate M Scott
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, 362 Leith St, Dunedin, 9016, New Zealand
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6
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Duh-Leong C, Canfield CF, Fuller AE, Gross RS, Reichman NE. Early Childcare Precarity and Subsequent Maternal Health. Womens Health Issues 2024; 34:115-124. [PMID: 37978038 PMCID: PMC10978296 DOI: 10.1016/j.whi.2023.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/30/2023] [Accepted: 10/05/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE We examined prospective associations between early childcare precarity, or the security and reliability of childcare arrangements, and subsequent maternal health. STUDY DESIGN We conducted a secondary analysis of survey responses from mothers of 2,836 children in the Future of Families and Child Wellbeing study. We assessed the following childcare measures: insecure childcare, insecure childcare with missed work, inadequate childcare, and emergency childcare support. We used linear and logistic regression models with robust standard errors to examine associations between these measures when the index child was age 3 and maternal health outcomes (overall health, depression, and parenting stress) later when the child was age 9. We then examined additive experiences of childcare measures across child ages 1 and 3 on maternal health outcomes. RESULTS Early inadequate childcare was associated with higher odds of later poor maternal overall health (adjusted odds ratio [aOR], 1.64; 95% confidence interval [CI], 1.11-2.41). All early childcare precarity measures were associated with higher odds of maternal depression (insecure childcare [aOR, 1.64; 95% CI, 1.23-2.18]; insecure childcare with missed work [aOR, 1.58; 95% CI, 1.13-2.22]; and inadequate childcare [aOR, 1.75; 95% CI, 1.22-2.51]). Emergency childcare support was associated with lower odds of adverse maternal health outcomes (poor overall health [aOR, 0.65; 95% CI, 0.48 to 0.88]; depression [aOR, 0.73; 95% CI, 0.54 to 0.99]; and parenting stress [B -0.45; 95% CI, -0.80 to -0.10]). Prolonged experiences had stronger associations with maternal health than shorter experiences. CONCLUSION Early childcare precarity has long-term adverse associations with maternal health, and emergency childcare support seems to be favorable for maternal health. These findings highlight childcare precarity as a social determinant of women's health for researchers, clinicians, and decision-makers.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York.
| | - Caitlin F Canfield
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
| | - Anne E Fuller
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Rachel S Gross
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
| | - Nancy E Reichman
- Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey; Child Health Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
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Santos CAD, Paula AP, Filho GGF, Alves MM, Nery AF, Pontes MGA, Macedo EYL, Oliveira RM, Freitas SM, Lima S, Varela FVC, Viana ALS, Silva ALP, Silva ÉGC, D'Souza-Li L. Developmental impairment in children exposed during pregnancy to maternal SARS-COV2: A Brazilian cohort study. Int J Infect Dis 2024; 139:146-152. [PMID: 38061413 DOI: 10.1016/j.ijid.2023.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/31/2023] Open
Abstract
OBJECTIVES To determine the effects of in-utero exposure to maternal SARS-CoV-2 infection on offspring's neurodevelopment during the first year of life. METHODS We performed a prospective cohort of babies exposed to SARS-CoV-2 during pregnancy, and a control group (CG) of unexposed babies in a low-income area in Brazil. Children's neurodevelopment was assessed using the guide for Monitoring Child Development in the Integrated Management of Childhood Illness context for both groups (at 1,2,3,4,5,6, 9, and 12 months), and the Ages & Stages Questionnaire (ASQ-3) for the exposed group (EG) (at 4, 6 and 12 months). RESULTS We followed 137 children for 1 year, 69 in the COVID-19-EG, and 68 in the CG. All mothers were unvaccinated at the time of cohort inclusion, and maternal demographics were similar in the two groups. 20.3% of EG children and 5.9% of the CG received a diagnosis of neurodevelopmental delay within 12 months of life (P = 0.013, relative risk = 3.44; 95% confidence interval, 1.19- 9.95). For the EG, the prevalence of neurodevelopment impairment using Ages & Stages Questionnaire was 35.7% at 4 months, 7% at 6 months, and 32.1% at 12 months. CONCLUSION SARS-CoV-2 exposure was associated with neurodevelopmental impairment, and specific guidelines are needed for the follow-up of these high-risk children to mitigate the long-term effects on children's health.
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Affiliation(s)
- Carolina A D Santos
- University of Campinas, UNICAMP, Faculty of Medical Science, Campinas, Brazil; Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil.
| | - Artemis P Paula
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Gentil G Fonseca Filho
- Federal University of Rio Grande do Norte, Natal, Brazil; Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - Manoella M Alves
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil; Federal University of Rio Grande do Norte, Natal, Brazil
| | - Andréia F Nery
- Federal University of Rio Grande do Norte, Natal, Brazil
| | - Monise G A Pontes
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Erianna Y L Macedo
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Ruy M Oliveira
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Sabrinna M Freitas
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Sarah Lima
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Fernanda V C Varela
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Andrezza L S Viana
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Aline L P Silva
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Érika G C Silva
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Lília D'Souza-Li
- University of Campinas, UNICAMP, Faculty of Medical Science, Department of Pediatrics, Campinas, Brazil
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Bird A, Reese E, Salmon K, Waldie K, Peterson E, Atatoa-Carr P, Morton S. Maternal depressive symptoms and child language development: Exploring potential pathways through observed and self-reported mother-child verbal interactions. Dev Psychopathol 2023:1-14. [PMID: 37969026 DOI: 10.1017/s0954579423001311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Maternal depressive symptoms (MDS) in the postnatal period may impact children's later development through poorer quality parent-child interactions. The current study tested a specific pathway from MDS (child age 9 months) to child receptive vocabulary (4 ½ years) through both self-reported and observed parent-child verbal interactions (at both 2 and 4 ½ years). Participants (n = 4,432) were part of a large, diverse, contemporary pre-birth national cohort study: Growing Up in New Zealand. Results indicated a direct association between greater MDS at 9 months and poorer receptive vocabulary at age 4 ½ years. There was support for an indirect pathway through self-reported parent-child verbal interactions at 2 years and through observed parent-child verbal interactions at 4 ½ years. A moderated mediation effect was also found: the indirect effect of MDS on child vocabulary through observed verbal interaction was supported for families living in areas of greater socioeconomic deprivation. Overall, findings support the potential role of parent-child verbal interactions as a mechanism for the influence of MDS on later child language development. This pathway may be particularly important for families experiencing socioeconomic adversity, suggesting that effective and appropriate supportive parenting interventions be preferentially targeted to reduce inequities in child language outcomes.
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Affiliation(s)
- Amy Bird
- University of Auckland, Auckland, New Zealand
- University of Waikato, Hamilton, New Zealand
| | | | - Karen Salmon
- Victoria University of Wellington, Wellington, New Zealand
| | | | | | | | - Susan Morton
- University of Auckland, Auckland, New Zealand
- University of Technology Sydney, Sydney, NSW, Australia
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9
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Gredebäck G, Dorji N, Sen U, Nyström P, Hellberg J, Wangchuk. Context dependent cognitive development in Bhutanese children. Sci Rep 2023; 13:19875. [PMID: 37963958 PMCID: PMC10645759 DOI: 10.1038/s41598-023-47254-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/10/2023] [Indexed: 11/16/2023] Open
Abstract
We assessed risk/protective factors for cognitive development of Bhutanese children (504 3-5 year-olds, 49% girls, major ethnicities Ngalop 26%, Tshangla 30%, Lhotsampa 34%) using a non-verbal test of cognitive capacity (SON-R) and primary caregiver interviews. Cognitive capacity was related to the family's SES and whether the family belonged to the primary Buddhist majority ethnic groups (Ngalop or Tshangla) or primarily Hindu minorities (Lhotsampa). In majority families more engagement in Buddhist practices was associated with higher cognitive capacity in children. Minority children were more impacted by parents autonomous-relatedness values. Results demonstrate that cognitive development is dependent on the financial and educational context of the family, societal events, and culture specific risk/protective factors that differ across sub-groups (majority/minority, culture/religion).
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Affiliation(s)
| | - Nidup Dorji
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Umay Sen
- Uppsala University, Uppsala, Sweden
| | | | | | - Wangchuk
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
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10
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Sanfilippo KRM, McConnell B, Darboe B, Huma HB, Glover V, Stewart L. The experience of maternal mental distress in The Gambia: A qualitative study identifying idioms of distress, perceptions of contributing factors and the supporting role of existing cultural practices. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002329. [PMID: 37676895 PMCID: PMC10484451 DOI: 10.1371/journal.pgph.0002329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/03/2023] [Indexed: 09/09/2023]
Abstract
Maternal mental health problems are experienced frequently in the perinatal period and can be up to twice as common in women from low- and middle-income countries. The terms used to describe mental illness symptoms and the factors that contribute to developing these symptoms are affected by culture and context. Based on 14 focus group discussions held with pregnant women, health professionals and cultural leaders, this qualitative study aimed to understand women's experiences of mental distress during the perinatal period in The Gambia. To do this it aimed to 1) identify the most commonly used idioms of distress, 2) identify the factors believed to affect women's perinatal mental health and 3) explore the role of existing cultural practices, including musical practices, that were identified as locally significant in supporting maternal and mental health. Sondomoo tenkung baliyaa (Mandinka) and xel bu dalut (Wolof) were identified as the most commonly used idioms of distress which roughly translate to lack of a steady mind/heart. Using thematic analysis, six themes (Poverty of the healthcare system, Shifting cultural context, Economic factors, Social factors, Spiritual factors, and Cultural practices involving music) were identified to describe the factors that shape women's experience of mental health during the perinatal period. Lack of economic resources, the prevailing poverty of the health system, an unsupportive husband and spiritual attack by evil spirits or witches were common reasons given for a woman experiencing maternal mental distress. Various existing cultural practices involving music, such as fertility societies, naming ceremonies and community music-making, were recognised as valuable for supporting women's mental health during the perinatal period. This work emphasises that initiatives to support perinatal mental health should be grounded in an understanding of local community cultural practices, knowledge, and experiences.
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Affiliation(s)
| | - Bonnie McConnell
- School of Music, The Australian National University, Canberra, Australia
| | - Buba Darboe
- The Ministry of Health and Social Welfare, Banjul, The Gambia
| | - Hajara B. Huma
- The Ministry of Health and Social Welfare, Banjul, The Gambia
- The National Centre for Arts and Culture, Banjul, The Gambia
| | - Vivette Glover
- Institute of Reproductive and Developmental Biology, Imperial College London, London, United Kingdom
| | - Lauren Stewart
- Psychology Department, Goldsmiths, University of London, London, United Kingdom
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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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Santos IS, Blumenberg C, Munhoz TN, Matijasevich A, Santos Júnior HG, Dos Santos LM, Correia LL, de Souza MR, Lira PI, Bortolotto CC, Barcelos R, Altafim E, Chicaro MF, Macana EC, da Silva RS, Victora CG. Course of depression during the first 2 years postpartum among Brazilian women enrolled in a conditional cash transfer program. Int J Soc Psychiatry 2023; 69:1193-1201. [PMID: 36938959 DOI: 10.1177/00207640231154376] [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] [Indexed: 03/21/2023]
Abstract
BACKGROUND Women living in low- and middle-income countries are more exposed to known risk factors for depression occurrence and persistency over time. AIM Our aim was to investigate the course of depression in the first 2 years postpartum among Brazilian women enrolled in a cash transfer program. METHOD Longitudinal analysis of baseline (T0; mean 3.7 months postpartum) and first follow-up data (T1; mean 18.6 months postpartum) from a trial to assess the impact of a child development promotion program in 30 municipalities from six Brazilian states. The program does not include any interventions against maternal depression. The Edinburgh Postnatal Depression Scale (EPDS) at cutoff ⩾10 was applied. Women were categorized into four groups based on EPDS at T0 and T1: absence of depression, persistence, discontinuity, or emergence pattern. Adjusted Poisson regressions were run using a multilevel hierarchical model. RESULTS Two thousand eight hundred sixty-three women were assessed. Prevalence of depression was 26.4% [24.8, 28.1] at T0 and 24.4% [22.8, 26.0] at T1. Persistence, discontinuation, and emergence were found in 14.1% [11.3, 17.6%], 12.8% [11.4, 14.3%], and 10.2% [8.0, 13.0], respectively. In adjusted analyses, the persistence pattern was directly associated with parity and inversely associated with schooling of the woman and of the child's father. Living with husband/partner and support from the child's father and family members during pregnancy were protective against persistence. The discontinuity and the emergence patterns were not associated with any of the exposure variables. CONCLUSIONS Depressive symptoms were highly prevalent during the first 2 years postpartum. About half of the women with depression at T1 were persistent cases that could have been detected earlier. Screening for maternal depression should be an essential component in every encounter of women with health professionals in primary health care settings.
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Affiliation(s)
- Ina S Santos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Cauane Blumenberg
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Tiago N Munhoz
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Curso de Psicologia, Universidade Federal de Pelotas, Rio Grande do Sul, Brasil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Letícia Marques Dos Santos
- Instituto de Humanidades Artes de Ciências da Universidade Federal da Bahia (UFBA); Salvador, Bahia, Brazil
| | - Luciano L Correia
- Departamento de Saúde Comunitária, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Marta Rovery de Souza
- Departamento de Saúde Coletiva, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Pedro Ic Lira
- Departamento de Nutrição do Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Caroline C Bortolotto
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Raquel Barcelos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Elisa Altafim
- Fundação Maria Cecília Souto Vidigal, São Paulo, São Paulo, Brazil
| | | | | | - Ronaldo Souza da Silva
- Secretaria de Avaliação e Gestão da Informação (SAGI), Ministério da Cidadania; Brasília, Federal District, Brazil
| | - Cesar G Victora
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Moureau A, Cordemans L, Gregoire C, Benoît P, Delvenne V. A 5 years' experience of a parent-baby day unit: impact on baby's development. Front Psychiatry 2023; 14:1121894. [PMID: 37398587 PMCID: PMC10308312 DOI: 10.3389/fpsyt.2023.1121894] [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: 12/12/2022] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Psychiatric Mother-Baby Units are well established in France, United Kingdom, and Australia, mostly in full-time hospitalization. Inpatient units are considered as best practice for improving outcomes for mothers and babies when the mother is experiencing severe mental illness and many studies have showed the effectiveness of care for the mother or the mother-infant relationship. Only a limited number of studies have focused on the day care setting or on the development of the baby. Our parent-baby day unit is the first day care unit in child psychiatry in Belgium. It offers specialized evaluation and therapeutic interventions focused on the baby and involves parents with mild or moderate psychiatric symptoms. The advantages of day care unit is to reduce the rupture with social and family living. Aims The objective of this study is to evaluate the effectiveness of parent-baby day unit in prevention of babies' developmental problems. First, we present the clinical characteristics of the population treated in the day-unit in comparison to the features presented in the literature review about mother-baby units, which usually receive full-time treatment. Then, we will identify the factors that might contribute to a positive evolution of the baby's development. Materials and methods In this study, we retrospectively analyze data of patients admitted between 2015 and 2020 in the day unit. Upon admission, the 3 pillars of perinatal care - babies, parents, and dyadic relationships - have systematically been investigated. All the families have received a standard perinatal medico-psycho-social anamnesis, including data on the pregnancy period. In this unit, all the babies are assessed at entry and at discharge using the diagnostic 0 to 5 scale, a clinical withdrawal risk, and a developmental assessment (Bayley). Parental psychopathology is assessed with the DSM5 diagnostic scale and the Edinburgh scale for depression. Parent-child interactions are categorized according to Axis II of the 0 to 5 scale. We have evaluated the improvement of children symptomatology, the child development and the mother-child relation between the entrance (T1) and the discharge (T2) and we have compared two groups of clinical situations: a group of patients with a successful evolution (considering baby's development and the alliance with the parents) and a group of unsuccessful evolution during hospitalization. Statistical analysis We use descriptive statistics to characterize our population. To compare the different groups of our cohort, we use the T-test and non-parametric tests for continue variables. For discrete variables, we used the Chi2 test of Pearson. Discussion The clinical population of the day unit is comparable to the mother-baby units in terms of psychosocial fragility but the psychopathological profile of the parents entering the day unit shows more anxiety disorder and less post-partum psychosis. The babies' development quotient is in the average range at T1 and is maintained at T2. In the day unit, the number of symptoms as well as the relational withdrawal of the babies is reduced between T1 and T2. The quality of parent-child relationship is improved between T1 and T2. The children of the group of pejorative evolution had a lower developmental quotient at the T1 and an overrepresentation of traumatic life events. Conclusion These results indicate that parent-baby day unit lead to positive outcomes in clinical situations with anxio-depressive parents, relational withdrawal of the babies, functional problems of the babies but not when a significant impact on the development of the baby already exists. The results of this study can guide therapeutic approaches for the benefit of care in parent-baby day units, and improve the development of the child and of the dyadic relationships.
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Affiliation(s)
- Audrey Moureau
- Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
- Child and Adolescent Psychiatry Department, Queen Fabiola Children’s University Hospital, Brussels, Belgium
| | - Louise Cordemans
- Child and Adolescent Psychiatry Department, Queen Fabiola Children’s University Hospital, Brussels, Belgium
- Faculty of Psychology, Université Libre de Bruxelles, Brussels, Belgium
| | - Caroline Gregoire
- Child and Adolescent Psychiatry Department, Queen Fabiola Children’s University Hospital, Brussels, Belgium
- Faculty of Psychology, Université Libre de Bruxelles, Brussels, Belgium
| | - Pirmez Benoît
- Faculty of Statistics, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Veronique Delvenne
- Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
- Child and Adolescent Psychiatry Department, Queen Fabiola Children’s University Hospital, Brussels, Belgium
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14
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Abdul Jafar NK, Tham EKH, Eng DZH, Yeo S, Rifkin-Graboi A, Gooley JJ, Loy SL, Eriksson JG, Chong YS, Tan KH, Chan JKY, Chen H, Shek LPC, Gluckman PD, Yap F, Meaney MJ, Broekman BFP, Kee MZL, Cai S. Preconception sleep quality moderates the association between preconception hair cortisol levels and mental health in pregnant women. J Affect Disord 2023; 334:187-196. [PMID: 37150222 DOI: 10.1016/j.jad.2023.04.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 03/17/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Poor sleep quality may elevate cortisol levels and affect prenatal mental health through altered HPA axis functioning. This study aims to examine whether subjective sleep quality during preconception moderates the association between preconception hair cortisol levels and mental health from preconception to pregnancy trimesters. METHODS Women from a prospective cohort study completed the Pittsburgh Sleep Quality Index (PSQI), the Edinburgh Postnatal Depression Scale (EPDS), and the State-Trait Anxiety Inventory (STAI) questionnaires during preconception (T0) and at each pregnancy trimesters (T1, T2, and T3). We analyzed 266 of these women who conceived and had fully completed measures at preconception for hair cortisol, sleep quality and either EPDS or STAI-state. Changes in EPDS and STAI-state scores were derived (i.e., T1-T0, T2-T0, T3-T0). Johnson-Neyman technique identified PSQI scores with significant moderation of cortisol on mental health. RESULTS After adjusting for potential covariates, there was a significant positive correlation between preconception hair cortisol levels and depressive symptom at the second trimester (rs (144) = 0.22, p = 0.008), but not the first and third trimesters (all ps > 0.05). The positive association between preconception hair cortisol and change in depressive symptoms between third trimester and preconception was significant only among women with poor preconception sleep quality (PSQI ≥ 7). LIMITATIONS Sleep quality and prenatal mood were derived from self-reported questionnaires, which may be more susceptible to bias. CONCLUSIONS The positive association between preconception hair cortisol and change in prenatal depressive symptoms is significant among women who reported poor sleep quality during preconception. Improving preconception sleep quality can potentially mitigate the association between preconception hair cortisol and depressive symptoms during pregnancy.
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Affiliation(s)
- Nur K Abdul Jafar
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Maternal Fetal Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore
| | - Elaine K H Tham
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Derric Z H Eng
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Sherwynn Yeo
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Anne Rifkin-Graboi
- Centre for Research in Child Development, Office of Educational Research, National Institute of Education, Nanyang Technological University, Singapore
| | - Joshua J Gooley
- Program in Neuroscience and Behavioural Disorders, Duke-NUS Medical School, Singapore
| | - See Ling Loy
- Department of Reproductive Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Johan G Eriksson
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yap-Seng Chong
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kok Hian Tan
- Department of Reproductive Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore; Paediatrics Academic Clinical Programme, Duke-NUS Medicine School, Singapore
| | - Jerry Kok Yen Chan
- Department of Reproductive Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Helen Chen
- Department of Psychological Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter D Gluckman
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael J Meaney
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Canada
| | - Birit F P Broekman
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Psychiatry, OLVG and Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program Amsterdam, the Netherlands
| | - Michelle Z L Kee
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Shirong Cai
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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15
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Do TTH, Bui QTT, Ha BTT, Le TM, Le VT, Nguyen QCT, Lakin KJ, Dang TT, Bui LV, Le TC, Tran ATH, Pham HTT, Nguyen TV. Using the WHO Self-Reporting Questionnaire-20 (SRQ-20) to Detect Symptoms of Common Mental Disorders among Pregnant Women in Vietnam: a Validation Study. Int J Womens Health 2023; 15:599-609. [PMID: 37082234 PMCID: PMC10112468 DOI: 10.2147/ijwh.s404993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Abstract
Purpose Detection of antenatal common mental disorders in low-resource settings like Vietnam is important and requires a reliable, valid and practical screening tool. Currently, there is no such tool validated for use among pregnant women in Vietnam. This study aims to assess the validity of the Vietnamese version of the 20-item Self Reporting Questionnaire (SRQ-20) by evaluating its reliability, factorial structure, and performance in detecting common mental disorder (CMD) symptoms, thereby identifying the optimum cut-off score for CMD screening among pregnant women in Vietnam. Participants and Methods A total of 210 pregnant women from four rural communes participated in a face-to-face interview using the Vietnamese version of the SRQ-20, followed by a clinical diagnostic interview based on ICD-10 diagnostic criteria of CMDs. The reliability of the SRQ-20 was assessed by calculating the scale's Cronbach's alpha to measure internal consistency. Factor analyses were undertaken to examine the factor structure of the instrument. The Receiver Operating Characteristic (ROC) curve analysis was performed to assess the performance of the SRQ-20 against the clinical diagnosis and to identify the optimum cut-off score. Results Internal consistency was good, with a Cronbach's alpha of 0.87. Factor analyses resulted in a 4-factor solution. The area under the ROC curve (AUC) for detection of CMDs was 0.90. The optimum cut-off score of the SRQ-20 for detection of CMD symptoms among Vietnamese pregnant women was 5/6. Conclusion The Vietnamese version of the SRQ-20 has the capacity to detect CMDs among pregnant women effectively and is recommended for use as a screening tool for CMDs in antenatal care settings in Vietnam.
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Affiliation(s)
- Trang Thi Hanh Do
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Quyen Thi Tu Bui
- Faculty and Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Bui Thi Thu Ha
- Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Thi Minh Le
- Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Vui Thi Le
- Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Quynh-Chi Thai Nguyen
- Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Kimberly Joyce Lakin
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Tung Thanh Dang
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Loi Van Bui
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Thien Cong Le
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - An Thi Ha Tran
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Hien Thi Thu Pham
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Tuan Van Nguyen
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
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16
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Osuna E, Symington EA, Malan L, Ricci C, Zandberg L, Smuts CM, Baumgartner J. Higher n-3 polyunsaturated fatty acid status during early pregnancy is associated with lower risk for depression at 12 months postpartum: The NuPED study. Prostaglandins Leukot Essent Fatty Acids 2023; 190:102528. [PMID: 36716632 DOI: 10.1016/j.plefa.2022.102528] [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: 07/06/2022] [Revised: 11/30/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023]
Abstract
Perinatal depression can negatively affect the health of the mother and her offspring. N-3 polyunsaturated fatty acids (PUFA) may play a role in the aetiology of depression. Therefore, we investigated the association of n-3 PUFA status during early pregnancy with perinatal depression among women living in urban Johannesburg, South Africa. For this prospective analysis, we analysed red blood cell (RBC) total phospholipid fatty acid (FA) composition (% of total FA) of 242 pregnant women at <18 weeks' gestation. We used the Edinburgh Postnatal Depression Scale (EPDS) to identify women at risk for depression (EPDS score ≥9) at <18, 22 and 36 weeks' gestation, and at 6 and 12 months postpartum. RBC EPA status was negatively (β=-0.22, p<0.05), and the AA/EPA ratio positively (β=0.24, p<0.05) associated with EPDS scores at 12 months postpartum. Higher RBC DHA and n-3 index were further associated with lower odds (OR=0.56 [95% CI: 0.32-0.91]; OR=0.63 [95% CI: 0.39-0.94]), while higher n-6/n-3 PUFA and AA/EPA ratios early in pregnancy were associated with higher odds for depression at 12 months postpartum ((OR=2.34 [95% CI: 1.12-4.97]; OR=1.02 [95% CI: 1.00-1.05]). Our results suggest that women with a higher RBC n-3 PUFA status during early pregnancy may be at lower risk for depression at 12 months postpartum.
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Affiliation(s)
- Ester Osuna
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland
| | - Elizabeth A Symington
- Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHER), North-West University, Potchefstroom, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland; Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa; Department of Nutritional Sciences, King's College London, London, United Kingdom.
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17
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Xie EB, Freeman M, Penner-Goeke L, Reynolds K, Lebel C, Giesbrecht GF, Rioux C, MacKinnon A, Sauer-Zavala S, Roos LE, Tomfohr-Madsen L. Building Emotional Awareness and Mental Health (BEAM): an open-pilot and feasibility study of a digital mental health and parenting intervention for mothers of infants. Pilot Feasibility Stud 2023; 9:27. [PMID: 36800982 PMCID: PMC9938356 DOI: 10.1186/s40814-023-01245-x] [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: 08/02/2022] [Accepted: 01/13/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Maternal mental health concerns and parenting stress in the first few years following childbirth are common and pose significant risks to maternal and child well-being. The COVID-19 pandemic has led to increases in maternal depression and anxiety and has presented unique parenting stressors. Although early intervention is crucial, there are significant barriers to accessing care. METHODS To inform a larger randomized controlled trial, the current open-pilot trial investigated initial evidence for the feasibility, acceptability, and efficacy of a newly developed online group therapy and app-based mental health and parenting program (BEAM) for mothers of infants. Forty-six mothers 18 years or older with clinically elevated depression scores, with an infant aged 6-17 months old, and who lived in Manitoba or Alberta were enrolled in the 10-week program (starting in July 2021) and completed self-report surveys. RESULTS The majority of participants engaged in each of the program components at least once and participants indicated relatively high levels of app satisfaction, ease of use, and usefulness. However, there was a high level of attrition (46%). Paired-sample t-tests indicated significant pre- to post-intervention change in maternal depression, anxiety, and parenting stress, and in child internalizing, but not externalizing symptoms. Effect sizes were in the medium to high range, with the largest effect size observed for depressive symptoms (Cohen's d = .93). DISCUSSION This study shows moderate levels of feasibility and strong preliminary efficacy of the BEAM program. Limitations to program design and delivery are being addressed for testing in adequately powered follow-up trials of the BEAM program for mothers of infants. TRIAL REGISTRATION NCT04772677 . Registered on February 26 2021.
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Affiliation(s)
- E. Bailin Xie
- grid.22072.350000 0004 1936 7697Department of Psychology, University of Calgary, Calgary, AB Canada
| | - Makayla Freeman
- grid.17091.3e0000 0001 2288 9830Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC Canada
| | - Lara Penner-Goeke
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada
| | - Kristin Reynolds
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada
| | - Catherine Lebel
- grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Radiology, University of Calgary, Calgary, AB Canada
| | - Gerald F. Giesbrecht
- grid.22072.350000 0004 1936 7697Department of Psychology, University of Calgary, Calgary, AB Canada ,grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Pediatrics, University of Calgary, Calgary, AB Canada
| | - Charlie Rioux
- grid.266900.b0000 0004 0447 0018Department of Psychology, University of Oklahoma, Norman, OK USA
| | - Anna MacKinnon
- grid.14848.310000 0001 2292 3357Department of Psychiatry and Addictology, Université de Montréal, Montréal, QC Canada ,grid.411418.90000 0001 2173 6322CHU Sainte-Justine Research Center, Montréal, QC Canada
| | - Shannon Sauer-Zavala
- grid.266539.d0000 0004 1936 8438Department of Psychology, University of Kentucky, Lexington, KY USA
| | - Leslie E. Roos
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada ,grid.460198.20000 0004 4685 0561Children’s Hospital Research Institute of Manitoba, Winnipeg, MB Canada
| | - Lianne Tomfohr-Madsen
- grid.17091.3e0000 0001 2288 9830Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC Canada
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de Voss S, Wilson P, Saxild S, Overbeck G. Increasing the psychosocial focus in child developmental assessments: a qualitative study. BMC Pediatr 2023; 23:44. [PMID: 36698093 PMCID: PMC9875422 DOI: 10.1186/s12887-023-03849-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 01/16/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Previous studies have indicated a need for increased psychosocial focus on children and their families to improve children's wellbeing and mental health. Child developmental assessments could be a place to implement changes to achieve this. A standardised record might be helpful to clinicians trying to increase psychosocial focus. The aim of this study is to investigate clinical barriers and facilitators when introducing standardised child records with increased focus on psychosocial wellbeing and mental health into child developmental assessments. METHODS This is a qualitative study based on 12 semi-structured interviews with four midwives and nine doctors who carry out child developmental assessments in general practice. Data is analysed in the framework of Normalisation Process Theory. RESULTS General practice-based clinicians were positive towards increasing the psychosocial focus in child developmental assessments. The main barriers when clinicians used the standardised child records were: feeling forced to ask certain questions, in turn making the conversation rigid; leaving less room for parents to bring up other issues; making clinicians feel awkward when addressing problems that they cannot solve; the need for extended consultation time; and medico-legal concerns when registering findings. The experience of positive aspects when using the standardised child records facilitated continuous use of the records. Positive aspects included having a standardised approach to recording important findings, thereby uncovering psychosocial problems that could potentially be overlooked. Additionally, structured observation of parent-child interaction and gaining a new vocabulary to describe the findings were valued by clinicians. Balancing a standardised approach with clinicians' ability to steer the consultation and explore topics in depth while preserving the potential for patients to bring up other issues became an important theme. CONCLUSION Clinicians need to be well-equipped to handle psychosocial problems through coping strategies, referral options and communication techniques in the psychosocial domain. The parent-child-interaction assessment might expose potentially dysfunctional parenting behaviours and could improve communication between health professionals. Implementing standardised child development records with an increased psychosocial focus is feasible but improvements could optimise the use of the records. Parental views on an increased psychosocial focus during child developmental assessments should be investigated prior to further implementation. TRIAL REGISTRATION Trial registry number for the FamilieTrivsel (Family Wellbeing) trial: NCT04129359.
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Affiliation(s)
- Sarah de Voss
- grid.5254.60000 0001 0674 042XDepartment of Public Health, Centre for General Practice, University of Copenhagen, Øster Farimagsgade 5, Opg. Q, CSS, Bg. 24, Postboks 2099, 1353 København K, Denmark
| | - Philip Wilson
- grid.5254.60000 0001 0674 042XDepartment of Public Health, Centre for General Practice, University of Copenhagen, Øster Farimagsgade 5, Opg. Q, CSS, Bg. 24, Postboks 2099, 1353 København K, Denmark ,grid.7107.10000 0004 1936 7291Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Old Perth Road Inverness, IV2 3JH Aberdeen, Scotland
| | - Sofie Saxild
- grid.5254.60000 0001 0674 042XDepartment of Public Health, Centre for General Practice, University of Copenhagen, Øster Farimagsgade 5, Opg. Q, CSS, Bg. 24, Postboks 2099, 1353 København K, Denmark
| | - Gritt Overbeck
- grid.5254.60000 0001 0674 042XDepartment of Public Health, Centre for General Practice, University of Copenhagen, Øster Farimagsgade 5, Opg. Q, CSS, Bg. 24, Postboks 2099, 1353 København K, Denmark
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Chen Y, Wu Y, Dill SE, Guo Y, Westgard CM, Medina A, Weber AM, Darmstadt GL, Zhou H, Rozelle S, Sylvia S. Effect of the mHealth-supported Healthy Future programme delivered by community health workers on maternal and child health in rural China: study protocol for a cluster randomised controlled trial. BMJ Open 2023; 13:e065403. [PMID: 36669837 PMCID: PMC9872510 DOI: 10.1136/bmjopen-2022-065403] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Millions of young rural children in China still suffer from poor health and malnutrition, partly due to a lack of knowledge about optimal perinatal and child care among rural mothers and caregivers. Meanwhile, there is an urgent need to improve maternal mental health in rural communities. Comprehensive home visiting programmes delivered by community health workers (CHWs) can bridge the caregiver knowledge gap and improve child health and maternal well-being in low-resource settings, but the effectiveness of this approach is unknown in rural China. Additionally, grandmothers play important roles in child care and family decision-making in rural China, suggesting the importance of engaging multiple caregivers in interventions. The Healthy Future programme seeks to improve child health and maternal well-being by developing a staged-based curriculum that CHWs deliver to mothers and caregivers of young children through home visits with the assistance of a tablet-based mHealth system. This protocol describes the design and evaluation plan for this programme. METHODS AND ANALYSIS We designed a cluster-randomised controlled trial among 119 rural townships in four nationally designated poverty counties in Southwestern China. We will compare the outcomes between three arms: one standard arm with only primary caregivers participating in the intervention, one encouragement arm engaging primary and secondary caregivers and one control arm with no intervention. Families with pregnant women or infants under 6 months of age are invited to enrol in the 12-month study. Primary outcomes include children's haemoglobin levels, exclusive breastfeeding rates and dietary diversity in complementary feeding. Secondary outcomes include a combination of health, behavioural and intermediate outcomes. ETHICS AND DISSEMINATION Ethical approval has been provided by Stanford University, Sichuan University and the University of Nevada, Reno. Trial findings will be disseminated through national and international peer-reviewed publications and conferences. TRIAL REGISTRATION NUMBER ISRCTN16800789.
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Affiliation(s)
- Yunwei Chen
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yuju Wu
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Sarah-Eve Dill
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Yian Guo
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Christopher Michael Westgard
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexis Medina
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Ann M Weber
- Department of Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Huan Zhou
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Scott Rozelle
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Sean Sylvia
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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20
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Aranbarri A, Aizpitarte A, Arranz-Freijo E, Fano E, de Miguel MS, Stahmer AC, Ibarluzea JM. What influences early cognitive development? Family context as a key mediator. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2022.101480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Koyratty N, Ntozini R, Mbuya MNN, Jones AD, Schuster RC, Kordas K, Li CS, Tavengwa NV, Majo FD, Humphrey J, Smith LE. Growth and growth trajectory among infants in early life: contributions of food insecurity and water insecurity in rural Zimbabwe. BMJ Nutr Prev Health 2022; 5:332-343. [PMID: 36619329 PMCID: PMC9813639 DOI: 10.1136/bmjnph-2022-000470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Stunting or linear growth faltering, measured by length-for-age Z-score (LAZ), remains a significant public health challenge, particularly in rural low-income and middle-income countries. It is a marker of inadequate environments in which infants are born and raised. However, the contributions of household resource insecurities, such as food and water, to growth and growth trajectory are understudied. Methods We used the cluster-randomised Sanitation Hygiene and Infant Nutrition Efficacy trial to determine the association of household-level food insecurity (FI) and water insecurity (WI) on LAZ and LAZ trajectory among infants during early life. Dimensions of FI (poor access, household shocks, low availability and quality) and WI (poor access, poor quality, low reliability) were assessed with the multidimensional household food insecurity and the multidimensional household water insecurity measures. Infant length was converted to LAZ based on the 2006 WHO Child Growth Standards. We report the FI and WI fixed effects from multivariable growth curve models with repeated measures of LAZ at 1, 3, 6, 12 and 18 months (M1-M18). Results A total of 714 and 710 infants were included in our analyses of LAZ from M1 to M18 and M6 to M18, respectively. Mean LAZ values at each time indicated worsening linear growth. From M1 to M18, low food availability and quality was associated with lower LAZ (β=-0.09; 95% -0.19 to -0.13). From M6 to M18, poor food access was associated with lower LAZ (β=-0.11; 95% -0.20 to -0.03). None of the WI dimensions were associated with LAZ, nor with LAZ trajectory over time. Conclusion FI, but not WI, was associated with poor linear growth among rural Zimbabwean infants. Specifically, low food availability and quality and poor food access was associated with lower LAZ. There is no evidence of an effect of FI or WI on LAZ trajectory.
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Affiliation(s)
- Nadia Koyratty
- Department of Poverty, Health and Nutrition, International Food Policy Research Institute, Washington DC, Washington DC, USA
| | - Robert Ntozini
- Statistics, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Mduduzi NN Mbuya
- Knowledge Leadership, Global Alliance for Improved Nutrition, Geneva, Switzerland
| | - Andrew D Jones
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Roseanne C Schuster
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, USA
| | - Chin-Shang Li
- School of Nursing, University at Buffalo, Buffalo, NY, USA
| | - Naume V Tavengwa
- Statistics, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Florence D Majo
- Statistics, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Jean Humphrey
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura E Smith
- Statistics, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe,Department of Public and Ecosystem Health, Cornell University, Ithaca, New York, USA
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22
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Best I, Breen LJ, Kane RT, Egan SJ, Collins KR, Somerville S, Rooney RM. Quality of the development of self-report instruments assessing women’s antepartum expectations of motherhood: a systematic review. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2022.2108694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ida Best
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Lauren J. Breen
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
- Curtin enAble Institute, Curtin University, Bentley, WA, Australia
| | - Robert T. Kane
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Sarah J. Egan
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
- Curtin enAble Institute, Curtin University, Bentley, WA, Australia
| | | | - Susanne Somerville
- Department of Psychological Medicine, King Edward Memorial Hospital, Subiaco, WA, Australia
| | - Rosanna M. Rooney
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
- Curtin enAble Institute, Curtin University, Bentley, WA, Australia
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23
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Zakeri MA, Khoram S, Bazmandegan G, Ghaedi-Heidari F, Talebi B, Ramezani N, Ahmadi F, Kamiab Z, Dehghan M. Postpartum depression and its correlates: a cross-sectional study in southeast Iran. BMC Womens Health 2022; 22:387. [PMID: 36138378 PMCID: PMC9494808 DOI: 10.1186/s12905-022-01978-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Postpartum depression has a negative impact on both infants and women. This study aimed to determine the correlates of postpartum depression in women in southern Iran.
Methods This cross-sectional study was performed on 186 mothers who had recently given birth to a baby. Data were collected using the demographic form, Quality of Prenatal Care Questionnaire, Edinburgh Postnatal Depression Scale (EPDS), Depression, Anxiety and Stress Scale—21 items (DASS-21) 3 days after delivery and EPDS and DASS-21 6 months after childbirth. Results Postpartum depression (PPD) was 24.2% and 3.2% 3 days and 6 months after delivery, respectively. Anxiety, Prenatal Care Quality and educational level predicted 34.0% of the variance of PPD 3 days after delivery (R2 = 34.0%). Anxiety, type of delivery, and stress predicted 24% of the variance of PPD 6 months after delivery (R2 = 24.0%).
Conclusions With an increase in stress and anxiety and a reduction in the quality of prenatal care, the risk of postpartum depression increases. Therefore, attention to the quality of prenatal care and postpartum stress and anxiety should be carefully evaluated to prevent PPD. Psychological support and interventions are recommended to promote the mental health of women before and after childbirth.
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Li H, Ning W, Zhang N, Zhang J, He R, Mao Y, Zhu B. Association between maternal depression and neonatal outcomes: Evidence from a survey of nationally representative longitudinal studies. Front Public Health 2022; 10:893518. [PMID: 36159263 PMCID: PMC9500377 DOI: 10.3389/fpubh.2022.893518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/22/2022] [Indexed: 01/22/2023] Open
Abstract
Background and aims Maternal depression before and after delivery has dramatically increased in China. Therefore, this study aimed to examine the association between antepartum and postpartum depression and neonatal outcomes. Design A population-based retrospective cohort study. Setting China. Participants Data were obtained from China Family Panel Studies (CFPS). Different mother-child/infant samples were included in this study. Mother in CFPS2012 and CFPS2016 were linked with 1-2-year-old children in CFPS2014 and CFPS2018, respectively. Besides, and mothers in CFPS2012, CFPS2016, and CFPS2018 were linked with 0-1-year-old infants in CFPS2012, CFPS2016, and CFPS2018, respectively. Methods Maternal depression was measured using the Center for Epidemiologic Studies Depression Scale. The neonatal outcomes included duration of gestational days, preterm birth, birth weight, birth weight z-score, weight, weight z-score, illness in the past month, and hospitalization in the past year. Propensity score matching was used to balance maternal, family, and infant/child characteristics between the maternal depression and non-maternal depression groups. Results Multivariable regression analysis of matched samples estimated that antepartum depression was associated with a shorter duration of gestation by 3.99 days (95% confidence interval [CI] = -7.21, -0.78). The association between antepartum depression and preterm birth, birth weight and birth weight z-score were not statistically significant. Postpartum depression was associated with more episodes of illness in the last month by 0.23 times (95% CI = 0.11, 0.36) and a higher odd of hospitalization in the previous year (OR = 1.59, 95% CI = 1.15, 2.20). The association between postpartum depression and weight or the weight z-score was not significant. Conclusion Maternal depression appears to be associated with worse neonatal outcomes.
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Affiliation(s)
- Haoran Li
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Wei Ning
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jingya Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China,*Correspondence: Ying Mao
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China,Bin Zhu
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25
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Xie EB, Simpson KM, Reynolds KA, Giuliano RJ, Protudjer JLP, Soderstrom M, Sauer-Zavala S, Giesbrecht GF, Lebel C, Mackinnon AL, Rioux C, Penner-Goeke L, Freeman M, Salisbury MR, Tomfohr-Madsen L, Roos LE. Building Emotional Awareness and Mental Health (BEAM): study protocol for a phase III randomized controlled trial of the BEAM app-based program for mothers of children 18-36 months. Trials 2022; 23:741. [PMID: 36064436 PMCID: PMC9441821 DOI: 10.1186/s13063-022-06512-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/05/2022] [Indexed: 02/06/2023] Open
Abstract
Background The prevalence of maternal depression and anxiety has increased during the COVID-19 pandemic, and pregnant individuals are experiencing concerningly elevated levels of mental health symptoms worldwide. Many individuals may now be at heightened risk of postpartum mental health disorders. There are significant concerns that a cohort of children may be at-risk for impaired self-regulation and mental illness due to elevated exposure to perinatal mental illness. With both an increased prevalence of depression and limited availability of services due to the pandemic, there is an urgent need for accessible eHealth interventions for mothers of young children. The aims of this trial are to evaluate the efficacy of the Building Emotion Awareness and Mental Health (BEAM) app-based program for reducing maternal depression symptoms (primary outcome) and improve anxiety symptoms, parenting stress, family relationships, and mother and child functioning (secondary outcomes) compared to treatment as usual (TAU). Methods A two-arm randomized controlled trial (RCT) with repeated measures will be used to evaluate the efficacy of the BEAM intervention compared to TAU among a sample of 140 mothers with children aged 18 to 36 months, who self-report moderate-to-severe symptoms of depression and/or anxiety. Individuals will be recruited online, and those randomized to the treatment group will participate in 10 weeks of psychoeducation modules, an online social support forum, and weekly group teletherapy sessions. Assessments will occur at 18–36 months postpartum (pre-test, T1), immediately after the last week of the BEAM intervention (post-test, T2), and at 3 months after the intervention (follow-up, T3). Discussion eHealth interventions have the potential to address elevated maternal mental health symptoms, parenting stress, and child functioning concerns during and after the COVID-19 pandemic and to provide accessible programming to mothers who are in need of support. This RCT will build on an open pilot trial of the BEAM program and provide further evaluation of this evidence-based intervention. Findings will increase our understanding of depression in mothers with young children and reveal the potential for long-term improvements in maternal and child health and family well-being. Trial registration ClinicalTrials.govNCT05306626. Registered on April 1, 2022
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Affiliation(s)
- E Bailin Xie
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
| | | | | | | | - Jennifer L P Protudjer
- University of Manitoba, Winnipeg, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | | | | | - Gerald F Giesbrecht
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - Catherine Lebel
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - Anna L Mackinnon
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - Charlie Rioux
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.,University of Manitoba, Winnipeg, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | | | - Makayla Freeman
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | | | - Lianne Tomfohr-Madsen
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - Leslie E Roos
- University of Manitoba, Winnipeg, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
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Mokwena K, Modjadji P. A comparative study of postnatal depression and associated factors in Gauteng and Free State provinces, South Africa. Afr J Prim Health Care Fam Med 2022; 14:e1-e11. [PMID: 36226935 PMCID: PMC9575337 DOI: 10.4102/phcfm.v14i1.3031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 11/06/2022] Open
Abstract
Background The factors contributing to probable postnatal depression (PND), a type of clinical depression that can affect woman after childbirth, are socially derived. Therefore, variations among groups of women necessitate studies in different communities. Aim This study compared the prevalence of PND and associated factors among women attending postnatal services facilities. Setting The study setting included Tshwane Municipal district in Gauteng province (GP) and Fezile Dabi District (FS) in Free State province (FSP), South Africa. Methods A total of 477 mothers within 12 weeks of giving birth were recruited by convenient sampling in health facilities. A self-developed questionnaire was used to obtain information on socio-demographics, obstetric history, and children’s characteristics. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data on depression symptoms, with a score of ≥ 13 used as a cut-off for probable PND. Data were analysed using STATA 14. Multivariate logistic regression was used to determine association between probable PND and various covariates. Results The overall mean age of women was 28 ± 6 years. The overall prevalence rate of PND was 22%, slightly higher in FS (23%) than in GP (21%). Most participants living in GP were married, had tertiary education, were employed and from the households with income of more than R8000.00. A chi-square test showed that planned pregnancy was significantly higher in GP compared with FS (p ≤ 0.001). Multivariate logistic regression showed that support from a partner or husband decreased the odds of a probable PND in GP (adjusted odd ratio [AOR] 0.37; 95% confidence interval [CI] [95%CI: 0.14–0.96; p = 0.041] and in the FS [AOR = 0.14, 95%CI: 0.05–0.40; p ≤ 0.001]). Significant associations of probable PND with several factors – planned pregnancy, baby age, support in difficult times, partner or husband drinking alcohol and stressful events – were more common in the FSP than in the GP. Conclusion The prevalence of probable PND and its associated risk factors in the GP and the FS indicates the need for routine screening and targeted interventions in both urban and rural settings. Contribution The results confirm that the prevalence of PND is similar in both rural and urban areas, and that pregnancy planning remains a challenge in the FS, which calls for increased efforts to revive family planning programmes in primary health care facilities.
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Affiliation(s)
- Kebogile Mokwena
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria.
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27
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Skoog M, Hallström IK, Vilhelmsson A. Health care professionals’ experiences of screening immigrant mothers for postpartum depression–a qualitative systematic review. PLoS One 2022; 17:e0271318. [PMID: 35834550 PMCID: PMC9282607 DOI: 10.1371/journal.pone.0271318] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/28/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Postpartum depression is considered a major public health problem, which immigrant mothers are at particular risk of being affected by, but it can also have long-lasting traumatic effects on the child’s health and development. The Edinburgh Postnatal Depression Scale is the world’s most commonly employed screening instrument for postpartum depression, used in connection with a clinical interview to screen for symptoms of postpartum depression. The aim of this study was to synthesize health care professionals (HCPs) experiences of identifying signs of postpartum depression and performing screening on immigrant mothers, since previous research suggested that this task might be challenging. Methods The databases CINAHL, PubMed, PsycINFO, SocINDEX, Embase and Cochrane were searched for papers published January 2000–December 2020, reporting qualitative data on immigrants, postpartum depression and the Edinburgh Postnatal Depression Scale. Eight papers representing eight studies from four countries were included and the Critical Appraisal Skills Program was used to assess their quality. The synthesis of studies was guided by Noblit & Hare’s seven-step method based on meta-ethnography. Findings The synthesis resulted in two final themes: “I do my best, but I doubt that it’s enough” and “I can find no way forward”. The themes convey the fear and frustration that health care professionals experienced; fear of missing mothers with signs of postpartum depression, related to feeling uncomfortable in the cross-cultural setting and frustration in handling difficulties associated with communication, translated versions of the Edinburgh Postnatal Depression Scale and cultural implications of postpartum depression. Conclusions and clinical implication By supporting HCPs’ self-efficacy in handling cultural implications of postpartum depression and by developing evidence-based clinical guidelines for the use of interpreters and translated versions of the Edinburgh Postnatal Depression Scale the screening of immigrant mothers may be facilitated.
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Affiliation(s)
- Malin Skoog
- Faculty of Medicine, Department of Health Sciences, Lund University, Sweden
- * E-mail:
| | | | - Andreas Vilhelmsson
- Faculty of Medicine, Department of Clinical Sciences, Lund University, Sweden
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Abufhele A, Narea M, Telias A. The Covid-19 Pandemic and Maternal Mental Health: A Longitudinal Study of Chilean and Foreign-Born Mothers. Int J Public Health 2022; 67:1604724. [PMID: 35910430 PMCID: PMC9327800 DOI: 10.3389/ijph.2022.1604724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/22/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives: We explore the effects of the pandemic on stress, depressive symptoms and parenting practices of mothers with children aged between 24- and 30-months, residents in Santiago, Chile, and the differences between foreign‐born and native‐born mothers. Methods: Using data from the longitudinal project Mil Primeros Días and lagged-dependent models, we analyzed parental stress, depressive symptoms and parenting practices for native-born and foreign-born mothers. Lagged-dependent model allows us to take advantage of the longitudinal data by controlling for the previous score and baseline individual characteristics. Results: After 8 months of the pandemic, mothers of young children have more depressive symptoms, are more stressed, and show more hostility towards their children. Foreign-born mothers had 0.29 and 0.22 standard deviations (SD) more than native-born mothers in the parental distress and difficult child scales from the Parental Stress Index (PSI), respectively, and 0.17 SD more in the hostile-reactive parental behavior dimension. Conclusion: Findings suggest the need to implement policies and programs that prevent mental health deterioration for mothers, especially migrant mothers, to improve women’s psychological condition and child wellness.
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Affiliation(s)
- Alejandra Abufhele
- Center for Advanced Studies on Educational Justice, Santiago, Chile
- *Correspondence: Alejandra Abufhele,
| | - Marigen Narea
- School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Amanda Telias
- Center for Advanced Studies on Educational Justice, Santiago, Chile
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O’Sullivan K, Rock N, Burke L, Boyle N, Joksimovic N, Foley H, Clark S. Gender Differences in the Psychosocial Functioning of Parents During the COVID-19 Pandemic. Front Psychol 2022; 13:846238. [PMID: 35899000 PMCID: PMC9309276 DOI: 10.3389/fpsyg.2022.846238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic significantly affected family life, increasing parental stress around health, job losses, reduced salaries, and maintaining domestic life in lockdown and social isolation. The transition to home-schooling and remote work with school and workplace closures caused additional stressors as families began living, working, and educating in one place. This research aims to understand the relationship between the pandemic and parental stress, focusing on family well-being and established characteristics of the family unit that may cause some family members to experience the adverse consequences of the pandemic in more or less profound ways, especially mothers. Previous research shows that mothers carry more family responsibilities than fathers and can experience higher stress levels. This study employed a quantitative cross-sectional online survey to extend our understanding of the interaction between home-schooling, work and home life, and stress levels in a group of 364 parents. In total, 232 mothers and 132 fathers completed the survey. Results revealed mothers were 10 times more likely to be responsible for home-schooling than fathers, and 44% of mothers felt they had no help with home-schooling and were generally more stressed than fathers. These results show that lack of support, managing home-schooling, and being a mother predicted increased stress. 10% of mothers reported leaving their jobs due to pressure added by home-schooling. This study broadens the understanding of the pandemic’s impact on gender imbalances in family responsibilities. It emphasises the need for extra consideration for the impact on mothers as we emerge from this pandemic.
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Goldstein E, Brown RL, Lennon RP, Zgierska AE. Latent class analysis of health, social, and behavioral profiles associated with psychological distress among pregnant and postpartum women during the COVID-19 pandemic in the United States. Birth 2022; 50:407-417. [PMID: 35802785 PMCID: PMC9349739 DOI: 10.1111/birt.12664] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 03/14/2022] [Accepted: 06/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is a growing body of literature documenting negative mental health impacts from the COVID-19 pandemic. The purpose of this study was to identify risk and protective factors associated with mental health and well-being among pregnant and postpartum women during the pandemic. METHODS This was a cross-sectional, anonymous online survey study distributed to pregnant and postpartum (within 6 months) women identified through electronic health records from two large healthcare systems in the Northeastern and Midwestern United States. Survey questions explored perinatal and postpartum experiences related to the pandemic, including social support, coping, and health care needs and access. Latent class analysis was performed to identify classes among 13 distinct health, social, and behavioral variables. Outcomes of depression, anxiety, and stress were examined using propensity-weighted regression modeling. RESULTS Fit indices demonstrated a three-class solution as the best fitting model. Respondents (N = 616) from both regions comprised three classes, which significantly differed on sleep- and exercise-related health, social behaviors, and mental health: Higher Psychological Distress (31.8%), Moderate Psychological Distress (49.8%), and Lower Psychological Distress (18.4%). The largest discriminatory issue was support from one's social network. Significant differences in depression, anxiety, and stress severity scores were observed across these three classes. Reported need for mental health services was greater than reported access. CONCLUSIONS Mental health outcomes were largely predicted by the lack or presence of social support, which can inform public health decisions and measures to buffer the psychological impact of ongoing waves of the COVID-19 pandemic on pregnant and postpartum women. Targeted early intervention among those in higher distress categories may help improve maternal and child health.
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Affiliation(s)
- Ellen Goldstein
- Department Population Health Nursing ScienceUniversity of Illinois at Chicago College of NursingChicagoIllinoisUSA
| | - Roger L. Brown
- University of Wisconsin‐Madison Schools of Nursing, Medicine and Public Health – Design and Statistics UnitMadisonWisconsinUSA
| | - Robert P. Lennon
- Department of Family and Community MedicinePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Aleksandra E. Zgierska
- Department of Family and Community MedicinePennsylvania State University College of MedicineHersheyPennsylvaniaUSA,Department of Anesthesiology and Perioperative MedicinePennsylvania State University College of MedicineHersheyPennsylvaniaUSA,Department of Public Health SciencesPennsylvania State University College of MedicineHersheyPennsylvaniaUSA
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Shah R, Camarena A, Park C, Martin A, Clark M, Atkins M, Schwartz A. Healthcare-Based Interventions to Improve Parenting Outcomes in LMICs: A Systematic Review and Meta-Analysis. Matern Child Health J 2022; 26:1217-1230. [PMID: 35579803 DOI: 10.1007/s10995-022-03445-y] [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: 02/28/2021] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Although a number of early childhood development (ECD) interventions in healthcare settings in low- and middle-income countries (LMICs) have been developed to improve parent-directed outcomes and support ECD, their impact have yet to be established. This review assesses the effectiveness of healthcare-based ECD interventions in LMICs on the following key evidence-informed parenting outcomes affecting ECD: (1) responsive caregiving (2) cognitive stimulation and (3) parental mental health. Impacts on parental knowledge regarding ECD and parenting stress were also assessed. METHODS PubMed, PsycINFO, Scopus, CINAHL and Embase were searched. We included randomized controlled trials reporting effects of healthcare-based ECD interventions in LMICs on parent-directed outcomes in the first five years of life. Data extraction included study characteristics, design, sample size, participant characteristics, settings, intervention descriptions, and outcomes. Meta-analyses were conducted using random effects models. RESULTS 8 articles were included. Summary standardized mean differences demonstrated significant benefits of healthcare-based interventions in LMICs for improving: (1) cognitive stimulation (n = 4; SMD = 0.32; 95% CI: 0.08 to 0.56) and (2) ECD knowledge (n = 4; SMD = 0.44; 95% CI: 0.27 to 0.60). No significant effects were seen on maternal depression and parenting stress; only one study assessed parent-child interactions in the context of responsiveness. Limitations included small number of studies for moderation analysis, high heterogeneity, variability in measures used for outcomes and timing of assessments. CONCLUSIONS FOR PRACTICE Our results demonstrate statistically significant effects of healthcare-based interventions in LMICs on improving key evidence-based parenting outcomes and offers one promising strategy to support children reach their full developmental potential.
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Affiliation(s)
- Reshma Shah
- Department of Pediatrics, University of Illinois at Chicago, 856 South Wood Street, 60612, Chicago, IL, United States.
| | - Andrea Camarena
- School of Medicine, Meharry Medical College, Nashville, TN, United States
| | - Christen Park
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States
| | - Aleah Martin
- Department of Pediatrics, University of Illinois at Chicago, 856 South Wood Street, 60612, Chicago, IL, United States
| | - Maureen Clark
- Library of the Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Department of Medical Education, University of Illinois at Chicago, Chicago, IL, United States
| | - Marc Atkins
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Alan Schwartz
- Department of Pediatrics, University of Illinois at Chicago, 856 South Wood Street, 60612, Chicago, IL, United States
- Department of Medical Education, University of Illinois at Chicago, Chicago, IL, United States
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Buechel C, Nehring I, Seifert C, Eber S, Behrends U, Mall V, Friedmann A. A cross-sectional investigation of psychosocial stress factors in German families with children aged 0-3 years during the COVID-19 pandemic: initial results of the CoronabaBY study. Child Adolesc Psychiatry Ment Health 2022; 16:37. [PMID: 35581664 PMCID: PMC9113073 DOI: 10.1186/s13034-022-00464-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/02/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Psychosocial stress during the COVID-19 pandemic is increasing particularly in parents. Although being specifically vulnerable to negative environmental exposures, research on psychosocial stress factors in infants' and toddlers' families during the pandemic is so far sparse. The CoronabaBY study investigates the perceived pandemic burden, parenting stress and parent and child mental health problems in families with children aged 0-3 years in Bavaria, Southern Germany. Further, the relationships between these psychosocial stressors are examined and sociodemographic characteristics that may be predictive of these factors will be explored. METHODS Participants were cross-sectionally surveyed via smartphone app. Standardized questionnaires on perceived pandemic burden, parenting stress, parental symptoms of depression and anxiety, infants' crying, sleeping and feeding problems or toddlers' emotional and behavioral problems were applied. RESULTS N = 991 parents (Mage = 33.7 years, SD = 4.5; 93.7% mothers, 91.5% born in Germany) with infants (n = 554; Mage = 5.9 months, SD = 3.0) or toddlers (n = 435; Mage = 25.9 months, SD = 6.5) participated in the first half-year of 2021. Sixty-five percent of the parents perceived a high pandemic burden, 37.7% experienced parenting stress and 24.1% showed affective symptoms (anxiety: 30.1%, depression: 18.5%). Feeding problems, crying/ sleeping problems and multiple regulatory problems were found in 34.8%, 26.2% and 13.5% of the infants, respectively. Amongst toddlers, 8.5% showed noticeable behavior and emotional problems. Children`s mental health problems correlated moderately with parenting stress and parental affective symptoms and weakly with perceived pandemic burden. A lower financial status, higher parental education and increasing child age were significant but weak predictors for higher parenting stress, affective symptoms and higher psychological problems in children. CONCLUSIONS A majority of the surveyed families with infants and toddlers experience the pandemic as stressful. The main challenges are parental affective symptoms and limited resources for childcare due to parenting stress. Overall, infants and toddlers show similar levels of mental health problems when being compared to pre-pandemic studies, but staggered detrimental effects on children`s mental health might occur if the stressful conditions persist. This is already indicated by correlations between parental and child psychosocial stress factors.
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Affiliation(s)
- Catherine Buechel
- Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany. .,, Heiglhofstraße 65, 81377, München, Germany.
| | - Ina Nehring
- grid.6936.a0000000123222966Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany
| | - Clara Seifert
- grid.6936.a0000000123222966Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany
| | - Stefan Eber
- Professional Association of Pediatricians in Bavaria and PaedNetz Bayern, Munich, Germany
| | - Uta Behrends
- grid.6936.a0000000123222966Department of Pediatrics, Kinderklinik München Schwabing, StKM GmbH and Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Volker Mall
- grid.6936.a0000000123222966Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany
| | - Anna Friedmann
- grid.6936.a0000000123222966Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany
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Markowitz AJ, Bassok D. Understanding the wellbeing of early educators in the wake of the coronavirus pandemic: Lessons from Louisiana. EARLY CHILDHOOD RESEARCH QUARTERLY 2022; 61:1-14. [PMID: 35571571 PMCID: PMC9085453 DOI: 10.1016/j.ecresq.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/27/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Anna J Markowitz
- Human Development and Psychology, Department of Education, School of Education and Information Studies, University of California, Los Angeles, United States
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Baik D, Reinsma K, Chhorvann C, Oy S, Heang H, Young MF. Program Impact Pathway of the Positive Deviance/Hearth Interactive Voice Calling Program in a Peri-Urban Context of Cambodia. Curr Dev Nutr 2022; 6:nzac045. [PMID: 35611354 PMCID: PMC9121803 DOI: 10.1093/cdn/nzac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 02/14/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background Positive Deviance/Hearth (PDH) is an internationally recognized nutrition rehabilitation program. However, nutritional improvements are inconsistent across contexts. It is unclear if variations are due to differences in program design, implementation, utilization, or other contextual factors. Furthermore, few PDH programs have addressed the high time and work burdens of caregivers and volunteers. To address this, the study integrated interactive voice calling (IVC) with PDH. Objectives A program impact pathway (PIP) analysis was used to evaluate the secondary outcomes of facilitators, barriers, and contextual factors that influenced the design, implementation, and utilization of a Positive Deviance/Hearth-Interactive Voice Calling program to improve the nutritional status of children in Cambodia. Methods A PIP analysis was done on data collected through in-depth interviews with caregivers (n = 32), key informant interviews with volunteers (n = 16) and project staff (n = 3), and surveys of project staff (n = 5). Results In the design phase, facilitators included quality training, technical support and design tools, community mobilization, and linkage to existing health services. Barriers included poor community mobilization. For the implementation phase, facilitators were good volunteer knowledge, follow-up tools and guidance, supervision, and spot checks of volunteers. Barriers were lack of time and overworked older caregivers. For the utilization phase, facilitators included family and volunteer support and access to phones, whereas barriers were lack of support, time, and financial resources; low levels of education and old age of caregivers; and inconsistent phone use. Contextual factors included food insecurity and increased childcare responsibilities of grandmothers due to migration of mothers. Conclusions The PIP analysis identified facilitators, barriers, and contextual factors that may affect the design, intervention, and utilization of IVC interventions for health and nutrition behavior change and elements to consider when designing and implementing them. When implementing child nutrition programs in Cambodia, supporting interventions addressing mental health and time and resource constraints of elderly caregivers should also be included.This trial was registered at clinicaltrials.gov as NCT03399058.
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Affiliation(s)
- Diane Baik
- World Vision International—Technical Service Organisation, Mississauga, Ontario, Canada
| | - Kate Reinsma
- World Vision International—Technical Service Organisation, Fort Collins, CO, USA
| | | | - Sreymom Oy
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Hen Heang
- World Vision International—Cambodia, Phnom Penh, Cambodia
| | - Melissa F Young
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Moltrecht B, Dalton LJ, Hanna JR, Law C, Rapa E. Young parents' experiences of pregnancy and parenting during the COVID-19 pandemic: a qualitative study in the United Kingdom. BMC Public Health 2022; 22:523. [PMID: 35300654 PMCID: PMC8927525 DOI: 10.1186/s12889-022-12892-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/17/2022] [Indexed: 12/21/2022] Open
Abstract
Young parents (aged 16–24 years) in the perinatal period are at an increased risk of poor mental health especially during the COVID-19 pandemic, due to multiple risk factors including social and economic instability. COVID-19 related restrictions had profound implications for the delivery of perinatal care services and other support structures for young parents. Investigating young parents’ experiences during the pandemic, including their perceived challenges and needs, is important to inform good practice and provide appropriate support for young parents. Qualitative interviews were conducted with young parents (n = 21) during the COVID-19 pandemic in the United Kingdom from February – May 2021. Data were analysed using thematic analysis. Three key themes were identified to describe parents’ experiences during the COVID-19 pandemic. Parents reported specific COVID-19 related anxieties and stressors, including worries around contracting the virus and increased feelings of distress due to uncertainty created by the implications of the pandemic. Parents described feeling alone both at home and during antenatal appointments and highlighted the absence of social support as a major area of concern. Parents also felt their perinatal care had been disrupted by the pandemic and experienced difficulties accessing care online or over the phone. This study highlights the potential impact of the COVID-19 pandemic on young parents, including their mental wellbeing and the perinatal support they were able to access. Insights from this study can inform the support and services offered to families going forward. Specifically, the findings emphasise the importance of (a) supporting both parents during perinatal appointments, (b) providing parents with mental health support early on and (c) finding ways to facilitate communication pathways between professionals and parents.
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Affiliation(s)
- Bettina Moltrecht
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.,Evidence-Base Practice Unit, University College London, London, N1 9JH, UK.,Centre for Longitudinal Studies, University College London, London, WC1H 0NU, UK
| | - Louise J Dalton
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Jeffrey R Hanna
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, BT9 7BL, UK
| | - Clare Law
- Centre for Early Child Development, Blackpool Better Start (NSPCC), Blackpool, UK
| | - Elizabeth Rapa
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
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Treatment of Peripartum Depression with Antidepressants and Other Psychotropic Medications: A Synthesis of Clinical Practice Guidelines in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041973. [PMID: 35206159 PMCID: PMC8872607 DOI: 10.3390/ijerph19041973] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/29/2022] [Accepted: 01/29/2022] [Indexed: 02/04/2023]
Abstract
This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers' compliance to the guidelines. We conducted a search using Medline and the Guidelines International Network database, combined with direct e-mail contact with national Riseup-PPD COST ACTION members and researchers within psychiatry. Of the 48 European countries examined, we screened 41 records and included 14 of them for full-text evaluation. After exclusion of ineligible and duplicate records, we included 12 CPGs. Multiple CPGs recommend antidepressant initiation or continuation based on maternal disease severity, non-response to first-line non-pharmacological interventions, and after risk-benefit assessment. Advice on treatment of comorbid anxiety is largely missing or unspecific. Antidepressant dispensing data suggest general prescribers' compliance with the preferred substances of the CPG, although country-specific differences were noted. To conclude, there is an urgent need for harmonized, up-to-date CPGs for pharmacological management of peripartum depression and comorbid anxiety in Europe. The recommendations need to be informed by the latest available evidence so that healthcare providers and women can make informed, evidence-based decisions about treatment choices.
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Martin A, Partika A, Castle S, Horm D, Johnson AD. Both sides of the screen: Predictors of parents' and teachers' depression and food insecurity during COVID-19-related distance learning. EARLY CHILDHOOD RESEARCH QUARTERLY 2022; 60:237-249. [PMID: 35153375 PMCID: PMC8825345 DOI: 10.1016/j.ecresq.2022.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 10/16/2021] [Accepted: 02/03/2022] [Indexed: 06/02/2023]
Abstract
The COVID-19 pandemic has placed unprecedented strains on both parents and teachers, both of whose mental and financial hardships have serious implications for young children's wellbeing. We drew on an existing cohort study of families with low incomes in Tulsa, OK when children were in their Spring of first grade in 2020. We surveyed parents and teachers - children's caregivers on both sides of the screen during distance learning - before and after the COVID-19 pandemic hit and schools were closed. We first compared the proportion of parents and teachers who were depressed and food-insecure before and after the pandemic struck. We then used pre-pandemic characteristics of parents and teachers in separate models to predict their depression and food insecurity during the pandemic. Results showed that rates of depression among both parents and teachers spiked after COVID-19, and food insecurity rates also increased among parents. For both parents and teachers, the strongest predictor of depression during COVID-19 was having experienced depression before the pandemic. Similarly, the strongest predictor of food insecurity during COVID-19 was having experienced food insecurity beforehand. These results point intervention efforts towards identifying the caregivers of children in low-income contexts whose mental and financial wellbeing are likely to be most compromised during this and perhaps future disasters.
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Affiliation(s)
- Anne Martin
- Independent Consultant, 237 West 11th St., 4A, New York, NY 10014
| | - Anne Partika
- Department of Psychology, Georgetown University, 303 White-Gravenor Hall, Washington, DC 20057
| | - Sherri Castle
- Early Childhood Education Institute, University of Oklahoma - Tulsa, 4502 E. 41st St., Room 4W-123, Tulsa, OK 74135
| | - Diane Horm
- Early Childhood Education Institute, University of Oklahoma - Tulsa, 4502 E. 41st St., Room 4W-123, Tulsa, OK 74135
| | - Anna D Johnson
- Department of Psychology, Georgetown University, 303 White-Gravenor Hall, Washington, DC 20057
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Kohrt BK, Saltiel MM, Rosen EL, Cholotio M. The use of formative research to culturally adapt a psychosocial support program for perinatal Mayan women in Guatemala. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Effect of perinatal depression on birth and infant health outcomes: a systematic review and meta-analysis of observational studies from Africa. Arch Public Health 2022; 80:34. [PMID: 35057865 PMCID: PMC8772173 DOI: 10.1186/s13690-022-00792-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 01/07/2022] [Indexed: 01/10/2023] Open
Abstract
Background Antenatal depression is associated with intrauterine growth retardation, preterm birth, and low birth weight. Infants born to mothers with postnatal depression also may suffer from malnutrition and other health problems. Even though there are few single studies conducted so far, a systematic review of these studies is highly important to highlight the effect of antenatal and perinatal depression on adverse birth and infant health outcomes in Africa. Methods We used the Preferred Report Items for Systematic Review and Meta-analysis (PRISMA) when conducting this study. Databases like CINAHL (EBSCO), MEDLINE (via Ovid and PubMed), PsycINFO, Emcare, Psychiatry Online, and Scopus were searched. In addition, Google Scholar and references from a list of eligible studies were explored. We included good quality observational studies based on Newcastle Ottawa Scale which are published in the English language between 2007 and 2018. Heterogeneity and publication bias were assessed. Meta-analysis with a random effect model was employed to determine the pooled effect sizes with a 95% confidence interval. The review protocol is registered in PROSPERO (CRD42018106714). Result We found three studies (1511 participants) and 11 studies (22,254 participants) conducted on the effect of antenatal depression on birth outcomes and perinatal depression on adverse infant health outcomes, respectively. The overall risk of having adverse birth outcomes was 2.26 (95% CI: 1.43, 3.58) times higher among pregnant mothers with depression. The risk of preterm birth and low birth weight was 1.77 (95% CI: 1.03, 3.04) and 2.98 (95% CI: 1.60, 5.55) respectively. Similarly, the risk of having adverse infant health outcomes namely malnutrition and febrile illness was 1.61 (95% CI: 1.34, 1.95) times higher among mothers who had perinatal depression. Conclusions We have found a significant association between antenatal depression and adverse birth outcomes, low birth weight and preterm birth. Similarly, a significant effect of perinatal depression on adverse infant health outcomes namely, malnutrition, and febrile illnesses was observed. The findings highlight that it is time to integrate mental health services with routine maternal health care services to improve birth outcomes and reduce infant morbidity. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00792-8.
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Basnet S, Frongillo EA, Nguyen PH, Moore S, Arabi M. Maternal resources for care are associated with child growth and early childhood development in Bangladesh and Vietnam. Child Care Health Dev 2022; 48:120-128. [PMID: 34505301 PMCID: PMC9292560 DOI: 10.1111/cch.12911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 08/12/2021] [Accepted: 08/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Suboptimal child growth and development are significant problems in low- and middle-income countries. Maternal resources for care may help to improve growth and development. This study examined the association of maternal resources for care on child length, motor development and language development of children 12-23.9 months old. METHODS We used baseline data from the Alive & Thrive household surveys collected in Bangladesh (n = 803) and Vietnam (n = 635). Resources for care were represented by maternal education, knowledge, height, well-nourishment, mental well-being, decision-making, employment, support in chores and perceived support. The regression analyses were adjusted for household wealth and other covariates on households, children and parents and accounted for geographical clustering. RESULTS Maternal height (Bangladesh β = 0.150 p < 0.001, Vietnam β = 0.156 p < 0.001), well-nourishment (Vietnam β = 0.882 p = 0.007) and mental well-being (Bangladesh β = 0.0649 p = 0.008, Vietnam β = 0.0742 p = 0.039) were associated with child length. Well-nourishment (Vietnam β = 0.670 p = 0.042) and support in chores (Bangladesh β = 0.0983 p = 0.021) were associated with child motor development. Mental well-being (Vietnam β = 0.0735 p = 0.013), decision-making autonomy (Bangladesh β = 0.0886 p = 0.029) and perceived support (Vietnam β = 0.445 p = 0.003) were associated with child language development. CONCLUSION Maternal height, well-nourishment, mental well-being, decision-making, support in chores and perceived social support were associated with child outcomes. Interventions that help to improve resources among mothers have potential to foster child growth and development.
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Affiliation(s)
- Sulochana Basnet
- Department of Health Promotion, Education, and BehaviorUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and BehaviorUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Phuong Hong Nguyen
- International Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| | - Spencer Moore
- Health & Society GroupWageningen University & ResearchWageningenNetherlands
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Lachman A, Jordaan ER, Stern M, Donald KA, Hoffman N, Lake MT, Zar HJ, Niehaus DJH, Puura K, Stein DJ. The Shared Pleasure Paradigm: A study in an observational birth cohort in South Africa. Arch Womens Ment Health 2022; 25:227-235. [PMID: 34985581 PMCID: PMC8784495 DOI: 10.1007/s00737-021-01199-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/20/2021] [Indexed: 11/26/2022]
Abstract
Mother-infant dyads in low- and middle-income countries (LMICs) may be exposed to a range of factors associated with suboptimal development. Optimal infant development is likely supported by synchronicity in the early mother-infant relationship, but limited corroborative research is available in LMICs. The Drakenstein Child Health Study (DCHS) provided an opportunity to study this synchronicity and its associations in South Africa. A South African birth cohort study investigating early-life determinants of child health in a LMIC context provided participants. The Shared Pleasure (SP) paradigm helped assess early mother-infant synchronicity in videos of a sub-set of 291 mother-infant dyads at their 14-week well baby visit. General linear regression models investigated the relationship between selected maternal and infant characteristics and the presence of Shared Pleasure moments. Out of a possible 291 dyads, 82% (n = 239) yielded Shared Pleasure moments. The mean age of mothers was 27 years, while infant sex distribution comprised 54% females and 46% males. The shortest single Shared Pleasure moment lasted at least 0.5 s and the longest 28 s. Shared Pleasure moments were associated with higher gestation age at delivery (p = 0.008) and higher infant birth weight (p = 0.006), but were not related to mother's mental health and infant health outcomes at 14 weeks. The high frequency of positive Shared Pleasure moments in reciprocal dyadic interactions in this sample suggests that significant disruption in shared pleasure may be present only in extreme cases (e.g. mothers with severe mental disorders). Further work is needed to investigate the mechanisms underlying the associations between early mother-infant synchronicity and better outcomes noted here, and to assess whether SP may serve as a culturally appropriate screen for assessing connectedness.
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Affiliation(s)
- Anusha Lachman
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.
| | - Esme R Jordaan
- Biostatistics Unit, South African Medical Research Council, Parow, South Africa
- Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
| | - Micky Stern
- South African Medical Research Council Unit On Risk and Resilience in Mental Disorders, Cape Town, South Africa
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council Unit On Child and Adolescent Health, Cape Town, South Africa
| | - Nadia Hoffman
- South African Medical Research Council Unit On Risk and Resilience in Mental Disorders, Cape Town, South Africa
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Marilyn T Lake
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council Unit On Child and Adolescent Health, Cape Town, South Africa
| | - Dana J H Niehaus
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Kaija Puura
- Department of Child Psychiatry, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Dan J Stein
- South African Medical Research Council Unit On Risk and Resilience in Mental Disorders, Cape Town, South Africa
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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42
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Juvrud J, Haas SA, Lindskog M, Astor K, Namgyel SC, Wangmo T, Wangchuk, Dorjee S, Tshering KP, Gredebäck G. High quality social environment buffers infants' cognitive development from poor maternal mental health: Evidence from a study in Bhutan. Dev Sci 2021; 25:e13203. [PMID: 34897908 DOI: 10.1111/desc.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 12/01/2022]
Abstract
Poor maternal mental health negatively impacts cognitive development from infancy to childhood, affecting both behavior and brain architecture. In a non-western context (Thimphu, Bhutan), we demonstrate that culturally-moderated factors such as family, community social support, and enrichment may buffer and scaffold the development of infant cognition when maternal mental health is poor. We used eye-tracking to measure early building blocks of cognition: attention regulation and social perception, in 9-month-old Bhutanese infants (N = 121). The cognitive development of Bhutanese infants in richer social environments was buffered from poor maternal mental health, while for infants in environments with lower rates of protective social environment factors, worse maternal mental health significantly predicted greater costs for infant attention, a fundamental building block cognition. International policies and interventions geared to improve maternal mental health and child health outcomes should incorporate each regions' unique family, cultural, and community support structures.
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Affiliation(s)
- Joshua Juvrud
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Sara A Haas
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Marcus Lindskog
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Kim Astor
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Sangay C Namgyel
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Tshering Wangmo
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Wangchuk
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Sithar Dorjee
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | | | - Gustaf Gredebäck
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
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Schoppmann J, Teismann T, Holleck-Weithmann VA, Hundertmark E, Jandewerth K, Obereiner P, Rudolph D, Seehagen S. Infant carrying is associated with reduced maternal repetitive negative thinking and increased maternal mental health. J Reprod Infant Psychol 2021:1-14. [PMID: 34882494 DOI: 10.1080/02646838.2021.2012647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Mental disorders, such as postnatal depression, are common in mothers. Repetitive negative thinking has been identified as a cognitive factor underlying the resulting difficulties in mother-infant interactions. METHOD The present online survey investigated associations between infant carrying (baby-wearing) and maternal repetitive negative thinking and positive mental health. RESULTS Repetitive negative thinking was significantly lower, and positive mental health was significantly higher while carrying compared to overall levels. There were no relations between maternal mental health and frequency of carrying. Maternal activities during carrying are portrayed. CONCLUSION These results are the first indication that carrying could be a low threshold, easily administered intervention method for maternal mental health problems.
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Affiliation(s)
| | - Tobias Teismann
- Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | | | | | | | | | - Dinah Rudolph
- Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Sabine Seehagen
- Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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44
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Venard G, Pina Brito V, Eeckhout P, Zimmermann G, Van Petegem S. Quand le parent veut trop bien faire : état de la littérature sur le phénomène de surprotection parentale. PSYCHOLOGIE FRANCAISE 2021. [DOI: 10.1016/j.psfr.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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45
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Wang H, Cousineau C, Hu YA, Hu G, Qi S, Sun A, Wu H, Rozelle S, Singh M. Examining the Relation between Caregiver Mental Health and Student Outcomes in Rural China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312613. [PMID: 34886336 PMCID: PMC8656998 DOI: 10.3390/ijerph182312613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022]
Abstract
Research continues to highlight the central relationship between caregivers' mental health and their children's development. This study examined the relation between primary caregivers' mental health and school-aged children's outcomes, including student mental health, resilience, and academic performance, in rural China. Using cross-sectional data from economically poor areas in the Gansu province, 2989 students (mean age = 11.51, 53.33% male, 46.67% female) and their primary caregivers (74.2% female) completed the 21-item, self-report Depression Anxiety Stress Scale. Students also completed the 25-item Connor-Davidson Resilience Scale and a standardized math test. The results indicated a high prevalence of caregiver depression (31%), stress (39%), and anxiety (24%). Characteristics that were significantly correlated with caregiver mental health issues included being a grandparent, having a low socioeconomic status and low education level, and living in a household with at least one migrant worker. Apart from caregiver stress and student resilience, caregiver mental health issues were negatively correlated with all student outcomes, including student mental health, resilience, and academic performance. Although additional empirical research is needed to investigate the associations between caregiver mental health and student outcomes, our results suggest that rural communities could benefit greatly from programs focused on improving the mental health of caregivers and this, in turn, may have a positive impact on student outcomes.
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Affiliation(s)
- Huan Wang
- Stanford Center on China’s Economy and Institutions, Stanford University, Palo Alto, CA 94305-6055, USA; (H.W.); (C.C.); (Y.A.H.); (G.H.); (S.Q.); (A.S.); (H.W.); (S.R.)
| | - Claire Cousineau
- Stanford Center on China’s Economy and Institutions, Stanford University, Palo Alto, CA 94305-6055, USA; (H.W.); (C.C.); (Y.A.H.); (G.H.); (S.Q.); (A.S.); (H.W.); (S.R.)
| | - Yuwei Adeline Hu
- Stanford Center on China’s Economy and Institutions, Stanford University, Palo Alto, CA 94305-6055, USA; (H.W.); (C.C.); (Y.A.H.); (G.H.); (S.Q.); (A.S.); (H.W.); (S.R.)
| | - Grace Hu
- Stanford Center on China’s Economy and Institutions, Stanford University, Palo Alto, CA 94305-6055, USA; (H.W.); (C.C.); (Y.A.H.); (G.H.); (S.Q.); (A.S.); (H.W.); (S.R.)
| | - Sunny Qi
- Stanford Center on China’s Economy and Institutions, Stanford University, Palo Alto, CA 94305-6055, USA; (H.W.); (C.C.); (Y.A.H.); (G.H.); (S.Q.); (A.S.); (H.W.); (S.R.)
| | - Adrian Sun
- Stanford Center on China’s Economy and Institutions, Stanford University, Palo Alto, CA 94305-6055, USA; (H.W.); (C.C.); (Y.A.H.); (G.H.); (S.Q.); (A.S.); (H.W.); (S.R.)
| | - Helen Wu
- Stanford Center on China’s Economy and Institutions, Stanford University, Palo Alto, CA 94305-6055, USA; (H.W.); (C.C.); (Y.A.H.); (G.H.); (S.Q.); (A.S.); (H.W.); (S.R.)
| | - Scott Rozelle
- Stanford Center on China’s Economy and Institutions, Stanford University, Palo Alto, CA 94305-6055, USA; (H.W.); (C.C.); (Y.A.H.); (G.H.); (S.Q.); (A.S.); (H.W.); (S.R.)
| | - Manpreet Singh
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry and Child Development, School of Medicine, Stanford University, Palo Alto, CA 94305-5719, USA
- Correspondence: ; Tel.: +1-(650)-725-5922
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Gordon S, Rotheram-Fuller E, Rezvan P, Stewart J, Christodoulou J, Tomlinson M. Maternal depressed mood and child development over the first five years of life in South Africa. J Affect Disord 2021; 294:346-356. [PMID: 34315096 DOI: 10.1016/j.jad.2021.07.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND While the negative impact of peri-natal depression is well-documented in high-income countries, the long-term effects across the life course in low and middle-income countries is less clear. Children's adjustment over the first five years is examined as a function of patterns of maternal depressed mood. METHODS Pregnant women in 24 peri-urban townships (N = 1,238) were randomized to a home-visiting intervention or standard care and reassessed five times, with high retention. There were no intervention effects on children past 18 months. Multilevel regression models examined the impact of depressed mood on child outcomes. Using the Edinburgh Postnatal Depression Scale, four patterns of maternal depressed mood were identified: never (40.6%); antenatal (13.0%); early childhood (26.1%); and recurrent episodes of depressed mood (20.3 %). FINDINGS Mothers' patterns of depressive symptoms and child outcomes were similar, regardless of intervention. Never depressed mothers were significantly younger, had higher income, less food insecurity, were more likely to have electricity, be living with HIV or have an HIV positive partner, and had fewer problems with alcohol than depressed mothers. Children of mothers who experienced depressed mood weighed less, were more aggressive, and were hospitalized more often than children of never depressed mothers, but were similar in cognitive and social development. INTERPRETATIONS Depressed mood, has significant negative impacts on South African children's growth and aggressive behavior. The timing of maternal depressed mood was less important than never having a depressed mood or a recurrent depressed mood. FUNDING There were no funding conflicts in executing this trial.
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Affiliation(s)
- Sarah Gordon
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | | | | | - Jackie Stewart
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | | | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa; School of Nursing and Midwifery, Queens University, Belfast, United Kingdom.
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47
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Kaggwa MM, Namatanzi B, Kule M, Nkola R, Najjuka SM, Al Mamun F, Hosen I, Mamun MA, Ashaba S. Depression in Ugandan Rural Women Involved in a Money Saving Group: The Role of Spouse's Unemployment, Extramarital Relationship, and Substance Use. Int J Womens Health 2021; 13:869-878. [PMID: 34588819 PMCID: PMC8473717 DOI: 10.2147/ijwh.s323636] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Rural women are highly prevalent to depression, where spouse-related factors, including extramarital affairs and poverty, intensify its likelihood of occurrence. However, women engaged with a Money-Saving Group (MSG) are financially self-dependent, which can reduce the risk of depression suffering. Despite this, there is less study among this cohort, which led us to investigate the prevalence and associated factors of depression among the Ugandan women involved in MSG. Methods This was a cross-sectional study in Uganda among rural married or cohabiting women aged 18 to 45 years engaged in MSG. The survey was carried out within a total of 153 participants (33.3 ± 6.7 years) in April 2021. Information related to socio-demographic of the participants, their spouse characteristics, and depression were collected. Results About 65.4% of the participants had depressive symptoms (based on the cutoff 10/27 at the PHQ-9). But, 8.15 times (CI: 2.83–23.44, p<0.001) and 16.69 times (CI: 4.85–57.39, p<0.001), higher risk of depression were observed, if the participants’ spouses were using an addictive substance and had been involved in an extramarital relationship, respectively. Similarly, there was an increased likelihood of depression when the participant or spouse was unemployed. Conclusion This study observed a higher prevalence of depression, which suggests paying attention to this cohort. Thus, there should be routine screening for depression among married women involved in MSG at lower-level health facilities in rural settings, especially those with spouses engaged in substance use, having an extramarital relationship, and being unemployed.
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Moses Kule
- Department of Psychiatry, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Rahel Nkola
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Firoj Al Mamun
- CHINTA Research Bangladesh, Savar, Dhaka, 1342, Bangladesh.,Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Ismail Hosen
- CHINTA Research Bangladesh, Savar, Dhaka, 1342, Bangladesh.,Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Mohammed A Mamun
- CHINTA Research Bangladesh, Savar, Dhaka, 1342, Bangladesh.,Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Scholastic Ashaba
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Gureje O, Oladeji B, Ayinde OO, Kola L, Abdulmalik J, Abass WAL, Faregh N, Zelkowitz P. Scaling up care for perinatal depression for improved maternal and infant health (SPECTRA): protocol of a hybrid implementation study of the impact of a cascade training of primary maternal care providers in Nigeria. Int J Ment Health Syst 2021; 15:73. [PMID: 34544456 PMCID: PMC8450310 DOI: 10.1186/s13033-021-00496-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The large treatment gap for mental disorders in low- and middle-income countries (LMIC) necessitates task-sharing approaches in scaling up care for mental disorders. Previous work have shown that primary health care workers (PHCW) can be trained to recognize and respond to common mental disorders but there are lingering questions around sustainable implementation and scale-up in real world settings. METHOD This project is a hybrid implementation-effectiveness study guided by the Replicating Effective Programmes Framework. It will be conducted in four overlapping phases in maternal care clinics (MCC) in 11 local government areas in and around Ibadan metropolis, Nigeria. In Phase I, engagement meetings with relevant stake holders will be held. In phase II, the organizational and clinical profiles of MCC to deliver chronic depression care will be assessed, using interviews and a standardized assessment tool administered to staff and managers of the clinics. To ascertain the current level of care, 167 consecutive women presenting for antenatal care for the first time and who screened positive for depression will be recruited and followed up till 12 months post-partum. In phase III, we will design and implement a cascade training programme for PHCW, to equip them to identify and treat perinatal depression. In phase IV, a second cohort of 334 antenatal women will be recruited and followed up as in Phase I, to ascertain post-training level of care. The primary implementation outcome is change in the identification and treatment of perinatal depression by the PHCW while the primary effectiveness outcome is recovery from depression among the women at 6 months post-partum. A range of mixed-method approaches will be used to explore secondary implementation outcomes, including fidelity and acceptability. Secondary effectiveness outcomes are measures of disability and of infant outcomes. DISCUSSION This study represents an attempt to systematically assess and document an implementation strategy that could inform the scaling up of evidence based interventions for perinatal depression using the WHO mhGAP-IG in LMIC. Trial registration This study was registered on 03 December, 2019. https://doi.org/10.1186/ISRCTN94230307 .
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Affiliation(s)
- Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.
| | | | | | - Lola Kola
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | | | | | - Neda Faregh
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Phyllis Zelkowitz
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, Canada
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Kim ET, Lillie M, Gallis J, Hembling J, McEwan E, Opiyo T, Acayo P, Baumgartner JN. Correlates of early stimulation activities among mothers of children under age two in Siaya County, Kenya: Maternal mental health and other maternal, child, and household factors. Soc Sci Med 2021; 287:114369. [PMID: 34517203 DOI: 10.1016/j.socscimed.2021.114369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/16/2021] [Accepted: 09/02/2021] [Indexed: 11/18/2022]
Abstract
RATIONALE The first two to three years of life are critical for early child development (ECD), which affects later life trajectories in health, development, and earning potential. Global calls for early stimulation activities to support optimal development among young children are increasing and there is a need to better understand the factors associated with maternal engagement in early stimulation activities, particularly maternal mental health. OBJECTIVE This study examined important factors associated with early stimulation activities performed by mothers of children ages 0-2 in rural Kenya. METHODS Baseline cohort data from an evaluation of an integrated maternal mental health and an ECD intervention included 374 interviews with mothers of children under 24 months. Descriptive and multivariable analyses were performed. RESULTS Maternal mental health was not associated with maternal early stimulation activities. Having worked in the past week was associated with more frequent early stimulation activities. At the child level, female sex was associated with more frequent early stimulation activities but prematurity at birth was associated with less frequent early stimulation activities. At the household level, ownership of children's toys and books was associated with more frequent early stimulation activities. CONCLUSIONS This study indicates that both mothers and families could benefit from availability of ECD-friendly resources such as homemade toys and children's books (particularly for low-income families), and tailored messaging to support early stimulation activities for both girl and boy children and for those prematurely-born. Local governments and community-based programs can aim to both raise awareness about the importance of early childhood development and educate caregivers on specific age-appropriate early stimulation activities that promote optimal growth. Future research should also explore the reciprocal and temporal relationships between maternal mental health and early stimulation activities to inform and elucidate their potential synergistic impact on ECD.
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Affiliation(s)
- Eunsoo Timothy Kim
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27708, USA.
| | - Margaret Lillie
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27708, USA
| | - John Gallis
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27708, USA
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50
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Effect of a lay counselor delivered integrated maternal mental health and early childhood development group-based intervention in Siaya County, Kenya: A quasi-experimental longitudinal study. J Affect Disord 2021; 292:284-294. [PMID: 34134027 PMCID: PMC8863180 DOI: 10.1016/j.jad.2021.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/17/2021] [Accepted: 06/01/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Maternal mental health is linked to early childhood development; yet there is a gap in evidence-based interventions for low-resource settings. This study estimates the impact of 'Integrated Mothers and Babies Course and Early Childhood Development' (iMBC/ECD), a cognitive-behavioral, group-based intervention, on maternal depression and early childhood social-emotional development in Siaya County, Kenya. METHODS This quasi-experimental study enrolled 417 pregnant women and mothers of children under age 2 across two sub-counties in Siaya County. The intervention area had 193 women in 23 groups implementing iMBC/ECD and the control area had 224 women in 30 groups exposed to ECD only content. Mother/index child dyads were followed for two years. To estimate the causal treatment effect from the non-randomized design, we implemented the propensity score weighting method with inverse probability weights. RESULTS At baseline, 10.2% of participants endorsed moderate/severe depressive symptoms. At 14-months post-intervention, 7.4% endorsed moderate/severe depression. Overall, iMBC/ECD intervention did not have a significant impact on reducing maternal depression or improving children's social and emotional development. However, sub-group analyses revealed that iMBC/ECD was associated with lowered depressive symptoms among women with no/low education, four or more children and/or no experience of intimate partner violence in the past year. Women with high program attendance (more than half of 14 sessions) also experienced consistently fewer depressive symptoms compared to those with lower attendance. LIMITATIONS Non-randomized study, sub-group analyses are exploratory. CONCLUSIONS The iMBC/ECD program may have the potential to improve maternal mental health and early child development for more targeted vulnerable populations.
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