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Padhani ZA, Salam RA, Rahim KA, Naz S, Zulfiqar A, Ali Memon Z, Meherali S, Atif M, Lassi ZS. Prevalence and risk factors of perinatal depression among mothers and fathers in Pakistan: a systematic review and meta-analysis. Health Psychol Behav Med 2024; 12:2383468. [PMID: 39135561 PMCID: PMC11318492 DOI: 10.1080/21642850.2024.2383468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/14/2024] [Indexed: 08/15/2024] Open
Abstract
Background Perinatal mental health issues affect approximately 10% of women in high-income countries and 30% in low- or middle-income countries. This review aims to determine the prevalence of perinatal depression among mothers and fathers in Pakistan and identify associated risk factors. Methods We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included quantitative studies on the prevalence or incidence of maternal and paternal perinatal depression, including antenatal or postnatal depression in Pakistan, with or without associated risk factors. We performed an electronic search, dual-title/abstract and full-text screening, and data extraction. Analysis was conducted on Revman and JBI SUMARI software. The quality of the included studies was assessed with the NHLBI tool. This review updated a previously published review that included 43 studies, with the last search date of 31st May 2019, now extended to literature published up to June 30, 2023. Results Consistent with the previous review, our analysis of 61 studies indicated a pooled prevalence of 37% (95% confidence interval (CI): 30.6-43.6) for maternal antenatal depression. Postnatal depression at different time points, revealed rates of 34.2% (95% CI: 22.7-46.7), 40.9% (95% CI: 0-97.4), and 43.1% (95% CI: 24.4-62.9) at 3, 6 and 12 months, respectively. Paternal postnatal depression was observed at 40.5% (95% CI: 14.9-69) based on two studies. Risk factors for maternal perinatal depression include multiparity, contraceptive failure, inadequate antenatal care, pregnancy-induced hypertension, previous psychiatric illness, passive smoking, drug abuse, low socio-economic status, marital problems, family hardships, recent bereavement, housing difficulties, food insecurity, husband's illiteracy, his unemployment, and being blamed for child disability. Conclusion The findings reveal a high prevalence of perinatal depression among mothers with very limited evidence of fathers residing in Pakistan, emphasising the need for prospective studies addressing mental health challenges. Registration This review is registered on PROSPERO (CRD42023442581).
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Affiliation(s)
- Zahra Ali Padhani
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Rehana A. Salam
- Centre of Research Excellence, Melanoma Institute Australia, University of Sydney, Sydney, Australia
| | - Komal Abdul Rahim
- Internal Medicine, Aga Khan University, Karachi, Pakistan
- Dean’s Office, Medical College, Aga Khan University, Karachi, Pakistan
| | - Samra Naz
- Australian Institute for Machine Learning, University of Adelaide, Adelaide, Australia
| | - Asma Zulfiqar
- Institute for Social Science Research, University of Queensland, Queensland, Australia
| | - Zahid Ali Memon
- Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Salima Meherali
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Canada
| | - Maria Atif
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Zohra S. Lassi
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
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Álvarez-García P, García-Fernández R, Martín-Vázquez C, Calvo-Ayuso N, Quiroga-Sánchez E. Postpartum Depression in Fathers: A Systematic Review. J Clin Med 2024; 13:2949. [PMID: 38792491 PMCID: PMC11122550 DOI: 10.3390/jcm13102949] [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: 03/20/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: Postpartum depression is usually defined as a major depressive episode that occurs shortly after childbirth. This condition is most commonly found in females; however, paternal postpartum depression has begun to attract more research attention. This study aims to identify different instruments for measuring this mental health problem and to detect risk factors as well as the main sources of resilience in paternal postpartum depression. Methods: A literature review was conducted following the PRISMA method. Results: After analyzing 10 articles, it was determined that the Edinburgh Postpartum Depression Scale is the most widely used instrument for the diagnosis of postpartum depression in the female population, and after several studies, it has already been validated for the male sex. After several studies were analyzed to highlight the main risk factors for paternal postpartum depression, it was established that the most influential factor is male gender role stress. These findings highlight the traditional role of fathers today. Most health professionals see the mother as the priority. Conclusions: Paternal depression is a major problem for mothers and fathers today, as well as for the newborn. As time goes on, there is a growing need to incorporate fathers into current and future mental health programs to be able to provide the necessary support.
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Affiliation(s)
| | - Rubén García-Fernández
- SALBIS Research Group, Department of Nursing and Physiotherapy, Faculty of Health Sciences, Campus de Ponferrada, Universidad de León, 24401 León, Spain; (N.C.-A.); (E.Q.-S.)
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, 1600-190 Lisbon, Portugal
| | - Cristian Martín-Vázquez
- Department of Nursing and Physiotherapy, Campus de Ponferrada, Universidad de León, 24401 León, Spain;
| | - Natalia Calvo-Ayuso
- SALBIS Research Group, Department of Nursing and Physiotherapy, Faculty of Health Sciences, Campus de Ponferrada, Universidad de León, 24401 León, Spain; (N.C.-A.); (E.Q.-S.)
| | - Enedina Quiroga-Sánchez
- SALBIS Research Group, Department of Nursing and Physiotherapy, Faculty of Health Sciences, Campus de Ponferrada, Universidad de León, 24401 León, Spain; (N.C.-A.); (E.Q.-S.)
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Jeong J, McCann JK, Joachim D, Ahun MN, Kabati M, Kaaya S. Fathers' mental health and coping strategies: a qualitative study in Mwanza, Tanzania. BMJ Open 2024; 14:e080933. [PMID: 38417960 PMCID: PMC10900361 DOI: 10.1136/bmjopen-2023-080933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/02/2024] [Indexed: 03/01/2024] Open
Abstract
OBJECTIVES To investigate the nature of paternal mental health problems, their causes and the coping strategies used by fathers of young children under the age of 2 years. DESIGN AND SETTING We conducted in-depth interviews with fathers, mothers, community leaders and community health workers as well as focus group discussions with fathers-only, mothers-only and mixed groups of fathers and mothers. Respondents provided their perspectives on the psychosocial challenges affecting fathers and how fathers responded to their mental health problems. Data were triangulated across stakeholders and analysed using thematic content analysis. SETTING The study was conducted in four communities in Mwanza, Tanzania. PARTICIPANTS The total sample included 56 fathers, 56 mothers and 8 community stakeholders that were equally distributed across the four communities. RESULTS Respondents highlighted a spectrum of mental health concerns affecting fathers, including elevated parenting stress, depressive symptoms, and anxiety. Causes of paternal mental health problems included poverty, child-related concerns, marital problems and family illness. When asked about paternal coping strategies, both fathers and mothers shared that fathers mostly turned to negative coping strategies to manage their distress, such as paternal alcohol use and poor conflict resolution strategies. However, respondents also shared how some fathers used positive coping strategies, such as seeking out social support from their family and friends, engaging in exercise and leisure activities and relying on their faith. CONCLUSIONS Overall, this study highlights the importance of supporting positive mental health among fathers. Our findings can inform the design of psychosocial programme components that can be integrated within parenting interventions to promote the well-being of specifically fathers and ultimately improve the family caregiving environment.
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Affiliation(s)
- Joshua Jeong
- Hubert Department of Global Health and Population, Emory University, Atlanta, Georgia, USA
| | - Juliet K McCann
- Hubert Department of Global Health and Population, Emory University, Atlanta, Georgia, USA
| | - Damas Joachim
- Tanzania Home Economics Organization, Mwanza, Tanzania, United Republic of
| | - Marilyn N Ahun
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Mary Kabati
- Tanzania Home Economics Organization, Mwanza, Tanzania, United Republic of
| | - Sylvia Kaaya
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
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Wedajo LF, Alemu SS, Tola MA, Teferi SM. Paternal postnatal depression and associated factors: Community-based cross-sectional study. SAGE Open Med 2023; 11:20503121231208265. [PMID: 37915842 PMCID: PMC10617258 DOI: 10.1177/20503121231208265] [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: 06/08/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Paternal postnatal depression is a type of depression that occurs among male partners after childbirth. Although the problem has a multidimensional impact, there is limited data in low-income countries, including Ethiopia. Therefore, this study aimed to uncover this problem in the study setting. Objective To assess paternal postnatal depression and associated factors. Method and study period A community-based cross-sectional study was employed from April 1 to 30, 2023, among 423 fathers in Mattu Town, Southwest Ethiopia. A face-to-face interviewer administered a structured questionnaire prepared by the Open Data Kit tool. The study participants were selected by simple random sampling techniques. A binary and multivariable logistic regression analysis was used. Both crude and adjusted odds ratios with a 95% confidence interval were calculated, and a p-value of less than 0.05 was used. Result Among 423 fathers, 412 participated, making the response rate 97.40%. The prevalence of paternal postnatal depression was 29.37% (95% confidence interval: 24.95%, 31.25). The poor wealth index (adjusted odds ratio (AOR): 1.67; 95% confidence interval: 1.88, 3.14), loneliness (AOR: 1.81; 95% confidence interval: 1.20, 3.20), poor social support (AOR: 6.08; 95% confidence interval: 2.55, 14.48), feeling of family income stress (AOR: 3.22; 95% confidence interval: 1.89, 5.50), and history of adverse pregnancy outcome (AOR: 3.00; 95% confidence interval: 1.62, 0.59) were significant associated factors at p-value less than 0.05. Conclusions The study identified nearly 3 in 10 fathers suffering from paternal postnatal depression. Therefore, the Ministry of Health and other concerned bodies should focus on this population group to alleviate it. In addition, health professionals and extension workers should provide evidence-based care plans based on the identified factors.
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Affiliation(s)
- Lema Fikadu Wedajo
- Department of Midwifery, Mattu University College Health Sciences, Mattu, Ethiopia
| | - Solomon Seyife Alemu
- Department of Midwifery, Madda Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Melese Adugna Tola
- Department of Midwifery, Mattu University College Health Sciences, Mattu, Ethiopia
| | - Shelema Mengistu Teferi
- Department of Midwifery, Madda Walabu University College of Medicine and Health Sciences, Robe, Ethiopia
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Surani Z, Parkar S, Afshan G, Elahi KN, Hoodbhoy Z, Hilal K, Jafri SK. Maternal and environmental Impact assessment on Neurodevelopment in Early childhood years (MINE): a prospective cohort study protocol from a low, middle-income country. BMJ Open 2023; 13:e070283. [PMID: 37423622 PMCID: PMC10335476 DOI: 10.1136/bmjopen-2022-070283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 06/23/2023] [Indexed: 07/11/2023] Open
Abstract
INTRODUCTION Environmental and psychosocial adversities negatively impact children's developmental outcomes. When these factors are experienced in early childhood-a sensitive period of development-the developing brain can be altered. While these associations have been drawn in high-income countries, it is necessary to understand child growth, neurodevelopment, and the role of environmental factors in developmental trajectories in low-income settings. The objective of this study is to longitudinally assess how demographic factors, maternal health, maternal development, and child health, are related to child development on a behavioural, cognitive, and neuroimaging level in low-socioeconomic communities. METHODS AND ANALYSIS Mother-child dyads will be identified in the peri-urban field sites of Rehri Goth and Ibrahim Hyderi, Karachi, Pakistan. Dyads will undergo yearly assessments for 4 years beginning when the child is 1 month, 3 months or 6 months of age (+≤30 days of age) (depending on group assignment). Maternal assessments include anthropometry, behavioural, cognitive, and developmental assessments (Edinburgh Postnatal Depression Scale; Parenting Stress Index; Maternal Autonomy Index; Hurt, Insult, Threaten, Scream Tool; Reynolds Intellectual Assessment Scales (RIAS)), and biological samples collection (breast milk, blood, stool, hair). Children's assessments include anthropometry, developmental assessments (Global Scales for Early Development (GSED); RIAS), MRI brain assessments, and biological sample collection (blood, stool, hair). Using cross-sectional and longitudinal data with statistical analysis tools, associations will be quantified between brain structure (MRI) and connectivity (resting state connectivity and diffusion tensor imaging), general cognitive skills (RIAS, GSED) and environmental influences (nutrition via biological samples, maternal mental health via questionnaires) through repeated measures analysis of variance tests and χ2 tests. Quantile regression and cortical analyses will be conducted to understand how demographic factors are related to the associations found. ETHICS AND DISSEMINATION The study has received ethical approval from the Aga Khan University Ethics Review Committee. The study's findings will be disseminated through scientific publications and project summaries for the participants.
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Affiliation(s)
- Zoya Surani
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Sadia Parkar
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Gul Afshan
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Kinza Naseem Elahi
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Zahra Hoodbhoy
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Kiran Hilal
- Department of Radiology, The Aga Khan University, Karachi, Pakistan
| | - Sidra Kaleem Jafri
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
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The neglect of male post-partum depression in Pakistan. Lancet Psychiatry 2022; 9:e52. [PMID: 36403602 DOI: 10.1016/s2215-0366(22)00341-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/19/2022]
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