Drowning deaths among Japanese children aged 1-4 years: different trends due to different risk reductions

Association Between Maternal Postpartum Depression and Unintentional Injury Among 4-Month-Old Infants in Japan

OBJECTIVES

Unintentional injury among infants is a major public health issue; however, the relationship between unintentional infant injury and postpartum depression remains unclear. In this study, we aim to investigate the association between the two.

METHODS

We administered an original questionnaire to mothers participating in a 3- or 4-month health check-up program (target n = 9707). This questionnaire assessed infant health, including types of unintentional injury experiences used in previous study, and maternal mental health such as postpartum depression, by the validated screening tool, the Edinburgh Postnatal Depression Scale (EPDS). Associations between infant injury and postpartum depression were assessed using logistic regression adjusted for covariates, including parental, infant, and household characteristics.

RESULTS

In total, 6534 women responded to the questionnaire with valid answers on the EPDS (valid response rate, 67 %). Of the sample, 9.8 % of infants experienced unintentional injury (fall: 5.6 %; near-drowning: 1.2 %), and 9.5 % of mothers had postpartum depression (EPDS score of 9+). After adjusting for covariates, postpartum depression was significantly positively associated with any unintentional injury (odds ratio [OR] 1.59, 95 % confidence interval [CI] 1.24-2.04), and falls (OR 1.41, 95 % CI 1.02-1.95), although near-drowning was not significantly associated.

CONCLUSION

Postpartum depression might be a risk factor for unintentional injury of infants aged up to 4 months. Further prospective studies are needed to confirm the association between postpartum depression and unintentional injury of infants.

Fatal river drowning: the identification of research gaps through a systematic literature review

INTRODUCTION

Drowning is a leading cause of unintentional death. Rivers are a common location for drowning. Unlike other location-specific prevention efforts (home swimming pools and beaches), little is known about prevention targeting river drowning deaths.

METHODS

A systematic literature review was undertaken using English language papers published between 1980 and 2014, exploring gaps in the literature, with a focus on epidemiology, risk factors and prevention strategies for river drowning.

RESULTS

Twenty-nine papers were deemed relevant to the study design including 21 (72.4%) on epidemiology, 18 (62.1%) on risk factors and 10 (34.5%) that proposed strategies for prevention. Risk factors identified included age, falls into water, swimming, using watercraft, sex and alcohol.

DISCUSSION

Gaps were identified in the published literature. These included a lack of an agreed definition for rivers, rates for fatal river drowning (however, crude rates were calculated for 12 papers, ranging from 0.20 to 1.89 per 100 000 people per annum), and consensus around risk factors, especially age. There was only one paper that explored a prevention programme; the remaining nine outlined proposed prevention activities. There is a need for studies into exposure patterns for rivers and an agreed definition (with consistent coding).

CONCLUSIONS

This systematic review has identified that river drowning deaths are an issue in many regions and countries around the world. Further work to address gaps in the published research to date would benefit prevention efforts.