|
1
|
Surkan PJ, Strobino DM, Mehra S, Shamim AA, Rashid M, Wu LSF, Ali H, Ullah B, Labrique AB, Klemm RDW, West KP, Christian P. Unintended pregnancy is a risk factor for depressive symptoms among socio-economically disadvantaged women in rural Bangladesh. BMC Pregnancy Childbirth 2018; 18:490. [PMID: 30545325 PMCID: PMC6292066 DOI: 10.1186/s12884-018-2097-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 11/19/2018] [Indexed: 01/09/2023] Open
Abstract
Background Little is known about the relation between unwanted pregnancy and intention discordance and maternal mental health in low-income countries. The study aim was to evaluate maternal and paternal pregnancy intentions (and intention discordance) in relation to perinatal depressive symptoms among rural Bangladeshi women. Methods Data come from a population-based, community trial of married rural Bangladeshi women aged 13–44. We examined pregnancy intentions among couples and pregnancy-intention discordance, as reported by women at enrollment soon after pregnancy ascertainment, in relation to depressive symptoms in the third trimester of pregnancy (N = 14,629) and six months postpartum (N = 31,422). We calculated crude and adjusted risk ratios for prenatal and postnatal depressive symptoms by pregnancy intentions. Results In multivariable analyses, women with unwanted pregnancies were at higher risk of prenatal (Adj. RR = 1.60, 95% CI: 1.37–1.87) and postnatal depressive symptoms (Adj. RR = 1.32, 95% CI: 1.21–1.44) than women with wanted pregnancies. Women who perceived their husbands did not want the pregnancy also were at higher risk for prenatal (Adj. RR = 1.42, 95% CI: 1.22–1.65) and postnatal depressive symptoms (Adj. RR = 1.30, 95% CI: 1.19–1.41). Both parents not wanting the pregnancy was associated with prenatal and postnatal depressive symptoms (Adj. RR = 1.34, 95% CI: 1.19–1.52; Adj. RR = 1.13, 95% CI: 1.06–1.21, respectively), compared to when both parents wanted it. Adjusting for socio-demographic and pregnancy intention variables simultaneously, maternal intentions and pregnancy discordance were significantly related to prenatal depressive symptoms, and perception of paternal pregnancy unwantedness and couple pregnancy discordance, with postnatal depressive symptoms. Conclusions Maternal, paternal and discordant couple pregnancy intentions, as perceived by rural Bangladeshi women, are important risk factors for perinatal maternal depressive symptoms.
Collapse
Affiliation(s)
- Pamela J Surkan
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E2519, Baltimore, MD, 21205-2179, USA. .,Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA.
| | - Donna M Strobino
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
| | - Sucheta Mehra
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E2519, Baltimore, MD, 21205-2179, USA
| | - Abu Ahmed Shamim
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Mahbubur Rashid
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Lee Shu-Fune Wu
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E2519, Baltimore, MD, 21205-2179, USA
| | - Hasmot Ali
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Barkat Ullah
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Alain B Labrique
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E2519, Baltimore, MD, 21205-2179, USA
| | - Rolf D W Klemm
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E2519, Baltimore, MD, 21205-2179, USA
| | - Keith P West
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E2519, Baltimore, MD, 21205-2179, USA
| | - Parul Christian
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E2519, Baltimore, MD, 21205-2179, USA
| |
Collapse
|