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Abebe GF, Alie MS, Adugna A, Asemelash D, Tesfaye T, Girma D, Asres A. Antenatal depression and its predictors among HIV positive women in Sub-Saharan Africa; a systematic review and meta-analysis. Front Psychiatry 2024; 15:1385323. [PMID: 38919635 PMCID: PMC11196764 DOI: 10.3389/fpsyt.2024.1385323] [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: 02/12/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
Background Antenatal depression in Human Immunodeficiency Virus (HIV) positive pregnant women can have significant adverse effects on both the mother and newborns, yet it is often overlooked in pregnancy care in Sub-Saharan Africa (SSA). Despite this, there is limited data on the combined prevalence of antenatal depression and its predictors among HIV-positive women in the region. Objective To assess the pooled prevalence of antenatal depression and its associated factors among HIV-positive women in SSA. Methods All primary cross-sectional studies published before 1st January/2024, were included. We conducted searches in relevant databases; PubMed, HINARI, Web of Science, PsycINFO, Psychiatry Online, ScienceDirect, and Google Scholar. The Joanna Briggs Institute checklist was used to critically appraise the selected studies. To assess heterogeneity among the studies, we utilized the I2 test. Publication bias was evaluated using a funnel plot and Egger's test. The forest plot was used to present the combined proportion of antenatal depression and odds ratio, along with a 95% confidence interval. Results The pooled prevalence of antenatal depression among HIV-positive women in Sub-Saharan Africa was found to be 30.6% (95% CI, 19.8%-41.3%). Factors significantly associated with antenatal depression among HIV-positive women in SSA included being unmarried (AOR: 3.09, 95% CI: 1.57 - 6.07), having a previous history of depression (AOR: 2.97, 95% CI: 1.79 - 4.91), experiencing intimate partner violence (IPV) (AOR: 2.11, 95% CI: 1.44 - 3.09), and experiencing stigma (AOR: 1.36, 95% CI: 1.05 - 1.76). Conclusion High prevalence of antenatal depression among HIV-positive women in SSA underscores the need for prioritizing identification and management. Interventions addressing factors like IPV and stigma, along with training for healthcare providers in recognizing symptoms and providing support, are recommended. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024508236.
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Affiliation(s)
- Gossa Fetene Abebe
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan, Ethiopia
| | - Melsew Setegn Alie
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Amanuel Adugna
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan, Ethiopia
| | - Daniel Asemelash
- Department of Laboratory, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Aman, Ethiopia
| | - Tamirat Tesfaye
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Desalegn Girma
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan, Ethiopia
| | - Abyot Asres
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
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Sarfraz Z, Sarfraz A, Amin SZ. Evaluating cognitive behavioral therapy as a solution for postnatal depression in economically disadvantaged regions. Arch Womens Ment Health 2024; 27:459-475. [PMID: 38294495 DOI: 10.1007/s00737-024-01428-2] [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: 04/09/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE Postnatal depression (PND) impacts numerous women after childbirth, leading to various impairments in their lives. Mental health interventions, such as cognitive behavioral therapy (CBT), need further evaluation in low- and middle-income countries (LMICs) where resources may be scarce. This study aimed to assess the effectiveness of CBT in treating PND in women from LMICs, comparing it to standard care. METHODS A systematic review and meta-analysis were conducted following the PRISMA Statement 2020 guidelines. Databases such as PubMed, CINAHL Plus, Cochrane Library, and PsycINFO were searched until September 2022. A modified Delphi process was employed to identify relevant studies. The primary outcome was mean depression scores, measured by the Edinburgh postnatal depression scale at baseline and post-intervention. RESULTS Out of 487 studies identified, five trials were included, totaling 1056 participants (520 in the intervention group and 536 in the comparator group). At baseline, a minor, insignificant positive effect size was found (Cohen's d = 0.1, 95% CI = - 0.15, 0.35). Post-CBT, the intervention group showed significant improvements in depression scores (Cohen's d = - 1.9, 95% CI = - 3.8, 0). When accounting for the influence of one study, (Ngai et al., Psychother Psychosom 84:294-303, 2015), which held substantial weight in the initial analysis, the effect size was adjusted to d = 0.5, highlighting a lesser but still significant difference. CONCLUSIONS CBT appears to be effective in improving PND symptoms among women in LMICs and may be considered a first-line treatment for at-risk mothers, including those who are displaced. However, the significant impact of one study on the results emphasizes the need for more rigorous research. The study also highlights the challenges and limitations of providing psychotherapies across LMICs, emphasizing the need for culturally adapted and contextually appropriate interventions to ensure successful implementation and sustainability of mental health care for postnatal women in these settings.
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Affiliation(s)
- Zouina Sarfraz
- Department of Medicine, Fatima Jinnah Medical University, Queen's Road, Mozang Chungi, Lahore, 54000, Punjab, Pakistan.
| | - Azza Sarfraz
- Department of Pediatrics, The Aga Khan University, Karachi, Pakistan
| | - Shah Zaib Amin
- Department of Research, King Edward Medical University, Lahore, Pakistan
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Asante HA, Boyetey ST, Essaw E, Nyame CA, Mante B, Dziwornu L, Okyere P. Prevalence and factors associated with antepartum depression among adolescent women in the assin north district of Ghana: a cross-sectional study. BMC Womens Health 2024; 24:276. [PMID: 38711102 DOI: 10.1186/s12905-024-03111-1] [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] [Received: 11/10/2023] [Accepted: 04/23/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Globally, depression is a leading cause of disease-related disability among women. In low-and-middle-income countries (LMICs), the prevalence rate of antepartum depression is estimated to range between 15% and 57% and even higher in adolescent antepartum women. Although a number of studies have shown that depression is common in adolescent pregnancies and has a prevalence rate between 28% and 67% among adolescent mothers, there currently exists no literature on depression among adolescent pregnant women in Ghana. The study aimed to determine the prevalence of antepartum depression and identify the factors associated with it among pregnant adolescent women. METHODS A quantitative cross-sectional study design was adopted by randomly recruiting 220 adolescent pregnant women visiting antenatal clinics in five selected health facilities in five communities in the Assin North District of Ghana. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS). Data analysis was performed using Stata version 14. Both descriptive and inferential analyses were performed. A chi-square analysis was conducted to identify the association between independent and dependent variables. A multivariate logistic regression analysis was carried out to identify the independent variables that were significantly associated with the dependent variable. In all analyses, p-values ≤ 0.05 were deemed statistically significant at a 95% confidence interval. RESULTS The results indicated prevalence of depression was 38.6% using the EPDS cut-off ≥ 13. Respondents who were cohabiting were less likely to experiencing antepartum depression compared to those who were single (AOR = 0.36, 95% CI: 0.20-0.64, p = 0.001). Also, Respondents who had completed Junior High School had a lower likelihood of experiencing antepartum depression compared to those who had no formal education (AOR = 0.19, 95% CI: 0.05-0.76, p = 0.019). Respondents who perceived pregnancy-related items to be costly had higher odds of experiencing antepartum depression (AOR = 2.05, 95% CI: 1.02-4.12, p = 0.042). Lastly, adolescent pregnant women who reported that pregnancy-related items are costly were likely to experience antepartum depression compared to those who did not report such costs (AOR = 2.12, 95% CI: 1.20-3.75, p < 0.001). CONCLUSION The results of this study highlight the importance of a multi-pronged strategy for combating antepartum depression in adolescents and improving the overall health and well-being of pregnant adolescents. Considering that adolescence is a transitional period occasioned by several bio-psycho-social challenges, setting up systems to ensure that young girls are motivated and supported to stay in school will enhance their economic prospects and improve their standards of life while providing psycho-social support will benefit their health and general well-being.
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Affiliation(s)
- Hannah Amoquandoh Asante
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Shadrach Tetteh Boyetey
- Department of Health Policy, Management and Economics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ebenezer Essaw
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Christopher Amoah Nyame
- Department of Occupational and Environmental Health and Safety, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bertha Mante
- Department of Real Estate and Land Management, University for Development Studies, Tamale, Ghana
| | - Louisa Dziwornu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Paul Okyere
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Dol J, Dennis CL, Campbell-Yeo M, Leahy-Warren P. Bibliometric analysis of published articles on perinatal depression from 1920 to 2020. Birth 2024; 51:28-38. [PMID: 37795646 DOI: 10.1111/birt.12779] [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: 04/05/2022] [Revised: 06/01/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023]
Abstract
AIM To analyze the characteristics and trends in published research on perinatal depression between 1920 and 2020. METHODS A search strategy in Web of Science identified all published literature on perinatal depression between January 1, 1920, and December 31, 2020. Output from Web of Science was used to analyze bibliometric information, and VOSViewer was used to visualize the networks of linkages between identified publications. RESULTS There were 16,961 publications identified. Among these publications, there were 82,726 unique authors and 140 countries represented. The United States had the highest frequency of publications (44.6%). Most publications (69.8%) occurred between 2011 and 2020, with the first publication identified in 1928. There were 2197 unique journals identified, with over half publishing only one (n = 948, 43.2%) or two relevant publications (n = 314, 14.3%). Authors with the largest number of publications were Wisner (n = 115), Dennis (n = 95), and Murray (n = 92), while authors with the largest number of citations were Cox (n = 7225), Murray (n = 2755), and O'Hara (n = 2069). LIMITATIONS While the Web of Science is a representative database identifying the greatest number of relevant articles, it may be unrepresentative of all published literature. CONCLUSION This is the first study mapping publications on perinatal depression between 1920 and 2020. The rate of publication on perinatal depression has been steadily increasing in recent years with a wide variety of authors, countries, and journals represented. As the field continues to grow, trends may shift as early career researchers emerge and the importance of mental health in low-income countries is prioritized.
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Affiliation(s)
- Justine Dol
- Li Ka Shing Knowledge Institute, St. Michael's Hospital; IWK Health, Halifax, Nova Scotia, Canada
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; Women's Health Research Chair, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Javadekar A, Karmarkar A, Chaudhury S, Saldanha D, Patil J. Biopsychosocial correlates of emotional problems in women during pregnancy and postpartum period. Ind Psychiatry J 2023; 32:S141-S146. [PMID: 38370921 PMCID: PMC10871396 DOI: 10.4103/ipj.ipj_225_23] [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: 11/25/2022] [Revised: 05/11/2023] [Accepted: 07/02/2023] [Indexed: 02/20/2024] Open
Abstract
Background Transition to motherhood is associated with several emotional problems that can have long-term consequences on the mother and baby. Aim To examine the association of various biomedical and cultural factors with the new onset of emotional problems during pregnancy and postpartum period. Materials and Methods This prospective longitudinal study included 300 pregnant women interviewed in the third trimester. Results The prevalence of emotional problems in the study group was 31.58%. The prevalence of anxiety disorder NOS and mixed anxiety and depressive disorder in the last trimester of pregnancy in our study was 4% and 1.33%, respectively, and 0.67% and 1.33%, respectively, at 4 days postpartum. At 6 weeks postpartum, the prevalence of anxiety disorder NOS was 1.33%, generalized anxiety disorder was 0.67%, and major depression was 1.33. The prevalence of postpartum blues in our study was 25.33%. Conclusion There was a significant association between psychiatric disorders during and postpartum period and the following factors: higher parity, increased maternal age, low hemoglobin levels, cesarean section, planned pregnancy, and extended family. Postpartum blues was associated with higher parity and low blood pressure.
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Affiliation(s)
- Archana Javadekar
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
| | - Arpita Karmarkar
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
| | - Daniel Saldanha
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
| | - Jaideep Patil
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
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Aoki A, Mochida K, Balogun OO, Tomo CK, Tchicondingosse L, Sapalalo P, Aiga H, Francisco KR, Takehara K. Association between the continuum of care and postpartum depression among Angolan mothers. J Affect Disord 2023; 339:325-332. [PMID: 37442453 DOI: 10.1016/j.jad.2023.07.020] [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: 03/22/2023] [Revised: 06/08/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND This study investigated the association between maternal and child health service utilization patterns and postpartum depression (PPD). METHODS This study analyzed a dataset of women who participated in a randomized controlled trial to examine the effectiveness of the Maternal and Child Health Handbook in Angola. We defined probable PPD as an Edinburgh Postpartum Depression Scale (EPDS) score ≥ 10. The EPDS was administered at approximately 6 months postpartum. Service utilization patterns were defined using numbers of antenatal care (ANC), facility delivery, and vaccination visits by 6 months postpartum. The association between service utilization patterns and PPD was examined using logistic regression analyses adjusting for socioeconomic factors and parity. The continuum of care (CoC) complete pattern (four ANC/facility delivery/four vaccination) was used as a reference. RESULTS The data of 7087 participants whose children were alive and aged 6 months or older at the endline survey were analyzed. Prevalence of PPD was 17.9 % in urban and 43.2 % in rural municipalities. In urban municipalities, dropouts from the CoC at delivery and after delivery had significantly higher odds of PPD (AOR = 1.45, 95 % CI = 1.00-2.10; AOR = 1.57, 95 % CI = 1.24-1.99). In rural municipalities, dropouts from the CoC after delivery (AOR = 1.60, 95 % CI = 1.12-2.28) had significantly higher odds of PPD. LIMITATIONS The onset of depressive symptoms was not assessed. The EPDS was validated in some Portuguese speaking countries but not in Angola. CONCLUSION PPD was associated with irregular service utilization patterns such as dropouts from the CoC. Therefore, CoC and mental health must be promoted simultaneously.
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Affiliation(s)
- Ai Aoki
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
| | - Keiji Mochida
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | | | - Caroline Kaori Tomo
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | | | - Pedro Sapalalo
- Domus Custodius (SU) Lda. Tchikos Agency, Luanda, Angola
| | - Hirotsugu Aiga
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan; Human Development Department, Japan International Cooperation Agency, Tokyo, Japan
| | | | - Kenji Takehara
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
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Henry LM, Manian N, Esposito G, Bornstein MH. The Home Environments of Infants of Mothers with Early, Remitted Clinical Depression and No Depression during the First Two Years Postpartum. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1471. [PMID: 37761432 PMCID: PMC10528664 DOI: 10.3390/children10091471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 09/29/2023]
Abstract
The current study examines stability, continuity, and group and gender differences in the home environments of infants of mothers with early, remitted clinical depression and no postpartum depression, overcoming methodological variations in the extant literature. Fifty-five mothers diagnosed with clinical depression (major or minor depression, dysthymia, or depressive disorder not otherwise specified) at 5 months and fully remitted by 15 and 24 months, and 132 mothers with no postpartum depression (Mage = 32.47; 69.7% European American) completed the Home Observation for Measurement of the Environment (HOME) Inventory Infant/Toddler version when their infants were 15 and 24 months old. No differences in stability estimates of the HOME scales were found between the groups. In terms of continuity, controlling for maternal education and infant birth order, HOME responsivity, involvement, and total score decreased, while HOME acceptance increased between 15 and 24 months in the full sample. There were no effects of group or gender. Results may point to the home environment as a key protective factor for infants of mothers with early, remitted clinical depression, or findings may suggest improved maternal parenting cognitions and practices following remission.
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Affiliation(s)
- Lauren M. Henry
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA;
| | - Nanmathi Manian
- Westat, Rockville, MD 20850, USA;
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy;
| | - Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA;
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Niazi A, Alekozay M, Osmani K, Najm AF. Prevalence and associated factors of depression, anxiety, and stress among pregnant women in Herat, Afghanistan: A cross-sectional study. Health Sci Rep 2023; 6:e1490. [PMID: 37575205 PMCID: PMC10416610 DOI: 10.1002/hsr2.1490] [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: 05/15/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023] Open
Abstract
Background and Aims Pregnancy is an important and natural event in a woman's life. It represents a time of substantial social and bio-psychological challenges for a pregnant woman that may increase vulnerability to emotional disturbances such as depression, anxiety, and stress (DAS). This study aims to assess the prevalence and associated factors of DAS among pregnant women in Herat city of Afghanistan. Methods This hospital-based cross-sectional study was conducted between July and November 2019, on 691 Dari-speaking pregnant women aged 15-49 years, who attended the antenatal clinic of Herat Razaei Maternity Hospital. The interview process involved the use of a structured questionnaire that collected data on sociodemographic characteristics of participants, as well as the validated Dari-translated version of DASS-42 questionnaire. A χ 2 test was used to test for association between categorical data. Forward likelihood ratio was used to assess the strength of association between sociodemographic variables and DAS; independently. The significance level was set to 0.05 and the confidence interval to 95% in all statistical analyses. Statistical analyses were performed in IBM SPSS Statistics (version 27). Results The mean age of participants was 26.17 ± 6.06. The overall prevalence of DAS among study participants were 42.8%, 40.0%, and 59.5%, respectively. Planning of current pregnancy, women's health, husband's health, women's nutrition, family support, husband's support, women's education, women's employment, and family economy were significantly associated with DAS, while gestational age was not significantly associated with DAS. Conclusion The prevalence of DAS among pregnant women in Herat city of Afghanistan is very high. Considering scientific evidence on high prevalence and associated factors of DAS among pregnant women, policymakers, public health authorities, and medical practitioners must devote significant attention in reducing the magnitude of these mental disorders and/or reducing their impact on women, their families, and the society.
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Affiliation(s)
- Aziz‐ur‐Rahman Niazi
- Department of Public Health and Infectious Diseases, Faculty of MedicineHerat UniversityHeratAfghanistan
| | - Mina Alekozay
- Department of Public Health and Infectious Diseases, Faculty of MedicineHerat UniversityHeratAfghanistan
| | - Khadejah Osmani
- Department of Surgery, Division of Obstetrics and Gynecology, Faculty of MedicineHerat UniversityHeratAfghanistan
| | - Abdul Fattah Najm
- Mental Health ProgramInternational Assistance MissionHeratAfghanistan
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Kurbi HA, Abebe SM, Mengistu NW, Ayele TA, Toni AT. Cultural Adaptation and Validation of the Amharic Version of the World Health Organization's Self Reporting Questionnaire (SRQ-20) Screening Tool Among Pregnant Women in North West Ethiopia, 2022: A Psychometric Validation. Int J Womens Health 2023; 15:779-791. [PMID: 37223068 PMCID: PMC10202208 DOI: 10.2147/ijwh.s402865] [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] [Received: 01/13/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023] Open
Abstract
Background The prevalence of prenatal common mental disorders afflicting the global community, including Ethiopia, is thriving. Therefore, a time-efficient and valid screening tool is required. This study aimed to culturally adapt and validate the self-reporting questionnaire-20 tool developed by the World Health Organization among pregnant mothers in Ethiopia. Methods A total of 310 pregnant women completed the questionnaire at two selected health centers in the regional state of Amhara. The World Health Organization's Self Reporting Questionnaire-20 tool was first translated into Amharic by two experts. The back translation was done by two English experts. Internal consistency and reliability were assessed using Cronbach's alpha. Convergent and discriminant validity were assessed using composite reliability and extracted mean variance. SRQ-20 was tested for reliability and validity using principal components analysis and the Kaiser-Meyer-Olkin measure of sample adequacy with a cutoff value of 0.50 for each item. Results The Kaiser-Meyer-Olkin measure (KMO = 0.733) for sample adequacy and the Bartlett's sphericity test for the identity matrix indicated that the data were amenable to exploratory factor analysis. Principal components analysis identified six factors that explained 64% of the variation in the self-report questionnaire 20. Cronbach's alpha was 0.817 for the entire scale and the extracted mean variance was greater than 0.5 for all factors, indicating convergent validity. The extracted mean variance, composite reliability, and factor loadings were all greater than 0.75 for all factors in this study, indicating that convergent validity was satisfactory and that discriminatory validity was also satisfied. The composite factor reliability scores ranged from 0.74 to 0.84, and the square roots of the mean variances were greater than the factor correlation scores. Conclusion The interview-based, culturally-adapted 20-item Amharic version of the SRQ-20 tool demonstrated good cultural adaptation and was also found to be valid and reliable in the present context.
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Affiliation(s)
- Helina Abebe Kurbi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Kotebe Metropolitan University, Menelik II Health Science College, Department of Mental Health, Addis Ababa, Ethiopia
| | - Solomon Mekonnen Abebe
- Department of Nutrition institute of public health, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia
| | - Nestanet Worku Mengistu
- Department of Nutrition institute of public health, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemayehu Teklu Toni
- Department of Pediatrics and School of Medicine, Institute of Public health, college of Medicine and health sciences, university of Gondar, Gondar, Ethiopia
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Insan N, Forrest S, Jaigirdar A, Islam R, Rankin J. Social Determinants and Prevalence of Antenatal Depression among Women in Rural Bangladesh: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2364. [PMID: 36767731 PMCID: PMC9915232 DOI: 10.3390/ijerph20032364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
The prevalence of antenatal depression in Bangladesh ranges from 18 to 33%. Antenatal depression has negative impacts on the mother and child such as suicidal ideations, low birth weight, and impaired fetal development. This cross-sectional study aims to determine the prevalence and social determinants of antenatal depression in rural Sylhet, Bangladesh. Data were collected from 235 pregnant women between March and November 2021. The validated Bangla Edinburgh Postnatal Depression Scale was used to measure antenatal depressive symptoms (ADS). Background information was collected using a structured questionnaire including the Duke Social Support and Stress Scale, pregnancy choices, and WHO Intimate Partner Violence questions. Point-prevalence of antenatal depression was 56%. Intimate partner violence (IPV) before pregnancy (adjusted odds ratio (AOR) 10.4 [95% confidence interval (CI) 2.7-39.7]) and perceived husband's male gender preference (AOR 9.9 [95% CI 1.6-59.6]) were significantly associated with increased odds of ADS among pregnant women. Increased family support was a significant protective factor for ADS (AOR 0.94 [95% CI 0.91-0.97]). Antenatal depression commonly occurs in rural Sylhet, Bangladesh, highlighting the need for improved screening and management within these settings. The findings suggest the need for community-based interventions for women with low family support and experiencing intimate partner violence, and educational programs and gender policies to tackle gender inequalities.
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Affiliation(s)
- Nafisa Insan
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK
| | - Simon Forrest
- Department of Sociology, Durham University, Durham DH1 3HN, UK
| | | | | | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK
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Lasater ME, Beebe M, Warren NE, Winch PJ, Soucko F, Keita M, Doumbia S, Murray SM. Reliability and validity of a perinatal depression screening instrument in rural Mali. SSM - MENTAL HEALTH 2022; 2:100059. [PMID: 36644110 PMCID: PMC9835090 DOI: 10.1016/j.ssmmh.2021.100059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background In order to reduce the burden of perinatal depression in low- and middle-income countries, health systems must be able to identify and treat women suffering from depression. The objective of our study was to develop a locally valid and reliable screening instrument for use in identifying pregnant women and mothers of young children with a local depression syndrome, dusukasi, in rural Mali. Methods We administered a locally adapted screening instrument containing items from the Edinburgh Postpartum Depression Scale (EPDS) and Hopkins Symptom Checklist (HSCL-25) to 180 pregnant women and mothers of children under age 2 in Sélingué, Mali to assess the instrument's psychometric properties and validity. Item Response Theory was used to develop an abbreviated version of the measure and the validity and psychometric properties of this shortened version were compared with the full-length scale. Results The full 28-item scale exhibited a single factor structure with good internal consistency (Cronbach's alpha = 0.92). Women who self-identified as suffering from dusukasi (n = 87) in a known groups analysis to assess construct validity had significantly higher depression and anxiety symptom scores (p < 0.0001) and functional impairment scores (p < 0.0001) compared to women not reporting dusukasi (n = 93). The shortened 16-item scale performed as well as the full scale in identifying women with dusukasi. Conclusions Construct validity of our adapted screening instrument was supported for identifying dusukasi in rural Malian women. Our methodology can be applied in other settings to develop similarly valid screening instruments for perinatal depression.
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Affiliation(s)
- Molly E. Lasater
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA,Corresponding author. 615 N. Wolfe St, Baltimore, MD, USA, 21205. (M.E. Lasater)
| | - Madeleine Beebe
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Nicole E. Warren
- School of Nursing, Johns Hopkins University, 525 N Wolfe St, Baltimore, MD, 21205, USA
| | - Peter J. Winch
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Fatoumata Soucko
- Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Mali
| | - Mariam Keita
- Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Mali
| | - Seydou Doumbia
- Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Mali
| | - Sarah M. Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
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Dagnaw FT, Addis WD, Tesfa D, Desale AT, Issa NA, Belachew YY, Yitbarek GY, Belay AT, Chanie ES, Hailemeskel HS. Determinants of postpartum depression among mothers in Debre Tabor town, North-central, Ethiopia: Community-based unmatched case-control study. Front Glob Womens Health 2022; 3:910506. [PMID: 36312871 PMCID: PMC9596969 DOI: 10.3389/fgwh.2022.910506] [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: 04/01/2022] [Accepted: 07/25/2022] [Indexed: 06/16/2023] Open
Abstract
Background Postpartum depression (PPD) is a non-psychotic depressive disorder of variable severity, and it can begin as early as 2 weeks after delivery and can persist indefinitely if left untreated. In Ethiopia, the prevalence of postpartum depression is high. There is a dearth of literature to determine factors associated with postpartum depression in Ethiopia, specifically in the study area. Objective This study aimed to identify factors associated with postpartum depression among mothers in Debre Tabor Town, Northcentral Ethiopia. Method A community-based unmatched case-control study was conducted among mothers who were living in Debre Tabor Town and fulfilled the inclusion criteria. Postpartum mothers were selected using a simple random sampling technique from the listed sampling frame at the health center. Then, the sample cases and controls were interviewed until the sample size was fulfilled by using a consecutive sampling method. The data were entered into the EPI data version 4.6 and then imported and analyzed using SPSS version 25. Descriptive statistics of different variables were done by cross-tabulation. Binary logistic regression was used to assess the determinant factors with the outcome variable. A P-value of < 0.05 was considered to declare statistical significance. Results A total of 308 postnatal mothers living in Debre Tabor Town were included, with a 97.5% response rate. History of substance use in the previous 3 months (AOR: 6.47, 95% CI; 2.61, 15.74), current baby illness (AOR: 3.9, 95% CI; 1.5, 10.12), marital dissatisfaction (AOR: 2.41, 95% CI; 1.22, 4.75), unplanned current pregnancy (AOR: 3.46, 95% CI; 1.32, 9.12), and breastfeeding (AOR: 0.22, 95% CI; 0.09, 0.55) were independent factors that affected the occurrence of PPD. Conclusion This study revealed that a recent history of substance use (in the past 3 months), current baby illness, marital satisfaction, unplanned current pregnancy, and breastfeeding were associated with postpartum depression. Healthcare providers working in maternal and child health clinics and health extension workers should give special attention to postpartum mothers who have had a history of substance use, current baby illness, unplanned pregnancy, non-breastfeeding mothers, and mothers with poor marital satisfaction.
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Affiliation(s)
- Fentaw Teshome Dagnaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wondimnew Desalegn Addis
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Desalegn Tesfa
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Aragaw Tesfaw Desale
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Nurayine Abubeker Issa
- Department of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yismaw Yimam Belachew
- Department of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getachew Yideg Yitbarek
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alebachew Taye Belay
- Department of Statistics, College of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ermias Sisay Chanie
- Department of Pediatrics and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Habtamu Shimels Hailemeskel
- Department of Pediatrics and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Huang W, Li X, Wu Z, Jiang N, Zhang X. Psychometric properties of the Postpartum Depression Literacy Scale (PoDLiS) among Chinese perinatal women: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:737. [PMID: 36184620 PMCID: PMC9526904 DOI: 10.1186/s12884-022-05067-2] [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: 04/05/2021] [Accepted: 09/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background The aim of the present work was to cross-culturally adapt the Postpartum Depression Literacy Scale (PoDLiS) and use a descriptive cross-sectional design to evaluate its psychometric properties in Chinese perinatal women. Methods Brislin’s translation theory was applied to translate the PoDLiS, with subsequent cultural adaptation. The reliability and validity of the PoDLiS were determined using a questionnaire in 635 Chinese perinatal women. Results Good internal consistency was found (omega coefficient, 0.894) for the Chinese version of the Postpartum Depression Literacy Scale (PoDLiS-C), with omega coefficients of the six dimensions of 0.865, 0.870, 0.838, 0.777, 0.837 and 0.794, and a test–retest reliability coefficient of 0.874. The item-level content validity index (CVI) ranged from 0.8 to 1 while the scale-level CVI was 0.968. Moreover, confirmatory factor analysis (CFA) determined satisfactory construct validity of the PoDLiS-C, with the six-factor model explaining 60.76% of the total variance, demonstrating good model fit (likelihood ratio χ2/df, 1.003; goodness-of-fit index, 0.916; adjusted goodness-of-fit index, 0.901; comparative fit index, 0.999; incremental fit index, 0.999; root mean square error of approximation, 0.003; and standardized root mean square error of approximation, 0.0478). Conclusions The PoDLiS-C has adequate psychometric properties. This tool could be used to assess the postpartum depression literacy of perinatal women in Chinese-speaking populations.
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Affiliation(s)
- Weijian Huang
- Eastern Operating Room, Yantai Yuhuangding Hospital, No.20 Yantai Yuhuangding Eastern Road, Zhifu Area, Yantai, Shandong Province, P. R. China.,School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China
| | - Xiaohan Li
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China.
| | - Zijing Wu
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China
| | - Nan Jiang
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China
| | - Xu Zhang
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China
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Hoffmann EV, Duarte CS, Matsuzaka CT, Milani ACC, Fossaluza V, Mello AF, Mello MF. The positive impact of maternal depression intervention on children's emotional and behavioral symptoms in a low-resource setting. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2022; 44. [PMID: 35816635 PMCID: PMC9851758 DOI: 10.47626/1516-4446-2022-2498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/02/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Children of depressed mothers are at risk of developing mental health problems. We sought to determine whether treatment for maternal depression delivered by community health workers (CHW) would decrease behavioral/emotional symptoms in their child. An intervention treating maternal depressive symptoms in a low-middle-income country can have a high global impact. METHODS CHW were trained to deliver a psychosocial intervention for mothers with depression in a primary care setting. 49 mothers and 60 children were assessed pre-intervention, post-intervention, and at a 6-months follow-up. Child behavioral/emotional symptoms were evaluated by type of change in maternal depressive symptoms: remission and response. RESULTS An overall decrease in maternal depressive symptoms from baseline to post-intervention and 6-month follow-up were found. Remission and response of maternal depression was associated with better outcomes related to child´s behavioral/emotional symptoms at the 6-month follow-up (p = 0.0247, Cohen's d: 0.76; p = 0.0224, Cohen's f: 0.44) but not at post-intervention (p = 0.1636, Cohen's d: 0.48; p = 0.0720, Cohen's f: 0.33). CONCLUSION Maternal depression improvement was related to their child's decreased behavioral/emotional symptoms. Our results suggest that interventions addressing maternal depression in primary care is a viable strategy to prevent behavioral/emotional symptoms in the next generation.
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Affiliation(s)
- Elis Viviane Hoffmann
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Cristiane S. Duarte
- Department of Child and Adolescent Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Camila T. Matsuzaka
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Victor Fossaluza
- Departamento de Matemática e Estatística, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Andrea F. Mello
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Marcelo F. Mello
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Hospital Israelita Albert Einstein, Faculdade de Medicina, São Paulo, SP, Brazil
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Desalegn SY, Asaye MM, Temesgan WZ, Badi MB. Antenatal depression and associated factors among HIV-positive pregnant women in South Gondar zone public health facilities, northwest Ethiopia, a cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Wake GE, Fitie GW, Ashenafi B, Tadese M, Tessema SD. Magnitude and Determinant Factors of Postpartum Depression Among Mothers Attending Their Postnatal and Vaccination Services at Public Health Institutions of Addis Ababa, Ethiopia. Front Public Health 2022; 10:882205. [PMID: 35615031 PMCID: PMC9124855 DOI: 10.3389/fpubh.2022.882205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background The postpartum period is known as a high-risk period for the onset of different maternal mental health problems. Globally, 10–20% of postnatal mothers suffer from depressive symptoms. This study aimed to assess the magnitude and determinant factors of postpartum depression among mothers attending their postnatal and vaccination services at public health institutions in Addis Ababa, Ethiopia. Methodology Health institution-based cross-sectional study was conducted among 461 postnatal mothers attending public health institutions in Addis Ababa from 15 May 2021 to 15 July 2021. A multistage sampling technique was employed to select the public health institutions and a systematic random sampling method was used to get selected, postnatal mothers. Epidata version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. P-value ≤ 0.05 was used as a cut point of statistical significance in multivariable binary logistic regression. Results From total postnatal mothers 91(19.7%) of them had postpartum depression. Occupational status [AOR = 3.39, 95% CI: 1.04, 8.15], marital status [AOR = 2.69, 95% CI =1.33, 5.45], income management [AOR = 3.76, 95% CI: 1.53, 8.21], sex of baby [AOR = 5.07, 95% CI: 1.24, 20.69], history of child death [AOR = 6.93, 95% CI: 2.67, 15.79], unplanned pregnancy [AOR = 3.08, 95% CI: 1.65, 7.93], negative life event [AOR = 2.39, 95% CI: 1.03, 5.39], substance use during pregnancy [AOR = 6.23, 95% CI: 2.72, 20.05], history of depression [AOR = 5.08, 95% CI: 1.79, 14.39], and marriage satisfaction [AOR = 6.37, 95% CI: 2.63, 14.29] were determinant factors of postpartum depression. Conclusion The prevalence of postpartum depression in this study is high compared to national findings. Occupational status, marital status, income management, sex of baby, history of child death, unplanned pregnancy, negative life event, substance use during pregnancy, history of depression, and marital satisfaction were determinant factors of postpartum depression. The ministry of health should integrate mental health services with existing maternal health care services. It would be better if all healthcare professionals working in the maternal and child health unit will routinely screen postpartum depressive symptoms and link them to mental health services.
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Elrassas H, Taha GR, Soliman AEDM, Madbole SAEK, Mahmoud DAM. Prevalence and related factors of perinatal depression in Egyptian mothers. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00203-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Early detection of perinatal depression and its cultural determinants could reduce its sequalae on mothers and their babies. This study investigated the prevalence of perinatal depression in Egyptian mothers and compare women with and without perinatal depression regarding the psychosocial factors.
Three-hundred one women were recruited (166 were pregnant and 135 were in postpartum period) from a primary healthcare unit. Full sociodemographic data, Social Classification Scale, Dyadic Adjustment Scale (DAS), and the Edinburgh Postnatal Depression Scale (EPDS) were completed. Subjects with EPDS score > 9 answered the structured clinical interview (SCID-I) for diagnosis of depression and Hamilton Rating Scale for Depression (HRSD) for depression severity.
Results
Depression with mild to moderate severity was reported in 5.4% and 3.7% of women during pregnancy and postpartum period, respectively. There was a statistically significant association between depression and employment (p = 0.031), mother-in-law disputes (p = 0.002), stigma of being the second wife (p = 0.047), and having financial burdens (p = 0.001). Marital satisfaction was a protective factor for depression (p < 0.001).
Conclusions
Prevalence of perinatal depression was comparable to other developing countries. It was strongly linked to culturally related factors including marital women’s employment, mother-in-law disputes, being the second wife, and socioeconomic burdens. Early detection of perinatal depression and its culturally related factors is important for its management.
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Adefolarin AO, Gershim A. Content validation of educational materials on maternal depression in Nigeria. BMC Pregnancy Childbirth 2022; 22:322. [PMID: 35428198 PMCID: PMC9012018 DOI: 10.1186/s12884-022-04575-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background This study describes the content validation process of the already developed English and Yoruba (poster and leaflet) and Yoruba (song) maternal depression educational materials in Nigeria. Methods This study is a cross sectional study which is a part of a larger study on training and supervision of Primary health care workers. Study utilized health professionals’ judgement for content validation, and maternal-child health clients’ evaluation for face validation with the use of Suitability Assessment of Materials (SAM). Six bilingual professionals validated both English and Yoruba version of materials (Song has only Yoruba version) and 50 clients evaluated each Yoruba material. Validity Index was calculated by formula and inter-rater agreement using intra-class coefficient (ICC) was analyzed on Professionals’ ratings. ICC, ‵t′ test and Pearson correlation were analyzed on professionals’ rating versus randomly selected six clients’ rating. Descriptive statistics, and fisher exact test were used for other statistical analysis with SPSS version 25. Results The mean age of the professionals for poster was 44.3 ± 6.0 years, for leaflet 39.8 ± 7.2 years, for song 43.8 ± 8.4 years. For maternal child health clients, mean age is: 30.7 ± 5.4 years for poster; 31.3 ± 5.2 for leaflet and 29.0 ± 5.1 for song. Outcomes of bilingual professionals’ validation are validity index: English {leaflet (0.94), poster (0.94)}, and Yoruba {leaflet (0.94) poster (0.94) and song (1.00)}. More than 80% clients rated the suitability of each material as superior. There is no significant relationship between clients’ sociodemographic characteristics and their ratings across content, literacy demand and cultural appropriateness domains of the three materials on fisher exact test. The inter-rater agreement among the professionals is excellent on leaflet and song ICC > 0.8, but it is weak on the poster ICC < 0.6. There is no inter-rater agreement on all the three Yoruba materials, but a negative linear correlation was found on the leaflet between the professionals’ ratings and the randomly selected clients’ ratings. ‵t′ test found no statistical difference in the ratings of the professionals and clients only on song material. Conclusion This study shows the process of validation of the English and Yoruba versions of the educational materials. This process should be leveraged in the content validation of other maternal-child health education materials in Africa.
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Insan N, Weke A, Rankin J, Forrest S. Perceptions and attitudes around perinatal mental health in Bangladesh, India and Pakistan: a systematic review of qualitative data. BMC Pregnancy Childbirth 2022; 22:293. [PMID: 35387619 PMCID: PMC8988352 DOI: 10.1186/s12884-022-04642-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 04/01/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Perinatal mental health (PMH) is a worldwide public health issue crossing cultural boundaries. However, the prevalence of PMH conditions vary considerably. These disparities stem in part from poor understanding and stigma surrounding PMH which hinder pregnant women from seeking mental health care and may exacerbate their conditions. Bangladesh, India and Pakistan are South Asian countries with a higher burden of PMH conditions than in the Global North-West and very different social and cultural norms around gender and mental health. The aim of this systematic review (PROSPERO Ref: CRD42020167903) was to identify, synthesise and appraise the available literature on perceptions and attitudes of perinatal (pregnant and postpartum) women, their families and healthcare providers surrounding PMH in Bangladesh, India and Pakistan. METHODS Five electronic databases, MEDLINE, Embase, PsycINFO, Scopus and Web of science, and grey literature were searched using predefined search terms. Qualitative or quantitative articles with a qualitative component reporting perceptions and attitudes surrounding PMH in Bangladesh, India and Pakistan were eligible for inclusion, if published in English between January 2000 and January 2021. The Critical Appraisal Skills Programme Qualitative Research Checklist and Newcastle-Ottawa Scale for cross-sectional studies were used to assess study quality. Findings were synthesised using thematic synthesis, as described by Thomas and Harden 2008. RESULTS Eight studies were included. Five overarching themes comprising 17 sub-categories were identified. These descriptive themes were: perceived causes of PMH, perceived symptoms of PMH, perceptions of motherhood, accessing PMH care and emotional sharing and coping strategies. Sociocultural expectations underpin many of the themes identified in this review including the importance of familial and societal causes of PMH, emphasis on physical symptoms, sacredness of motherhood, lack of awareness, stigma, shame, limited resources allocated for mental health and lack of emotional sharing. CONCLUSIONS There is a complex range of perceptions and attitudes around PMH which influence women's experiences and access to PMH care. These findings will inform policy and practice through targeted interventions to tackle stigmatising attitudes and increasing education and training for healthcare providers.
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Affiliation(s)
- Nafisa Insan
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
| | - Anthony Weke
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Simon Forrest
- Department of Sociology, Durham University, Durham, UK
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Asare H, Rosi A, Scazzina F, Faber M, Smuts CM, Ricci C. Maternal postpartum depression in relation to child undernutrition in low- and middle-income countries: a systematic review and meta-analysis. Eur J Pediatr 2022; 181:979-989. [PMID: 34652508 DOI: 10.1007/s00431-021-04289-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
Perinatal (antenatal and postpartum) depression is increasingly becoming a global public health problem. Studies have shown that the presence of depression during the perinatal period impact on a mother's ability to adequately provide nutritional care for herself and her infants and young children. This may thus negatively influence the nutritional status of these vulnerable children resulting in poor growth, such as stunting which is currently a public health problem in low- and middle-income countries (LMICs). The aim of this systematic review and meta-analysis was to determine the association between maternal postpartum depression and child growth in LMICs. Electronic databases were systematically reviewed by screening abstracts, titles, full text and additional data sources of eligible papers. Articles were eligible for inclusion if based on children aged 0 to 59 months, if reporting maternal postpartum depression as an exposure, if based on observational studies evaluating the relation between maternal postpartum depression and child growth, if reporting at least one physical growth indicator such as stunting as an outcome, and if published after 2000. Article selection was based on the PRISMA guidelines for reporting systematic reviews. Twelve articles were included in the quantitative synthesis (12 for stunting, 8 for underweight and 2 for wasting). Maternal postpartum depression was observed to be associated with an increased risk of child stunting (1.87 (95% CI: 1.52, 2.30; I2 = 41.6%, p = 0.064)) and underweight (1.81 (95% Cl: 1.25, 2.62; I2 = 70.7%, p = 0.001)). These results were confirmed after influence analyses, with publication bias being negligible. Conclusion: Maternal depression is a risk factor for poor child growth in LMICs. This study contributes to the knowledge on this topic and calls on policymakers to improve on its understanding, screening and treatment to alleviate the potential negative impact on child growth. What is Known: • Maternal postpartum depression is currently a public health relevance in low- and middle-income countries (LMICs). • Maternal postpartum depression is a risk factor for poor nutritional status in children from LMICs. What is New: • Maternal postpartum depression is associated with an 80 to 90% increased risk of childhood stunting and underweight in LMICs. • The association between risk of childhood stunting and underweight with maternal postpartum depression is slightly influenced by geographical area, rural or urban location, by factors such as study design, study quality and sample size.
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Affiliation(s)
- Hannah Asare
- Centre of Excellence for Nutrition, North-West University, 11 Hoffman Street, Potchefstroom, South Africa.
| | - Alice Rosi
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Francesca Scazzina
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Mieke Faber
- Centre of Excellence for Nutrition, North-West University, 11 Hoffman Street, Potchefstroom, South Africa.,Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, 11 Hoffman Street, Potchefstroom, South Africa
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
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Insan N, Weke A, Forrest S, Rankin J. Social determinants of antenatal depression and anxiety among women in South Asia: A systematic review & meta-analysis. PLoS One 2022; 17:e0263760. [PMID: 35139136 PMCID: PMC8827460 DOI: 10.1371/journal.pone.0263760] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 01/26/2022] [Indexed: 11/19/2022] Open
Abstract
Background Pregnancy is a time of major psychological changes making pregnant women more susceptible to depression and anxiety. Prevalence is higher among women living in Bangladesh, India and Pakistan, compared to high-income countries, due to poor understanding and lack of mental health integration within antenatal care. Antenatal depression/anxiety is associated with adverse outcomes including postnatal depression, low birth weight and impaired fetal development. Existing systematic reviews provided only limited information on the social determinants of antenatal depression/anxiety in these South Asian countries. Objective This review aimed to identify, synthesise and appraise the evidence on the social determinants associated with antenatal depression and anxiety in women living in Bangladesh, India and Pakistan. Methods We searched five databases (MEDLINE, Embase, PsycINFO, Scopus, Web of Science) and PROSPERO. Observational studies published between 1st January 2000 and 4th January 2021 were included if they were in the English language, used validated tools for measuring depression/anxiety in pregnant women and reported statistical associations or raw numbers. Summary estimates were obtained using random-effects model. Heterogeneity and publication bias was measured using the I2 statistic and Egger’s test, respectively. This review was registered on PROSPERO (reference: CRD42020167903). Results We included 34 studies (with 27,379 women). Meta-analysis of Adjusted Odds Ratios (AOR) found that Intimate partner violence (AOR 2.48, 95% CI 1.41–4.33), unplanned pregnancy (AOR 1.53, 95% CI 1.28–1.83), male gender preference (AOR 3.06, 95% CI 1.40–6.72) and poor relationship with in-laws (AOR 2.69, 95% CI 1.25–5.80) were significantly associated with antenatal depression/anxiety. Conclusion The review identified a complex range of social determinants of antenatal depression and anxiety in Bangladesh, India and Pakistan. Screening tools to identify pregnant women at high risk should be integrated within antenatal care to prevent adverse outcomes. Knowledge of these social determinants will inform the development of such screening tools and interventions.
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Affiliation(s)
- Nafisa Insan
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
- * E-mail:
| | - Anthony Weke
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Simon Forrest
- Department of Sociology, Durham University, Durham, United Kingdom
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
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Wyatt S, Ostbye T, De Silva V, Long Q. Antenatal depression in Sri Lanka: a qualitative study of public health midwives' views and practices. Reprod Health 2022; 19:23. [PMID: 35090509 PMCID: PMC8796187 DOI: 10.1186/s12978-022-01330-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 01/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Almost all pregnant people in Sri Lanka receive antenatal care by public health midwives. While there is strong infrastructure in Sri Lanka for postpartum mental health care, the current practices within antenatal mental health care have not been externally evaluated. The purpose of this study is to investigate the current clinical guidelines and experiences of how public health midwives diagnose and treat antenatal depression. Methods We conducted in-depth interviews with 12 public health midwives from four antenatal clinics in the Bope Poddala division in Galle, Sri Lanka and reviewed and extracted information on antenatal depression from clinical guidelines. Data was collected in Sinhala and translated into English. We used applied thematic analysis and worked closely with our local team to ensure data trustworthiness. Results Midwives (n = 12) reported varying degrees of knowledge on antenatal depression and did not have standardized diagnosis patterns. However, they were very consistent in their clinical practices, following guidelines for referral and follow-up of case management, building strong rapport. In their practice, midwives continue to face challenges of lack of human resources and high stigma around mental illness. They suggested that that care could be improved with use of a standardized diagnostic tool, and easier access to specialist care. We found the clinical guideline on the diagnosis and treatment of antenatal depression is lacking key details on symptoms for appropriate diagnosis, but it clearly guides on how to navigate treatment. Conclusions Public health midwives are following the clinical guideline to refer pregnant women who need intervention for antenatal depression and follow-up for case management. However, there is a need for more specific and context-relevant guidelines, especially for diagnosis of antenatal depression. Formative research is needed to explore intervention strategies to improve antenatal depression management in Sri Lanka. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-022-01330-z. We interviewed 12 midwives at pregnancy clinics in southern Sri Lanka about what happens if a pregnant woman gets depressed. Some midwives knew a lot about depression, while others did not know very much. They all had different ideas of what the signs of depression were, and what percentage of pregnant women are usually depressed. They have a rule book about how to be a midwife, but it is not clear about how they should find out if a pregnant woman has depression. However, all midwives agreed on what they should do if they meet a depressed woman during an antenatal appointment in their clinic, following the rule book closely. They said they need to tell their supervisor, who will tell a psychiatrist who can treat the depression. However, sometimes there are problems. Midwives said that they, their supervisor and the psychiatrist are all very busy and don’t have enough time to spend with pregnant women. Also, a lot of the women in their clinics don’t want to get treated because they feel embarrassed about having depression, and don’t want other people to know. Midwives told us they could do their jobs better if they could give a quick test for depression to every woman visiting their clinic. This would be an easy solution, because they already use a test like this for after women give birth.
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Affiliation(s)
- Sage Wyatt
- Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316, Jiangsu, China.,University of Bergen, Bergen, Vestland, Norway
| | - Truls Ostbye
- Duke Global Health Institute, Duke University, Durham, NC, USA.,University of Bergen, Bergen, Vestland, Norway
| | - Vijitha De Silva
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Faculty of Medicine, University of Ruhuna, Matara, Southern Province, Sri Lanka
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, 215316, Jiangsu, China.
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Tamiru D, Misgana T, Tariku M, Tesfaye D, Alemu D, Weldesenbet AB, Gebremichael B, Dheresa M. Prevalence and Associated Factors of Common Mental Disorders Among Pregnant Mothers in Rural Eastern Ethiopia. Front Psychiatry 2022; 13:843984. [PMID: 35418883 PMCID: PMC8995426 DOI: 10.3389/fpsyt.2022.843984] [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: 12/27/2021] [Accepted: 03/01/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Antenatal common mental disorder is a significant public health issue, especially in low- and middle-income countries with an extensive treatment gap. Common mental disorders have multifaceted implications on maternal and fetal health outcomes during pregnancy with long-running economic and social sequels. This study aimed to determine the prevalence of common mental disorder and associated factors among pregnant mothers in eastern Ethiopia, Kersa and Haramaya Health, and Demographic surveillance sites. METHODS A community-based cross-sectional study was conducted in Kersa and Haramaya health and demographic surveillance sites from January 30 to April 30, 2021. World Health Organization Self-Reporting Questionnaire (SRQ-20) was used to measure common mental disorder among 1,015 randomly selected pregnant women. Data were collected face-to-face using open data kit software. Logistic regression was fitted to identify factors associated with common mental disorders. RESULTS The overall prevalence of common mental disorders (SRQ > 6) among pregnant women was 37.5% (95% CI: 34.5, 40.5). Current substance use (AOR = 1.99, 95% CI 1.37, 2.88), intimate partner violence (AOR = 2.67, 95% CI 2.02, 3.53), null parity (AOR = 3.10, 95% CI 1.65, 5.84), gestational age [first trimester (AOR = 2.22, 95% CI 1.01, 4.93) and third trimester (AOR = 1.74, 95% CI 1.31, 2.31)], history of abortion (AOR = 2.03, 95% CI 1.27, 3.24), and absence of antenatal care follow-up (AOR = 1.43, 95% CI 1.08, 1.89) were significantly associated with common mental disorder during pregnancy. CONCLUSION Common mental disorders are prevalent among pregnant women in the study area with significant correlates. Administration of regular screening programs for maternal mental health conditions in rural, low-income communities, integrating into primary health care settings is imperative to reduce the risk.
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Affiliation(s)
- Dawit Tamiru
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Misgana
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mandaras Tariku
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Berhe Gebremichael
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Yator O, John-Stewart G, Khasakhala L, Kumar M. Preliminary Effectiveness of Group Interpersonal Psychotherapy for Young Kenyan Mothers With HIV and Depression: A Pilot Trial. Am J Psychother 2021; 75:89-96. [PMID: 34915725 DOI: 10.1176/appi.psychotherapy.20200050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors adopted a task-sharing strategy in which lay health workers delivered group interpersonal psychotherapy (IPT-G) in primary care clinics in Nairobi, Kenya, to young mothers with HIV and depression. The study examined the acceptability, feasibility, and effectiveness of IPT-G in improving depression and antiretroviral therapy adherence. METHODS Twenty-four mothers (ages 18-24 years and 6-12 weeks postpartum) participated. The women were randomly assigned to IPT-G or to a waitlist. Eight lay providers administered the IPT-G sessions across 8 weeks. The primary outcome was pre- to postintervention change in depression scores as measured on the Edinburgh Postnatal Depression Scale. The secondary outcome was antiretroviral therapy adherence. All waitlist participants subsequently received the intervention, and a secondary outcome, within-group analysis, was conducted and included those participants. RESULTS Participants' median age was 23.0 years, 17 (71%) lived with a partner, and 19 (79%) had fewer than two children. The intervention group had a mean±SD depression score of 15.9±4.3 at baseline and 6.8±7.0 postintervention. For the waitlist control group, the mean score was 17.3±5.9 at baseline and 13.2±6.6 at the first follow-up. Waitlist participants had significantly greater mean depression scores than did intervention group participants at the first follow-up (after the intervention group's 8-week IPT-G) (β=6.42, 95% confidence interval=1.17 to 11.66, p=0.017). No difference was observed between groups in antiretroviral therapy adherence. CONCLUSIONS This study provides preliminary evidence that IPT-G led by community health workers may have benefits for postpartum depression among young mothers with HIV.
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Affiliation(s)
- Obadia Yator
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya (Yator, Khasakhala, Kumar); Departments of Global Health, Medicine, Epidemiology, and Pediatrics, University of Washington, Seattle (John-Stewart); Department of Psychology, University College London, London (Kumar)
| | - Grace John-Stewart
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya (Yator, Khasakhala, Kumar); Departments of Global Health, Medicine, Epidemiology, and Pediatrics, University of Washington, Seattle (John-Stewart); Department of Psychology, University College London, London (Kumar)
| | - Lincoln Khasakhala
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya (Yator, Khasakhala, Kumar); Departments of Global Health, Medicine, Epidemiology, and Pediatrics, University of Washington, Seattle (John-Stewart); Department of Psychology, University College London, London (Kumar)
| | - Manasi Kumar
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya (Yator, Khasakhala, Kumar); Departments of Global Health, Medicine, Epidemiology, and Pediatrics, University of Washington, Seattle (John-Stewart); Department of Psychology, University College London, London (Kumar)
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25
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Adefolarin AO, Gershim A, Sola AO, Oye G. The effect of training and supervision on primary health care workers' competence to deliver maternal depression inclusive health education in Ibadan, Nigeria: a quasi-experimental study. BMC Health Serv Res 2021; 21:1286. [PMID: 34847938 PMCID: PMC8630868 DOI: 10.1186/s12913-021-07208-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background Health workers lack the competence to address maternal depression in the routine health education in Nigeria. Hence, awareness among maternal-child health clients is low. We assessed the effect of training and supervision on knowledge, skills, and self-efficacy of primary healthcare workers in delivering health talks and the clients’ knowledge on maternal depression. Methods A quasi-experimental study design was adopted. Five Local Government Area (LGAs) in the Ibadan metropolis were grouped according to geographical proximity and randomly assigned to experimental (Group A = two LGAs) and control (Group B = three LGAs) with 12 primary health centres in each group. All primary health care workers recruited in group A received a one-day training on maternal depression. Good Knowledge Gain (GKG), Good Skill Gain (GSG) and Self-Efficacy (SEG) were assessed in both groups. 1-week post-training, the knowledge of all the PHCs’ attendees in the two groups was assessed. Two weeks post- training, a half of experimental group’s PHCs received supportive supervision and a clinic-based health education delivery skill assessment was conducted. The knowledge of clients and their health seeking were also assessed. Fisher’s exact test, independent t test and Poisson regression were used to analyze differences in percentages and mean/ factors associated with GKG, GSG and SE, using SPSS 25. Results Training improved gains in the experimental versus controls as follows: GKG (84.3% vs. 15.7%), GSG (90.7% vs 9.3%) and SEG (100% vs 0%). Training contributed to the good gain in knowledge (RR = 6.03; 95%CI =2.44–16.46; p < 0.01); skill (RR = 1.88; CI = 1.53–2.33; p < 0.01).) and self-efficacy (RR = 2.74; CI = 2.07–2.73; p < 0.01). Clients in the experimental group had higher knowledge gain score than in the control (7.10 ± 2.4 versus − 0.45 ± 2.37); p < 0.01). The rater supervisor observed better motivation in the supervised group than the not supervised. Forty clients sought help in the intervention group while none in the control group. Thirty-five clients sought help in the supervised group while only five did in the not supervised. Conclusions Training followed by supervision improved the competence of health workers to transfer knowledge to clients. This intervention is recommended for primary healthcare settings to improve uptake of maternal mental health services. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07208-3.
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Affiliation(s)
- Adeyinka Olufolake Adefolarin
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria. .,Department of Health Promotion and Education, Faculty Public Health, University of Ibadan, Ibadan, Nigeria.
| | - Asiki Gershim
- African Population and Health Research Center, Nairobi, Kenya.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Arulogun Oyedunni Sola
- Department of Health Promotion and Education, Faculty Public Health, University of Ibadan, Ibadan, Nigeria.,Centre for Entrepreneurship and Innovation, University of Ibadan, Ibadan, Nigeria
| | - Gureje Oye
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.,WHO Collaborating Centre, Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
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Kaur D, Malhotra A, Ranjan P, Chopra S, Kumari A, Vikram NK. Weight management in postpartum women - An Indian perspective. Diabetes Metab Syndr 2021; 15:102291. [PMID: 34598009 DOI: 10.1016/j.dsx.2021.102291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/31/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS This narrative review is intended to present an evidence and opinion-based weight management module for Indian postpartum women to be used by clinicians. MATERIAL AND METHODS Electronic databases such as PubMed and Google Scholar were accessed to extract relevant studies to derive evidence-based information. The reference list of the extracted studies was also checked to obtain further relevant articles. The opinion-based information was achieved from the consensus among the gynaecologists, nutritionists and doctors from Medicine according to their practical experiences in real time. In this review, we have used the term "postpartum" to represent the time period of two years after delivery. RESULTS A postpartum weight management module consisting of information about diet, physical activity, sleep and breastfeeding was devised to be used in regular clinical practice, particularly in the Indian settings. CONCLUSION Postpartum women deal with various unique challenges as compared to other population groups. Individualised weight management strategies should be adopted to facilitate sustainable postpartum weight management.
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Affiliation(s)
- Divjyot Kaur
- Department of Home Science, University of Delhi, India
| | - Anita Malhotra
- Department of Home Science, Lakshmibai College, University of Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Teenage Mothers in Yaoundé, Cameroon-Risk Factors and Prevalence of Perinatal Depression Symptoms. J Clin Med 2021; 10:jcm10184164. [PMID: 34575274 PMCID: PMC8470336 DOI: 10.3390/jcm10184164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Perinatal depression is defined as a non-psychotic depressive episode occurring during pregnancy or during the first year following childbirth. This depressive disorder is highly prevalent among teenage women but there is a lack of data in low- and middle-income countries. The objective of this study was to provide baseline data on the sociodemographic characteristics of pregnant teenagers or teenage mothers in an urban zone in Yaoundé, Cameroon. Risk factors were assessed, and prevalence of depressive disorders was determined. METHODS Women aged 20 years old or less in the perinatal period were invited to participate in the study. A total of 1344 women participated in the four-stage data collection process involving a questionnaire including questions on sociodemographic background, an assessment of their risk of perinatal depression using the EPDS questionnaire (Edinburgh Postnatal Depression Scale), a clinical interview based on the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders), and a final section focusing on risk factors of perinatal depression. RESULTS The EPDS score was obtained for 1307 women. The prevalence of depressive disorder symptoms among teenage or young pregnant women is estimated to be 70.0%. This risk is significantly increased by different factors including unintended or unplanned pregnancy (aOR: 1.33, 1.14-1.56 CI95%), being separated or single (aOR: 1.34, 1.12-1.60 CI95%), experiencing depression and anxiety before childbirth (aOR: 1.50, 1.02-2.27 CI95%), abortion experience (aOR: 2.60, 1.03-7.14 CI95%) and domestic violence (aOR: 1.76, 1.12-2.83 CI95%). CONCLUSION The results of this study reveal a high prevalence of depressive disorder symptoms within the study population. These findings highlight the need to develop maternal care programs to support both mothers and their infants.
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Mokwena KE. Neglecting Maternal Depression Compromises Child Health and Development Outcomes, and Violates Children's Rights in South Africa. CHILDREN-BASEL 2021; 8:children8070609. [PMID: 34356588 PMCID: PMC8303702 DOI: 10.3390/children8070609] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022]
Abstract
The intention of the South African Children’s Act 38 of 2005 is to provide guarantees for the protection and promotion of optimum health and social outcomes for all children. These guarantees are the provision of basic nutrition, basic health care and social services, optimal family or parental care, as well as protection from maltreatment, neglect and abuse services. However, despite these guarantees, child and maternal mortality remain high in South Africa. The literature identifies maternal depression as a common factor that contributes to negative health and social outcomes for both mothers and their children. Despite the availability of easy-to-use tools, routine screening for maternal depression is not carried out in public health services, which is the source of services for the majority of women in South Africa. The results are that the mothers miss out on being diagnosed and treated for maternal depression, which results in negative child outcomes, such as malnutrition, as well as impacts on mental, social and physical health, and even death. The long-term impacts of untreated maternal depression include compromised child cognitive development, language acquisition and deviant behaviors and economic disadvantage in later life. The author concludes that the neglect of screening for, and treatment of maternal depression therefore violates the constitutional rights of the affected children, and goes against the spirit of the Constitution. The author recommends that maternal and child health services integrate routine screening for maternal depression, which will not only satisfy the Constitutional mandate, but also improve the health and developmental outcomes of the children and reduce child mortality.
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Affiliation(s)
- Kebogile Elizabeth Mokwena
- Department of Public Health, Sefako Makgatho Health Sciences University, Molotlegi Drive, Ga-Rankuwa, Pretoria 0204, South Africa
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29
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Ana Y, Lewis MG, van Schayck OCP, Babu GR. Is physical activity in pregnancy associated with prenatal and postnatal depressive symptoms?: Results from MAASTHI cohort study in South India. J Psychosom Res 2021; 144:110390. [PMID: 33740554 PMCID: PMC7611353 DOI: 10.1016/j.jpsychores.2021.110390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Physical inactivity leads to depression and other adverse health consequences. Pregnant women are an important subgroup to study the health consequences due to physical inactivity since it can lead to adverse outcomes in pregnancy and even after delivery. Therefore, we aimed at understanding the level of physical activity among pregnant women, prevalence of prenatal and postnatal depressive symptoms and whether level of physical activity is associated with prenatal and postnatal depressive symptoms. METHODS In an ongoing cohort study, we measured the physical activity using a validated Physical Activity Level (PAL) questionnaire. We administered the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy and within seven days of delivery to assess depressive symptoms in 1406 women. Associations were adjusted for potential confounders such as maternal age, education, socioeconomic status, gravida, EPDS score during pregnancy, social support, skinfold thickness, blood pressure, blood sugar level. RESULTS We found that 7.2% of pregnant women had low levels of physical activity. The prevalence of prenatal and postnatal depressive symptoms was 9.0% and 31.9% respectively. Pregnant women with a low level of physical activity had significantly higher odds of developing postpartum depressive symptoms (OR = 3.15, CI: 1.98-5.02, p < 0.001) when adjusted for potential confounders. CONCLUSIONS Moderate level of physical activity among pregnant mothers is essential and has its association with postnatal depressive symptoms. Health care professionals need to counsel pregnant women to assess depressive symptoms at both the prenatal and postpartum period and inform them about the importance of the optimal level of physical activity.
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Affiliation(s)
- Yamuna Ana
- Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bangalore, India.
| | - Melissa Glenda Lewis
- Indian Institute of Public Health-Hyderabad, Public Health Foundation of India (PHFI), Hyderabad, India.
| | - Onno C P van Schayck
- Care, and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands.
| | - Giridhara R Babu
- Lifecourse Epidemiology, Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bangalore, India; Public health and clinical medicine, Wellcome Trust/DBT India Alliance, New Delhi, India.
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Mishkin K, Maqsood SS, Ahmed HM. Antenatal Depression Symptoms Among Pregnant Women Seeking Health Services in Erbil, Iraq. Matern Child Health J 2021; 25:1043-1049. [PMID: 33905065 DOI: 10.1007/s10995-021-03142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Maternal depression, which includes depression in the prenatal and postpartum periods, is estimated to affect between 10 and 20% of women globally but the rate is higher in the Middle East. Research focused on maternal depression in Iraq is limited to one study focused on postpartum depression. This paper identifies the prevalence and factors associated with antenatal depression among pregnant Iraqi women. METHODS Women seeking maternal health services at primary health centers were invited to participate. Data were collected by trained midwifery students in Erbil, Iraq. Responses to the PHQ-2 PRIME-MD depression questions were used to identify depressive symptoms. Chi-square and logistic regression analyses were used to analyze findings. RESULTS Of the 179 participants, 86 (48%) reported depressive symptoms. In bivariate analysis, antenatal depression was associated with gestational age (p = 0.03), first prenatal visit in the second trimester (p = 0.003), loss of appetite (p = 0.003), not having help at home (p = 0.03), and use of prenatal vitamins (p = 0.002). Gravida approached significance (p = 0.07). In adjusted analysis, women reporting loss of appetite were more likely to report depressive symptoms (OR = 3.09, 95% CI: 1.47-6.51). DISCUSSION Consistent with other research from the region, nearly half the women reported depressive symptoms. Because lack of appetite is associated with depressive symptoms, women reporting loss of appetite should be prioritized for depression screening in time-constrained settings.
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Affiliation(s)
- Kathryn Mishkin
- Department of Health Policy, Management, Behavior, University at Albany, Albany, NY, USA.
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Okunola TO, Awoleke JO, Olofinbiyi B, Rosiji B, Olubiyi AO, Omoya S. Predictors of postpartum depression among an obstetric population in South-Western Nigeria. J Reprod Infant Psychol 2021; 40:420-432. [PMID: 33641549 DOI: 10.1080/02646838.2021.1886259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Perinatal maternal depression is the most common mood disturbance associated with pregnancy. It has grave consequences on both maternal health and wellbeing of offsprings, albeit usually neglected in low- and middle-income countries.Objective: To evaluate the relationship between antenatal depression(APD) and postpartum depression(PPD) and predictors of postpartum depression among an obstetric population in South-western Nigeria.Methods: This was a prospective longitudinal cohort study involving272 pregnant women recruited between 34 and 36 weeks of pregnancy and followed up to till 6 weeks after delivery. Edinburgh Postnatal Depression Scale (EPDS) questionnaires were administered to collect data. Data were analysed with SPSS version 23.A p-value < 0.05 was taken as statistically significant.Results: The prevalences of antepartum and postpartum depression were 6.3%, (95% CI 3.4%-9.2%) and 8.8% (95% CI 5.4%-12.1%) respectively. The Spearman correlation coefficient for antepartum EPDS and postpartum EPDS scores was 0.52, p < 0.001.The predictors of postpartum depression were antepartum depression (adjusted OR 10.6, 95% CI 8.33-48.60, p < 0.001), puerperal sepsis (adjusted OR 4.33, 95% CI 3.89-8.69, p = 0.03), domestic violence (adjusted OR 3.40, 95% CI 1.94-15.67, p = 0.01) and age group 25-34 years (adjusted OR 0.11, 95% CI 0.02-0.75, p = 0.02), and household income $1671-$3330 (adjusted OR 0.10, 95% CI 0.02-0.56, p = 0.01).Conclusion: There was a positive association between the antenatal EPDS and postnatal EPDS scores. Screening for maternal depression should be considered in prenatal period. Further studies are necessary to explore the novel finding of predictive role of puerperal sepsis in PPD.
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Affiliation(s)
| | - Jacob Olumuyiwa Awoleke
- Department of Obstetrics and Gynaecology, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
| | - Babatunde Olofinbiyi
- Department of Obstetrics and Gynaecology, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
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Ashenafi W, Mengistie B, Egata G, Berhane Y. The role of intimate partner violence victimization during pregnancy on maternal postpartum depression in Eastern Ethiopia. SAGE Open Med 2021; 9:2050312121989493. [PMID: 33552514 PMCID: PMC7841856 DOI: 10.1177/2050312121989493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/30/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Intimate partner violence during pregnancy is a strong predictor of maternal postpartum depression. In Ethiopia, evidence on the association of intimate partner violence during pregnancy with postpartum depression is very limited. To design appropriate intervention, it is thus important to understand how postpartum depression varies as a function of the type and severity of intimate partner violence victimization during pregnancy. The aim of this study is to explore the association of different types of intimate partner violence during pregnancy and its severity with postpartum depression in Eastern Ethiopia. Method: A community-based cross-sectional study was conducted from January to October 2018. The study included a sample of 3015 postpartum women residing in Eastern Ethiopia. The cutoff point for postpartum depression was defined as ⩾13 points according to the Edinburgh Postnatal Depression Scale. The prevalence ratio with 95% confidence intervals was calculated, and the association between the main predictor (i.e. intimate partner violence during pregnancy) and the outcome variable (postpartum depression) was determined using log binomial regression model. Results: 16.3% (95% confidence interval: 14.9–17.7) of women experienced postpartum depression. After controlling potential confounding factors, the prevalence of postpartum depression among women exposed to severe physical intimate partner violence during pregnancy was 1.98 times higher as compared to those not exposed to physical intimate partner violence during pregnancy (adjusted prevalence ratio = 1.98; 95% confidence interval: 1.53–2.54). Exposure to psychological intimate partner violence during pregnancy was found to increase the prevalence of postpartum depression by 1.79 as compared to non-exposure to psychological intimate partner violence during pregnancy (adjusted prevalence ratio = 1.79; 95% confidence interval: 1.48–2.18). Conclusion: The study provides evidence that psychological and severe physical intimate partner violence during pregnancy were significantly associated with maternal postpartum depression. Screening of pregnant women for intimate partner violence and providing them the necessary support can minimize the risk to postpartum depression.
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Affiliation(s)
- Wondimye Ashenafi
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bezatu Mengistie
- Department of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gudina Egata
- Addis Ababa University College of Health Sciences, Public Health Nutrition Department, Addis Ababa, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Seiiedi-Biarag L, Mirghafourvand M, Esmaeilpour K, Hasanpour S. A randomized controlled clinical trial of the effect of supportive counseling on mental health in Iranian mothers of premature infants. BMC Pregnancy Childbirth 2021; 21:6. [PMID: 33402123 PMCID: PMC7782568 DOI: 10.1186/s12884-020-03502-w] [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] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 12/16/2020] [Indexed: 11/13/2022] Open
Abstract
Background Premature birth can affect maternal mental health. Considering that the mental health disorder in mothers may play a vital role in the growth and development of their children, therefore, this study was conducted to determine the effect of supportive counseling on mental health (primary outcome), mother-child bonding and infant anthropometric indices (secondary outcomes) in mothers of premature infants. Methods This randomized controlled clinical trial was carried out on 66 mothers with hospitalized neonates in the NICU of Alzahra hospital in Tabriz- Iran. Participants were randomly allocated into two groups of intervention (n = 34) and control (n = 32) through a block randomization method. The intervention group received 6 sessions of supportive counseling (45–60 minutes each session) by the researcher, and the control group received routine care. Questionnaires of Goldberg General Health and the postpartum bonding were completed before the intervention (first 72 hours postpartum) and 8 weeks postpartum. Also, the anthropometric index of newborns were measured at the same time. Results There was no statistically significant difference between the two groups in terms of socio-demographic characteristics. After the intervention, based on ANCOVA with adjusting the baseline score, mean score of mental health (AMD: -9.8; 95% Confident Interval (95% CI): -12.5 to -7.1; P < 0.001) and postpartum bonding (AMD: -10.0; 95% CI: -0.6 to 13.9; P < 0.001) in the counseling group was significantly lower than those of the control group; however, in terms of weight (P = 0.536), height (P = 0.429) and head circumference (P = 0.129), there was no significant difference between the two groups. Conclusions Supportive counseling may improve mental health and postpartum bonding in mothers of premature infants. Thus, it may be recommendable for health care providers to offer it to mothers. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N45. Date of registration: October 29, 2018.
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Affiliation(s)
- Leila Seiiedi-Biarag
- Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | | | - Shirin Hasanpour
- Women's Reproductive Health Research Center, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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Chae HK, East P, Delva J, Lozoff B, Gahagan S. Maternal Depression Trajectories Relate to Youths' Psychosocial and Cognitive Functioning at Adolescence and Young Adulthood. JOURNAL OF CHILD AND FAMILY STUDIES 2020; 29:3459-3469. [PMID: 33776389 PMCID: PMC7992359 DOI: 10.1007/s10826-020-01849-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This study evaluated how patterns of mothers' depressive symptoms across their child's childhood relate to children's psychosocial adjustment at adolescence and young adulthood and to cognitive functioning at adolescence. Depressive symptoms were measured in 1,273 mothers when their children were 1, 5, 10, and 14.6 years of age. Children (53.5% male; n = 1,024) completed the Youth Self-Report at adolescence (M = 14.6y), and the Adult Self-Report in young adulthood (M = 20.5y; n = 817) to assess internalizing and externalizing symptoms. Adolescents also completed standardized cognitive tests to assess verbal and mathematical skills. Growth mixture modeling analyses identified four patterns of maternal depressive symptom trajectories: infrequent (55%), increasing at adolescence (20%), decreasing at adolescence (14%), and chronic severe (11%). Results indicated that exposure to maternal depression of any duration, severity or time period during childhood portended higher levels of externalizing and attention problems at both adolescence and adulthood and higher levels of internalizing problems at adulthood. Adolescents whose mothers had chronic severe depressive symptoms had lower language, vocabulary, reading comprehension and mathematical test scores than youth whose mothers had stable infrequent depressive symptoms. Findings illustrate the significance and long-term ramifications of mothers' depressed mood for their children's mental and psychosocial health into adulthood. Findings also demonstrate that the lower cognitive abilities among children of severely depressed mothers persist beyond childhood and pertain to a broad range of cognitive abilities.
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Affiliation(s)
- Heekyung K Chae
- Department of Pediatrics, University of California, San Diego. 9500 Gilman Drive, Mail Code 0927, La Jolla, CA 92093-0927
| | - Patricia East
- Department of Pediatrics, University of California, San Diego, La Jolla, CA
| | - Jorge Delva
- School of Social Work, Boston University, Boston, MA
| | - Betsy Lozoff
- Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Sheila Gahagan
- Department of Pediatrics, University of California, San Diego, La Jolla, CA
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Postpartum depression and associated factors among postpartum women in Ethiopia: a systematic review and meta-analysis, 2020. Public Health Rev 2020; 41:21. [PMID: 32974057 PMCID: PMC7493842 DOI: 10.1186/s40985-020-00136-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/12/2020] [Indexed: 11/15/2022] Open
Abstract
Introduction The postpartum period is recognized as a high-risk period for the development of various mood disorders like postpartum depression. Globally, postnatal depression is a serious public health problem that has a negative impact on the mother’s health and child development, especially in developing countries. In Ethiopia, even though there are different primary studies conducted on postpartum depression, there is no nationally representative evidence. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence and associated factors of postpartum depression in Ethiopia. Methods Published and unpublished articles from various electronic databases and digital libraries were accessed. This systematic review included studies that were conducted on the magnitude and factors associated with postpartum depression among postnatal women in Ethiopia. A random-effect model was used to estimate the pooled magnitude of postpartum depression with a 95% confidence interval (CI). Inverse variance (I2) was used to visualize the presence of heterogeneity, and forest plot was used to estimate the pooled magnitude of postpartum depression. Publication bias was assessed by funnel plots and Egger’s statistical tests. A meta-regression and subgroup analysis were computed to minimize underlying heterogeneity. Result Initially, a total of 764 studies were accessed. Twenty-eight full articles were assessed for eligibility criteria, of which twelve studies fulfilled inclusion criteria were included in the final meta-analysis. The overall pooled magnitude of postpartum depression was 22.89% (95% CI 17.75%, 28.03%) with the lowest (12.20%) and highest (33.82%) in the Southern nations region. Unplanned pregnancy, domestic violence, lack of social support, previous history of depression, infant loss, and dissatisfaction in marriage showed a statistically significant association with postpartum depression. Conclusions In the current analysis, the prevalence of postpartum depression was high as compared with other developing countries. Routine screening of mothers in the postpartum period and integrating mental health with maternal health care is highly recommended.
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Alenko A, Dejene S, Girma S. Sociodemographic and Obstetric Determinants of Antenatal Depression in Jimma Medical Center, Southwest Ethiopia: Facility Based Case-Control Study. Int J Womens Health 2020; 12:557-565. [PMID: 32801933 PMCID: PMC7394501 DOI: 10.2147/ijwh.s252385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/18/2020] [Indexed: 11/23/2022] Open
Abstract
Background Worldwide, 10–20% of women experience depression during pregnancy. In sub-Saharan countries, depression during pregnancy is estimated to be 15–57%. Even though there is a high burden of depression during pregnancy, little attention has been given to identify sociodemographic and obstetric determinants in diverse populations like Ethiopia. Objective To identify sociodemographic and obstetric determinants of antenatal depression among women attending an antenatal clinic at Jimma Medical Center, southwest Ethiopia. Patients and Methods A case–control study was conducted among 246 pregnant mothers (82 cases and 164 controls) attending an antenatal clinic in Jimma Medical Center from June 1 to August 30, 2019. Antenatal depression was assessed using the Beck Depression Inventory-II. Epidata 3.1 and SPSS v24 were used for data entry and analysis, respectively. Adjusted odds ratios (AOR) and 95%CIs were estimated using logistic regression models. Statistical significance was set at P<0.05. Results Married mothers were 67% (AOR=0.33, 95%CI: 0.15–0.75), housewives were 97% (AOR=0.03, 95%CI: 0.01–0.14), private workers were 87% (AOR=0.13, 95%CI: 0.04–0.44), and government employees were 84% (AOR=0.16, 95%CI: 0.05–0.46), less likely to develop antenatal depression. Multigravida were 88% (AOR=0.12, 95%CI: 0.04–0.37) less likely to develop antenatal depression. Third trimester pregnancy was four times (AOR=4.04, 95%CI: 1.51–10.81) more likely to have depression. Mothers who having wanted pregnancy were 83% (AOR=0.17, 95%CI: 0.04–0.81) less likely to develop antenatal depression compared with mothers having unwanted pregnancy. Conclusion and Recommendation Being married, multigravida, having wanted pregnancy and occupation status (housewives, private workers and government employees) can protect mothers from developing antenatal depression. Mothers with third trimester pregnancy were four times more likely to have depression. Designing a screening and intervention strategy for antenatal depression must consider the aforementioned protective and risk factors.
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Affiliation(s)
- Arefayne Alenko
- Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Sisay Dejene
- Department of Health Service Management, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Shimelis Girma
- Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia
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Uptake of referrals for women with positive perinatal depression screening results and the effectiveness of interventions to increase uptake: a systematic review and meta-analysis. Epidemiol Psychiatr Sci 2020; 29:e143. [PMID: 32677601 PMCID: PMC7372167 DOI: 10.1017/s2045796020000554] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
AIMS Perinatal depression threatens the health of maternal women and their offspring. Although screening programs for perinatal depression exist, non-uptake of referral to further mental health care after screening reduces the utility of these programs. Uptake rates among women with positive screening varied widely across studies and little is known about how to improve the uptake rate. This study aimed to systematically review the available evidence on uptake rates, estimate the pooled rate, identify interventions to improve uptake of referral and explore the effectiveness of those interventions. METHODS This systematic review has been registered in PROSPERO (registration number: CRD42019138095). We searched Pubmed, Web of Science, Cochrane Library, Ovid, Embase, CNKI, Wanfang Database and VIP Databases from database inception to January 13, 2019 and scanned reference lists of relevant researches for studies published in English or Chinese. Studies providing information on uptake rate and/or effectiveness of interventions on uptake of referral were eligible for inclusion. Studies were excluded if they did not report the details of the referral process or did not provide exact uptake rate. Data provided by observational studies and quasi-experimental studies were used to estimate the pooled uptake rate through meta-analysis. We also performed meta-regression and subgroup analyses to explore the potential source of heterogeneity. To evaluate the effectiveness of interventions, we conducted descriptive analyses instead of meta-analyses since there was only one randomised controlled trial (RCT). RESULTS Of 2302 records identified, 41 studies were eligible for inclusion, including 39 observational studies (n = 9337), one quasi-experimental study (n = 43) and one RCT (n = 555). All but two studies were conducted in high-income countries. The uptake rates reported by included studies varied widely and the pooled uptake rate of referral was 43% (95% confidence intervals [CI] 35-50%) by a random-effect model. Meta-regression and subgroup analyses both showed that referral to on-site assessment or treatment (60%, 95% CI 51-69%) had a significantly higher uptake rate than referral to mental health service (32%, 95% CI 23-41%) (odds ratio 1.31, 95% CI 1.13-1.52). The included RCT showed that the referral intervention significantly improved the uptake rate (p < 0.01). CONCLUSIONS Almost three-fifths of women with positive screening results do not take up the referral offers after perinatal depression screening. Referral to on-site assessment and treatment may improve uptake of referral, but the quality of evidence on interventions to increase uptake was weak. More robust studies are needed, especially in low-and middle-income countries.
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Molenaar J, Hanlon C, Alem A, Wondimagegn D, Medhin G, Prince M, Stevenson EGJ. Perinatal mental distress in a rural Ethiopian community: a critical examination of psychiatric labels. BMC Psychiatry 2020; 20:223. [PMID: 32398030 PMCID: PMC7216512 DOI: 10.1186/s12888-020-02646-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 05/03/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Perinatal mental distress poses a heavy burden in low- and middle-income countries (LMICs). This study investigated perceptions and experiences of perinatal mental distress among women in a rural Ethiopian community, in an effort to advance understanding of cross-cultural experiences of perinatal mental distress. METHODS We employed a sequential explanatory study design. From a population-based cohort study of 1065 perinatal women in the Butajira Health and Demographic Surveillance Site, we purposively selected 22 women according to their scores on a culturally validated assessment of perinatal mental distress (the Self-Reporting Questionnaire). We examined concordance and discordance between qualitative semi-structured interview data ('emic' perspective) and the layperson-administered fully-structured questionnaire data ('etic' perspective) of perinatal mental distress. We analysed the questionnaire data using summary statistics and we carried out a thematic analysis of the qualitative data. RESULTS Most women in this setting recognised the existence of perinatal mental distress states, but did not typically label such distress as a discrete illness. Instead, perinatal mental distress states were mostly seen as non-pathological reactions to difficult circumstances. The dominant explanatory model of perinatal mental distress was as a response to poverty, associated with inadequate food, isolation, and hopelessness. Support from family and friends, both emotional and instrumental support, was regarded as vital in protecting against mental distress. Although some women considered their distress amenable to biomedical solution, many thought medical help-seeking was inappropriate. Integration of perspectives from the questionnaire and semi-structured interviews highlighted the important role of somatic symptoms and nutritional status. It also demonstrated the differential likelihood of endorsement of symptoms when screening tools versus in-depth interviews are used. CONCLUSIONS This study highlights the importance of the wider social context within which mental health problems are situated, specificially the inseparability of mental health from gender disadvantage, physical health and poverty. This implies that public health prevention strategies, assessments and interventions for perinatal distress should be developed from the bottom-up, taking account of local contexts and explanatory frameworks.
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Affiliation(s)
- Jil Molenaar
- School of Global Health, University of Copenhagen, Øster Farimagsgade 5, Building 9, 1353 Copenhagen, Denmark
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, WHO Collaborating Centre for Mental Health Research and Capacity Building, 6th Floor, College of Health Sciences Building, Tikur Anbessa Hospital, Addis Ababa, Ethiopia
- College of Health Sciences, Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Atalay Alem
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, WHO Collaborating Centre for Mental Health Research and Capacity Building, 6th Floor, College of Health Sciences Building, Tikur Anbessa Hospital, Addis Ababa, Ethiopia
| | - Dawit Wondimagegn
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, WHO Collaborating Centre for Mental Health Research and Capacity Building, 6th Floor, College of Health Sciences Building, Tikur Anbessa Hospital, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Addis Ababa University, Aklilu-Lemma Institute of Pathobiology, Sifra Selam, Addis Ababa, Ethiopia
| | - Martin Prince
- King’s College London, King’s Global Health Institute, Room 1.49, Franklin Wilkins Building, 127, Stamford Street, London, UK
| | - Edward G. J. Stevenson
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham, DH1 3LE UK
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Kang HK, John D, Bisht B, Kaur M, Alexis O, Worsley A. PROTOCOL: Effectiveness of interpersonal psychotherapy in comparison to other psychological and pharmacological interventions for reducing depressive symptoms in women diagnosed with postpartum depression in low and middle-income countries: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1074. [PMID: 37131982 PMCID: PMC8356357 DOI: 10.1002/cl2.1074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Postpartum Depression (PPD) is highly prevalent among women in low and middle income countries (LMICs). World Heath Organization has recognised interpersonal Psychotherapy (IPT) as the first line treatment for the postpartum depression. The primary aim of this review is to evaluate the effectiveness of IPT alone or in combination with pharmacotherapy or other psychosocial therapies for treating depressive symptoms in women with postpartum depression. The generated evidence from this review will help to inform policies in relation to the treatment of postpartum depression in LMICs.
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Affiliation(s)
| | | | - Bandana Bisht
- Chitkara University College of NursingChitkara UniversityHimachal PradeshIndia
| | - Manmeet Kaur
- Chitkara School of Health SciencesChitkara UniversityPunjabIndia
| | - Obrey Alexis
- Faculty of Health and Life SciencesOxford Brookes UniversitySwindonUK
| | - Aaron Worsley
- Faculty of Health and Life SciencesOxford Brookes UniversitySwindonUK
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Joshi MN, Raut AV. Maternal depression and its association with responsive feeding and nutritional status of infants: A cross-sectional study from a rural medical college in central India. J Postgrad Med 2019; 65:212-218. [PMID: 31204726 PMCID: PMC6813688 DOI: 10.4103/jpgm.jpgm_479_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Globally, around half of all under-5 deaths are attributable to undernutrition. The magnitude of child undernutrition in India is one of the highest in the world. Responsive feeding that has the potential to optimize nutrition and development depends on a "healthy mother". Objectives The objective of this study was to find out the magnitude and determinants of maternal depression among mothers of infants who attended immunization clinic in a rural medical college in central India and observe its association with infant-feeding practices and nutritional status of infants. Study Design This was an analytical cross-sectional study. Materials and Methods Study was conducted among consecutively chosen 300 mothers and their infants who visited the immunization clinic of hospital during May-September, 2016. Data were collected individually by interviewing each mother, and anthropometry of her infant was done. The mothers with depression were diagnosed according to the 10-item Edinburgh Postnatal Depression Scale. Magnitude of depression has been reported using frequency and percentage, whereas association has been studied using prevalence odds ratio with 95% confidence interval (CI) and logistic regression at 0.05 significance level. Results The magnitude of maternal depression was 19% (95% CI 14.4-23.5). Mothers with depression had significantly higher odds for not indulging in responsive feeding. Maternal education had significant association with maternal depression after adjusting for other variables. Conclusions Burden of maternal depression is high among mothers of infants who attended immunization clinic in a rural medical college in central India and is significantly associated with nonresponsive feeding practices.
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Affiliation(s)
- M N Joshi
- Department of Community Medicine, MGIMS, Sewagram, Wardha, Maharashtra, India
| | - A V Raut
- Department of Community Medicine, MGIMS, Sewagram, Wardha, Maharashtra, India
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Shamblaw AL, Cardy RE, Prost E, Harkness KL. Abuse as a risk factor for prenatal depressive symptoms: a meta-analysis. Arch Womens Ment Health 2019; 22:199-213. [PMID: 30196369 DOI: 10.1007/s00737-018-0900-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 08/08/2018] [Indexed: 10/28/2022]
Abstract
Depression is the most common mental disorder in pregnancy. An important risk factor in the development of prenatal depression is lifetime history of abuse. The current review quantitatively synthesized research on the association between history of abuse and prenatal depressive symptoms using a meta-analytic technique. A total of 3322 articles were identified through electronic searches of the following databases: PsycINFO, PubMed, CINAHL, and EMBASE Cochrane Collaboration databases between the years of 1980 and 2016. All were independently screened against the following inclusion criteria: articles reporting on original data that included measures of prenatal depression and abuse. Data were extracted by the first and second authors. Descriptive analyses were conducted using Excel version 15.32, and all analyses involving effect sizes were conducted using comprehensive meta-analysis (CMA) version 3.0. Seventy articles met the inclusion criteria and were included in the meta-analyses. Meta-bias detected no publication bias. Abuse had a significant positive relation with prenatal depressive symptoms, with effect sizes in the moderate range for any abuse ([Formula: see text] = 0.287), physical abuse ([Formula: see text] = 0.271), sexual abuse ([Formula: see text] = 0.259), and emotional abuse ([Formula: see text] = 0.340; Cohen 1969. Statistical power analysis for the behavioral sciences. Academic Press, New York). The meta-analyses found a robust relation between abuse and prenatal depressive symptoms holding across a variety of demographic and study design characteristics. These results reinforce the established association between trauma victimization and subsequent psychopathology, extending current knowledge to specifically address the under-studied area of prenatal depression. These findings highlight the need for women who have survived child or adulthood abuse to receive appropriate referral and psychological treatment to mitigate their risk for prenatal depression.
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Affiliation(s)
- Amanda L Shamblaw
- Department of Psychology, Queen's University, Kingston, Ontario, Canada.
| | - Robyn E Cardy
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Eric Prost
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
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The association between social support and postpartum depression in women: A cross sectional study. Women Birth 2018; 32:e238-e242. [PMID: 30274879 DOI: 10.1016/j.wombi.2018.07.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 07/19/2018] [Accepted: 07/21/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Prevalence of postpartum depression is estimated to be about 10-15% worldwide. Many risk factors are supposed to play a role leading a new mother to maternal postpartum depression which can considerably affect the baby, mother, family and also the society. OBJECTIVE To investigate the prevalence of maternal postpartum depression and its association with social support. METHODS Using a cross-sectional study, 200 new mothers who attended three teaching hospitals in Tehran, Iran were selected with a convenience sampling. Postpartum depression was assessed using the Iranian version of Edinburgh Postpartum Depression Scale and women's levels of social support were measured using the Iranian version of Social Support Questionnaire. RESULTS Prevalence of postpartum depression was 43.5% in new mothers. The mean (±Standard Deviation) score of social support network was 2.09±0.99; which is lower in depressed mothers in comparison to non-depressed mothers (1.78±0.87 vs. 2.33±1.00 respectively, P<0.001). A reverse significant association was found between social support and postpartum depression after adjusting for confounding variables such as past history of depression, illness of baby and medication consumption during pregnancy (Odds Ratio=0.47, 95% Confidence Interval=0.33-0.67). CONCLUSION The bigger the social network of a mother, the less postpartum depression occurs. It is suggested to educate the family about the very important role of social support and improve it in every aspect of health care in order to prevent postpartum depression.
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Azale T, Fekadu A, Hanlon C. Postpartum depressive symptoms in the context of high social adversity and reproductive health threats: a population-based study. Int J Ment Health Syst 2018; 12:42. [PMID: 30069229 PMCID: PMC6064119 DOI: 10.1186/s13033-018-0219-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/14/2018] [Indexed: 01/13/2023] Open
Abstract
Background Postpartum depression is an important but neglected public health issue in low- and middle-income countries. The aim of this study was to assess postpartum depressive (PPD) symptoms and associated factors in a rural Ethiopian setting characterized by high social adversity and reproductive health threats. We hypothesized that infant gender preference would be associated with PPD symptoms. Methods A cross-sectional, population-based study was conducted in Sodo district, southern Ethiopia, between March and June 2014. A total of 3147 postpartum women (one to 12 months after delivery) were recruited and interviewed in their homes. The questionnaire included demographic, reproductive health and psychosocial factors in addition to a culturally validated measure of depressive symptoms, the Patient Health Questionnaire. Scores of 5 or more were indicative of high levels of PPD symptoms. Results The prevalence of high PPD symptoms was 12.2%, with 95% confidence interval (CI) between 11.1 and 13.4. Of these, 12.0% of the study participants had suicidal ideation. Preference of the husband for a boy baby was associated with PPD symptoms in univariate analysis (crude odds ratio 1.43: 95% CI 1.04, 1.91) but became non-significant after adjusting for confounders. In the final multivariable analysis, rural residence [adjusted odds ratio (aOR) 2.56: 95% CI 2.56, 4.19], grand multiparity (aOR 2.00: 1.22, 3.26), perinatal complications (aOR: 2.55: 1.89, 3.44), a past history of abortion (aOR 1.50: 1.07, 2.11), experiencing hunger in the preceding 1 month (aOR 2.38: 1.75, 3.23), lower perceived wealth (aOR 2.11: 1.19, 3.76), poor marital relationship (aOR 2.47: 1.79, 3.42), and one or more stressful events in the preceding 6 months (aOR 2.36: 1.82, 3.06) were associated significantly with high PPD symptoms. Conclusion PPD symptoms affected more than one in 10 women in this Ethiopian community setting. Social adversity and reproductive health threats were associated with poorer mental health. Interventions focusing on poor rural women with low access to care are necessary. This research can serve as an entry point for the adaptation of a psychosocial intervention.
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Affiliation(s)
- Telake Azale
- 1Department of Health Education and Behavioral Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,5Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- 3Center for Innovative Drug Development and Therapeutic Trials for Africa, Addis Ababa University, Addis Ababa, Ethiopia.,4Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,5Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- 2Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,5Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Wemakor A, Iddrisu H. Maternal depression does not affect complementary feeding indicators or stunting status of young children (6-23 months) in Northern Ghana. BMC Res Notes 2018; 11:408. [PMID: 29941023 PMCID: PMC6019211 DOI: 10.1186/s13104-018-3528-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/20/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Maternal depression may affect child feeding practice which is an important determinant of child nutritional status. The objective of this study was to explore the association between maternal depression and WHO complementary feeding indicators [minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)] or stunting status of children (6-23 months) in Tamale Metropolis, Ghana. A community-based cross-sectional study was carried out involving 200 mother-child pairs randomly sampled from three communities in Tamale Metropolis, Ghana. RESULTS The prevalence of MDD, MMF, and MAD were 56.5, 65.0, and 44.0% respectively and 41.0% of the children sampled were stunted. A third of the mothers (33.5%) screened positive for depression. Maternal depression did not influence significantly MDD (p = 0.245), MMF (p = 0.442), and MAD (p = 0.885) or children's risk of stunting (p = 0.872). In conclusion maternal depression and child stunting are prevalent in Northern Ghana but there is a lack of evidence of an association between maternal depression and child feeding practices or nutritional status in this study population. Further research is needed to assess the effect of maternal depression on feeding practices and growth of young children.
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Affiliation(s)
- Anthony Wemakor
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, Ghana
| | - Habib Iddrisu
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, Ghana
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Azale T, Fekadu A, Medhin G, Hanlon C. Coping strategies of women with postpartum depression symptoms in rural Ethiopia: a cross-sectional community study. BMC Psychiatry 2018; 18:41. [PMID: 29422037 PMCID: PMC5806287 DOI: 10.1186/s12888-018-1624-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 01/29/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Most women with postpartum depression (PPD) in low- and middle-income countries remain undiagnosed and untreated, despite evidence for adverse effects on the woman and her child. The aim of this study was to identify the coping strategies used by women with PPD symptoms in rural Ethiopia to inform the development of socio-culturally appropriate interventions. METHODS A population-based, cross-sectional study was conducted in a predominantly rural district in southern Ethiopia. All women with live infants between one and 12 months post-partum (n = 3147) were screened for depression symptoms using the validated Patient Health Questionnaire, 9 item version (PHQ-9). Those scoring five or more, 'high PPD symptoms', (n = 385) were included in this study. The Brief Coping with Problems Experienced (COPE-28) scale was used to assess coping strategies. Construct validity of the brief COPE was evaluated using confirmatory factor analysis. RESULTS Confirmatory factor analysis of the brief COPE scale supported the previously hypothesized three dimensions of coping (problem-focused, emotion-focused, and dysfunctional). Emotion-focused coping was the most commonly employed coping strategy by women with PPD symptoms. Urban residence was associated positively with all three dimensions of coping. Women who had attended formal education and who attributed their symptoms to a physical cause were more likely to use both problem-focused and emotion-focused coping strategies. Women with better subjective wealth and those who perceived that their husband drank too much alcohol were more likely to use emotion-focused coping. Dysfunctional coping strategies were reported by women who had a poor relationship with their husbands. CONCLUSIONS As in high-income countries, women with PPD symptoms were most likely to use emotion-focused and dysfunctional coping strategies. Poverty and the low level of awareness of depression as an illness may additionally impede problem-solving attempts to cope. Prospective studies are needed to understand the prognostic significance of coping styles in this setting and to inform psychosocial intervention development.
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Affiliation(s)
- Telake Azale
- 0000 0000 8539 4635grid.59547.3aUniversity of Gondar, College of Medicine and Health Sciences, Department of Health Education and Behavioral Sciences, Gondar, Ethiopia ,Addis Ababa University, Department of Psychiatry, School of Medicine, College of Health Sciences, 9086 Addis Ababa, PO Ethiopia
| | - Abebaw Fekadu
- Addis Ababa University, Department of Psychiatry, School of Medicine, College of Health Sciences, 9086 Addis Ababa, PO Ethiopia ,0000 0001 2322 6764grid.13097.3cKing’s College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, London, UK
| | - Girmay Medhin
- 0000 0001 1250 5688grid.7123.7Addis Ababa University, Aklilu Lemma Institute of Pathobiology, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Addis Ababa University, Department of Psychiatry, School of Medicine, College of Health Sciences, 9086, Addis Ababa, PO, Ethiopia. .,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK.
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Mbawa M, Vidmar J, Chingwaru C, Chingwaru W. Understanding postpartum depression in adolescent mothers in Mashonaland Central and Bulawayo Provinces of Zimbabwe. Asian J Psychiatr 2018; 32:147-150. [PMID: 29274541 DOI: 10.1016/j.ajp.2017.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 05/20/2017] [Accepted: 11/27/2017] [Indexed: 11/17/2022]
Abstract
This study has shown evidence of significant prevalence of postpartum depression (PPD) among adolescent mothers (ADLM) (13.0%) than among adult mothers (ADM) (7.2%) (p < 0.001) in Mashonaland Central and Bulawayo provinces of Zimbabwe. The following were shown to significantly associate with PPD among ADLM: (p < 0.05): (i) abandonment by a partner, (ii) lack access to childhood needs, (iii) bad relationships within families, (iv) social insecurity, (v) prenatal depression (vi) unplanned pregnancies, (vii) lack of information about contraception, (viii) negative perception of teenage pregnancy, (ix) absence of both parents during childhood and (x) negative familial relationships during childhood [OR > 1, 95% CI; p < 0.05).
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Affiliation(s)
- Martha Mbawa
- Faculty of Science Education, Bindura University Science Education, P. Bag 1020, Bindura, Zimbabwe
| | - Jerneja Vidmar
- Institute Ceres, Zavod Ceres, Lahovna 16, 3000 Celje, Slovenia; Department of Plastic and Reconstructive Surgery, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia
| | - Constance Chingwaru
- Department of Biological Sciences, Faculty of Science, Bindura University Science Education, P. Bag 1020, Bindura, Zimbabwe
| | - Walter Chingwaru
- Institute Ceres, Zavod Ceres, Lahovna 16, 3000 Celje, Slovenia; Department of Biological Sciences, Faculty of Science, Bindura University Science Education, P. Bag 1020, Bindura, Zimbabwe.
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Orta OR, Gelaye B, Bain PA, Williams MA. The association between maternal cortisol and depression during pregnancy, a systematic review. Arch Womens Ment Health 2018; 21:43-53. [PMID: 28942465 PMCID: PMC5764810 DOI: 10.1007/s00737-017-0777-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 09/07/2017] [Indexed: 12/16/2022]
Abstract
Timing of cortisol collection during pregnancy is an important factor within studies reporting on the association between maternal cortisol and depression during pregnancy. Our objective was to further examine the extent to which reported associations differed across studies according to time of maternal cortisol collection during pregnancy. On December 15, 2016, records were identified using PubMed/MEDLINE (National Library of Medicine), EMBASE (Elsevier; 1974-), Cumulative Index to Nursing and Allied Health Literature (CINAHL, EBSCO), PsycINFO (EBSCO), and Web of Science Core Collection (Thomson Reuters). Unique abstracts were screened using the following inclusion criteria: (1) maternal cortisol assessed during pregnancy; (2) antepartum depression assessed during pregnancy using a screening instrument; (3) reports on the association between maternal cortisol and antepartum depression; (4) provides information on timing of cortisol assessment during pregnancy, including time of day and gestation; and (5) not a review article or a case study. One thousand three hundred seventy-five records were identified, resulting in 826 unique abstracts. Twenty-nine articles met all inclusion criteria. On balance, most studies reported no association between maternal cortisol and antepartum depression (N = 17), and saliva and blood were the most common reported matrices. Morning and second and third trimesters were the most common times of collection during pregnancy. Among studies reporting an association (N = 12), second-trimester and third-trimester cortisol assessments more consistently reported an association and elevated cortisol concentrations were observed in expected recovery periods. Our review adds to the existing literature on the topic, highlighting gaps and strategic next steps.
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Affiliation(s)
- Olivia R. Orta
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts,Corresponding author:
| | - Bizu Gelaye
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Paul A. Bain
- Countway Library of Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Michelle A. Williams
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
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Adefolarin A, Arulogun O. Need Assessment for Health Education Service Provision on Maternal Depression Among Primary Health Care Service Providers. ARCHIVES OF BASIC AND APPLIED MEDICINE 2018; 6:27-33. [PMID: 30258981 PMCID: PMC6152917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Maternal depression is gradually becoming a prevailing condition among women of reproductive age in Nigeria but there are little efforts towards addressing this problem. Need assessment for health education service provision on maternal depression therefore becomes necessary. Hence, this study assessed the needs of Primary Health Care (PHC) workers regarding the provision of routine health talk on maternal depression. This study was descriptive in design and it adopted a mixed method. Four Key Informant Interviews (KII) and a survey which involved 100 Health Workers (HWs) were carried out. KII participants were purposively selected from the 4 LGAs where volunteers were found and the 100 HWs were conveniently selected from all the Comprehensive Clinics (CCs) in the 5 LGAs. A KII guide and structured questionnaire were used to collect data and data were analyzed thematically, with descriptive statistics and chi-square. The mean age of the key informant's interviewees was 54±6.1years and the mean age of the survey respondents was 42±5.2 years. The interviewees identified HWs' inability to communicate maternal depression to the service users in appropriate local terms and non-availability of Information, Education and Communication (IEC) materials as barriers to giving health talk on maternal depression. Survey respondents identified certain needs with a statistical significance across cadres. Eighty-three (88.3%) identified training need, education aid materials 61.7%; p<0.05, maternal depression health education guide 27.7%; p<0.05 and need for more staff 22.3%. Training need, non-availability of maternal depression targeted educational materials and the need for more staff were the primary identified needs.
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Affiliation(s)
- A.O. Adefolarin
- Department of Health Promotion and Education, Faculty of Public Health, University of Ibadan
- Department of Psychiatry, College of Medicine, University of Ibadan. Ibadan, Nigeria
| | - O.S. Arulogun
- Department of Health Promotion and Education, Faculty of Public Health, University of Ibadan
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Flynn EP, Chung EO, Ozer EJ, Fernald LCH. Maternal Depressive Symptoms and Child Behavior among Mexican Women and Their Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121566. [PMID: 29258221 PMCID: PMC5750984 DOI: 10.3390/ijerph14121566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 01/12/2023]
Abstract
Over 50% of mothers in rural Mexico have high depressive symptoms, and their children's health and development are likely to be negatively affected. A critical question is whether children vary in their vulnerability to the effects of high maternal depressive symptoms according to their indigenous ethnicity, maternal education, or household wealth. Our sample included 4442 mothers and 5503 children from an evaluation of Mexico's social welfare program. Maternal depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) Scale, and child behavior was measured using an adapted version of the Behavior Problems Index (BPI). Multiple linear regression models were used to explore the associations between maternal depressive symptoms and child behavior problems, and the heterogeneity of associations by indigenous ethnicity, maternal education, and household assets. We found that having greater maternal depressive symptoms was significantly associated with having a child with more behavior problems (β = 0.114, p < 0.0001, [95% CI 0.101, 0.127]), in adjusted models. In tests of heterogeneity, the association between maternal depressive symptoms and child behavior problems was strongest in households with indigenous ethnicity, low maternal education, or in households with fewer assets. These results strengthen the case for effective mental health interventions in low- and middle-income countries, particularly among the most vulnerable families where mothers and children appear to be at the greatest risk.
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Affiliation(s)
- Emily P Flynn
- Country Doctor Community Health Centers and Swedish Cherry Hill Family Medicine Residency, Seattle, WA 98122, USA.
| | - Esther O Chung
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA.
| | - Emily J Ozer
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA.
| | - Lia C H Fernald
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA.
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50
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Place JMS, Allen-Leigh B, Billings DL, Dues KM, de Castro F. Detection and care practices for postpartum depressive symptoms in public-sector obstetric units in Mexico: Qualitative results from a resource-constrained setting. Birth 2017; 44:390-396. [PMID: 28833511 DOI: 10.1111/birt.12304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/03/2017] [Accepted: 07/05/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND Postpartum depression (PPD) is amenable to detection and treatment, but effectively addressing it is contingent on policies, practices, and health care providers working together to address the issue. The aim of this study is to describe a sample of health care providers' existing practices in public-sector obstetric units in Mexico related to detecting and offering care to women with depressive symptomology. METHODS Semi-structured interviews with 40 health care providers (16 physicians, 13 nurses, three social workers, and eight psychologists) from one tertiary-level and two secondary-level, public-sector obstetric units, were conducted by members of a trained research team from May to July 2012. Qualitative data were analyzed in Spanish according to Grounded Theory, using Nvivo 10 software. RESULTS Lack of hospital guidelines, training, and time constraints are reasons given for not detecting PPD symptoms among women. Providers reported that their role is cursory and limited to giving women anticipatory guidance for what to expect emotionally after childbirth or providing a trusting atmosphere for women to express their feelings. Care is fragmented and inadequate, in part because of the lack of protocols that define who makes mental health referrals and where. Providers indicated PPD is important but not prioritized in health care for pregnant and postpartum women. CONCLUSION Critical needs in obstetric units include formal mental health care detection and care protocols during the perinatal period, strategies to address mental health needs despite short hospital stays, and training for providers on how to implement detection and care protocols and strategies.
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Affiliation(s)
- Jean Marie S Place
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
| | - Betania Allen-Leigh
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Deborah L Billings
- Choose Well Initiative, Columbia, SC, USA.,Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kiya M Dues
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
| | - Filipa de Castro
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
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