Perinatal mental distress and infant morbidity in Ethiopia: a cohort study


Ross, J; Hanlon, C; Medhin, G; Alem, A; Tesfaye, F; Worku, B; Dewey, M; Patel, V; Prince, M; (2011) Perinatal mental distress and infant morbidity in Ethiopia: a cohort study. Archives of disease in childhood Fetal and neonatal edition, 96 (1). F59-F64. ISSN 1359-2998 DOI: https://doi.org/10.1136/adc.2010.183327

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Abstract

Objectives (1) To investigate the impact of perinatal common mental disorders (CMD) in Ethiopia on the risk of key illnesses of early infancy: diarrhoea, fever and acute respiratory illnesses (ARI) and (2) to explore the potential mediating role of maternal health behaviours. Design Population-based cohort study. Setting Demographic surveillance site in a predominantly rural area of Ethiopia. Participants 1065 women (86.3% of eligible) in the third trimester of pregnancy were recruited and 954 (98.6%) of surviving, singleton mother-infant pairs were followed up until 2 months after birth. Main exposure measure High levels of CMD symptoms, as measured by the locally validated Self-Reporting Questionnaire (SRQ-20 >= 6 in pregnancy only, postnatally only and at both time-points ('persistent'). Main outcome measures Maternal report of infant illness episodes in first 2 months of life. Results The percentages of infants reported to have experienced diarrhoea, ARI and fever were 26.0%, 25.0% and 35.1%, respectively. Persistent perinatal CMD symptoms were associated with 2.15 times (95% CI 1.39 to 3.34) increased risk of infant diarrhoea in a fully adjusted model. The strength of association was not affected by including potential mediators: breast feeding practices, hygiene, the infant's vaccination status or impaired maternal functioning. Persistent perinatal CMD was not associated with infant ARI or fever after adjusting for confounders. Conclusions Persistent perinatal CMD was associated with infant diarrhoea in this low-income country setting. The observed relationship was independent of maternal health-promoting practices. Future research should further explore the mechanisms underlying the observed association to inform intervention strategies.

Item Type: Article
Keywords: AFRICAN PERIURBAN SETTLEMENT, LOW-BIRTH-WEIGHT, MATERNAL DEPRESSION, POSTNATAL-DEPRESSION, POSTPARTUM DEPRESSION, DEVELOPING-COUNTRIES, RISK-FACTORS, YOUNG-CHILDREN, HEALTH-CARE, DIARRHEA, Adolescent, Adult, Child of Impaired Parents, statistics & numerical data, Cohort Studies, Confounding Factors (Epidemiology), Developing Countries, Diarrhea, Infantile, epidemiology, etiology, Ethiopia, epidemiology, Female, Fever, epidemiology, etiology, Health Behavior, Humans, Infant, Newborn, Mental Disorders, epidemiology, psychology, Middle Aged, Mothers, psychology, Pregnancy, Pregnancy Complications, epidemiology, psychology, Respiratory Tract Diseases, epidemiology, etiology, Risk Factors, Rural Health, statistics & numerical data, Young Adult
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Global Mental Health
Centre for Maternal, Reproductive and Child Health (MARCH)
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 20667895
Web of Science ID: 286167900012
URI: http://researchonline.lshtm.ac.uk/id/eprint/1295

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