Cohort Profile: Perinatal depression and child socioemotional development ; the Bachpan cohort study from rural Pakistan

Sikander, Siham; Ahmad, Irshad; Bates, Lisa M.; Gallis, John A.; Hagaman, Ashley; O’Donnell, Karen; Turner, Elizabeth L.; Zaidi, Ahmed; Rahman, Atıf; Maselko, Joanna

doi:10.1136/bmjopen-2018-025644

Cited by 39 publications

(33 citation statements)

References 62 publications

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“…These weights were specific to the cluster. All non-depressed women in a cluster were weighted by the inverse proportion of non-depressed women screened for depression in that cluster who were subsequently enrolled in the study [24, 26]. Since all depressed women were invited to participate in the study, all received a weight of 1.…”

Section: Methodsmentioning

confidence: 99%

Psychosocial determinants of sustained maternal functional impairment: Longitudinal findings from a pregnancy-birth cohort study in rural Pakistan

et al. 2019

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Function is an important marker of health throughout the life course, however, in low-and-middle-income-countries, little is known about the burden of functional impairment as women transition from pregnancy to the first year post-partum. Leveraging longitudinal data from 960 women participating in the Share Child Cohort in Pakistan, this study sought to (1) characterize functional trajectories over time among women in their perinatal period and (2) assess predictors of chronic poor functioning following childbirth. We used a group-based trajectory modeling approach to examine maternal patterns of function from the third trimester of pregnancy through 12 months post-partum. Three trajectory groups were found: persistently well-functioning (51% of women), poor functioning with recovery (39% of women), and chronically poor functioning (10% of women). When compared to mothers in the highest functioning group, psychosocial characteristics (e.g., depression, stress, and serious life events) were significantly associated with sustained poor functioning one-year following child-birth. Mothers living in nuclear households were more likely to experience chronic poor functioning. Higher education independently predicted maternal function recovery, even when controlling for psychosocial characteristics. Education, above and beyond socio-economic assets, appears to play an important protective role in maternal functional trajectories following childbirth. Public health implications related to maternal function and perinatal mental health are discussed.

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Section: Methodsmentioning

confidence: 99%

Psychosocial determinants of sustained maternal functional impairment: Longitudinal findings from a pregnancy-birth cohort study in rural Pakistan

et al. 2019

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“…We used the PHQ-9 so that it would be generalizable across the prenatal, postnatal, and longer-term postpartum periods given the goal of the larger study. We chose to use the SCID-IV given its cross-cultural validation and use in this study setting [24,30,31]. Thus, studies using other instruments to assess symptom severity and MDE may generate different results.…”

Section: Postpartum Practices' Differential Effectsmentioning

confidence: 99%

Maternal depression in rural Pakistan: the protective associations with cultural postpartum practices

et al. 2020

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Background: Traditional postpartum practices are intended to provide care to mothers, but there is mixed evidence concerning their impact on postpartum depression (PPD). It remains unknown if there is a unique impact of postpartum practices on PPD separately from other types of social support, or if practices differentially affect those with existing prenatal depression. In Pakistan, chilla (‫چ‬ ‫ل‬ ‫ه‬) is a traditional postpartum practice in which women receive relief from household work, additional familial support, and supplemental food for up to 40 days postpartum. This study aims to understand if chilla protects against PPD independent of other support and whether this relationship varies by prenatal depression status. Methods: Data come from the Bachpan cohort study in rural Pakistan. Chilla participation and social support (Multidimensional Scale of Perceived Social Support) were assessed at 3 months postpartum. Women were assessed for major depressive episodes (MDE) with the Structured Clinical Interview, DSM-IV and for depression symptom severity with the Patient Health Questionnaire (PHQ-9) in their third trimester and at 6 months postpartum. Adjusted linear mixed models were used to assess the relationship between chilla participation and PPD. Results: Eighty-nine percent of women (N = 786) participated in chilla and almost 70% of those that participated took part in all of chilla's aspects. In adjusted models, chilla participation was inversely related to MDE (OR = 0.56; 95%CI = 0.31,1.03) and symptom severity (Mean Difference (MD) = − 1.54;95%CI: − 2.94,-0.14). Chilla participation was associated with lower odds of MDE (OR = 0.44;95%CI = 0.20,0.97) among those not prenatally depressed and with lower symptom severity among those prenatally depressed (MD =-2.05;95%CI:-3.81,-0.49). Conclusions: Chilla is inversely associated with both MDE and symptom severity at 6 months postpartum above and beyond social support. Specifically, chilla is inversely associated with MDE among those not prenatally depressed and with lower symptom severity among those prenatally depressed. This relationship signals an opportunity for interventions aimed at preventing and treating PPD in this region to draw upon chilla and similar traditional postpartum practices in creating community-based, low-cost, sustainable interventions for maternal mental health.

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“…Maternal depression could affect household income, productivity, child development [12], and quality of life [13]. Pregnant women with depression can produce a high level of stress hormones such as cortisol that can subsequently affect fetal growth [14] and brain development [15,16]. Depression during pregnancy has been reported as a risk factor for low birth weight [17] and preterm births [18][19][20][21][22] and may also affect the child stress coping ability in later life [23].…”

Section: Introductionmentioning

confidence: 99%

Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis

2020

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Background Depression in pregnancy (antenatal depression) in many low and middle-income countries is not well documented and has not been given priority for intervention due to competing urgencies and the belief that it does not immediately cause fatalities, which mainly emanated from lack of comprehensive research on the area. To fill this research gap, this systematic review was conducted to investigate the burden of antenatal depression and its consequences on birth outcomes in low-and middle-income countries. Methods We systematically searched the databases: CINHAL, MEDLINE, EMCare, PubMed, PSyc Info, Psychiatry online, and Scopus for studies conducted in low and middle-income countries about antenatal depression and its association with adverse birth outcomes. We have included observational studies (case control, cross-sectional and cohort studies), written in English-language, scored in the range of "good quality" on the Newcastle Ottawa Scale (NOS), and were published between January 1, 2007 and December 31, 2017. Studies were excluded if a standardized approach was not used to measure main outcomes, they were conducted on restricted (high risk) populations, or had fair to poor quality score on NOS. We used Higgins and Egger's to test for heterogeneity and publication bias. Primary estimates were pooled using a random effect meta-analysis. The study protocol was registered in PROSPERO with protocol number CRD42017082624. Result We included 64 studies (with 44, 035 women) on antenatal depression and nine studies (with 5,540 women) on adverse birth outcomes. Antenatal depression was higher in the lower-income countries (Pooled Prevalence (PP) = 34.0%; 95%CI: 33.1%-34.9%) compared to the middle-income countries (PP = 22.7%, 95%CI: 20.1%-25.2%) and increased

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Cohort Profile: Perinatal depression and child socioemotional development ; the Bachpan cohort study from rural Pakistan

Cited by 39 publications

References 62 publications

Psychosocial determinants of sustained maternal functional impairment: Longitudinal findings from a pregnancy-birth cohort study in rural Pakistan

Psychosocial determinants of sustained maternal functional impairment: Longitudinal findings from a pregnancy-birth cohort study in rural Pakistan

Maternal depression in rural Pakistan: the protective associations with cultural postpartum practices

Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis

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