Longitudinal course of ante- and postpartum generalized anxiety symptoms and associated factors in West-African women from Ghana and Côte d’Ivoire

Barthel, Dana; Kriston, Levente; Barkmann, Claus; Appiah-Poku, John; Bonle, Marguerite Te; Doris, Kra Yao Esther; Esther, Bony Kotchi Carine; Armel, Koffi Ekissi Jean; Mohammed, Yasmin; Osei, Y.; Fordjour, Daniel; Owusu, Dorcas; Eberhardt, Kirsten Alexandra; Hinz, Rebecca; Koffi, Mathurin; N’Goran, Eliézer K.; Nguah, Samuel Blay; Tagbor, Harry; Schoppen, Stefanie; Ehrhardt, Stephan; Bindt, Carola

doi:10.1016/j.jad.2016.03.014

Cited by 23 publications

(15 citation statements)

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“…A substantial body of work has demonstrated that resilience is often the predominant response trajectory after exposure to stressors (Bonanno, 2004), and the present report is among the first to demonstrate its presence in the context of childbirth [see also Barthel et al (2016) and Galatzer-Levy et al (2011)]. Resilient mothers were more likely to be older than the mothers in the improving class, consistent with prior work noting that older age is a protective factor after childbirth (Rubertsson et al 2003; Buttner et al 2015).…”

Section: Discussionsupporting

confidence: 84%

Distinguishing postpartum and antepartum depressive trajectories in a large population-based cohort: the impact of exposure to adversity and offspring gender

et al. 2017

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Background Distinguishing temporal patterns of depressive symptoms during pregnancy and after childbirth has important clinical implications for diagnosis, treatment, and maternal and child outcomes. The primary aim of the present study was to distinguish patterns of chronically elevated levels of depressive symptoms v. trajectories that are either elevated during pregnancy but then remit after childbirth, v. patterns that increase after childbirth. Methods The report uses latent growth mixture modeling in a large, population-based cohort (N = 12 121) to investigate temporal patterns of depressive symptoms. We examined theoretically relevant sociodemographic factors, exposure to adversity, and offspring gender as predictors. Results Four distinct trajectories emerged, including resilient (74.3%), improving (9.2%), emergent (4.0%), and chronic (11.5%). Lower maternal and paternal education distinguished chronic from resilient depressive trajectories, whereas higher maternal and partner education, and female offspring gender, distinguished the emergent trajectory from the chronic trajectory. Younger maternal age distinguished the improving group from the resilient group. Exposure to medical, interpersonal, financial, and housing adversity predicted membership in the chronic, emergent, and improving trajectories compared with the resilient trajectory. Finally, exposure to medical, interpersonal, and financial adversity was associated with the chronic v. improving group, and inversely related to the emergent class relative to the improving group. Conclusions There are distinct temporal patterns of depressive symptoms during pregnancy, after childbirth, and beyond. Most women show stable low levels of depressive symptoms, while emergent and chronic depression patterns are separable with distinct correlates, most notably maternal age, education levels, adversity exposure, and child gender.

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Section: Discussionsupporting

confidence: 84%

Distinguishing postpartum and antepartum depressive trajectories in a large population-based cohort: the impact of exposure to adversity and offspring gender

et al. 2017

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“…We contrasted the results with findings on the longitudinal trajectories of anxiety symptoms in the same sample of West African women [ 38 ]. In this prior study, we employed GMM as well and identified four classes of anxiety symptom trajectories, namely stable low, increasing, decreasing, and transient anxiety symptoms [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…Maternal age, the number of children from relatives or acquaintances living in the same household, and the socioeconomic status (SES) were also assessed at recruitment. We described the SES index in detail elsewhere [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

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Trajectories of maternal ante- and postpartum depressive symptoms and their association with child- and mother-related characteristics in a West African birth cohort study

et al. 2017

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BackgroundThe vast majority of research on mental health has been undertaken in high income countries. This study aimed at investigating the long-term course of maternal depressive symptoms and its association with various mother- and child-related characteristics in two West African lower middle income countries with focus on the relationship with long-term anxiety symptoms.MethodsIn the Child Development Study, a prospective birth cohort study in Côte d’Ivoire and Ghana, the 9-item Patient Health Questionnaire (PHQ-9) was answered by N = 776 women 3 months antepartum, and 3, 12, and 24 months postpartum between April 2010 and March 2014. Growth mixture modeling was used to identify distinct trajectories of depressive symptoms. Several psychosocial, obstetric, and sociodemographic characteristics were assessed and multinomial regression analysis was performed to investigate the influence of these variables on the different depression trajectories.ResultsWe found three distinct classes of depressive symptoms that were characterized by an asymptomatic trajectory (91.5%), by recurrent risk (4.3%) and by postnatal risk (4.3%). The longitudinal course of depressive symptoms was strongly associated with anxiety symptoms (χ2 = 258.54, df = 6, p < 0.001; φ = .577). Among other factors, higher levels of anxiety, new pregnancy 2 years after birth, economic stress, and family stress were associated with the risk classes.ConclusionsA substantial proportion of West African women in our sample developed unfavorable patterns of depressive symptoms during the vulnerable phase of pregnancy and early motherhood. Psychosocial factors, especially antepartum anxiety symptoms, played a decisive role in this process. Perceived economic hardship further exaggerated the mental health burden.

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“…Also these results are supported by Fereshteh Jahdi etal [8] who reported that the average anxiety score in the two groups before exorcise was moderate. Unlike these results, Barthel D et al, in his study about ante-and postpartum generalized anxiety symptoms and associated factors, revealed that 11.4% had elevated anxiety scores before and around childbirth that decreased gradually without any intervention [27], [28].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Slow-Stroke Back Message on Anxiety Level of Low Risk Parturient Mothers in the Fourth Stage of Labor

Elkheshen

Ahmed

Abdelgawad

2017

IJND

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Aim of the study: To assess the impact of slow-stroke back message on anxiety level of low risk parturient mothers in the fourth stage of labor. Subjects and methods: Design: quasi-experimental design. Setting: obstetric department at Al Galaa maternity hospital. Sample: 44 low risk parturient mothers per group (study and control) fulfilling the inclusion and exclusion criteria were included in the study. Tools used: sociodemographic questionnaire, State trait anxiety inventory questionnaire, slow stroke back message. Results: About half of the experimental and control groups women`s age was between 25-30 years of age. For the experimental group about 36.4 % of the mothers had a basic education, and 70 % were housewives. The results also revealed that there was decrease in the anxiety scores throughout the study time starting from immediately at the beginning of fourth stage of labor till discharge from hospital in the study group unlike the control group whose results revealed that most women remain in the same level of anxiety (mild to moderate) 52.3% and 59% immediately after labor and before discharge respectively. Conclusion and recommendation: The findings of our study showed that slow-stroke back massage in the first few hours after birth (6-12 hrs.) reduced the mother's anxiety level, so it is recommended to use massage in the early hours after labor to help the mother to reduce their anxiety.

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Longitudinal course of ante- and postpartum generalized anxiety symptoms and associated factors in West-African women from Ghana and Côte d’Ivoire

Cited by 23 publications

References 58 publications

Distinguishing postpartum and antepartum depressive trajectories in a large population-based cohort: the impact of exposure to adversity and offspring gender

Distinguishing postpartum and antepartum depressive trajectories in a large population-based cohort: the impact of exposure to adversity and offspring gender

Trajectories of maternal ante- and postpartum depressive symptoms and their association with child- and mother-related characteristics in a West African birth cohort study

The Impact of Slow-Stroke Back Message on Anxiety Level of Low Risk Parturient Mothers in the Fourth Stage of Labor

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