Postpartum depression and child growth in Tanzania: a cohort study

Holm-Larsen, Christina Elise; Madsen, Frederikke Kjerulff; Rogathi, Jane; Manongi, Rachel; Mushi, Declare; Meyrowitsch, Dan Wolf; Gammeltoft, Tine; Sigalla, Geofrey; Rasch, Vibeke

doi:10.1111/1471-0528.15495

Cited by 20 publications

(16 citation statements)

References 15 publications

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“…Poor mental disorder. Post-partum depression was found to be associated with impaired child growth [56]. Psychological morbidity during pregnancy was not associated with age, employment status [59] nor HIV [59,64].…”

Section: Discussionmentioning

confidence: 84%

“…In relation to prevalence of common mental disorder, 15 studies reporting on common mental disorder considered for inclusion within this review did include pregnant or previously pregnant adolescents within their samples [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67]. However, 11 of these studies did not stratify outcomes of common mental disorder according to age, so prevalence rates within the adolescent group could not be identified [53-55, 57, 58, 60-63, 66, 67].…”

Section: Discussionmentioning

confidence: 99%

“…However, 11 of these studies did not stratify outcomes of common mental disorder according to age, so prevalence rates within the adolescent group could not be identified [53-55, 57, 58, 60-63, 66, 67]. Four studies did stratify common mental disorder outcomes according to adolescence, yet did not stratify by HIV status [56,59,64,65]. Within these studies, rates of common mental disorder amongst pregnant adolescents (two studies focused on pregnancy [59,64], one the postpartum period [0-36 months] [65] and, one on both pregnancy and the postpartum period [56]) ranged from 8.8% to 21.6% (total number of pregnant/previously pregnant adolescents ≥14 years included within the studies = 517) [56,59,64,65].…”

Section: Discussionmentioning

confidence: 99%

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Understanding Mental Health in the Context of Adolescent Pregnancy and HIV in Sub-Saharan Africa: A Systematic Review Identifying a Critical Evidence Gap

et al. 2021

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Adolescent (10–19 years) mental health remains an overlooked global health issue. Rates of adolescent pregnancy within sub-Saharan Africa are some of the highest in the world and occur at the epicentre of the global HIV epidemic. Both experiencing adolescent pregnancy and living with HIV have been found to be associated with adverse mental health outcomes, when investigated separately. Poor mental health may have implications for both parent and child. The literature regarding mental health within groups experiencing both HIV and adolescent pregnancy is yet to be summarised. This systematic review sought to identify (1) the prevalence/occurrence of common mental disorder amongst adolescents who are living with HIV and have experienced pregnancy, (inclusive of adolescent fathers) in sub-Saharan Africa (2) risk and protective factors for common mental disorder among this group, and (3) interventions (prevention/treatment) for common mental disorder among this group. A systematic search of electronic databases using pre-defined search terms, supplemented by hand-searching, was undertaken in September 2020. One author and an independent researcher completed a title and abstract screening of results from the search. A full-text search of all seemingly relevant manuscripts (both quantitative and qualitative) was undertaken and data extracted using pre-determined criteria. A narrative synthesis of included studies is provided. Quality and risk of bias within included studies was assessed using the Newcastle-Ottawa scale. A systematic keyword search of databases and follow-up hand searching identified 2287 unique records. Of these, thirty-eight full-text quantitative records and seven full-text qualitative records were assessed for eligibility. No qualitative records met the eligibility criteria for inclusion within the review. One quantitative record was identified for inclusion. This study reported on depressive symptomology amongst 14 pregnant adolescents living with HIV in Kenya, identifying a prevalence of 92.9%. This included study did not meet the high methodological quality of this review. No studies were identified reporting on risk and protective factors for common mental disorder, and no studies were found identifying any specific interventions for common mental disorder for this group, either for prevention or for treatment. The limited data identified within this review provides no good quality evidence relating to the prevalence of common mental disorder among adolescents living with HIV who have experienced pregnancy in sub-Saharan Africa. No data was available relating to risk and protective factors or interventions for psychological distress amongst this group. This systematic review identifies a need for rigorous evidence regarding the mental health of pregnant and parenting adolescents living with HIV, and calls for granular interrogation of existing data to further our understanding of the needs of this group. The absence of research on this topic (both quantitative and qualitative) is a critical evidence gap, limiting evidence-based policy and programming responses, as well as regional development opportunities.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Understanding Mental Health in the Context of Adolescent Pregnancy and HIV in Sub-Saharan Africa: A Systematic Review Identifying a Critical Evidence Gap

et al. 2021

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“…Depressed mothers are more likely to be irritable, hostile and disengaged when interacting with their offspring (Field, 2010;Lovejoy et al, 2000), which impairs cognitive skills of the child (Liu et al, 2017). Furthermore, maternal depression has severe effects on offspring emotional development (Liu et al, 2017;Murray et al, 1999) and it is associated with offspring growth deficits (Holm-Larsen et al, 2018;Surkan et al, 2011). Therefore, perinatal screening for depression is recommended in some countries (Accortt and Wong, 2017; Committee on Obstetric Practice, 2015; Meltzer-Brody, 2011).…”

Section: Introductionmentioning

confidence: 99%

Postnatal depressive symptoms display marked similarities across continents

Wesselhoeft

Madsen

Lichtenstein

et al. 2020

Journal of Affective Disorders

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Background Postnatal depressive symptoms measured by the Edinburgh Postnatal Depression Scale (EPDS) are reported to display measurement variance regarding factor structure and the frequency of specific depressive symptoms. However, postnatal depressive symptoms measured by EPDS have not been compared between women representing three continents. Methods A cross-sectional study including birth cohort samples from Denmark, Vietnam and Tanzania. Women were included during pregnancy at routine care sites. Depressive symptoms were selfreported 40-90 days postpartum using the EPDS. Exploratory and confirmatory factor analyses and generalized additive regression models were performed. Results A total of N=4,516 participated in the study (Denmark N=2,069, Vietnam N=1,278, Tanzania N=1,169). Factor analyses identified three factors (anhedonia, anxiety and depression) that were almost identical in the three study populations. The only variation between countries was that the item 'self-harm' loaded differently. Women from Tanzania and Denmark were more likely to have an EPDS total score above cutoff 12 (12.6% and 6.4%), compared to women from Vietnam (1.9%) (p<0.001). A low level of education was associated with significantly more depressive symptoms after adjusting for country (p<0.001). Limitations EPDS data was collected at a later time point in the Danish sample. Conclusions Postnatal depressive symptoms constitute a three-factor model across cultures including the factors anhedonia, anxiety and depression. The frequency of postnatal depressive symptoms differs between high-, medium-, and low-income countries. However, clinicians should bear in mind that low-educated women worldwide are more likely to experience postnatal depressive symptoms.

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“…Maternal FoB and DS can also affect the infant's future, potentially leading to decreased birth weight, delayed psychosocial development, reduced breastfeeding duration, hindered growth, severe malnutrition, more episodes of diarrhoea, and poor compliance with immunisation plans [23,42,43]. This might create problematic mother-newborn bonding, with subsequent attachment di culties that may affect infant growth and development, including cognitive development [44][45][46].…”

Section: Introductionmentioning

confidence: 99%

Fear of Childbirth and Depressive Symptoms Among Pregnant Women: A Cross-sectional Survey in Tanzania

Massae¹,

Svanberg²,

Larsson³

et al. 2021

Preprint

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Background: Many women experience fear of childbirth (FoB) and depressive symptoms (DS) during pregnancy, but little is known about FoB among Tanzanian women. The current study aimed to assess the prevalence of FoB and DS among pregnant women and determine predictors of each and both, focusing on sociodemographic and obstetric predictors.Methods: A cross-sectional study was conducted at six health facilities in two districts in Tanzania between 2018 and 2019. In total, 694 pregnant women with gestational age between 32 and 40 weeks and expecting vaginal delivery were consecutively recruited and assessed for FoB and DS. We collected data through interviews using the Wijma Delivery Expectancy Questionnaire Version A and Edinburgh Postnatal Depression Scale. We performed multivariable logistic regression to investigate the predictors of FoB and DS. Results: The prevalence rates of FoB and DS among pregnant women were 15.1% and 17.7%, respectively. FoB and DS were more likely in women aged above 30 years (AOR 6.29, 95% CI 1.43–27.84) and in single mothers (AOR 2.57, 95% CI 1.14–5.78). Women with secondary education and above and those who had given birth previously were less likely to have FoB (AOR 0.22, 95%CI 0.05–0.99) and DS (AOR 0.27, 95% CI 0.01–0.87). Women who had previous obstetric complications, and those who did not receive any social support from male partners in previous childbirth were more likely to have FoB and DS. FoB was strongly associated with DS (AOR 3.42, 95% CI 21.20–5.53). DS only was more common in women who had inadequate income (AOR 2.35, 95% CI 1.38–3.99) or had previously experienced a perineal tear (AOR 2.32, 95% CI 1.31–4.08).Conclusions: Not having a formal education, having only primary education, being aged above 30 years, being single, being nulliparous, having experienced obstetric complications, and having a lack of social support from a male partner during previous pregnancy and childbirth were predictors of FoB and DS during pregnancy. FoB and DS were strongly associated with each other. It is vital to identify at-risk women early, to offer support during pregnancy and childbirth.

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Postpartum depression and child growth in Tanzania: a cohort study

Cited by 20 publications

References 15 publications

Understanding Mental Health in the Context of Adolescent Pregnancy and HIV in Sub-Saharan Africa: A Systematic Review Identifying a Critical Evidence Gap

Understanding Mental Health in the Context of Adolescent Pregnancy and HIV in Sub-Saharan Africa: A Systematic Review Identifying a Critical Evidence Gap

Postnatal depressive symptoms display marked similarities across continents

Fear of Childbirth and Depressive Symptoms Among Pregnant Women: A Cross-sectional Survey in Tanzania

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