Postnatal depressive symptoms and child psychological development at 10 years: a prospective study of longitudinal data from the South African Birth to Twenty cohort (original) (raw)
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Social Psychiatry and Psychiatric Epidemiology, 2019
Purpose Latent modelling was used to identify trajectories of depressive symptoms among low-income perinatal women in South Africa. Predictors of trajectories and the association of trajectories with child outcomes were assessed. Methods This is a secondary analysis of data collected among women living in Cape Town settlements (N = 446). Participants were eligible if pregnant and 18 years or older, and included in the analysis if allocated to the control arm (routine perinatal care). Participants were excluded in case of non-singleton birth and baby death. Follow-up assessments were at 2 weeks, 6-, 18-, and 36-month postpartum. Trajectories of depressive symptoms were based on the Edinburgh Postnatal Depression Scale scores until 18-month postpartum, using latent class growth analysis. Child physical, cognitive, socio-emotional, and behavioural outcomes were assessed at 18 and/or 36 months. Univariate and multivariate regressions were used to identify predictors of trajectories and differences in child outcomes. Results Four trajectories were identified: chronic low (71.1%), late postpartum (10.1%), early postpartum (14.4%), and chronic high (4.5%). Low social support, unwanted pregnancy, and risky drinking were associated with the chronic high trajectory; unemployment and HIV-positive status with the early postpartum trajectory; and intimate partner violence with the late postpartum trajectory. Weight-to-length and weight-forage z-scores at 18 months, and weight-forage z-scores, length-forage z-scores, emotional symptom, and peer problem scores at 36 months differed across trajectories. Conclusions Severe depressive symptoms in postpartum period have a lasting effect on child physical and socio-emotional outcomes. Multiple screening throughout pregnancy and 1-year postpartum is essential.
African Journal of Primary Health Care & Family Medicine
Background: The factors contributing to probable postnatal depression (PND), a type of clinical depression that can affect woman after childbirth, are socially derived. Therefore, variations among groups of women necessitate studies in different communities.Aim: This study compared the prevalence of PND and associated factors among women attending postnatal services facilities.Setting: The study setting included Tshwane Municipal district in Gauteng province (GP) and Fezile Dabi District (FS) in Free State province (FSP), South Africa.Methods: A total of 477 mothers within 12 weeks of giving birth were recruited by convenient sampling in health facilities. A self-developed questionnaire was used to obtain information on socio-demographics, obstetric history, and children’s characteristics. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data on depression symptoms, with a score of ≥ 13 used as a cut-off for probable PND. Data were analysed using STATA 14. Multiva...
African Journal of Primary Health Care & Family Medicine, 2020
Background The prevalence and factors that influence postnatal depression (PND) vary according to context. Aim To determine the prevalence and factors associated with PND in the postnatal clinic of a large community health centre. Setting This study was conducted at Levai Mbatha Community healthcare centre, in Evaton, South of Gauteng. Method In a cross-sectional study, the Edinburg Postnatal Depression Scale (EPDS) was administered on 227 consecutive mothers during postnatal clinic visits. In addition, sociodemographic and clinical information were collected. Analysis included descriptive statistics, chi-square test and logistic regression. A score of greater than 13 on the EPDS screened positive for PND. Results Participants’ mean age was 27 years, and most completed less than grade 12 education (52.4%), were single (55.5%), were employed or had a working partner (60%) and had no previous PND (97%). The proportion of participants screening positive was 38.8%. In the adjusted logis...
Postnatal depression--an examination of psychosocial factors
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1995
Postnatal depression (PND) has been underreported in South Africa. This retrospective study investigated factors which appear to predispose women to PND. Two groups, one consisting of women who suffered from PND and the other of women free of this complaint, provided information on a number of biological, psychological and social factors. In line with current opinion it was found that no single causative factor could be isolated but that a variety of factors may contribute to the problem. Among the factors which distinguished the two groups were the mothers' emotional health during pregnancy, complications after birth, marital relations, relationship with their own mothers, social support and preparation for motherhood. An alarming finding was that a large proportion of the PND sufferers had not known of the disorder's existence before their own diagnosis.
Journal of Consulting and Clinical Psychology, 2019
Objective: The consequences of maternal depressed mood on children's growth, health, and cognitive and language development are examined over the first 3 years of life. Method: Pregnant women in 24 periurban township neighborhoods in Cape Town, South Africa (N ϭ 1,238 mothers) were randomized by neighborhood to a home visiting intervention or a standard care condition. Reassessments were conducted for 93%-85% of mothers at 2-weeks, 6-, 18-, and 36-months postbirth. Regressions were conducted on measures of children's growth, behavior, language, and cognition to examine the impact of four patterns of depressed mood: antenatal only (n ϭ 154, 13.8%), postnatal only (n ϭ 272, 24.3%), antenatal and postnatal (n ϭ 220, 19.7%), and no depressed mood on any assessment (n ϭ 473, 42.3%). Results: Patterns of depressed mood were similar across intervention conditions. Depressed mothers were significantly less educated, had lower incomes, were less likely to be employed or to have electricity; were more likely to report problematic drinking of alcohol, experience food insecurity, interpersonal partner violence, and to be HIV seropositive. At 36 months, the pattern of maternal depressed mood over time was significantly associated with children's compromised physical growth, both in weight and height, and more internalizing and externalizing symptoms of behavior problems. Measures of language and cognition were similar across maternal patterns of depressed mood. Conclusions: Mothers who report depressed mood face significantly more life challenges, both environmental stressors related to poverty and other problematic behaviors. More proximal, postnatal depressed mood appears to have a larger influence on their children, compared with antenatal depressed mood. What is the public health significance of this article? The data from this study demonstrate that economic resources and maternal mental health problems, HIV, and problematic alcohol use are associated with patterns of maternal depression over time, as well as deficits in child growth and behavior.
Perinatal maternal depression in rural South Africa: Child outcomes over the first two years
Journal of affective disorders, 2019
Aims: To examine child outcomes over time among mothers with perinatally depressed mood in rural South Africa (SA). Methods: A representative sample of consecutive births (470/493) in the OR Tambo District of the Eastern Cape of South Africa (SA) were recruited and were reassessed at five points over the course of the next two years: 85% were reassessed at 3 months, 92% at 6 months, 88% at 9 months, 91% at 12 months, and 88% at 2 years post-birth. Over time, the children of mothers with perinatally depressed mood (16%) were compared to children of mothers without depressed mood using multiple linear and logistic regressions. Results: Mothers with perinatal depressed mood are significantly less likely to live with the child's father or their in-laws (23% vs 35%), have household incomes above 2000 ZAR (154 USD) (31% vs 51%), and significantly more likely to have experienced IPV prior (19% vs 9%) and during (32% vs 20%) pregnancy compared to mothers without depressed mood. There are no differences in age, education, primipara, HIV status (29% ser-opositive), or alcohol use. Growth and developmental delays and motor and speech milestones through 24 months post-birth are similar for mothers with and without perinatal depressed mood. Conclusions: Despite increased economic and partner difficulties associated with perinatal depressed mood, infant outcomes are similar in mothers with and without depressed mood in rural South Africa.
The lancet. Psychiatry, 2016
Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating ne...
Prevalence and social correlates of postnatal depression in a low income country
Archives of Womens Mental Health, 2006
Postnatal depression is an important public health problem worldwide. Recent evidence suggests that rates may be relatively higher in developing countries. We aimed to explore the prevalence of postnatal depression and its association with social support and other risk factors in a sample of Pakistani women. Population-based survey of 149 women at 12 weeks postnatal using the Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS) and Personal Information Questionnaire (PIQ). Thirty six percent women scored > or =12 on EPDS. High depression score was associated with lower social support, increased stressful life events in the preceding year and higher levels of psychological distress in the antenatal period. There is a high prevalence of postnatal depression in Pakistani women. Early interventions should be developed that target the antenatal period and strengthen social support networks in women at risk.