1. Course of perinatal depressive symptoms among South African women: associations with child outcomes at 18 and 36 months
- Author
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Garman, Emily Claire, Cois, Annibale, Tomlinson, Mark, Rotheram-Borus, Mary Jane, and Lund, Crick
- Subjects
Midwifery ,Health Sciences ,Behavioral and Social Science ,Prevention ,Pediatric ,Mental Health ,Depression ,Clinical Research ,Reproductive health and childbirth ,Mental health ,Good Health and Well Being ,Adult ,Black People ,Child Behavior ,Child ,Preschool ,Depression ,Postpartum ,Emotions ,Female ,Humans ,Infant ,Male ,Mass Screening ,Postpartum Period ,Poverty ,Pregnancy ,Pregnancy Complications ,Psychiatric Status Rating Scales ,Risk Factors ,South Africa ,Latent class growth analysis ,Trajectories ,Perinatal ,Child development ,Clinical Sciences ,Psychology ,Cognitive Sciences ,Psychiatry ,Epidemiology ,Public health ,Clinical and health psychology - Abstract
PurposeLatent 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.MethodsThis 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.ResultsFour 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-for-age z-scores at 18 months, and weight-for-age z-scores, length-for-age z-scores, emotional symptom, and peer problem scores at 36 months differed across trajectories.ConclusionsSevere 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.
- Published
- 2019