Trajectories of maternal ante- and postpartum depressive symptoms and their association with child- and mother-related characteristics in a West African birth cohort study
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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. / Barthel, Dana; Kriston, Levente; Fordjour, Daniel; Mohammed, Yasmin; Kra-Yao, Esther Doris; Bony Kotchi, Carine Esther; Koffi Armel, Ekissi Jean; Eberhardt, Kirsten Alexandra; Feldt, Torsten; Hinz, Rebecca; Mathurin, Koffi; Schoppen, Stefanie; Bindt, Carola; Ehrhardt, Stephan; International CDS Study Group.
In: PLOS ONE, Vol. 12, No. 11, 06.11.2017, p. e0187267.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Trajectories of maternal ante- and postpartum depressive symptoms and their association with child- and mother-related characteristics in a West African birth cohort study
AU - Barthel, Dana
AU - Kriston, Levente
AU - Fordjour, Daniel
AU - Mohammed, Yasmin
AU - Kra-Yao, Esther Doris
AU - Bony Kotchi, Carine Esther
AU - Koffi Armel, Ekissi Jean
AU - Eberhardt, Kirsten Alexandra
AU - Feldt, Torsten
AU - Hinz, Rebecca
AU - Mathurin, Koffi
AU - Schoppen, Stefanie
AU - Bindt, Carola
AU - Ehrhardt, Stephan
AU - International CDS Study Group
PY - 2017/11/6
Y1 - 2017/11/6
N2 - BACKGROUND: The 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.METHODS: In 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.RESULTS: We 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.CONCLUSIONS: A 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.
AB - BACKGROUND: The 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.METHODS: In 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.RESULTS: We 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.CONCLUSIONS: A 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.
KW - Child
KW - Cote d'Ivoire
KW - Depression, Postpartum
KW - Female
KW - Ghana
KW - Humans
KW - Pregnancy
KW - Surveys and Questionnaires
KW - Journal Article
U2 - 10.1371/journal.pone.0187267
DO - 10.1371/journal.pone.0187267
M3 - SCORING: Journal article
C2 - 29107975
VL - 12
SP - e0187267
JO - PLOS ONE
JF - PLOS ONE
SN - 1932-6203
IS - 11
ER -