TY - JOUR
T1 - Depressive symptoms in mothers after perinatal and early infant loss in rural Bangladesh
T2 - a population-based study
AU - Surkan, Pamela J.
AU - Sakyi, Kwame
AU - Strobino, Donna M.
AU - Mehra, Sucheta
AU - Labrique, Alain
AU - Ali, Hasmot
AU - Ullah, Barkat
AU - Wu, Lee
AU - Klemm, Rolf
AU - Rashid, Mahbubur
AU - West, Keith P.
AU - Christian, Parul
N1 - Funding Information:
This work was supported by the National Institute of Child Health and Development at the National Institutes of Health [1 RO3 HD069731-01A1], Bethesda, MD; The Bill and Melinda Gates Foundation (GH614, Global Control of Micronutrient Deficiency, Project Officer: Ellen Piwoz), Seattle, WA; Office of Health, Infectious Diseases and Nutrition, United States Agency for International Development (Micronutrients for Health Cooperative Agreement HRN-A-00-97-00015-00 and Global Research Activity GHS-A-00-03-00019-00), Washington DC; United States Agency for International Development Mission Bangladesh, Dhaka; Ministry of Health and Family Welfare, Government of the Peoples' Republic of Bangladesh, Dhaka; and The Sight and Life Global Nutrition Research Institute, Baltimore, MD.
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/7
Y1 - 2016/7
N2 - Purpose We examined stillbirth and neonatal death as predictors of depressive symptoms in women experiencing these events during the first 6 months postpartum. Methods We performed secondary analyses using data from 41,348 married women aged 13–44 years, originally collected for the JiVitA-1 study (2001–2007) in northwest Bangladesh. Adjusted relative risk ratios were estimated to determine the associations between stillbirth and early infant death and women's risk of reported depressive symptoms (trichotomized 0, 1–2, 3–5) up to 6 months after the death. Adjusted risk ratios, comparing 0–2 versus 3–5 depressive symptoms, were used in stratified analyses. Results Women having fetal/infant deaths had elevated risk of experiencing 1–2 postpartum depressive symptoms (adj RRRs between 1.2 and 1.7) and of experiencing 3–5 postpartum depressive symptoms (adj RRRs between 1.9 and 3.3), relative to women without a fetal/infant death. Notably, those whose infants died in the early postneonatal period had over a three-fold risk of 3–5 depressive symptoms (adj relative risk ratio [RRR] = 3.3; 95% confidence interval [CI], 2.6–4.3) compared to a two-fold risk for women experiencing a stillbirth (adj RRR = 1.9; 95% CI, 1.7–2.1). After early postneonatal deaths, women with higher levels of education were more likely to suffer 3–5 depressive symptoms (adj relative risk [RR] = 10.6; 95% CI, 5.2–21.7, ≥10 years of education) compared to women with lower levels of education (adj RR = 2.0; 95% CI, 1.6–2.4, no education; adj RR = 2.2; 95% CI, 1.6–2.9, 1–9 years of education). Conclusions Women's mental health needs should be prioritized in low-resource settings, where these outcomes are relatively common and few mental health services are available.
AB - Purpose We examined stillbirth and neonatal death as predictors of depressive symptoms in women experiencing these events during the first 6 months postpartum. Methods We performed secondary analyses using data from 41,348 married women aged 13–44 years, originally collected for the JiVitA-1 study (2001–2007) in northwest Bangladesh. Adjusted relative risk ratios were estimated to determine the associations between stillbirth and early infant death and women's risk of reported depressive symptoms (trichotomized 0, 1–2, 3–5) up to 6 months after the death. Adjusted risk ratios, comparing 0–2 versus 3–5 depressive symptoms, were used in stratified analyses. Results Women having fetal/infant deaths had elevated risk of experiencing 1–2 postpartum depressive symptoms (adj RRRs between 1.2 and 1.7) and of experiencing 3–5 postpartum depressive symptoms (adj RRRs between 1.9 and 3.3), relative to women without a fetal/infant death. Notably, those whose infants died in the early postneonatal period had over a three-fold risk of 3–5 depressive symptoms (adj relative risk ratio [RRR] = 3.3; 95% confidence interval [CI], 2.6–4.3) compared to a two-fold risk for women experiencing a stillbirth (adj RRR = 1.9; 95% CI, 1.7–2.1). After early postneonatal deaths, women with higher levels of education were more likely to suffer 3–5 depressive symptoms (adj relative risk [RR] = 10.6; 95% CI, 5.2–21.7, ≥10 years of education) compared to women with lower levels of education (adj RR = 2.0; 95% CI, 1.6–2.4, no education; adj RR = 2.2; 95% CI, 1.6–2.9, 1–9 years of education). Conclusions Women's mental health needs should be prioritized in low-resource settings, where these outcomes are relatively common and few mental health services are available.
KW - Bangladesh
KW - Depressive symptoms
KW - Mental health
KW - Neonatal death
KW - Stillbirth
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U2 - 10.1016/j.annepidem.2016.06.001
DO - 10.1016/j.annepidem.2016.06.001
M3 - Article
C2 - 27449568
AN - SCOPUS:85027241752
SN - 1047-2797
VL - 26
SP - 467
EP - 473
JO - Annals of epidemiology
JF - Annals of epidemiology
IS - 7
ER -