Mental health related determinants of parenting stress among urban mothers of young children - results from a birth-cohort study in Ghana and Côte d'Ivoire

Nan Guo, Carola Bindt, Marguerite Te Bonle, John Appiah-Poku, Cecilia Tomori, Rebecca Hinz, Dana Barthel, Stefanie Schoppen, Torsten Feldt, Claus Barkmann, Mathurin Koffi, Wibke Loag, Samuel B. Nguah, Kirsten A. Eberhardt, Harry Tagbor, Judith Bass, Eliezer N'Goran, Stephan Ehrhardt, Jana Baum, Gerd D. BurchardLisa Claussen, Simon Deymann, Heike Ewert, Daniel Fordjour, Andreas Hahn, Anna Jaeger, Jean E. Koffi, Esther Kra, Jürgen May, Yasmin Mohammed, Yaw Osei, Sarah Posdzich, Birgit Reime, Lisa Schlüter, Egbert Tannich

Research output: Contribution to journalArticle

Abstract

Background: There are limited data on the parenting stress (PS) levels in sub-Saharan African mothers and on the association between ante- and postnatal depression and anxiety on PS.Methods: A longitudinal birth cohort of 577 women from Ghana and Côte d'Ivoire was followed from the 3rd trimester in pregnancy to 2 years postpartum between 2010 and 2013. Depression and anxiety were assessed by the Patient Health Questionnaire depression module (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) at baseline, 3 month, 12 month and 24 month postpartum. PS was measured using the Parenting Stress Index-Short Form (PSI-SF) at 3, 12 and 24 month. The mean total PS score and the subscale scores were compared among depressed vs. non-depressed and among anxious vs. non-anxious mothers at 3, 12 and 24 month postpartum. The proportions of clinical PS (PSI-SF raw score > 90) in depressed vs. non-depressed and anxious vs. non-anxious mothers were also compared. A generalized estimating equation (GEE) approach was used to estimate population-averaged associations between women's depression/anxiety and PS adjusting for age, child sex, women's anemia, education, occupation, spouse's education, and number of sick child visits.Results: A total of 577, 531 and 264 women completed the PS assessment at 3 month, 12 month and 24 month postpartum across the two sites and the prevalences of clinical PS at each time point was 33.1%, 24.4% and 14.9% in Ghana and 30.2%, 33.5% and 22.6% in Côte d'Ivoire, respectively. At all three time points, the PS scores were significantly higher among depressed mothers vs. non-depressed mothers. In the multivariate regression analyses, antepartum and postpartum depression were consistently associated with PS after adjusting for other variables.Conclusions: Parenting stress is frequent and levels are high compared with previous studies from high-income countries. Antepartum and postpartum depression were both associated with PS, while antepartum and postpartum anxiety were not after adjusting for confounders. More quantitative and qualitative data are needed in sub-Saharan African populations to assess the burden of PS and understand associated mechanisms. Should our findings be replicated, it appears prudent to design and subsequently evaluate intervention strategies.

Original languageEnglish (US)
Article number156
JournalBMC Psychiatry
Volume14
Issue number1
DOIs
StatePublished - May 29 2014

Fingerprint

Ghana
Parenting
Mental Health
Cohort Studies
Mothers
Parturition
Postpartum Period
Postpartum Depression
Anxiety
Depression
Pregnancy Trimesters
Education
Anxiety Disorders
Spouses
Occupations

Keywords

  • Africa
  • Antepartum
  • Children
  • Depression
  • Generalized estimating equation
  • Mothers
  • Parenting stress
  • Perinatal
  • Post-partum
  • Pregnancy

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Medicine(all)

Cite this

Mental health related determinants of parenting stress among urban mothers of young children - results from a birth-cohort study in Ghana and Côte d'Ivoire. / Guo, Nan; Bindt, Carola; Te Bonle, Marguerite; Appiah-Poku, John; Tomori, Cecilia; Hinz, Rebecca; Barthel, Dana; Schoppen, Stefanie; Feldt, Torsten; Barkmann, Claus; Koffi, Mathurin; Loag, Wibke; Nguah, Samuel B.; Eberhardt, Kirsten A.; Tagbor, Harry; Bass, Judith; N'Goran, Eliezer; Ehrhardt, Stephan; Baum, Jana; Burchard, Gerd D.; Claussen, Lisa; Deymann, Simon; Ewert, Heike; Fordjour, Daniel; Hahn, Andreas; Jaeger, Anna; Koffi, Jean E.; Kra, Esther; May, Jürgen; Mohammed, Yasmin; Osei, Yaw; Posdzich, Sarah; Reime, Birgit; Schlüter, Lisa; Tannich, Egbert.

In: BMC Psychiatry, Vol. 14, No. 1, 156, 29.05.2014.

Research output: Contribution to journalArticle

Guo, N, Bindt, C, Te Bonle, M, Appiah-Poku, J, Tomori, C, Hinz, R, Barthel, D, Schoppen, S, Feldt, T, Barkmann, C, Koffi, M, Loag, W, Nguah, SB, Eberhardt, KA, Tagbor, H, Bass, J, N'Goran, E, Ehrhardt, S, Baum, J, Burchard, GD, Claussen, L, Deymann, S, Ewert, H, Fordjour, D, Hahn, A, Jaeger, A, Koffi, JE, Kra, E, May, J, Mohammed, Y, Osei, Y, Posdzich, S, Reime, B, Schlüter, L & Tannich, E 2014, 'Mental health related determinants of parenting stress among urban mothers of young children - results from a birth-cohort study in Ghana and Côte d'Ivoire', BMC Psychiatry, vol. 14, no. 1, 156. https://doi.org/10.1186/1471-244X-14-156
Guo, Nan ; Bindt, Carola ; Te Bonle, Marguerite ; Appiah-Poku, John ; Tomori, Cecilia ; Hinz, Rebecca ; Barthel, Dana ; Schoppen, Stefanie ; Feldt, Torsten ; Barkmann, Claus ; Koffi, Mathurin ; Loag, Wibke ; Nguah, Samuel B. ; Eberhardt, Kirsten A. ; Tagbor, Harry ; Bass, Judith ; N'Goran, Eliezer ; Ehrhardt, Stephan ; Baum, Jana ; Burchard, Gerd D. ; Claussen, Lisa ; Deymann, Simon ; Ewert, Heike ; Fordjour, Daniel ; Hahn, Andreas ; Jaeger, Anna ; Koffi, Jean E. ; Kra, Esther ; May, Jürgen ; Mohammed, Yasmin ; Osei, Yaw ; Posdzich, Sarah ; Reime, Birgit ; Schlüter, Lisa ; Tannich, Egbert. / Mental health related determinants of parenting stress among urban mothers of young children - results from a birth-cohort study in Ghana and Côte d'Ivoire. In: BMC Psychiatry. 2014 ; Vol. 14, No. 1.
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abstract = "Background: There are limited data on the parenting stress (PS) levels in sub-Saharan African mothers and on the association between ante- and postnatal depression and anxiety on PS.Methods: A longitudinal birth cohort of 577 women from Ghana and C{\^o}te d'Ivoire was followed from the 3rd trimester in pregnancy to 2 years postpartum between 2010 and 2013. Depression and anxiety were assessed by the Patient Health Questionnaire depression module (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) at baseline, 3 month, 12 month and 24 month postpartum. PS was measured using the Parenting Stress Index-Short Form (PSI-SF) at 3, 12 and 24 month. The mean total PS score and the subscale scores were compared among depressed vs. non-depressed and among anxious vs. non-anxious mothers at 3, 12 and 24 month postpartum. The proportions of clinical PS (PSI-SF raw score > 90) in depressed vs. non-depressed and anxious vs. non-anxious mothers were also compared. A generalized estimating equation (GEE) approach was used to estimate population-averaged associations between women's depression/anxiety and PS adjusting for age, child sex, women's anemia, education, occupation, spouse's education, and number of sick child visits.Results: A total of 577, 531 and 264 women completed the PS assessment at 3 month, 12 month and 24 month postpartum across the two sites and the prevalences of clinical PS at each time point was 33.1{\%}, 24.4{\%} and 14.9{\%} in Ghana and 30.2{\%}, 33.5{\%} and 22.6{\%} in C{\^o}te d'Ivoire, respectively. At all three time points, the PS scores were significantly higher among depressed mothers vs. non-depressed mothers. In the multivariate regression analyses, antepartum and postpartum depression were consistently associated with PS after adjusting for other variables.Conclusions: Parenting stress is frequent and levels are high compared with previous studies from high-income countries. Antepartum and postpartum depression were both associated with PS, while antepartum and postpartum anxiety were not after adjusting for confounders. More quantitative and qualitative data are needed in sub-Saharan African populations to assess the burden of PS and understand associated mechanisms. Should our findings be replicated, it appears prudent to design and subsequently evaluate intervention strategies.",
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author = "Nan Guo and Carola Bindt and {Te Bonle}, Marguerite and John Appiah-Poku and Cecilia Tomori and Rebecca Hinz and Dana Barthel and Stefanie Schoppen and Torsten Feldt and Claus Barkmann and Mathurin Koffi and Wibke Loag and Nguah, {Samuel B.} and Eberhardt, {Kirsten A.} and Harry Tagbor and Judith Bass and Eliezer N'Goran and Stephan Ehrhardt and Jana Baum and Burchard, {Gerd D.} and Lisa Claussen and Simon Deymann and Heike Ewert and Daniel Fordjour and Andreas Hahn and Anna Jaeger and Koffi, {Jean E.} and Esther Kra and J{\"u}rgen May and Yasmin Mohammed and Yaw Osei and Sarah Posdzich and Birgit Reime and Lisa Schl{\"u}ter and Egbert Tannich",
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TY - JOUR

T1 - Mental health related determinants of parenting stress among urban mothers of young children - results from a birth-cohort study in Ghana and Côte d'Ivoire

AU - Guo, Nan

AU - Bindt, Carola

AU - Te Bonle, Marguerite

AU - Appiah-Poku, John

AU - Tomori, Cecilia

AU - Hinz, Rebecca

AU - Barthel, Dana

AU - Schoppen, Stefanie

AU - Feldt, Torsten

AU - Barkmann, Claus

AU - Koffi, Mathurin

AU - Loag, Wibke

AU - Nguah, Samuel B.

AU - Eberhardt, Kirsten A.

AU - Tagbor, Harry

AU - Bass, Judith

AU - N'Goran, Eliezer

AU - Ehrhardt, Stephan

AU - Baum, Jana

AU - Burchard, Gerd D.

AU - Claussen, Lisa

AU - Deymann, Simon

AU - Ewert, Heike

AU - Fordjour, Daniel

AU - Hahn, Andreas

AU - Jaeger, Anna

AU - Koffi, Jean E.

AU - Kra, Esther

AU - May, Jürgen

AU - Mohammed, Yasmin

AU - Osei, Yaw

AU - Posdzich, Sarah

AU - Reime, Birgit

AU - Schlüter, Lisa

AU - Tannich, Egbert

PY - 2014/5/29

Y1 - 2014/5/29

N2 - Background: There are limited data on the parenting stress (PS) levels in sub-Saharan African mothers and on the association between ante- and postnatal depression and anxiety on PS.Methods: A longitudinal birth cohort of 577 women from Ghana and Côte d'Ivoire was followed from the 3rd trimester in pregnancy to 2 years postpartum between 2010 and 2013. Depression and anxiety were assessed by the Patient Health Questionnaire depression module (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) at baseline, 3 month, 12 month and 24 month postpartum. PS was measured using the Parenting Stress Index-Short Form (PSI-SF) at 3, 12 and 24 month. The mean total PS score and the subscale scores were compared among depressed vs. non-depressed and among anxious vs. non-anxious mothers at 3, 12 and 24 month postpartum. The proportions of clinical PS (PSI-SF raw score > 90) in depressed vs. non-depressed and anxious vs. non-anxious mothers were also compared. A generalized estimating equation (GEE) approach was used to estimate population-averaged associations between women's depression/anxiety and PS adjusting for age, child sex, women's anemia, education, occupation, spouse's education, and number of sick child visits.Results: A total of 577, 531 and 264 women completed the PS assessment at 3 month, 12 month and 24 month postpartum across the two sites and the prevalences of clinical PS at each time point was 33.1%, 24.4% and 14.9% in Ghana and 30.2%, 33.5% and 22.6% in Côte d'Ivoire, respectively. At all three time points, the PS scores were significantly higher among depressed mothers vs. non-depressed mothers. In the multivariate regression analyses, antepartum and postpartum depression were consistently associated with PS after adjusting for other variables.Conclusions: Parenting stress is frequent and levels are high compared with previous studies from high-income countries. Antepartum and postpartum depression were both associated with PS, while antepartum and postpartum anxiety were not after adjusting for confounders. More quantitative and qualitative data are needed in sub-Saharan African populations to assess the burden of PS and understand associated mechanisms. Should our findings be replicated, it appears prudent to design and subsequently evaluate intervention strategies.

AB - Background: There are limited data on the parenting stress (PS) levels in sub-Saharan African mothers and on the association between ante- and postnatal depression and anxiety on PS.Methods: A longitudinal birth cohort of 577 women from Ghana and Côte d'Ivoire was followed from the 3rd trimester in pregnancy to 2 years postpartum between 2010 and 2013. Depression and anxiety were assessed by the Patient Health Questionnaire depression module (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) at baseline, 3 month, 12 month and 24 month postpartum. PS was measured using the Parenting Stress Index-Short Form (PSI-SF) at 3, 12 and 24 month. The mean total PS score and the subscale scores were compared among depressed vs. non-depressed and among anxious vs. non-anxious mothers at 3, 12 and 24 month postpartum. The proportions of clinical PS (PSI-SF raw score > 90) in depressed vs. non-depressed and anxious vs. non-anxious mothers were also compared. A generalized estimating equation (GEE) approach was used to estimate population-averaged associations between women's depression/anxiety and PS adjusting for age, child sex, women's anemia, education, occupation, spouse's education, and number of sick child visits.Results: A total of 577, 531 and 264 women completed the PS assessment at 3 month, 12 month and 24 month postpartum across the two sites and the prevalences of clinical PS at each time point was 33.1%, 24.4% and 14.9% in Ghana and 30.2%, 33.5% and 22.6% in Côte d'Ivoire, respectively. At all three time points, the PS scores were significantly higher among depressed mothers vs. non-depressed mothers. In the multivariate regression analyses, antepartum and postpartum depression were consistently associated with PS after adjusting for other variables.Conclusions: Parenting stress is frequent and levels are high compared with previous studies from high-income countries. Antepartum and postpartum depression were both associated with PS, while antepartum and postpartum anxiety were not after adjusting for confounders. More quantitative and qualitative data are needed in sub-Saharan African populations to assess the burden of PS and understand associated mechanisms. Should our findings be replicated, it appears prudent to design and subsequently evaluate intervention strategies.

KW - Africa

KW - Antepartum

KW - Children

KW - Depression

KW - Generalized estimating equation

KW - Mothers

KW - Parenting stress

KW - Perinatal

KW - Post-partum

KW - Pregnancy

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U2 - 10.1186/1471-244X-14-156

DO - 10.1186/1471-244X-14-156

M3 - Article

C2 - 24884986

AN - SCOPUS:84902120777

VL - 14

JO - BMC Psychiatry

JF - BMC Psychiatry

SN - 1471-244X

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