UCL Centre for International Health and Development, Institute of Child Health, University College London, UK.
J Affect Disord. 2012 May;138(3):277-86. doi: 10.1016/j.jad.2012.01.029. Epub 2012 Feb 17.
Maternal common mental disorders are prevalent in low-resource settings and have far-reaching consequences for maternal and child health. We assessed the prevalence and predictors of psychological distress as a proxy for common mental disorders among mothers in rural Jharkhand and Orissa, eastern India, where over 40% of the population live below the poverty line and access to reproductive and mental health services is low.
We screened 5801 mothers around 6 weeks after delivery using the Kessler-10 item scale, and identified predictors of distress using multiple hierarchical logistic regression.
11.5% (95% CI: 10.7-12.3) of mothers had symptoms of distress (K10 score >15). High maternal age, low asset ownership, health problems in the antepartum, delivery or postpartum periods, caesarean section, an unwanted pregnancy for the mother, small perceived infant size and a stillbirth or neonatal death were all independently associated with an increased risk of distress. The loss of an infant or an unwanted pregnancy increased the risk of distress considerably (AORs: 7.06 95% CI: 5.51-9.04 and 1.49, 95% CI: 1.12-1.97, respectively).
We did not collect data on antepartum depression, domestic violence or a mother's past birth history, and were therefore unable to examine the importance of these factors as predictors of psychological distress.
Mothers living in underserved areas of India who experience infant loss, an unwanted pregnancy, health problems in the perinatal and postpartum periods and socio-economic disadvantage are at increased risk of distress and require access to reproductive healthcare with integrated mental health interventions.
在资源匮乏的环境中，产妇常见精神障碍普遍存在，并对母婴健康产生深远影响。我们评估了印度东部贾坎德邦和奥里萨邦农村地区产妇心理困扰（常见精神障碍的代表）的流行率和预测因素，这些地区有超过 40%的人口生活在贫困线以下，获得生殖和心理健康服务的机会有限。
我们使用 Kessler-10 项量表在产后 6 周左右筛查了 5801 名母亲，并使用多阶逻辑回归分析识别了困扰的预测因素。
11.5%（95%CI：10.7-12.3）的母亲有困扰症状（K10 得分>15）。母亲年龄较大、资产拥有量低、产前、分娩或产后出现健康问题、剖宫产、母亲意外怀孕、婴儿感知大小小以及死胎或新生儿死亡均与困扰风险增加独立相关。婴儿丧失或意外怀孕显著增加了困扰的风险（OR 值：7.06，95%CI：5.51-9.04 和 1.49，95%CI：1.12-1.97）。
我们没有收集产前抑郁、家庭暴力或母亲过去分娩史的数据，因此无法检查这些因素作为心理困扰预测因素的重要性。
印度服务不足地区的母亲，如果经历婴儿丧失、意外怀孕、围产期和产后健康问题以及社会经济劣势，她们面临困扰的风险增加，需要获得生殖保健服务，同时提供综合心理健康干预。
