Eastwood John G, Jalaludin Bin B, Kemp Lynn A, Phung Hai N, Barnett Bryanne E W
South Western Sydney Local Health District, Locked Mail Bag 7008, Liverpool BC, NSW 1871, Australia.
Spat Spatiotemporal Epidemiol. 2013 Sep;6:49-58. doi: 10.1016/j.sste.2013.04.003. Epub 2013 Apr 25.
The purpose is to explore the multilevel spatial distribution of depressive symptoms among migrant mothers in South Western Sydney and to identify any group level associations that could inform subsequent theory building and local public health interventions. Migrant mothers (n=7256) delivering in 2002 and 2003 were assessed at 2-3 weeks after delivery for risk factors for depressive symptoms. The binary outcome variables were Edinburgh Postnatal Depression Scale scores (EPDS) of >9 and >12. Individual level variables included were: financial income, self-reported maternal health, social support network, emotional support, practical support, baby trouble sleeping, baby demanding and baby not content. The group level variable reported here is aggregated social support networks. We used Bayesian hierarchical multilevel spatial modelling with conditional autoregression. Migrant mothers were at higher risk of having depressive symptoms if they lived in a community with predominantly Australian-born mothers and strong social capital as measured by aggregated social networks. These findings suggest that migrant mothers are socially isolated and current home visiting services should be strengthened for migrant mothers living in communities where they may have poor social networks.
目的是探究悉尼西南部移民母亲抑郁症状的多层次空间分布，并确定任何可能为后续理论构建和当地公共卫生干预提供信息的群体层面关联。对2002年和2003年分娩的移民母亲（n = 7256）在分娩后2至3周进行抑郁症状风险因素评估。二元结局变量为爱丁堡产后抑郁量表（EPDS）得分>9分和>12分。纳入的个体层面变量包括：经济收入、自我报告的母亲健康状况、社会支持网络、情感支持、实际支持、婴儿睡眠问题、婴儿需求高和婴儿不满足。此处报告的群体层面变量是汇总的社会支持网络。我们使用了带有条件自回归的贝叶斯分层多水平空间模型。如果移民母亲居住在以澳大利亚出生的母亲为主且社会资本雄厚（通过汇总社会网络衡量）的社区，她们出现抑郁症状的风险更高。这些发现表明移民母亲在社会上处于孤立状态，对于生活在社交网络可能较差社区的移民母亲，当前的家访服务应予以加强。
