Khan Ahad Mahmud, Flora Meerjady Sabrina
Johns Hopkins University-Projahnmo, Dhaka, Bangladesh.
Institute of Epidemiology Disease Control & Research (IEDCR), Dhaka, Bangladesh.
Int J Ment Health Syst. 2017 Mar 14;11:23. doi: 10.1186/s13033-017-0129-3. eCollection 2017.
Poor maternal mental health has a negative impact on child growth and development. The objective of the study was to find out the associated factors of maternal common mental disorders (CMD) in an urban slum area of Bangladesh.
This cross-sectional study was carried out from September to November 2013 among conveniently selected 264 mothers having under-five children at Kamrangirchar area of Dhaka. A structured questionnaire based on Self-Reporting Questionnaire-20 (SRQ-20) was used for data collection where a cut-off of 7 was considered to ascertain CMD.
Majority of the mothers were housewives (89.8%), educated up to primary level (40.9%) and lived in nuclear families (83.0%) with low socioeconomic status (64.4%) and moderate household food insecurity (57.5%). The prevalence of maternal CMD was 46.2%. In bivariate analysis, the associated factors of CMD were higher maternal age ( = 0.043), lower educational qualification ( = 0.015), low socioeconomic status ( = 0.004), household food insecurity ( < 0.001), maternal undernutrition ( = 0.001), child wasting (p = 0.005) and child underweight (p < 0.001). Household food insecurity ( < 0.001) and maternal undernutrition ( = 0.004) were identified as associated factors of maternal CMD after controlling for socio-demographic variables. There were about 5 times and 12 times increased odds of having maternal CMD in moderately (adjusted OR = 4.8, 95% CI 2.0-11.7) and severely food insecure household (adjusted OR = 11.6, 95% CI 3.5-38.1), respectively, than food secure one. Underweight mothers had 2.5 times increased odds of experiencing CMD as compared with mothers who were not underweight (adjusted OR = 2.6, 95% CI 1.4-5.0).
The prevalence of maternal CMD was relatively higher than other developing countries studied so far. Household food insecurity and maternal under-nutrition were the associated factors of maternal CMD. Therefore, interventions to improve household food security and maternal nutrition can improve maternal CMD and thus make useful contributions to child growth and development.
孕产妇心理健康状况不佳会对儿童生长发育产生负面影响。本研究的目的是找出孟加拉国一个城市贫民窟地区孕产妇常见精神障碍(CMD)的相关因素。
2013年9月至11月,在达卡的坎兰吉尔查尔地区对264名有5岁以下子女的母亲进行了一项横断面研究,这些母亲是方便选取的。使用基于自填问卷-20(SRQ-20)的结构化问卷收集数据,以7分为界值来确定CMD。
大多数母亲是家庭主妇(89.8%),受教育程度为小学水平(40.9%),生活在核心家庭(83.0%),社会经济地位较低(64.4%),家庭粮食不安全状况中等(57.5%)。孕产妇CMD的患病率为46.2%。在双变量分析中,CMD的相关因素有较高的孕产妇年龄(P = 0.043)、较低的教育程度(P = 0.015)、较低的社会经济地位(P = 0.004)、家庭粮食不安全(P < 0.001)、孕产妇营养不良(P = 0.001)、儿童消瘦(P = 0.005)和儿童体重不足(P < 0.001)。在控制了社会人口学变量后,家庭粮食不安全(P < 0.001)和孕产妇营养不良(P = 0.004)被确定为孕产妇CMD的相关因素。与粮食安全家庭相比,中度粮食不安全家庭(调整后的OR = 4.8,95%CI 2.0 - 11.7)和重度粮食不安全家庭(调整后的OR = 11.6,95%CI 3.5 - 38.1)中孕产妇患CMD的几率分别增加了约5倍和12倍。体重不足的母亲患CMD的几率是体重正常母亲的2.5倍(调整后的OR = 2.6,95%CI 1.4 - 5.0)。
孕产妇CMD的患病率相对高于迄今为止研究的其他发展中国家。家庭粮食不安全和孕产妇营养不良是孕产妇CMD的相关因素。因此,改善家庭粮食安全和孕产妇营养的干预措施可以改善孕产妇CMD,从而为儿童生长发育做出有益贡献。