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营养、亲密伴侣暴力和社会支持在埃塞俄比亚农村孕妇产前抑郁症状中的作用:基于社区的出生队列研究。

The role of nutrition, intimate partner violence and social support in prenatal depressive symptoms in rural Ethiopia: community based birth cohort study.

机构信息

Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany.

Food Security Center, University of Hohenheim, Stuttgart, Germany.

出版信息

BMC Pregnancy Childbirth. 2018 Sep 15;18(1):374. doi: 10.1186/s12884-018-2009-5.

Abstract

BACKGROUND

Depression during pregnancy has far-reaching adverse consequences on mothers, children and the whole family. The magnitude and determinants of prenatal depressive symptoms in low-resource countries are not well established. This study aims to describe the prevalence of prenatal depressive symptoms and whether it is associated with maternal nutrition, intimate partner violence and social support among pregnant women in rural Ethiopia.

METHODS

This study is based on the baseline data from a large prospective, community-based, birth cohort study conducted in the South Western part of Ethiopia from March 2014 to March 2016. A total of 4680 pregnant women were recruited between 12 and 32 weeks of gestation. Depressed mood was assessed using the Patient Health Questionnaire (PHQ-9) scale and a cut off of ≥8 was taken to define prenatal depressive symptoms. Data collection was conducted electronically on handheld tablets and submitted to a secured server via an internet connection. Bivariate and multivariate logistic regression analyses were computed using IBM SPSS version 20 software.

RESULT

The community based prevalence of depressive symptoms during pregnancy was 10.8% (95%Confidence Interval (CI): 9.92-11.70). Adjusting for confounding variables, moderate household food insecurity (OR 1.74; 95% CI: 1.31-2.32), severe household food insecurity (OR 7.90; 95% CI: 5.87-10.62), anaemia (OR = 1.30; 95% CI: 1.04-1.61) and intimate partner violence (OR 3.08; 95% CI: 2.23-4.25) were significantly associated with prenatal depressive symptoms. On the other hand, good social support from friends, families and husband reduced the risk of prenatal depressive symptoms by 39% (OR 0.61; 95% CI: 0.50-0.76).

CONCLUSION

Prenatal depressive symptomatology is rather common during pregnancy in rural Ethiopia. In this community based study, household food insecurity, anaemia and intimate partner violence were significantly associated with prenatal depressive symptoms. Good maternal social support from friends, families and spouse was rather protective. The study highlights the need for targeted screening for depression and intimate partner violence during pregnancy. Policies aimed at reducing household food insecurity, maternal anaemia and intimate partner violence during pregnancy may possibly reduce depression.

摘要

背景

孕期抑郁对母亲、儿童和整个家庭都有深远的不良影响。资源匮乏国家产前抑郁症状的严重程度和决定因素尚未得到充分确立。本研究旨在描述农村埃塞俄比亚孕妇产前抑郁症状的流行程度,以及其是否与母亲营养、亲密伴侣暴力和社会支持有关。

方法

本研究基于 2014 年 3 月至 2016 年 3 月在埃塞俄比亚西南部进行的一项大型前瞻性、基于社区的出生队列研究的基线数据。在 12 至 32 周妊娠期间共招募了 4680 名孕妇。使用患者健康问卷(PHQ-9)量表评估抑郁情绪,将得分≥8 定义为产前抑郁症状。数据采集在手持平板电脑上进行,并通过互联网连接提交到安全的服务器。使用 IBM SPSS 版本 20 软件进行单变量和多变量逻辑回归分析。

结果

基于社区的孕期抑郁症状流行率为 10.8%(95%置信区间:9.92-11.70)。调整混杂变量后,中度家庭粮食不安全(OR 1.74;95%置信区间:1.31-2.32)、严重家庭粮食不安全(OR 7.90;95%置信区间:5.87-10.62)、贫血(OR=1.30;95%置信区间:1.04-1.61)和亲密伴侣暴力(OR 3.08;95%置信区间:2.23-4.25)与产前抑郁症状显著相关。另一方面,来自朋友、家庭和丈夫的良好社会支持将产前抑郁症状的风险降低了 39%(OR 0.61;95%置信区间:0.50-0.76)。

结论

在农村埃塞俄比亚,孕期产前抑郁症状相当普遍。在这项基于社区的研究中,家庭粮食不安全、贫血和亲密伴侣暴力与产前抑郁症状显著相关。来自朋友、家庭和配偶的良好母亲社会支持具有保护作用。该研究强调了在孕期进行抑郁和亲密伴侣暴力针对性筛查的必要性。旨在减少孕期家庭粮食不安全、孕产妇贫血和亲密伴侣暴力的政策可能会降低抑郁风险。

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