Institute of Nutrition Science (140a), University of Hohenheim, Stuttgart, Germany.
Food Security Center, University of Hohenheim, Stuttgart, Germany.
Int Breastfeed J. 2021 Mar 20;16(1):27. doi: 10.1186/s13006-021-00375-3.
Maternal depression and other psychosocial factors have been shown to have adverse consequences on infant feeding practices. This study explored the longitudinal relationship of maternal depressive symptoms and other selected psychosocial factors with infant feeding practices (IFPs) in rural Ethiopia using summary IFP index.
This study uses existing data from the ENGINE birth cohort study, conducted from March 2014 to March 2016 in three districts in the southwest of Ethiopia. A total of 4680 pregnant women were recruited and data were collected once during pregnancy (twice for those in the first trimester), at birth, and then every 3 months until the child was 12 months old. A standardized questionnaire was used to collect data on IFPs, maternal depressive symptoms, household food insecurity, intimate partner violence (IPV), maternal social support, active social participation, and other sociodemographic variables. A composite measure of IFP index was computed using 14 WHO recommended infant and young child feeding (IYCF) practice indicators. High IFP index indicated best practice. Prenatal and postnatal maternal depressive symptoms were assessed using the patient health questionnaire (PHQ-9). Linear multilevel mixed effects model was fitted to assess longitudinal relationship of IFPs with maternal depression and other psychosocial factors.
Reports of higher postnatal depressive symptoms (ß = - 1.03, P = 0.001) and IPV (ß = - 0.21, P = 0.001) were associated with lower scores on the IFP index. Whereas, reports of better maternal social support (ß = 0.11, P = 0.002) and active social participation (ß = 0.55, P < 0.001) were associated with higher scores on the IFP index. Contrary to expectations, moderate household food insecurity (ß = 0.84, P = 0.003), severe household food insecurity (ß = 1.03, P = 0.01) and infant morbidity episodes (ß = 0.63, P = 0.013) were associated with higher scores on the IFP index.
Overall, a multitude of factors are related to IFPs and hence coordinated, multi-sectoral and multi-stakeholder interventions including maternal depressive symptoms screening and management are needed to improve infant feeding practices.
已证实，产妇抑郁和其他社会心理因素对婴儿喂养方式有不良影响。本研究使用婴儿喂养综合指数，探索了埃塞俄比亚农村地区产妇抑郁症状和其他选定社会心理因素与婴儿喂养方式（IFP）的纵向关系。
本研究使用 ENGINE 出生队列研究的现有数据，该研究于 2014 年 3 月至 2016 年 3 月在埃塞俄比亚西南部的三个地区进行。共招募了 4680 名孕妇，在怀孕期间（第一孕期两次）、分娩时以及之后每 3 个月收集一次数据，直到孩子 12 个月大。使用标准化问卷收集 IFP、产妇抑郁症状、家庭粮食不安全、亲密伴侣暴力（IPV）、产妇社会支持、积极的社会参与和其他社会人口学变量的数据。使用 14 项世界卫生组织推荐的婴儿和幼儿喂养（IYCF）实践指标计算 IFP 指数综合衡量标准。高 IFP 指数表示最佳实践。使用患者健康问卷（PHQ-9）评估产前和产后产妇抑郁症状。使用线性多层混合效应模型评估 IFP 与产妇抑郁和其他社会心理因素的纵向关系。
报告产后抑郁症状较高（ß=-1.03，P=0.001）和 IPV（ß=-0.21，P=0.001）与 IFP 指数得分较低有关。而报告的更好的产妇社会支持（ß=0.11，P=0.002）和积极的社会参与（ß=0.55，P<0.001）与 IFP 指数得分较高有关。与预期相反，中度家庭粮食不安全（ß=0.84，P=0.003）、严重家庭粮食不安全（ß=1.03，P=0.01）和婴儿发病次数（ß=0.63，P=0.013）与 IFP 指数得分较高有关。
总体而言，多种因素与 IFP 相关，因此需要协调、多部门和多利益攸关方的干预措施，包括产妇抑郁症状筛查和管理，以改善婴儿喂养方式。
