Liverpool School of Tropical Medicine, Liverpool, UK.
King's Mill Hospital, Sutton-in-Ashfield, UK.
Womens Health (Lond). 2023 Jan-Dec;19:17455057231189547. doi: 10.1177/17455057231189547.
Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality.
To explore how PND influences neonatal feeding and care practices among women in the early postnatal period in rural Western Kenya.
A cross-sectional study.
Semi-structured interviews were conducted at 2-weeks postpartum among mothers of newborn infants identified <72 h old from the postnatal wards and clinics across five health facilities in Kisumu County of Western Kenya. They were all screened for features suggestive of postnatal depression using the Edinburgh Postnatal Depression Scale.
Twenty-four mothers were interviewed, 13 of whom had features suggestive of PND. All mothers experienced health or socio-economic adversities in the perinatal period, including traumatic deliveries, financial constraints, and challenging relationships with partners/other family members. Feeding difficulties due to perceived insufficient breastmilk were a particular challenge for mothers with features of PND, who were more likely to introduce complementary feeds. Maternal health-seeking decisions were influenced by high financial cost, long waiting times and poor interactions with health care providers that induced stress and fear among mothers. Maternal caregiving capacity was influenced by her ability to juggle other household duties, which was difficult for mothers with features suggestive of PND. Support from friends and relatives positively impacted maternal mood and caregiving ability.
Mothers experienced many stress-inducing events in the perinatal period which potentially exacerbated features of PND in the immediate postnatal period. Women with features of PND were particularly vulnerable to these stressors that influenced infant caregiving practices. Addressing the socio-economic challenges and health system gaps that include scale up of compassionate and respectful care for women during pregnancy and childbirth, as well as early screening and intervention of PND, through enhanced referral pathways between health facilities and community support structures, could mitigate against the impact of PND on neonatal caregiving.
产后抑郁症（PND）与婴儿神经发育不良结局有关。在肯尼亚等中低收入国家，PND 如何影响新生儿（<28 天）结局的证据有限，而这些国家承担着全球新生儿发病率和死亡率的负担。
探讨 PND 如何影响肯尼亚西部农村地区产后早期妇女的新生儿喂养和护理行为。
横断面研究。
在基苏木县的五家卫生机构的产后病房和诊所，对出生后 <72 小时的新生儿母亲在产后 2 周时进行半结构式访谈。所有母亲都使用爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale）筛查产后抑郁的特征。
共访谈了 24 位母亲，其中 13 位有产后抑郁的特征。所有母亲在围产期都经历了健康或社会经济方面的困境，包括创伤性分娩、经济拮据以及与伴侣/其他家庭成员的困难关系。由于认为母乳不足而导致的喂养困难是患有产后抑郁特征的母亲特别面临的挑战，她们更有可能引入补充喂养。母亲的就医决策受到高昂的经济成本、长时间的等待时间和与医疗保健提供者不良互动的影响，这些因素给母亲带来了压力和恐惧。母亲的照顾能力受到她平衡其他家务能力的影响，对于有产后抑郁特征的母亲来说，这是很困难的。来自朋友和亲戚的支持对母亲的情绪和照顾能力产生了积极影响。
母亲在围产期经历了许多导致压力的事件，这可能在产后即刻加剧了 PND 的特征。有产后抑郁特征的女性特别容易受到这些压力源的影响，这些压力源影响了婴儿的护理行为。通过加强卫生机构和社区支持结构之间的转诊途径，解决社会经济挑战和卫生系统差距，包括扩大怀孕期间和分娩期间对妇女的同情和尊重护理，以及早期筛查和干预 PND，可以减轻 PND 对新生儿护理的影响。
