Gulbicki Lauren, Fertig Madison, Githaiga Jennifer, Gwangqa Linda, Kabel Katherine, Lee Jane, Knight Lucia, O'Cleirigh Conall, Psaros Christina, Stanton Amelia
Massachusetts General Hospital.
Boston University.
Res Sq. 2024 Oct 24:rs.3.rs-5041479. doi: 10.21203/rs.3.rs-5041479/v1.
Perinatal mental health disorders place a particularly high public health burden on South Africa (SA) via negative health outcomes for the birthing parent and adverse health outcomes for infants (e.g., low birth weight, preterm deliveries, malnourishment) as well as emotional and behavioral problems in children. Depression, posttraumatic stress disorder (PTSD), and other mental health disorders may also compromise engagement in HIV prevention behaviors during the perinatal period, when HIV acquisition risk increases. This is particularly important in SA, where almost a quarter of women between ages 15 to 49 have HIV. There is little research exploring the anticipated impacts mental health symptoms have on one's ability to emotionally connect or caregive after delivery; this critical information will enable providers to support women and their mental health during the transition from pregnancy to postpartum. HIV-negative pregnant persons were recruited from an antenatal clinic in Cape Town as a part of a larger study investigating mental health barriers to pre-exposure prophylaxis (PrEP) uptake during pregnancy. Participants qualified for an in-depth interview based on elevated symptoms of depression and/or PTSD. The interviews explored the likely impact of their mental health symptoms on their baby's wellbeing, their ability to bond with their baby, and their ability to meet their baby's needs. Following the principles of thematic analysis, we identified three main themes that described these relationships: (1) a strong perceived connection between maternal mental health and baby's wellbeing; (2) perceived strains on bonding with the baby; and (3) negative impact of mental health on likelihood of completing parenting tasks. This study will inform future mental health programming to prepare pregnant persons with mental health symptoms for a successful postpartum period with respect to bonding and caring for their infant.
围产期心理健康障碍给南非带来了特别沉重的公共卫生负担，这表现为分娩母亲出现负面健康结果、婴儿出现不良健康结果（如低体重、早产、营养不良）以及儿童出现情绪和行为问题。在围产期，当感染艾滋病毒的风险增加时，抑郁症、创伤后应激障碍（PTSD）和其他心理健康障碍也可能影响艾滋病毒预防行为的参与度。这在南非尤为重要，因为15至49岁的女性中几乎有四分之一感染了艾滋病毒。很少有研究探讨心理健康症状对产后情感连接或照顾能力的预期影响；这些关键信息将使医疗服务提供者能够在从怀孕到产后的过渡期间支持女性及其心理健康。作为一项关于孕期暴露前预防（PrEP）使用的心理健康障碍的大型研究的一部分，从开普敦的一家产前诊所招募了艾滋病毒阴性的孕妇。根据抑郁症和/或创伤后应激障碍症状的升高，参与者有资格接受深入访谈。访谈探讨了她们的心理健康症状对婴儿健康、与婴儿建立亲密关系的能力以及满足婴儿需求的能力可能产生的影响。遵循主题分析的原则，我们确定了描述这些关系的三个主要主题：（1）强烈感觉到母亲心理健康与婴儿健康之间的联系；（2）感觉到与婴儿建立亲密关系存在困难；（3）心理健康对完成育儿任务可能性的负面影响。这项研究将为未来的心理健康规划提供信息，帮助有心理健康症状的孕妇在产后成功地与婴儿建立亲密关系并进行照顾。
