Hanif Suhi, Momo Jannat-E-Tajreen, Jahan Farjana, Goldberg Liza, Herbert Natalie, Yeamin Afsana, Shoab Abul Kasham, Akhter Reza Mostary, Roy Sajal Kumar, Heitmann Gabriella Barratt, Ercumen Ayse, Rahman Mahbubur, Tofail Fahmida, Wong-Parodi Gabrielle, Benjamin-Chung Jade
Department of Epidemiology and Population Health, Stanford University, Stanford, California, United States of America.
Environmental Health and WASH, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
PLOS Glob Public Health. 2025 Jul 21;5(7):e0004792. doi: 10.1371/journal.pgph.0004792. eCollection 2025.
Prenatal depression can have lasting adverse impacts on child health. Little is known about the impact of floods on prenatal depression in low- and middle-income countries. We conducted a cross-sectional survey of 881 pregnant women from September 24, 2023 to July 19, 2024 in riverine communities in rural Bangladesh. We recorded participant-reported flooding in the past 6 months, administered the Edinburgh Postnatal Depression Scale (EPDS), and obtained water level data and remote sensing data on distance to surface water. We fit generalized linear and log-linear models adjusting for month, wealth, education, age, and gestational age. We conducted 2 focus group discussions with 20 adult women. 3.6% of compounds were flooded in the past 6 months. Flooding of compounds was associated with elevated depression (adjusted prevalence ratio (aPR) = 2.08, 95% CI 1.24, 3.51) and thoughts of self-harm (aPR = 8.40, 95% CI 4.19, 16.10). Latrine flooding was associated with higher depression (aPR = 3.58, 95% CI 2.22, 5.75)). Higher water levels and shorter distance to permanent surface water were significantly associated with mean EPDS scores. Focus groups revealed that domestic violence, inadequate sanitation, gendered vulnerabilities in accessing latrines, childcare difficulties, and food insecurity were key drivers of depression due to floods. Flood preparedness strategies included relocation, storing food, and home modifications. In summary, in rural Bangladesh, flooding, higher water levels, and proximity to water bodies were associated with prenatal depression, and depression following floods was strongly influenced by inadequate sanitation and hygiene infrastructure.
产前抑郁会对儿童健康产生持久的不利影响。在低收入和中等收入国家，关于洪水对产前抑郁的影响知之甚少。2023年9月24日至2024年7月19日，我们在孟加拉国农村的河流社区对881名孕妇进行了横断面调查。我们记录了参与者报告的过去6个月内的洪水情况，使用爱丁堡产后抑郁量表（EPDS）进行评估，并获取了水位数据和到地表水距离的遥感数据。我们拟合了广义线性模型和对数线性模型，并对月份、财富、教育程度、年龄和孕周进行了调整。我们与20名成年女性进行了2次焦点小组讨论。在过去6个月中，3.6%的住家被洪水淹没。住家被洪水淹没与抑郁情绪升高（调整患病率比（aPR）=2.08，95%置信区间1.24，3.51）和自杀念头（aPR = 8.40，95%置信区间4.19，16.10）相关。厕所被洪水淹没与更高的抑郁情绪相关（aPR = 3.58，95%置信区间2.22，5.75）。更高的水位和到永久性地表水的较短距离与EPDS平均得分显著相关。焦点小组揭示，家庭暴力、卫生设施不足、使用厕所方面的性别脆弱性、育儿困难以及粮食不安全是洪水导致抑郁的关键驱动因素。防洪准备策略包括搬迁、储存食物和房屋改造。总之，在孟加拉国农村，洪水、更高的水位以及靠近水体与产前抑郁相关，洪水后的抑郁受到卫生和卫生基础设施不足的强烈影响。
