Assessing factors associated with poor maternal mental health among mothers of children born small and sick at 24–47 months in rural Rwanda

BMC Pregnancy and Childbirth

Kim Wilson¹  Ann C. Miller²  Marie Claire Abimana³  Ibrahim Hakizimana³  Catherine M. Kirk³  Kathryn Beck³  Mathieu Nemerimana³  Alphonse Nshimyiryo³  Egide Karangwa³  Alphonsine Uwamahoro⁴  Sadallah Bahizi⁴  Silas Havugarurema⁴ 

[1] Division of General Pediatrics, Boston Children’s Hospital, Boston, USA;Division of Global Health and Social Medicine, Harvard Medical School, Boston, USA;Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda;Rwanda Ministry of Health, Kirehe District Hospital, Kirehe, Rwanda;

关键词: Maternal mental health;    Prematurity;    Low birthweight;    Rwanda;    Nurturing care;    Toxic stress;    Developmental disability;   

DOI  :  10.1186/s12884-020-03301-3

来源: Springer

【 摘 要 】

BackgroundGlobal investments in neonatal survival have resulted in a growing number of children with morbidities surviving and requiring ongoing care. Little is known about the caregivers of these children in low- and middle-income countries, including maternal mental health which can further negatively impact child health and development outcomes. We aimed to assess the prevalence and factors associated with poor maternal mental health in mothers of children born preterm, low birthweight (LBW), and with hypoxic ischemic encephalopathy (HIE) at 24–47 months of age in rural Rwanda.MethodsCross-sectional study of children 24–47 months born preterm, LBW, or with HIE, and their mothers discharged from the Neonatal Care Unit (NCU) at Kirehe Hospital between May 2015–April 2016 or discharged and enrolled in a NCU follow-up program from May 2016–November 2017. Households were interviewed between October 2018 and June 2019. Mothers reported on their mental health and their child’s development; children’s anthropometrics were measured directly. Backwards stepwise procedures were used to assess factors associated with poor maternal mental health using logistic regression.ResultsOf 287 total children, 189 (65.9%) were born preterm/LBW and 34.1% had HIE and 213 (74.2%) screened positive for potential caregiver-reported disability. Half (n = 148, 51.6%) of mothers reported poor mental health. In the final model, poor maternal mental health was significantly associated with use of violent discipline (Odds Ratio [OR] 2.29, 95% Confidence Interval [CI] 1.17,4.45) and having a child with caregiver-reported disability (OR 2.96, 95% CI 1.55, 5.67). Greater household food security (OR 0.80, 95% CI 0.70–0.92) and being married (OR = 0.12, 95% CI 0.04–0.36) or living together as if married (OR = 0.13, 95% CI 0.05, 0.37) reduced the odds of poor mental health.ConclusionsHalf of mothers of children born preterm, LBW and with HIE had poor mental health indicating a need for interventions to identify and address maternal mental health in this population. Mother’s poor mental health was also associated with negative parenting practices. Specific interventions targeting mothers of children with disabilities, single mothers, and food insecure households could be additionally beneficial given their strong association with poor maternal mental health.

【 授权许可】

CC BY