Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa

Reproductive Health

Research

Allison K. Groves¹  Luwam T. Gebrekristos²  Luz McNaughton Reyes³  Suzanne Maman³  Dhayendre Moodley⁴  Mags Beksinska⁵ 

[1] Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA;Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market Street, 19140, Philadelphia, PA, USA;Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA;Department of Obstetrics and Gynaecology, University of KwaZulu-Natal Nelson R. Mandela School of Medicine, Durban, South Africa;MatCH Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa;

关键词: Adolescent mothers;    Postpartum depression;    Intimate partner violence;    Pregnancy;    South Africa;    Maternal health;   

DOI  :  10.1186/s12978-023-01605-z

 received in 2022-10-01, accepted in 2023-03-29,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIt is estimated that 38.8% of mothers develop postpartum depression (PPD) in South Africa. While empirical evidence documents an association between intimate partner violence (IPV) victimization in pregnancy and PPD among adult women, the association has been underexamined among adolescent mothers (< 19 years). The study’s purpose is to examine whether IPV victimization during pregnancy is associated with PPD among adolescent mothers.MethodsAdolescent mothers (14–19 years) were recruited at a regional hospital’s maternity ward in KwaZulu Natal, South Africa between July 2017-April 2018. Participants completed behavioral assessments at two visits (n = 90): baseline (up to 4 weeks postpartum) and follow-up (6–9 weeks postpartum, when PPD is typically assessed). The WHO modified conflict tactics scale was used to create a binary measure of any physical and/or psychological IPV victimization that occurred during pregnancy. Participants with scores ≥ 13 on the Edinburgh Postpartum Depression Scale (EPDS) were classified as having symptoms of PPD. We used a modified Poisson regression with robust standard errors to assess PPD in association with IPV victimization during pregnancy, controlling for relevant covariates.ResultsNearly one-half (47%) of adolescent mothers reported symptoms of PPD by 6–9 weeks post-delivery. Further, IPV victimization during pregnancy was highly prevalent (40%). Adolescent mothers who reported IPV victimization during pregnancy had marginally higher risk of PPD at follow-up (RR: 1.50, 95 CI: 0.97–2.31; p = 0.07). The association was strengthened and significant in covariate-adjusted analysis (RR: 1.62, 95 CI: 1.06–2.49; p = 0.03).ConclusionsPoor mental health was common among adolescent mothers, and IPV victimization during pregnancy was associated with PPD risk among adolescent mothers. Implementing IPV and PPD routine screenings during the perinatal period may aid in identifying adolescent mothers for IPV and PPD interventions and treatment. With the high prevalence of IPV and PPD in this vulnerable population and the potential negative impact on maternal and infant outcomes, interventions to reduce IPV and PPD are needed to improve adolescent mothers’ well-being and their baby’s health.

【 授权许可】

CC BY   
© The Author(s) 2023