Predicting postnatal depressive symptoms in a prospective cohort study in Rwanda: the impact of poor maternal social support

Frontiers in Global Women's Health

Global Women's Health

Providence M. Umuziga¹  Darius Gishoma¹  Michaela Hynie²  Etienne Nsereko³  Laetitia Nyirazinyoye⁴ 

[1] Department of Mental Health Nursing, College of Medicine and Health Sciences, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda;Department of Psychology, York University, Toronto, ON, Canada;School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;

关键词: postnatal depression;    maternal social support scale;    edinburgh postnatal depression scale;    mental health;    Rwanda;   

DOI  :  10.3389/fgwh.2023.1113483

 received in 2022-12-01, accepted in 2023-06-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundPostnatal depression is a significant public health issue that demands attention, and recent evidence indicates that rates are relatively high in low-income countries such as Rwanda. However, lack of social support is recognized as a potential risk factor for postnatal depressive symptoms. This study sought to explore the influence of poor maternal social support on postnatal depressive symptoms in a sample of women in Rwanda.MethodA prospective cohort research design was conducted with women recruited from four different health centers in Rwanda's Southern Province. A sample of 396 pregnant women accessing antenatal care services was recruited at the baseline from their late second term or later, then followed up after giving birth. The dropout rate was 21.46%; thus, the data of 311 women were analyzed. The outcome variable was the presence of depressive symptoms (Edinburgh Postnatal Depression Scale (EPDS) (≥12 cut-off score), while predictor variables included maternal social support measured using a modified Maternal Social Support Scale (MSSS), perceived health status, socio-demographic information (marital status, wealth class, age, education, occupation), negative life events, gestational and obstetric information (parity, pregnancy intention, age at birth, children given birth, and mode of delivery). Univariate and multivariate analyses were performed.ResultsFrom a sample of 311 participants, over a quarter (20.9%) had elevated postnatal depressive symptoms (EPDS ≥ 12 scores). Elevated scores were predicted by poor perceived health status; respondents reporting neither poor nor good (AOR = 0.28, CI = 0.11; 0.72, p = 0.007) or good health (AOR = 0.14, CI = 0.05; 0.37, p = 0.001) were less likely to be affected. Poor maternal social support was also linked with postnatal depressive symptoms; poor partner support (AOR = 4.22; CI = 1.44; 12.34; p = 0.009) was associated with high risk, while good friend support (AOR = 0.47, CI = 0.23; 0.98, p = 0.04) was a significant protector. Additionally, violence or negative life events were also independent predictors of postnatal depressive symptoms (AOR: 2.94, CI: 1.37–6.29, p = 0.005).ConclusionPostnatal depressive symptoms were found to affect one in five Rwandan women. However, good maternal social support can be a strong protector. Early interventions targeting mothers in the postnatal period and strengthened social support networks for women at risk should be developed.

【 授权许可】

Unknown   
© 2023 Umuziga, Gishoma, Hynie, Nyirazinyoye and Nsereko.