Mental health related determinants of parenting stress among urban mothers of young children – results from a birth-cohort study in Ghana and Côte d’Ivoire

BMC Psychiatry

Research Article

Marguerite Te Bonle¹  Torsten Feldt²  Kirsten A Eberhardt²  Rebecca Hinz²  Dana Barthel²  Stefanie Schoppen²  Harry Tagbor³  John Appiah-Poku⁴  Samuel Blay Nguah⁵  Claus Barkmann⁶  Carola Bindt⁶  Cecilia Tomori⁷  Nan Guo⁷  Stephan Ehrhardt⁸  Judith K Bass⁹  Wibke Loag^1,10  Mathurin Koffi^1,11  Eliezer N’Goran^1,12 

[1] Centre de Guidance Infantile, Institut National de Santé Publique, BP V 47, Abidjan, Côte d’Ivoire;Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany;Department Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Department of Behavioural Sciences, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana;Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany;Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany;Jean Lorougnon Guede University, Daloa, Côte d’Ivoire;Research Unit of Parasitology and Parasite Ecology at Unité de Formation et de Recherche en Biosciences, Université de Cocody, Abidjan, Côte d’Ivoire;

关键词: Africa;    Children;    Mothers;    Parenting stress;    Depression;    Perinatal;    Antepartum;    Post-partum;    Pregnancy;    Generalized estimating equation;   

DOI  :  10.1186/1471-244X-14-156

 received in 2014-01-28, accepted in 2014-05-15,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThere are limited data on the parenting stress (PS) levels in sub-Saharan African mothers and on the association between ante- and postnatal depression and anxiety on PS.MethodsA longitudinal birth cohort of 577 women from Ghana and Côte d’Ivoire was followed from the 3rd trimester in pregnancy to 2 years postpartum between 2010 and 2013. Depression and anxiety were assessed by the Patient Health Questionnaire depression module (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) at baseline, 3 month, 12 month and 24 month postpartum. PS was measured using the Parenting Stress Index-Short Form (PSI-SF) at 3, 12 and 24 month. The mean total PS score and the subscale scores were compared among depressed vs. non-depressed and among anxious vs. non-anxious mothers at 3, 12 and 24 month postpartum. The proportions of clinical PS (PSI-SF raw score > 90) in depressed vs. non-depressed and anxious vs. non-anxious mothers were also compared. A generalized estimating equation (GEE) approach was used to estimate population-averaged associations between women’s depression/anxiety and PS adjusting for age, child sex, women’s anemia, education, occupation, spouse’s education, and number of sick child visits.ResultsA total of 577, 531 and 264 women completed the PS assessment at 3 month, 12 month and 24 month postpartum across the two sites and the prevalences of clinical PS at each time point was 33.1%, 24.4% and 14.9% in Ghana and 30.2%, 33.5% and 22.6% in Côte d’Ivoire, respectively. At all three time points, the PS scores were significantly higher among depressed mothers vs. non-depressed mothers. In the multivariate regression analyses, antepartum and postpartum depression were consistently associated with PS after adjusting for other variables.ConclusionsParenting stress is frequent and levels are high compared with previous studies from high-income countries. Antepartum and postpartum depression were both associated with PS, while antepartum and postpartum anxiety were not after adjusting for confounders. More quantitative and qualitative data are needed in sub-Saharan African populations to assess the burden of PS and understand associated mechanisms. Should our findings be replicated, it appears prudent to design and subsequently evaluate intervention strategies.

【 授权许可】

Unknown   
© Guo et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.