Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa.
Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa.
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DOI：
10.1186/s12978-023-01605-z
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发表时间：
2023-05-02
影响因子：
3.4
通讯作者：
Maman, Suzanne
中科院分区：
文献类型：
--
作者：
Gebrekristos, Luwam T.;Groves, Allison K.;Reyes, Luz McNaughton;Moodley, Dhayendre;Beksinska, Mags;Maman, Suzanne
关键词：
据估计，南非38.8%的母亲患有产后抑郁症(PPD)。虽然经验证据表明，亲密伴侣在怀孕期间遭受暴力侵害与成年女性产后抑郁之间存在关联，但这种关联在青春期母亲中一直未得到充分研究(<； 19岁)。这项研究的目的是检查怀孕期间感染IPV是否与青春期母亲的产后抑郁有关。2017年7月至2018年4月，南非夸祖鲁纳塔尔的一家地区医院的产科病房招募了14-19岁的青少年母亲。参与者在两次就诊时完成了行为评估(n = 90)：基线(产后4周)和随访(产后6-9周，通常是评估产后抑郁的时候)。使用世卫组织修订的冲突战术量表对怀孕期间发生的任何身体和/或心理IPV受害情况进行二元测量。在爱丁堡产后抑郁量表上 ≥ 评分为13分的受试者被归类为产后抑郁症状。我们使用具有稳健标准误差的修正泊松回归来评估产后抑郁与妊娠期间IPV受害之间的关系，并控制相关的协变量。近一半(47%)的青春期母亲报告在分娩后6-9周出现产后抑郁症状。此外，在怀孕期间感染IPV的情况非常普遍(40%)。报告怀孕期间感染IPV的青春期母亲在随访时患产后抑郁的风险略高(RR：1.5 0，95CI：0.97-2.31；p = 0.0 7)。在协变量调整分析中，这种关联性得到加强且显著(RR：1.6 2，95 CI：1.0 6-2.49；p = 0.0 3)。心理健康状况不佳在青少年母亲中很常见，怀孕期间受害的IPV与青少年母亲患PPD的风险有关。在围产期实施IPV和PPD常规筛查可能有助于确定青春期母亲是否需要IPV和PPD干预和治疗。鉴于IPV和PPD在这一脆弱人群中的高患病率以及对母婴结局的潜在负面影响，需要采取干预措施来降低IPV和PPD，以改善青少年母亲的福祉及其婴儿的健康。在南非，超过三分之一的成年母亲患有产后抑郁症(PPD)，亲密伴侣暴力(IPV)受害是成年母亲患PPD的强烈风险因素。然而，没有关于青少年母亲的研究着眼于IPV受害和产后抑郁之间的联系。这篇论文的目的是研究怀孕期间感染IPV是否与南非青少年母亲产后抑郁有关。我们让90名青春期母亲(年龄14-19岁)完成了从分娩到产后4周的初步调查，以收集她们怀孕期间的IPV信息。参与者在产后6至9周内完成了一项额外的调查，以收集有关产后抑郁症状的信息。近一半(47%)的青春期母亲报告在分娩后6-9周出现产后抑郁症状。在怀孕期间感染IPV的报告也很高(40%)。在怀孕期间经历IPV受害的青少年母亲更有可能在产后6至9周内报告PPD症状。PPD和IPV在我们的样本中非常常见，怀孕期间IPV受害与青少年母亲的PPD有关。在孕期和产后进行常规筛查可以确定青春期母亲的IPV和PPD干预和治疗。鉴于该样本中IPV和PPD的高报告以及对母婴结局的潜在负面影响，需要采取干预措施来降低IPV和PPD，以改善青春期母亲的福祉和婴儿的健康。
It 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. Adolescent 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. Nearly 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). Poor 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. More than one-third of adult mothers experience postpartum depression (PPD) in South Africa and intimate partner violence (IPV) victimization is a strong risk factor of PPD for adult mothers. However, there are no studies on adolescent mothers that look at the link between IPV victimization and PPD. This paper aims to examine whether IPV victimization during pregnancy is associated with PPD among adolescent South African mothers. We had 90 adolescent mothers (aged 14–19 years old) complete an initial survey between delivery and 4 weeks postpartum to collect information on IPV during their pregnancy. Participants completed an additional survey between 6 and 9 week postpartum to collect information on the symptoms of PPD. Nearly one-half (47%) of adolescent mothers reported symptoms of PPD by 6–9 weeks post-delivery. Report of IPV victimization during pregnancy was also very high (40%). Adolescent mothers who experienced IPV victimization during pregnancy were more likely to report symptoms of PPD between 6 and 9 weeks postpartum. PPD and IPV was very common in our sample, and IPV victimization during pregnancy was linked to PPD among adolescent mothers. Having routine screenings during pregnancy and postpartum period can identify adolescent mothers IPV and PPD interventions and treatment. With the high reports of IPV and PPD in this sample 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.
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