Evaluating maternal depression among adolescent and adult women in Kenya

评估肯尼亚青少年和成年妇女的孕产妇抑郁情况

• 批准号: 10304116
• 负责人: Anna M Larsen
• 金额: $ 3.47万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-12-16 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10304116
• 关键词: 15 year old; 20 year old; Adolescence; Adolescent; Adult; Africa South of the Sahara; Age; Area; Child Health; Childbirth; Clinical; Cluster randomized trial; Cohort Studies; Country; Cross-Sectional Studies; Data; Development; Diagnostic; Educational Background; Emotional; Epidemiology; Equation; Evaluation; Frequencies; Future; Health Professional; High Prevalence; High-Risk Pregnancy; Hormonal; Hormonal Change; Income; Individual; Infant; Infant Health; Intervention; Kenya; Life Cycle Stages; Link; Loneliness; Longitudinal Studies; Low Birth Weight Infant; Marital Status; Maternal Health; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Monitor; Mothers; Performance; Perinatal; Physiological; Positioning Attribute; Postnatal Care; Postpartum Period; Postpartum Women; Pregnancy; Pregnancy in Adolescence; Pregnancy loss; Pregnant Women; Premature Birth; Prevalence; Procedures; Psychosocial Factor; Reporting; Research; Research Personnel; Research Project Grants; Risk; Sample Size; Self Efficacy; Severities; Social support; South Africa; Symptoms; Time; Training; Visit; Woman; adolescent health; adverse childhood events; adverse outcome; age group; antenatal; antepartum depression; cohort; critical period; depressive symptoms; epidemiology study; experience; high risk; improved; infant morbidity/mortality; infant outcome; instrument; intimate partner violence; longitudinal analysis; low and middle-income countries; maternal depression; mental training; neonatal death; novel; parity; perceived stress; perinatal outcomes; peripartum depression; pre-doctoral; pregnant; pregnant teen; prospective; psychosocial; screening; stillbirth; systematic review; tool; young woman

ABSTRACT This F31 project aims to advance understanding of the manifestation and trajectory of maternal depression among adolescent women (age 15-19) compared to adults throughout pregnancy and postpartum, and to develop a risk score to identify pregnancies at high risk for adverse perinatal outcomes. Approximately 13% of peripartum women worldwide report mental health issues, predominantly depression. Adolescence is a period of substantial developmental and hormonal changes which add to physiologic and psychosocial changes in pregnancy. Frequency of depression among adolescent pregnant and postpartum women is up to 30% higher than their adult and non-pregnant counterparts. Perinatal depression among adolescents has not been rigorously characterized in a large-scale, longitudinal study. Almost all adolescent pregnancies (95%) worldwide occur in low- and middle-income countries (LMICs), yet few data exist on maternal depression among adolescents in these settings. A recent systematic review found higher prevalence of maternal depression in LMICs (16% in pregnancy, 20% in postpartum) than in high-income country settings (HICs). Several studies in HICs have linked depression and adolescence to preterm birth and low birthweight, yet critical gaps remain in understanding implications of maternal depression on perinatal outcomes within SSA where the burden of infant morbidity and mortality is highest worldwide. The proposed F31 research project leverages data collected in an ongoing randomized cluster trial (PrIMA Study, R01AI125498, MPI: John-Stewart/Baeten) among adolescent and adult pregnant Kenyan women (≥15 years old) who are followed through 9-months postpartum. We are screening >4000 Kenyan women (median age: 24 years, ~25% age <20 years) longitudinally via antenatal/postnatal care (ANC/PNC) for depressive symptoms. In Aim 1, we will use data from initial ANC, 6 weeks PNC, and 9 months PNC to longitudinally compare maternal depression among adolescent versus adult women, identifying predictors, symptoms, and changes in prevalence and severity to inform future interventions. In Aim 2 we will develop and validate an empiric risk score to predict adverse perinatal outcomes that incorporates depressive score in pregnancy and other maternal factors (e.g., adolescent age). Results from Aim 2 will contribute a clinical prediction tool to inform who may need intensified monitoring to avert adverse perinatal outcomes like preterm birth and low birthweight. This large-scale study to longitudinally compare depression among adolescents and adults from pregnancy through 9 months postpartum will contribute a novel clinical prediction tool using depression score to predict perinatal outcomes. This research plan will provide the F31 candidate rigorous predoctoral training including 1) quantitative analysis of longitudinal data, 2) experience developing and internally validating a risk score, and 3) content-area expertise in maternal depression, an area critical to closing gaps in maternal, adolescent, and child health.

摘要

项目成果

Improving Quality of PrEP Counseling for Adolescent Girls and Young Women in Kenya With Standardized Patient Actors: A Dose-Response Analysis.

• DOI: 10.1097/qai.0000000000002814
• 发表时间: 2022-01-01
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Larsen A;Abuna F;Owiti G;Kemunto V;Sila J;Wilson KS;Owens T;Pintye J;Richardson BA;Kinuthia J;John-Stewart G;Kohler P
• 通讯作者: Kohler P

What will it take for the Global Plan priority countries in Sub-Saharan Africa to eliminate mother-to-child transmission of HIV?

• DOI: 10.1186/s12879-019-4393-5
• 发表时间: 2019-09-16
• 期刊: BMC INFECTIOUS DISEASES
• 影响因子: 3.7
• 作者: Goga, Ameena E.;Thu-Ha Dinh;Mahy, Mary
• 通讯作者: Mahy, Mary

Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review.

• DOI: 10.1016/j.eclinm.2022.101289
• 发表时间: 2022-03
• 期刊: EClinicalMedicine
• 影响因子: 15.1
• 作者: Mutahi J;Larsen A;Cuijpers P;Peterson SS;Unutzer J;McKay M;John-Stewart G;Jewell T;Kinuthia J;Gohar F;Lai J;Wamalwa D;Gachuno O;Kumar M
• 通讯作者: Kumar M

Trajectories and predictors of perinatal depressive symptoms among Kenyan women: a prospective cohort study.

• DOI: 10.1016/s2215-0366(22)00110-9
• 发表时间: 2022-07
• 期刊: LANCET PSYCHIATRY
• 影响因子: 64.3
• 作者: Larsen, Anna;Pintye, Jillian;Marwa, Mary M.;Watoyi, Salphine;Kinuthia, John;Abuna, Felix;Richardson, Barbra A.;Gomez, Lauren;Dettinger, Julia C.;John-Stewart, Grace
• 通讯作者: John-Stewart, Grace

Contraceptive Method Mix and HIV Risk Behaviors Among Kenyan Adolescent Girls and Young Women Seeking Family Planning Services: Implications for Integrating HIV Prevention.

• DOI: 10.3389/frph.2021.667413
• 发表时间: 2021
• 期刊: Frontiers in reproductive health
• 作者: Nyaboe E;Larsen A;Sila J;Kinuthia J;Owiti G;Abuna F;Kohler P;John-Stewart G;Pintye J
• 通讯作者: Pintye J