Perinatal mental distress and infant morbidity in Ethiopia: a cohort study

Joanna Ross, Charlotte Hanlon, Girmay Medhin, Atalay Alem, Fikru Tesfaye, Bogale Worku, Michael Dewey, Vikram Patel, Martin Prince

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49 Citations (Scopus)
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Objectives: (1) To investigate the impact of perinatal common mental disorders (CMD) in Ethiopia on the risk of key illnesses of early infancy: diarrhoea, fever and acute respiratory illnesses (ARI) and (2) to explore the potential mediating role of maternal health behaviours.

Design: Population-based cohort study.

Setting: Demographic surveillance site in a predominantly rural area of Ethiopia.

Participants: 1065 women (86.3% of eligible) in the third trimester of pregnancy were recruited and 954 (98.6%) of surviving, singleton mother–infant pairs were followed up until 2 months after birth.

Main exposure measure: High levels of CMD symptoms, as measured by the locally validated Self-Reporting Questionnaire (SRQ-20 ≥6), in pregnancy only, postnatally only and at both time-points (‘persistent’).

Main outcome measures: Maternal report of infant illness episodes in first 2 months of life.

Results: The percentages of infants reported to have experienced diarrhoea, ARI and fever were 26.0%, 25.0% and 35.1%, respectively. Persistent perinatal CMD symptoms were associated with 2.15 times (95% CI 1.39 to 3.34) increased risk of infant diarrhoea in a fully adjusted model. The strength of association was not affected by including potential mediators: breast feeding practices, hygiene, the infant's vaccination status or impaired maternal functioning. Persistent perinatal CMD was not associated with infant ARI or fever after adjusting for confounders.

Conclusions: Persistent perinatal CMD was associated with infant diarrhoea in this low-income country setting. The observed relationship was independent of maternal health-promoting practices. Future research should further explore the mechanisms underlying the observed association to inform intervention strategies.
Original languageEnglish
Pages (from-to)F59 - F64
Number of pages6
JournalArchives of Disease in Childhood Fetal and Neonatal Edition
Issue number1
Early online date28 Jul 2010
Publication statusPublished - Jan 2011


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