Psychosocial determinants of sustained maternal functional impairment: Longitudinal findings from a pregnancy-birth cohort study in rural Pakistan


Autoři: Ashley Hagaman aff001;  John A. Gallis aff003;  Sonia Bhalotra aff005;  Victoria Baranov aff006;  Elizabeth L. Turner aff003;  Siham Sikander aff007;  Joanna Maselko aff009
Působiště autorů: Department of Social Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America aff001;  Center for Methods in Implementation and Prevention Sciences, Yale University, New Haven, Connecticut, United States of America aff002;  Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America aff003;  Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America aff004;  Department of Economics, University of Essex, Essex, England, United Kingdom aff005;  Department of Economics, The University of Melbourne, Melbourne, Australia aff006;  Maternal and Neonatal Child Health Department, Health Services Academy, Islamabad, Pakistan aff007;  Human Development Research Foundation, Islamabad, Pakistan aff008;  Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America aff009
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225163

Souhrn

Function is an important marker of health throughout the life course, however, in low-and-middle-income-countries, little is known about the burden of functional impairment as women transition from pregnancy to the first year post-partum. Leveraging longitudinal data from 960 women participating in the Share Child Cohort in Pakistan, this study sought to (1) characterize functional trajectories over time among women in their perinatal period and (2) assess predictors of chronic poor functioning following childbirth. We used a group-based trajectory modeling approach to examine maternal patterns of function from the third trimester of pregnancy through 12 months post-partum. Three trajectory groups were found: persistently well-functioning (51% of women), poor functioning with recovery (39% of women), and chronically poor functioning (10% of women). When compared to mothers in the highest functioning group, psychosocial characteristics (e.g., depression, stress, and serious life events) were significantly associated with sustained poor functioning one-year following child-birth. Mothers living in nuclear households were more likely to experience chronic poor functioning. Higher education independently predicted maternal function recovery, even when controlling for psychosocial characteristics. Education, above and beyond socio-economic assets, appears to play an important protective role in maternal functional trajectories following childbirth. Public health implications related to maternal function and perinatal mental health are discussed.

Klíčová slova:

Depression – Children – Labor and delivery – Mothers – Pregnancy – Psychological and psychosocial issues – Psychological stress – Socioeconomic aspects of health


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2019 Číslo 11