Premium
Social Support Modifies Bidirectional Linkages Between Food Insecurity and Prenatal Depressive Symptoms while Domestic Violence Alters the Unidirectional Impact of Food Insecurity on Prenatal Depressive Symptoms
Author(s) -
Natamba Barnabas,
Mehta Saurabh,
Mou Sophie,
Ghosh Shibani,
Stoltzfus Rebecca,
Griffiths Jeffrey,
Young Sera
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.261.8
Subject(s) - psychological intervention , domestic violence , food insecurity , confounding , medicine , depression (economics) , depressive symptoms , food security , prenatal care , mental health , pregnancy , demography , environmental health , poison control , psychiatry , injury prevention , population , geography , anxiety , biology , genetics , archaeology , sociology , economics , macroeconomics , agriculture
To inform perinatal nutrition and mental health interventions, we used a cohort study to: 1) examine the directionality of relationships between maternal food insecurity (MFI) and prenatal depressive symptoms (PDS); and 2) see if social support (SS) or domestic violence (DV) modify this relationship. We enrolled 403 Ugandan pregnant women (33% HIV+ on antiretrovirals)) in mid‐gestation and assessed them monthly through delivery for MFI (IFIAS) and the PDS (CES‐D) using validated scales. Each woman contributed ~ 4.3 study visits including enrollment visits. At baseline, 58.3% of the women had probable prenatal depression (CES‐D蠅17), 27.1% had experienced DV, and 74.4% reported moderate or severe MFI. Longitudinal mixed effects models indicate that MFI and PDS predicted each other. Multivariate lagged response and covariate models confirmed bidirectional relationships for MFI and PDS. SS modified the relationship in both directions ((β MFI*SS =‐0.050 , p<0.001), (β PDS*SS =‐0.005 , p=0.02)).DV modified the unidirectional impact of MFI on PDS ((β MFI*DV =0.369 ; p<0.001)).Fixed effects models showed that the bidirectional relationship between MFI and PDS might not be explained by residual confounding. Our results suggest the need for designing and evaluating integrated food security and prenatal depression interventions that take into account factors such as social support and domestic violence