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Perinatal common mental disorders and child survival in E thiopia
Author(s) -
Adewuya Abiodun O,
Hanlon Charlotte,
Medhin Girmay,
Dewey Michael,
Alem Atalay,
Worku Bogale,
Prince Martin
Publication year - 2014
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12411
Subject(s) - medicine , pregnancy , hazard ratio , pediatrics , confidence interval , cohort , confounding , obstetrics , cohort study , genetics , biology
Aims The study aims to evaluate the impact of perinatal common mental disorders ( CMD s) on child mortality up to 3.5 years in a demographic surveillance site at Butajira, Ethiopia. Methods One thousand sixty‐five eligible women were assessed for CMD in the third trimester of pregnancy and at 2 months post‐delivery using the S elf‐ R eporting Q uestionnaire. We derived a four‐level categorical exposure variable for the course of perinatal CMD . The outcome measure was child death recorded from 1 month after the postnatal assessment up to 3.5 years. Potential confounders and mediators were evaluated. Results The cumulative child mortality rates were 62.6/1000 at 1 year and 82.5/1000 at 3.5 years, respectively. Exposure to perinatal CMD did not significantly affect child survival at 3.5 years, with results showing fully adjusted hazard ratio ( HR ) and 95% confidence interval (95% CI ) of 1.85 (0.43, 7.88) for CMD in pregnancy only, 1.47 (0.14, 15.66) for CMD in postnatal period only and 0.41 (0.02, 7.38) for persistent CMD (both in pregnancy and postnatal). Only using soap less frequently than daily ( HR 5.67, 95% CI 1.58–20.30) and episode of malaria in pregnancy ( HR 5.02, 95% CI 2.15–11.72) were associated with child mortality in multivariable analysis. Conclusions Maternal health, health behaviours and family structure appear to be the most important factors affecting post‐neonatal child mortality in this Ethiopian birth cohort, with little evidence for an effect of maternal perinatal CMD .