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Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study

BACKGROUND: Perinatal depression is a significant contributor to maternal morbidity and mortality globally. Migrant women, particularly those living in low- and middle-income settings, represent a particularly vulnerable group due to stressors experienced before, during and after migration. The vast...

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Autores principales: Fellmeth, Gracia, Plugge, Emma, Fazel, Mina, Oo, May May, Pimanpanarak, Mupawjay, Phichitpadungtham, Yuwapha, Wai, Kerry, Charunwatthana, Prakaykaew, Simpson, Julie A., Nosten, François, Fitzpatrick, Raymond, McGready, Rose
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161117/
https://www.ncbi.nlm.nih.gov/pubmed/32295545
http://dx.doi.org/10.1186/s12888-020-02572-6
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author Fellmeth, Gracia
Plugge, Emma
Fazel, Mina
Oo, May May
Pimanpanarak, Mupawjay
Phichitpadungtham, Yuwapha
Wai, Kerry
Charunwatthana, Prakaykaew
Simpson, Julie A.
Nosten, François
Fitzpatrick, Raymond
McGready, Rose
author_facet Fellmeth, Gracia
Plugge, Emma
Fazel, Mina
Oo, May May
Pimanpanarak, Mupawjay
Phichitpadungtham, Yuwapha
Wai, Kerry
Charunwatthana, Prakaykaew
Simpson, Julie A.
Nosten, François
Fitzpatrick, Raymond
McGready, Rose
author_sort Fellmeth, Gracia
collection PubMed
description BACKGROUND: Perinatal depression is a significant contributor to maternal morbidity and mortality globally. Migrant women, particularly those living in low- and middle-income settings, represent a particularly vulnerable group due to stressors experienced before, during and after migration. The vast majority of global migration flows occurring within and between low- and middle-income regions, yet existing evidence focuses predominantly on migrants in high-income destinations. This study aimed to redress this significant gap in the evidence by determining the prevalence and determinants of perinatal depression among migrant women on the Thai-Myanmar border. METHODS: A cohort of labour migrant and refugee women was followed-up from the first trimester of pregnancy to one month post-partum. Depression status was assessed in the first, second and third trimesters of pregnancy and at one month post-partum using the Structured Clinical Interview for the Diagnosis of DSM-IV Disorders. Women diagnosed with depression had immediate access to care. Data on potential demographic, social and clinical associated factors was collected using a questionnaire. Prevalence and incidence of any depressive disorder and moderate-severe depressive disorder was calculated. Univariable and multivariable logistic regression using complete case analysis was used to estimate odds ratios (OR) of association between exposure variables and depression status. RESULTS: Five hundred sixty-eight women participated. Period prevalence (from first trimester of pregnancy to one month post-partum) of moderate-severe perinatal depression was 18.5% (95% CI 15.4–21.9%). Overall, 15.4% (95% CI 11.8–19.6%) of women developed new-onset moderate-severe depression during the study period. Forty-two participants received treatment for depression. Risk factors were interpersonal violence (OR 4.5; 95% CI 1.9–11.1); history of trauma (OR 2.4; 95% CI 1.4–4.3); self-reported history of depression (OR 2.3; 95% CI 1.2–4.2); labour migrant status (OR 2.1; 95% CI 1.1–4.0); low social support (OR 2.1; 95% CI 1.1–3.7); and maternal age (OR 1.1 per year; 95% CI 1.0–1.1). Limitations of the study include that culturally specific manifestations of depression may have been missed. CONCLUSIONS: Perinatal depression represents a significant burden among migrant women on the Thai-Myanmar border. Programmes to address the determinants along with early case identification and effective treatment and referral systems are key to addressing perinatal depression in this low-resource setting.
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spelling pubmed-71611172020-04-22 Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study Fellmeth, Gracia Plugge, Emma Fazel, Mina Oo, May May Pimanpanarak, Mupawjay Phichitpadungtham, Yuwapha Wai, Kerry Charunwatthana, Prakaykaew Simpson, Julie A. Nosten, François Fitzpatrick, Raymond McGready, Rose BMC Psychiatry Research Article BACKGROUND: Perinatal depression is a significant contributor to maternal morbidity and mortality globally. Migrant women, particularly those living in low- and middle-income settings, represent a particularly vulnerable group due to stressors experienced before, during and after migration. The vast majority of global migration flows occurring within and between low- and middle-income regions, yet existing evidence focuses predominantly on migrants in high-income destinations. This study aimed to redress this significant gap in the evidence by determining the prevalence and determinants of perinatal depression among migrant women on the Thai-Myanmar border. METHODS: A cohort of labour migrant and refugee women was followed-up from the first trimester of pregnancy to one month post-partum. Depression status was assessed in the first, second and third trimesters of pregnancy and at one month post-partum using the Structured Clinical Interview for the Diagnosis of DSM-IV Disorders. Women diagnosed with depression had immediate access to care. Data on potential demographic, social and clinical associated factors was collected using a questionnaire. Prevalence and incidence of any depressive disorder and moderate-severe depressive disorder was calculated. Univariable and multivariable logistic regression using complete case analysis was used to estimate odds ratios (OR) of association between exposure variables and depression status. RESULTS: Five hundred sixty-eight women participated. Period prevalence (from first trimester of pregnancy to one month post-partum) of moderate-severe perinatal depression was 18.5% (95% CI 15.4–21.9%). Overall, 15.4% (95% CI 11.8–19.6%) of women developed new-onset moderate-severe depression during the study period. Forty-two participants received treatment for depression. Risk factors were interpersonal violence (OR 4.5; 95% CI 1.9–11.1); history of trauma (OR 2.4; 95% CI 1.4–4.3); self-reported history of depression (OR 2.3; 95% CI 1.2–4.2); labour migrant status (OR 2.1; 95% CI 1.1–4.0); low social support (OR 2.1; 95% CI 1.1–3.7); and maternal age (OR 1.1 per year; 95% CI 1.0–1.1). Limitations of the study include that culturally specific manifestations of depression may have been missed. CONCLUSIONS: Perinatal depression represents a significant burden among migrant women on the Thai-Myanmar border. Programmes to address the determinants along with early case identification and effective treatment and referral systems are key to addressing perinatal depression in this low-resource setting. BioMed Central 2020-04-15 /pmc/articles/PMC7161117/ /pubmed/32295545 http://dx.doi.org/10.1186/s12888-020-02572-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Fellmeth, Gracia
Plugge, Emma
Fazel, Mina
Oo, May May
Pimanpanarak, Mupawjay
Phichitpadungtham, Yuwapha
Wai, Kerry
Charunwatthana, Prakaykaew
Simpson, Julie A.
Nosten, François
Fitzpatrick, Raymond
McGready, Rose
Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study
title Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study
title_full Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study
title_fullStr Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study
title_full_unstemmed Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study
title_short Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study
title_sort prevalence and determinants of perinatal depression among labour migrant and refugee women on the thai-myanmar border: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161117/
https://www.ncbi.nlm.nih.gov/pubmed/32295545
http://dx.doi.org/10.1186/s12888-020-02572-6
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