Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa
Abstract Background It is estimated that 38.8% of mothers develop postpartum depression (PPD) in South Africa. While empirical evidence documents an association between intimate partner violence (IPV) victimization in pregnancy and PPD among adult women, the association has been underexamined among...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Reproductive Health |
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| Online Access: | https://doi.org/10.1186/s12978-023-01605-z |
| _version_ | 1797832015769239552 |
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| author | Luwam T. Gebrekristos Allison K. Groves Luz McNaughton Reyes Dhayendre Moodley Mags Beksinska Suzanne Maman |
| author_facet | Luwam T. Gebrekristos Allison K. Groves Luz McNaughton Reyes Dhayendre Moodley Mags Beksinska Suzanne Maman |
| author_sort | Luwam T. Gebrekristos |
| collection | DOAJ |
| description | Abstract Background It is estimated that 38.8% of mothers develop postpartum depression (PPD) in South Africa. While empirical evidence documents an association between intimate partner violence (IPV) victimization in pregnancy and PPD among adult women, the association has been underexamined among adolescent mothers (< 19 years). The study’s purpose is to examine whether IPV victimization during pregnancy is associated with PPD among adolescent mothers. Methods Adolescent mothers (14–19 years) were recruited at a regional hospital’s maternity ward in KwaZulu Natal, South Africa between July 2017-April 2018. Participants completed behavioral assessments at two visits (n = 90): baseline (up to 4 weeks postpartum) and follow-up (6–9 weeks postpartum, when PPD is typically assessed). The WHO modified conflict tactics scale was used to create a binary measure of any physical and/or psychological IPV victimization that occurred during pregnancy. Participants with scores ≥ 13 on the Edinburgh Postpartum Depression Scale (EPDS) were classified as having symptoms of PPD. We used a modified Poisson regression with robust standard errors to assess PPD in association with IPV victimization during pregnancy, controlling for relevant covariates. Results Nearly one-half (47%) of adolescent mothers reported symptoms of PPD by 6–9 weeks post-delivery. Further, IPV victimization during pregnancy was highly prevalent (40%). Adolescent mothers who reported IPV victimization during pregnancy had marginally higher risk of PPD at follow-up (RR: 1.50, 95 CI: 0.97–2.31; p = 0.07). The association was strengthened and significant in covariate-adjusted analysis (RR: 1.62, 95 CI: 1.06–2.49; p = 0.03). Conclusions Poor mental health was common among adolescent mothers, and IPV victimization during pregnancy was associated with PPD risk among adolescent mothers. Implementing IPV and PPD routine screenings during the perinatal period may aid in identifying adolescent mothers for IPV and PPD interventions and treatment. With the high prevalence of IPV and PPD in this vulnerable population and the potential negative impact on maternal and infant outcomes, interventions to reduce IPV and PPD are needed to improve adolescent mothers’ well-being and their baby’s health. |
| first_indexed | 2024-04-09T14:02:01Z |
| format | Article |
| id | doaj.art-4624a736647b486e897b779423d130bf |
| institution | Directory Open Access Journal |
| issn | 1742-4755 |
| language | English |
| last_indexed | 2024-04-09T14:02:01Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Health |
| spelling | doaj.art-4624a736647b486e897b779423d130bf2023-05-07T11:14:56ZengBMCReproductive Health1742-47552023-05-012011910.1186/s12978-023-01605-zIntimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South AfricaLuwam T. Gebrekristos0Allison K. Groves1Luz McNaughton Reyes2Dhayendre Moodley3Mags Beksinska4Suzanne Maman5Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public HealthDepartment of Community Health and Prevention, Drexel University Dornsife School of Public HealthDepartment of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public HealthDepartment of Obstetrics and Gynaecology, University of KwaZulu-Natal Nelson R. Mandela School of MedicineMatCH Research Unit (MRU), Faculty of Health Sciences, University of the WitwatersrandDepartment of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public HealthAbstract Background It is estimated that 38.8% of mothers develop postpartum depression (PPD) in South Africa. While empirical evidence documents an association between intimate partner violence (IPV) victimization in pregnancy and PPD among adult women, the association has been underexamined among adolescent mothers (< 19 years). The study’s purpose is to examine whether IPV victimization during pregnancy is associated with PPD among adolescent mothers. Methods Adolescent mothers (14–19 years) were recruited at a regional hospital’s maternity ward in KwaZulu Natal, South Africa between July 2017-April 2018. Participants completed behavioral assessments at two visits (n = 90): baseline (up to 4 weeks postpartum) and follow-up (6–9 weeks postpartum, when PPD is typically assessed). The WHO modified conflict tactics scale was used to create a binary measure of any physical and/or psychological IPV victimization that occurred during pregnancy. Participants with scores ≥ 13 on the Edinburgh Postpartum Depression Scale (EPDS) were classified as having symptoms of PPD. We used a modified Poisson regression with robust standard errors to assess PPD in association with IPV victimization during pregnancy, controlling for relevant covariates. Results Nearly one-half (47%) of adolescent mothers reported symptoms of PPD by 6–9 weeks post-delivery. Further, IPV victimization during pregnancy was highly prevalent (40%). Adolescent mothers who reported IPV victimization during pregnancy had marginally higher risk of PPD at follow-up (RR: 1.50, 95 CI: 0.97–2.31; p = 0.07). The association was strengthened and significant in covariate-adjusted analysis (RR: 1.62, 95 CI: 1.06–2.49; p = 0.03). Conclusions Poor mental health was common among adolescent mothers, and IPV victimization during pregnancy was associated with PPD risk among adolescent mothers. Implementing IPV and PPD routine screenings during the perinatal period may aid in identifying adolescent mothers for IPV and PPD interventions and treatment. With the high prevalence of IPV and PPD in this vulnerable population and the potential negative impact on maternal and infant outcomes, interventions to reduce IPV and PPD are needed to improve adolescent mothers’ well-being and their baby’s health.https://doi.org/10.1186/s12978-023-01605-zAdolescent mothersPostpartum depressionIntimate partner violencePregnancySouth AfricaMaternal health |
| spellingShingle | Luwam T. Gebrekristos Allison K. Groves Luz McNaughton Reyes Dhayendre Moodley Mags Beksinska Suzanne Maman Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa Reproductive Health Adolescent mothers Postpartum depression Intimate partner violence Pregnancy South Africa Maternal health |
| title | Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa |
| title_full | Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa |
| title_fullStr | Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa |
| title_full_unstemmed | Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa |
| title_short | Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa |
| title_sort | intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in south africa |
| topic | Adolescent mothers Postpartum depression Intimate partner violence Pregnancy South Africa Maternal health |
| url | https://doi.org/10.1186/s12978-023-01605-z |
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