Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modelling
Abstract Background The postpartum period is a time where mothers can undergo significant changes that increase vulnerability for depression, anxiety and posttraumatic stress disorder symptoms. However, the direct and indirect factors of depression, anxiety and posttraumatic stress disorder symptoms...
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Archives of Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13690-022-00978-0 |
| _version_ | 1797991708378529792 |
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| author | Marelign Tilahun Malaju Getu Degu Alene |
| author_facet | Marelign Tilahun Malaju Getu Degu Alene |
| author_sort | Marelign Tilahun Malaju |
| collection | DOAJ |
| description | Abstract Background The postpartum period is a time where mothers can undergo significant changes that increase vulnerability for depression, anxiety and posttraumatic stress disorder symptoms. However, the direct and indirect factors of depression, anxiety and posttraumatic stress disorder symptoms and their direction of relationships following childbirth is not well investigated in Ethiopia. The aim of this study was to determine the direct and indirect factors of depression, anxiety and posttraumatic stress disorder symptoms and their direction of relationships following childbirth. Methods A total of 775 women consented to participate at the first, second and third follow-up of the study (6th, 12th and 18th week of postpartum period) during October, 2020 – March, 2021. Women were recruited after childbirth and before discharge using the World Health Organization maternal morbidity working group criteria to identify exposed and non-exposed groups. A cross-lagged autoregressive path analysis and linear structural equation modelling were carried out using Stata version 16 software. Results Prevalence rates of anxiety were 18.5%, 15.5% and 8.5% at the 6th, 12th and 18th week of postpartum respectively. The prevalence rates for depression were also found to be 15.5%, 12.9% and 8.6% respectively during the same follow up period and for posttraumatic stress disorder it was found to be 9.7%, 6.8% and 3.5% at the 6th, 12th and 18th week of postpartum respectively. Moreover, anxiety and depression were found to be a causal risk factors for posttraumatic stress disorder in the postpartum period. Direct maternal morbidity, fear of childbirth, higher gravidity, perceived traumatic childbirth and indirect maternal morbidity were found to have a direct and indirect positive association with depression, anxiety and posttraumatic stress disorder. In contrast, higher parity, higher family size and higher social support have a direct and indirect negative association. Conclusion Postnatal mental health screening, early diagnosis and treatment of maternal morbidities, developing encouraging strategies for social support and providing adequate information about birth procedures and response to mothers’ needs during childbirth are essential to improve maternal mental health in the postpartum period. |
| first_indexed | 2024-04-11T08:56:42Z |
| format | Article |
| id | doaj.art-b643f196efdc4e588ebf18fd4e470078 |
| institution | Directory Open Access Journal |
| issn | 2049-3258 |
| language | English |
| last_indexed | 2024-04-11T08:56:42Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Archives of Public Health |
| spelling | doaj.art-b643f196efdc4e588ebf18fd4e4700782022-12-22T04:33:17ZengBMCArchives of Public Health2049-32582022-10-0180112310.1186/s13690-022-00978-0Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modellingMarelign Tilahun Malaju0Getu Degu Alene1Department of Public Health, College of Health Sciences, Debre Tabor UniversitySchool of Public Health, College of Medicine and Health Sciences, Bahir Dar UniversityAbstract Background The postpartum period is a time where mothers can undergo significant changes that increase vulnerability for depression, anxiety and posttraumatic stress disorder symptoms. However, the direct and indirect factors of depression, anxiety and posttraumatic stress disorder symptoms and their direction of relationships following childbirth is not well investigated in Ethiopia. The aim of this study was to determine the direct and indirect factors of depression, anxiety and posttraumatic stress disorder symptoms and their direction of relationships following childbirth. Methods A total of 775 women consented to participate at the first, second and third follow-up of the study (6th, 12th and 18th week of postpartum period) during October, 2020 – March, 2021. Women were recruited after childbirth and before discharge using the World Health Organization maternal morbidity working group criteria to identify exposed and non-exposed groups. A cross-lagged autoregressive path analysis and linear structural equation modelling were carried out using Stata version 16 software. Results Prevalence rates of anxiety were 18.5%, 15.5% and 8.5% at the 6th, 12th and 18th week of postpartum respectively. The prevalence rates for depression were also found to be 15.5%, 12.9% and 8.6% respectively during the same follow up period and for posttraumatic stress disorder it was found to be 9.7%, 6.8% and 3.5% at the 6th, 12th and 18th week of postpartum respectively. Moreover, anxiety and depression were found to be a causal risk factors for posttraumatic stress disorder in the postpartum period. Direct maternal morbidity, fear of childbirth, higher gravidity, perceived traumatic childbirth and indirect maternal morbidity were found to have a direct and indirect positive association with depression, anxiety and posttraumatic stress disorder. In contrast, higher parity, higher family size and higher social support have a direct and indirect negative association. Conclusion Postnatal mental health screening, early diagnosis and treatment of maternal morbidities, developing encouraging strategies for social support and providing adequate information about birth procedures and response to mothers’ needs during childbirth are essential to improve maternal mental health in the postpartum period.https://doi.org/10.1186/s13690-022-00978-0AnxietyDepressionPosttraumatic stress disorderCross-laggedAutoregressiveStructural equation modelling |
| spellingShingle | Marelign Tilahun Malaju Getu Degu Alene Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modelling Archives of Public Health Anxiety Depression Posttraumatic stress disorder Cross-lagged Autoregressive Structural equation modelling |
| title | Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modelling |
| title_full | Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modelling |
| title_fullStr | Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modelling |
| title_full_unstemmed | Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modelling |
| title_short | Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modelling |
| title_sort | longitudinal patterns of the relation between anxiety depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in northwest ethiopia a cross lagged autoregressive structural equation modelling |
| topic | Anxiety Depression Posttraumatic stress disorder Cross-lagged Autoregressive Structural equation modelling |
| url | https://doi.org/10.1186/s13690-022-00978-0 |
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