Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort

BACKGROUND:Antenatal maternal psychological distress is common in low and middle-income countries (LMIC), but there is a dearth of research on its effect on birth and developmental outcomes in these settings, particularly in Sub-Saharan Africa. This study set out to identify risk factors for antenat...

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Main Authors: Macginty, R, Kariuki, S, Barnett, W, Wedderburn, C, Hardy, A, Hoffman, N, Newton, C, Zar, H, Donald, K, Stein, D
Format: Journal article
Language:English
Published: Elsevier 2019
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author Macginty, R
Kariuki, S
Barnett, W
Wedderburn, C
Hardy, A
Hoffman, N
Newton, C
Zar, H
Donald, K
Stein, D
author_facet Macginty, R
Kariuki, S
Barnett, W
Wedderburn, C
Hardy, A
Hoffman, N
Newton, C
Zar, H
Donald, K
Stein, D
author_sort Macginty, R
collection OXFORD
description BACKGROUND:Antenatal maternal psychological distress is common in low and middle-income countries (LMIC), but there is a dearth of research on its effect on birth and developmental outcomes in these settings, particularly in Sub-Saharan Africa. This study set out to identify risk factors for antenatal maternal psychological distress and determine whether antenatal maternal psychological distress was associated with infant birth and developmental outcomes, using data from the Drakenstein Child Health Study (DCHS), a birth cohort study in South Africa. METHODS:Pregnant women were enrolled in the DCHS from primary care antenatal clinics. Antenatal maternal psychological distress was measured using the Self-Reporting Questionnaire 20-item (SRQ-20). A range of psychosocial measures, including maternal childhood trauma, depression, and posttraumatic stress disorder (PTSD) were administered. Birth outcomes, including premature birth, weight-for-age z-score and head circumference-for-age z-score, were measured using revised Fenton growth charts. The Bayley III Scales of Infant and Toddler Development was administered at 6 months of age to assess infant development outcomes, including cognitive, language, and motor domains in a subset of n=231. Associations of maternal antenatal psychological distress with psychosocial measures, and with infant birth and developmental outcomes were examined using linear regression models. RESULTS:961 women were included in this analysis, with 197 (21%) reporting scores indicating the presence of psychological distress. Antenatal psychological distress was associated with maternal childhood trauma, antenatal depression, and PTSD, and inversely associated with partner support. No association was observed between antenatal maternal psychological distress and preterm birth or early developmental outcomes, but antenatal maternal psychological distress was associated with a smaller head circumference at birth (coefficient=-0.30, 95% CI: -0.49; -0.10). CONCLUSION:Antenatal maternal psychological distress is common in LMIC settings and was found to be associated with key psychosocial measures during pregnancy, as well as with adverse birth outcomes, in our study population. These associations highlight the potential value of screening for antenatal maternal psychological distress as well as of developing targeted interventions.
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spelling oxford-uuid:65bae548-d759-4dcb-b0c7-9cb272b551252022-03-26T18:27:27ZAssociations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohortJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:65bae548-d759-4dcb-b0c7-9cb272b55125EnglishSymplectic Elements at OxfordElsevier2019Macginty, RKariuki, SBarnett, WWedderburn, CHardy, AHoffman, NNewton, CZar, HDonald, KStein, DBACKGROUND:Antenatal maternal psychological distress is common in low and middle-income countries (LMIC), but there is a dearth of research on its effect on birth and developmental outcomes in these settings, particularly in Sub-Saharan Africa. This study set out to identify risk factors for antenatal maternal psychological distress and determine whether antenatal maternal psychological distress was associated with infant birth and developmental outcomes, using data from the Drakenstein Child Health Study (DCHS), a birth cohort study in South Africa. METHODS:Pregnant women were enrolled in the DCHS from primary care antenatal clinics. Antenatal maternal psychological distress was measured using the Self-Reporting Questionnaire 20-item (SRQ-20). A range of psychosocial measures, including maternal childhood trauma, depression, and posttraumatic stress disorder (PTSD) were administered. Birth outcomes, including premature birth, weight-for-age z-score and head circumference-for-age z-score, were measured using revised Fenton growth charts. The Bayley III Scales of Infant and Toddler Development was administered at 6 months of age to assess infant development outcomes, including cognitive, language, and motor domains in a subset of n=231. Associations of maternal antenatal psychological distress with psychosocial measures, and with infant birth and developmental outcomes were examined using linear regression models. RESULTS:961 women were included in this analysis, with 197 (21%) reporting scores indicating the presence of psychological distress. Antenatal psychological distress was associated with maternal childhood trauma, antenatal depression, and PTSD, and inversely associated with partner support. No association was observed between antenatal maternal psychological distress and preterm birth or early developmental outcomes, but antenatal maternal psychological distress was associated with a smaller head circumference at birth (coefficient=-0.30, 95% CI: -0.49; -0.10). CONCLUSION:Antenatal maternal psychological distress is common in LMIC settings and was found to be associated with key psychosocial measures during pregnancy, as well as with adverse birth outcomes, in our study population. These associations highlight the potential value of screening for antenatal maternal psychological distress as well as of developing targeted interventions.
spellingShingle Macginty, R
Kariuki, S
Barnett, W
Wedderburn, C
Hardy, A
Hoffman, N
Newton, C
Zar, H
Donald, K
Stein, D
Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort
title Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort
title_full Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort
title_fullStr Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort
title_full_unstemmed Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort
title_short Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort
title_sort associations of antenatal maternal psychological distress with infant birth and development outcomes results from a south african birth cohort
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