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Postnatal depression and intimate partner violence: a nationwide clinic-based cross-sectional study in Malaysia.
BMJ Open. 2018 05 14; 8(5):e020649.BO

Abstract

INTRODUCTION

An estimated 13% of women in the postnatal period suffer from postnatal depression (PND) worldwide. In addition to underprivileged women, women who are exposed to violence are at higher risk of PND. This study aimed to investigate the relationship between intimate partner violence (IPV) and PND in Malaysia.

METHODS

This survey was conducted as a nationwide cross-sectional study using a cluster sampling design. Probable PND was assessed using a self-administered Edinburgh Postnatal Depression Scale (EPDS). Demographic profiles and IPV were assessed using a locally validated WHO Multicountry Study on Women's Health and Life Events Questionnaire that was administered in a face-to-face interview. An EPDS total score of 12 or more and/or a positive tendency to self-harm were used to define PND.

RESULTS

Out of 6669 women, 5727 respondents were successfully interviewed with a response rate of 85.9%. The prevalence of probable PND was 4.4% (95% CI 2.9 to 6.7). The overall prevalence of IPV was 4.9% (95% CI 3.8 to 6.4). Among the women in this group, 3.7% (95% CI 2.7 to 5.0), 2.6% (95% CI 1.9 to 3.5) and 1.2% (95% CI 0.9 to 1.7) experienced emotional, physical and sexual violence, respectively. Logistic regression analysis revealed that women who were exposed to IPV were at 2.3 times the risk for probable PND, with an adjusted OR (aOR) of 2.34 (95% CI 1.12 to 4.87). Other factors for PND were reported emotional violence (aOR 3.79, 95% CI 1.93 to 7.45), unplanned pregnancy (aOR 3.32, 95% CI 2.35 to 4.69), lack of family support during confinement (aOR 1.79, 95% CI 1.12 to 2.87), partner's use of alcohol (aOR 1.59, 95% CI 1.07 to 2.35) or being from a household with a low income (aOR 2.99; 95% CI 1.63 to 5.49).

CONCLUSIONS

Exposure to IPV was significantly associated with probable PND. Healthcare personnel should be trained to detect and manage both problems. An appropriate referral system and support should be made available.

Authors+Show Affiliations

Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Public Health Department, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Public Health Department, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Public Health Department, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Public Health Department, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29764882

Citation

Ahmad, Noor Ani, et al. "Postnatal Depression and Intimate Partner Violence: a Nationwide Clinic-based Cross-sectional Study in Malaysia." BMJ Open, vol. 8, no. 5, 2018, pp. e020649.
Ahmad NA, Silim UA, Rosman A, et al. Postnatal depression and intimate partner violence: a nationwide clinic-based cross-sectional study in Malaysia. BMJ Open. 2018;8(5):e020649.
Ahmad, N. A., Silim, U. A., Rosman, A., Mohamed, M., Chan, Y. Y., Mohd Kasim, N., Yusof, M., Abd Razak, M. A., Omar, M., Abdul Aziz, F. A., Jamaluddin, R., Ismail, F., Ibrahim, N., & Aris, T. (2018). Postnatal depression and intimate partner violence: a nationwide clinic-based cross-sectional study in Malaysia. BMJ Open, 8(5), e020649. https://doi.org/10.1136/bmjopen-2017-020649
Ahmad NA, et al. Postnatal Depression and Intimate Partner Violence: a Nationwide Clinic-based Cross-sectional Study in Malaysia. BMJ Open. 2018 05 14;8(5):e020649. PubMed PMID: 29764882.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postnatal depression and intimate partner violence: a nationwide clinic-based cross-sectional study in Malaysia. AU - Ahmad,Noor Ani, AU - Silim,Umi Adzlin, AU - Rosman,Azriman, AU - Mohamed,Majdah, AU - Chan,Ying Ying, AU - Mohd Kasim,Noraida, AU - Yusof,Muslimah, AU - Abd Razak,Mohamad Aznuddin, AU - Omar,Maisarah, AU - Abdul Aziz,Fazly Azry, AU - Jamaluddin,Rasidah, AU - Ismail,Fatanah, AU - Ibrahim,Nurashikin, AU - Aris,Tahir, Y1 - 2018/05/14/ PY - 2018/5/17/entrez PY - 2018/5/17/pubmed PY - 2019/5/22/medline KW - depression KW - family support KW - intimate partner violence KW - postpartum SP - e020649 EP - e020649 JF - BMJ open JO - BMJ Open VL - 8 IS - 5 N2 - INTRODUCTION: An estimated 13% of women in the postnatal period suffer from postnatal depression (PND) worldwide. In addition to underprivileged women, women who are exposed to violence are at higher risk of PND. This study aimed to investigate the relationship between intimate partner violence (IPV) and PND in Malaysia. METHODS: This survey was conducted as a nationwide cross-sectional study using a cluster sampling design. Probable PND was assessed using a self-administered Edinburgh Postnatal Depression Scale (EPDS). Demographic profiles and IPV were assessed using a locally validated WHO Multicountry Study on Women's Health and Life Events Questionnaire that was administered in a face-to-face interview. An EPDS total score of 12 or more and/or a positive tendency to self-harm were used to define PND. RESULTS: Out of 6669 women, 5727 respondents were successfully interviewed with a response rate of 85.9%. The prevalence of probable PND was 4.4% (95% CI 2.9 to 6.7). The overall prevalence of IPV was 4.9% (95% CI 3.8 to 6.4). Among the women in this group, 3.7% (95% CI 2.7 to 5.0), 2.6% (95% CI 1.9 to 3.5) and 1.2% (95% CI 0.9 to 1.7) experienced emotional, physical and sexual violence, respectively. Logistic regression analysis revealed that women who were exposed to IPV were at 2.3 times the risk for probable PND, with an adjusted OR (aOR) of 2.34 (95% CI 1.12 to 4.87). Other factors for PND were reported emotional violence (aOR 3.79, 95% CI 1.93 to 7.45), unplanned pregnancy (aOR 3.32, 95% CI 2.35 to 4.69), lack of family support during confinement (aOR 1.79, 95% CI 1.12 to 2.87), partner's use of alcohol (aOR 1.59, 95% CI 1.07 to 2.35) or being from a household with a low income (aOR 2.99; 95% CI 1.63 to 5.49). CONCLUSIONS: Exposure to IPV was significantly associated with probable PND. Healthcare personnel should be trained to detect and manage both problems. An appropriate referral system and support should be made available. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/29764882/Postnatal_depression_and_intimate_partner_violence:_a_nationwide_clinic_based_cross_sectional_study_in_Malaysia_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&pmid=29764882 DB - PRIME DP - Unbound Medicine ER -