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Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort.
Compr Psychiatry 2019; 96:152128CP

Abstract

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.

Authors+Show Affiliations

Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa. Electronic address: rae.macginty@uct.ac.za.KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, UK.Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa.Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.Statistical Consulting Service, Department of Statistical Science, University of Cape Town, South Africa.Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa.KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, UK.Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa.Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa; South African Medical Research Council (SAMRC) Unit on Risk & Resilience in Mental Disorders, South Africa.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31715335

Citation

MacGinty, R P., et al. "Associations of Antenatal Maternal Psychological Distress With Infant Birth and Development Outcomes: Results From a South African Birth Cohort." Comprehensive Psychiatry, vol. 96, 2019, p. 152128.
MacGinty RP, Kariuki SM, Barnett W, et al. Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort. Compr Psychiatry. 2019;96:152128.
MacGinty, R. P., Kariuki, S. M., Barnett, W., Wedderburn, C. J., Hardy, A., Hoffman, N., ... Stein, D. J. (2019). Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort. Comprehensive Psychiatry, 96, p. 152128. doi:10.1016/j.comppsych.2019.152128.
MacGinty RP, et al. Associations of Antenatal Maternal Psychological Distress With Infant Birth and Development Outcomes: Results From a South African Birth Cohort. Compr Psychiatry. 2019 Oct 17;96:152128. PubMed PMID: 31715335.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort. AU - MacGinty,R P, AU - Kariuki,S M, AU - Barnett,W, AU - Wedderburn,C J, AU - Hardy,A, AU - Hoffman,N, AU - Newton,C R, AU - Zar,H J, AU - Donald,K A, AU - Stein,D J, Y1 - 2019/10/17/ PY - 2019/02/04/received PY - 2019/07/30/revised PY - 2019/09/09/accepted PY - 2019/11/13/pubmed PY - 2019/11/13/medline PY - 2019/11/13/entrez KW - Antenatal maternal psychological distress KW - Foetal growth KW - South Africa SP - 152128 EP - 152128 JF - Comprehensive psychiatry JO - Compr Psychiatry VL - 96 N2 - 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. SN - 1532-8384 UR - https://www.unboundmedicine.com/medline/citation/31715335/Associations_of_antenatal_maternal_psychological_distress_with_infant_birth_and_development_outcomes:_Results_from_a_South_African_birth_cohort L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010-440X(19)30051-3 DB - PRIME DP - Unbound Medicine ER -