Perinatal common mental disorders and child survival in Ethiopia

Authors

  • Abiodun O Adewuya,

    Corresponding author
    1. Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
    • Correspondence: Dr Abiodun O Adewuya, Department of Behavioural Medicine, Lagos State University College of Medicine, 1-5, Oba Akinjobi Way, PMB 21266, Ikeja, Lagos 100010, Nigeria. email: biodunwuya@yahoo.com

    Search for more papers by this author
  • Charlotte Hanlon,

    1. King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, United Kingdom
    2. Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
    Search for more papers by this author
  • Girmay Medhin,

    1. Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
    Search for more papers by this author
  • Michael Dewey,

    1. King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, United Kingdom
    Search for more papers by this author
  • Atalay Alem,

    1. Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
    Search for more papers by this author
  • Bogale Worku,

    1. Department of Paediatrics and Community Health, Addis Ababa University, Addis Ababa, Ethiopia
    Search for more papers by this author
  • Martin Prince

    1. King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, United Kingdom
    Search for more papers by this author

  • Conflict of interest: There is no conflict of interest to declare.
  • [The copyright line for this article was changed on 3 February 2017 after original online publication.]

Abstract

Aims

The study aims to evaluate the impact of perinatal common mental disorders (CMDs) on child mortality up to 3.5 years in a demographic surveillance site at Butajira, Ethiopia.

Methods

One thousand sixty-five eligible women were assessed for CMD in the third trimester of pregnancy and at 2 months post-delivery using the Self-Reporting Questionnaire. We derived a four-level categorical exposure variable for the course of perinatal CMD. The outcome measure was child death recorded from 1 month after the postnatal assessment up to 3.5 years. Potential confounders and mediators were evaluated.

Results

The cumulative child mortality rates were 62.6/1000 at 1 year and 82.5/1000 at 3.5 years, respectively. Exposure to perinatal CMD did not significantly affect child survival at 3.5 years, with results showing fully adjusted hazard ratio (HR) and 95% confidence interval (95% CI) of 1.85 (0.43, 7.88) for CMD in pregnancy only, 1.47 (0.14, 15.66) for CMD in postnatal period only and 0.41 (0.02, 7.38) for persistent CMD (both in pregnancy and postnatal). Only using soap less frequently than daily (HR 5.67, 95% CI 1.58–20.30) and episode of malaria in pregnancy (HR 5.02, 95% CI 2.15–11.72) were associated with child mortality in multivariable analysis.

Conclusions

Maternal health, health behaviours and family structure appear to be the most important factors affecting post-neonatal child mortality in this Ethiopian birth cohort, with little evidence for an effect of maternal perinatal CMD.

Ancillary