Anna Dow1, Queen Dube, Brian W Pence, Annelies Van Rie. 1. *Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC; and †Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi.
Abstract
BACKGROUND: HIV-infected women face several risk factors related to postpartum depression (PPD). We aimed to describe the prevalence and cumulative incidence of PPD in the low-income setting of Malawi and to determine the association between maternal and infant HIV and PPD. METHODS: This longitudinal cohort study included 156 HIV-uninfected and 373 HIV-infected Malawian women enrolled 10-14 weeks after delivery who returned at 6, 9, 12, 15, and 18 months for follow-up visits. PPD was assessed at all visits. The prevalence of PPD at all visits was estimated using the Edinburgh Postnatal Depression Scale (EPDS). Association between PPD at 10-14 weeks and maternal and infant HIV status was assessed using log binomial regression. Cumulative incidence of PPD was assessed using Kaplan-Meier curves. RESULTS: Prevalence of PPD was highest (11%) at 10-14 weeks postpartum and decreased to 2.9% at 18 months. There was no association between maternal HIV status and PPD (prevalence ratio, 1.18; 95% confidence interval: 0.68 to 2.08). Among HIV-infected women, prevalence of PPD was higher among women whose infants had acquired HIV (prevalence ratio, 2.0; 95% confidence interval: 1.1 to 3.6). The cumulative probability of experiencing PPD over the first 12 months postpartum was estimated to be 33.5% for HIV-infected mothers with HIV-infected infants vs. 22.5% for HIV-infected mothers with uninfected infants and 23.2% for HIV-uninfected mothers. CONCLUSIONS: PPD prevalence did not differ between HIV-infected and -uninfected mothers but increased among women with an HIV-infected infant. Our findings suggest that it may be important to monitor PPD among women with HIV-infected infants.
BACKGROUND:HIV-infectedwomen face several risk factors related to postpartum depression (PPD). We aimed to describe the prevalence and cumulative incidence of PPD in the low-income setting of Malawi and to determine the association between maternal and infant HIV and PPD. METHODS: This longitudinal cohort study included 156 HIV-uninfected and 373 HIV-infected Malawianwomen enrolled 10-14 weeks after delivery who returned at 6, 9, 12, 15, and 18 months for follow-up visits. PPD was assessed at all visits. The prevalence of PPD at all visits was estimated using the Edinburgh Postnatal Depression Scale (EPDS). Association between PPD at 10-14 weeks and maternal and infant HIV status was assessed using log binomial regression. Cumulative incidence of PPD was assessed using Kaplan-Meier curves. RESULTS: Prevalence of PPD was highest (11%) at 10-14 weeks postpartum and decreased to 2.9% at 18 months. There was no association between maternal HIV status and PPD (prevalence ratio, 1.18; 95% confidence interval: 0.68 to 2.08). Among HIV-infectedwomen, prevalence of PPD was higher among women whose infants had acquired HIV (prevalence ratio, 2.0; 95% confidence interval: 1.1 to 3.6). The cumulative probability of experiencing PPD over the first 12 months postpartum was estimated to be 33.5% for HIV-infected mothers with HIV-infectedinfants vs. 22.5% for HIV-infected mothers with uninfected infants and 23.2% for HIV-uninfected mothers. CONCLUSIONS: PPD prevalence did not differ between HIV-infected and -uninfected mothers but increased among women with an HIV-infectedinfant. Our findings suggest that it may be important to monitor PPD among women with HIV-infectedinfants.
Authors: Jane Fisher; Meena Cabral de Mello; Vikram Patel; Atif Rahman; Thach Tran; Sara Holton; Wendy Holmes Journal: Bull World Health Organ Date: 2011-11-24 Impact factor: 9.408
Authors: Christine E Parsons; Katherine S Young; Tamsen J Rochat; Morten L Kringelbach; Alan Stein Journal: Br Med Bull Date: 2011-11-29 Impact factor: 4.291
Authors: Violeta J Rodriguez; Gladys Matseke; Ryan Cook; Seanna Bellinger; Stephen M Weiss; Maria L Alcaide; Karl Peltzer; Doyle Patton; Maria Lopez; Deborah L Jones Journal: AIDS Behav Date: 2018-06
Authors: Bulent Turan; Kristi L Stringer; Maricianah Onono; Elizabeth A Bukusi; Sheri D Weiser; Craig R Cohen; Janet M Turan Journal: BMC Pregnancy Childbirth Date: 2014-12-03 Impact factor: 3.007
Authors: Andreas D Haas; Malango T Msukwa; Matthias Egger; Lyson Tenthani; Hannock Tweya; Andreas Jahn; Oliver J Gadabu; Kali Tal; Luisa Salazar-Vizcaya; Janne Estill; Adrian Spoerri; Nozgechi Phiri; Frank Chimbwandira; Joep J van Oosterhout; Olivia Keiser Journal: Clin Infect Dis Date: 2016-07-26 Impact factor: 9.079