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Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study: a cohort study

Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study: a cohort study
Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study: a cohort study

Background: perinatal depression is a significant contributor to maternal morbidity and mortality globally. Migrant women, particularly those living in low- and middle-income settings, represent a particularly vulnerable group due to stressors experienced before, during and after migration. The vast majority of global migration flows occurring within and between low- and middle-income regions, yet existing evidence focuses predominantly on migrants in high-income destinations. This study aimed to redress this significant gap in the evidence by determining the prevalence and determinants of perinatal depression among migrant women on the Thai-Myanmar border.

Methods: a cohort of labour migrant and refugee women was followed-up from the first trimester of pregnancy to one month post-partum. Depression status was assessed in the first, second and third trimesters of pregnancy and at one month post-partum using the Structured Clinical Interview for the Diagnosis of DSM-IV Disorders. Women diagnosed with depression had immediate access to care. Data on potential demographic, social and clinical associated factors was collected using a questionnaire. Prevalence and incidence of any depressive disorder and moderate-severe depressive disorder was calculated. Univariable and multivariable logistic regression using complete case analysis was used to estimate odds ratios (OR) of association between exposure variables and depression status.

Results: five hundred sixty-eight women participated. Period prevalence (from first trimester of pregnancy to one month post-partum) of moderate-severe perinatal depression was 18.5% (95% CI 15.4-21.9%). Overall, 15.4% (95% CI 11.8-19.6%) of women developed new-onset moderate-severe depression during the study period. Forty-two participants received treatment for depression. Risk factors were interpersonal violence (OR 4.5; 95% CI 1.9-11.1); history of trauma (OR 2.4; 95% CI 1.4-4.3); self-reported history of depression (OR 2.3; 95% CI 1.2-4.2); labour migrant status (OR 2.1; 95% CI 1.1-4.0); low social support (OR 2.1; 95% CI 1.1-3.7); and maternal age (OR 1.1 per year; 95% CI 1.0-1.1). Limitations of the study include that culturally specific manifestations of depression may have been missed.

Conclusions: perinatal depression represents a significant burden among migrant women on the Thai-Myanmar border. Programmes to address the determinants along with early case identification and effective treatment and referral systems are key to addressing perinatal depression in this low-resource setting.

Cohort Studies, Depression/epidemiology, Depressive Disorder, Female, Humans, Myanmar/epidemiology, Pregnancy, Prevalence, Refugees, Thailand, Transients and Migrants
1471-244X
Fellmeth, Gracia
691f80d3-fb29-4219-86ed-848b117e6f09
Plugge, Emma
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Fazel, Mina
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Oo, May May
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Pimanpanarak, Mupawjay
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Phichitpadungtham, Yuwapha
864f54eb-4255-4e6b-acb6-112c7cd83828
Wai, Kerry
ac577e6e-6036-417a-8ce7-e7ba7b89264e
Charunwatthana, Prakaykaew
a2c22c2c-b4d9-4e83-bfb0-edd3dfd553f2
Simpson, Julie A.
3e978f4f-08c6-4c29-82cf-9904ac9e5e55
Nosten, François
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Fitzpatrick, Raymond
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McGready, Rose
901b40d0-a81c-4d92-bebf-7573eb8df859
Fellmeth, Gracia
691f80d3-fb29-4219-86ed-848b117e6f09
Plugge, Emma
b64d2086-6cf2-4fae-98bf-6aafa3115b35
Fazel, Mina
24c4df8f-d9e0-4d84-9353-cee4adafe55e
Oo, May May
26fa0e18-56e4-4cbe-b7c0-68f8adff72e8
Pimanpanarak, Mupawjay
d9942e1a-7e32-4d64-b84a-e1619a38bcad
Phichitpadungtham, Yuwapha
864f54eb-4255-4e6b-acb6-112c7cd83828
Wai, Kerry
ac577e6e-6036-417a-8ce7-e7ba7b89264e
Charunwatthana, Prakaykaew
a2c22c2c-b4d9-4e83-bfb0-edd3dfd553f2
Simpson, Julie A.
3e978f4f-08c6-4c29-82cf-9904ac9e5e55
Nosten, François
4a9e868e-9b19-49a0-89f8-891ad84886e4
Fitzpatrick, Raymond
bea5c739-8a31-41ad-995b-c91919bb4211
McGready, Rose
901b40d0-a81c-4d92-bebf-7573eb8df859

Fellmeth, Gracia, Plugge, Emma, Fazel, Mina, Oo, May May, Pimanpanarak, Mupawjay, Phichitpadungtham, Yuwapha, Wai, Kerry, Charunwatthana, Prakaykaew, Simpson, Julie A., Nosten, François, Fitzpatrick, Raymond and McGready, Rose (2020) Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study: a cohort study. BMC Psychiatry, 20, [168]. (doi:10.1186/s12888-020-02572-6).

Record type: Article

Abstract

Background: perinatal depression is a significant contributor to maternal morbidity and mortality globally. Migrant women, particularly those living in low- and middle-income settings, represent a particularly vulnerable group due to stressors experienced before, during and after migration. The vast majority of global migration flows occurring within and between low- and middle-income regions, yet existing evidence focuses predominantly on migrants in high-income destinations. This study aimed to redress this significant gap in the evidence by determining the prevalence and determinants of perinatal depression among migrant women on the Thai-Myanmar border.

Methods: a cohort of labour migrant and refugee women was followed-up from the first trimester of pregnancy to one month post-partum. Depression status was assessed in the first, second and third trimesters of pregnancy and at one month post-partum using the Structured Clinical Interview for the Diagnosis of DSM-IV Disorders. Women diagnosed with depression had immediate access to care. Data on potential demographic, social and clinical associated factors was collected using a questionnaire. Prevalence and incidence of any depressive disorder and moderate-severe depressive disorder was calculated. Univariable and multivariable logistic regression using complete case analysis was used to estimate odds ratios (OR) of association between exposure variables and depression status.

Results: five hundred sixty-eight women participated. Period prevalence (from first trimester of pregnancy to one month post-partum) of moderate-severe perinatal depression was 18.5% (95% CI 15.4-21.9%). Overall, 15.4% (95% CI 11.8-19.6%) of women developed new-onset moderate-severe depression during the study period. Forty-two participants received treatment for depression. Risk factors were interpersonal violence (OR 4.5; 95% CI 1.9-11.1); history of trauma (OR 2.4; 95% CI 1.4-4.3); self-reported history of depression (OR 2.3; 95% CI 1.2-4.2); labour migrant status (OR 2.1; 95% CI 1.1-4.0); low social support (OR 2.1; 95% CI 1.1-3.7); and maternal age (OR 1.1 per year; 95% CI 1.0-1.1). Limitations of the study include that culturally specific manifestations of depression may have been missed.

Conclusions: perinatal depression represents a significant burden among migrant women on the Thai-Myanmar border. Programmes to address the determinants along with early case identification and effective treatment and referral systems are key to addressing perinatal depression in this low-resource setting.

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s12888-020-02572-6 - Version of Record
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Accepted/In Press date: 26 March 2020
e-pub ahead of print date: 15 April 2020
Keywords: Cohort Studies, Depression/epidemiology, Depressive Disorder, Female, Humans, Myanmar/epidemiology, Pregnancy, Prevalence, Refugees, Thailand, Transients and Migrants

Identifiers

Local EPrints ID: 485229
URI: http://eprints.soton.ac.uk/id/eprint/485229
ISSN: 1471-244X
PURE UUID: 70533d5c-68ca-43cc-b82e-2cf289173f43
ORCID for Emma Plugge: ORCID iD orcid.org/0000-0002-8359-0071

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Date deposited: 01 Dec 2023 17:43
Last modified: 12 Jul 2024 02:06

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Contributors

Author: Gracia Fellmeth
Author: Emma Plugge ORCID iD
Author: Mina Fazel
Author: May May Oo
Author: Mupawjay Pimanpanarak
Author: Yuwapha Phichitpadungtham
Author: Kerry Wai
Author: Prakaykaew Charunwatthana
Author: Julie A. Simpson
Author: François Nosten
Author: Raymond Fitzpatrick
Author: Rose McGready

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