Abstract
BackgroundLittle is known of the relationship between perinatal somatic and common mental disorder (CMD) symptoms and impaired functioning in women from settings where the burden of undernutrition and infectious disease morbidity is high.MethodsA population-based sample of 1065 women from Butajira, Ethiopia, was recruited in pregnancy (86.4% of those eligible) and reassessed two months postnatal (954 with singleton, live infants). At both time-points, women were administered a modified version of the Patient Health Questionnaire-15 and the Self-Reporting Questionnaire (locally-validated) to assess somatic and CMD symptoms, respectively. Negative binomial regression was used to investigate associations of CMD and somatic symptoms with functional impairment (World Health Organisation Disability Assessment Scale, version-II), after adjusting for maternal anthropometric measures, physical ill-health and sociodemographic factors.ResultsIn pregnancy, somatic and CMD symptoms were independently associated with worse maternal functional impairment after adjustment for confounders (WHODAS-II score multiplied by 1.09 (95%CI 1.06, 1.13) and 1.11 (95%CI 1.08, 1.14) respectively for each additional symptom). In the postnatal period, the size of association between somatic symptoms and functional impairment was diminished, but the association with CMD symptoms was virtually unchanged (multiplier value 1.04 (95%CI 1.00, 1.09) and 1.11 (95%CI 1.07, 1.16) respectively).LimitationsUse of largely self-report measures.ConclusionsSomatic and CMD symptoms were independently associated with functional impairment in both pregnancy and the postnatal period, with CMD symptoms showing a stronger and more consistent association. This emphasises the public health relevance of both CMD and somatic symptoms in the perinatal period.
Highlights
Somatic complaints are common in the perinatal period (Brown and Lumley, 2000; Webb et al, 2008) and oftenV
common mental disorder (CMD) symptoms and difficulty working (Table 5). Both Patient Health Questionnaire (PHQ)-13 and SRQ-20 scores were independently associated with being unable to work for 15 or more days in the preceding month, both in pregnancy and postnatally, after adjusting for confounders. In this population-based study in rural Ethiopia, perinatal somatic symptoms were cross-sectionally associated with maternal CMD at both the pregnancy and postnatal timepoints, but, unlike antenatal CMD symptoms, antenatal somatic symptoms were not prospectively associated with postnatal CMD
The size of the total score correlation coefficients between the PHQ-13 and SRQ-20 and factor analysis indicated that the scales were measuring distinct constructs
Summary
Somatic complaints are common in the perinatal period (Brown and Lumley, 2000; Webb et al, 2008) and oftenV. Methods: A population-based sample of 1065 women from Butajira, Ethiopia, was recruited in pregnancy (86.4% of those eligible) and reassessed two months postnatal (954 with singleton, live infants). At both time-points, women were administered a modified version of the Patient Health Questionnaire-15 and the Self-Reporting Questionnaire (locally-validated) to assess somatic and CMD symptoms, respectively. Conclusions: Somatic and CMD symptoms were independently associated with functional impairment in both pregnancy and the postnatal period, with CMD symptoms showing a stronger and more consistent association. This emphasises the public health relevance of both CMD and somatic symptoms in the perinatal period
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