Abstract
BackgroundThere is a high prevalence of antepartum depression and low birth weight (LBW) in Bangladesh. In high- and low-income countries, prior evidence linking maternal depressive and anxiety symptoms with infant LBW is conflicting. There is no research on the association between maternal mental disorders and LBW in Bangladesh. This study aims to investigate the independent effect of maternal antepartum depressive and anxiety symptoms on infant LBW among women in a rural district of Bangladesh.MethodsA population-based sample of 720 pregnant women from two rural subdistricts was assessed for symptoms of antepartum depression, using the Edinburgh Postpartum Depression Scale (EPDS), and antepartum anxiety, using the State Trait Anxiety Inventory (STAI), and followed for 6-8 months postpartum. Infant birth weight of 583 (81%) singleton live babies born at term (≥37 weeks of pregnancy) was measured within 48 hours of delivery. Baseline data provided socioeconomic, anthropometric, reproductive, obstetric, and social support information. Trained female interviewers carried out structured interviews. Chi-square, Fisher's exact, and independent-sample t tests were done as descriptive statistics, and a multiple logistic regression model was used to identify predictors of LBW.ResultsAfter adjusting for potential confounders, depressive (OR = 2.24; 95% CI 1.37-3.68) and anxiety (OR = 2.08; 95% CI 1.30-3.25) symptoms were significantly associated with LBW (≤2.5 kg). Poverty, maternal malnutrition, and support during pregnancy were also associated with LBW.ConclusionsThis study provides evidence that maternal depressive and anxiety symptoms during pregnancy predict the LBW of newborns and replicates results found in other South Asian countries. Policies aimed at the detection and effective management of depressive and anxiety symptoms during pregnancy may reduce the burden on mothers and also act as an important measure in the prevention of LBW among offspring in Bangladesh.
Highlights
There is a high prevalence of antepartum depression and low birth weight (LBW) in Bangladesh
In order to confirm the evidence from South Asia, the research needed to be replicated in other countries of South Asia, one of them being Bangladesh, where the estimated point prevalence of antepartum depression is as high as 33% [22] and LBW 36% [23]
Anxious women were more likely to be poor in terms of landholding and per capita daily household expenditure on food, and had a lower body mass index (BMI) and mid upper arm circumference (MUAC) than the non-anxious women
Summary
There is a high prevalence of antepartum depression and low birth weight (LBW) in Bangladesh. In high- and low-income countries, prior evidence linking maternal depressive and anxiety symptoms with infant LBW is conflicting. Impaired mental health has been associated with unhealthy maternal antenatal behavior including reduced attendance for antenatal care, increased substance use, and lower weight gain in pregnancy [11], which in turn has led to an increased likelihood of LBW [12]. Despite these vulnerabilities, the evidence linking maternal depressive and anxiety symptoms with infant LBW is conflicting. In order to confirm the evidence from South Asia, the research needed to be replicated in other countries of South Asia, one of them being Bangladesh, where the estimated point prevalence of antepartum depression is as high as 33% [22] and LBW 36% [23]
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