Abstract
Migrant and refugee women are at risk of perinatal depression due to stressors experienced before, during and after migration. This study assesses the associations between social support and perinatal depression among migrant and refugee women on the Thai–Myanmar border. We conducted a cohort study of pregnant and post-partum women. Depression status was assessed using a structured clinical interview. Received support, perceived support and partner support were measured in the third trimester. Logistic regression was used to calculate associations between social support measures and perinatal depression controlling for demographic, socio-economic, migration, obstetric and psychosocial factors. Four hundred and fifty-one women (233 migrants; 218 refugees) were included. The prevalence of perinatal depression was 38.6% in migrants and 47.3% in refugees. Migrants had higher levels of received, perceived and partner support than refugees. After controlling for all other variables, higher levels of received support remained significantly associated with a lower likelihood of perinatal depression in migrants (adjusted odds ratio 0.82; 95% CI 0.68–0.99). In both groups, depression history and trauma were strongly associated with perinatal depression. Our study highlights the importance of received social support to perinatal depression in migrant women on the Thailand–Myanmar border. The perinatal period offers a valuable opportunity to ask women about their support and offer community-level or public policy interventions to nurture support networks in current locations and resettlement destinations.This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.
Highlights
Maternal mental disorders are a significant contributor to maternal morbidity worldwide with potentially severe consequences for women, their families and wider society [1,2]
Among migrants, when all three measures of social support were simultaneously entered into the model, only received support remained statistically significantly associated with perinatal depression
When we explored the associations of the three measures of support simultaneously, only received support remained significantly correlated with depression in migrants: each unit increase in received support scores was associated with a 20% reduction in the odds of perinatal depression
Summary
Maternal mental disorders are a significant contributor to maternal morbidity worldwide with potentially severe consequences for women, their families and wider society [1,2]. Perinatal depression is the most common perinatal mental disorder, disproportionately affecting women living in poverty. Across low- and middle-income countries (LMIC), the estimated prevalence of perinatal depression is 19%, estimates vary between settings [4]. Perinatal depression is associated with distress and suffering and may limit women’s ability to engage in paid work and provide care. Perinatal depression is associated with suicide—an important cause of maternal death across LMIC and high-income settings alike, among marginalized populations [5,6,7]. Children of mothers with depression are more likely to experience a range of poor physical, cognitive and emotional outcomes [8]. In LMIC especially, these poor outcomes among children perpetuate the inter-generational cycle of social and economic deprivation
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