Prevalence and Determinants of Perinatal Depression Among Labour Migrant and Refugee Women on the Thai-Myanmar Border: A Cohort Study

Abstract

Background: This study examines 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 and at one month post-partum using a structured clinical interview. Outcomes: A sample of 568 women was recruited. Period prevalence 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. 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; 95% CI 1.0-1.1). Interpretation: 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. Funding Statement: SMRU is part of the Mahidol Oxford Tropical Medicine Research Unit funded by the Wellcome Trust (WT-106698). Declaration of Interests: All authors declare no conflict of interests. Ethics Approval Statement: Ethical approval was granted by the University of Oxford Tropical Research Ethics Committee (OxTREC 28-15), the Mahidol University Faculty of Tropical Medicine Ethics Committee (TMEC 15-045) and the Tak Border Community Advisory Board (T-CAB 6/2/2015).