Postpartum Depression Threatens Mothers, Babies in Poor Countries

Mothers in low-income countries who suffer from postpartum depression may go unrecognized and thus untreated, affecting their own health and that of their babies.

In a report published online December 7, 2012, in the International Journal of Gynecology and Obstetrics, researchers at the University of Michigan said that their study suggests that if efforts to reduce child mortality and improve infant growth, health, and nutritional status in less-developed countries are to succeed, they must address the mental health of new mothers.

The study was conducted at the Mother-Baby Unit of the Komfo Anokye Teaching Hospital in Kumasi, Ghana, from June 6, 2011, to August 15, 2011. Kumasi is the second-largest city in Ghana and home to one of the country’s major medical schools. It is in the Ashanti region of Ghana, which is representative of the country as a whole in terms of health and socioeconomic indicators.

Semistructured interviews were conducted with women who had a hospitalized newborn during the study period. Surveys gathered information on maternal demographics, pregnancy and delivery, exposure to interpersonal violence, and availability of social support. Postpartum depression was measured with the Patient Health Questionnaire (PHQ-9). Two-thirds of the participating mothers showed high risk for symptoms of clinical depression.

“Postpartum depression is well known in the United States, and we recognize that pregnancy and the postpartum period are vulnerable times for maternal mental health,” said Katherine Gold, M.D., M.S.W., an assistant professor of family medicine in the Department of Obstetrics and Gynecology at the University of Michigan Medical School, in a statement describing the study’s results. “But in low-income nations, many people view symptoms of depression as spiritual or personal issues rather than as a psychiatric condition which could be treated.”

Lack of trained staff, limited financial resources, and stigma all present significant challenges to providing adequate perinatal mental health care in Ghana, said Gold and colleagues in their report.

The researchers emphasized that these findings are particularly important because of the serious impact that maternal depression can have on infants’ health outcomes. In low- and middle-income nations, they noted, children with mothers who are depressed are nearly twice as likely to be underweight and to experience growth stunting. Maternal depression has also been linked to poor infant nutritional status, diarrhea, and respiratory illness—critical factors affecting a child’s survival.

“Our research provides a mental health snapshot for this population of high-risk moms,” said Gold. “We know that if a mother has postpartum depression, both she and her baby face substantial health risks.”

The study was funded by a grant from the University of Michigan’s GlobalREACH program. Gold’s salary was supported by a training grant from the National Institute of Mental Health. ■

“Depression and Risk Factors for Depression Among Mothers of Sick Infants in Kumasi, Ghana” is posted at http://www.sciencedirect.com/science/article/pii/S0020729212005760.