Psychosocial determinants of sustained maternal functional impairment: Longitudinal findings from a pregnancy-birth cohort study in rural Pakistan
Public Deposited- Creator
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Hagaman, A
- Other Affiliation: Department of Social Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
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Gallis, J.A
- Other Affiliation: Duke Global Health Institute, Duke University, Durham, NC, United States
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Bhalotra, S
- Other Affiliation: Department of Economics, University of Essex, Essex, United Kingdom
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Baranov, V
- Other Affiliation: Department of Economics, University of Melbourne, Melbourne, Australia
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Turner, E.L
- Other Affiliation: Duke Global Health Institute, Duke University, Durham, NC, United States
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Sikander, S
- Other Affiliation: Maternal and Neonatal Child Health Department, Health Services Academy, Islamabad, Pakistan
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Maselko, J
- Affiliation: Gillings School of Global Public Health, Department of Epidemiology
- Abstract
- Function is an important marker of health throughout the life course, however, in low-and-middle-income-countries, little is known about the burden of functional impairment as women transition from pregnancy to the first year post-partum. Leveraging longitudinal data from 960 women participating in the Share Child Cohort in Pakistan, this study sought to (1) characterize functional trajectories over time among women in their perinatal period and (2) assess predictors of chronic poor functioning following childbirth. We used a group-based trajectory modeling approach to examine maternal patterns of function from the third trimester of pregnancy through 12 months post-partum. Three trajectory groups were found: persistently well-functioning (51% of women), poor functioning with recovery (39% of women), and chronically poor functioning (10% of women). When compared to mothers in the highest functioning group, psychosocial characteristics (e.g., depression, stress, and serious life events) were significantly associated with sustained poor functioning one-year following child-birth. Mothers living in nuclear households were more likely to experience chronic poor functioning. Higher education independently predicted maternal function recovery, even when controlling for psychosocial characteristics. Education, above and beyond socio-economic assets, appears to play an important protective role in maternal functional trajectories following childbirth. Public health implications related to maternal function and perinatal mental health are discussed.
- Date of publication
- 2019
- Keyword
- illness trajectory
- rural population
- major clinical study
- Psychology, Social
- Adult
- Women's Health
- women's health
- longitudinal study
- maternal disease
- Peripartum Period
- human
- functional disease
- third trimester pregnancy
- adult
- psychosocial disorder
- social psychology
- perinatal period
- female
- Mental Health
- Socioeconomic Factors
- nuclear family
- life event
- prediction
- rural area
- Cohort Studies
- pregnancy
- socioeconomics
- educational status
- Pregnancy
- Humans
- childbirth
- mental health
- cohort analysis
- Rural Population
- Female
- epidemiology
- controlled study
- Article
- Pakistan
- public health
- puerperium
- DOI
- Identifier
- Resource type
- Article
- Rights statement
- In Copyright
- License
- Attribution 4.0 International
- Journal title
- PLoS ONE
- Journal volume
- 14
- Journal issue
- 11
- Language
- English
- Version
- Publisher
- Funder
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD: P2CHD050924, T32HD007168
- National Institute of Child Health and Human Development, NICHD: R01HD075875
- National Institute of Mental Health, NIMH: U19MH95687
- ISSN
- 1932-6203
- Publisher
- Public Library of Science
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