Palfreyman, Alexis;
(2021)
Addressing Psychosocial Vulnerabilities Through Antenatal Care—Depression, Suicidal Ideation, and Behavior: A Study Among Urban Sri Lankan Women.
Frontiers in Psychiatry
, 12
, Article 554808. 10.3389/fpsyt.2021.554808.
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Abstract
An absence of data persists for common perinatal mental disorders and suicidal ideation and/or behaviors (SIB), particularly from low- and middle-income countries and from the antenatal period. Capitalizing on Sri Lanka's strong antenatal platform, we identify the prevalence of antenatal depressive symptomology, lifetime- and current-pregnancy SIB and their risk factors in women in urbanizing Sri Lanka, and present opportunities for improved antenatal detection of psychosocial vulnerabilities. One thousand antenatal women in Gampaha District from all trimesters of pregnancy were screened in 2016 using a novel three-part instrument, including the validated Edinburgh Postnatal Depression Scale, a modified Columbia-Suicide Severity Rating Scale for first ever use among a perinatal and South Asian population, and an original Life Circumstances questionnaire (with validated subscales). Prevalence and risk factors associated with depressive symptomology and SIB were explored using univariate, bivariate and logistic regression analyses. Women ranged from 16 to 42 years; 46% were nulliparous. Past-week prevalence of antenatal depressive symptomology was high (29.6%). One in four women reported a lifetime history of SIB, while SIB during the current pregnancy was reported at 7.4%. Exposure to intimate partner violence and lifetime SIB emerged as the strongest correlates of both depressive and current-pregnancy SIB outcomes (p < 0.05). This study evidences the high prevalence of multiple psychosocial vulnerabilities in pregnant women in Sri Lanka and underscores the need for their improved comprehensive assessment. Given antenatal care's high rates of use in Sri Lanka and in low- and middle-income countries in general, this study presents it as a promising mechanism through which to effectively screen for multiple psychosocial vulnerabilities, supporting early identification and intervention for at-risk women and their families.
| Type: | Article |
|---|---|
| Title: | Addressing Psychosocial Vulnerabilities Through Antenatal Care—Depression, Suicidal Ideation, and Behavior: A Study Among Urban Sri Lankan Women |
| Location: | Switzerland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fpsyt.2021.554808 |
| Publisher version: | https://doi.org/10.3389/fpsyt.2021.554808 |
| Language: | English |
| Additional information: | Copyright © 2021 Palfreyman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (http://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| Keywords: | antenatal care, pregnancy, depression, Edinburgh Postnatal Depression Scale, suicide, Columbia-Suicide Severity Rating Scale, Sri Lanka |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10189884 |
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