Adversity, social capital, and mental distress among mothers of small children: A cross-sectional study in three low and middle-income countries.

Journal: PloS one

Volume: 15

Issue: 1

Year of Publication: 2020

Affiliated Institutions:  Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States of America. Division of Adolescent and Young Adult Medicine, Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston Children's Hospital, Boston, MA, United States of America. Women and Health Initiative, Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, United States of America.

Abstract summary 

Maternal mental health is becoming recognized as a global health priority. Mental distress among mothers of young children may be exacerbated by exposure to adversity. Social capital may buffer the impact of adversity on mental distress during the postnatal period and beyond. This paper examines the relationship between adversity, cognitive social capital and mental distress among mothers of young children in three low and middle-income countries.This study uses data from the Young Lives study on 5,485 women from Ethiopia, India, and Vietnam. Logistic regression was used to examine the association between exposure to stressful life events (SLEs) and mental distress in women between 6 months and 1.5 years post-partum. Logistic and linear regression was used to examine the potential for effect modification by social capital.The proportion of women with mental distress during the period between 6-18 months following the birth of a child in the sample was 32.6% in Ethiopia, 30.5% in India and 21.1% in Vietnam. For each additional SLE to which a woman was exposed, the odds of MMD increased by 1.28 (95% CI: 1.22, 1.36; p<0.001) in Ethiopia, 1.17 (1.11, 1.25; p<0.001) in India, and 1.98 (1.75, 2.25; p<0.001) in Vietnam. Exposure to family SLEs was significantly associated with MMD in all three countries with odds ratios of 1.76 (95% CI: 1.30, 2.38; p<0.001), 1.62 (95% CI: 1.12, 2.33; p<0.01 in India), 1.93 (95% CI: 1.27, 2.92; p<0.01), respectively. In Ethiopia and India, economic SLEs were also significantly associated with MMD after adjustment (Ethiopia OR: 1.68; 95% CI: 1.12, 2.52; p<0.01 and India OR: 1.44; 95% CI: 1.01, 2.05; p<0.05), while in India, crime SLEs (OR: 1.93; 95% CI: 1.27, 2.92; p<0.01) were associated with MMD. Cognitive social capital was found to modify the association between SLEs and symptomology of mental distress in Ethiopia, India and Vietnam.This study suggests that adversity may increase the risk of maternal mental distress in three LMICs, while social capital may buffer its effect.

Authors & Co-authors:  Gausman Jewel J Austin S Bryn SB Subramanian S V SV Langer Ana A

Study Outcome 

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Statistics
Citations :  Howard LM, Piot P, Stein A. No health without perinatal mental health. The Lancet. 2014;384(9956):1723–4.
Authors :  4
Identifiers
Doi : e0228435
SSN : 1932-6203
Study Population
Women,Mothers
Mesh Terms
Cross-Sectional Studies
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Ethiopia
Publication Country
United States