Mental health related determinants of parenting stress among urban mothers of young children – results from a birth-cohort study in Ghana and Côte d’Ivoire

Abstract

BackgroundThere are limited data on the parenting stress (PS) levels in sub-Saharan African mothers and on the association between ante- and postnatal depression and anxiety on PS.MethodsA longitudinal birth cohort of 577 women from Ghana and Côte d’Ivoire was followed from the 3rd trimester in pregnancy to 2 years postpartum between 2010 and 2013. Depression and anxiety were assessed by the Patient Health Questionnaire depression module (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) at baseline, 3 month, 12 month and 24 month postpartum. PS was measured using the Parenting Stress Index-Short Form (PSI-SF) at 3, 12 and 24 month. The mean total PS score and the subscale scores were compared among depressed vs. non-depressed and among anxious vs. non-anxious mothers at 3, 12 and 24 month postpartum. The proportions of clinical PS (PSI-SF raw score > 90) in depressed vs. non-depressed and anxious vs. non-anxious mothers were also compared. A generalized estimating equation (GEE) approach was used to estimate population-averaged associations between women’s depression/anxiety and PS adjusting for age, child sex, women’s anemia, education, occupation, spouse’s education, and number of sick child visits.ResultsA total of 577, 531 and 264 women completed the PS assessment at 3 month, 12 month and 24 month postpartum across the two sites and the prevalences of clinical PS at each time point was 33.1%, 24.4% and 14.9% in Ghana and 30.2%, 33.5% and 22.6% in Côte d’Ivoire, respectively. At all three time points, the PS scores were significantly higher among depressed mothers vs. non-depressed mothers. In the multivariate regression analyses, antepartum and postpartum depression were consistently associated with PS after adjusting for other variables.ConclusionsParenting stress is frequent and levels are high compared with previous studies from high-income countries. Antepartum and postpartum depression were both associated with PS, while antepartum and postpartum anxiety were not after adjusting for confounders. More quantitative and qualitative data are needed in sub-Saharan African populations to assess the burden of PS and understand associated mechanisms. Should our findings be replicated, it appears prudent to design and subsequently evaluate intervention strategies.

Maternal depression does not affect complementary feeding indicators or stunting status of young children (6–23 months) in Northern Ghana

“…A higher prevalence of maternal depression was estimated (33.5%) than previously reported for a population of mothers in Ghana (3.8–27.8%) [11, 13, 32–36]. Among these studies the highest rate (27.8%) was reported for mothers in Northern Ghana [11] while lower rates were reported for southern Ghana (3.8–11.3%).…”

Prevalence and determinants of depression in mothers of children under 5 years in Bole District, Ghana

“…Two previous studies, both of which used the Centre for Epidemiologic Studies Depression Scale, reported about twice our rate in Northern Ghana mothers i.e., 27.8% in 2016 [4] and 33.5% in 2018 [5]. However, six studies conducted on mothers outside northern Ghana recorded lower rates (3.8–11.3%) [6–11]. The lack of a nationally representative study on the prevalence of depression in Ghana makes judging these figures difficult.…”

“…In the developed world, 10 to 16% of all mothers are estimated to experience depression [2] while in Africa, a review based on 35 studies estimated that 18.3% of mothers have depression [3]. In Northern Ghana, the prevalence of depression was estimated in two community-based studies as 27.8% in 2016 [4] and 33.5 in 2018 [5] while six studies conducted on mothers outside northern Ghana recorded lower rates (3.8–11.3%) [6–11]. Depression is the leading cause of morbidity and mortality worldwide [12].…”

Antecedents of maternal parenting stress: the role of attachment style, prenatal attachment, and dyadic adjustment in first-time mothers

“… Misri et al (2010) , in a study with pregnant women prospectively monitored for depression and anxiety during the third trimester and 3 and 6 months postpartum, found that prenatal depression and anxiety directly impact postnatal maternal parenting stress. In a recent longitudinal birth cohort study following sub-Saharan African women from the third trimester in pregnancy to 2 years postnatal and adjusting for confounders, Guo et al (2014) found that prenatal depression was associated with parenting stress, while prenatal anxiety was not. Another study focused on the role of a woman’s own parenting history in postnatal parenting stress.…”