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In low- and middle-income countries little is known about changes in
women's mental health status from the perinatal period to 15 months
postpartum or the factors associated with different trajectories.
Aims
To determine the incidence and rates of recovery from common mental
disorders (CMD) among rural Vietnamese women and the risk and protective
factors associated with these outcomes from the perinatal period to 15
months after giving birth.
Method
In a population-based prospective study, a systematically recruited
cohort of women completed baseline assessments in either the last
trimester of pregnancy or 4–6 weeks after giving birth and were followed
up 15 months later. The common mental disorders of major depression,
generalised anxiety and panic disorder were assessed by
psychiatrist-administered Structured Clinical Interview for DSM-IV
Disorders at both baseline and follow-up.
Results
A total of 211 women provided complete data in this study. The incidence
rate of CMD in the first postpartum year was 13% (95% CI 8–19), and 70%
(95% CI 59–80) of women who had perinatal CMD recovered within the first
postpartum year. Incidence was associated with having experienced
childhood maltreatment, experiencing the intimate partner as providing
little care, sensitivity, kindness or affection, and the chronic stress
of household poverty. Recovery was associated with higher quality of a
woman's relationships with her intimate partner and her own mother,
longer period of mandated rest following birth, and sharing of domestic
tasks and infant care.
Conclusions
Modifiable social factors, in particular the quality of a woman's closest
relationships with her partner and her own mother, and participation by
family members in domestic work and infant care, are closely related to
women's mental health in the first year after giving birth in
resource-constrained settings.
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