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Psychosocial Determinants of Sustained Maternal Functional Impairment: Longitudinal Findings from a Pregnancy-Birth Cohort Study in Rural Pakistan

Citation

Hagaman, Ashley K.; Gallis, John A.; Bhalotra, Sonia; Baranov, Victoria; Turner, Elizabeth L.; Sikander, Siham; & Maselko, Joanna (2019). Psychosocial Determinants of Sustained Maternal Functional Impairment: Longitudinal Findings from a Pregnancy-Birth Cohort Study in Rural Pakistan. PLOS ONE, 14(11), e0225163. PMCID: PMC6863521

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.

URL

http://dx.doi.org/10.1371/journal.pone.0225163

Notes

R01 HD075875/HD/NICHD NIH HHS/United States

Reference Type

Journal Article

Journal Title

PLOS ONE

Author(s)

Hagaman, Ashley K.
Gallis, John A.
Bhalotra, Sonia
Baranov, Victoria
Turner, Elizabeth L.
Sikander, Siham
Maselko, Joanna

Year Published

2019

Volume Number

14

Issue Number

11

Pages

e0225163

PMCID

PMC6863521

Reference ID

12685