Perinatal Distress and Depression in Culturally and Linguistically Diverse (CALD) Australian Women: The Role of Psychosocial and Obstetric Factors
Abstract
:1. Introduction
2. Methods
2.1. Data Source
2.2. Study Setting
2.3. Study Factors
2.4. Outcome Variables
2.5. Statistical Analysis
2.6. Ethics
3. Results
3.1. Prevalence and Determinants of Antenatal Distress (Edinburgh Postnatal Depression Scale (EPDS) = 10–12)
3.2. Prevalence and Determinants of Antenatal Depressive Symptoms (EPDS ≥ 13)
3.3. Prevalence and Determinants of Postnatal Distress (EPDS = 10–12)
3.4. Prevalence and Determinants of Postnatal Depressive Symptoms (EPDS ≥ 13)
4. Discussion
Policy Implications of the Study Findings
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Complete Cases | Multiple Imputation * | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Participants | Cases | % | Unadjusted OR (95%CI) | P Value | Adjusted OR (95% CI) # | P Value | Unadjusted OR (95% CI) | P Value | Adjusted OR (95% CI) # | P Value | |
Antenatal distress | 20,560 | 2078 | 10.1 | ||||||||
Psychosocial factors | |||||||||||
Maternal age group | |||||||||||
20–34 years | 19,333 | 1955 | 10.1 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
≥35 years | 1134 | 113 | 10.0 | 1.0 (0.8–1.2) | 0.941 | 1.1 (0.8–1.4) | 0.460 | 1.0 (0.8–1.2) | 0.941 | 1.1 (0.8–1.4) | 0.471 |
<20 years | 93 | 10 | 10.8 | 1.2 (0.6–2.3) | 0.617 | 1.6 (0.4–5.8) | 0.439 | 1.2 (0.6–2.3) | 0.617 | 1.7 (0.4–5.8) | 0.430 |
Socioeconomic status category | |||||||||||
Low | 10,385 | 1143 | 11.0 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Middle | 7606 | 666 | 8.7 | 0.7 (0.7–0.8) | <0.001 | 0.8 (0.7–0.9) | 0.006 | 0.7 (0.7–0.8) | <0.001 | 0.8 (0.7–0.9) | 0.001 |
High | 1336 | 103 | 7.7 | 0.6 (0.5–0.7) | <0.001 | 0.7 (0.5–1.0) | 0.096 | 0.6 (0.5–0.8) | <0.001 | 0.7 (0.5–0.9) | 0.042 |
Supportive partner | |||||||||||
Yes | 19,491 | 1929 | 9.9 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
No | 559 | 90 | 16.1 | 2.6 (2.1–3.4) | <0.001 | 3.0 (2.1–4.3) | <0.001 | 2.6 (2.1–3.3) | <0.001 | 3.2 (2.3–4.5) | <0.001 |
Maternal history of childhood abuse | |||||||||||
No | 19,102 | 1873 | 9.8 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 708 | 109 | 15.4 | 2.0 (1.6–2.4) | <0.001 | 1.9 (1.4–2.6) | <0.001 | 2.0 (1.6–2.5) | <0.001 | 1.9 (1.4-2.6) | <0.001 |
Psychological IPV | |||||||||||
No | 19,759 | 1953 | 9.9 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 308 | 58 | 18.8 | 2.9 (2.1–3.9) | <0.001 | 2.8 (1.7–4.5) | <0.001 | 2.9 (2.1–3.9) | <0.001 | 2.6 (1.6-4.1) | <0.001 |
Physical IPV | |||||||||||
No | 19,757 | 1965 | 10.0 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 259 | 39 | 15.1 | 2.3 (1.6–3.3) | <0.001 | 0.9 (0.5–1.7) | 0.950 | 2.3 (1.6–3.3) | <0.001 | 1.1 (0.6–1.8) | 0.830 |
Mother was known to FACS | |||||||||||
No | 17,188 | 1702 | 9.9 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 126 | 26 | 20.6 | 3.1 (2.0–4.9) | <0.001 | 2.0 (1.1–3.8) | 0.018 | 3.1 (2.0–5.0) | <0.001 | 2.0 (1.1–3.6) | 0.012 |
Previous child in OOHC | |||||||||||
No | 12,988 | 1218 | 9.3 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 446 | 71 | 15.9 | 1.9 (1.5–2.5) | <0.001 | 1.6 (1.1–2.2) | 0.003 | 2.0 (1.5–2.6) | <0.001 | 1.6 (1.2–2.2) | 0.002 |
Major nationality group | |||||||||||
Oceania | 1186 | 133 | 11.2 | 1.0 | 1.0 | ||||||
North-West Europe | 312 | 18 | 5.8 | 0.4 (0.2–0.7) | 0.002 | 0.3 (0.1–0.7) | 0.008 | 0.4 (0.4–0.5) | <0.001 | 0.3 (0.2–0.4) | <0.001 |
Southern-Eastern Europe | 1066 | 55 | 5.2 | 0.3 (0.2–0.5) | <0.001 | 0.4 (0.3–0.7) | 0.001 | 0.4 (0.4–0.4) | <0.001 | 0.4 (0.4–0.5) | <0.001 |
North Africa and the Middle East | 4801 | 545 | 11.4 | 1.0 (0.8–1.2) | 0.684 | 1.1 (0.8–1.5) | 0.712 | 1.0 (1.0–1.1) | 0.038 | 1.0 (1.0–1.1) | 0.049 |
South-East Asia | 5077 | 463 | 9.1 | 0.7 (0.6–0.9) | 0.007 | 0.6 (0.4–0.8) | 0.002 | 0.7 (0.7–0.8) | <0.001 | 0.6 (0.6–0.7) | <0.001 |
North-East Asia | 2692 | 212 | 7.9 | 0.6 (0.5–0.7) | <0.001 | 0.6 (0.4–0.8) | 0.005 | 0.6 (0.6–0.7) | <0.001 | 0.6 (0.5–0.6) | <0.001 |
Southern and Central Asia | 4234 | 540 | 12.7 | 1.1 (0.9–1.4) | 0.187 | 1.2 (0.9–1.6) | 0.205 | 1.1 (1.1–1.2) | <0.001 | 1.1 (1.1–1.2) | <0.001 |
Americas | 487 | 36 | 7.4 | 0.6 (0.4–0.8) | 0.010 | 0.6 (0.3–1.1) | 0.182 | 0.6 (0.5–0.6) | 0.012 | 0.6 (0.5–0.7) | <0.001 |
Sub-Saharan Africa | 705 | 76 | 10.7 | 0.9 (0.6–1.2) | 0.621 | 0.9 (0.6–1.4) | 0.794 | 0.9 (0.8–0.9) | <0.001 | 0.9 (0.9–1.0) | 0.560 |
Obstetric factors | |||||||||||
Alcohol use in pregnancy | |||||||||||
No | 20,049 | 2011 | 10.0 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 163 | 25 | 15.3 | 1.6 (1.0–2.4) | 0.028 | 1.6 (1.1–2.3) | 0.011 | 1.6 (1.0–2.4) | 0.031 | 1.6 (0.8–2.9) | 0.160 |
Antenatal health problems | |||||||||||
No | 16,364 | 1589 | 9.7 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 3501 | 410 | 11.7 | 1.3 (1.1–1.4) | <0.001 | 1.2 (1.1–1.4) | 0.002 | 1.3 (1.1–1.4) | <0.001 | 1.3 (1.1–1.6) | 0.001 |
Complete Cases | Multiple Imputation * | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Participants | Cases | % | Unadjusted OR (95% CI) | P Value | Adjusted OR (95% CI) # | P Value | Unadjusted OR (95% CI) | P Value | Adjusted OR (95% CI) # | P Value | |
Antenatal depressive symptoms | 20,560 | 1510 | 7.3 | ||||||||
Psychosocial factors | |||||||||||
Maternal age group | |||||||||||
20–34 years | 19,333 | 1392 | 7.2 | 1.0 | 1.0 | 1.0 | |||||
≥35 years | 1134 | 104 | 9.2 | 1.3 (1.1–1.6) | 0.014 | 1.2 (0.9–1.6) | 0.095 | 1.3 (1.1–1.6) | 0.014 | 1.2 (0.9–1.6) | 0.159 |
<20 years | 93 | 14 | 15.1 | 2.3 (1.3–4.1) | 0.004 | 1.2 (0.2–1.2) | 0.805 | 2.3 (1.3–4.1) | 0.004 | 2.1 (0.5–7.6) | 0.246 |
Socioeconomic status category | |||||||||||
Low | 10,385 | 915 | 8.8 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Middle | 7606 | 456 | 6.0 | 0.6 (0.6–0.7) | <0.001 | 0.7 (0.5–0.8) | <0.001 | 0.6 (0.6–0.7) | <0.001 | 0.7 (0.6–0.8) | <0.001 |
High | 1336 | 59 | 4.4 | 0.4 (0.3–0.5) | <0.001 | 0.5 (0.3–0.7) | 0.001 | 0.4 (0.3–0.6) | <0.001 | 0.5 (0.3–0.7) | <0.001 |
Supportive partner | |||||||||||
Yes | 19,491 | 1263 | 6.5 | 1.0 | <0.001 | 1.0 | 1.0 | 1.0 | |||
No | 559 | 186 | 33.3 | 8.5 (6.9–10.2) | <0.001 | 6.7 (4.9–9.1) | <0.001 | 8.0 (6.6–9.7) | <0.001 | 6.5 (4.9–8.7) | <0.001 |
Maternal history of childhood abuse | |||||||||||
No | 19,102 | 1288 | 6.7 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 708 | 137 | 19.4 | 3.6 (3.0–4.4) | <0.001 | 3.2 (2.4–4.3) | <0.001 | 3.6 (3.0–3–4.4) | <0.001 | 3.1 (2.3–4.2) | <0.001 |
Psychological IPV | |||||||||||
No | 19,759 | 1382 | 7.0 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 308 | 82 | 26.6 | 5.8 (4.4–7.5) | <0.001 | 1.8 (1.0–3.1) | 0.025 | 5.8 (4.4–7.5) | <0.001 | 1.9 (1.1–3.1) | 0.010 |
Physical IPV | |||||||||||
No | 19,757 | 1370 | 6.9 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 259 | 80 | 30.9 | 4.7 (3.9–5.7) | <0.001 | 2.6 (1.5–4.4) | <0.001 | 6.8 (5.1–9.0) | <0.001 | 2.6 (1.5–4.3) | <0.001 |
Mother was known to FACS | |||||||||||
No | 17,188 | 1201 | 7.0 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 126 | 31 | 24.6 | 5.3 (3.4–8.1) | <0.001 | 2.3 (1.2–4.3) | 0.006 | 5.3 (3.4–8.1) | <0.001 | 1.9 (1.0–3.4) | 0.033 |
Previous child in OOHC | |||||||||||
No | 12,988 | 903 | 7.0 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 446 | 57 | 12.8 | 2.1 (1.6–2.8) | <0.001 | 1.4 (0.9–2.0) | 0.378 | 2.1 (1.6–2.8) | <0.001 | 1.4 (1.0–2.0) | 0.043 |
Major nationality group | |||||||||||
Oceania | 1186 | 112 | 9.4 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
North-West Europe | 312 | 5 | 1.6 | 0.1 (0.1–0.3) | <0.001 | 0.1 (0.04–0.7) | 0.017 | 0.1 (0.1–0.2) | <0.001 | 0.1 (0.1–0.2) | <0.001 |
Southern-Eastern Europe | 1066 | 29 | 2.7 | 0.2 (0.1–0.3) | <0.001 | 0.2 (0.1–0.5) | <0.001 | 0.2 (0.2–0.3) | <0.001 | 0.2 (0.2–0.3) | <0.001 |
North Africa and the Middle East | 4801 | 559 | 11.6 | 1.2 (1.0–1.5) | 0.029 | 1.7 (1.2–2.3) | 0.001 | 1.2 (1.2–1.3) | <0.001 | 1.6 (1.5–1.7) | <0.001 |
South-East Asia | 5077 | 263 | 5.2 | 0.5 (0.4–0.6) | <0.001 | 0.5 (0.4–0.8) | 0.002 | 0.5 (0.4–0.5) | <0.001 | 0.5 (0.5–0.6) | <0.001 |
North-East Asia | 2692 | 103 | 3.8 | 0.3 (0.2–0.4) | <0.001 | 0.4 (0.3–0.7) | 0.001 | 0.3 (0.3–0.4) | <0.001 | 0.4 (0.4–0.5) | <0.001 |
Southern and Central Asia | 4234 | 362 | 8.6 | 0.9 (0.7–1.1) | 0.425 | 1.1 (0.8–1.6) | 0.373 | 0.9 (0.8–0.9) | <0.001 | 1.1 (1.0–1.2) | <0.001 |
Americas | 487 | 28 | 5.8 | 0.5 (0.3–0.8) | 0.007 | 0.7 (0.4–1.4) | 0.438 | 0.5 (0.5–0.6) | <0.001 | 0.7 (0.6–0.8) | <0.001 |
Sub-Saharan Africa | 705 | 49 | 7.0 | 0.7 (0.4–1.0) | 0.056 | 0.5 (0.3–0.9) | 0.044 | 0.7 (0.6–0.7) | <0.001 | 0.5 (0.4–0.6) | <0.001 |
Obstetric factors | |||||||||||
Alcohol use in pregnancy | |||||||||||
No | 20,049 | 1471 | 7.3 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 163 | 11 | 6.8 | 0.9 (0.5–1.8) | 0.937 | 0.6 (0.2–1.7) | 0.413 | 0.9 (0.5–1.8) | 0.962 | 0.9 (0.3–2.1) | 0.853 |
Antenatal health problems | |||||||||||
No | 16,364 | 1129 | 6.9 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 3501 | 309 | 8.8 | 1.3 (1.2–1.5) | <0.001 | 1.3 (1.0–1.6) | 0.011 | 1.3 (1.2–1.5) | <0.001 | 1.3 (1.0–1.6) | 0.010 |
Complete Cases | Multiple Imputation * | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Participants | Cases | % | Unadjusted OR (95% CI) | P Value | Adjusted OR (95% CI) # | P Value | Unadjusted OR (95% CI) | P Value | Adjusted OR (95% CI) # | P Value | |
Postnatal distress | 19,342 | 1194 | 6.2 | ||||||||
Psychosocial factors | |||||||||||
Antenatal EPDS | |||||||||||
EPDS ≤ 9 | 13,075 | 559 | 4.3 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
EPDS 10–12 | 1633 | 213 | 13.2 | 3.6 (3.0–4.2) | <0.001 | 4.0 (3.1–5.2) | <0.001 | 2.8 (2.4–3.3) | <0.001 | 3.0 (2.3–3.8) | <0.001 |
EPDS ≥ 13 | 1189 | 183 | 15.4 | 4.9 (4.1–5.9) | <0.001 | 5.5 (4.1–7.3) | <0.001 | 3.7 (3.1–4.4) | <0.001 | 3.9 (3.0–5.1) | <0.001 |
Maternal age group | |||||||||||
20–34 years | 18,147 | 1114 | 6.1 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
≥35 years | 1106 | 74 | 6.7 | 1.1 (0.8–1.4) | 0.366 | 1.1 (0.7–1.6) | 0.460 | 1.0 (0.8–1.3) | 0.493 | 1.1 (0.7–1.5) | 0.577 |
<20 years | 89 | 6 | 6.7 | 1.1 (0.4–2.5) | 0.795 | 0.1 (0.1–9.4) | 0.885 | 1.1 (0.5–2.3) | 0.770 | 0.9 (0.1–6.7) | 0.922 |
Socioeconomic status category | |||||||||||
Low | 9629 | 584 | 6.1 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Middle | 7389 | 437 | 5.9 | 0.9 (0.8–1.0) | 0.516 | 1.1 (0.9–1.3) | 0.276 | 0.9 (0.8–1.0) | 0.584 | 1.0 (0.8–1.3) | 0.416 |
High | 1345 | 103 | 7.7 | 1.2 (0.9–1.5) | 0.042 | 1.6 (1.1–2.3) | 0.009 | 1.1 (0.9–1.4) | 0.169 | 1.4 (1.0–1.9) | 0.050 |
Supportive partner | |||||||||||
Yes | 16,275 | 967 | 5.9 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
No | 451 | 49 | 10.9 | 2.1 (1.5–2.9) | <0.001 | 1.2 (0.7–2.1) | 0.379 | 2.1 (1.5–2.9) | <0.001 | 1.3 (0.8–2.2) | 0.224 |
Maternal history of childhood abuse | |||||||||||
No | 15,846 | 931 | 5.9 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 607 | 61 | 10.1 | 1.9 (1.4–2.5) | <0.001 | 1.2 (0.7–1.9) | 0.328 | 1.7 (1.3–2.2) | <0.001 | 1.1 (0.7–1.8) | 0.532 |
Psychological IPV | |||||||||||
No | 16,420 | 982 | 5.9 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 264 | 26 | 9.9 | 1.8 (1.2–2.8) | 0.003 | 1.0 (0.4–2.2) | 0.997 | 1.7 (1.2–2.6) | 0.004 | 1.0 (0.5–2.2) | 0.835 |
Physical IPV | |||||||||||
No | 16,418 | 991 | 6.0 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 220 | 15 | 6.8 | 1.2 (0.7–2.2) | 0.334 | 0.8 (0.3–2.2) | 0.734 | 1.3 (0.8–2.1) | 0.262 | 0.7 (0.2–1.8) | 0.481 |
Mother was known to FACS | |||||||||||
No | 14,357 | 845 | 5.9 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 103 | 11 | 10.7 | 2.3 (1.2–4.5) | 0.008 | 1.8 (0.8–4.4) | 0.144 | 1.9 (1.0–3.6) | 0.038 | 1.5 (0.6–3.4) | 0.321 |
Previous child in OOHC | |||||||||||
No | 10,639 | 590 | 5.6 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 345 | 19 | 5.5 | 1.0 (0.6–1.6) | 0.966 | 0.6 (0.3–1.4) | 0.250 | 0.9 (0.6–1.5) | 0.951 | 0.7 (0.4–1.3) | 0.328 |
Major nationality group | |||||||||||
Oceania | 1143 | 59 | 5.2 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
North–West Europe | 284 | 15 | 5.3 | 1.0 (0.5–1.8) | 0.929 | 1.4 (1.0–1.5) | 0.525 | 0.9 (0.9–1.1) | 0.983 | 1.1 (0.9–1.3) | 0.169 |
Southern–Eastern Europe | 1030 | 49 | 4.8 | 0.8 (0.6–1.3) | 0.585 | 1.3 (1.0–1.5) | 0.453 | 0.9 (0.8–0.9) | 0.036 | 1.1 (1.0–1.2) | 0.027 |
North Africa and the Middle East | 4218 | 271 | 6.4 | 1.2 (0.9–1.7) | 0.083 | 1.9 (1.0–1.5) | 0.014 | 1.2 (1.1–1.2) | <0.001 | 1.4 (1.3–1.6) | <0.001 |
South–East Asia | 4940 | 282 | 5.7 | 1.1 (0.8–1.4) | 0.478 | 1.6 (1.0–1.5) | 0.074 | 1.0 (1.0–1.1) | 0.006 | 1.2 (1.1–1.4) | <0.001 |
North–East Asia | 2540 | 152 | 6.0 | 1.1 (0.8–1.5) | 0.334 | 1.8 (1.0–1.5) | 0.035 | 1.1 (1.0–1.1) | <0.001 | 1.4 (1.3–1.5) | <0.001 |
Southern and Central Asia | 4011 | 298 | 7.4 | 1.4 (1.1–1.9) | 0.007 | 2.0 (1.0–1.5) | 0.008 | 1.3 (1.2–1.4) | <0.001 | 1.6 (1.5–1.8) | <0.001 |
Americas | 501 | 32 | 6.4 | 1.2 (0.7–1.9) | 0.365 | 1.2 (1.0–1.5) | 0.630 | 1.1 (1.0–1.2) | <0.001 | 1.1 (0.9–1.2) | 0.096 |
Sub–Saharan Africa | 675 | 36 | 5.3 | 1.0 (0.6–1.6) | 0.835 | 2.6 (1.0–1.5) | 0.004 | 1.0 (0.9–1.1) | 0.238 | 1.8 (1.6–2.1) | <0.001 |
Obstetric factors | |||||||||||
Alcohol use in pregnancy | |||||||||||
No | 17,001 | 1039 | 6.1 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 143 | 13 | 9.1 | 1.5 (0.8–2.6) | 0.158 | 1.4 (0.5–3.8) | 0.413 | 1.5 (0.8–2.6) | 0.156 | 1.7 (0.8–3.9) | 0.148 |
Antenatal health problems | |||||||||||
No | 15,755 | 960 | 6.1 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 3041 | 206 | 6.8 | 1.1 (0.9–1.3) | 0.114 | 1.2 (0.9–1.6) | 0.084 | 1.0 (0.9–1.2) | 0.234 | 1.1 (1.1–1.2) | <0.001 |
Type of delivery | |||||||||||
Normal vaginal | 11,336 | 602 | 5.3 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Assisted vaginal | 2323 | 176 | 7.6 | 1.4 (1.2–1.7) | <0.001 | 1.2 (0.8–4.4) | 0.175 | 1.3 (1.1–1.6) | 0.001 | 1.3 (0.9–1.8) | 0.092 |
Caesarean section | 5658 | 415 | 7.3 | 1.4 (1.2–1.6) | <0.001 | 1.1 (0.9–1.4) | 0.262 | 1.3 (1.1–1.5) | <0.001 | 1.1 (0.8–1.3) | 0.372 |
Complete Cases | Multiple Imputation * | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Participants | Cases | % | Unadjusted OR (95% CI) | P Value | Adjusted OR (95%CI) # | P Value | Unadjusted OR (95% CI) | P Value | Adjusted OR (95% CI) # | P Value | |
Postnatal depressive symptoms | 19,342 | 723 | 3.7 | ||||||||
Psychosocial factors | |||||||||||
Antenatal EPDS | |||||||||||
EPDS ≤ 9 | 13,075 | 268 | 2.1 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
EPDS 10–12 | 1633 | 112 | 6.9 | 3.9 (3.1–4.9) | <0.001 | 4.5 (3.2–6.3) | <0.001 | 2.9 (2.3–3.6) | <0.001 | 3.1 (2.2–4.4) | <0.001 |
EPDS ≥ 13 | 1189 | 201 | 16.9 | 11.4 (9.3–13.8) | <0.001 | 11.4 (9.3–16.1) | <0.001 | 7.6 (6.3–9.2) | <0.001 | 7.3 (5.4–9.9) | <0.001 |
Maternal age group | |||||||||||
20–34 years | 18,147 | 659 | 3.6 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
≥35 years | 1106 | 60 | 5.4 | 1.5 (1.1–2.0) | 0.002 | 1.5 (1.0–2.4) | 0.026 | 1.3 (1.0–1.8) | 0.019 | 1.3 (0.9–2.0) | 0.113 |
<20 years | 89 | 4 | 4.5 | 1.2 (0.4–3.4) | 0.655 | 1.4 (0.1–12.3) | 0.748 | 1.2 (0.45–3.4) | 0.659 | 1.0 (0.1–9.2) | 0.953 |
Socioeconomic status category | |||||||||||
Low | 9629 | 432 | 4.5 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Middle | 7389 | 228 | 3.1 | 0.6 (0.5–0.7) | <0.001 | 0.8 (0.86–1.0) | 0.103 | 0.7 (0.6–0.8) | <0.001 | 0.8 (0.6–1.0) | 0.105 |
High | 1345 | 30 | 2.2 | 0.4 (0.3–0.7) | 0.008 | 0.4 (0.2–0.9) | 0.036 | 0.5 (0.4–0.8) | 0.002 | 0.5 (0.2–1.0) | 0.078 |
Supportive partner | |||||||||||
Yes | 16,275 | 555 | 3.4 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
No | 451 | 53 | 11.8 | 4.0 (2.9–5.4) | <0.001 | 1.2 (0.7–2.1) | 0.399 | 3.9 (2.9–5.3) | <0.001 | 1.7 (1.1–2.9) | 0.018 |
Maternal history of childhood abuse | |||||||||||
No | 15,846 | 540 | 3.4 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 607 | 52 | 8.6 | 2.8 (2.0–3.7) | <0.001 | 2.0 (1.2–3.1) | 0.003 | 2.4 (1.7–3.3) | <0.001 | 1.6 (1.0–2.5) | 0.044 |
Psychological IPV | |||||||||||
No | 16,420 | 581 | 3.5 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 264 | 29 | 11.0 | 3.5 (2.3–5.2) | <0.001 | 1.0 (1.0–3.2) | 0.979 | 3.0 (2.0–4.5) | <0.001 | 0.9 (0.4–1.9) | 0.923 |
Physical IPV | |||||||||||
No | 16,418 | 573 | 3.5 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 220 | 32 | 14.6 | 4.7 (3.2–7.0) | <0.001 | 2.5 (1.2–5.4) | 0.015 | 3.9 (2.6–5.7) | <0.001 | 2.0 (1.0–4.1) | 0.037 |
Mother was known to FACS | |||||||||||
No | 14,357 | 488 | 3.4 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 103 | 21 | 20.4 | 7.8 (4.8–12.9) | <0.001 | 4.0 (1.9–8.4) | <0.001 | 5.5 (3.4–9.0) | <0.001 | 2.9 (1.4–5.8) | 0.002 |
Previous child in OOHC | |||||||||||
No | 10,639 | 355 | 3.3 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 345 | 17 | 4.9 | 1.5 (0.9–2.4) | 0.110 | 0.7 (0.3–1.3) | 0.315 | 1.3 (0.8–2.1) | 0.182 | 0.8 (0.4–1.4) | 0.503 |
Major nationality group | |||||||||||
Oceania | 1143 | 38 | 3.3 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
North–West Europe | 284 | 10 | 3.5 | 1.0 (0.5–2.1) | 0.866 | 2.1 (1.0–1.5) | 0.208 | 1.0 (0.9–1.1) | 0.563 | 1.7 (1.4–2.1) | <0.001 |
Southern–Eastern Europe | 1030 | 13 | 1.3 | 0.3 (0.1–0.6) | 0.002 | 0.4 (1.0–1.5) | 0.176 | 0.4 (0.4–0.5) | <0.001 | 0.6 (0.5–0.7) | <0.001 |
North Africa and the Middle East | 4218 | 230 | 5.4 | 1.7 (1.2–2.4) | 0.003 | 1.6 (1.0–1.5) | 0.071 | 1.5 (1.4–1.6) | <0.001 | 1.3 (1.2–1.5) | <0.001 |
South–East Asia | 4940 | 154 | 3.1 | 0.9 (0.6–1.3) | 0.742 | 0.8 (1.0–1.5) | 0.655 | 0.9 (0.9–1.0) | 0.202 | 0.8 (0.8–0.9) | 0.014 |
North–East Asia | 2540 | 74 | 2.9 | 0.8 (0.5–1.3) | 0.530 | 1.5 (1.0–1.5) | 0.194 | 0.9 (0.8–0.9) | 0.008 | 1.2 (1.1–1.3) | <0.001 |
Southern and Central Asia | 4011 | 168 | 4.2 | 1.3 (0.9–1.8) | 0.146 | 1.6 (1.0–1.5) | 0.088 | 1.2 (1.1–1.3) | <0.001 | 1.4 (1.3–1.6) | <0.001 |
Americas | 501 | 7 | 1.4 | 0.4 (0.1–0.9) | 0.035 | 0.3 (1.0–1.5) | 0.188 | 0.5 (0.4–0.6) | <0.001 | 0.5 (0.4–0.6) | <0.001 |
Sub–Saharan Africa | 675 | 29 | 4.3 | 1.3 (0.7–2.1) | 0.285 | 1.3 (1.0–1.5) | 0.526 | 1.2 (1.1–1.3) | <0.001 | 1.2 (1.0–1.3) | 0.005 |
Obstetric factors | |||||||||||
Alcohol use in pregnancy | |||||||||||
No | 17,001 | 619 | 3.6 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 143 | 3 | 2.1 | 0.5 (0.1–1.8) | 0.316 | 0.9 (0.7–2.1) | 0.953 | 0.7 (0.2–2.0) | 0.572 | 0.7 (0.1–3.1) | 0.689 |
Antenatal health problems | |||||||||||
No | 15,755 | 552 | 3.5 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Yes | 3041 | 140 | 4.6 | 1.3 (1.1–1.6) | 0.003 | 0.9 (0.6–1.3) | 0.726 | 1.2 (1.0–1.5) | 0.017 | 0.9 (0.8–0.9) | 0.008 |
Type of delivery | |||||||||||
Normal vaginal | 11,336 | 376 | 3.3 | 1.0 | 1.0 | 1.0 | 1.0 | ||||
Assisted vaginal | 2323 | 84 | 3.6 | 1.1 (0.8–1.4) | 0.351 | 1.6 (1.0–2.5) | 0.032 | 1.0 (0.8–1.3) | 0.501 | 1.4 (0.9–2.2) | 0.096 |
Caesarean section | 5658 | 262 | 4.6 | 1.4 (1.2–1.7) | <0.001 | 1.4 (1.1–1.9) | 0.007 | 1.3 (1.1–1.5) | <0.001 | 1.3 (1.0–1.7) | 0.034 |
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Ogbo, F.A.; Kingsley Ezeh, O.; Dhami, M.V.; Naz, S.; Khanlari, S.; McKenzie, A.; Agho, K.; Page, A.; Ussher, J.; Perz, J.; et al. Perinatal Distress and Depression in Culturally and Linguistically Diverse (CALD) Australian Women: The Role of Psychosocial and Obstetric Factors. Int. J. Environ. Res. Public Health 2019, 16, 2945. https://doi.org/10.3390/ijerph16162945
Ogbo FA, Kingsley Ezeh O, Dhami MV, Naz S, Khanlari S, McKenzie A, Agho K, Page A, Ussher J, Perz J, et al. Perinatal Distress and Depression in Culturally and Linguistically Diverse (CALD) Australian Women: The Role of Psychosocial and Obstetric Factors. International Journal of Environmental Research and Public Health. 2019; 16(16):2945. https://doi.org/10.3390/ijerph16162945
Chicago/Turabian StyleOgbo, Felix Akpojene, Osita Kingsley Ezeh, Mansi Vijaybhai Dhami, Sabrina Naz, Sarah Khanlari, Anne McKenzie, Kingsley Agho, Andrew Page, Jane Ussher, Janette Perz, and et al. 2019. "Perinatal Distress and Depression in Culturally and Linguistically Diverse (CALD) Australian Women: The Role of Psychosocial and Obstetric Factors" International Journal of Environmental Research and Public Health 16, no. 16: 2945. https://doi.org/10.3390/ijerph16162945