Prevalence and factors associated with the multiple morbidity of postpartum depression, diabetes mellitus and hypertension among mothers in Mbarara district, south western Uganda: A parallel convergent mixed methods study
Notice bibliographique
Résumé
Background: The occurrence of multiple morbidities of postpartum depression (PPD), hypertension and diabetes mellitus (DM) among postpartum mothers poses a health care challenge because it not only affects the mother but also the life of the new born baby and that of close family members. Therefore, this study aimed at examining the prevalence and factors associated with these comorbidities among mothers in public health facilities in Mbarara, south western Uganda. Methods: We conducted a facility based cross sectional study using parallel convergent mixed methods to collect information from 309 postpartum mothers from 6 weeks to 6 months after childbirth. Using consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities: Mbarara Regional Referral Hospital and Bwizibwera Health Center IV in urban and rural southwestern Uganda respectively. A psychiatric classification based on the Mini-International Neuropsychiatric Interview (MINI 7.0.2) for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) was used. DM was diagnosed by measuring Hemoglobin A1c (HbA1c). Hypertension was diagnosed when a person's systolic blood pressure (SBP) was ≥140 mm Hg and/or their diastolic blood pressure (DBP) was ≥90 mm Hg following repeated examination. The primary outcome was multiple morbidity defined as co-occurrence of PPD, hypertension and DM. Logistic regression was used to determine the factors associated with multiple morbidity. In the qualitative phase, 20 key informant interviews each lasting 30-45 min were conducted purposively. The interviews were audio recorded, transcribed verbatim and translated from the local dialect of Runyankore to English and analyzed thematically. Results: The prevalence of multiple morbidity was 13.6% (95% CI: 10.2-19.3%). The prevalence of multi - morbidity did not vary significantly across age categories, p = 0.056. Having high cortisol levels between 6 weeks and 6 months postpartum was the only factor significantly associated with multi-morbidity among mothers with postpartum depression in both bivariate analysis and multivariate analysis adjusted OR = 6.9, (95% CI: 3.29-14.47), p < 0.001. In addition, this study revealed that psychological and socioeconomic factors, intimate partner violence and life style changes were likely to predispose the mothers to the multiple morbidity of PPD, Hypertension and DM. Conclusion: Both quantitative and qualitative data offered complementary insights. The quantitative analysis highlighted high cortisol levels and diabetes mellitus as key biological factors associated with the multiple morbidity of PPD, hypertension and DM and qualitative findings enriched this understanding by illustrating the psychological, socioeconomic hardships, IPV and lifestyle changes context of these biological changes as they were frequently reported, offering a more holistic view of the factors influencing multiple morbidity among postpartum mothers.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».