Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort.

OBJECTIVE:To investigate the association between maternal antenatal and/or postnatal psychosocial risk factors (including depression, psychological distress, alcohol abuse and intimate partner violence (IPV) and infant lower respiratory tract infection (LRTI) in a low- and middle-income-country (LMI...

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Main Authors: Rae MacGinty, Maia Lesosky, Whitney Barnett, Polite M Nduru, Aneesa Vanker, Dan J Stein, Heather J Zar
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0226144
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spelling doaj-d703cfb031c249d294f9b05c6090b0262021-03-03T21:18:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011412e022614410.1371/journal.pone.0226144Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort.Rae MacGintyMaia LesoskyWhitney BarnettPolite M NduruAneesa VankerDan J SteinHeather J ZarOBJECTIVE:To investigate the association between maternal antenatal and/or postnatal psychosocial risk factors (including depression, psychological distress, alcohol abuse and intimate partner violence (IPV) and infant lower respiratory tract infection (LRTI) in a low- and middle-income-country (LMIC). STUDY DESIGN:Pregnant women (n = 1137) enrolled in a South African birth cohort study, the Drakenstein Child Health Study (DCHS) were longitudinally assessed for psychosocial risk factors including depression, psychological distress, alcohol abuse and/or intimate partner violence (IPV). Infants were followed from birth until one year of age for the development of LRTI by active surveillance. Two outcomes were evaluated: any LRTI, and severe and/or hospitalised LRTI. Logistic regression was used to identify associations between individual maternal psychosocial risk factors and LRTI outcomes. Analyses stratified by age were also performed to determine which age groups related to infant LRTI were linked with maternal psychosocial risk factors. RESULTS:There were 606 LRTI episodes in 369 infants in the first year (crude incidence rate = 0.53 episodes per person-year, 95%CI: 0.50; 0.56); 31% (n = 186) of episodes were severe or hospitalised events. Maternal psychosocial risk factors were associated with LRTI and severe LRTI, particularly postnatal and long-term maternal psychological distress, antenatal maternal alcohol consumption, and postnatal maternal IPV. Age stratified analyses found that antenatal maternal alcohol consumption was associated with early infant LRTI, while antenatal maternal depression was linked with infant severe LRTI between 3 and 6 months of age, and postnatal maternal IPV was associated with early LRTI and severe forms of LRTI. CONCLUSION:The associations between maternal psychosocial risk factors and infant LRTI highlight the potential value of screening for maternal psychosocial risk factors in clinical settings and developing targeted interventions. Such interventions may not only improve maternal well-being, but also help reduce the burden of infant LRTI in LMIC settings.https://doi.org/10.1371/journal.pone.0226144
collection DOAJ
language English
format Article
sources DOAJ
author Rae MacGinty
Maia Lesosky
Whitney Barnett
Polite M Nduru
Aneesa Vanker
Dan J Stein
Heather J Zar
spellingShingle Rae MacGinty
Maia Lesosky
Whitney Barnett
Polite M Nduru
Aneesa Vanker
Dan J Stein
Heather J Zar
Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort.
PLoS ONE
author_facet Rae MacGinty
Maia Lesosky
Whitney Barnett
Polite M Nduru
Aneesa Vanker
Dan J Stein
Heather J Zar
author_sort Rae MacGinty
title Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort.
title_short Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort.
title_full Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort.
title_fullStr Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort.
title_full_unstemmed Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort.
title_sort maternal psychosocial risk factors and lower respiratory tract infection (lrti) during infancy in a south african birth cohort.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2019-01-01
description OBJECTIVE:To investigate the association between maternal antenatal and/or postnatal psychosocial risk factors (including depression, psychological distress, alcohol abuse and intimate partner violence (IPV) and infant lower respiratory tract infection (LRTI) in a low- and middle-income-country (LMIC). STUDY DESIGN:Pregnant women (n = 1137) enrolled in a South African birth cohort study, the Drakenstein Child Health Study (DCHS) were longitudinally assessed for psychosocial risk factors including depression, psychological distress, alcohol abuse and/or intimate partner violence (IPV). Infants were followed from birth until one year of age for the development of LRTI by active surveillance. Two outcomes were evaluated: any LRTI, and severe and/or hospitalised LRTI. Logistic regression was used to identify associations between individual maternal psychosocial risk factors and LRTI outcomes. Analyses stratified by age were also performed to determine which age groups related to infant LRTI were linked with maternal psychosocial risk factors. RESULTS:There were 606 LRTI episodes in 369 infants in the first year (crude incidence rate = 0.53 episodes per person-year, 95%CI: 0.50; 0.56); 31% (n = 186) of episodes were severe or hospitalised events. Maternal psychosocial risk factors were associated with LRTI and severe LRTI, particularly postnatal and long-term maternal psychological distress, antenatal maternal alcohol consumption, and postnatal maternal IPV. Age stratified analyses found that antenatal maternal alcohol consumption was associated with early infant LRTI, while antenatal maternal depression was linked with infant severe LRTI between 3 and 6 months of age, and postnatal maternal IPV was associated with early LRTI and severe forms of LRTI. CONCLUSION:The associations between maternal psychosocial risk factors and infant LRTI highlight the potential value of screening for maternal psychosocial risk factors in clinical settings and developing targeted interventions. Such interventions may not only improve maternal well-being, but also help reduce the burden of infant LRTI in LMIC settings.
url https://doi.org/10.1371/journal.pone.0226144
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