Background: Despite public perception to the contrary, pregnancy does not offer a protective effect for suicide ideation. In low and middle income countries (LMIC) multiple concurrent risk factors including unplanned ...Background: Despite public perception to the contrary, pregnancy does not offer a protective effect for suicide ideation. In low and middle income countries (LMIC) multiple concurrent risk factors including unplanned pregnancies, testing for HIV, intimate partner violence and depression may increase suicide risk among pregnant women. We examine suicide ideation among women attending routine antenatal care in rural South Africa. Method: A consecutive series of 109 women in the second half of pregnancy were enrolled in a cross-sectional study at a large primary health care facility in a rural area of KwaZulu-Natal with high HIV prevalence. Using a mixed-methods approach, women were assessed using the Major Depression Section of the Structured Clinical Interview for Depression (SCID) for DSM-IV diagnosis;qualitative interview data were collected on women’s experiences of suicide ideation and plans. Women were assessed two weeks after routine HIV testing as part of Prevention of Mother-to-Child Transmission (PMTCT) screening. Results: Both HIV-positive (49/109) and HIV-negative (60/109) women were assessed. Depression was high (51/109, 46.7%) and equally common amongst HIV-positive and negative women. Suicide ideation was high (30/109, 27.5%) with thoughts of self harm closely linked to suicide plans. Age, previous history of depression and current depression were significantly associated with suicide ideation. Close to equal numbers of HIV-positive and negative women were suicidal. Suicide methods were frequently violent and most women cited family and partnership conflict related to an unplanned pregnancy or their newly HIV-positive status as triggers to their suicide ideation. Conclusions: Rates of suicide ideation among pregnant women testing for HIV are high. Testing HIV-positive causes considerable distress, and among HIV-negative women unplanned and unwanted pregnancies are important risk factors for suicide ideation. Pregnancy brings women into increased contact with the health services with important oppor展开更多
目的:探索北方农村地区妇女孕期化肥暴露与其子代高出生体重(HBW)发生风险之间的关联。方法:在2007-2012年山西省平定县出生人口监测系统中妊娠时间≥37周、出生体重≥4000g的新生儿中随机选取296例新生儿作为HBW病例进行随访,并将病例...目的:探索北方农村地区妇女孕期化肥暴露与其子代高出生体重(HBW)发生风险之间的关联。方法:在2007-2012年山西省平定县出生人口监测系统中妊娠时间≥37周、出生体重≥4000g的新生儿中随机选取296例新生儿作为HBW病例进行随访,并将病例分为≥4000~<4200g HBW组(171例)和≥4200 g HBW组(125例);随机选择204例妊娠≥37周,出生体重≥2500~<4000 g的健康新生儿作为对照。根据妇女居住村庄村级化肥年施用量及妇女所在家庭化肥年施用量衡量妇女孕期化肥暴露。采用分层多因素Logistic回归分析探索妇女孕期化肥暴露与HBW发生风险的关联。结果:调整混杂因素后,≥4000~<4200 g HBW组孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是村级年化肥施用量<50吨妇女的2.46倍(95%CI 1.02~5.95);合并的HBW组病例对照的分层多因素logistic回归结果显示,调整了混杂因素后,孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是暴露于村级年化肥施用量<50吨妇女的2.16倍(95%CI 1.05~4.44)。结论:北方农村地区妇女孕期暴露于化肥施用可能是高出生体重的危险因素,建议妇女孕期尽量避免化肥施用暴露。展开更多
文摘Background: Despite public perception to the contrary, pregnancy does not offer a protective effect for suicide ideation. In low and middle income countries (LMIC) multiple concurrent risk factors including unplanned pregnancies, testing for HIV, intimate partner violence and depression may increase suicide risk among pregnant women. We examine suicide ideation among women attending routine antenatal care in rural South Africa. Method: A consecutive series of 109 women in the second half of pregnancy were enrolled in a cross-sectional study at a large primary health care facility in a rural area of KwaZulu-Natal with high HIV prevalence. Using a mixed-methods approach, women were assessed using the Major Depression Section of the Structured Clinical Interview for Depression (SCID) for DSM-IV diagnosis;qualitative interview data were collected on women’s experiences of suicide ideation and plans. Women were assessed two weeks after routine HIV testing as part of Prevention of Mother-to-Child Transmission (PMTCT) screening. Results: Both HIV-positive (49/109) and HIV-negative (60/109) women were assessed. Depression was high (51/109, 46.7%) and equally common amongst HIV-positive and negative women. Suicide ideation was high (30/109, 27.5%) with thoughts of self harm closely linked to suicide plans. Age, previous history of depression and current depression were significantly associated with suicide ideation. Close to equal numbers of HIV-positive and negative women were suicidal. Suicide methods were frequently violent and most women cited family and partnership conflict related to an unplanned pregnancy or their newly HIV-positive status as triggers to their suicide ideation. Conclusions: Rates of suicide ideation among pregnant women testing for HIV are high. Testing HIV-positive causes considerable distress, and among HIV-negative women unplanned and unwanted pregnancies are important risk factors for suicide ideation. Pregnancy brings women into increased contact with the health services with important oppor
文摘目的:探索北方农村地区妇女孕期化肥暴露与其子代高出生体重(HBW)发生风险之间的关联。方法:在2007-2012年山西省平定县出生人口监测系统中妊娠时间≥37周、出生体重≥4000g的新生儿中随机选取296例新生儿作为HBW病例进行随访,并将病例分为≥4000~<4200g HBW组(171例)和≥4200 g HBW组(125例);随机选择204例妊娠≥37周,出生体重≥2500~<4000 g的健康新生儿作为对照。根据妇女居住村庄村级化肥年施用量及妇女所在家庭化肥年施用量衡量妇女孕期化肥暴露。采用分层多因素Logistic回归分析探索妇女孕期化肥暴露与HBW发生风险的关联。结果:调整混杂因素后,≥4000~<4200 g HBW组孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是村级年化肥施用量<50吨妇女的2.46倍(95%CI 1.02~5.95);合并的HBW组病例对照的分层多因素logistic回归结果显示,调整了混杂因素后,孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是暴露于村级年化肥施用量<50吨妇女的2.16倍(95%CI 1.05~4.44)。结论:北方农村地区妇女孕期暴露于化肥施用可能是高出生体重的危险因素,建议妇女孕期尽量避免化肥施用暴露。
