Factors associated with postpartum physical and mental morbidity among women with known HIV status in Lusaka, Zambia

Abstract

The objective of our study was to investigate factors associated with postpartum physical and mental morbidity among women in Lusaka, Zambia with particular reference to known HIV status. Our study was part of the Breastfeeding and Postpartum Health (BFPH) longitudinal cohort study conducted between June 2001 and July 2003. Women were recruited at 34 weeks gestation and followed up to 16 weeks postpartum. Data on maternal health were collected at 3, 7, 10, and 14 days and at 3, 4, 5, 6, 9, 12, and 16 weeks postpartum. Maternal mental health data were collected from April 2002 onwards at recruitment and at seven days and six weeks postpartum. Data on physical morbidity were collected for 429 women (218 HIV-negative, 211 HIV-positive) and data on mental morbidity were collected for 272 women (134 HIV-negative, 138 HIV-positive). Multivariate logistic regression was used to examine factors associated with postpartum physical or mental morbidity. Postpartum physical morbidity was associated with HIV status, parity ≥5 and age < 20 years. Neither antenatal nor postpartum mental morbidity, as indicated by a self-reporting questionnaire 20-item (SRQ-20) score ≥7, were associated with HIV status or with postpartum physical morbidity in this population. Larger comparative studies are required to corroborate or contest these findings.

Acknowledgments

The authors are most grateful to Professor Chifumbe Chintu, Dr Moses Sinkala, Dr Christine Kaseba, Dr Francis Kasolo and Professor Andrew Tomkins for their input into design and management of the main Breastfeeding and Postpartum Health Study; to Tamara Kavimba, Esther Simwanza, Loveness Chilala and all the other Chilenje midwives for care of the women; to John Chobo for home visits; to Solomon Kagulula and Rose Ng'andu for psychiatric assessments and counselling; to William Phiri, Rachel Gitau, Katie Newens and Laura Hindle for laboratory work and to Hildah Mabuda for data management and project administration.