Perinatal depression in migrant and refugee women on the Thai–Myanmar border: does social support matter?

Author:

Fellmeth Gracia12ORCID,Plugge Emma3,Fazel Mina4,Nosten Suphak2,Oo May May2,Pimanpanarak Mupawjay2,Phichitpadungtham Yuwapha2,Fitzpatrick Raymond1,McGready Rose25

Affiliation:

1. Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford OX3 7LT, UK

2. Shoklo Malaria Research Unit, Mahidol Oxford Tropical Medicine Research Unit, 68/30 Bantung Road, PO Box 46, Mae Sot, Tak 63110, Thailand

3. Health and Justice Team, Health Improvement Directorate, Public Health England, 60 Caversham Road, Reading RG1 7EB, UK

4. Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK

5. Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok 10400, Thailand

Abstract

Migrant and refugee women are at risk of perinatal depression due to stressors experienced before, during and after migration. This study assesses the associations between social support and perinatal depression among migrant and refugee women on the Thai–Myanmar border. We conducted a cohort study of pregnant and post-partum women. Depression status was assessed using a structured clinical interview. Received support, perceived support and partner support were measured in the third trimester. Logistic regression was used to calculate associations between social support measures and perinatal depression controlling for demographic, socio-economic, migration, obstetric and psychosocial factors. Four hundred and fifty-one women (233 migrants; 218 refugees) were included. The prevalence of perinatal depression was 38.6% in migrants and 47.3% in refugees. Migrants had higher levels of received, perceived and partner support than refugees. After controlling for all other variables, higher levels of received support remained significantly associated with a lower likelihood of perinatal depression in migrants (adjusted odds ratio 0.82; 95% CI 0.68–0.99). In both groups, depression history and trauma were strongly associated with perinatal depression. Our study highlights the importance of received social support to perinatal depression in migrant women on the Thailand–Myanmar border. The perinatal period offers a valuable opportunity to ask women about their support and offer community-level or public policy interventions to nurture support networks in current locations and resettlement destinations. This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.

Funder

Wellcome Trust

Publisher

The Royal Society

Subject

General Agricultural and Biological Sciences,General Biochemistry, Genetics and Molecular Biology

Reference41 articles.

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5. Knight M, Nair M, Tuffnell D, Kenyon S, Shakespeare J, Brocklehurst P, Kurinczuk JJ, on behalf of MBRRACE-UK. 2016 Saving lives, improving mothers’ care—surveillance of maternal deaths in the UK 2012-14 and lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2009–14. Oxford, UK: National Perinatal Epidemiology Unit, University of Oxford. See https://www.npeu.ox.ac.uk/downloads/files/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202016%20-%20website.pdf (accessed 30 November 2020).

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