ArticleBMJ open2019
Food-insecure pregnant women in South Africa: a cross-sectional exploration of maternal depression as a mediator of violence and trauma risk factors.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Water-Energy-Food Security and Health in South Africa: A Scoping Review.JAMA network open · 2026Article
- Associations between recent intimate partner violence and sustained viral suppression among pregnant and postpartum women living with HIV in western Kenya: A secondary analysis of a prospective cohort (Opt4Mamas).International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- MISAPSY: childhood maltreatment, food insecurity, psychological distress and professional integration among socioeconomically disadvantaged young adults - a mixed-methods study protocol.BMC psychology · 2026Article
- Reply to: Intervening on Social Determinants for Better Outcomes in Pediatric Tuberculosis Management.American journal of respiratory and critical care medicine · 2023Article
- Exploring intimate partner violence among pregnant Eswatini women seeking antenatal care: How agency and food security impact violence-related outcomes.Global public health · 2022Article
- Systematic review of food insecurity and violence against women and girls: Mixed methods findings from low- and middle-income settings.PLOS global public health · 2022Article
- The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study.SSM - population health · 2021Article
- Perception of Women with Lived Experience of Domestic Violence and Abuse on the Involvement of the Dental Team in Supporting Adult Patients with Lived Experience of Domestic Abuse in England: A Pilot Study.International journal of environmental research and public health · 2021Article
- The Association between Maternal Depression, Infant Characteristics and Need for Assistance in A Low-Income-Country.Journal of substance abuse and alcoholism · 2021Article
- Food Insecurity, Maternal Mental Health, and Domestic Violence: A Call for a Syndemic Approach to Research and Interventions.Maternal and child health journal · 2020Article
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Authors and funding
7 authors.
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Abstract
objectivesBetter understanding of psychosocial risk factors for food insecurity (FI) during pregnancy and how they interact is crucial, given long-term health implications for maternal and child health. We investigated the association between maternal childhood trauma as well as intimate partner violence (IPV) and FI among pregnant women in South Africa, in the Drakenstein Child Health Study, and whether maternal depression mediates these relationships.
settingTwo primary care clinics in Paarl, South Africa.
participants992 pregnant women; inclusion criteria were clinic attendance and remaining in area for at least 1 year; women were excluded if a minor.
methodsWe examined psychosocial predictors of FI using multivariate regression. Mediation analyses investigated whether depression mediated the relationship between IPV and FI as well as between childhood trauma and FI, including disaggregation by two study communities. FI was assessed using an adapted US Department of Agriculture food security scale; households were coded as food insecure where 2 of 5 affirmative responses were recorded.
resultsAmong 992 pregnant women, there were high rates of IPV (7%-27%), depression (24%) and childhood trauma (34%). In multivariate cross-sectional analysis, emotional IPV (adjusted OR [aOR] 1.60; 95% CI 1.04 to 2.46), depression (aOR 1.05; 95% CI 1.01 to 1.08) and childhood trauma (aOR 1.52; 95% CI 1.08 to 2.15) predicted FI. In mediation models, depression partially mediated the relationship between emotional IPV and FI as well as physical IPV and FI; depression partially mediated the relationship between childhood trauma and FI. Differing degrees of mediation were found when applied to communities.
conclusionsAntenatal maternal depression, IPV and childhood trauma were highly prevalent and associated with FI. Depression, IPV and trauma screening services should be considered within routine antenatal care and may offer an opportunity to identify and intervene. Community-level differences in risk and in mediation analyses indicate that contextual tailoring of interventions may be important.
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