ArticlePloS one2022
Longitudinal path analysis for the directional association of depression, anxiety and posttraumatic stress disorder with their comorbidities and associated factors among postpartum women in Northwest Ethiopia: A cross-lagged autoregressive modelling study.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Posttraumatic stress disorder prevalence and childbirth: update meta-analysis after the introduction of the DSM-5 and COVID-19 pandemic.Archives of women's mental health · 2024Pooled it
- The direct and indirect factors of health related quality of life of postpartum women using structural equation modelling.Scientific reports · 2025Article
- Assessing Factors Affecting Postpartum Post-Traumatic Stress Disorder and Development of Risk Prediction Nomogram Model.Actas espanolas de psiquiatria · 2025Article
- Mental disorders in the Postpartum Period in Rio de Janeiro 2021-2023: Nascer no Brasil II Study.Revista de saude publica · 2025Article
- A structural equation modelling of the direct and indirect factors associated with functional status over time as measured by WHODAS-32 items among postpartum women in Northwest Ethiopia.Archives of public health = Archives belges de sante publique · 2023Article
- Health-related quality of life among postpartum women with preeclampsia, southern Ethiopia: a prospective cohort study.Health and quality of life outcomes · 2022Article
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3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionVulnerability for depression, anxiety and posttraumatic stress disorder symptoms due to perceived traumatic birth increase during the postpartum period. Traumatic birth has been defined as an event occurring during labour and birth that may be a serious threat to the life and safety of the mother and/or child. However, the comorbidity and multimorbidity of depression, anxiety and PTSD with their direct and indirect predictors is not well investigated in the postpartum period. In addition, the longitudinal directional association of depression, anxiety and PTSD with their comorbidities is not studied in Ethiopia.
objectiveThe aim of this study was to assess prevalence of postnatal comorbid and multimorbid anxiety, depression and PTSD. It also aimed to determine the directional association of postnatal anxiety, depression and PTSD with the comorbidity and multimorbidity of these mental health problems over time and to explore the factors that are directly or indirectly associated with comorbidity and multimorbidity of anxiety, depression and PTSD.
methodsA total of 775 women were included at the first, second and third follow-up of the study (6th, 12th and 18th week of postpartum period) during October, 2020 -March, 2021. A cross-lagged autoregressive path analysis was carried out using Stata 16.0 software in order to determine the autoregressive and cross-lagged effects of depression, anxiety and PTSD with their comorbidities. In addition, a linear structural equation modelling was also carried out to determine the direct and indirect effects of independent variables on the comorbidities of depression, anxiety and PTSD.
resultsComorbidity of anxiety with depression was the most common (14.5%, 12.1% and 8.1%) at the 6th, 12th and 18th week of postnatal period respectively. With regard to the direction of association, comorbidity of PTSD (due to perceived traumatic birth) with depression, PTSD with anxiety, depression with anxiety and triple comorbidity predicted depression and anxiety in subsequent waves of measurement. Direct and indirect maternal morbidity, fear of childbirth and perceived traumatic childbirth were found to have a direct and indirect positive association with comorbidities of depression, anxiety and PTSD. In contrast, higher parity, higher family size and higher social support had a direct and indirect negative association with these mental health disorders.
conclusionPostnatal mental health screening, early diagnosis and treatment of maternal morbidities, developing encouraging strategies for social support and providing adequate information about birth procedures and response to mothers' needs during childbirth are essential to avert comorbidity of anxiety, depression and PTSD in the postpartum period.
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