Obstetric Risk Factors and Subsequent Mental Health Problems in a Child Psychiatry Clinic Population in Nigeria

Background: Studies suggest that obstetric complications are associated with several child psychiatric conditions. In planning for child psychiatric services it is important to monitor patterns of morbidity and associated risk factors. Identifying obstetric risk factors in a newly opened child psychiatric clinic population with provide crucial information for future planning and collaboration. Objective: To determine the prevalence and pattern of obstetric risk factors and associations with morbidity found in a child psychiatric clinic population. Method: The study population consisted of all attendees at a newly opened child and adolescent psychiatric clinic at the University College Hospital, Ibadan. All attendees had a standardised comprehensive psychiatric assessment and an obstetric history was obtained from mothers. Results: In the period under study, 144 children and adolescents were referred to this clinic. Obstetrical complications were found in 32 (29%) of the 112 children from whom this history was obtained. The commonest complications were birth asphyxia (11%), and emergency caesarean sections (6%). Delivery complications were associated with unskilled fathers\' (x2 =8.4; p=0.015) and mothers above 40 years of age, (x2 =9.5; p=0.011). Children with mental retardation were more likely to have suffered birth injuries (x2 =14.05; p=0.000). The highest number of obstetric complications occurred in children with disruptive behaviour disorder (42.9%), and autistic disorder (33.3%). No statistically significant relationship was found between specific groups and obstetric complications. Conclusion:This descriptive study illustrates that obstetric complications are a contributing factor to mental health problems in children. Many of the complications could have been prevented with better health care. Further studies may also want to compare obstetric complications in this child psychiatric clinic population with a sample of children in the general population. Key Words: obstetric risk factors, child psychiatric disorders. [Trop J Obstet Gynaecol, 2004;21:15-20

Psychiatric morbidity among pregnant and non pregnant women in Ibadan, Nigeria

A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.Impact statement What is already known on this subject? Psychiatric morbidity has immense effects on a woman’s quality of life, social functioning, obstetric outcome, and economic productivity. What do the results of this study add? Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression. What are the implications of these findings for clinical practice and/or further research? Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability