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Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study

Ginja, Samuel; Jackson, Katherine; Newham, James J.; Henderson, Emily J.; Smart, Debbie; Lingam, Raghu

Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study Thumbnail


Authors

Samuel Ginja

Katherine Jackson

James J. Newham

Emily J. Henderson

Debbie Smart

Raghu Lingam



Abstract

Background: International data suggest that living in a rural area is associated with an increased risk of perinatal mental illness. This study tested the association between rurality and risk for two mental illnesses prevalent in perinatal women - depression and anxiety. Methods: Using a cross-sectional design, antenatal and postnatal women were approached by healthcare professionals and through other networks in a county in Northern England (UK). After providing informed consent, women completed a questionnaire where they indicated their postcode (used to determine rural-urban status) and completed three outcome measures: the Edinburgh Postnatal Depression Scale (EPDS), the Whooley questions (depression measure), and the Generalised Anxiety Disorder 2-item (GAD-2). Logistic regression models were developed, both unadjusted and adjusted for potential confounders, including socioeconomic status, social support and perinatal stage. Results: Two hundred ninety-five participants provided valid data. Women in rural areas (n = 130) were mostly comparable to their urban counterparts (n = 165). Risk for depression and/or anxiety was found to be higher in the rural group across all models: unadjusted OR 1.67 (0.42) 95% CI 1.03 to 2.72, p = .038. This difference though indicative did not reach statistical significance after adjusting for socioeconomic status and perinatal stage (OR 1.57 (0.40), 95% CI 0.95 to 2.58, p = .078), and for social support (OR 1.65 (0.46), 95% CI 0.96 to 2.84, p = .070). Conclusions: Data suggested that women in rural areas were at higher risk of depression and anxiety than their urban counterparts. Further work should be undertaken to corroborate these findings and investigate the underlying factors. This will help inform future interventions and the allocation of perinatal services to where they are most needed.

Citation

Ginja, S., Jackson, K., Newham, J. J., Henderson, E. J., Smart, D., & Lingam, R. (2020). Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study. BMC Pregnancy and Childbirth, 20(1), Article 464. https://doi.org/10.1186/s12884-020-03132-2

Journal Article Type Article
Acceptance Date Jul 23, 2020
Online Publication Date Aug 14, 2020
Publication Date 2020
Deposit Date Sep 2, 2020
Publicly Available Date Sep 2, 2020
Journal BMC Pregnancy and Childbirth
Electronic ISSN 1471-2393
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 20
Issue 1
Article Number 464
DOI https://doi.org/10.1186/s12884-020-03132-2
Public URL https://durham-repository.worktribe.com/output/1293378

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.





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