Maternal depression and other psychosocial factors have been shown to have adverse consequences on infant feeding practices. This study explored the longitudinal relationship of maternal depressive symptoms and other selected psychosocial factors with infant feeding practices (IFPs) in rural Ethiopia using summary IFP index. This study uses existing data from the ENGINE birth cohort study, conducted from March 2014 to March 2016 in three districts in the southwest of Ethiopia. A total of 4680 pregnant women were recruited and data were collected once during pregnancy (twice for those in the first trimester), at birth, and then every 3 months until the child was 12 months old. A standardized questionnaire was used to collect data on IFPs, maternal depressive symptoms, household food insecurity, intimate partner violence (IPV), maternal social support, active social participation, and other sociodemographic variables. A composite measure of IFP index was computed using 14 WHO recommended infant and young child feeding (IYCF) practice indicators. High IFP index indicated best practice. Prenatal and postnatal maternal depressive symptoms were assessed using the patient health questionnaire (PHQ-9). Linear multilevel mixed effects model was fitted to assess longitudinal relationship of IFPs with maternal depression and other psychosocial factors. Reports of higher postnatal depressive symptoms (ß = − 1.03, P = 0.001) and IPV (ß = − 0.21, P = 0.001) were associated with lower scores on the IFP index. Whereas, reports of better maternal social support (ß = 0.11, P = 0.002) and active social participation (ß = 0.55, P < 0.001) were associated with higher scores on the IFP index. Contrary to expectations, moderate household food insecurity (ß = 0.84, P = 0.003), severe household food insecurity (ß = 1.03, P = 0.01) and infant morbidity episodes (ß = 0.63, P = 0.013) were associated with higher scores on the IFP index. Overall, a multitude of factors are related to IFPs and hence coordinated, multi-sectoral and multi-stakeholder interventions including maternal depressive symptoms screening and management are needed to improve infant feeding practices.

中文翻译：

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埃塞俄比亚农村地区母亲抑郁症状对婴儿喂养方式的影响：基于社区的出生队列研究


母亲抑郁和其他社会心理因素已被证明会对婴儿喂养方式产生不利影响。本研究利用总结性 IFP 指数探讨了埃塞俄比亚农村地区母亲抑郁症状和其他选定的社会心理因素与婴儿喂养方式 (IFP) 的纵向关系。本研究使用 ENGINE 出生队列研究的现有数据，该研究于 2014 年 3 月至 2016 年 3 月在埃塞俄比亚西南部的三个地区进行。总共招募了 4680 名孕妇，并在怀孕期间收集一次数据（孕早期收集两次）、出生时收集数据，然后每 3 个月收集一次数据，直到孩子 12 个月大。使用标准化问卷收集有关 IFP、孕产妇抑郁症状、家庭粮食不安全、亲密伴侣暴力 (IPV)、孕产妇社会支持、积极社会参与和其他社会人口统计学变量的数据。 IFP 指数的综合衡量标准是使用 14 个 WHO 推荐的婴幼儿喂养 (IYCF) 实践指标来计算的。高 IFP 指数表明最佳实践。使用患者健康问卷（PHQ-9）评估产前和产后母亲抑郁症状。拟合线性多水平混合效应模型来评估 IFP 与母亲抑郁症和其他心理社会因素的纵向关系。较高的产后抑郁症状 (ß = − 1.03，P = 0.001) 和 IPV (ß = − 0.21，P = 0.001) 报告与较低的 IFP 指数得分相关。然而，据报道，更好的母亲社会支持（ß = 0.11，P = 0.002）和积极的社会参与（ß = 0.55，P < 0.001）与较高的 IFP 指数得分相关。与预期相反，中度家庭粮食不安全（ß = 0.84，P = 0。003）、严重的家庭粮食不安全（ß = 1.03，P = 0.01）和婴儿发病事件（ß = 0.63，P = 0.013）与较高的 IFP 指数得分相关。总体而言，许多因素与 IFP 相关，因此需要协调、多部门和多利益相关者的干预措施，包括母亲抑郁症状筛查和管理，以改善婴儿喂养实践。