Browsing by Author "Menon, Anitha J."

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Admission to the kangaroo mother care ward and maternal postpartum depression in Lusaka, Zambia: a randomised controlled trial study protocol
(2026-10-26) Manasyan, Albert; Lakhwani, Jyoti; Kapesa, Herbert; Menon, Anitha J.; Sharma, Anjali; Pry, Jake M.; Brown, Catherine; Tembo, Taniya; Carlo, Waldemar A.
Abstract Introduction: Postpartum depression (PPD) is a serious public health problem affecting 17% of women globally with higher rates (up to 40%) recorded in southern Africa. Admission to the neonatal intensive care unit (NICU) is a risk factor for PPD. The study aims to determine whether initiation of Kangaroo Mother Care (KMC) at the NICU followed by admission to the KMC Ward for continued support for more than 2 days before discharge home reduces maternal PPD and other maternal and infant adverse outcomes in low-resource settings. Methods and analysis: This study will enrol mother-infant dyads (n=612), fathers (up to n=612) and a purposive subset of mothers (n=24), fathers (n=24) and family members (n=24) who will complete in-depth interviews (IDIs). Mother-infant dyads will be recruited from the NICU at the Women and Newborn Hospital - University Teaching Hospitals in Lusaka, Zambia. Once deemed stable for admission to the KMC Ward as part of step-down care, mother-infant dyads will be randomised to either the control arm where they will remain at the KMC Ward ≤2 days per standard of care or the intervention arm where they will remain at the KMC Ward for >2 days. The primary outcome is maternal PPD at 6–8 weeks postnatal screened using the Edinburgh Postnatal Depression Scale (EPDS) screening tool. IDIs will explore the feasibility and barriers to practising KMC post-discharge from the perspective of the parents and other family members. Ethics and dissemination: The study was approved by the University of Zambia Biomedical Research Ethics Committee, the National Health Research Authority and the University of Alabama at Birmingham Institutional Review Board. A Data Safety Monitoring Board (DSMB) has been constituted. Dissemination will be via publications in peer-reviewed journals, conferences, social media and revision of national guidelines.
Postpartum depression among newly delivered mothers based on postnatal newborn care
(2025-11-28) Manasyan, Albert; Lakhwani, Jyoti; Kapesa, Herbert; Owuor, Kevin; Menon, Anitha J.; Bosomprah, Samuel; Nalwamba, Leukanji; Machona, Sylvia; Carlo, Waldemar A.
Abstract Background Postpartum depression (PPD) is a serious public health problem affecting ~ 17% of women globally, with higher rates recorded in southern Africa – ~40%. Admission to the neonatal intensive care unit (NICU) is a risk factor for PPD. Our primary hypothesis was that infant care in the Kangaroo Mother Care Ward (KMC) after NICU stay would be associated with a lower prevalence of maternal PPD. Methods We conducted a cross-sectional study among newly delivered mothers at the University Teaching Hospitals in Lusaka, Zambia, between June 2022 – May 2023. Mothers of infants discharged home from the Newborn Nursery (if NICU admission was not required), NICU (unwell newborns requiring NICU care), or NICU/KMC Ward (unwell newborns requiring NICU care followed by further monitoring at the KMC ward) were screened for PPD using the Edinburgh Postnatal Depression Scale (EPDS) screening tool at 6–8 weeks postnatally. Mothers who scored 11 + were categorized as having PPD. Poisson models were used to estimate prevalence ratios (PR) for screening positive for PPD. The primary outcome was PPD following KMC versus NICU discharge. Results We screened 1056 newly delivered women for PPD pooled from mother-infant pairs discharged from the newborn nursery (n = 352), NICU/KMC (n = 352), or NICU (n = 352). Overall, mothers’ average age was 27.5 years, 61.1% had secondary education, 59.2% were unemployed, and 11.2% were HIV-positive. The proportion of women who screened positive for maternal PPD among all three arms was 20.5% with anxiety reaching 50.5%. Mothers whose newborns were admitted to the NICU/KMC arm had a lower proportion of women who screened positive for PPD (21.3%) compared to those directly discharged home from the NICU (29.0%) (p < 0.001). The adjusted prevalence of PPD positivity rate was significantly higher in the NICU and KMC arms compared to the Newborn Nursery arm, RR = 2.44 (95% CI 1.61, 3.73) and RR = 1.94 (95% CI 1.04, 3.61), respectively. However, in the adjusted analysis, there was no significant difference in the PPD positivity rate between the KMC and the NICU arms. Conclusion Admission to the KMC ward following the NICU was not associated with a lower PPD prevalence among newly delivered mothers compared to direct NICU discharge.