Catherine Atuhaire, Taseera Kabanda, Daniel Atwine, Godfrey Zari Rukundo, Judith Byaruhanga, Samuel Maling, Francis Bajunirwe
{"title":"乌干达西南部农村姆巴拉拉地区产后母亲血清皮质醇水平升高及其相关因素","authors":"Catherine Atuhaire, Taseera Kabanda, Daniel Atwine, Godfrey Zari Rukundo, Judith Byaruhanga, Samuel Maling, Francis Bajunirwe","doi":"10.1007/s44337-025-00486-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Serum cortisol is often elevated in postpartum mothers, but data on its prevalence and associated factors remain limited in many settings. The current study aimed at examining the factors associated with elevated serum cortisol levels among postpartum mothers in Mbarara district, rural southwestern Uganda.</p><p><strong>Methods: </strong>We conducted a facility based cross sectional study among mothers between 6 weeks and 6 months after childbirth. Using consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health Center IV, a county level health facility in rural southwestern Uganda. The blood cortisol levels were measured using a chemiluminescence with the use of a standard, commercially available competitive immunoassay (Diagnostic Products Corp. Nichols Institute Diagnostics, San Juan Capistrano, CA). Postpartum depression (PPD) was diagnosed using the Mini-International Neuropsychiatric Interview (MINI) version 7.0.2, based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria.</p><p><strong>Results: </strong>We enrolled 309 postpartum mothers, and the prevalence of elevated serum cortisol levels was 26.2% (95% CI 22.0-31.4). Elevated serum cortisol levels were significantly associated with PPD (AOR = 2.9, 95% CI 1.6-5.3, <i>p</i> < 0.001), health facility level attended by the mother (AOR = 3.8, 95% CI 1.9-7.6, <i>p</i> = 0.001), pre-diabetes (AOR = 2.5, 95% CI 1.3-5.0, <i>p</i> = 0.008) and diabetes mellitus status (AOR = 4.0, 95% CI 1.8-8.9, <i>p</i> = 0.001), and decreased involvement in physical activity (AOR = 0.3, 95% CI 0.1-0.7, <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>In this study of elevated serum cortisol levels was significantly associated with postpartum depression, attending a rural healthcare facility, having pre-diabetes or diabetes mellitus status, and reduced physical activity. These findings underscore the need for targeted holistic interventions addressing both physical and mental health challenges in postpartum women.</p>","PeriodicalId":520361,"journal":{"name":"Discover medicine","volume":"2 1","pages":"275"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511175/pdf/","citationCount":"0","resultStr":"{\"title\":\"Elevated serum cortisol levels and associated factors among postpartum mothers in Mbarara district, rural south western Uganda.\",\"authors\":\"Catherine Atuhaire, Taseera Kabanda, Daniel Atwine, Godfrey Zari Rukundo, Judith Byaruhanga, Samuel Maling, Francis Bajunirwe\",\"doi\":\"10.1007/s44337-025-00486-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Serum cortisol is often elevated in postpartum mothers, but data on its prevalence and associated factors remain limited in many settings. The current study aimed at examining the factors associated with elevated serum cortisol levels among postpartum mothers in Mbarara district, rural southwestern Uganda.</p><p><strong>Methods: </strong>We conducted a facility based cross sectional study among mothers between 6 weeks and 6 months after childbirth. Using consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health Center IV, a county level health facility in rural southwestern Uganda. The blood cortisol levels were measured using a chemiluminescence with the use of a standard, commercially available competitive immunoassay (Diagnostic Products Corp. Nichols Institute Diagnostics, San Juan Capistrano, CA). Postpartum depression (PPD) was diagnosed using the Mini-International Neuropsychiatric Interview (MINI) version 7.0.2, based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria.</p><p><strong>Results: </strong>We enrolled 309 postpartum mothers, and the prevalence of elevated serum cortisol levels was 26.2% (95% CI 22.0-31.4). Elevated serum cortisol levels were significantly associated with PPD (AOR = 2.9, 95% CI 1.6-5.3, <i>p</i> < 0.001), health facility level attended by the mother (AOR = 3.8, 95% CI 1.9-7.6, <i>p</i> = 0.001), pre-diabetes (AOR = 2.5, 95% CI 1.3-5.0, <i>p</i> = 0.008) and diabetes mellitus status (AOR = 4.0, 95% CI 1.8-8.9, <i>p</i> = 0.001), and decreased involvement in physical activity (AOR = 0.3, 95% CI 0.1-0.7, <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>In this study of elevated serum cortisol levels was significantly associated with postpartum depression, attending a rural healthcare facility, having pre-diabetes or diabetes mellitus status, and reduced physical activity. 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引用次数: 0
摘要
背景：产后母亲血清皮质醇经常升高，但在许多情况下，其患病率和相关因素的数据仍然有限。目前的研究旨在研究乌干达西南部农村姆巴拉拉地区产后母亲血清皮质醇水平升高的相关因素。方法：我们对分娩后6周至6个月的母亲进行了基于设施的横断面研究。通过连续抽样，从两家卫生机构的产后诊所招募了母亲，这两家卫生机构是姆巴拉拉地区转诊医院和比兹布韦拉第四卫生中心，后者是乌干达西南部农村的一个县级卫生机构。使用化学发光法测量血液皮质醇水平，使用标准的、市售的竞争性免疫分析法（诊断产品公司尼科尔斯研究所诊断，圣胡安卡皮斯特拉诺，加利福尼亚州）。产后抑郁症（PPD）的诊断采用MINI -国际神经精神病学访谈（MINI） 7.0.2版，基于精神障碍诊断与统计手册第5版（DSM-5）的标准。结果：我们招募了309名产后母亲，血清皮质醇水平升高的患病率为26.2% （95% CI 22.0-31.4）。血清皮质醇水平升高与PPD （AOR = 2.9, 95% CI 1.6-5.3, p = 0.001）、糖尿病前期（AOR = 2.5, 95% CI 1.3-5.0, p = 0.008）和糖尿病状态（AOR = 4.0, 95% CI 1.8-8.9, p = 0.001）以及体力活动减少（AOR = 0.3, 95% CI 0.1-0.7, p = 0.002）显著相关。结论：在这项研究中，血清皮质醇水平升高与产后抑郁症、农村医疗机构就诊、糖尿病前期或糖尿病状态以及体力活动减少显著相关。这些发现强调需要有针对性的整体干预措施，解决产后妇女的身心健康挑战。
Elevated serum cortisol levels and associated factors among postpartum mothers in Mbarara district, rural south western Uganda.
Background: Serum cortisol is often elevated in postpartum mothers, but data on its prevalence and associated factors remain limited in many settings. The current study aimed at examining the factors associated with elevated serum cortisol levels among postpartum mothers in Mbarara district, rural southwestern Uganda.
Methods: We conducted a facility based cross sectional study among mothers between 6 weeks and 6 months after childbirth. Using consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health Center IV, a county level health facility in rural southwestern Uganda. The blood cortisol levels were measured using a chemiluminescence with the use of a standard, commercially available competitive immunoassay (Diagnostic Products Corp. Nichols Institute Diagnostics, San Juan Capistrano, CA). Postpartum depression (PPD) was diagnosed using the Mini-International Neuropsychiatric Interview (MINI) version 7.0.2, based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria.
Results: We enrolled 309 postpartum mothers, and the prevalence of elevated serum cortisol levels was 26.2% (95% CI 22.0-31.4). Elevated serum cortisol levels were significantly associated with PPD (AOR = 2.9, 95% CI 1.6-5.3, p < 0.001), health facility level attended by the mother (AOR = 3.8, 95% CI 1.9-7.6, p = 0.001), pre-diabetes (AOR = 2.5, 95% CI 1.3-5.0, p = 0.008) and diabetes mellitus status (AOR = 4.0, 95% CI 1.8-8.9, p = 0.001), and decreased involvement in physical activity (AOR = 0.3, 95% CI 0.1-0.7, p = 0.002).
Conclusion: In this study of elevated serum cortisol levels was significantly associated with postpartum depression, attending a rural healthcare facility, having pre-diabetes or diabetes mellitus status, and reduced physical activity. These findings underscore the need for targeted holistic interventions addressing both physical and mental health challenges in postpartum women.
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