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Introduction Food security is a prerequisite for achieving optimal health, and mothers and children living in food insecure households face barriers to physical and mental health and healthy development. Mothers in food insecure households often also experience poor mental health and domestic violence. Although associations between these domains have been explored, little research exists about the intersection of these three phenomena. Methods In this commentary, we briefly identify existing, relevant research that investigates the relationships between and among food insecurity, maternal mental health, and domestic violence. Results A substantial body of evidence from cross-sectional and longitudinal studies has demonstrated significant relationships and pathways between these co-morbidities, with bi-directional associations between food insecurity and poor mental health, domestic violence and poor mental health, and cumulative risks attributed to more severe symptoms and exposures. However, there is limited evidence about interventions that target these three areas concurrently. More specifically, there are few sustained, multi-disciplinary efforts that tackle these issues in a broad, cross-cutting way. Discussion In line with the Sustainable Development Goals, we suggest the adoption of an interdisciplinary approach to address more effectively the needs of the most vulnerable mothers who rest at the intersection of these issues. We identify three avenues for further research efforts., Author(s): Christina Laurenzi [sup.1] , Sally Field [sup.2] , Simone Honikman [sup.2] Author Affiliations: (1) grid.11956.3a, 0000 0001 2214 904X, Institute for Life Course Health Research, Department of Global Health, [...]

Anxiety is highly prevalent in many populations; however, the burden of anxiety disorders amongst pregnant women in low-resource settings is not well documented. We investigated the prevalence and predictors of antenatal anxiety disorders amongst low-income women living with psychosocial adversity. Pregnant women were recruited from an urban, primary level clinic in Cape Town, South Africa. The Mini-International Neuropsychiatric Interview diagnostic interview assessed prevalence of anxiety disorders. Four self-report questionnaires measured psychosocial characteristics. Logistic regression models explored demographic and socioeconomic characteristics, psychosocial risk factors and psychiatric comorbidity as predictors for anxiety disorders. Amongst 376 participants, the prevalence of any anxiety disorder was 23%. Although 11% of all women had post-traumatic stress disorder, 18% of the total sample was diagnosed with other anxiety disorders. Multivariable analysis revealed several predictors for anxiety including a history of mental health problems (adjusted odds ratio [AOR] 4.11; 95% confidence interval (CI) 2.03-8.32), Major depressive episode (MDE) diagnosis (AOR 3.83; CI 1.99-7.31), multigravidity (AOR 2.87; CI 1.17-7.07), food insecurity (AOR 2.57; CI 1.48-4.46), unplanned and unwanted pregnancy (AOR 2.14; CI 1.11-4.15), pregnancy loss (AOR 2.10; CI 1.19-3.75) and experience of threatening life events (AOR 1.30; CI 1.04-1.57). Increased perceived social support appeared to reduce the risk for antenatal anxiety (AOR 0.95; CI 0.91-0.99). A range of antenatal anxiety disorders are prevalent amongst pregnant women living in low-resource settings. Women who experience psychosocial adversity may be exposed to multiple risk factors, which render them vulnerable to developing antenatal anxiety disorders.

Pregnant women are at increased risk for suicidal ideation and behaviours (SIB) compared to the general population. To date, studies have focused on the psychiatric correlates of SIB with lesser attention given to the associated contextual risk factors, particularly in low- and middle-income countries. We investigated the prevalence and associated psychiatric and socio-economic contextual factors for SIB among pregnant women living in low resource communities in South Africa. Three hundred seventy-six pregnant women were evaluated using a range of tools to collect data on socio-economic and demographic factors, social support, life events, interpersonal violence and mental health diagnoses. We examined the significant risk factors for SIB using univariate, bivariate and logistic regression analyses (p ≤ 0.05). The 1-month prevalence of SIB was 18%. SIB was associated with psychiatric illness, notably major depressive episode (MDE) and any anxiety disorder. However, 67% of pregnant women with SIB had no MDE diagnosis, and 65% had no anxiety disorder, while 54% had neither MDE nor anxiety disorder diagnoses. Factors associated with SIB included lower socio-economic status, food insecurity, interpersonal violence, multiparousity, and lifetime suicide attempt. These findings focus attention on the importance of socio-economic and contextual factors in the aetiology of SIB and lend support to the idea that suicide risk should be assessed independently of depression and anxiety among pregnant women.