Advances and Applications in Statistics
Volume 55, Issue 1, Pages 19 - 34
(March 2019) http://dx.doi.org/10.17654/AS055010019 |
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TRANSITIONS IN DEPRESSIVE SYMPTOMS AMONG PREGNANT WOMEN EXPOSED TO ENVIRONMENTAL TOBACCO SMOKE: AN APPLICATION OF LATENT TRANSITION ANALYSIS
Alfred K. Mbah, Wei Wei He, Ronee Wilson, O’Neil Lynch, Karen Bruder and Hamisu M. Salihu
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Abstract: In this prospective study, we investigate the influence of environmental tobacco smoke (ETS) exposure during pregnancy on pre- and post-partum depressive symptom. Two hundred and thirty six pregnant women (N = 236) less than 20 weeks of gestation were recruited from a university-affiliated obstetric clinic in Tampa, Florida between November 2009 and July 2011. Tobacco use/exposure was measured at baseline using questionnaire and confirmed by salivary cotinine analysis, while depressive symptomatology was assessed during the pre- and post-partum period using the Edinburgh Perinatal Depression Scale (EPDS). Nine of the ten EPDS items were categorized into two classes (a high-risk and low-risk) employed to estimate the incidence of latent class transition from the prenatal to the post-partum period. The majority of the women who were exposed to ETS and were high risk during pregnancy remained high risk after delivery, whereas, majority of unexposed women transitioned from high risk before delivery to low risk after delivery. Furthermore, the odds of transitioning from low depressive class in the prenatal period to a high depressive class in the post-partum period was 2.3 (p = 0.01) and 1.5 (p = 0.04) times more in the active and passive smoking mothers respectively, compared to unexposed mothers. This study is important because it utilizes a novel methodology to investigate the association between exposure to ETS pre-delivery and depressive symptomology in the prenatal and post-partum period. |
Keywords and phrases: latent transition analysis, environmental tobacco smoke, depressive symptoms, pregnancy.
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