Flooding and elevated prenatal depression in rural Bangladesh: A mixed methods study

Area of Science:

• Environmental Health
• Maternal Mental Health
• Disaster Epidemiology

Background:

• Prenatal depression poses risks to child development.
• The impact of natural disasters like floods on maternal mental health in low- and middle-income countries is understudied.
• Rural riverine communities face unique vulnerabilities during flood events.

Purpose of the Study:

• To investigate the association between flooding and prenatal depression in rural Bangladesh.
• To identify specific flood-related factors contributing to maternal depression.
• To explore community-based flood preparedness strategies.

Main Methods:

• A cross-sectional survey of 881 pregnant women in rural Bangladesh.
• Data collection included self-reported flooding, Edinburgh Postnatal Depression Scale (EPDS) scores, water level data, and remote sensing.
• Generalized linear and log-linear models were used for analysis, supplemented by focus group discussions.

Main Results:

• Compound flooding was linked to a twofold increase in depression and an eightfold increase in self-harm thoughts.
• Latrine flooding showed a 3.5-fold increase in depression.
• Higher water levels and proximity to surface water correlated with higher EPDS scores.

Conclusions:

• Flooding, elevated water levels, and proximity to water bodies are associated with increased prenatal depression in rural Bangladesh.
• Inadequate sanitation and hygiene infrastructure are key drivers of flood-related maternal depression.
• Community flood preparedness involves relocation, food storage, and home modifications.