Risk and Protective Factors Associated with Suicidal Ideation Among 3rd-trimester Pregnant Adolescent Girls in Rural Ugandan Communities: A Case of Kyotera and Rakai Districts.
Abstract:
Background:
Despite expanding global literature on suicidal ideation, LMIC pregnant adolescent girls' suicidal ide ation is unstudied. This study sought to establish risk and protective factors associated with suicidal ideation among 3rd trimester pregnant adolescent girls (10–19-year-olds) in Kyotera and Rakai districts.
Methods: A cross-sectional study in the 22 sub-counties of Kyotera and Rakai districts, that involved the quantita tive data collection.' It involved pregnant adolescent girls between 10 and 19 years who were in their third trimester. These adolescents participated in a three-year psychological support implementation research project in ten government health facilities and provided prenatal and postnatal care through community health worker mobilization and adoles cent-friendly clinics. The study employed a number of tools including; a self-reported questionnaire; a Wellbeing in Pregnancy tool; and an SGBV questionnaire that collected demographic, pregnancy, family planning, and SGBV data. Data from the PostgresSQL database was extracted, cleaned, and exported to STATA 14 for analysis. The data is pre sented in frequencies, mean, standard deviation, median, and interquartile ranges for continuous data and percentages or proportions for categorical data.
Results: Among the 582 pregnant adolescent girls, 367 were nulliparas, 170 primipara and 47 Multiparas. The mean (SD) age at enrolment was 17.8 ± 1.3 years. Prevalence of SI was 12.7%, which increased as the gestation age pro gressed i.e., 7 months (10.6%), at 8 months (13.0%), and at 9 months (14.9%). Adolescent girls with somatic distress had a 3.58-fold (95% CI: 1.18 to 10.91) significant (p = 0.025) likelihood of experiencing SI. "Feeling worthless", "crying more than usual" and "feeling unhappy" had a 2.4-fold (95% CI: 1.47–4.03); a 2-fold (95% CI: 1.16–3.45); and 65% (95% CI: 1.01–2.69) increase in SI, respectively. Panic disorders such as “shaking hands” (AOR 1.68: 95%CI: 1.10 2.57) (p = 0017) and breathing difficulties (AOR 1.53: 95%CI: 1.02–2.30) (p = 0041) increased SI. Factors such as “lik ing physical appearance” (AOR 0.61: 95%CI:0.039 - 0.97) (p=0035) and decision making (AOR 0.59: 95%CI:0.035 -1.00) (p=0048) protected against SI.
Conclusions: Adolescent women in their third trimester have higher rates of suicidal ideation. Somatic distress and feeling worthless are two risk factors that should be included in screening protocol during antenatal visits. Adolescent programs that provide comprehensive obstetrics care should screen and treat for suicide ideation in all pregnant girls in 3rd trimester. that resonate with natural forms and structures. Overall, the importance of fractal dimension lies in its ability to bridge disciplines, providing insights into complex systems and offering tools for better analysis and understanding of natural and artificial structures. The current exposition provides a plethora of numerous potential fractal open problems to es tablish a next generation research platform combing fractal oncology, fractal biomedicine, fractal medicine and fractal clinical sciences.
