{
  "abstract": "Objectives We aim to identify trajectories of probable maternal common mental disorders (CMD), as well as risk and protective factors associated with maternal mental health among postpartum women during the pandemic using life course theory approach.Design Prospective individual level cohort study from the Iracema-COVID Study.Population Mothers (n=335) at postpartum period who delivered during the COVID-19 pandemic in the fourth largest city in Brazil.Methods Probable CMDs were accessed using validated instruments in five cohort waves at postpartum period. Sequence analyses (SA) were employed to extract CMD trajectories, and a set of generalised binomial logistic and log-Poisson multivariable regression models with robust variance were employed to assess risk and protective factors for probable CMDs diagnosis.Outcome measures Trajectories patterns of probable maternal common mental disorders.Results Fit indices demonstrated a two-cluster-SA solution of probable CMD. The patterns of probable CMDs indicated that 335 mothers were clustered into occasional/transitory (n=240, 71.64%) and mostly/persistent (n=95, 28.36%) CMD trajectories. We found that mothers with low education (OR: 2.44; 95% CI 1.13 to 5.23), single (OR: 1.97; 95% CI 1.03 to 3.75) or in a stable union (OR: 2.00; 95% CI 1.02 to 3.90) and travel time spent to access the nearest primary healthcare unit (OR: 1.02; 95% CI 1.006 to 1.04) were associated with increased OR of belonging to the mostly/persistent CMD trajectory. Deprived green areas acted as a risk factor to maternal CMDs prevalence (OR: 1.37; 95% CI 1.002 to 1.87).Conclusions This study provides evidence that individual vulnerabilities and neighbourhood deprivation play an important role in understanding maternal mental health, beyond the patterns and trajectories of probable maternal CMD due to issues confronted during the COVID-19 outbreak in the northeastern region of Brazil. Policies to prevent and treat maternal mental health issues and improvement in neighbourhood deprivation need to be developed and addressed to avoid exacerbation of probable maternal CMDs.",
  "authors": [
    {
      "affiliations": [
        "Department of Community Health, Universidade Federal do Ceará Faculdade de Medicina, Fortaleza, Conformité Européenne, Brazil",
        "Postgraduate Program of Economics, Latin American Institute for Economy, Society and Politics, Federal University of Latin-American Integration, Foz do Iguaçu, Paraná, Brazil"
      ],
      "name": "Gabriel Alves Sampaio Morais"
    },
    {
      "affiliations": [
        "Department of Community Health, Universidade Federal do Ceará Faculdade de Medicina, Fortaleza, Conformité Européenne, Brazil"
      ],
      "name": "Luciano Lima Correia"
    },
    {
      "affiliations": [
        "Department of Health Sciences, Federal University of Santa Catarina Centre for Sciences Technologies and Health, Araranguá, Santa Catarina, Brazil"
      ],
      "name": "Simone Farías-Antúnez"
    },
    {
      "affiliations": [
        "Department of Community Health, Universidade Federal do Ceará Faculdade de Medicina, Fortaleza, Conformité Européenne, Brazil"
      ],
      "name": "David Augusto Batista Sá Araújo"
    },
    {
      "affiliations": [
        "Department of Community Health, Universidade Federal do Ceará Faculdade de Medicina, Fortaleza, Conformité Européenne, Brazil"
      ],
      "name": "Sophia C Vasconcelos"
    },
    {
      "affiliations": [
        "Department of Community Health, Universidade Federal do Ceará Faculdade de Medicina, Fortaleza, Conformité Européenne, Brazil"
      ],
      "name": "Marcia Maria Tavares Machado"
    },
    {
      "affiliations": [
        "Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"
      ],
      "name": "Marcia C Castro"
    }
  ],
  "title": "Typologies of common maternal mental disorders and associated factors: a quantitative life course study applied to cohort data in a resource-constrained setting in Northeastern Brazil",
  "uid": "60fd4d88-1812-55fa-955a-6a953d629a92"
}