ORTHOSTATIC HYPOTENSION AND ITS ASSOCIATION WITH FAMILY SCAPEGOATING ABUSE IN POSTPARTUM WOMEN OF NDOLA, ZAMBIA

Kartheek R. Balapala, Suriyakala Perumal Chandran, Rebecca C. Mandeville, Chanda Chisanga

Abstract


This cross-sectional study investigated the prevalence of orthostatic hypotension (OH) and its association with family scapegoating abuse (FSA) and mental health symptoms among postpartum women aged 20–30 years in Ndola, Zambia. A total of 666 postpartum women stratified by parity (one or three) were assessed using standardized standing blood pressure measurements to identify OH, defined by ≥20 mm Hg systolic or ≥10 mm Hg diastolic drop within 3 minutes of standing. Psychosocial variables were evaluated using the Family Scapegoating Abuse Questionnaire (FSA-25) and the Depression Anxiety Stress Scale (DASS-21). The overall prevalence of OH was 13.96%. Family scapegoating abuse affected 25% of participants, classified as mild (4.2%), moderate (13.2%), and severe (7.2%). A statistically significant association existed between OH and higher levels of FSA (χ²(3) = 223.72, p < 0.001), with women experiencing OH more likely to report moderate to severe abuse. Body mass index (BMI) showed a strong relationship with both conditions: obese women had over nine times the odds of OH (OR = 9.19, 95% CI: 4.46–18.92) compared to normal/underweight counterparts, and higher obesity rates were observed in women reporting moderate and severe abuse. Sociodemographic factors such as education level, employment status, and marital status were characterized but showed less direct association with OH. These findings reinforce the complex interplay of physiological and psychosocial stressors in postpartum cardiovascular regulation. The study highlights the importance of integrated postpartum care approaches in low-resource settings that address physiological and mental health dimensions, particularly family dynamics and social support. Future longitudinal studies are recommended to clarify causal pathways and optimize interventions to improve maternal cardiovascular outcomes in Zambia.

 

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orthostatic hypotension, postpartum women, family scapegoating abuse, mental health, BMI, Zambia

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References


Ahad, A. A., Sanchez-Gonzalez, M., & Junquera, P. 2023. "Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review." Cureus 15(5). https://doi.org/10.7759/cureus.39549

Balapala, Kartheek R., Rebecca C. Mandeville, and Mandy Sizalobuhle Mpofu. 2024. Impact of a Seminar Intervention on Psychological Well-Being Among Medical Students: A Study of Family Scapegoating Abuse and Mental Health. European Journal of Public Health Studies 8(1). http://dx.doi.org/10.46827/ejphs.v8i1.202

Campos Munoz, A., Vohra, S., & Gupta, M. 2023. Orthostasis (Archived). In StatPearls. StatPearls Publishing. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30422533/

Cheng, Y. C., Vyas, A., Hymen, E., & Perlmuter, L. C. 2011. Gender Differences in Orthostatic Hypotension. The American Journal of the Medical Sciences 342(3): 221-225. https://doi.org/10.1097/maj.0b013e318208752b

Ebong, I. A., Quesada, O., Fonkoue, I. T., Mattina, D., Sullivan, S., Oliveira, G. M. M., Spikes, T., Sharma, J., Commodore, Y., Ogunniyi, M. O., Aggarwal, N. R., Vaccarino, V., & American College of Cardiology Cardiovascular Disease in Women Committee. 2024. Journal of the American College of Cardiology 84(3): 298-314. https://doi.org/10.1016/j.jacc.2024.05.016

Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., Goldstein, D. S., Hainsworth, R., Hilz, M. J., Jacob, G., Kaufmann, H., Jordan, J., Lipsitz, L. A., Levine, B. D., Low, P. A., Mathias, C., van Dijk, J. G. 2011. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clinical autonomic research: official journal of the Clinical Autonomic Research Society, 21(2), 69–72. https://doi.org/10.1007/s10286-011-0119-5

Hamilton-Giachritsis, Catherine E., and Kevin D. Browne. 2005. A Retrospective Study of Risk to Siblings in Abusive Families. Journal of Family Psychology 19(4): 619-624. Retrieved from https://doi.org/10.1037/0893-3200.19.4.619

Lovibond, S. H., and P. F. Lovibond. 1995. Depression Anxiety Stress Scales (DASS--21, DASS--42). APA PsycTests. Retrieved from https://www2.psy.unsw.edu.au/dass/.




DOI: http://dx.doi.org/10.46827/ejphs.v8i3.232

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