Hermione Lovel

The University of Manchester, Manchester, England, United Kingdom

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Publications (12)74.18 Total impact

  • European Psychiatry 04/2008; 23. DOI:10.1016/j.eurpsy.2008.01.264 · 3.44 Impact Factor
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    A Rahman · J Bunn · H Lovel · F Creed
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    ABSTRACT: There is a high prevalence of depression in south Asian women. We aimed to examine the association between antenatal depression and low birthweight (LBW) in infants in a rural community in Rawalpindi, Pakistan. A total of 143 physically healthy mothers with ICD-10 depression in the third trimester of pregnancy and 147 non-depressed mothers of similar gestation were followed from birth. Infant weight was measured and information collected on socioeconomic status, maternal body-mass index and sociodemographic factors. Infants of depressed mothers had lower birthweight (mean 2910 g) than infants of non-depressed mothers (mean 3022 g). The relative risk for LBW (< or =2500 g) in infants of depressed mothers was 1.9 (95% CI 1.3-2.9). The association remained significant after adjustment for confounders by multivariate analyses. Low birthweight is a major public health problem in developing countries. Maternal depression during pregnancy predicts LBW. Interventions aimed at maternal depression may help improve infant outcomes.
    Acta Psychiatrica Scandinavica 06/2007; 115(6):481-6. DOI:10.1111/j.1600-0447.2006.00950.x · 5.55 Impact Factor
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    A Rahman · J. E. Bunn · H Lovel · F Creed
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    ABSTRACT: To examine the associations between postnatal depression in mothers and diarrhoeal illness in their infants in the first year of life in a low-income country. Using a prospective cohort design, 265 infants (n = 130 of mothers having a depressive episode according to the International Classification of Diseases, 10th revision, at 3 months postnatal and n = 135 of psychologically well mothers) living in rural Rawalpindi, Pakistan, were followed up for 1 year. Frequency of diarrhoeal episodes was measured fortnightly by health workers using a standard questionnaire. Infants of depressed mothers had significantly more diarrhoeal episodes per year than those of controls (mean 5.5 v 4.0; 95% confidence interval (CI) 0.9 to 2.0). The relative risk of having > or =5 diarrhoeal episodes per year in infants of depressed mothers was 2.3 (95% CI 1.6 to 3.1). The association remained significant after adjustment for other risk factors by multivariate analysis. Maternal depression is associated with infant diarrhoeal morbidity in a low-income community setting. It is independent of the effects of known factors such as undernutrition, socioeconomic status and parental education. Preventive child health programmes targeting mothers must consider their mental health.
    Archives of Disease in Childhood 01/2007; 92(1):24-8. DOI:10.1136/adc.2005.086579 · 2.91 Impact Factor
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    ABSTRACT: Recent studies have shown associations between size and body proportions at birth and health outcomes throughout the life cycle, but there are few data on how neonatal phenotype varies in different populations around the world. Data from the UK, Finland, India, Sri Lanka, China, DR Congo, Nigeria, and Jamaica (n=22,067) were used to characterize geographical differences in phenotype in singleton, live-born newborns. Measurements included birth weight, placental weight, length, head, chest, abdominal and arm circumferences, and skinfolds. Neonates in Europe were the largest, followed by Jamaica, East Asia (China), then Africa and South Asia. Birth weight varied widely (mean values 2,730-3,570 g), but in contrast, head circumference was similar in all except China (markedly smaller). The main difference in body proportions between populations was the head to length ratio, with small heads relative to length in China and large heads relative to length in South Asia and Africa. These marked geographical differences in neonatal phenotype need to be considered when investigating determinants of fetal growth, and optimal phenotype for short-term and long-term outcomes.
    Acta Obstetricia Et Gynecologica Scandinavica 02/2006; 85(9):1080-9. DOI:10.1080/00016340600697447 · 1.99 Impact Factor
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    ABSTRACT: Size and body proportions at birth are partly determined by maternal body composition, but most studies of mother-baby relationships have only considered the effects of maternal height and weight on offspring birth weight, and few have examined the size of effects. Paternal size and body composition also play a role, primarily through the fetal genome, although few studies have investigated relationships with neonatal phenotype. Data from the UK, Finland, India, Sri Lanka, China, DR Congo, Nigeria and Jamaica were used to investigate the effects of maternal measures (derived at 30 weeks' gestation, n=16,418), and also paternal size (n=3,733) on neonatal phenotype, for singleton, live-born, term births. After accounting for variation in maternal size and shape across populations, differences in neonatal phenotype were markedly reduced. Mother-baby relationships were similar across populations, although some were stronger in developing countries. Maternal height was generally the strongest predictor of neonatal length, maternal head circumference of neonatal head and maternal skinfold thickness of neonatal skinfolds. Relationships with maternal arm muscle area were generally weak. Effects of paternal height and body mass index were weaker than the equivalent maternal measurements in most studies. Differences in maternal body composition account for a large part of the geographical variation in neonatal phenotype. The size of the effects of all maternal measures on neonatal phenotype suggests that nutrition at every stage of the mother's life cycle may influence fetal growth. Further research is needed into father-baby relationships and the genetic mechanisms that influence fetal growth.
    Acta Obstetricia Et Gynecologica Scandinavica 02/2006; 85(9):1066-79. DOI:10.1080/00016340600697306 · 1.99 Impact Factor
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    ABSTRACT: Little is known about causes of asthma and sensitization in desert countries. To investigate risk factors associated with asthma and sensitization in Kuwait. One hundred sixty children (9-16 years) with physician-diagnosed asthma were recruited and matched (age, sex) with 303 healthy controls. Risk factors were assessed by questionnaires, determination of sensitization status (skin tests and IgE), and home allergen exposure (mite, cat, dog, cockroach; ELISA). Home allergen levels and frequency of pet ownership were very low (cat, 4.1%; dog, 1.5%). The risk of cat sensitization increased significantly among cat owners (odds ratio [OR], 3.53; 95% CI, 1.33-9.41; P = .01), and in children with reported contact with cats during the first year of life (OR, 2.60; 95% CI, 1.17-5.80; P = .019). In the multivariate analysis, maternal atopy (OR, 1.77; 95% CI, 1.13-2.75; P = .01) and cat ownership (OR, 3.32; 95% CI, 1.19-9.25; P = .02) remained significant associates of cat sensitization. Current dog ownership significantly increased the risk of sensitization to dog (OR, 6.05; 95% CI, 1.33-27.54; P = .02). In the multivariate analysis, dog ownership remained the only significant associate of dog sensitization (OR, 6.02; 95% CI, 1.30-27.96; P = .02). Sensitization to Alternaria was the strongest independent associate of the asthma group. Family history of asthma, history of whooping cough, current cat ownership, and breast-feeding <2 months were other significant and independent risk factors for asthma. Pet ownership markedly increased the risk of sensitization to pets. Despite low allergen exposure, the pattern of childhood asthma in Kuwait follows that described in Western communities (strong association with sensitization).
    Journal of Allergy and Clinical Immunology 01/2005; 114(6):1389-94. DOI:10.1016/j.jaci.2004.09.005 · 11.25 Impact Factor
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    ABSTRACT: The risk for emotional and behavioral problems is known to be high among children of depressed mothers, but little is known about the impact of prenatal and postnatal depression on the physical health of infants. To determine whether maternal depression is a risk factor for malnutrition and illness in infants living in a low-income country. Prospective cohort study. Rural community in Rawalpindi, Pakistan. Six hundred thirty-two physically healthy women were assessed in their third trimester of pregnancy to obtain at birth a cohort of 160 infants of depressed mothers and 160 infants of psychologically well mothers. All infants were weighed and measured at birth and at 2, 6, and 12 months of age, and they were monitored for episodes of diarrhea and acute respiratory infections. The mothers' mental states were reassessed at 2, 6, and 12 months. Data were collected on potential confounders of infant outcomes, such as birth weight and socioeconomic status. Infants of prenatally depressed mothers showed significantly more growth retardation than controls at all time points. The relative risks for being underweight (weight-for-age z score of less than -2) were 4.0 (95% confidence interval [CI], 2.1 to 7.7) at 6 months of age and 2.6 (95% CI, 1.7 to 4.1) at 12 months of age, and the relative risks for stunting (length-for-age z score of less than -2) were 4.4 (95% CI, 1.7 to 11.4) at 6 months of age and 2.5 (95% CI, 1.6 to 4.0) at 12 months of age. The relative risk for 5 or more diarrheal episodes per year was 2.4 (95% CI, 1.7 to 3.3). Chronic depression carried a greater risk for poor outcome than episodic depression. The associations remained significant after adjustment for confounders by multivariate analyses. Maternal depression in the prenatal and postnatal periods predicts poorer growth and higher risk of diarrhea in a community sample of infants. As depression can be identified relatively easily, it could be an important marker for a high-risk infant group. Early treatment of prenatal and postnatal depression could benefit not only the mother's mental health but also the infant's physical health and development.
    Archives of General Psychiatry 10/2004; 61(9):946-52. DOI:10.1001/archpsyc.61.9.946 · 13.75 Impact Factor
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    Sara Mackian · Nafisa Bedri · Hermione Lovel
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    ABSTRACT: The concept of health-seeking behaviour continues to permeate the development literature, and this paper reviews the main approaches. However, it also suggests that health-seeking behaviour is a somewhat over-utilized and under-theorized tool. Although it remains a valid tool for rapid appraisal of a particular issue at a particular time, it is of little use as it stands to explore the wider relationship between populations and health systems development. If we wish to move the debate into new and more fruitful arenas, we need to develop a tool for understanding how populations engage with health systems, rather than using health-seeking behaviour as a tool for describing how individuals engage with services. The paper suggests one way in which we might start to frame the debate, using reflexive communities and social capital as key theoretical and analytical concepts.
    Health Policy and Planning 06/2004; 19(3):137-46. · 3.00 Impact Factor
  • A Rahman · H Lovel · J Bunn · Z Iqbal · R Harrington
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    ABSTRACT: Epidemiological studies in Pakistan show high rates of depression in women, while rates of malnutrition in children are also high. This study aimed to determine whether poor maternal mental health is associated with an increased risk of infant undernutrition. Clinic-based case-control study. A total of 172 consecutive infants and their mothers attending for 9-month measles immunization were recruited over a 3-month period. Eighty-two undernourished infants [weight for age below the National Centre for Health Statistics (NCHS)/World Health Organization (WHO) third centile] were matched to 90 controls (weight for age above 10th centile), and their mothers interviewed for mental distress using the Self-Reporting Questionnaire (WHO SRQ-20, a psychiatric screening instrument). Infants' exposure to maternal distress (score > or = 10 on SRQ-20) and other potential risk or protective biological, social, socio-economic and family factors were measured. Mental distress determined by WHO SRQ-20 was associated with increased risk of undernutrition in infants (odds ratio 3.91, 95% confidence interval 1.95-7.86). This association remained significant after controlling for birthweight and social factors. Exposure to maternal mental distress is associated with undernutrition in 9-month infants in urban Pakistan. These mothers may represent a group whose children are at higher risk of ill health, and potentially be a specific target for advice on infant care. Early recognition and treatment of mental health problems in mothers may help reduce morbidity and mortality rates in children.
    Child Care Health and Development 01/2004; 30(1):21-7. DOI:10.1111/j.1365-2214.2004.00382.x · 1.83 Impact Factor
  • Journal of Allergy and Clinical Immunology 02/2003; 111(1). DOI:10.1016/S0091-6749(03)80523-7 · 11.25 Impact Factor
  • Journal of Allergy and Clinical Immunology 01/2002; 109(1). DOI:10.1016/S0091-6749(02)81237-4 · 11.25 Impact Factor
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    ABSTRACT: Keywords:allergen;cat;cockroach;dog;exposure;mite;passive
    Allergy 01/2002; 56(12):1237-8. DOI:10.1034/j.1398-9995.2001.00389.x · 6.00 Impact Factor

Publication Stats

670 Citations
74.18 Total Impact Points

Institutions

  • 2004–2008
    • The University of Manchester
      • Centre for Primary Care
      Manchester, England, United Kingdom
    • Manchester Mental Health and Social Care Trust
      Manchester, England, United Kingdom
  • 2002
    • Kuwait University
      Al Kuwayt, Al Asimah, Kuwait