Background: Prenatal depression may have adverse health effects on mothers and their offspring. Perceived stress is an important risk factor for depression during pregnancy. Studies have shown that both perceived stress and depression may negatively influence birth outcomes. While 20% of pregnancies in Suriname, a middle-income Caribbean country located in northern South America, results in adverse birth outcomes, data on prenatal depression and its risk factors are lacking. This study aimed to assess the influence of perceived stress on depression during pregnancy in Surinamese women. Methods: Survey data were used from 1143 pregnant women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study that addresses the impact of chemical and non-chemical environmental exposures in mother/child dyads in Suriname. The Edinburgh Depression Scale and Cohen Perceived Stress Scale were used to screen for probable depression (cut-off ≥ 12) and high stress (cut-off ≥ 20), respectively. The association between perceived stress and depression was examined using bivariate and multiple logistic regression analyses, adjusted for social support (including resilience) and maternal demographics. Results: The prevalence of high perceived stress during the first two trimesters and the third trimester were 27.2% and 24.7% respectively. 22.4% of the participants had probable depression during first or second trimester and 17.6% during the third trimester. Women experiencing high stress levels during the first two trimesters had 1.92 increased odds (95% CI 1.18–3.11, p = 0.008) of having probable depression during the third trimester of pregnancy than those with low stress levels. Pregnant women with low individual resilience during early pregnancy (52.1%) had 1.65 (95% CI 1.03–2.63, p = 0.038) increased odds of having probable depression during later stages of pregnancy compared to those with high individual resilience. Low educational level (p = 0.004) and age of the mother (20–34 years) (p = 0.023) were significantly associated with probable depression during the third trimester. Conclusions: Early detection and management of stress and depression during pregnancy are important. Health education programs, targeting the reduction of stress during pregnancy, may help to reduce depression and its potential adverse health effects on the mother and child.

Prenatal exposure to mercury, stress, and depression may have adverse effects on birth outcomes. Little is known on the influence of chemical and non-chemical stressors on birth outcomes in the country of Suriname. We assessed the influence of prenatal exposure to mercury, perceived stress, and depression on adverse birth outcomes in 1143 pregnant Surinamese women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study. Associations between mercury (≥1.1 μg/g hair, USEPA action level/top versus bottom quartile), probable depression (Edinburgh Depression Scale ≥12), high perceived stress (Cohen’s Perceived Stress Scale ≥20), and adverse birth outcomes (low birthweight (<2500 g), preterm birth (<37 completed weeks of gestation), and low Apgar score (<7 at 5 min)) were assessed using bivariate and multivariate logistic regressions. Prevalence of elevated mercury levels, high perceived stress, and probable depression were 37.5%, 27.2%, and 22.4%, respectively. Mercury exposure was significantly associated with preterm birth in the overall study cohort (OR 2.47; 95% CI 1.05–5.83) and perceived stress with a low Apgar score (OR 9.73; 95% CI 2.03–46.70). Depression was not associated with any birth outcomes. These findings can inform policy- and practice-oriented solutions to improve maternal and child health in Suriname.

The cumulative exposure to chemical and non-chemical stressors may have an impact on birth outcomes. The aim of this study is to examine the cumulative exposure of a mixture of chemicals (mercury, lead, selenium and tin) and non-chemical stressors (social support, perceived stress, probable depression and BMI) on birth outcomes (birthweight, gestational age at birth, and Apgar score at 5 min). The study population is a subset (n = 384) of the Caribbean Consortium for Research in Environmental and Occupational Health–MeKiTamara prospective cohort study. Associations between the latent chemical construct, non-chemical stressors and birth outcomes were assessed using path models. The results showed a significant direct relationship between perceived stress and birthweight (β = −0.17), however even though the relationship between perceived stress and depression was significant in all three path models (β = 0.61), the association between depression and birth outcomes was not significant. Perceived stress was significantly associated with community engagement (β = −0.12) and individual resilience (β = −0.12). BMI (β = 0.12) was also significantly directly associated with birthweight. The latent chemical construct did not show an association with the birth outcomes. Our data indicate the need for the development of a support system for pregnant women by involving them in prenatal care programs to reduce maternal stress, which may also influence depression and (in)directly improve the birth outcomes. Interventions regarding weight management for women of childbearing age are necessary to halt obesity and its negative effects on birth outcomes.

Objective. To determine the sociodemographic risk factors associated with coronavirus disease 2019 (COVIDMethods. This was a retrospective cohort study. All registered deaths from COVID-19 in Suriname (n=1112) between March 13, 2020 and November 11, 2021 were included. Data were collected from medical records and included demographic variables and hospitalization duration of patients who died. Descriptive statistics, chi-squared tests, ANOVA models, and logistic regression analyses were used to determine associations between sociodemographic variables, length of hospitalization, and mortality during four epidemic waves. Results. The case fatality rate over the study period was 22 per 1 000 population. The first epidemic wave was from July to August 2020, the second from December 2020 to January 2021, the third from May to June 2021, and the fourth from August to September 2021. Significant differences were found in the number of deaths and hospitalization duration by wave (p<0.001). Patients were more likely to have a longer hospitalization during the first (OR 1.66; 95% CI: 0.98, 2.82) and third waves (OR 2.37; 95% CI: 1.71, 3.28) compared with the fourth wave. Significant differences in mortality were also seen between ethnicities by wave (p=0.010). Compared with the mixed and other group, people of Creole ethnicity (OR 2.7; 95% CI: 1.33, 5.29) and Tribal people (OR 2.8; 95% CI: 1.12, 7.02) were more likely to die during the fourth wave than the third wave. Conclusions. Tailored interventions are needed for males, people of Creole descent, Tribal and Indigenous peoples, and people older than 65 years.

Background: Lead (Pb) exposure remains a major global health issue, and Pb stable isotope ratio analysis is a powerful tool for identifying potential exposure sources. However, traditional whole blood collection is difficult to implement in remote or resource-limited settings. We developed and validated a novel method for measuring Pb isotopic composition in dried blood spots (DBS) using a multi-collector inductively coupled plasma mass spectrometer (MC-ICP-MS) and applied it in a pilot study of DBS collected from children in Suriname, South America. Methods: Method accuracy was evaluated by comparing isotopic ratios (²⁰⁸Pb/²⁰⁶Pb and ²⁰⁷Pb/²⁰⁶Pb) measured in laboratory-spiked DBS (15 µL of blood per DBS) with those from matched whole blood samples (1 mL) across a range of Pb concentrations (2.1–28.9 µg/dL). The method was then applied to DBS collected from 18 children, ages 6 months to 5 years, in Suriname. Potential local exposure sources, including soil, shotgun pellets, and cooking utensils, were also analyzed for lead isotopic composition and compared with DBS isotope ratios to assess source concordance. Results: DBS isotopic ratios accurately reflected whole blood values when Pb concentrations exceeded ~315 pg/punch (~2.1 µg/dL), with greater accuracy observed above 5 µg/dL. In the Suriname DBSs, blank-corrected ²⁰⁸Pb/²⁰⁶Pb ratios were consistent across regions (mean 2.12 ± 0.018; n = 15) and showed no significant geographic stratification (p = 0.11). DBS signatures (isotope ratios) most closely aligned with shotgun pellets and soil samples, whereas those from cooking utensils did not match DBS signatures. A positive correlation was observed between estimated blood total Pb and soil Pb concentrations (ρ = 0.60, p = 0.20). Conclusions: Overall, DBS provided reliable Pb isotopic ratio measurements above ~2–5 µg/dL, spanning the current CDC reference value of 3.5 µg/dL at which children’s exposures warrant investigation. These findings support DBS as a minimally invasive, scalable tool for exposure source identification in environmental epidemiology, particularly in remote settings where traditional venipuncture is impractical. What this study adds: This study establishes the first validated method for high-precision lead (Pb) stable isotopic ratio analysis using dried blood spots (DBS). By implementing a sample blank correction, we demonstrate that DBS can accurately resolve isotopic signatures even at low blood lead concentrations. Applied in DBS collected in Suriname, the method successfully linked DBS signatures to local shotgun pellets and soils, illustrating a common exposure profile across diverse regions. This work expands the utility of DBS beyond simple screening, offering a minimally invasive, scalable tool for source attribution in global health research and environmental epidemiology in remote regions.

Maternal anemia and prenatal exposure to neurotoxic metals are widespread in low- and middle-income countries and may affect early childhood development. In Suriname, where mercury contamination from artisanal gold mining and social disparities coexist, we examined associations between maternal anemia, prenatal exposure to mercury (Hg), lead (Pb), manganese (Mn), selenium (Se), and cadmium (Cd), and early neurodevelopment. The study included 755 pregnant women and 644 children (10–26 months) from the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) cohort. Maternal anemia was defined using WHO criteria for Hb, metals were measured in maternal blood, and child development was assessed using the Bayley Scales of Infant and Toddler Development, third edition (BSID-III-NL). Analyses used non-parametric tests, correlations, and multivariable regression. Anemia, though common (34%), was not independently associated with cognitive, language, motor, or social–emotional outcomes. However, iron status was not directly measured; therefore, the absence of an observed association should not be interpreted as evidence that maternal iron deficiency is unrelated to early neurodevelopment. Pb showed the most consistent associations, with higher prenatal levels predicting poorer cognitive, motor, and language scores. Hg demonstrated weaker but significant negative associations with several domains, while Mn and Cd showed limited direct effects. Interaction analyses suggested a potential modifying role of Se in certain metal-neurodevelopment associations; however, these findings require confirmation in future studies. Overall, these results suggest that prenatal exposure to neurotoxic metals and sociodemographic disparities may be important contributors to variation in early neurodevelopment in this population, but causal inferences cannot be made from this cross-sectional analysis.