1
|
Kisaka Y, Yamamoto M, Yanase K, Sakurai K, Eguchi A, Watanabe M, Mori C, Todaka E. Association Between Antibiotic Exposure During Pregnancy and Postpartum Depressive Symptoms: The Japan Environment and Children's Study. Res Nurs Health 2025; 48:211-221. [PMID: 39777688 PMCID: PMC11873760 DOI: 10.1002/nur.22442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/02/2024] [Accepted: 12/17/2024] [Indexed: 01/11/2025]
Abstract
Postpartum depressive symptoms (PDS) are a common mental health condition among women after delivery. Although various causative factors have been reported, PDS remains a challenging condition to predict and prevent. The disruption of the gut microbiota due to antibiotic exposure has been reported to affect psychiatric conditions. Similarly, previous research suggests that antibiotic exposure during pregnancy could be related to PDS. Therefore, this prospective study examines the association between antibiotic exposure during pregnancy and PDS for 6 months after delivery. Data were obtained from 65,272 mothers from the Japan environment and children's study, a prospective birth cohort study. The ratios of maternal PDS at 1 and 6 months after delivery were 12.3% and 10.1%, respectively. During pregnancy, 10.7% of women took antibiotics orally. Antibiotic exposure during pregnancy was associated with an increased risk of PDS only at 6 months after delivery (OR = 1.13, 95% CI [1.00, 1.26]), adjusted for potential confounding factors. An increase in Edinburgh Postnatal Depression Scale scores in relation to antibiotic exposure during pregnancy was primarily observed via psychological distress during pregnancy. Although a causal link was not established, antibiotic exposure during pregnancy may be a contributing risk factor for PDS. Therefore, when antibiotic administration is required, clinical practitioners and perinatal care providers should consider the potential risk for PDS.
Collapse
Affiliation(s)
- Yumi Kisaka
- Department of Sustainable Health Science, Graduate School of Medical and Pharmaceutical SciencesChiba UniversityChibaJapan
| | - Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical SciencesChiba UniversityChibaJapan
| | - Kana Yanase
- Chiba Foundation for Health Promotion and Disease PreventionChibaJapan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical SciencesChiba UniversityChibaJapan
| | - Akifumi Eguchi
- Department of Sustainable Health Science, Center for Preventive Medical SciencesChiba UniversityChibaJapan
| | - Masahiro Watanabe
- Department of Sustainable Health Science, Center for Preventive Medical SciencesChiba UniversityChibaJapan
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical SciencesChiba UniversityChibaJapan
- Department of Bioenvironmental Medicine, Graduate School of MedicineChiba UniversityChibaJapan
| | - Emiko Todaka
- Department of Bioenvironmental Medicine, Graduate School of MedicineChiba UniversityChibaJapan
- Department of Global Preventive Medicine, Center for Preventive Medical SciencesChiba UniversityChibaJapan
| |
Collapse
|
2
|
Koyama Y, Tan AP, Sadikova E, Setoh P, Broekman B, Zhou JH, Gluckman P, Chen H, Tiemeier H. Maternal depressive symptoms in childhood and offspring brain cortical and subcortical volumetric change: A repeated imaging study from age 4-10 years. Dev Cogn Neurosci 2025; 72:101531. [PMID: 39961201 PMCID: PMC11872126 DOI: 10.1016/j.dcn.2025.101531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 02/08/2025] [Accepted: 02/11/2025] [Indexed: 03/06/2025] Open
Abstract
Maternal depressive symptoms have been associated with offspring's brain structural differences. However, previous studies were limited by cross-sectional designs, brain region-of-interest analyses, or clinical samples. Importantly, few studies assessed the early childhood brain. This study analyzed data from a Singaporean cohort of 217 children with 589 repeated structural neuroimaging from 4.5 to 10.5 years (2-4 assessments) in relation to maternal depressive symptoms. Maternal depressive symptoms were measured by questionnaire at child age 4.5 years. Mixed models explored within-sample change accounting for non-linear brain development. Multiple testing was corrected, and a stringent threshold was applied. Maternal depressive symptoms were associated with persistently smaller precentral gyral volume over time (β = -0.162 [-0.238; -0.086], padj < 0.001). In analysis with time interaction, maternal symptoms were associated with curvilinear changes in the volumes of supramarginal (β = -0.019 [-0.027; -0.010], padj < 0.001) and precuneus gyrus (β = -0.016 [-0.025; -0.007], padj = 0.007); this suggests delayed volumetric development in brain areas governing attention, memory, and language among children exposed to severe maternal symptoms. The findings implicate that childhood maternal depressive symptoms are associated with persistent differences in precentral volume and affect the brain volumetric development of complex sensory information processing regions, rather than in emotion regulation areas implicated in the depression experience. Our findings emphasize repeated childhood imaging to understand child brain development risk factors.
Collapse
Affiliation(s)
- Yuna Koyama
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Diagnostic Imaging, National University Hospital Singapore, Singapore 119074, Singapore; Department of Public Health, Institute of Science Tokyo, Tokyo 113-8510, Japan.
| | - Ai Peng Tan
- Department of Diagnostic Imaging, National University Hospital Singapore, Singapore 119074, Singapore; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A⁎STAR), Singapore 138632, Singapore; Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Ekaterina Sadikova
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Peipei Setoh
- Psychology Division, School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore
| | - Birit Broekman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A⁎STAR), Singapore 138632, Singapore; Department of Psychiatry, Amsterdam UMC, location VUmc, VU University, Amsterdam 1076, the Netherlands; Department of Psychiatry, Onze Lieve Vrouwe Gasthuis, Amsterdam 1061, the Netherlands
| | - Juan Helen Zhou
- Centre for Sleep and Cognition, Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549, Singapore; Human Potential Translational Research Program, Department of Medicine, National University of Singapore, Singapore 117597, Singapore; Department of Electrical and Computer Engineering, Integrative Science and Engineering Programme (ISEP), NUS Graduate School, National University of Singapore, Singapore 119077, Singapore
| | - Peter Gluckman
- International Science Council, Paris 75116, France; Koi Tu: The Centre for Informed Futures, University of Auckland, Auckland 1010, New Zealand
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore; Duke-National University of Singapore, Singapore 118420, Singapore
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| |
Collapse
|
3
|
Banchoff EM, Axinn WG, Ghimire DJ, Scott KM. Intergenerational Associations of Maternal Depression with Daughters' Family Formation. JOURNAL OF MARRIAGE AND THE FAMILY 2025; 87:415-436. [PMID: 40114989 PMCID: PMC11922536 DOI: 10.1111/jomf.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 07/23/2024] [Indexed: 03/22/2025]
Abstract
Objective This work investigates the potential associations between maternal major depressive disorder (MDD) and daughters' family formation behaviors, specifically the timing of marriage and first birth. Background Family and life course research has established the importance of intergenerational ties and linked lives for children's health, education, social life, and transition to adulthood more broadly. However, mothers' MDD has remained a relatively understudied factor shaping young people's family formation behaviors. Method The analyses used a sample of 1,127 linked mother-father-daughter triads from the Chitwan Valley Family Study (CVFS) in Nepal. Discrete-time event-history models at the month-level were run to assess whether daughters' differential exposure to maternal MDD was prospectively associated with entry into marital unions and parenthood. Results Although there was no relationship between maternal lifetime MDD and daughters' family formation, results showed that being first exposed to maternal MDD during childhood, specifically between the ages of 0 and 10, increased the monthly odds of transitioning to parenthood by more than 80%. Additional findings showed that an increased pace of getting married was a primary determinant of accelerated childbearing. Conclusion Daughters' exposure to mothers' depression was associated with daughters' family formation transitions. The timing of exposure, however, was a particularly important driver of that association. We argue that the study of parents' mental ill-health provides untapped opportunity for future intergenerational research.
Collapse
Affiliation(s)
- Emma M Banchoff
- Department of Sociology, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - William G Axinn
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Dirgha J Ghimire
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Kate M Scott
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| |
Collapse
|
4
|
Al Rajabi A, Alkatheeri H, Hijazi R, Kennedy L. Breastfeeding is associated with reduction in postpartum depression in the United Arab Emirates: a retrospective cross-sectional study. Sci Rep 2025; 15:10528. [PMID: 40148394 PMCID: PMC11950439 DOI: 10.1038/s41598-025-94912-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Accepted: 03/18/2025] [Indexed: 03/29/2025] Open
Abstract
Postpartum Depression (PPD) is a common mental health disorder affecting mothers. Breastfeeding may be protective against PPD. Global estimates of breastfeeding and PPD rates vary, especially for women living in Middle Eastern countries. The current study aims to assess breastfeeding and PPD prevalence and to identify factors associated with reduced PPD risk within the social and cultural contexts of the UAE. We used a purposive, convenience snowball sampling technique to recruit participants. Inclusion criteria were female ≥ 18 years, mother of a child ≤ three years, and resident of Abu Dhabi, UAE. Data was collected using an online survey distributed via email and social media platforms. The survey comprised four sections: sociodemographic characteristics, breastfeeding behaviour, Edinburgh Postnatal Depression Scale (EPDS), and The International Physical Activity Questionnaire -Short Form (IPAQ-SF). Pearson chi-squared tests and binary logistic regression model were used to investigate the associations between PPD levels and potential predictors using SPSS statistical software. Variables included in the regression model were breastfeeding duration, delivery mode, BMI, education, general health, physical activity level, employment status, number of children, and age. All statistical significance was considered at p-value < 0.05. In total 403 subjects consented to participate; 204 met the inclusion criteria and were included in the final analysis (age [mean ± SD] = 31.2 ± 7.3 years). Among them, 34.8% suffered from moderate-to-severe PPD, and 66.2% breastfed their last child for > 3 months. Regression model results showed that (OR; 95% CI) college education (0.39; 0.19-0.80), having more than one child (0.40; 0.17-0.94), self-reported very good (0.43; 0.19-0.98) and excellent health (0.21; 0.08-0.51), and breastfeeding for > three months (0.46; 0.23-0.92), were significantly associated with reduced odds of moderate-to-severe PPD. None of the remaining variables -including physical activity- were significant. In conclusion, breastfeeding is significantly associated with a reduction in moderate-to-severe PPD among mothers in Abu Dhabi, UAE.
Collapse
Affiliation(s)
- Ala Al Rajabi
- Department of Nutrition Sciences, College of Health Science, QU Health, Qatar University, Doha, Qatar.
| | - Hind Alkatheeri
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
| | - Rafiq Hijazi
- Department of Mathematics and Statistics, College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
| | - Lynne Kennedy
- Department of Public Health, College of Health Science, QU Health, Qatar University, Doha, Qatar
| |
Collapse
|
5
|
Duan CC, Zhang C, Xu HL, Tao J, Yu JL, Zhang D, Wu S, Zeng X, Zeng WT, Zhang ZY, Dennis CL, Liu H, Wu JY, Mol BWJ, Huang HF, Wu YT. Internet-Based Cognitive Behavioral Therapy for Preventing Postpartum Depressive Symptoms Among Pregnant Individuals With Depression: Multicenter Randomized Controlled Trial in China. J Med Internet Res 2025; 27:e67386. [PMID: 40053801 PMCID: PMC11920666 DOI: 10.2196/67386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2024] [Revised: 12/20/2024] [Accepted: 12/29/2024] [Indexed: 03/09/2025] Open
Abstract
BACKGROUND Women are particularly vulnerable to depression during pregnancy, which is one of the strongest risk factors for developing postpartum depression (PPD). Addressing antenatal depressive symptoms in these women is crucial for preventing PPD. However, little is known about the effectiveness of internet-based cognitive behavioral therapy (ICBT) in preventing PPD in this high-risk group. OBJECTIVE This study aims to evaluate the short- and long-term effects of ICBT in preventing PPD among women with antenatal depressive symptoms. METHODS Participants were screened for antenatal depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) and randomly allocated (1:1) to either the ICBT group (receiving weekly online modules starting antenatally and continuing into early postpartum) or the control group (observed without treatment). Follow-up assessments were conducted up to 12 months postpartum, and data were analyzed using generalized estimating equations. The primary outcome was the prevalence of depressive symptoms at 6 weeks postpartum. A subgroup analysis based on the severity of antenatal depressive symptoms was also performed. The secondary outcomes included the long-term effects of ICBT on maternal depression, as well as its impact on anxiety, sleep quality, social support, parenting stress, co-parenting relationships, and infant development. RESULTS Between August 2020 and September 2021, 300 pregnant individuals were recruited from 5 centers across China. No significant differences were observed in depressive symptoms at 6 weeks postpartum (P=.18) or at any longer-term follow-up time points (P=.18). However, a post hoc subgroup analysis showed that participants with antenatal EPDS scores of 10-12 in the ICBT group had a lower risk of developing depression during the first year postpartum (odds ratio 0.534, 95% CI 0.313-0.912; P=.02), but this was not observed for participants with more severe depression. Additionally, this subgroup demonstrated higher levels of co-parenting relationships (P=.02). CONCLUSIONS Among individuals with antenatal depression, ICBT did not prevent the development of PPD. However, ICBT may be a preferable option for those with mild to moderate antenatal depressive symptoms. Future research is needed to explore modifications to ICBT to address more severe depressive symptoms. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000033433; https://www.chictr.org.cn/showproj.html?proj=54482. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-022-06728-5.
Collapse
Affiliation(s)
- Chen-Chi Duan
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
| | - Chen Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
| | - Hua-Lin Xu
- Shaoxing Maternity and Child Health Care Hospital, Shaoxing, China
| | - Jing Tao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jia-Le Yu
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dan Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shan Wu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Gynecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiu Zeng
- Hunan Maternal and Child Health Care Hospital, Changsha, China
| | | | | | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Han Liu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
| | - Jia-Ying Wu
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ben Willem J Mol
- Department of Obstetrics and Gynecology, Monash University, Clayton, Australia
| | - He-Feng Huang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan-Ting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
| |
Collapse
|
6
|
Olhaberry M, Morán-Kneer J, Sieverson C, Costa-Cordella S, Muzard A, Honorato C, León MJ, Leyton F. Impact of strength-based video-feedback intervention on maternal sensitivity in mother-infant dyads with maternal depressive symptoms. Infant Ment Health J 2025; 46:160-180. [PMID: 39725982 DOI: 10.1002/imhj.22154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 11/06/2024] [Accepted: 11/27/2024] [Indexed: 12/28/2024]
Abstract
Strength-based video-feedback (SB-VF) is an attached base and culturally sensitive video-feedback intervention which promotes maternal well-being and sensitivity through using mentalization technics. The goals of this study were to investigate the feasibility, acceptability, and preliminary effectiveness of internet-delivered SB-VF to mother with post-partum depression during COVID-19 pandemic. A pilot randomized, two arm controlled trial was conducted (trial registration NCT04748731) with depressive symptoms' women (n = 172) from Chilean public primary health centers, 79 were randomized to either experimental group (on-line SB-VF plus treatment as usual [TAU], n = 41) or control group (TAU, n = 38). Primary outcomes were feasibility measured by eligibility rate, recruitment rate and intervention completion, and acceptability measured by in depth interviews to mothers and therapists. Secondary outcomes were change in depressive symptoms, maternal sensitivity and parental reflective function. The study demonstrated favorable feasibility and acceptability. Despite moderate recruitment rates, the completion rate was notably high in comparison to other online interventions. Participants reported positive experiences, though some faced challenges with internet access and privacy. Maternal sensitivity improved in the intervention group with a small to large effect size. The SB-VF intervention is feasible and preliminarily effective in public health system, with potential for scaling up in similar contexts.
Collapse
Affiliation(s)
- Marcia Olhaberry
- Escuela de Psicología, Pontificia Universidad Católica, Santiago, Chile
- Millennium Institute for depression and Personality Research (MIDAP), Santiago, Chile
| | - Javier Morán-Kneer
- Millennium Institute for depression and Personality Research (MIDAP), Santiago, Chile
- Escuela de Psicología, Universidad de Valparaíso, Valparaíso, Chile
| | - Catalina Sieverson
- Millennium Institute for depression and Personality Research (MIDAP), Santiago, Chile
| | - Stefanella Costa-Cordella
- Millennium Institute for depression and Personality Research (MIDAP), Santiago, Chile
- Facultad de Psicología Universidad Diego Portales, Santiago, Chile
| | - Antonia Muzard
- Escuela de Psicología, Pontificia Universidad Católica, Santiago, Chile
- Millennium Institute for depression and Personality Research (MIDAP), Santiago, Chile
- Escuela de Psicología Universidad Finis Terrae, Santiago, Chile
| | - Carolina Honorato
- Millennium Institute for depression and Personality Research (MIDAP), Santiago, Chile
| | - María José León
- Escuela de Psicología, Pontificia Universidad Católica, Santiago, Chile
- Millennium Institute for depression and Personality Research (MIDAP), Santiago, Chile
| | - Fanny Leyton
- Millennium Institute for depression and Personality Research (MIDAP), Santiago, Chile
- Escuela de Medicina, Universidad de Valparaíso, Viña del Mar, Chile
- Centro Interdisciplinario de Estudios en Salud (CIESAL), Viña del Mar, Chile
| |
Collapse
|
7
|
He X, Wang X, Li G, Zhu S, Wu Y, Sun X, Wu Y, Hu B, Wu J, Feng L, Li G, Zhang L, Wang N, Li X. Influencing factors of depressive symptoms during pregnancy in Beijing, China. Front Psychiatry 2025; 16:1500034. [PMID: 40027599 PMCID: PMC11868264 DOI: 10.3389/fpsyt.2025.1500034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Accepted: 01/31/2025] [Indexed: 03/05/2025] Open
Abstract
Objective Prenatal depression is a prevalent mental health challenge encountered during pregnancy and is notably associated with adverse maternal and neonatal outcomes. This study aimed to elucidate the likelihood and determinants of depressive symptoms among pregnant individuals in Beijing, thereby laying a foundational framework for the theoretical underpinning of prenatal screening and preemptive interventions for mental disorders. Methods The study dataset was derived from 4,564 pregnant individuals in Beijing utilizing a cross-sectional survey methodology. Data collection focused primarily on the personal and obstetric information of the participants. The Edinburgh Postnatal Depression Scale (EPDS) was employed as the primary screening tool to identify depressive symptoms. Results The prevalence of depressive symptoms among the included pregnant individuals was 4.1%. The univariate analysis results revealed statistically significant differences in the incidence of depressive symptoms in women with different parities, numbers of births, medication use, numbers of abortions, prepregnancy weights, and body mass indices (BMIs) (the χ2 values were 61.130, 52.008, 23.291, 5.293, and 12.681, respectively; P<0.05). There were statistically significant differences in the incidence of depressive symptoms among women with different occupation types (χ2 = 30.263, P<0.01). The multivariate logistic regression analysis results revealed that a greater number of pregnancies, number of births, and BMI were risk factors for prenatal depression, whereas the commercial and service worker occupation types were protective factors against prenatal depression. Conclusion Future directives should emphasize the enhancement of screening for depressive symptoms among pregnant individuals with greater parity and BMIs, alongside encouraging continued employment and flexible job selection. It is imperative to implement suitable intervention strategies for pregnant individuals exhibiting depressive symptoms to mitigate the incidence of adverse maternal and neonatal outcomes.
Collapse
Affiliation(s)
- Xiayue He
- Department of Psychiatry and Mental Health, Beijing HuiLongGuan Hospital, Beijing, China
| | - Xiaoqian Wang
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Guoguang Li
- Department of Psychiatry and Mental Health, Fourth People’s Hospital of Liaocheng, Liaocheng, Shandong, China
| | - Simin Zhu
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yifan Wu
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xiaotong Sun
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yuze Wu
- Department of Psychiatry and Mental Health, Beijing HuiLongGuan Hospital, Beijing, China
| | - Bo Hu
- Department of Psychiatry and Mental Health, Beijing HuiLongGuan Hospital, Beijing, China
| | - Jianyin Wu
- Department of Psychiatry and Mental Health, Fourth People’s Hospital of Liaocheng, Liaocheng, Shandong, China
| | - Lina Feng
- Department of Psychiatry and Mental Health, Yanqing District Mental Health Center of Beijing, Beijing, China
| | - Guihong Li
- Department of Psychiatry and Mental Health, Beijing Daxing Xinkang Hospital, Beijing, China
| | - Lei Zhang
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ning Wang
- Department of Psychiatry and Mental Health, Beijing HuiLongGuan Hospital, Beijing, China
| | - Xuehan Li
- Department of Psychiatry and Mental Health, Beijing Daxing Xinkang Hospital, Beijing, China
| |
Collapse
|
8
|
Vigod SN, Frey BN, Clark CT, Grigoriadis S, Barker LC, Brown HK, Charlebois J, Dennis CL, Fairbrother N, Green SM, Letourneau NL, Oberlander TF, Sharma V, Singla DR, Stewart DE, Tomasi P, Ellington BD, Fleury C, Tarasoff LA, Tomfohr-Madsen LM, Da Costa D, Beaulieu S, Brietzke E, Kennedy SH, Lam RW, Milev RV, Parikh SV, Ravindran AV, Samaan Z, Schaffer A, Taylor VH, Tourjman SV, Van M, Yatham LN, Van Lieshout RJ. Canadian Network for Mood and Anxiety Treatments 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety, and Related Disorders: Guide de pratique 2024 du Canadian Network for Mood and Anxiety Treatments pour le traitement des troubles de l'humeur, des troubles anxieux et des troubles connexes périnatals. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2025:7067437241303031. [PMID: 39936923 DOI: 10.1177/07067437241303031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2025]
Abstract
BACKGROUND The Canadian Network for Mood and Anxiety Treatments (CANMAT) publishes clinical practice guidelines for mood and anxiety disorders. This CANMAT guideline aims to provide comprehensive clinical guidance for the pregnancy and postpartum (perinatal) management of mood, anxiety and related disorders. METHODS CANMAT convened a core editorial group of interdisciplinary academic clinicians and persons with lived experience (PWLE), and 3 advisory panels of PWLE and perinatal health and perinatal mental health clinicians. We searched for systematic reviews of prevention and treatment interventions for perinatal depressive, bipolar, anxiety, obsessive-compulsive and post-traumatic stress disorders (January 2013-October 2023). We prioritized evidence from reviews of randomized controlled trials (RCTs), except for the perinatal safety of medications where reviews of large high-quality observational studies were prioritized due to the absence of RCT data. Targeted searches for individual studies were conducted when systematic reviews were limited or absent. Recommendations were organized by lines of treatment based on CANMAT-defined levels of evidence quality, supplemented by editorial group consensus to balance efficacy, safety, tolerability and feasibility considerations. RESULTS The guideline covers 10 clinical sections in a question-and-answer format that maps onto the patient care journey: case identification; organization and delivery of care; non-pharmacological (lifestyle, psychosocial, psychological), pharmacological, neuromodulation and complementary and alternative medicine interventions; high-risk clinical situations; and mental health of the father or co-parent. Equity, diversity and inclusion considerations are provided. CONCLUSIONS This guideline's detailed evidence-based recommendations provide clinicians with key information to promote the delivery of effective and safe perinatal mental healthcare. It is hoped that the guideline will serve as a valuable tool for clinicians in Canada and around the world to help optimize clinical outcomes in the area of perinatal mental health.
Collapse
Affiliation(s)
- Simone N Vigod
- Department of Psychiatry and Women's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton ON, Canada
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Crystal T Clark
- Department of Psychiatry and Women's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sophie Grigoriadis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Lucy C Barker
- Department of Psychiatry and Women's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hilary K Brown
- Department of Psychiatry and Women's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Health and Society, University of Toronto, Scarborough, ON, Canada
| | - Jaime Charlebois
- Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
| | - Cindy-Lee Dennis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Nichole Fairbrother
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
- Michael Smith Foundation for Health Research, Vancouver, BC, Canada
| | - Sheryl M Green
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton ON, Canada
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | | | - Tim F Oberlander
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Verinder Sharma
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Obstetrics and Gynecology, Western University, London, ON, Canada
| | - Daisy R Singla
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Donna E Stewart
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto General Hospital Research Institute, Centre for Mental Health, University Health Network, Toronto, ON, Canada
| | - Patricia Tomasi
- Canadian Perinatal Mental Health Collaborative, Barrie, ON, Canada
| | - Brittany D Ellington
- Department of Psychiatry and Women's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada
| | - Cathleen Fleury
- Department of Psychiatry and Women's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada
| | - Lesley A Tarasoff
- Department of Psychiatry and Women's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC, Canada
| | - Deborah Da Costa
- Department of Medicine, McGill University, Montreal, QC, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Serge Beaulieu
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Elisa Brietzke
- Department of Psychiatry, Queen's University and Providence Care Hospital, Kingston, ON, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Roumen V Milev
- Department of Psychiatry, Queen's University and Providence Care Hospital, Kingston, ON, Canada
| | - Sagar V Parikh
- Department of Psychiatry, University of Michigan, Ann Arbour, MI, USA
| | - Arun V Ravindran
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Zainab Samaan
- Department of Psychiatry, Queen's University and Providence Care Hospital, Kingston, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Smadar V Tourjman
- Department of Psychiatry, Montreal Institute of Mental Health, Université de Montréal, Montréal, QC, Canada
| | - Michael Van
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton ON, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton ON, Canada
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| |
Collapse
|
9
|
Gebregziabher NK, Netsereab TB, Alazar FA, Fessaha YG, Sium AH, Ghebrehiwet NK. Translation and Validation of the Edinburgh Postnatal Depression Scale for Eritrea: A Screening Tool for Postpartum Depression in Primary Health Care Facilities. Int J Womens Health 2025; 17:299-310. [PMID: 39931670 PMCID: PMC11809234 DOI: 10.2147/ijwh.s487258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 01/24/2025] [Indexed: 02/13/2025] Open
Abstract
Introduction Postpartum depression (PPD) is a mood disorder characterized by symptoms such as changes in sleep and eating patterns, fatigue, sadness, crying, anxiety, and guilt. The Edinburgh Postnatal Depression Scale (EPDS) was developed to be used as a self-report questionnaire for English-speaking populations to screen for postnatal depression. This study aims to translate, validate, and adapt the EPDS into Eritrean settings. Methods This study employed a cross-sectional study design to evaluate the performance of the EPDS as a screening tool by using a sample of 380 mothers from four primary healthcare facilities. The standard Diagnostic and Statistical Manual of Mental Disorders was used as a criterion to assess depression in postpartum women. Results Postpartum depression was identified in 28 (7.4%) of the mothers based on the standard Diagnostic and Statistical Manual of Mental Disorders. The translated Tigrinya version EPDS has good internal consistency with Cronbach's alpha of 0.712. The exploratory factor analysis identified three factors, confirming the EPDS's multidimensionality. The area under the receiver operating characteristic curve was 0.87, and optimal sensitivity and specificity combination was found at 10/11 score cut-off points, 85.7% and 88%, respectively. Conclusion The Eritrean version of EPDS has proven to be a valid and reliable instrument for the identification of postpartum depression in clinical settings.
Collapse
Affiliation(s)
- Nahom Kiros Gebregziabher
- Department of Community Medicine, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
- Department of Epidemiology & Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Tesfit Brhane Netsereab
- Department of Community Medicine, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
| | | | | | | | | |
Collapse
|
10
|
Astbury L, Pinnington DM, Milgrom J, Bei B. The longitudinal trajectory of depression and anxiety across the perinatal period. J Affect Disord 2025; 370:1-8. [PMID: 39461375 DOI: 10.1016/j.jad.2024.10.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 10/06/2024] [Accepted: 10/20/2024] [Indexed: 10/29/2024]
Abstract
The understanding of long-term depression and anxiety trajectories across the perinatal periods is lacking. This longitudinal study investigated the change trajectories of both depressive and anxiety symptoms, as well as the associations of their trajectories over five years. The study included nulliparous participants (N = 163, Mage = 33.47, SDage = 3.53) with self-reported depressive and anxiety symptoms collected via questionnaires at 30- and 35 weeks' gestation, 1.5, 3, 6, 12, 24, and 60 months postpartum. Data were analysed using structural equation latent growth modelling with and without covariates. Symptoms of depression increased significantly during pregnancy (p < .001), and both depression and anxiety symptoms increased during postpartum (p-values<.001). A previous mental health history was significantly associated with greater depressive symptomology (p = .001), and White individuals (compared to non-White) tended to have greater depression and anxiety symptoms during pregnancy (p-values<.05). At 30- and 35-weeks' gestation, 6 weeks postpartum, 3, 6, 12, 24 months, and 5 years postpartum 2.5 %, 2.0 %, 4.6 %, 4.0 %, 7.3 %, 5.6 %, 3.5 % and 8.0 % of participants had clinically significant depressive symptoms and 6.1 %, 8.5 %, 7.1 %, 12.0 %, 11.9 %, 8.1 %, 7.9 %, and 28 % had clinically significant anxiety symptoms. This study highlights the need to assess both depression and anxiety in perinatal care, and to identify individuals who may require intervention.
Collapse
Affiliation(s)
- Laura Astbury
- Faculty of Medicine, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Nursing and Health Sciences, Monash University, Victoria, Australia.
| | - Donna M Pinnington
- Faculty of Medicine, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Nursing and Health Sciences, Monash University, Victoria, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Victoria, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health and Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia
| | - Bei Bei
- Faculty of Medicine, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Nursing and Health Sciences, Monash University, Victoria, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Victoria, Australia.
| |
Collapse
|
11
|
Ku S, Werchan DM, Feng X, Blair C. Trajectories of maternal depressive symptoms from infancy through early childhood: The roles of perceived financial strain, social support, and intimate partner violence. Dev Psychopathol 2025; 37:515-528. [PMID: 38561991 DOI: 10.1017/s0954579424000117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Although new mothers are at risk of heightened vulnerability for depressive symptoms, there is limited understanding regarding changes in maternal depressive symptoms over the course of the postpartum and early childhood of their child's life among rural, low-income mothers from diverse racial backgrounds. This study examined distinct trajectories of depressive symptoms among rural low-income mothers during the first five years of their child's life, at 6, 15, 24, and 58 months, using data from the Family Life Project (N = 1,292). Latent class growth analysis identified four distinct trajectories of maternal depressive symptoms, including Low-decreasing (50%; n = 622), Low-increasing (26%; n = 324), Moderate-decreasing (13%; n = 156), and Moderate-increasing (11%; n = 131) trajectories. Multinomial logistic regression demonstrated that higher perceived financial strain and intimate partner violence, and lower social support predicted higher-risk trajectories (Low-increasing, Moderate-decreasing, and Moderate-increasing) relative to the Low-decreasing trajectory. Compared to the Low-decreasing trajectory, lower neighborhood safety/quietness predicted to the Low-increasing trajectory. Moreover, lower social support predicted the Moderate-increasing trajectory, the highest-risk trajectory, compared to those in Moderate-decreasing. The current analyses underscore the heterogeneity on patterns of depressive symptoms among rural, low-income mothers, and that the role of both proximal and broader contexts contributing to distinct trajectories of maternal depressive symptoms over early childhood.
Collapse
Affiliation(s)
| | | | - Xin Feng
- The Ohio State University, Columbus, OH, USA
| | - Clancy Blair
- New York University School of Medicine, New York, NY, USA
| |
Collapse
|
12
|
Mahdavishahri R, Gutierrez D. Relationship Satisfaction, Attachment, and Perinatal Depression in Women of Color: A Quantitative Investigation. Behav Sci (Basel) 2024; 14:1142. [PMID: 39767282 PMCID: PMC11673134 DOI: 10.3390/bs14121142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Revised: 11/20/2024] [Accepted: 11/25/2024] [Indexed: 01/11/2025] Open
Abstract
The purpose of this study was to examine the relationships among relationship satisfaction, perceived attachment injury, and perinatal depression for Women of Color (WOC) who have given birth within the last 12 months. In addition, this study aimed to examine the impact of relationship satisfaction and romantic attachment quality on these mothers' attachments to their newborns. The sample consisted of 120 WOC with perinatal depression. Linear regression and hierarchical multiple regression were used for data analysis. The results indicated that (a) lower relationship satisfaction is predicted with higher severity of perinatal depression, (b) attachment insecurity predicts the severity of perinatal depression, and (c) relationship dissatisfaction, attachment insecurity, and a disrupted attachment bond between mothers and their newborns are predictive of perinatal depression. The results of this study have significant implications for couple and family therapists addressing the needs of pregnant and postpartum WOC. Ultimately, fostering healthy couple relationships during these critical times can play a crucial role in enhancing maternal mental health and overall family wellbeing.
Collapse
Affiliation(s)
- Reihaneh Mahdavishahri
- The Professional School of Psychology, Alliant International University, San Diego, CA 92131, USA;
| | | |
Collapse
|
13
|
Baños RM, Miragall M. Gender Matters: A Critical Piece in Mental Health. THE SPANISH JOURNAL OF PSYCHOLOGY 2024; 27:e28. [PMID: 39523884 DOI: 10.1017/sjp.2024.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
Gender is a socially constructed concept influenced by social practices, norms, and expectations. The impact of gender differences on mental health has been long recognized, with consequences such as over-diagnosis and pathologization or under-diagnosis of some disorders depending on gender. This also has implications for the treatments that each gender receives. In this narrative review, we will analyze (a) the gender differences in the prevalence of mental disorders, (b) the explanations for gender differences in mental health, including biological, social constructionist, and sociocultural risk factors, and (c) the gender differences in the treatment of mental disorders, including differences in health-seeking behavior and treatment outcomes. Overall, there is a consistent pattern of differences in prevalence, with women more likely to have internalizing disorders (e.g., anxiety or depression) and men more likely to have externalizing disorders (e.g., antisocial personality or substance use). The explanations aimed at disentangling the reasons for these gender differences are complex, and several approaches should be considered to achieve a comprehensive explanation. In addition to biological factors (e.g., hormonal changes), social constructionist factors (e.g., biased diagnostic criteria and clinicians' gender bias) and sociocultural factors (e.g., feminization of poverty, gender discrimination, violence against women, and prescriptive beauty standards) should be considered. Future studies in the field of mental health should consider gender differences and explore the bio-psycho-socio-cultural factors that may underlie these differences.
Collapse
Affiliation(s)
- Rosa María Baños
- Universidad de Valencia (Spain)
- Instituto de Salud Carlos III (Spain)
| | - Marta Miragall
- Universidad de Valencia (Spain)
- Instituto de Salud Carlos III (Spain)
| |
Collapse
|
14
|
Kumari P, Basu S. Postpartum Depression and Its Determinants: A Cross-Sectional Study. Cureus 2024; 16:e74044. [PMID: 39712834 PMCID: PMC11659481 DOI: 10.7759/cureus.74044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2024] [Indexed: 12/24/2024] Open
Abstract
Background Postpartum depression (PPD) is the most prevalent psychological disorder after childbirth associated with a negative impact on the daily functioning of mothers and the cognitive development of infants. Inequitable primary mental health access in lower-middle-income countries (LMICs) further aggravates this major public health problem. Objective The objective of this study is to estimate the prevalence and determinants of PPD among women reporting to secondary care facilities in Delhi, India. Methods A cross-sectional study was conducted in the outpatient settings of two secondary care (one government and one private) hospitals in the Delhi-National Capital Region among mothers of infants aged below six months. The study was conducted from January to June 2023. Data were collected by a single trained investigator using a self-designed interview schedule, while PPD was measured by administering the Edinburgh Postnatal Depression Scale (EPDS). Data were analyzed with Stata statistical software, version 15.1 (StataCorp LLC, College Station, TX). P < 0.05 was considered statistically significant. Results The mean age of the study participants was 28.49 ± 3.77 years with 53 (18.28%) detected as having possible postpartum depression on screening with the EPDS. On adjustment for covariates, the participants with husbands consuming alcohol (adjusted odds ratio, 6.97; 95% confidence interval {CI}, 2.73-17.8), those who underwent C-section (adjusted odds ratio, 4.39; 95% CI, 1.02-18.85), and those giving birth in private hospitals (adjusted odds ratio, 5.48; 95% CI, 1.53-19.55) had significantly higher odds of having PPD. In contrast, mothers staying at home (not employed) (adjusted odds ratio, 0.08; 95% CI, 0.02-0.41), without specific preference for the newborn's gender (adjusted odds ratio, 0.07; 95% CI, 0.01-0.78), and those living in nuclear families (adjusted odds ratio, 0.03; 95% CI, 0.005-0.19) had significantly lower odds of PPD. Conclusion Nearly one in five mothers were screened for having possible PPD. Prioritizing birth preparedness during the antenatal period and strengthening health system screening protocols may prevent and mitigate the effects of PPD.
Collapse
Affiliation(s)
- Puja Kumari
- Epidemiology and Public Health, Indian Institute of Public Health-Delhi, Delhi, IND
| | - Saurav Basu
- Community Medicine, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Kolkata, IND
| |
Collapse
|
15
|
Wilson K, Martínez-Camblor P, Gifford K, Jankowski MK. Association Between Postpartum Depression Symptoms and Social Determinants of Health in Outpatient Pediatric Clinic. J Pediatr Health Care 2024; 38:812-822. [PMID: 39297831 DOI: 10.1016/j.pedhc.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/22/2024] [Accepted: 08/08/2024] [Indexed: 11/17/2024]
Abstract
INTRODUCTION We aimed to (1) identify the prevalence of postpartum depression (PPD) symptoms using the Patient Health Questionnaire-2 (PHQ-2) and the Edinburgh Postnatal Depression Scale (EPDS), and (2) analyze the relationship between PPD symptoms and social determinants of health (SDoH). METHOD We obtained data from 1327 infant/mother dyads at 1 and 6-month well-child checks. We used Chi-square and T-tests to compare social determinants between PPD screening groups and logistical regression to construct predictive models for PPD. RESULTS The prevalence of positive PPD screens was 5-7%, but only 1.85% screened positive at both periods. Although the EPDS and PHQ-2 were correlated (Pearson 0.66), the PHQ-2 missed 65% of those identified by the EPDS. Positive PPD screens were associated with greater SDoH concerns. DISCUSSION Our study highlights the importance of repeated PPD screening. The EPDS detected more mothers at risk than the PHQ-2. Multiple SDoH were associated with PPD symptoms.
Collapse
Affiliation(s)
| | - Pablo Martínez-Camblor
- Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH
| | - Kimberly Gifford
- Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Pediatrics, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH
| | - Mary Kay Jankowski
- Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Psychiatry, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH
| |
Collapse
|
16
|
Padhani ZA, Salam RA, Rahim KA, Naz S, Zulfiqar A, Ali Memon Z, Meherali S, Atif M, Lassi ZS. Prevalence and risk factors of perinatal depression among mothers and fathers in Pakistan: a systematic review and meta-analysis. Health Psychol Behav Med 2024; 12:2383468. [PMID: 39135561 PMCID: PMC11318492 DOI: 10.1080/21642850.2024.2383468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/14/2024] [Indexed: 08/15/2024] Open
Abstract
Background Perinatal mental health issues affect approximately 10% of women in high-income countries and 30% in low- or middle-income countries. This review aims to determine the prevalence of perinatal depression among mothers and fathers in Pakistan and identify associated risk factors. Methods We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included quantitative studies on the prevalence or incidence of maternal and paternal perinatal depression, including antenatal or postnatal depression in Pakistan, with or without associated risk factors. We performed an electronic search, dual-title/abstract and full-text screening, and data extraction. Analysis was conducted on Revman and JBI SUMARI software. The quality of the included studies was assessed with the NHLBI tool. This review updated a previously published review that included 43 studies, with the last search date of 31st May 2019, now extended to literature published up to June 30, 2023. Results Consistent with the previous review, our analysis of 61 studies indicated a pooled prevalence of 37% (95% confidence interval (CI): 30.6-43.6) for maternal antenatal depression. Postnatal depression at different time points, revealed rates of 34.2% (95% CI: 22.7-46.7), 40.9% (95% CI: 0-97.4), and 43.1% (95% CI: 24.4-62.9) at 3, 6 and 12 months, respectively. Paternal postnatal depression was observed at 40.5% (95% CI: 14.9-69) based on two studies. Risk factors for maternal perinatal depression include multiparity, contraceptive failure, inadequate antenatal care, pregnancy-induced hypertension, previous psychiatric illness, passive smoking, drug abuse, low socio-economic status, marital problems, family hardships, recent bereavement, housing difficulties, food insecurity, husband's illiteracy, his unemployment, and being blamed for child disability. Conclusion The findings reveal a high prevalence of perinatal depression among mothers with very limited evidence of fathers residing in Pakistan, emphasising the need for prospective studies addressing mental health challenges. Registration This review is registered on PROSPERO (CRD42023442581).
Collapse
Affiliation(s)
- Zahra Ali Padhani
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Rehana A. Salam
- Centre of Research Excellence, Melanoma Institute Australia, University of Sydney, Sydney, Australia
| | - Komal Abdul Rahim
- Internal Medicine, Aga Khan University, Karachi, Pakistan
- Dean’s Office, Medical College, Aga Khan University, Karachi, Pakistan
| | - Samra Naz
- Australian Institute for Machine Learning, University of Adelaide, Adelaide, Australia
| | - Asma Zulfiqar
- Institute for Social Science Research, University of Queensland, Queensland, Australia
| | - Zahid Ali Memon
- Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Salima Meherali
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Canada
| | - Maria Atif
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Zohra S. Lassi
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| |
Collapse
|
17
|
Abboud N, Wainstock T, Sheiner E, Nassar R, Leibson T, Pariente G, Reuveni I. Adverse life events among bedouin and jewish women and the risk for postpartum depressive symptoms. Arch Womens Ment Health 2024. [DOI: 10.1007/s00737-024-01496-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 07/29/2024] [Indexed: 08/25/2024]
|
18
|
Attia Hussein Mahmoud H, Lakkimsetti M, Barroso Alverde MJ, Shukla PS, Nazeer AT, Shah S, Chougule Y, Nimawat A, Pradhan S. Impact of Paternal Postpartum Depression on Maternal and Infant Health: A Narrative Review of the Literature. Cureus 2024; 16:e66478. [PMID: 39246890 PMCID: PMC11380704 DOI: 10.7759/cureus.66478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2024] [Indexed: 09/10/2024] Open
Abstract
Postpartum depression (PPD) has been widely studied, assessed, and promptly intervened in new mothers. However, paternal postpartum depression gained attention not long ago. Postpartum depression in men could present over one year following the birth of the child, frequently presenting with symptoms like irritability, low mood, sleep disturbances, changes in appetite, fatigue, and loss of interest in everyday activities; amongst other symptoms of Major Depressive Disorder which may hinder them from taking care of themselves and the baby. Paternal PPD significantly impacts partner relationships causing maternal PPD, poor infant bonding, and therefore, affecting overall child development. The following narrative review is based on a literature search of articles published on paternal postnatal depression. The primary emphasis of this review has been to provide an overview of the current comprehension of paternal postpartum depression regarding prevalence, global incidence, and risk factors and to explore potential diagnostic tools for assessment and interventional strategies to treat this condition. Interestingly, pandemic-related stressors have been positively attributed to an increase in PPD prevalence post-pandemic. While more research is being conducted on this subject, research on the measurement characteristics of the diagnostic tools is highly recommended to implement well-defined criteria for early diagnosis of paternal PPD. The significant adverse consequences of PPD for not just the new mother, but also the infants, necessitate proper and timely diagnosis of PPD. Despite its severity, there have been no specific treatment modalities.
Collapse
Affiliation(s)
| | | | | | - Pranav S Shukla
- Medical School, Grant Medical College and Sir J.J. Group of Hospitals, Mumbai, IND
| | - Alviya T Nazeer
- Obstetrics and Gynaecology, Government Medical College and Hospital, Pudukkottai, IND
| | - Sukesh Shah
- Medical School, American University of Integrative Sciences, Bridgetown, BRB
| | | | - Amisha Nimawat
- Internal Medicine, Interfaith Medical Center, New York, USA
| | | |
Collapse
|
19
|
Daehn D, Meyer C, Loew V, Wabiszczewicz J, Pohl S, Böttche M, Pawils S, Renneberg B. Smartphone-based intervention for postpartum depressive symptoms (Smart-e-Moms): study protocol for a randomized controlled trial. Trials 2024; 25:469. [PMID: 38987846 PMCID: PMC11234544 DOI: 10.1186/s13063-024-08304-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/28/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Postpartum depression constitutes a significant public health issue, with prevalence rates ranging between 8 and 19% in high-income nations. Nevertheless, numerous barriers, including time constraints, societal stigmatization, and feelings of shame, contribute to the limited utilization of healthcare services during the postpartum period. Digital interventions offer an opportunity to enhance care for women experiencing postpartum depressive symptoms. METHODS We will conduct a two-arm randomized controlled trial to assess the effectiveness of a smartphone-based intervention in comparison to a treatment-as-usual control group in Germany. Our aim is to randomize 556 participants in a 1:1 ratio. Participants in the intervention group will be provided access to a preventive smartphone-based intervention called "Smart-e-Moms," which incorporates therapeutic support and comprises 10 concise modules rooted in cognitive-behavioral therapy. For the intervention group, evaluations will take place at baseline (t0), prior to sessions 4 and 8 (intermediate assessments), and upon completing the intervention 6 weeks after baseline (t1). The control group's assessments will be at baseline (t0) and 6 weeks after baseline. Follow-up assessments are scheduled at 12 and 24 weeks from baseline to examine the short-term stability of any observed effects. We anticipate that participants in the intervention group will exhibit improvements in their postpartum depressive symptoms (as measured with the Edinburgh Postnatal Depression Scale). Additionally, we will analyze secondary outcomes, including maternal bonding, stress levels, self-efficacy, satisfaction with the intervention, and healthcare utilization. DISCUSSION If Smart-e-Moms proves to be effective, it has the potential to play a significant role in postpartum depression care within German-speaking regions. Ideally, this intervention could not only benefit maternal well-being but also improve the prospects for healthy child development. TRIAL REGISTRATION German clinical trials registry DRKS00032324. Registered on January 26, 2024.
Collapse
Affiliation(s)
- Daria Daehn
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
| | - Caroline Meyer
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Viola Loew
- Department of Medical Psychology, University Medical Center Hamburg‑Eppendorf, Hamburg, Germany
| | | | - Steffi Pohl
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Maria Böttche
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Silke Pawils
- Department of Medical Psychology, University Medical Center Hamburg‑Eppendorf, Hamburg, Germany
| | - Babette Renneberg
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| |
Collapse
|
20
|
Mmasa KN, Liu Y, Jao J, Malee K, Legbedze J, Sun S, Kgole S, Masasa G, Mmalane M, Makhema J, Mafa N, Abrams EJ, Powis KM, Bonner LB. Association between maternal HIV status and postpartum depressive symptoms in Botswana. AIDS Care 2024; 36:1-6. [PMID: 38976581 PMCID: PMC11707039 DOI: 10.1080/09540121.2024.2373398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 06/21/2024] [Indexed: 07/10/2024]
Abstract
Few studies have evaluated postpartum depression (PPD) in women living with HIV (WLHIV) in Botswana, a high prevalence HIV setting. The Edinburgh Postnatal Depression Scale (EPDS) was used to evaluate PPD symptoms in WLHIV (n = 300) and women who are HIV-uninfected (n = 131) in the Tshilo Dikotla study, an observational cohort study with a nested randomized trial. The EPDS was administered at 2, 6, and 12 months postpartum. We assessed the association of (1) HIV infection and (2) antiretroviral therapy (ART) with odds of PPD symptoms (EPDS ≥ 10 or thoughts of self-harm) in the first year postpartum using generalized estimating equations. Of WLHIV, 24 (8.00%) had PPD symptoms at one or more follow-up time points, compared to 9 (6.9%) women who were HIV-seronegative. There was no association between HIV status and PPD symptoms (adjusted odds ratio [aOR]:1.69, 95% confidence interval [CI]: 0.73-3.93, p = 0.225); however, WLHIV on efavirenz-based ART regimens had higher odds of experiencing PPD symptoms compared to dolutegravir-based ART (aOR:3.05, 95% CI:1.16-8.03, p = 0.024).
Collapse
Affiliation(s)
- Keolebogile N Mmasa
- County Durham and Darlington NHS Trust, Centre for Clinical Research and Innovation, Darlington Memorial Hospital, Darlington, UK
- Botswana-Harvard Health Institute Partnership, Gaborone, Botswana
| | - Yishan Liu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jennifer Jao
- Botswana-Harvard Health Institute Partnership, Gaborone, Botswana
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Kathleen Malee
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Justine Legbedze
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Shan Sun
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Sam Kgole
- Botswana-Harvard Health Institute Partnership, Gaborone, Botswana
| | - Gosego Masasa
- Botswana-Harvard Health Institute Partnership, Gaborone, Botswana
| | - Mompati Mmalane
- Botswana-Harvard Health Institute Partnership, Gaborone, Botswana
| | - Joseph Makhema
- Botswana-Harvard Health Institute Partnership, Gaborone, Botswana
| | - Nelly Mafa
- Mental Health Department, Ministry of Health and Wellness, Gaborone, Botswana
| | - Elaine J Abrams
- ICAP, Mailman School of Public Health, Columbia University, New York, NY, USA
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Kathleen M Powis
- Botswana-Harvard Health Institute Partnership, Gaborone, Botswana
- Department of Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lauren B Bonner
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
21
|
Gusak N, Kendall S, Nizalova O. Exploring prevalence and factors associated with postpartum depression among Ukrainian women. Eur J Midwifery 2024; 8:EJM-8-35. [PMID: 38957354 PMCID: PMC11218278 DOI: 10.18332/ejm/188800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION Postpartum depression negatively impacts maternal mental health and child development. The high prevalence of postpartum depression (PPD) in low and lower middle-income countries raises questions about its predictors. This study examines the association between PPD and breastfeeding experience, child death, unresolved pregnancy, forced displacement, COVID-19 pandemic lockdown, marital, and financial status among Ukrainian women. METHODS This online study recruited 1634 Ukrainian mothers of children aged 0-5 years through non-governmental organizations providing services to them. The Edinburgh Postnatal Depression Scale (EPDS), with a cut-off of ≥13, was used to assess depressive symptoms in the postpartum period. Independent t-tests, chi-squared tests, one-way ANOVA, non-parametric correlations, and logistic regression tests were used to analyze the data. RESULTS The prevalence of depressive symptoms was 39.0% (n=1631). There was a positive association between EPDS scores and breastfeeding difficulties, pandemic lockdown, and financial difficulties. We did not find an association between PPD symptoms and unresolved pregnancy, death of a child, being affected by COVID-19, and forced displacement. We found that EPDS scores for women who did not experience forced displacement (n=1528) were significantly higher compared to displaced mothers (n=74). CONCLUSIONS The present study of Ukrainian women shows that women experienced depressive symptoms influenced by various factors including breastfeeding difficulties, pandemic lockdown, and financial difficulties. There is a need for additional research into such factors as unresolved pregnancy, the death of a child, being affected by COVID-19, and forced displacement.
Collapse
Affiliation(s)
- Nataliia Gusak
- School of Social Work, National University of Kyiv Mohyla Academy, Kyiv, Ukraine
| | - Sally Kendall
- Centre for Health Services Studies, University of Kent, Canterbury, United Kingdom
| | - Olena Nizalova
- Centre for Health Services Studies, University of Kent, Canterbury, United Kingdom
| |
Collapse
|
22
|
Mwita M, Patten S, Dewey D. Prevalence and predictors of postpartum depression and generalized anxiety symptoms among women who delivered at a tertiary hospital in Mwanza Tanzania: a cross-sectional study. DISCOVER MENTAL HEALTH 2024; 4:21. [PMID: 38849688 PMCID: PMC11161451 DOI: 10.1007/s44192-024-00074-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 06/03/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Postpartum depression and anxiety are major public health concerns that affect 3-39% of women after childbearing and can adversely affect maternal and child health. Most studies have investigated postpartum depression and anxiety and their associated factors among women 4-12 weeks after delivery. There is a scarcity of research among women immediately after delivery from low- and middle-income countries, the gap this study aimed to fill. METHODS A descriptive cross-sectional study was conducted among 386 postpartum women within one week after delivery. The Edinburg Postnatal Depression Scale was used to assess depressive symptoms and the Generalized Anxiety Disorder - 7 scale was used to screen for symptoms of generalized anxiety disorder. Participants were systematically selected from the postnatal wards and interviewed by trained research assistants from November 2019 to March 2020. RESULTS Using standard cut points, the prevalence of depressive and anxiety symptoms was 25.39%, and 37.31% respectively. Having a baby with a weight of 2.5 kgs or more and having partner support were associated with decreased odds of both depression and anxiety symptoms. In contrast, complications during delivery, caesarian section, marital status, and partner violence, were associated with increased odds of depressive and anxiety symptoms post-delivery. CONCLUSION There was a high prevalence of postpartum depression and anxiety symptoms among the study participants in the first week post-delivery, with delivery complications and outcome and psychosocial supports identified as associated factors for depression and anxiety symptoms. These findings highlight the need for early screening to identify those at risk for appropriate intervention.
Collapse
Affiliation(s)
- Matiko Mwita
- Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania.
- Psychiatry Department, Bugando Medical Centre (BMC), Mwanza, Tanzania.
- Department of Psychiatry, Catholic University of Health and Allied Sciences, P.O.Box 1464, Mwanza, Tanzania.
| | - Scott Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, Canada
| | - Deborah Dewey
- Departments of Pediatrics and Community Health Sciences, University of Calgary, Calgary, Canada
| |
Collapse
|
23
|
Mattar B, Abu-Rmeileh NME, Wahdan Y. Postpartum depression symptoms: prevalence, risk factors, and childbirth experiences in Palestine. BMC Public Health 2024; 24:1357. [PMID: 38769541 PMCID: PMC11107043 DOI: 10.1186/s12889-024-18829-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/10/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Worldwide mothers are suffering from postpartum depression (PPD) which impairs mothers' well-being, children, and families, and leads to adverse outcomes for mothers and their growing newborns. Low and middle-income countries have a higher prevalence of PPD and limited studies about it. This study assessed the percentage of Palestinian mothers experiencing PPD nationally, identified mothers at a higher risk of PPD, and studied the correlation between PPD and mistreatment during childbirth. METHODS The study is based on a secondary data analysis from a cross-sectional study in the occupied Palestinian territory (oPt). A total of 745 telephone-based interviews with mothers were done within 2-4 weeks post-childbirth. The Patient Health Questionnaire (PHQ-9) was used as a screening tool for PPD. The Statistical Package for Social Science (SPSS) was used for analyzing the data. RESULTS In the context of descriptive epidemiology, we observed that 12.6% of the selected Palestinian mothers experienced PPD, with a higher occurrence of PPD among mothers living in the Gaza Strip, a politically and economically unstable region in Palestine, compared to mothers living in the West Bank (Adjusted Odd Ratio (AOD: 2.2, Confidence Interval (CI): 1.4-3.44). Older mothers were two times more likely to develop PPD compared to young mothers (AOR: 2.03, CI: 1.070-3.84). Mothers who experienced disrespectful behaviors represented by any abuse, negligence, abandonment, ineffective communication, or poor pain management in childbirth settings were more likely to report PPD than those who were not exposed to the disrespect. CONCLUSION A notable percentage of Palestinian mothers were identified as experiencing PPD, especially among mothers who experienced mistreatment in childbirth settings. It is essential to support healthcare providers to improve their practices and attitudes to eliminate mistreatment and abusive behaviors of mothers during childbirth.
Collapse
Affiliation(s)
- Batoul Mattar
- Institute of Community and Public Health, Birzeit University, P. O. Box 14, Ramallah, West Bank, occupied Palestinian territory.
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, P. O. Box 14, Ramallah, West Bank, occupied Palestinian territory
| | - Yasmeen Wahdan
- Institute of Community and Public Health, Birzeit University, P. O. Box 14, Ramallah, West Bank, occupied Palestinian territory
| |
Collapse
|
24
|
Subba P, Petersen Williams P, Luitel NP, Jordans MJD, Breuer E. A qualitative study on the adaptation of community programmes for the promotion of early detection and health-seeking of perinatal depression in Nepal. BMC Womens Health 2024; 24:273. [PMID: 38704570 PMCID: PMC11069154 DOI: 10.1186/s12905-024-03122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/30/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Despite the high burden of perinatal depression in Nepal, the detection rate is low. Community-based strategies such as sensitization programmes and the Community Informant Detection Tool (CIDT) have been found to be effective in raising awareness and thus promoting the identification of mental health problems. This study aims to adapt these community strategies for perinatal depression in the Nepalese context. METHODS We followed a four-step process to adapt the existing community sensitization program manual and CIDT. Step 1 included in-depth interviews with women identified with perinatal depression (n=36), and focus group discussions were conducted with health workers trained in community mental health (n=13), female community health volunteers (FCHVs), cadre of Nepal government for the prevention and promotion of community maternal and child health (n=16), and psychosocial counsellors (n=5). We explored idioms and understanding of depression, perceived causes, and possible intervention. Step 2 included draft preparation based on the qualitative study. Step 3 included a one-day workshop with the psychosocial counsellors (n=2) and health workers (n=12) to assess the understandability and comprehensiveness of the draft and to refine the content. A review of the CIDT and community sensitization program manual by a psychiatrist was performed in Step 4. RESULTS The first step led to the content development for the CIDT and community sensitization manual. Multiple stakeholders and experts reviewed and refined the content from the second to fourth steps. Idioms of depression and commonly cited risk factors were incorporated in the CIDT. Additionally, myths of perinatal depression and the importance of the role of family were added to the community sensitization manual. CONCLUSION Both the CIDT and community sensitization manual are grounded in the local context and are simple, clear, and easy to understand.
Collapse
Affiliation(s)
- Prasansa Subba
- Research Department, Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal.
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom.
| | - Petal Petersen Williams
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | | | - Mark J D Jordans
- Centre for Global Mental Health, King's College London, London, United Kingdom
| | - Erica Breuer
- Department of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
| |
Collapse
|
25
|
Broberg L, Bendix JM, Røhder K, Løkkegaard E, Væver M, Grew JC, Johnsen H, Juhl M, de Lichtenberg V, Schiøtz M. Combining the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale in Early Pregnancy in Danish Antenatal Care-A Qualitative Descriptive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:454. [PMID: 38673365 PMCID: PMC11050197 DOI: 10.3390/ijerph21040454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/04/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Pregnant women with a history of mental disorders, neglect, or low social support are at increased risk of mental health problems. It is crucial to identify psychosocial risk factors in early pregnancy to reduce the risk of short- and long-term health consequences for mother and child. The Antenatal Risk Questionnaire has been found acceptable as a psychosocial screening tool among pregnant women in Australia, but it has not been tested in a Scandinavian context. The aim of this study was to explore the experiences of pregnant women when using the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale as part of a model to identify psychosocial vulnerabilities in pregnancy in Denmark. We conducted individual interviews (n = 18) and used thematic analysis. We identified two main themes: (1) Feeling heard and (2) An occasion for self-reflection. Overall, the pregnant women deemed the online ANRQ/EPDS acceptable as a screening tool. The screening model provided a feeling of being heard and provided an occasion for self-reflection about mental health challenges related to pregnancy and motherhood. However, some women expressed that the screening raised concerns and fear of the consequences of answering honestly. A non-judgmental, open, emphatic, and reassuring approach by clinicians may help reduce stigma.
Collapse
Affiliation(s)
- Lotte Broberg
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark; (J.C.G.); (M.S.)
- Department of Gynecology and Obstetrics, Slagelse Hospital, Fælledvej 14, 4200 Slagelse, Denmark
| | - Jane M. Bendix
- Department of Gynecology and Obstetrics, Copenhagen University Hospital—North Zealand, Dyrehavevej 29, 3400 Hillerød, Denmark; (J.M.B.); (E.L.)
| | - Katrine Røhder
- Center for Early Intervention and Family Research, Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen, Denmark; (K.R.); (M.V.)
| | - Ellen Løkkegaard
- Department of Gynecology and Obstetrics, Copenhagen University Hospital—North Zealand, Dyrehavevej 29, 3400 Hillerød, Denmark; (J.M.B.); (E.L.)
| | - Mette Væver
- Center for Early Intervention and Family Research, Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen, Denmark; (K.R.); (M.V.)
| | - Julie C. Grew
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark; (J.C.G.); (M.S.)
| | - Helle Johnsen
- Department of Midwifery and Therapeutic Science, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark; (H.J.); (M.J.); (V.d.L.)
| | - Mette Juhl
- Department of Midwifery and Therapeutic Science, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark; (H.J.); (M.J.); (V.d.L.)
| | - Vibeke de Lichtenberg
- Department of Midwifery and Therapeutic Science, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark; (H.J.); (M.J.); (V.d.L.)
| | - Michaela Schiøtz
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark; (J.C.G.); (M.S.)
| |
Collapse
|
26
|
Radoš SN, Akik BK, Žutić M, Rodriguez-Muñoz MF, Uriko K, Motrico E, Moreno-Peral P, Apter G, den Berg MLV. Diagnosis of peripartum depression disorder: A state-of-the-art approach from the COST Action Riseup-PPD. Compr Psychiatry 2024; 130:152456. [PMID: 38306851 DOI: 10.1016/j.comppsych.2024.152456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/26/2023] [Accepted: 01/28/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Peripartum depression (PPD) is a major depression disorder (MDD) episode with onset during pregnancy or within four weeks after childbirth, as defined in DSM-5. However, research suggests that PPD may be a distinct diagnosis. The goal of this study was to summarize the similarities and differences between PPD and MDD by synthesizing the current research on PPD diagnosis concerning different clinical features and give directions for improving diagnosis of PPD in clinical practice. METHODS To lay the groundwork for this narrative review, several databases were searched using general search phrases on PPD and its components of clinical diagnosis. RESULTS When compared to MDD, peripartum depression exhibits several distinct characteristics. PPD manifests with a variety of symptoms, i.e., more anxiety, psychomotor symptoms, obsessive thoughts, impaired concentration, fatigue and loss of energy, but less sad mood and suicidal ideation, compared to MDD. Although PPD and MDD prevalence rates are comparable, there are greater cross-cultural variances for PPD. Additionally, PPD has some distinct risk factors and mechanisms such as distinct ovarian tissue expression, premenstrual syndrome, unintended pregnancy, and obstetric complications. CONCLUSION There is a need for more in-depth research comparing MDD with depression during pregnancy and the entire postpartum year. The diagnostic criteria should be modified, particularly with (i) addition of specific symptoms (i.e., anxiety), (ii) onset specifier extending to the first year following childbirth, (iii) and change the peripartum onset specifier to either "pregnancy onset" or "postpartum onset". Diagnostic criteria for PPD are further discussed.
Collapse
Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | | | - Maja Žutić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Maria F Rodriguez-Muñoz
- Department of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Kristiina Uriko
- Department of Psychology and Behavioural Sciences, Tallinn University, Tallinn, Estonia
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
| | - Patricia Moreno-Peral
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA), Málaga, Spain
| | - Gisèle Apter
- Child and Perinatal Psychiatric Department, Le Havre University Hospital, University Rouen Normandie, Le Havre, France
| | - Mijke Lambregtse-van den Berg
- Departments of Psychiatry and Child & Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
| |
Collapse
|
27
|
Kapoor B, Malik N, Gupta G, Khan IA. A Cross-Sectional Study Exploring Postpartum Depression at a Tertiary Care Center in Eastern Uttar Pradesh, India. Cureus 2024; 16:e58653. [PMID: 38770470 PMCID: PMC11104705 DOI: 10.7759/cureus.58653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 05/22/2024] Open
Abstract
Background Postpartum depression (PPD) is a significant public health concern globally characterized by a spectrum of mood disturbances ranging from mild mood swings to severe depressive episodes initiating within four weeks post childbirth and potentially persisting up to 12 months. Besides affecting the mother, it also affects the mental health and development of the babies born to affected mothers. Despite its considerable burden and potential adverse effects on both maternal and child well-being, PPD often goes undetected and untreated. Materials and methods A cross-sectional study was conducted from January 2024 to March 2024 at a tertiary care center in Gorakhpur to assess PPD in 280 postpartum women. The Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10 was used to confirm depression. Data collection involved a pretested, structured questionnaire. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, NY). A p-value < 0.05 was considered statistically significant. Results The prevalence of PPD was 12.14%. Age and education were significant sociodemographic risk factors (p < 0.05). In psychosocial factors, adverse life events (p < 0.001), wishing for a male child but giving birth to a female (p = 0.01), domestic violence (p = 0.005), relationship issues, an alcoholic spouse (p = 0.01), and poor in-law relations (p < 0.001) were found to be linked to PPD. Obstetric factors such as complicated antenatal history, physical illness, cesarean section, complicated intranatal history, and postpartum complications were also found to be important factors. Conclusion PPD affects many women, emphasizing the need for effective measures. Initiatives like the appointment of healthcare counselors and PPD screening programs in healthcare settings are essential to detect and support affected mothers.
Collapse
Affiliation(s)
- Babita Kapoor
- Obstetrics and Gynecology, Maharshi Devraha Baba Autonomous State Medical College, Deoria, IND
| | - Najma Malik
- Obstetrics and Gynecology, Baba Raghav Das Medical College, Gorakhpur, IND
| | - Geeta Gupta
- Obstetrics and Gynecology, Autonomous State Medical College, Kushinagar, IND
| | - Imran Ahmed Khan
- Community Medicine, Baba Raghav Das Medical College, Gorakhpur, IND
| |
Collapse
|
28
|
Colombage RL, Holden S, Lamport DJ, Barfoot KL. The effects of flavonoid supplementation on the mental health of postpartum parents. Front Glob Womens Health 2024; 5:1345353. [PMID: 38577523 PMCID: PMC10993701 DOI: 10.3389/fgwh.2024.1345353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction During the postpartum period, parents face psychological challenges and consequently, changes in mood and associated mood disorders have become increasingly prevalent in the 6-months following birth. Dietary flavonoids have been found to benefit mood and are therefore an appealing non-pharmacological option for potentially treating mood disorders in the postpartum. The aim of this study was to investigate whether a two-week dietary flavonoid intervention would improve mothers' and fathers' mental health in the immediate 6-month postpartum period. Method The study employed a randomised, parallel groups, controlled design to explore the effects of a flavonoid intervention vs. control group on several outcomes, including mood (PANAS), postpartum depression (EPDS), postpartum anxiety (PSAS-RSF-C) and quality of life (WHOQOL). Sixty participants (mothers n = 40, fathers n = 20) in the 6-month post-partum period were randomised to either a "flavonoid" or "control" condition. The flavonoid group were asked to add two flavonoid-rich foods (approximate flavonoid intake 218 mg/day) into their daily diet whilst controls (n = 23) were asked to continue with their usual diet for two-weeks (ClinicalTrials.gov (NCT04990622). Results Significant effects were found in the flavonoid group where mothers reported higher positive affect and lower postpartum depression after the two-week intervention relative to baseline. This finding is especially relevant as a clinical reduction in postpartum depression scores in the flavonoid group by an average 2.6 scoring points was observed, which equated to a reduction from "possible depression" at baseline to "little or no depression" at 2-weeks, which was not observed in the control group. Fathers' data was not analysed due to non-compliance with the intervention. Discussion This study provides evidence for the benefits of a dietary flavonoid intervention for mood and mental health in new mothers, supporting the utility of non-pharmacological, self-administrable changes to the diet for improving positive mood outcomes and reducing symptoms of postpartum depression in mothers during an especially challenging time. Further research for the effect of dietary interventions on paternal mental health is needed. Clinical Trial Registration ClinicalTrials.gov, identifier NCT04990622.
Collapse
Affiliation(s)
| | | | | | - Katie Louise Barfoot
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| |
Collapse
|
29
|
Shinba T, Suzuki H, Urita M, Shinba S, Shinba Y, Umeda M, Hirakuni J, Matsui T, Onoda R. Heart Rate Variability Measurement Can Be a Point-of-Care Sensing Tool for Screening Postpartum Depression: Differentiation from Adjustment Disorder. SENSORS (BASEL, SWITZERLAND) 2024; 24:1459. [PMID: 38474995 DOI: 10.3390/s24051459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/06/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
Postpartum depression (PPD) is a serious mental health issue among women after childbirth, and screening systems that incorporate questionnaires have been utilized to screen for PPD. These questionnaires are sensitive but less specific, and the additional use of objective measures could be helpful. The present study aimed to verify the usefulness of a measure of autonomic function, heart rate variability (HRV), which has been reported to be dysregulated in people with depression. Among 935 women who had experienced childbirth and completed the Edinburgh Postnatal Depression Scale (EPDS), HRV was measured in EPDS-positive women (n = 45) 1 to 4 weeks after childbirth using a wearable device. The measurement was based on a three-behavioral-state paradigm with a 5 min duration, consisting of rest (Rest), task load (Task), and rest-after-task (After) states, and the low-frequency power (LF), the high-frequency power (HF), and their ratio (LF/HF) were calculated. Among the women included in this study, 12 were diagnosed with PPD and 33 were diagnosed with adjustment disorder (AJD). Women with PPD showed a lack of adequate HRV regulation in response to the task load, accompanying a high LF/HF score in the Rest state. On the other hand, women with AJD exhibited high HF and reduced LF/HF during the After state. A linear discriminant analysis using HRV indices and heart rate (HR) revealed that both the differentiation of PPD and AJD patients from the controls and that of PPD patients from AJD patients were possible. The sensitivity and specificity for PPD vs. AJD were 75.0% and 90.9%, respectively. Using this paradigm, an HRV measurement revealed the characteristic autonomic profiles of PPD and AJD, suggesting that it may serve as a point-of-care sensing tool in PPD screening systems.
Collapse
Affiliation(s)
- Toshikazu Shinba
- Department of Psychiatry, Shizuoka Saiseikai General Hospital, Shizuoka 422-8527, Japan
- Research Division, Saiseikai Research Institute of Health Care and Welfare, Tokyo 108-0073, Japan
- Autonomic Nervous System Consulting, Shizuoka 420-0839, Japan
| | - Hironori Suzuki
- Department of Obstetrics and Gynecology, Shizuoka Saiseikai General Hospital, Shizuoka 422-8527, Japan
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Michiko Urita
- Department of Psychiatry, Shizuoka Saiseikai General Hospital, Shizuoka 422-8527, Japan
| | - Shuntaro Shinba
- Autonomic Nervous System Consulting, Shizuoka 420-0839, Japan
| | - Yujiro Shinba
- Autonomic Nervous System Consulting, Shizuoka 420-0839, Japan
| | - Miho Umeda
- Ward North 3, Shizuoka Saiseikai General Hospital, Shizuoka 422-8527, Japan
| | - Junko Hirakuni
- Ward North 3, Shizuoka Saiseikai General Hospital, Shizuoka 422-8527, Japan
| | - Takemi Matsui
- School of System Design, Tokyo Metropolitan University, Tokyo 191-0065, Japan
| | - Ryo Onoda
- Department of Obstetrics and Gynecology, Shizuoka Saiseikai General Hospital, Shizuoka 422-8527, Japan
| |
Collapse
|
30
|
Castro J, Gigase FAJ, Molenaar NM, Ibroçi E, Perez-Rodriguez MM, Lieb W, Janevic T, de Witte LD, Bergink V, Rommel AS. Increased postpartum anxiety symptoms after perinatal SARS-CoV-2 infection in a large, prospective pregnancy cohort in New York City. J Psychiatr Res 2024; 170:130-137. [PMID: 38134722 PMCID: PMC10905645 DOI: 10.1016/j.jpsychires.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/15/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
Numerous studies reported an increase of postpartum mood symptoms during the COVID-19 pandemic. Yet, the link between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and perinatal mental health is less well understood. We investigated the associations between prenatal SARS-CoV-2 infection and postpartum depressive and anxiety symptoms, including examinations of infection timing and pandemic timeline. We included 595 participants from Generation C, a prospective pregnancy cohort in New York City (2020-2022). Prenatal SARS-CoV-2 infection was determined via laboratory or medical diagnosis. Depression and anxiety symptoms were measured 4-12 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder questionnaire (GAD), respectively. Quantile regressions were conducted with prenatal SARS-CoV-2 infection as exposure and continuously measured EPDS and GAD scores as outcomes. We reran the analyses in those with COVID-19-like symptoms in the trimester during which infection occurred. 120 (20.1%) participants had prenatal SARS-CoV-2 infection. After adjusting for socio-demographic, obstetric and other maternal health factors, prenatal SARS-CoV-2 infection was associated with higher median postpartum anxiety scores (b = 0.55, 95% CI = 0.15; 0.96). Late gestation infection (b = 1.15, 95% CI = 0.22; 2.09) and symptomatic infection (b = 1.15, 95% CI = 0.12; 2.18) were also associated with higher median postpartum anxiety scores. No associations were found with depressive symptoms. The associations were not moderated by time since the start of the pandemic. This study suggests that prenatal SARS-CoV-2 infection increases the risk of postpartum anxiety symptoms among participants reporting median anxiety symptoms. Given that this association was not affected by pandemic timing and that SARS-CoV-2 transmission continues, individuals infected with SARS-CoV-2 during pregnancy should be monitored for postpartum anxiety symptoms.
Collapse
Affiliation(s)
- Juliana Castro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Frederieke A J Gigase
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Nina M Molenaar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Erona Ibroçi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | | | - Whitney Lieb
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Teresa Janevic
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Lot D de Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Anna-Sophie Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| |
Collapse
|
31
|
AlAteeq D, Almajed E, AlZabin A, AlOtaibi A, Salamah RB, AlDhafyan S, AlMutiri WA, AlHarbi A, AlQntash N, AlTamimi R, AlRasheed R, Fayed A. Validity and reliability of the Arabic version of the population postpartum depression literacy scale (PoDLiS): a web-based survey in Saudi Arabia. BMC Pregnancy Childbirth 2024; 24:40. [PMID: 38184534 PMCID: PMC10770988 DOI: 10.1186/s12884-024-06245-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/01/2024] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Proper knowledge about postpartum depression (PPD) will help recognize symptoms and encourage women to seek the needed professional help. Until now, there has been a scarcity of research on the literacy level of PPD among the Saudi population and the factors affecting it. This study translated the Postpartum Depression Literacy Scale (PoDLiS) into Arabic and evaluated its psychometric properties. Furthermore, the Saudi population's mental health literacy for PPD and the factors associated with it were examined as a secondary objective. METHODS This cross-sectional study involved 2,336 participants selected via convenience sampling from all over Saudi Arabia, all of whom willingly agreed to participate. Data collection was done through an online questionnaire using Google Forms, covering sociodemographic characteristics and the Arabic PoDLiS. RESULTS The Arabic version of PoDLiS showed acceptable goodness-of-fit between the observed data and the resulting six-factor solution, RMSEA = 0.049, 90% confidence interval RMSEA (0.010-0.050), pCLOSE = 0.742, CFI = 0.962, TLI = 0.940, χ2(270) = 1576.12, p-value = 0.742. The total Cronbach's alpha (α) of the PoDLiS showed acceptable internal consistency, measuring at 0.742. High literacy was seen in married and young participants with a postgraduate degree and sufficient household income who have known someone with PPD. Significantly lower literacy was seen in male, non-Saudi participants and those residing in the central and northern regions of Saudi Arabia. CONCLUSIONS The Arabic version of the PoDLiS showed good psychometric properties, and it can be used to assess PPD literacy among perinatal women and to examine the impact of PPD awareness programs. Despite reporting relatively good PPD literacy in the Saudi population, there is a persistent gap in participants' beliefs about available professional help and the attitudes that facilitate recognizing PPD. Our findings highlight the importance of implementing public education campaigns to improve overall knowledge about PPD and promote prevention, early recognition, and treatment of PPD.
Collapse
Affiliation(s)
- Deemah AlAteeq
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia.
| | - Ebtesam Almajed
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Alya AlZabin
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Aisha AlOtaibi
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Rawan Bin Salamah
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Shahad AlDhafyan
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Wijdan A AlMutiri
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Asma AlHarbi
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Norah AlQntash
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Reem AlTamimi
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Raghad AlRasheed
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| | - Amel Fayed
- Internal Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
- Family and Community Medicine Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 16711, Saudi Arabia
| |
Collapse
|
32
|
Norazman CW, Lee LK. The influence of social support in the prevention and treatment of postpartum depression: An intervention-based narrative review. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241275587. [PMID: 39238240 PMCID: PMC11378223 DOI: 10.1177/17455057241275587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
Postpartum depression (PPD) is a mental health disorder that affects 10%-15% women globally. Longitudinal and meta-analyses have consistently demonstrated the negative impacts of PPD on both the affected mothers and subsequent infant development. Given the consideration that antidepressant side effects in breastfeeding infants and the cost-effectiveness considerations of psychotherapies, attention has been paid towards the promising role of social support interventions in order to prevent and reduce the PPD symptoms. Confirming the assertion, this narrative review examines the potential of five social support interventions to ameliorate PPD-related maternal and infant outcomes. The wide implications of psychoeducational strategy, nurses' supportive and non-directive counselling and home-visiting approach are outlined. Furthermore, the evidence underlying the role of peer support, culturally tailored intervention and community-based participatory approach in PPD is elucidated. In clinical practice, this review reinforce the roles of discharge educational intervention led by the experienced nurse during the postpartum stay, in order to maintain psychological mental health among the postpartum mothers. More importantly, the skilled and competence public health nurses act as valuable assets in treating PPD, and this effective treatment alternative should be considered by healthcare planners. In future, major investigations will be strategized to discover the synergistic effects of combined social support approaches to yield a better outcome in the prevention and treatment of PPD.
Collapse
Affiliation(s)
- Camilla Wahida Norazman
- Food Technology Program, School of Industrial Technology, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
| | - Lai Kuan Lee
- Food Technology Program, School of Industrial Technology, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
| |
Collapse
|
33
|
Johansson M, Ledung Higgins K, Dapi Nzefa L, Benderix Y. Postpartum depression and life experiences of mothers with an immigrant background living in the south of Sweden. Int J Qual Stud Health Well-being 2023; 18:2187333. [PMID: 36880807 PMCID: PMC10013500 DOI: 10.1080/17482631.2023.2187333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
PURPOSE Postpartum Depression (PPD) -a common health problem for mothers' postpartum increases the risk of negative interaction between mothers and infants as it reduces the former's ability to respond to the latter's needs appropriately. Migrant mothers exhibit a higher prevalence of risk factors for PPD. Hence, this study aimed to investigate migrant mothers' life experiences pertaining to motherhood and PPD. METHODS Qualitative interviews were conducted with 10 immigrant mothers in the south of Sweden during 2021. RESULTS The qualitative content analysis revealed the following main themes: 1) PPD (two sub themes-psychosomatic symptoms and burden of responsibility due to feelings of loneliness); 2) mistrust of social services (one sub-theme-afraid of losing their children and Swedish social services' lack of understanding); 3) inadequate healthcare (two sub-themes-limited healthcare literacy for migrant mothers and language barrier; 4) women's coping strategy for well-being (two sub-themes-better awareness and understanding of the Swedish system and society, and freedom and independence in the new country). CONCLUSIONS PPD, mistrust of social services, and inadequate healthcare lacking personal continuity were common among immigrant women, thus precipitating discrimination-including lack of access to services because of limited health literacy, cultural differences, language barriers, and insufficient support.
Collapse
Affiliation(s)
- Maude Johansson
- Department of Psychology, Linnaeus University, Växjö, Sweden
| | | | | | - Ylva Benderix
- Department of Psychology, Linnaeus University, Växjö, Sweden
| |
Collapse
|
34
|
Yang X, Qiu M, Yang Y, Yan J, Tang K. Maternal postnatal confinement practices and postpartum depression in Chinese populations: A systematic review. PLoS One 2023; 18:e0293667. [PMID: 37903136 PMCID: PMC10615300 DOI: 10.1371/journal.pone.0293667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/14/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The postpartum period is critical for maternal health status after childbirth. The traditional Chinese postpartum confinement practice, "doing-the-month", is considered especially effective in helping mothers recover during the postpartum period. However, research has not provided evidence to confirm its benefits. Postpartum depression is a common postpartum disease that seriously threatens maternal health. The systematic review aims to explore the association between "doing-the-month" and postpartum depression in the Chinese female population and to provide a scientific foundation for evidence-based postpartum maternal care. METHODS Five databases (PubMed, Embase, Web of Science, Scopus, Cochrane, PsycINFO, and Web of Science) were searched according to the protocol (INPALSY202320102). The JBI assessment tool was used to assess the quality of the included studies. RESULTS Sixteen quantitative studies from China and Chinese female immigrants in other countries, including 15 cross-sectional studies and 1 randomized controlled study, were identified. Four studies indicated that "doing-the-month" rituals reduced postpartum depression risk while 2 studies showed opposite results; 10 studies did not show a significant association between "doing-the-month" practices and postpartum depression. CONCLUSION There is conflicting evidence regarding the association between "doing-the-month" and the likelihood of developing postpartum depression. Some studies have explored the impact of family ties, particular rituals, and specific stressors during the postpartum period on the occurrence of postpartum depression in Chinese women. According to current research, "doing-the-month" practice failed to show a significant protective effect on postpartum depression in the Chinese maternal population. Evidence-based medical health education for the Chinese postpartum female community is urgently needed.
Collapse
Affiliation(s)
- Xiao Yang
- Health Policy and Management Department, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Mujie Qiu
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yichun Yang
- Department of Obstetrics, Longgang District Central Hospital of Shenzhen, Shenzhen, China
| | - Junlin Yan
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| |
Collapse
|
35
|
Gebeyehu NA, Tegegne KD, Abebe K, Asefa Y, Assfaw BB, Adella GA, Alemu BW, Sewyew DA. Global prevalence of post-abortion depression: systematic review and Meta-analysis. BMC Psychiatry 2023; 23:786. [PMID: 37884930 PMCID: PMC10605843 DOI: 10.1186/s12888-023-05278-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Depression after abortion is a common problem for all women of reproductive age. However, there are not any data on post-abortion depression at a global level. Consequently, the purpose of this study was to find out the global prevalence of post-abortion depression. METHODS The present study involved a comprehensive search of several databases, including Science Direct, Scopus, EMBSE, Google Scholar, and PubMed. The search was conducted between February 1, 2023, and March 10, 2023. The data was extracted using Microsoft Excel (version 14) and analyzed using STATA statistical software. To evaluate publication bias, a forest plot, Begg's test, and Egger's test were employed. Heterogeneity was assessed using I2, and a pooled estimated analysis was conducted. Additionally, subgroup analysis was performed based on the study continent/region, World Bank income group, screening instrument, and study design. RESULTS This analysis included 15 papers with a total of 18,207 research participants out of a total of 657 articles. The overall pooled prevalence of post-abortion depression was found to be 34.5% (95% CI: 23.34, 45.68), with an I2 value of 71.6%. The prevalence of post-abortion depression varied based on geographic location, World Health Organization (WHO) regions, World Bank income category, screening approach, and study design. The highest proportion of post-abortion depression was observed in Asia (37.5%), while the WHO's Eastern Mediterranean region had the greatest rate of post-abortion depression (43.1%). Lower-middle-income countries had the highest frequency of post-abortion depression (42.91%) based on World Bank economic classification. The Center of Epidemiological Studies Depression Scale was found to have the highest incidence of reported depression prevalence (30%) across diagnostic tools. Furthermore, the prevalence of depression was higher in cross-sectional study designs (36.42%) compared to cohort studies (22.7%). CONCLUSION In conclusion, the occurrence of post-abortion depression has been observed to be widespread globally. The prevalence of post-abortion is found to be influenced by several factors, including the methodology employed in the study, the diagnostic tool utilized, the geographical location, and the socioeconomic status of the population. Healthcare providers should prioritize the provision of post-abortion counseling, care, and emotional support to women.
Collapse
Affiliation(s)
- Natnael Atnafu Gebeyehu
- School of Midwifery, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia.
| | - Kirubel Dagnaw Tegegne
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Kelemu Abebe
- School of Midwifery, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia
| | - Yibeltal Asefa
- Department of Public Health, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Belete Birhan Assfaw
- Department of Psychiatry, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Biresaw Wassihun Alemu
- Department of Midwifery, College of Medicine and Health Science, Indiana University, Injibara, Ethiopia
| | - Dagne Addisu Sewyew
- Department of Midwifery, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| |
Collapse
|
36
|
Prins-Engelsman S, Cwikel J. Postpartum Depression Symptoms in Various Sects of Ultra-Orthodox Society in Israel. JOURNAL OF RELIGION AND HEALTH 2023; 62:3327-3346. [PMID: 36715878 DOI: 10.1007/s10943-023-01745-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Ultra-Orthodox society in Israel is characterized by a higher birth rate than Israeli Jewish society. This study investigated the association of reproductive experiences among different sects of 254 ultra-Orthodox women with symptoms of postpartum depression (PPD) and general depression, controlling for demographic features. PPD symptoms were found among 22% of the participants, with Sephardic women with higher rates of symptoms (34%) than women from the Lithuanian sect (16%) and Hasidic women (14%), and those who were formerly secular also had higher rates of PPD (33%) compared to 19% among those born ultra-Orthodox. Implications for health care practitioners are discussed.
Collapse
Affiliation(s)
| | - Julie Cwikel
- The Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 679, 84105, Beer Sheva, Israel
| |
Collapse
|
37
|
Reis YA, Akay A, Aktan B, Tetik S, Fıratlıgil FB, Kayıkçıoğlu F. The Effect of Clinical Pilates Exercises and Prenatal Education on Maternal and Fetal Health. Z Geburtshilfe Neonatol 2023; 227:354-363. [PMID: 37473767 DOI: 10.1055/a-2096-6454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The mental, physical and sexual health of women as well as maternal and fetal health should be considered during the prenatal and postnatal periods. Investigating the effect of clinical Pilates exercises and prenatal education (CPE & PE) on obstetric and neonatal outcomes as well as the mental, physical, and sexual health of women was intended. METHODS In the second trimester, mothers with singleton pregnancies who attended (n=79, study group) or did not attend (n=80, control group) CPE & PR were recruited to this prospective cohort study, and were evaluated in the prenatal and postnatal periods. Depression was assessed with Beck Depression Inventory (BDI), sexual functions with Female Sexual Function Index (FSFI), muscle strength with Gross Muscle Scales (GMS), and labor pain with Visual Analogue Scale (VAS). In addition, the presence of low back pain (LBP) was questioned. RESULTS No significant association of CPE & PE with obstetric outcomes such as cesarean rates, preterm birth, and neonatal outcomes such as birth weight and Apgar scores were identified. Changes in VAS scores, the incidence of perineal trauma, and episiotomy were not associated with CPE & PE. However, CPE & PE was associated with lower BDI scores, a gradual increase in the total scores of FSFI, increased GMS, and reduced LBP. CONCLUSION CPE & PE had no adverse effects on obstetric and neonatal outcomes and was associated with improved mental, physical, sexual health scores during pregnancy and postpartum.
Collapse
Affiliation(s)
- Yıldız Akdaş Reis
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Arife Akay
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Berrin Aktan
- Physiotherapist, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Sinan Tetik
- Psychologist, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Fahri Burçin Fıratlıgil
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Fulya Kayıkçıoğlu
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| |
Collapse
|
38
|
Stefana A, Langfus JA, Palumbo G, Cena L, Trainini A, Gigantesco A, Mirabella F. Comparing the factor structures and reliabilities of the EPDS and the PHQ-9 for screening antepartum and postpartum depression: a multigroup confirmatory factor analysis. Arch Womens Ment Health 2023; 26:659-668. [PMID: 37464191 PMCID: PMC10491522 DOI: 10.1007/s00737-023-01337-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/05/2023] [Indexed: 07/20/2023]
Abstract
To evaluate and compare the factor structure and reliability of EPDS and PHQ in antepartum and postpartum samples. Parallel analysis and exploratory factor analysis were conducted to determine the structure of both scales in the entire sample as well as in the antepartum and postpartum groups. McDonald's omega statistics examined the utility of treating items as a single scale versus multiple factors. Multigroup confirmatory factor analysis (MCFA) was utilized to test the measurement invariance between the antepartum and postpartum groups. Two-factor models fit best for the EPDS in both the antepartum and postpartum groups; however, the most reliable score variance was attributable to a general factor for each scale. MCFA provided evidence of weak invariance across groups regarding factor loadings and partial invariance regarding item thresholds. PHQ-9 showed a two-factor model in the antepartum group; however, the same model did not fit well in the postpartum group. EPDS should be preferred to PHQ-9 for measuring depressive symptoms in peripartum populations. Both scales should be used as a single-factor scale. Caution is required when comparing the antepartum and postpartum scores.
Collapse
Affiliation(s)
- Alberto Stefana
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Joshua A Langfus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Gabriella Palumbo
- Center for Behavioural Sciences and Mental Health, National Institute of Health, Rome, Italy
| | - Loredana Cena
- Department of Clinical and Experimental Sciences, Section of Neuroscience, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy
| | - Alice Trainini
- Department of Clinical and Experimental Sciences, Section of Neuroscience, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy
| | - Antonella Gigantesco
- Center for Behavioural Sciences and Mental Health, National Institute of Health, Rome, Italy
| | - Fiorino Mirabella
- Center for Behavioural Sciences and Mental Health, National Institute of Health, Rome, Italy
| |
Collapse
|
39
|
Mulugeta Y, Mohammed AA, Ibrahim IM, Getachew G, Ahmed KY. Postpartum depression and associated factors in Afar Region, northeast Ethiopia. Heliyon 2023; 9:e19914. [PMID: 37809513 PMCID: PMC10559328 DOI: 10.1016/j.heliyon.2023.e19914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/11/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Background To effectively address the burden of postpartum depression (PPD), it is crucial to gain a comprehensive understanding of its magnitude and the factors associated with it in the pastoral and hot region of the Afar Region. This will help identify the progress made thus far and highlight areas that require further attention to accelerate efforts toward reducing the impact of PPD. Notably, no previous study has examined the prevalence and associated factors of PPD specifically in pastoral communities within Ethiopia, including the Afar Region. Accordingly, we investigated the prevalence and associated factors of PPD among postpartum women in the Afar Region, Northeast Ethiopia. Methods An institution-based cross-sectional study was conducted in the Awsi Rasu Zone of Afar Regional State from June to July 2021. The study employed a systematic random sampling method to select a total of 302 postpartum mothers who had visited the Expanded Program of Immunisation (EPI) clinics in public health facilities within the Awsi Rasu Zone of the Afar Region. The measurement of PPD was performed using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable binary logistic regression modelling was used to investigate associations between sociodemographic, obstetric and health service, and psychosocial factors with PPD. Results The overall prevalence of PPD was 37.4% with a 95% confidence interval (CI) from 32.0% to 43.0%. Postpartum women who attained high school education were associated with a lower odds of PPD compared to those who did not attain formal schooling (adjusted odds ratio [AOR] = 0.31; 95% CI: 0.12, 0.82). Postpartum women with a family history of mental illness (AOR = 2.34; 95% CI: 1.24, 4.41), those who had trouble in infant feeding (AOR = 4.26; 95% CI: 2.32, 7.83), and those who experienced intimate partner violence (AOR = 3.09; 95% CI: 1.58, 6.04) were positively associated with PPD. Conclusion The results of our study revealed that the prevalence of PPD in the Awsi Rasu Zone of the Afar Region is higher than both the national and global averages. The findings also highlighted the need for targeted interventions addressing the needs of pastoral postpartum women who experience various stressors, such as feeding difficulties and intimate partner violence.
Collapse
Affiliation(s)
| | - Ahmed Adem Mohammed
- Department of Nursing, College of Medicine and Health Science, Samara University, PO Box: 132, Samara, Ethiopia
| | - Ibrahim Mohammed Ibrahim
- Department of Midwifery, College of Medicine and Health Science, Samara University, PO Box: 132, Samara, Ethiopia
| | | | - Kedir Y. Ahmed
- Department of Public Health, College of Medicine and Health Science, Samara University, PO Box: 132, Samara, Ethiopia
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| |
Collapse
|
40
|
Sim CSM, Chen H, Chong SL, Xia OJ, Chew E, Guo X, Ng LP, Ch'ng YC, Ong JLH, Tan J, Ng DCC, Tan NC, Chan YH. Primary health level screening for postpartum depression during well-child visits: Prevalence, associated risk factors, and breastfeeding. Asian J Psychiatr 2023; 87:103701. [PMID: 37517174 DOI: 10.1016/j.ajp.2023.103701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023]
Abstract
Postpartum depression (PPD) is a public health problem that is associated with detrimental effects on the wellbeing of the mother, child and family. Early detection for PPD at the primary health level provides an opportunity for intervention. We aim to examine: (1) the prevalence rate of PPD in the primary care population, (2) acceptance and attendance rates of intervention for women who screened positive for PPD, (3) sociodemographic and maternal risk factors of PPD, and (4) the impact of PPD on breastfeeding. We implemented a mother-child dyadic screening program using the modified Patient Health Questionnaire-2 during routine well-child visits at 2 or 3 months postpartum between July 2019 and December 2021. We performed multivariable logistic regression to identify independent risk factors for PPD and described using adjusted odds ratio (OR) with corresponding 95 % confidence intervals. Among 5561 mothers, the prevalence rate of probable PPD was 2.4 %. About half (54.4 %) of mothers who screened positive accepted intervention and of these, about two-thirds accepted onward referrals to tertiary care and community mental health service, with higher attendance at the latter. In the final adjusted model, mothers who had probable PPD were more likely to be older than age 35 years (OR 1.88, 95 % CI 1.05-3.45; p < 0.05) and not breastfeeding (OR 1.9, 95 % CI 1.06-3.38; p < 0.05). Overall, our findings highlight the importance of early PPD screening and management in primary care. These findings can help inform maternal mental health service development and utilization, thereby optimizing maternal and infant outcomes.
Collapse
Affiliation(s)
- Cherie Sze Min Sim
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore; SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore.
| | - Shu-Ling Chong
- SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore; Paediatric Emergency Medicine Department, KK Women's and Children's Hospital, Singapore
| | | | - Elaine Chew
- SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore; Adolescent Medicine Service, KK Women's and Children's Hospital, Singapore
| | - Xiaoxuan Guo
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Lai Peng Ng
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Ying Chia Ch'ng
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore
| | | | | | - David Chee Chin Ng
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Yoke Hwee Chan
- SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore; Division of Medicine, KK Women's and Children's Hospital, Singapore
| |
Collapse
|
41
|
Obichili MI, Ogwo CA, Udeh K, Obiechina CK, Kakwagh VV, Eze CC, Gever VC. Effect of social media-based psychodrama therapy on reduction in symptoms of postpartum depression in women with first birth experience: The contributing role of spousal support. Health Care Women Int 2023; 45:892-909. [PMID: 37561457 DOI: 10.1080/07399332.2023.2243240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
We aimed to examine the impact of social media-based psychodrama therapy in reducing postpartum depression symptoms in first-time mothers. We conducted this study using a quasi-experiment with the use of pretest, posttest and follow-up evaluation after six months. We found a significant main effect of social media-based psychodrama therapy in reducing symptoms of postpartum depression in women F(1,503)= 713.413, p = 0.001, eta squared .441. We also found that this relationship is moderated by spousal support like physical, emotional and social support. Additionally, our results showed that first-time mothers experience PPD symptoms after childbirth more than experienced mothers. We equally found that psychodrama contributed in reducing symptoms of PPD in experienced mothers more than in first-time mothers. The implication of our result is that first-time mothers require more attention to assist them to recover from PPD symptoms than their experienced counterparts.
Collapse
Affiliation(s)
| | - Comfort Ajuma Ogwo
- Department of Mass Communication, Prince Abubakar Audu University Anyigba, Anyigba, Nigeria
| | | | | | | | | | | |
Collapse
|
42
|
Santos IS, Blumenberg C, Munhoz TN, Matijasevich A, Santos Júnior HG, Dos Santos LM, Correia LL, de Souza MR, Lira PI, Bortolotto CC, Barcelos R, Altafim E, Chicaro MF, Macana EC, da Silva RS, Victora CG. Course of depression during the first 2 years postpartum among Brazilian women enrolled in a conditional cash transfer program. Int J Soc Psychiatry 2023; 69:1193-1201. [PMID: 36938959 DOI: 10.1177/00207640231154376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
BACKGROUND Women living in low- and middle-income countries are more exposed to known risk factors for depression occurrence and persistency over time. AIM Our aim was to investigate the course of depression in the first 2 years postpartum among Brazilian women enrolled in a cash transfer program. METHOD Longitudinal analysis of baseline (T0; mean 3.7 months postpartum) and first follow-up data (T1; mean 18.6 months postpartum) from a trial to assess the impact of a child development promotion program in 30 municipalities from six Brazilian states. The program does not include any interventions against maternal depression. The Edinburgh Postnatal Depression Scale (EPDS) at cutoff ⩾10 was applied. Women were categorized into four groups based on EPDS at T0 and T1: absence of depression, persistence, discontinuity, or emergence pattern. Adjusted Poisson regressions were run using a multilevel hierarchical model. RESULTS Two thousand eight hundred sixty-three women were assessed. Prevalence of depression was 26.4% [24.8, 28.1] at T0 and 24.4% [22.8, 26.0] at T1. Persistence, discontinuation, and emergence were found in 14.1% [11.3, 17.6%], 12.8% [11.4, 14.3%], and 10.2% [8.0, 13.0], respectively. In adjusted analyses, the persistence pattern was directly associated with parity and inversely associated with schooling of the woman and of the child's father. Living with husband/partner and support from the child's father and family members during pregnancy were protective against persistence. The discontinuity and the emergence patterns were not associated with any of the exposure variables. CONCLUSIONS Depressive symptoms were highly prevalent during the first 2 years postpartum. About half of the women with depression at T1 were persistent cases that could have been detected earlier. Screening for maternal depression should be an essential component in every encounter of women with health professionals in primary health care settings.
Collapse
Affiliation(s)
- Ina S Santos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Cauane Blumenberg
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Tiago N Munhoz
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Curso de Psicologia, Universidade Federal de Pelotas, Rio Grande do Sul, Brasil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Letícia Marques Dos Santos
- Instituto de Humanidades Artes de Ciências da Universidade Federal da Bahia (UFBA); Salvador, Bahia, Brazil
| | - Luciano L Correia
- Departamento de Saúde Comunitária, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Marta Rovery de Souza
- Departamento de Saúde Coletiva, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Pedro Ic Lira
- Departamento de Nutrição do Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Caroline C Bortolotto
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Raquel Barcelos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Elisa Altafim
- Fundação Maria Cecília Souto Vidigal, São Paulo, São Paulo, Brazil
| | | | | | - Ronaldo Souza da Silva
- Secretaria de Avaliação e Gestão da Informação (SAGI), Ministério da Cidadania; Brasília, Federal District, Brazil
| | - Cesar G Victora
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| |
Collapse
|
43
|
Sanfilippo KRM, Glover V, Cornelius V, Amiel Castro RT, McConnell B, Darboe B, Huma HB, Ceesay H, Ramchandani P, Cross I, Stewart L. Expression of antenatal symptoms of common mental disorders in The Gambia and the UK: a cross-sectional comparison study. BMJ Open 2023; 13:e066807. [PMID: 37429695 PMCID: PMC10335499 DOI: 10.1136/bmjopen-2022-066807] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 05/23/2023] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVES It is important to be able to detect symptoms of common mental disorders (CMDs) in pregnant women. However, the expression of these disorders can differ across cultures and depend on the specific scale used. This study aimed to (a) compare Gambian pregnant women's responses to the Edinburgh Postnatal Depression Scale (EPDS) and Self-reporting Questionnaire (SRQ-20) and (b) compare responses to the EPDS in pregnant women in The Gambia and UK. DESIGN This cross-sectional comparison study investigates Gambian EPDS and SRQ-20 scores through correlation between the two scales, score distributions, proportion of women with high levels of symptoms, and descriptive item analysis. Comparisons between the UK and Gambian EPDS scores were made by investigating score distributions, proportion of women with high levels of symptoms, and descriptive item analysis. SETTING This study took place in The Gambia, West Africa and London, UK. PARTICIPANTS 221 pregnant women from The Gambia completed both the SRQ-20 and the EPDS; 368 pregnant women from the UK completed the EPDS. RESULTS Gambian participants' EPDS and SRQ-20 scores were significantly moderately correlated (rs=0.6, p<0.001), had different distributions, 54% overall agreement, and different proportions of women identified as having high levels of symptoms (SRQ-20=42% vs EPDS=5% using highest cut-off score). UK participants had higher EPDS scores (M=6.5, 95% CI (6.1 to 6.9)) than Gambian participants (M=4.4, 95% CI (3.9 to 4.9)) (p<0.001, 95% CIs (-3.0 to -1.0), Cliff's delta = -0.3). CONCLUSIONS The differences in scores from Gambian pregnant women to the EPDS and SRQ-20 and the different EPDS responses between pregnant women in the UK and The Gambia further emphasise how methods and understanding around measuring perinatal mental health symptoms developed in Western countries need to be applied with care in other cultures.Cite Now.
Collapse
Affiliation(s)
| | - Vivette Glover
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK
| | | | - Bonnie McConnell
- School of Music, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Buba Darboe
- Ministry of Health and Social Welfare The Gambia, Banjul, Gambia
| | - Hajara B Huma
- Ministry of Health and Social Welfare The Gambia, Banjul, Gambia
- National Centre for Arts and Culture The Gambia, Banjul, Gambia
| | - Hassoum Ceesay
- National Centre for Arts and Culture The Gambia, Banjul, Gambia
| | - Paul Ramchandani
- Faculty of Education, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Ian Cross
- Centre for Music & Science, Faculty of Music, Cambridge University, Cambridge, Cambridgeshire, UK
| | - Lauren Stewart
- Psychology Department, Goldsmiths University of London, London, UK
| |
Collapse
|
44
|
Fish-Williamson A, Hahn-Holbrook J. Nutritional factors and cross-national postpartum depression prevalence: an updated meta-analysis and meta-regression of 412 studies from 46 countries. Front Psychiatry 2023; 14:1193490. [PMID: 37398595 PMCID: PMC10311512 DOI: 10.3389/fpsyt.2023.1193490] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/02/2023] [Indexed: 07/04/2023] Open
Abstract
Background Postpartum depression (PPD) is the most common complication associated with childbirth and can lead to adverse outcomes for both mothers and their children. A previous meta-analysis found that PPD prevalence varies widely across countries. One potential underexplored contributor to this cross-national variation in PPD is diet, which contributes to mental health and varies significantly around the world. Here, we sought to update the global and national estimates of PPD prevalence using systematic review and meta-analysis. Further, we examined whether cross-national variation in PPD prevalence is associated with cross-national variation in diet using meta-regression. Methods To estimate national rates of PPD prevalence, we conducted an updated systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale between 2016-2021 and combined our findings with a previous meta-analysis of articles published between 1985-2015. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To examine dietary predictors, we extracted data on sugar-sweetened beverage, fruit, vegetable, total fiber, yogurt, and seafood consumption from the Global Dietary Database. Random effects meta-regression was used to test whether between-country and within-country variation in dietary factors predicted variation in PPD prevalence, controlling for economic and methodological variables. Results 412 studies of 792,055 women from 46 countries were identified. The global pooled prevalence of PPD was 19.18% (95% confidence interval: 18.02 to 20.34%), ranging from 3% in Singapore to 44% in South Africa. Countries that consumed more sugar-sweetened beverages (SSBs) had higher rates of PPD (Coef. = 0.325, p = 0.044, CI:0.010-0.680); Moreover, in years when higher rates of sugar-sweetened beverages were consumed in a country, there were correspondingly higher rates of PPD in that country (Coef. = 0.129, p = 0.026, CI: 0.016-0.242). Conclusion The global prevalence of PPD is greater than previous calculations, and drastically varies by country. Sugar-sweetened beverage consumption explained some of the national variation in PPD prevalence.
Collapse
|
45
|
Harrison S, Quigley MA, Fellmeth G, Stein A, Alderdice F. The impact of the Covid-19 pandemic on postnatal depression: analysis of three population-based national maternity surveys in England (2014-2020). THE LANCET REGIONAL HEALTH. EUROPE 2023:100654. [PMID: 37363795 PMCID: PMC10183799 DOI: 10.1016/j.lanepe.2023.100654] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 06/28/2023]
Abstract
Background Few studies have evaluated postnatal depression before and during the Covid-19 pandemic using comparable data across time. We used data from three national maternity surveys in England to compare prevalence and risk factors for postnatal depression before and during the pandemic. Methods Analysis was conducted using population-based surveys carried out in 2014 (n = 4571), 2018 (n = 4509), and 2020 (n = 4611). Weighted prevalence estimates for postnatal depression (EPDS score ≥13) were compared across surveys. Modified Poisson regression was used to estimate adjusted risk ratios (aRR) for the association between sociodemographic, pregnancy- and birth-related, and biopsychosocial factors, and postnatal depression. Findings Prevalence of postnatal depression increased from 10.3% in 2014 to 16.0% in 2018 (difference = +5.7% (95% CI: 4.0-7.4); RR = 1.55 (95% CI: 1.36-1.77)) and to 23.9% in 2020 (difference = +7.9% (95% CI: 5.9-9.9); RR = 1.49 (95% CI: 1.34-1.66)). Having a long-term mental health problem (aRR range = 1.48-2.02), antenatal anxiety (aRR range = 1.73-2.12) and antenatal depression (aRR range = 1.44-2.24) were associated with increased risk of postnatal depression, whereas satisfaction with birth (aRR range = 0.89-0.92) and social support (aRR range = 0.73-0.78) were associated with decreased risk before and during the pandemic. Interpretation This analysis indicates that Covid-19 had an important negative impact on postnatal women's mental health and may have accelerated an existing trend of increasing prevalence of postnatal depression. Risk factors for postnatal depression were consistent before and during the pandemic. Timely identification, intervention and follow-up are key to supporting women at risk, and it is essential that mechanisms to support women are strengthened during times of heightened risk such as the pandemic. Funding NIHR Policy Research Programme.
Collapse
Affiliation(s)
- Siân Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Maria A Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Gracia Fellmeth
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Alan Stein
- Department of Psychiatry, Medical Sciences Division, University of Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- African Health Research Institute, KwaZulu-Natal, South Africa
| | - Fiona Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| |
Collapse
|
46
|
Putri AS, Wurisastuti T, Suryaputri IY, Mubasyiroh R. Postpartum Depression in Young Mothers in Urban and Rural Indonesia. J Prev Med Public Health 2023; 56:272-281. [PMID: 37287205 DOI: 10.3961/jpmph.22.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 04/20/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES Young mothers are vulnerable to postpartum depression due to role transition-related stress. Understanding the causes underlying these stressors is essential for developing effective interventions. METHODS This study analyzed the 2018 Indonesian Basic Health Research data. The Mini International Neuropsychiatric Interview was used to assess postpartum depression symptoms in mothers aged 15-24 years with infants aged 0-6 months. In 1285 subjects, the risk factors for postpartum depression were evaluated using multivariate logistic regression. RESULTS The overall prevalence of depression in the 6 months postpartum was 4.0%, with a higher prevalence in urban areas (5.7%) than in rural areas (2.9%). Urban and rural young mothers showed distinct postpartum depression risk factors. In urban areas, living without a husband (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.24 to 11.76), experiencing preterm birth (OR, 4.67; 95% CI, 1.50 to 14.50), having pregnancy complications (OR, 3.03; 95% CI, 1.20 to 7.66), and having postpartum complications (OR, 5.23; 95% CI, 1.98 to 13.80) were associated with a higher risk of postpartum depression. In rural areas, postpartum depression was significantly associated with a smaller household size (OR, 3.22; 95% CI, 1.00 to 10.38), unwanted pregnancy (OR, 4.40; 95% CI, 1.15 to 16.86), and pregnancy complications (OR, 3.41; 95% CI, 1.31 to 8.88). CONCLUSIONS In both urban and rural contexts, postpartum depression relates to the availability of others to accompany young mothers throughout the postpartum period and offer support with reproductive issues. Support from the family and the healthcare system is essential to young mothers' mental health. The healthcare system needs to involve families to support young mothers' mental health from pregnancy until the postpartum period.
Collapse
Affiliation(s)
- Alifa Syamantha Putri
- Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency, Bogor, Indonesia
| | - Tri Wurisastuti
- Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency, Bogor, Indonesia
| | - Indri Yunita Suryaputri
- Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency, Bogor, Indonesia
| | - Rofingatul Mubasyiroh
- Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency, Bogor, Indonesia
| |
Collapse
|
47
|
Tsai JM, Tsai LY, Tsay SL, Chen YH. The prevalence and risk factors of postpartum depression among women during the early postpartum period: a retrospective secondary data analysis. Taiwan J Obstet Gynecol 2023; 62:406-411. [PMID: 37188444 DOI: 10.1016/j.tjog.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE Postpartum depression (PPD) is common and detrimental affecting both maternal health and child development. The purpose of this study was to determine the prevalence and factors of PPD screened immediately after delivery. MATERIALS AND METHODS A retrospective study design using secondary data analysis is applied. Four years of data, containing linkable maternal, neonate and PPD screen records between 2014 and 2018, was retrieved and combined from the electronic medical systems of MacKay Memorial Hospital in Taiwan. For each woman, the PPD screen record contained self-reported depressive symptoms assessed by the Edinburgh Postnatal Depression Scale (EPDS) within 48-72 h after delivery. A set of factors pertaining to maternal, pregnancy and obstetric, neonatal and breastfeeding were selected from the combined data set. RESULTS In total, 10.2% (1244 of 12,198) of women reported with the symptoms of PPD (EPDS ≥10). Through logistic regression analysis, eight predictors of PPD were identified. Specifically, PPD was shown to be associated with educational level of high school or lower (odds ratio (OR) = 1.57, 95% confidence interval (CI) 1.27-1.93), marital status of unmarried (OR = 1.52, 95% CI 1.18-1.99), unemployed (OR = 1.26, 95% CI 1.11-1.42), Cesarean section (OR = 1.7, 95% CI 1.5-1.93), unplanned pregnancy (OR = 1.38, 95% CI = 1.22-1.57), gestational age at 24-36 weeks (OR = 1.3, 95% CI 1.08-1.56), non-intention of breastfeeding (OR = 1.7, 95% CI 1.18-2.45) and Apgar at 5 min < 7 (OR = 2.18, 95% CI 1.11-4.29). CONCLUSION Low educational level, unmarried, unemployed, Caesarean section, unplanned pregnancy, preterm delivery, not breastfeeding and low Apgar at 5 min are predictors for postpartum women to develop PPD. These predictors are easily recognized in the clinical environment for patient guidance, support and referral as early as possible to ensure the health and well-being of the mothers and the neonates.
Collapse
Affiliation(s)
- Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, No. 168, University Rd., Dacun, Changhua, 515006, Taiwan; Mackay Memorial Hospital, Taipei City, Taiwan; Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| | - Li-Yun Tsai
- College of Nursing, Central Taiwan University of Science and Technology, No. 666, Buzih Rd., Beitun Dist., Taichung, 406053, Taiwan.
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Dayeh University, No. 168, University Rd., Dacun, Changhua, 515006, Taiwan.
| | - Yi-Heng Chen
- Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| |
Collapse
|
48
|
Poo ZX, Quah PL, Chen H, Wright A, Teoh TG, Tan LK, Tan KH. Knowledge, Attitude and Perceptions Around Perinatal Mental Health Among Doctors in an Obstetrics and Gynaecology Academic Department in Singapore. Cureus 2023; 15:e38906. [PMID: 37303430 PMCID: PMC10257555 DOI: 10.7759/cureus.38906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
Background Frontline healthcare professionals who provide regular care to women in the antenatal and postnatal period play a critical role in the early detection and management of maternal perinatal mental health (PMH). This study aimed to assess the knowledge, attitudes, and perceptions of doctors around perinatal mental health in an obstetrics and gynaecology (O&G) department in Singapore. Methods Using an online survey, data was collected from 55 doctors who participated in the Doctor's Knowledge, Attitudes and Perceptions of Perinatal Mental Health (I-DOC) study. The survey questions assessed the knowledge, attitudes, perceptions and practices in relation to PMH among doctors in the O&G specialty. Descriptive data was presented as means and standard deviations (SDs), or frequency and percentages. Results Out of the 55 doctors, more than half (60.0%) were not aware of the adverse impacts of poor PMH; 83.7% of doctors were not confident in providing PMH advice and 65.5% did not routinely screen patients for PMH disorders. There was a lower percentage of doctors (10.9% vs. 34.5%, p<0.001) who discussed PMH issues in the antenatal period compared to the postnatal period and this was statistically significant. Majority of doctors (98.2%) agreed that having standardised PMH guidelines will be useful. All doctors agreed on the benefits of having PMH guidelines, education and routine screening for patients. Conclusion There is inadequate PMH literacy among O&G doctors and lack of emphasis on antenatal PMH disorder. The findings highlighted the need for increased education and development of perinatal mental health guidelines.
Collapse
Affiliation(s)
- Zi Xi Poo
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Phai Ling Quah
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, SGP
| | - Ann Wright
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Tiong Ghee Teoh
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Lay Kok Tan
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| |
Collapse
|
49
|
The impact of the 2015 ACOG screening guidelines on the diagnosis of postpartum depression among privately insured women. J Affect Disord 2023; 328:103-107. [PMID: 36764363 DOI: 10.1016/j.jad.2023.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 01/25/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Postpartum depression (PPD), is underdiagnosed and undertreated. In 2015, the American College of Obstetricians and Gynecologists (ACOG) recommended that women be screened for PPD at least once during the perinatal period. The effect of the recommendation on PPD diagnosis is unknown. METHODS Using the MerativeTM MarketScan® database, PPD prevalence was identified in privately insured women ages 13-45 with a live birth between 2013 and 2016. Postpartum depression was defined as an ICD diagnosis code for PPD or other depression, or a new pharmacy claim for an antidepressant medication during the first 12 months following delivery. Multivariable logistic regression was used to estimate the likelihood of PPD both before and after the ACOG PPD Committee Opinion. RESULTS The study included 244,624 women ages 13-45 who had a live birth in 2013 through 2016. PPD prevalence before and after the 2015 ACOG Committee Opinion was 15.1 % and 17.2 %, respectively. The likelihood of PPD was not statistically different following the 2015 Committee Opinion (adjusted OR, 1.00, 95 % CI, 0.97-1.03) when controlling for age, year, delivery complications, and geographic region. LIMITATIONS Sociodemographic variables are not included in the MarketScan database and therefore could not be analyzed as covariates. Re-defining a PPD diagnosis as above interfered with the ability to measure a prior history of mood disorders as a covariate. CONCLUSION Implementation of the ACOG recommendations was not associated with a significant increase in PPD diagnosis. This suggests that physician organization recommendations alone are not sufficient to increase detection of PPD.
Collapse
|
50
|
Fukuzawa RK, Park CG. Role of Intrapartum Social Support in Preventing Postpartum Depression. J Perinat Educ 2023; 32:104-115. [PMID: 37415935 PMCID: PMC10321456 DOI: 10.1891/jpe-2022-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
A cross-sectional, multicenter study examined the role of intrapartum social support (SS) on postpartum depression (PPD), using survey data that covered eight of the 25 PPD risk factors identified by a recent umbrella review. A total of 204 women participated at an average of 1.26 months after birth. An existing U.S. Listening to Mothers-II/Postpartum survey questionnaire was translated, culturally adapted, and validated. Multiple linear regression found four statistically significant independent variables. A path analysis determined that prenatal depression, pregnancy and childbirth complications, intrapartum SS from healthcare providers and partners, and postpartum SS from husbands and others were significant predictors of PPD, while intrapartum and postpartum SS were intercorrelated. In conclusion, intrapartum companionship is as important as postpartum SS in preventing PPD.
Collapse
Affiliation(s)
- Rieko Kishi Fukuzawa
- Correspondence regarding this article should be directed to Rieko Kishi Fukuzawa. E-mail:
| | | |
Collapse
|