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Bright KS, Stuart S, Mcneil DA, Murray L, Kingston DE. Feasibility and Acceptability of Internet-based Interpersonal Psychotherapy for Stress, Anxiety, and Depression in Prenatal Women: Thematic Analysis Abstract (Preprint). JMIR Form Res 2022; 6:e23879. [PMID: 35687403 PMCID: PMC9233251 DOI: 10.2196/23879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/30/2022] [Accepted: 05/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Prenatal mental health is a global health concern. Despite the far-reaching impact of prenatal mental health issues, many women do not receive the psychological care they require. Women in their childbearing years are frequent users of the internet and smartphone apps. Prenatal women are prime candidates for internet-based support for mental health care. Objective This study aimed to examine the feasibility and acceptability of internet-based interpersonal psychotherapy (IPT) for prenatal women. Methods Semistructured interviews were conducted with women who had received internet-based IPT modules with guided support as a component of a randomized controlled trial evaluating the scale-up implementation of a digital mental health platform (The Healthy Outcomes of Pregnancy and Postpartum Experiences digital platform) for pregnant women. Qualitative thematic analysis was used to explore and describe women’s experiences. Data were analyzed for emerging themes, which were identified and coded. Results A total of 15 prenatal women were interviewed to examine their experiences and views on the feasibility and acceptability of internet-based IPT modules. Participants found the content informative and appreciated the ways in which the digital mental health platform made the IPT modules accessible to users. Participants voiced some differing requirements regarding the depth and the way information was presented and accessed on the digital mental health platform. The important areas for improvement that were identified were acknowledging greater depth and clarity of content, the need for sociability and relationships, and refinement of the digital mental health platform to a smartphone app. Conclusions This study provides useful evidence regarding treatment format and content preferences, which may inform future development. It also provides research data on the feasibility and acceptability of web-based applications for prenatal mental health care. Trial Registration ClinicalTrials.gov NCT01901796; https://clinicaltrials.gov/ct2/show/NCT01901796
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Affiliation(s)
- Katherine S Bright
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Women's Mental Health Clinic, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Scott Stuart
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Deborah A Mcneil
- Maternal Newborn Child & Youth Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
| | - Lindsay Murray
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Dawn E Kingston
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
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Social support mediates the influence of cerebellum functional connectivity strength on postpartum depression and postpartum depression with anxiety. Transl Psychiatry 2022; 12:54. [PMID: 35136017 PMCID: PMC8826948 DOI: 10.1038/s41398-022-01781-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 02/05/2023] Open
Abstract
Post-Partum Depression (PPD) is the most common health issue impacting emotional well being in women and is often comorbid with anxiety (PPD-A). Previous studies have shown that adequate social support can protect against PPD and PPD-A. However, how the brain connectome is disrupted in PPD and PPD-A and the neural basis underlying the role of social support in PPD and PPD-A remains unclear. The present study aims to explore these issues in patients with PPD and PPD-A. Well-established questionnaires and resting-state functional Magnetic Resonance Imaging (rsfMRI) were performed in 45 PPD, 31 PDD-A patients and 62 Healthy Postnatal Women (HPW). Brain functional integration was measured by analysis of Functional Connectivity Strength (FCS). Association and mediation analyses were performed to investigate relationships between FCS, PPD and PPD-A symptoms and social support. PPD patients showed specifically higher FCS in right parahippocampus, whereas PPD-A patients showed specifically higher FCS in left ventrolateral prefrontal cortex. In all postpartum women, depression symptoms positively correlated with FCS in left paracentral lobule; depression and anxiety symptoms were negatively correlated with FCS in right cerebellem posterior lobe (CPL), a brain region implicated in supporting social cognition and regulation of emotion. Subsequent mediation analysis revealed that perceived social support mediated the association between right CPL FCS and PPD and PPD-A symptoms. Measurement of FCS in disorder-specific neural circuits offers a potential biomarker to study and measure the efficacy of social support for PPD and PPD-A.
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Genova F, Neri E, Trombini E, Stella M, Agostini F. Severity of preterm birth and perinatal depressive symptoms in mothers and fathers: Trajectories over the first postpartum year. J Affect Disord 2022; 298:182-189. [PMID: 34728282 DOI: 10.1016/j.jad.2021.10.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/12/2021] [Accepted: 10/23/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Preterm birth has been recognized as a risk factor for perinatal depression (PND), with consequences for parenting and child development; however, the impact of severity of prematurity on parental PND course has not been studied extensively. Exploring the PND trajectory across postpartum period, investigating whether it changed according to birth weight and parental role, can help developing effective interventions. METHODS At 3 (T1), 9 (T2) and 12 (T3) months postpartum, the Edinburgh Postnatal Depression Scale (EPDS) was administered to 177 parental couples, differentiated in 38 parents of extremely low birth weight (ELBW), 56 of very low birth weight (VLBW) and 83 of full-term (FT) infants. Trajectories were modeled by Growth Curve Models. RESULTS As a function of time, results revealed a general decrease in PND across the year. Considering birth weight, ELBW parents showed higher PND levels at T1 and a higher reduction of symptoms over time than VLBW and FT ones. Given also parental role, ELBW mothers showed higher PND levels at T1 and a higher decrease of symptoms over time than VLBW and FT mothers and fathers. LIMITATIONS Limitations included modest sample size, self-report measures, and unmeasured potential confounders. CONCLUSION Findings suggest that premature birth in relation to its severity may lead to different affective reactions in mothers and fathers; particularly mothers, in case of more serious preterm condition, are at higher risk for PND in the first trimester, however showing improvement over time. Interventions should be promoted, and tailored, according to the risk connected to severity of prematurity.
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Affiliation(s)
- Federica Genova
- Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy.
| | - Erica Neri
- Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy
| | - Elena Trombini
- Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy
| | - Marcello Stella
- Paediatric and Neonatal Intensive Care Unit, Maurizio Bufalini Hospital, Cesena, Italy
| | - Francesca Agostini
- Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy
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Li S, Wang L, Wang W, Hou S, Xie C, Zeng M, Xian J, Cai Z, Zhao Y. Comparison of sleep quality among puerperal women before and during the COVID-19 pandemic: a cross-sectional survey in Lanzhou, China. Sleep Breath 2022; 26:1829-1836. [PMID: 35059980 PMCID: PMC8776371 DOI: 10.1007/s11325-021-02553-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/10/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
Purpose Methods Results Conclusions
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Affiliation(s)
- Shengping Li
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Lianlian Wang
- The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenling Wang
- Perinatology Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China
| | - Shengzhe Hou
- The Second Clinical College, Chongqing Medical University, Chongqing, China
| | - Changxiao Xie
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Mao Zeng
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Jinli Xian
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Zhengjie Cai
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, Chongqing, China.
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Hicks LM, Ou C, Charlebois J, Tarasoff L, Pawluski J, Roos LE, Hooykaas A, Fairbrother N, Carter M, Tomfohr-Madsen L. Assessment of Canadian perinatal mental health services from the provider perspective: Where can we improve? Front Psychiatry 2022; 13:929496. [PMID: 36213903 PMCID: PMC9537741 DOI: 10.3389/fpsyt.2022.929496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Perinatal mental health disorders are common, and rates have increased during the COVID-19 pandemic. It is unclear where providers may improve perinatal mental health care, particularly in countries lacking national guidelines, such as Canada. METHODS A cross-sectional survey of perinatal health providers was conducted to describe the landscape of perinatal mental health knowledge, screening, and treatment practices across Canada. Providers were recruited through listservs, social media, and snowball sampling. Participants completed an online survey that assessed their perinatal mental health training, service provision types, their patient wait times, and treatment barriers, and COVID-19 pandemic-related impacts. RESULTS A total of 435 providers completed the survey, including physicians, midwives, psychologists, social workers, nurses, and allied non-mental health professionals. Most (87.0%) did not have workplace mandated screening for perinatal mental illness but a third (66%) use a validated screening tool. Many (42%) providers stated their patients needed to wait more than 2 months for services. More than half (57.3%) reported they did not receive or were unsure if they received specialized training in perinatal mental health. Most (87.0%) indicated there were cultural, linguistic, and financial barriers to accessing services. Over two-thirds (69.0%) reported the COVID-19 pandemic reduced access to services. CONCLUSION Survey findings reveal significant gaps in training, screening tool use, and timely and culturally safe treatment of perinatal mental health concerns. There is critical need for coordinated and nationally mandated perinatal mental health services in Canada to improve care for pregnant and postpartum people.
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Affiliation(s)
- Laurel M Hicks
- Renée Crown Wellness Institute, University of Colorado Boulder, Boulder, CO, United States
| | - Christine Ou
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | | | - Lesley Tarasoff
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Jodi Pawluski
- IRSET - Institut de Recherche en Santé, Environnement et Travail, University of Rennes 1, Rennes, France
| | - Leslie E Roos
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Amanda Hooykaas
- College of Social and Applied Social Sciences, University of Guelph, Guelph, ON, Canada
| | | | - Michelle Carter
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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Hernandez-Castro I, Toledo-Corral CM, Chavez T, Habre R, Grubbs B, Al-Marayati L, Lerner D, Lurvey N, Lagomasino I, Eckel SP, Dunton GF, Farzan SF, Breton CV, Bastain TM. Perceived vulnerability to immigration policies among postpartum Hispanic/Latina women in the MADRES pregnancy cohort before and during the COVID-19 pandemic. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221125103. [PMID: 36148937 PMCID: PMC9511002 DOI: 10.1177/17455057221125103] [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] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/22/2022] [Accepted: 08/16/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION AND OBJECTIVES Research suggests that perceived immigration policy vulnerability has important health implications. Coupled with the mental and physical stressors accompanying the postpartum period and a growing awareness of the discrimination and structural racism experienced by marginalized communities globally, the coronavirus disease 2019 period may have exacerbated stress among vulnerable populations, specifically postpartum Hispanic/Latina women. This study evaluated perceived immigration policy vulnerability (i.e. discrimination, social isolation, and family threats) in early postpartum Hispanic/Latina women in Los Angeles before and during the coronavirus disease 2019 pandemic. METHODS The Perceived Immigration Policy Effects Scale (PIPES) was administered cross-sectionally at 1 month postpartum to 187 Hispanic/Latina women in the MADRES cohort. Respondents between September 2018 and March 2020 were classified as "pre-pandemic" (N = 128), between March 2020 and July 2020 as "early pandemic" (N = 38), and between August 2020 and November 2021 as "later pandemic" (N = 21). Average PIPES subscale scores were dichotomized into "higher" and "lower" groups (⩽median, >median) and logistic regression models were performed. RESULTS Approximately half of participants had incomes of <$50,000 (50.3%) and were Latin American born (54.6%). After adjusting for age, nativity, education, income, postpartum distress, and employment status, early pandemic respondents had 5.05 times the odds of a higher score on the perceived discrimination subscale (95% CI: 1.81, 14.11), 6.47 times the odds of a higher score on the social isolation subscale (95% CI: 2.23, 18.74), 2.66 times the odds of a higher score on the family threats subscale (95% CI: 0.97, 7.32), and 3.36 times the odds of a higher total score (95% CI: 1.19, 9.51) when compared to pre-pandemic respondents. There were no significant subscale score differences between later pandemic and pre-pandemic periods. CONCLUSION Higher perceived immigration policy vulnerability was reported among postpartum women during the early coronavirus disease 2019 pandemic versus pre-pandemic periods. This suggests greater social inequities during the early pandemic period.
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Affiliation(s)
- Ixel Hernandez-Castro
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia M Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Health Sciences, California State University Northridge, Northridge, CA, USA
| | - Thomas Chavez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendan Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Isabel Lagomasino
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Pebryatie E, Paek SC, Sherer P, Meemon N. Associations Between Spousal Relationship, Husband Involvement, and Postpartum Depression Among Postpartum Mothers in West Java, Indonesia. J Prim Care Community Health 2022; 13:21501319221088355. [PMID: 35343810 PMCID: PMC8966113 DOI: 10.1177/21501319221088355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Indonesia is actively promoting husband involvement in maternal health care, since it has been claimed to impact the wellbeing of mothers. This study aims to investigate the extent to which spousal relationship, husband involvement, and maternal health behavior affect postpartum depression among Indonesian mothers. METHOD A survey was carried out among 336 postpartum mothers who received maternal care in 27 independent midwifery clinics in 7 regions of West Java Province, Indonesia. The measurement model of husband involvement comprising 4 dimensions, namely maternity care engagement, instrumental support, emotional support, and informational support were developed and validated using confirmatory factor analysis. The Quality of Marriage Index (QMI) and the Edinburgh Postnatal Depression Scale (EPDS) were also validated and used to measure spousal relationship and postpartum depressive symptoms. A structural equation model was specified to examine the association between spousal relationship, husband involvement, maternal healthy behavior, and postpartum depression. RESULTS The study confirms the assumption that the quality of the spousal relationship could determine husband's involvement during pregnancy, childbirth, and postpartum (γ = .60, P < .001), eventually leading to better maternal healthy behavior (γ = .015, P < .001) and a decrease in postpartum depressive symptoms among mothers (γ = -.21, P < .001). CONCLUSIONS The study results suggest the needs to promote comprehensive husband involvement to enhance the wellbeing of mothers. This can be achieved through couple interventions at the community level and the inclusion of a supportive role for husbands in the maternal and childcare guidebook offered during ANC visits.
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Affiliation(s)
- Elit Pebryatie
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.,Poltekkes Kemenkes Tasikmalaya, Indonesia
| | - Seung Chun Paek
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Penchan Sherer
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Natthani Meemon
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
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Noorjahan N, Cattini PA. Neurogenesis in the Maternal Rodent Brain: Impacts of Gestation-Related Hormonal Regulation, Stress, and Obesity. Neuroendocrinology 2022; 112:702-722. [PMID: 34510034 DOI: 10.1159/000519415] [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: 01/04/2021] [Accepted: 09/02/2021] [Indexed: 11/19/2022]
Abstract
In order to maintain maternal behavior, it is important that the maternal rodent brain promotes neurogenesis. Maternal neurogenesis is altered by the dynamic shifts in reproductive hormone levels during pregnancy. Thus, lifestyle events such as gestational stress and obesity that can affect hormone production will affect neuroendocrine control of maternal neurogenesis. However, there is a lack of information about the regulation of maternal neurogenesis by placental hormones, which are key components of the reproductive hormonal profile during pregnancy. There is also little known about how maternal neurogenesis can be affected by health concerns such as gestational stress and obesity, and its relationship to peripartum mental health disorders. This review summarizes the changing levels of neurogenesis in mice and rats during gestation and postpartum as well as regulation of neurogenesis by pregnancy-related hormones. The influence of neurogenesis on maternal behavior is also discussed while bringing attention to the effect of health-related concerns during gestation, such as stress and obesity on neuroendocrine control of maternal neurogenesis. In doing so, this review identifies the gaps in the literature and specifically emphasizes the importance of further research on maternal brain physiology to address them.
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Affiliation(s)
- Noshin Noorjahan
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Peter A Cattini
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Shorey S, Tan TC, Mathews J, Yu CY, Lim SH, Shi L, Ng ED, Chan YH, Law E, Chee C, Chong YS. Development of a Supportive Parenting App to Improve Parent and Infant Outcomes in the Perinatal Period: Development Study. J Med Internet Res 2021; 23:e27033. [PMID: 36260376 PMCID: PMC8785955 DOI: 10.2196/27033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/05/2021] [Accepted: 11/10/2021] [Indexed: 02/06/2023] Open
Abstract
Background The transition to parenthood can be challenging, and parents are vulnerable to psychological disorders during the perinatal period. This may have adverse long-term consequences on a child’s development. Given the rise in technology and parents’ preferences for mobile health apps, a supportive mobile health intervention is optimal. However, there is a lack of a theoretical framework and technology-based perinatal educational intervention for couples with healthy infants. Objective The aim of this study is to describe the Supportive Parenting App (SPA) development procedure and highlight the challenges and lessons learned. Methods The SPA development procedure was guided by the information systems research framework, which emphasizes a nonlinear, iterative, and user-centered process involving 3 research cycles—the relevance cycle, design cycle, and rigor cycle. Treatment fidelity was ensured, and team cohesiveness was maintained using strategies from the Tuckman model of team development. Results In the relevance cycle, end-user requirements were identified through focus groups and interviews. In the rigor cycle, the user engagement pyramid and well-established theories (social cognitive theory proposed by Bandura and attachment theory proposed by Bowlby) were used to inform and justify the features of the artifact. In the design cycle, the admin portal was developed using Microsoft Visual Studio 2017, whereas the SPA, which ran on both iOS and Android, was developed using hybrid development tools. The SPA featured knowledge-based content, informational videos and audio clips, a discussion forum, chat groups, and a frequently asked questions and expert advice section. The intervention underwent iterative testing by a small group of new parents and research team members. Qualitative feedback was obtained for further app enhancements before official implementation. Testing revealed user and technological issues, such as web browser and app incompatibility, a lack of notifications for both administrators and users, and limited search engine capability. Conclusions The information systems research framework documented the technical details of the SPA but did not take into consideration the interpersonal and real-life challenges. Ineffective communication between the health care research team and the app developers, limited resources, and the COVID-19 pandemic were the main challenges faced during content development. Quick adaptability, team cohesion, and hindsight budgeting are crucial for intervention development. Although the effectiveness of the SPA in improving parental and infant outcomes is currently unknown, this detailed intervention development study highlights the key aspects that need to be considered for future app development.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Thiam Chye Tan
- Mount Elizabeth Novena Specialist Centre, Singapore, Singapore
| | - Jancy Mathews
- National University Polyclinics, Singapore, Singapore
| | | | | | - Luming Shi
- Singapore Clinical Research Institute, Singapore, Singapore
| | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Evelyn Law
- National University Hospital, Singapore, Singapore
| | | | - Yap Seng Chong
- National University Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Predictors of postpartum depression among Chinese mothers and fathers in the early postnatal period: A cross-sectional study. Midwifery 2021; 105:103233. [PMID: 34968820 DOI: 10.1016/j.midw.2021.103233] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/02/2021] [Accepted: 12/18/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Postpartum depression is a serious mental health problem in early parenthood. The prevalence of postpartum depression is currently increasing. However, no studies have yet examined and compared maternal and paternal psychological health during the early postpartum period. The objectives of this study were therefore to explore the prevalence of postpartum depression and identify its predictors among Chinese mothers and fathers in the early postpartum period. DESIGN A cross-sectional study was conducted from September 24, 2020 to April 7, 2021 in Guangzhou, China. SETTING A regional teaching hospital in Guangzhou, China, with approximately 3000 births per year. PARTICIPANTS Four hundred and fifty-four married couples in the 2, 3 days postpartum period following a singleton, full-term birth. MEASUREMENTS AND FINDINGS Participants completed the Edinburgh Postnatal Depression Scale, Parenting Satisfaction Subscale and Parenting Efficacy Subscale, Social Support Rating Scale, and the demographic and obstetric datasheet. The prevalence of depressive symptoms (Edinburgh Postnatal Depression Scale score ≥ 13) was 13.0% and 7.5% in mothers and fathers, respectively, in the early postpartum period. The predictors of maternal depression were maternal parenting satisfaction, paternal depression, maternal social support and maternal relationship with mother-in-law (adjusted R2= 0.34, F = 58.40, df = [4, 449], P < 0.001). While the predictors of paternal depression were paternal parenting satisfaction and self-efficacy, maternal depression and whether the pregnancy was planned (adjusted R2= 0.28, F = 44.85, df = [4, 449], P < 0.001). KEY CONCLUSIONS Maternal and paternal depression were positively correlated and were predictive factors for one another. IMPLICATIONS FOR PRACTICE Healthcare professionals should screen both mothers and fathers for depression in the early postpartum period and provide targeted support during time in hospital following birth. In addition, the focus of future interventions should be on both parents rather than just mothers.
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Abdollahi F, Lye MS, Yazdani Cherati J, Zarghami M. Depressive symptoms in men immediately after birth. J Psychosom Res 2021; 151:110650. [PMID: 34739946 DOI: 10.1016/j.jpsychores.2021.110650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Depression is the second leading cause of morbidity worldwide. This study aimed to assess the prevalence and associated risk factors of paternal postpartum depressive symptoms (PPD). METHODS In a cross-sectional study, via a stratified random and convenience sampling method 591 couples who were referred to Mazandaran primary health centers between 2 and 8 weeks postpartum were recruited from March to October 2017. Couples were screened for depressive symptoms using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ-12) as well. Data was analyzed using multiple logistic regression. RESULTS Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age, maternal depressive symptoms, higher GHQ-12 scores and increased recent life events were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD. CONCLUSION Depressive symptoms especially in first-time fathers following the birth of a child are not uncommon. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease suffering of depression for both depressed parents are recommended.
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Affiliation(s)
- Fatemeh Abdollahi
- Department of Public Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran; Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Munn-Sann Lye
- Formerly, Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia
| | - Jamshid Yazdani Cherati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Science, Sari, Iran
| | - Mehran Zarghami
- Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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Ruybal AL, Siegel JT. Increasing social support for women with postpartum depression through attribution theory guided vignettes and video messages: The understudied role of effort. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2021. [DOI: 10.1016/j.jesp.2021.104197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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63
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Rizzo A, Bruno A, Torre G, Mento C, Pandolfo G, Cedro C, Laganà AS, Granese R, Zoccali RA, Muscatello MRA. Subthreshold psychiatric symptoms as potential predictors of postpartum depression. Health Care Women Int 2021; 43:129-141. [PMID: 34652261 DOI: 10.1080/07399332.2021.1963730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The authors' purpose in the present study is to examine the role of subthreshold mental disorders as predictors of Postpartum Depression (PPD). 110 pregnancy women were evaluated as follow: the General 5-Spectrum Measure at 26 weeks of gestation; the Edinburgh Postnatal Depression Scale at 3/6 months after delivery. Only 4.5% of the sample developed PPD at 3/6 months after delivery. Agoraphobia/panic, depressed mood, social anxiety and eating problems relate positively to PPD at 3/6 months. Early identification of symptoms that could indicate the development of future mood problems in the mother is of crucial importance for mental health and prevention.
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Affiliation(s)
- Amelia Rizzo
- Psychiatry Unit, Hospital University of Messina, Messina, Italy
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Giovanna Torre
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Carmela Mento
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Gianluca Pandolfo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Clemente Cedro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Roberta Granese
- Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood "G. Barresi", University Hospital "G. Martino", Messina, Italy
| | - Rocco Antonio Zoccali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Darling EV, Byatt N, Maher EL, Gray TD, Simas TAM, Cordova JV. The Before Baby Relationship Checkup: A Couples-Based Intervention to Reduce Relationship Risk Factors for Perinatal Mood and Anxiety Disorders. J Clin Psychol Med Settings 2021; 29:295-309. [PMID: 34617155 DOI: 10.1007/s10880-021-09819-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 11/27/2022]
Abstract
Relationship conflict and lack of partner support are risk factors for perinatal mood and anxiety disorders. An intervention to strengthen couples' relationships before birth may reduce relationship risk factors for perinatal mood and anxiety disorders, though no research has explored this to date. The aims of this Stage 1 open-series non-experimental proof of concept study were to adapt the 'Marriage Checkup', an evidence-based intervention for relationship distress, as a preventative intervention for perinatal mood and anxiety disorders and to assess its feasibility and acceptability. Pregnant women receiving care at a university-based obstetric practice, and their partners, were recruited. Ten couples participated in the Before Baby Relationship Checkup, a personalized relationship health service offered in the obstetric clinic. Quantitative and qualitative data gathered suggests the intervention is feasible to implement in an obstetric setting, and acceptable to perinatal couples. Specific adaptations to the Marriage Checkup for perinatal couples are warranted and further testing is needed to evaluate efficacy.
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Affiliation(s)
- Ellen V Darling
- Department of Psychology, Clark University, Worcester, MA, USA.
| | - Nancy Byatt
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Emily L Maher
- Department of Psychology, Clark University, Worcester, MA, USA
| | - Tatiana D Gray
- Department of Psychology, Clark University, Worcester, MA, USA
| | - Tiffany A Moore Simas
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA
| | - James V Cordova
- Department of Psychology, Clark University, Worcester, MA, USA
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65
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Socioeconomic and racial/ethnic disparities in postpartum consultation for mental health concerns among US mothers. Arch Womens Ment Health 2021; 24:781-791. [PMID: 33855652 DOI: 10.1007/s00737-021-01132-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 04/07/2021] [Indexed: 11/27/2022]
Abstract
Limited research has examined factors that impact access to postpartum mental healthcare. We investigated the predisposing, enabling, and need factors associated with postpartum consultation for mental health concerns in US mothers with or without depressive symptoms and examined potential disparities in access. We utilized cross-sectional data from the Listening to Mothers II Survey, the second national US survey of women's childbearing experiences. The survey recruited 1573 women, aged 18-45 years, who spoke English and had given birth. Depressive symptoms were measured with the Postpartum Depression Screening Scale (PDSS-SF). The dependent variable was postpartum consultation for mental health concerns. Logistic regression analyses showed that mothers with scores of 14-21 and 22-35 on the PDSS-SF had higher odds of consulting a provider for mental health concerns (OR 3.97; OR 12.91). Latinas had lower odds of seeking mental health consultations than Whites (OR 0.39). Mothers who were employed prenatally full-time or part-time had lower odds of seeking consultations than non-employed mothers (OR 0.62; OR 0.52). Mothers with household incomes of $50,000-$74,999 had higher odds of seeking consultations than those with incomes less than $25,000 (OR 2.20). When regression analyses were restricted to mothers with PDSS-SF scores ≥ 14, findings were similar by race/ethnicity and prenatal employment. Significant depressive symptoms are common in women after giving birth and few sought any form of mental health consultation. Latinas and low-income women are less likely to seek postpartum mental health consultations. Mental health care interventions could be geared towards targeting these at-risk groups.
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Dagla M, Dagla C, Mrvoljak-Theodoropoulou I, Sotiropoulou D, Kavakou AT, Kontiza E, Antoniou E. Do Maternal Stress and Depressive Symptoms in Perinatal Period Predict the Lactation Mastitis Occurrence? A Retrospective Longitudinal Study in Greek Women. Diagnostics (Basel) 2021; 11:diagnostics11091524. [PMID: 34573866 PMCID: PMC8469520 DOI: 10.3390/diagnostics11091524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/21/2021] [Accepted: 08/23/2021] [Indexed: 12/14/2022] Open
Abstract
Background: The aim of this study is to investigate whether symptoms of anxiety and depression disorders in women during the perinatal period predict the occurrence of lactation mastitis. Methods: This is a retrospective longitudinal study of 622 Greek women who were monitored from pregnancy until the first year postpartum (during the period January 2015–May 2018). The Edinburgh Postnatal Depression Scale (EPDS) and the Perinatal Anxiety Screening Scale (PASS) were administered at four time points: (a) 24th–28th gestation week, (b) 34th–38th gestation week, (c) 6 weeks postpartum, and (d) 12 months postpartum. Multivariate binary logistic regression analyses were performed. Results: Results showed that (a) increased EPDS (p < 0.02) and PASS (p < 0.05) scores during the last period before birth, (b) increased EPDS score at 6 weeks postpartum (p < 0.02), (c) PMS symptoms (p < 0.03), (d) traumatic life events during the last year (p < 0.03), and (e) the existence of a history of psychotherapy (before pregnancy) (p = 0.050) appear to be the psycho-emotional factors that can predict the possible occurrence of lactation mastitis in a breastfeeding mother. Conclusions: The association between women’s poor mental health and the occurrence of a physical health problem, such as lactation mastitis, is recognized. This study highlights the important role of early and timely detection of perinatal mental health disorders.
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Affiliation(s)
- Maria Dagla
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (C.D.); (I.M.-T.); (D.S.); (A.-T.K.); (E.K.); (E.A.)
- Department of Midwifery, University of West Attica, 12243 Athens, Greece
- Correspondence: ; Tel.: +30-210-932-4415
| | - Calliope Dagla
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (C.D.); (I.M.-T.); (D.S.); (A.-T.K.); (E.K.); (E.A.)
| | - Irina Mrvoljak-Theodoropoulou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (C.D.); (I.M.-T.); (D.S.); (A.-T.K.); (E.K.); (E.A.)
| | - Dimitra Sotiropoulou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (C.D.); (I.M.-T.); (D.S.); (A.-T.K.); (E.K.); (E.A.)
| | - Aikaterini-Taxiarchoula Kavakou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (C.D.); (I.M.-T.); (D.S.); (A.-T.K.); (E.K.); (E.A.)
| | - Eleni Kontiza
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (C.D.); (I.M.-T.); (D.S.); (A.-T.K.); (E.K.); (E.A.)
| | - Evangelia Antoniou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (C.D.); (I.M.-T.); (D.S.); (A.-T.K.); (E.K.); (E.A.)
- Department of Midwifery, University of West Attica, 12243 Athens, Greece
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Branquinho M, Rodriguez-Muñoz MDLF, Maia BR, Marques M, Matos M, Osma J, Moreno-Peral P, Conejo-Cerón S, Fonseca A, Vousoura E. Effectiveness of psychological interventions in the treatment of perinatal depression: A systematic review of systematic reviews and meta-analyses. J Affect Disord 2021; 291:294-306. [PMID: 34062397 DOI: 10.1016/j.jad.2021.05.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Perinatal depression is a high prevalent mental health problem with serious consequences. Evidence about effective psychological interventions in treating perinatal depression has been increasing, but it lacks a comprehensive synthesis of findings. METHODS A systematic review of systematic reviews and meta-analyses concerning the effectiveness of psychological interventions in treating perinatal depression (depression during pregnancy and the first 12 months postpartum) in adult women was conducted. The electronic databases MEDLINE (PubMed), PsycINFO, The Cochrane Library, Web of Science and Prospero were searched, on May 2020, using a combination of keywords. Data were independently extracted by two authors and a synthesis of the results was presented. Methodological quality was independently assessed by two authors, using AMSTAR-2. RESULTS Seven systematic reviews were included and reported, overall, the effectiveness of psychological interventions in decreasing depressive symptoms in women in the perinatal period, both short and long-term. CBT was found to be the most effective intervention, regardless of the treatment format. LIMITATIONS Grey literature was not searched, and some studies may overlap among the included systematic reviews. These (the included reviews) were rated with low methodological quality, which weakens the evidence of the reported results. CONCLUSIONS CBT is currently the most evidence-based psychological intervention, provided in different delivery formats (individual, group, face-to-face or Internet-based). Further studies, including systematic reviews, with other types of psychological interventions (e.g., third-wave CBT) and with higher quality are needed.
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Affiliation(s)
- Mariana Branquinho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal
| | | | - Berta Rodrigues Maia
- Universidade Católica Portuguesa, Faculty of Philosophy and Social Sciences, Centre for Philosophical and Humanistic Studies, Portugal
| | - Mariana Marques
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal; Coimbra Hospital and Universitary Centre (CHUC), Portugal; Institute of Psychological Medicine (IPM), Coimbra, Portugal
| | - Marcela Matos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Jorge Osma
- Universidad de Zaragoza and Instituto de Investigación Sanitaria de Aragón, Spain
| | | | | | - Ana Fonseca
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Eleni Vousoura
- Department of Psychiatry, Eginition Hospital, University of Athens, Greece
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Walker AL, de Rooij SR, Dimitrova MV, Witteveen AB, Verhoeven CJ, de Jonge A, Vrijkotte TGM, Henrichs J. Psychosocial and peripartum determinants of postpartum depression: Findings from a prospective population-based cohort. The ABCD study. Compr Psychiatry 2021; 108:152239. [PMID: 33905988 DOI: 10.1016/j.comppsych.2021.152239] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/07/2021] [Accepted: 03/13/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Postpartum depression is prevalent and concerns a serious health problem for women and their families. The current large-scale birth cohort study investigated: (1) the associations of various potential determinants of postpartum depression using a multidimensional approach, and (2) the individual contribution of obstetric and perinatal determinants and pregnancy-specific anxiety to the risk of postpartum depression. METHODS This study was based on a large-scale birth cohort study in Amsterdam, the Netherlands (ABCD-study). In 5109 women depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (cut-off ≥16 indicating high risk of postpartum depression). Determinants were assessed using self-report or perinatal registries. RESULTS In the final multivariable model, other-Western and non-Western ethnic background, increased antepartum depressive symptoms, increased antepartum anxiety, increased pregnancy-specific anxiety, being unemployed, poor sleep quality, unwanted pregnancy, abuse, multiparity, and congenital abnormality were all independently related to an increased risk of postpartum depression. The strongest risk factors for postpartum depression were antepartum depressive symptoms (adjusted odds ratio (AOR) = 3.86, 95% confidence interval (CI) 3.02-4.92), having a baby with a congenital abnormality (AOR = 2.33, 95% CI 1.46-3.73), and abuse (AOR = 1.95, 95% CI 1.02-3.73). The final model accounted for 24.5% of the variance. LIMITATIONS Our dataset did not provide information on social support or maternal and family history of depression. Next to these determinants, future research should include biological factors. CONCLUSIONS The determinants identified provide opportunities for the development of multidimensional early screening and early intervention strategies for women with an increased risk of postpartum depression.
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Affiliation(s)
- Annika L Walker
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands.
| | - Susanne R de Rooij
- Amsterdam University Medical Center, University of Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam University Medical Center, University of Amsterdam, Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Academic UMC, Meibergdreef 9, Amsterdam, Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
| | - Marta V Dimitrova
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Anke B Witteveen
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Corine J Verhoeven
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands; Department of Obstetrics and Gynecology, Maxima Medical Centre, Veldhoven, Netherlands; Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Ank de Jonge
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Tanja G M Vrijkotte
- Amsterdam University Medical Center, University of Amsterdam, Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Academic UMC, Meibergdreef 9, Amsterdam, Netherlands
| | - Jens Henrichs
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
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Ladyman C, Signal TL, Sweeney B, Jefferies M, Gander P, Paine SJ, Huthwaite M. Multiple dimensions of sleep are consistently associated with chronically elevated depressive symptoms from late pregnancy to 3 years postnatal in Indigenous and non-Indigenous New Zealand women. Aust N Z J Psychiatry 2021; 55:687-698. [PMID: 33176439 DOI: 10.1177/0004867420972762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Poor sleep and depressive symptoms are common throughout the perinatal period, but little is known about the extended time course of depression and the sleep dimensions associated with these trajectories. OBJECTIVE This study investigated different depression trajectories in New Zealand Māori and non-Māori women from late pregnancy to 3 years postnatal. Relationships between multiple dimensions of sleep and these depression trajectories were also investigated. METHODS Data from 856 women (30.6% Māori and 69.4% non-Māori) from the longitudinal Moe Kura cohort study were used. Depressive symptoms and multiple dimensions of sleep (quality, duration, latency, continuity and daytime sleepiness) were collected at 36 weeks' gestation, 12 weeks postnatal and 3 years postnatal. Trajectory analysis was completed using latent class analysis. RESULTS Latent class analysis revealed two distinct groups of depressive symptom trajectories: 'chronic high' and 'stable mild' for both Māori and non-Māori women. Māori women in both trajectories were more likely than non-Māori women to have clinically significant depressive symptoms at every time point. Poorer sleep quality, latency, continuity and greater daytime sleepiness were consistently associated with the chronic high depressive symptom trajectory at all three time points, after controlling for sociodemographic factors. CONCLUSION A significant proportion of Māori and non-Māori women experience chronically high depressive symptoms during the perinatal period and the following years. Across this extended time frame, Māori women have a higher probability of experiencing clinically significant depressive symptoms compared to non-Māori women. These persistent patterns of depressive symptoms occur concurrently with multiple dimensions of poor sleep. Given the well-described impact of maternal depression on the mother, child, family and community, this highlights the importance of healthcare professionals asking about mothers' sleep quality, continuity, latency and daytime sleepiness as potential indicators of long-term mood outcomes.
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Affiliation(s)
- Clare Ladyman
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - T Leigh Signal
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Bronwyn Sweeney
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Mona Jefferies
- Health Services Research Centre, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Philippa Gander
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Sarah-Jane Paine
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Mark Huthwaite
- Department of Psychological Medicine (Wellington), University of Otago, Wellington, New Zealand
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Schnakenberg P, Hahn L, Stickel S, Stickeler E, Habel U, Eickhoff SB, Chechko N, Dukart J. Examining early structural and functional brain alterations in postpartum depression through multimodal neuroimaging. Sci Rep 2021; 11:13551. [PMID: 34193913 PMCID: PMC8245412 DOI: 10.1038/s41598-021-92882-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/16/2021] [Indexed: 11/09/2022] Open
Abstract
Postpartum depression (PPD) affects approximately 1 in 10 women after childbirth. A thorough understanding of a preexisting vulnerability to PPD will likely aid the early detection and treatment of PPD. Using a within-sample association, the study examined whether the brain's structural and functional alterations predict the onset of depression. 157 euthymic postpartum women were subjected to a multimodal MRI scan within the first 6 days of childbirth and were followed up for 12 weeks. Based on a clinical interview 12 weeks postpartum, participants were classified as mentally healthy or having either PPD or adjustment disorder (AD). Voxel-based morphometry and resting-state functional connectivity comparisons were performed between the three groups. 13.4% of women in our study developed PPD (n = 21) and 12.1% (n = 19) adjustment disorder (AD). The risk factors for PPD were a psychiatric history and the experience and severity of baby blues and the history of premenstrual syndrome. Despite the different risk profiles, no differences between the PPD, AD and control group were apparent based on structural and functional neuroimaging data immediately after childbirth. At 12 weeks postpartum, a significant association was observed between Integrated Local Correlation (LCor) and the Edinburgh Postnatal Depression Score (EPDS). Our findings do not support the notion that the brain's structural and resting-state functional alterations, if present, can be used as an early biomarker of PPD or AD. However, effects may become apparent if continuous measures of symptom severity are chosen.
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Affiliation(s)
- Patricia Schnakenberg
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Aachen, Germany. .,Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany. .,Institute of Neuroscience and Medicine, JARA Institute Brain Structure Function Relationship (INM-10), Research Centre Jülich, Jülich, Germany.
| | - Lisa Hahn
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany.,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Susanne Stickel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine, JARA Institute Brain Structure Function Relationship (INM-10), Research Centre Jülich, Jülich, Germany
| | - Elmar Stickeler
- Department of Gynecology and Obstetrics, Medical Faculty, Uniklinik RWTH Aachen University, Aachen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine, JARA Institute Brain Structure Function Relationship (INM-10), Research Centre Jülich, Jülich, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany.,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Natalia Chechko
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany.,Institute of Neuroscience and Medicine, JARA Institute Brain Structure Function Relationship (INM-10), Research Centre Jülich, Jülich, Germany
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany.,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Ng KL, Buvanaswari P, Loh LWL, Chee CYI, Teng JY, Wang W, He HG. A descriptive qualitative study exploring the experiences of fathers with partners suffering from maternal perinatal depression. Midwifery 2021; 102:103075. [PMID: 34237515 DOI: 10.1016/j.midw.2021.103075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 04/12/2021] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The onset of maternal perinatal depression poses many challenges for fathers, yet in Singapore and Asia, the topic remains largely unexplored. This study aimed to gain insight into the experiences of fathers whose partners suffer from perinatal depression in the Asian milieu. DESIGN A descriptive qualitative study design was adopted. Purposive and snowball sampling methods were used to recruit participants. Semi-structured, face-to-face interviews were conducted individually with participants to collect data, which were analysed using thematic analysis. SETTING AND PARTICIPANTS Twelve fathers were recruited for the study. Eleven were from a perinatal mental health service in a tertiary hospital in Singapore, while 1 father was recruited via snowball sampling. FINDINGS Five themes describing the fathers' journey through their partners' perinatal depression emerged from the analysis. The themes are: (1) feeling their world collapse; (2) struggling with the depression; (3) enduring the emotional toll; (4) coping with the situation; and (5) emerging from the other side. KEY CONCLUSIONS The findings of this study highlighted the struggles, coping methods, and support needs of fathers whose partners suffer from perinatal depression. Fathers were often unable to identify perinatal depression in their partners. Notably, they testified to the need to tolerate verbal and sometimes violent outbursts from their partners, and requested for more available information, resources, and peer support groups. IMPLICATIONS FOR PRACTICE The findings underscore a need for pre-emptive education on maternal perinatal depression and more accessible resources. Healthcare professionals should assess fathers' emotional responses to parenthood and their partners' depression.
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Affiliation(s)
- Kai Lin Ng
- BSc(Nursing)(Honours) graduate, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore.
| | - P Buvanaswari
- National University Health System, Singapore; Department of Psychological Medicine, National University Hospital, Singapore.
| | | | - Cornelia Yin Ing Chee
- National University Health System, Singapore; Department of Psychological Medicine, National University Hospital, Singapore; Women's Emotional Health Service, National University Hospital, Singapore.
| | - Jia Ying Teng
- National University Health System, Singapore; Department of Psychological Medicine, National University Hospital, Singapore.
| | - Wenru Wang
- BSc(Nursing)(Honours) graduate, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore.
| | - Hong-Gu He
- BSc(Nursing)(Honours) graduate, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore.
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Bo HX, Yang Y, Chen J, Zhang M, Li Y, Zhang DY, Li Y, Li R, Cheung T, Ng CH, Wu XJ, Xiang YT. Prevalence of Depressive Symptoms Among Pregnant and Postpartum Women in China During the COVID-19 Pandemic. Psychosom Med 2021; 83:345-350. [PMID: 33337594 DOI: 10.1097/psy.0000000000000904] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE According to recent studies, the COVID-19 pandemic has been associated with an increased risk of mental health problems across many subpopulations including pregnant and postnatal women. This study examined the prevalence and correlates of depressive symptoms (depression hereafter) in Chinese pregnant and postpartum women during the COVID-19 pandemic. METHODS This was a multicenter, cross-sectional study comprising 1309 pregnant and postpartum women across 12 provinces in China during the COVID-19 pandemic. Depression was assessed using the nine-item Patient Health Questionnaire. Univariate analyses and multivariate logistic regression analyses were conducted. RESULTS The prevalence of depression in pregnant and postpartum women was 27.43% (95% confidence interval [CI] = 25.01%-29.85%). Women who were worried about themselves or their babies being infected with COVID-19 (odds ratio [OR] = 2.562, 95% CI = 1.670-3.929), and those who had delayed regular medical checkups (OR = 2.434, 95% CI = 1.580-3.750) were at higher risk of depression. Compared with those living in central and western parts of China, women living in northern (OR = 0.513, 95% CI = 0.326-0.807) and southeastern parts of China (OR = 0.626, 95% CI = 0.463-0.846) were less likely to have depression. CONCLUSIONS The COVID-19 pandemic was associated with an increased likelihood of mental health problems among pregnant and postnatal women. Over a quarter of the pregnant and postpartum women in China had depression during the COVID-19 pandemic. Considering the negative health impact of depression, preventive measures, regular mental health screening, and medical checkups are needed with the goal to reduce the risk of depression in this vulnerable population during a pandemic.
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Affiliation(s)
- Hai-Xin Bo
- From the Department of Nursing (Bo), Peking Union Medical College Hospital, Beijing; Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences (Yang, Xiang), University of Macau; Center for Cognition and Brain Sciences (Yang, Xiang), University of Macau, Macao SAR; Department of Psychiatry (Yang), Southern Medical University Nanfang Hospital, Guangdong; Department of Gynaecology and Obstetrics (Chen, M. Zhang, D.Y. Zhang, Y. Li, Y. Li, R. Li), Peking Union Medical College Hospital, Beijing; School of Nursing (Cheung), Hong Kong Polytechnic University, Hong Kong SAR, China; and Department of Psychiatry (Ng), The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
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73
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Hamwi S, Lorthe E, Barros H. Language Proficiency and Migrant-Native Disparities in Postpartum Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094782. [PMID: 33947149 PMCID: PMC8125143 DOI: 10.3390/ijerph18094782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 01/08/2023]
Abstract
Migrant women have a higher risk of developing postpartum depressive symptoms (PPDS) than do native women. This study aimed to investigate the role of host-country language proficiency in this disparity. We analysed the data of 1475 migrant and 1415 native women who gave birth at a Portuguese public hospital between 2017 and 2019 and were participants in the baMBINO cohort study. Migrants’ language proficiency was self-rated and comprised understanding, speaking, reading, and writing skills. PPDS were assessed using the Edinburgh Postnatal Depression Scale with a cut-off score of ≥10. Multivariable logistic regression models were fitted to estimate the association between language proficiency and PPDS. PPDS were experienced by 7.2% of native women and 12.4% among migrants (p < 0.001). Increasing proportions of PPDS were observed among decreasing Portuguese proficiency levels; 11% among full, 13% among intermediate, and 18% among limited proficiency women (ptrend < 0.001). Full (aOR 1.63 (95% CI 1.21–2.19)), intermediate (aOR 1.68 (95% CI 1.16–2.42)), and limited (aOR 2.55 (95% CI 1.64–3.99)) language proficiencies were associated with increasingly higher odds of PPDS among migrant women, compared to native proficiency. Prevention measures should target migrant women at high risk of PPDS, namely those with limited language skills, and promote awareness, early detection, and help-seeking, in addition to facilitating communication in their perinatal healthcare encounters.
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Affiliation(s)
- Sousan Hamwi
- EPIUnit–Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal;
- Correspondence: ; Tel.: +351-22-206-1820
| | - Elsa Lorthe
- Unit of Population Epidemiology, Department of Primary Care, Geneva University Hospitals, 1205 Geneva, Switzerland;
- Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Université de Paris, F-75004 Paris, France
| | - Henrique Barros
- EPIUnit–Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal;
- Departamento de Ciências de Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, 4200-450 Porto, Portugal
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Calthorpe LM, Baer RJ, Chambers BD, Steurer MA, Shannon MT, Oltman SP, Karvonen KL, Rogers EE, Rand LI, Jelliffe-Pawlowski LL, Pantell MS. The association between preterm birth and postpartum mental healthcare utilization among California birthing people. Am J Obstet Gynecol MFM 2021; 3:100380. [PMID: 33932629 DOI: 10.1016/j.ajogmf.2021.100380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND While mental health conditions such as postpartum depression are common, little is known about how mental healthcare utilization varies after term versus preterm delivery. OBJECTIVE This study aimed to determine whether preterm birth is associated with postpartum inpatient and emergency mental healthcare utilization. STUDY DESIGN The study sample was obtained from a database of live-born neonates delivered in California between the years of 2011 and 2017. The sample included all people giving birth to singleton infants between the gestational age of 20 and 44 weeks. Preterm birth was defined as <37 weeks' gestation. Emergency department visits and hospitalizations with a mental health diagnosis within 1 year after birth were identified using International Classification of Diseases codes. Logistic regression was used to compare relative risks of healthcare utilization among people giving birth to preterm infants vs term infants, adjusting for the following covariates: age, race or ethnicity, parity, previous preterm birth, body mass index, tobacco use, alcohol or drug use, hypertension, diabetes mellitus, adequacy of prenatal care, education, insurance payer, and the presence of a mental health diagnosis before birth. Results were then stratified by mental health diagnosis before birth to determine whether associations varied based on mental health history. RESULTS Of our sample of 3,067,069 births, 6.7% were preterm. In fully adjusted models, compared with people giving birth to term infants, people giving birth to preterm infants had a 1.5 times (relative risk; 95% confidence interval, 1.4-1.7) and 1.3 times (relative risk; 95% confidence interval, 1.2-1.4) increased risk of being hospitalized with a mental health diagnosis within 3 months and 1 year after delivery, respectively. People giving birth to preterm infants also had 1.4 times (95% confidence interval, 1.3-1.5) and 1.3 times (95% confidence interval, 1.2-1.4) increased risk of visiting the emergency department for a mental health diagnosis within 3 months and 1 year after birth, respectively. Stratifying by preexisting mental health diagnosis, preterm birth was associated with an elevated risk of mental healthcare utilization for people with and without a previous mental health diagnosis. CONCLUSION We found that preterm birth is an independent risk factor for postpartum mental healthcare utilization. Our findings suggest that screening for and providing mental health resources to birthing people after delivery are crucial, particularly among people giving birth to preterm infants, regardless of mental health history.
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Affiliation(s)
- Lucia M Calthorpe
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon).
| | - Rebecca J Baer
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
| | - Brittany D Chambers
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
| | - Martina A Steurer
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
| | - Maureen T Shannon
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
| | - Scott P Oltman
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
| | - Kayla L Karvonen
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
| | - Elizabeth E Rogers
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
| | - Larry I Rand
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
| | - Laura L Jelliffe-Pawlowski
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
| | - Matthew S Pantell
- University of California San Francisco School of Medicine, San Francisco, CA (Ms Calthorpe); California Preterm Birth Initiative (Ms Baer, Dr Chambers, Mr Oltman, and Drs Rand, Jelliffe-Pawlowski, and Pantell); Department of Epidemiology and Biostatistics (Drs Chambers and Steurer, Mr Oltman, and Dr Jelliffe-Pawlowski); Department of Pediatrics (Drs Steurer, Karvonen, Rogers, and Pantell); Department of Obstetrics, Gynecology, and Reproductive Sciences (Dr Rand), University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CA (Ms Baer); University of California San Francisco School of Nursing, San Francisco, CA (Dr Shannon)
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Eid K, Torkildsen ØF, Aarseth J, Flemmen HØ, Holmøy T, Lorentzen ÅR, Myhr KM, Riise T, Simonsen C, Torkildsen CF, Wergeland S, Willumsen JS, Øksendal N, Gilhus NE, Bjørk MH. Perinatal Depression and Anxiety in Women With Multiple Sclerosis: A Population-Based Cohort Study. Neurology 2021; 96:e2789-e2800. [PMID: 33883236 PMCID: PMC8205461 DOI: 10.1212/wnl.0000000000012062] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 03/11/2021] [Indexed: 12/04/2022] Open
Abstract
Objective To assess the occurrence of perinatal depression and anxiety in women before and after diagnosis of multiple sclerosis (MS). Methods A total of 114,629 pregnant women were included in the Norwegian Mother, Father and Child Cohort study (1999–2008). We assessed depression and anxiety by questionnaires during and after pregnancy. Women with MS were identified from national health registries and hospital records and grouped into (1) MS diagnosed before pregnancy (n = 140) or MS diagnosed after pregnancy with (2) symptom onset before pregnancy (n = 98) or (3) symptom onset after pregnancy (n = 308). Thirty-five women were diagnosed with MS in the postpartum period. The reference group (n = 111,627) consisted of women without MS. Results Women with MS diagnosed before pregnancy had an adjusted odds ratio of 2.0 (95% confidence interval, 1.2–3.1) for depression in the third trimester. Risk factors were adverse socioeconomic factors and history of psychiatric disease and physical/sexual abuse. The risk of anxiety was not increased. Women diagnosed with MS in the postpartum period had especially high risk of postpartum depression. Women with MS symptom onset within 5 years after pregnancy had increased risk of both depression and anxiety during pregnancy, whereas women with more than 5 years until symptom onset did not. Conclusion Women diagnosed with MS have increased risk of perinatal depression. Women with MS symptom onset within 5 years after pregnancy have increased risk of both depression and anxiety during pregnancy.
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Affiliation(s)
- Karine Eid
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway.
| | - Øivind Fredvik Torkildsen
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Aarseth
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Heidi Øyen Flemmen
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Trygve Holmøy
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Åslaug Rudjord Lorentzen
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjell-Morten Myhr
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Trond Riise
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Cecilia Simonsen
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Cecilie Fredvik Torkildsen
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Stig Wergeland
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Johannes Sverre Willumsen
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Nina Øksendal
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Nils Erik Gilhus
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Marte-Helene Bjørk
- From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway
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Ruohomäki A, Toffol E, Airaksinen V, Backman K, Voutilainen R, Hantunen S, Tuomainen TP, Lampi J, Kokki H, Luoma I, Kumpulainen K, Heinonen S, Keski-Nisula L, Pekkanen J, Pasanen M, Lehto SM. The impact of postpartum depressive symptoms on self-reported infant health and analgesic consumption at the age of 12 months: A prospective cohort study. J Psychiatr Res 2021; 136:388-397. [PMID: 33640540 DOI: 10.1016/j.jpsychires.2021.02.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/26/2022]
Abstract
The infants of mothers with elevated depressive symptoms (EDS) postpartum appear to be at increased risk of somatic health problems during their first 12 months of life in low- and lower-middle-income countries. However, in higher-income countries, knowledge of this association is scarce. We sought to examine whether maternal reports of infant health problems, adherence to vaccination schedules and analgesic supply to the infant during the first 12 months of life differ between mothers with and without postpartum EDS. Altogether, 969 women who were enrolled in the Kuopio Birth Cohort study (www.kubico.fi) during 2012-2017 were included in this investigation. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale during pregnancy (1st and/or 3rd trimester) and at eight weeks postpartum. Infant health data were collected as a part of a 12-month online follow-up questionnaire for mothers and were based on self-reports of either maternal observations or physician-determined diagnoses. Postpartum EDS were associated with a 2- to 5-fold increased likelihood of abnormal crying and paroxysmal wheezing (based on parental observations), as well as gastroesophageal reflux and food allergy (based on physician-determined diagnoses). Mothers with postpartum EDS also supplied their infants with analgesic medication for longer periods. Adherence to vaccination schedules was similar between the examined groups. In conclusion, infants of mothers with postpartum EDS may be more likely to experience health problems or to be perceived by their mother as having health problems, and thus receive more medications.
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Affiliation(s)
- Aleksi Ruohomäki
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland.
| | - Elena Toffol
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, P.O. Box 20, FI, 00014, Helsinki, Finland
| | - Ville Airaksinen
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Katri Backman
- Institute of Clinical Medicine / Pediatrics, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Raimo Voutilainen
- Institute of Clinical Medicine / Pediatrics, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Jussi Lampi
- Department of Health Security, National Institute for Health and Welfare, P.O. Box 95, FI, 70701, Kuopio, Finland
| | - Hannu Kokki
- Institute of Clinical Medicine / Anaesthesiology, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Ilona Luoma
- Institute of Clinical Medicine / Child Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland; Department of Child Psychiatry, Kuopio University Hospital, P.O. Box 100, FI, 70029, Kuopio, Finland
| | - Kirsti Kumpulainen
- Institute of Clinical Medicine / Child Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynaecology, University of Helsinki, P.O. Box 22, FI, 00014, Helsinki, Finland; Department of Obstetrics and Gynaecology, Helsinki University Hospital, P.O. Box 140, FI, 00029, Helsinki, Finland
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynaecology, Kuopio University Hospital, P.O. Box 100, FI, 70029, Kuopio, Finland; Institute of Clinical Medicine / Obstetrics and Gynaecology, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Juha Pekkanen
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, P.O. Box 20, FI, 00014, Helsinki, Finland; Department of Health Security, National Institute for Health and Welfare, P.O. Box 95, FI, 70701, Kuopio, Finland
| | - Markku Pasanen
- Faculty of Health Sciences, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland; Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, FI, 00014, Helsinki, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, FI, 00014, Helsinki, Finland
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Costa J, Santos O, Virgolino A, Pereira ME, Stefanovska-Petkovska M, Silva H, Navarro-Costa P, Barbosa M, das Neves RC, Duarte e Silva I, Alarcão V, Vargas R, Heitor MJ. MAternal Mental Health in the WORKplace (MAMH@WORK): A Protocol for Promoting Perinatal Maternal Mental Health and Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052558. [PMID: 33806518 PMCID: PMC7967657 DOI: 10.3390/ijerph18052558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 01/10/2023]
Abstract
Women are exposed to increased burden of mental disorders during the perinatal period: 13–19% experience postpartum depression. Perinatal psychological suffering affects early mother-child relationship, impacting child’s emotional and cognitive development. Return-to-work brings additional vulnerability given the required balance between parenting and job demands. The MAternal Mental Health in the WORKplace (MAMH@WORK) project aims to develop and evaluate the effectiveness of a brief and sustainable intervention, promoting (a) maternal mental health throughout pregnancy and first 12 months after delivery, and (b) quality of mother–child interactions, child emotional self-regulation, and cognitive self-control, while (c) reducing perinatal absenteeism and presenteeism. MAMH@WORK is a three-arm randomized controlled trial. A short-term cognitive-behavioral therapy-based (CBT-based) psychoeducation plus biofeedback intervention will be implemented by psychiatrists and psychologists, following a standardized procedure manual developed after consensus (Delphi method). Participants (n = 225, primiparous, singleton pregnant women at 28–30 weeks gestational age, aged 18–40 years, employed) will be randomly allocated to arms: CBT-based psychoeducation intervention (including mindfulness); psychoeducation plus biofeedback intervention; and control. Assessments will take place before and after delivery. Main outcomes (and main tools): mental health literacy (MHLS), psychological wellbeing (HADS, EPDS, KBS, CD-RISC, BRIEF COPE), quality of mother–child interaction, child–mother attachment, child emotional self-regulation and cognitive self-control (including PBQ, Strange Situation Procedure, QDIBRB, SGS-II, CARE-Index), job engagement (UWES), and presenteeism. Intention-to-treat and per-protocol analyses will be conducted; Cohen’s d coefficient, Cramer’s V and odds ratio will be used to assess the effect size of the intervention. MAMH@WORK is expected to contribute to mental health promotion during the perinatal period and beyond. Its results have the potential to inform health policies regarding work–life balance and maternal mental health and wellbeing promotion in the workplace.
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Affiliation(s)
- Joana Costa
- EnviHeB Lab., Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (J.C.); (A.V.); (M.S.-P.); (V.A.)
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (P.N.-C.); (M.B.); (M.J.H.)
| | - Osvaldo Santos
- EnviHeB Lab., Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (J.C.); (A.V.); (M.S.-P.); (V.A.)
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (P.N.-C.); (M.B.); (M.J.H.)
- Faculdade de Medicina, Universidade de Lisboa (FMUL), 1649-028 Lisboa, Portugal;
- Unbreakable Idea Research, Lda., 2550-426 Painho, Portugal
- Correspondence: ; Tel.: +351-21-799-9489
| | - Ana Virgolino
- EnviHeB Lab., Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (J.C.); (A.V.); (M.S.-P.); (V.A.)
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (P.N.-C.); (M.B.); (M.J.H.)
- Faculdade de Medicina, Universidade de Lisboa (FMUL), 1649-028 Lisboa, Portugal;
| | - M. Emília Pereira
- Centro Hospitalar Psiquiátrico de Lisboa, 1749-002 Lisboa, Portugal;
| | - Miodraga Stefanovska-Petkovska
- EnviHeB Lab., Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (J.C.); (A.V.); (M.S.-P.); (V.A.)
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (P.N.-C.); (M.B.); (M.J.H.)
| | - Henrique Silva
- Pharmacol. Sc Depart, Universidade de Lisboa, Faculty of Pharmacy, 1649-003 Lisboa, Portugal;
| | - Paulo Navarro-Costa
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (P.N.-C.); (M.B.); (M.J.H.)
- Instituto Gulbenkian de Ciência, 2780-156 Oeiras, Portugal
| | - Miguel Barbosa
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (P.N.-C.); (M.B.); (M.J.H.)
- Faculdade de Medicina, Universidade de Lisboa (FMUL), 1649-028 Lisboa, Portugal;
| | - Rui César das Neves
- CAST—Consultoria e Aplicações em Sistemas e Tecnologia, Lda., 1800-075 Lisboa, Portugal;
| | - Inês Duarte e Silva
- Faculdade de Medicina, Universidade de Lisboa (FMUL), 1649-028 Lisboa, Portugal;
- Centro Hospitalar Universitário Lisboa Norte (CHULN), 1649-035 Lisboa, Portugal
| | - Violeta Alarcão
- EnviHeB Lab., Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (J.C.); (A.V.); (M.S.-P.); (V.A.)
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (P.N.-C.); (M.B.); (M.J.H.)
- Centro de Investigação e Estudos de Sociologia, ISCTE—Instituto Universitário de Lisboa (ISCTE-IUL), 1649-026 Lisboa, Portugal
| | - Ricardo Vargas
- Consulting House, 1600-477 Lisboa, Portugal;
- Research Center for Psychological Science (CICPSI), Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal
| | - Maria João Heitor
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (P.N.-C.); (M.B.); (M.J.H.)
- Faculdade de Medicina, Universidade de Lisboa (FMUL), 1649-028 Lisboa, Portugal;
- Departamento de Psiquiatria e Saúde Mental do Hospital Beatriz Ângelo, 2674-514 Loures, Portugal
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Cajiao-Nieto J, Torres-Giménez A, Merelles-Tormo A, Botet-Mussons F. Paternal symptoms of anxiety and depression in the first month after childbirth: A comparison between fathers of full term and preterm infants. J Affect Disord 2021; 282:517-526. [PMID: 33433381 DOI: 10.1016/j.jad.2020.12.175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/26/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although men have a higher risk of developing a mental disorder during the perinatal period, few studies have focused on new fathers' mental health screening. This study compares anxiety and depression symptoms between fathers with newborn infants in the neonatal intensive care unit (NICU) and fathers of healthy full-term infants, assessing the impact of stress caused by the NICU.. METHODS A longitudinal and prospective study with control (n= 33) and study groups (n=51) was designed. The dependent variables assessed were post-natal depression and anxiety-state while the social and demographic information, health background and the parental stress in the neonatal unit were the independent variables. The fathers were assessed twice during the first month after birth. RESULTS Significant differences in the EPDS scores were found between both groups in the first assessment (p = .006) but not in the second assessment (p = .60). Significant differences in STAI scores were found between the groups for both assessments (p = .003 and p = .002). The stress caused by the infant's appearance and behavior was predictive of depression and anxiety in the study group. LIMITATIONS The sample was collected at one hospital, immigrants were underrepresented, and no prenatal assessment of paternal mental health is available. CONCLUSIONS Our results suggest that the hospitalization of newborn infants increases the risk of developing anxiety or depression disorder in fathers. Health providers should be aware of the emotional changes in men shortly after childbirth and include them in the screening of and support for mental health disorders.
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Affiliation(s)
| | - Anna Torres-Giménez
- Perinatal Mental Health Unit, Department of Psychiatry and Clinical Psychology, Institute of Neuroscience, Hospital Clinic, IDIBAPS, Barcelona, Spain; Faculty of Psychology, Universitat de Barcelona. Spain
| | | | - Francesc Botet-Mussons
- Institute Clinic of Obstetrics, Gynecology and Neonatology (ICGON), Hospital Clínic, Barcelona, Spain; Faculty of Medicine. Universitat de Barcelona, Spain
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Ollivier R, Aston DM, Price DS, Sim DM, Benoit DB, Joy DP, Iduye D, Nassaji NA. Mental Health & Parental Concerns during COVID-19: The Experiences of New Mothers Amidst Social Isolation. Midwifery 2021; 94:102902. [PMID: 33421662 DOI: 10.1016/i.midw.2020.102902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in an unprecedented situation for new parents, with public health orders greatly affecting daily life as well as various aspects of parenting and new parent wellbeing. OBJECTIVES To understand the impact of the COVID-19 pandemic on mothers/parents across Nova Scotia who are caring for a child 0-12 months of age. DESIGN This study utilized an online qualitative survey to collect data. Feminist poststructuralism and discourse analysis guided the analysis and discussion. SETTING Nova Scotia, Canada PARTICIPANTS: : 68 participants were recruited from across the province of Nova Scotia. FINDINGS Mental health and socialization were both major concerns for new mothers/parents, as many expressed feelings of worry, anxiety, loneliness, isolation, and stress. KEY CONCLUSIONS Online support was sought by many new mothers/parents as a way of supporting their own mental health. Some found ways to make it meaningful for them, while others believed that it could not replace or offer the same benefits as in-person interaction and support. IMPLICATIONS FOR PRACTICE Informal and formal support systems are both essential for new mothers. As public health systems and health care services learn to adapt to COVID-19, further research is required to examine how health services may best meet the needs of new mothers/parents.
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Affiliation(s)
- Rachel Ollivier
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Megan Aston
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Sheri Price
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Meaghan Sim
- Nova Scotia Health Authority, Healthy Populations Institute, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Britney Benoit
- Rankin School of Nursing, St. Francis Xavier University, C251, Camden Hall, PO Box 5000, 2340 Notre Dame Avenue, Antigonish, Nova Scotia, Canada B2G 2W5.
| | - Dr Phillip Joy
- Applied Human Nutrition, Mount Saint Vincent University, 166 Bedford Highway, Halifax, Nova Scotia, Canada B3M 2J6.
| | - Damilola Iduye
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Neda Akbari Nassaji
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
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Roubinov DS, Luecken LJ, Curci SG, Somers JA, Winstone LK. A prenatal programming perspective on the intergenerational transmission of maternal adverse childhood experiences to offspring health problems. AMERICAN PSYCHOLOGIST 2021; 76:337-349. [PMID: 33734799 PMCID: PMC7995605 DOI: 10.1037/amp0000762] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Decades of research indicate that individuals exposed to childhood adversity are at risk for poor physical and mental health across their life span. More recently, intergenerational transmission of trauma and prenatal programming frameworks suggest an even longer reach for adverse childhood experiences (ACEs), with consequences that extend to subsequent generations. Beyond the individual-level consequences typically observed by empirical studies of ACEs, mothers' experiences of early adversity may also compromise the maternal-child dyadic relationship. We propose a conceptual model whereby mothers' ACEs impact maternal-infant dyadic functioning and later biobehavioral health outcomes through heightened perinatal psychosocial risk. We provide support for the proposed paths and mechanistic processes in our model with data drawn from Las Madres Nuevas, a longitudinal study of low-income Mexican-origin families who participated in a series of home and laboratory visits from the prenatal period through early childhood. Higher ACEs exposure among Las Madres Nuevas participants was associated with numerous perinatal psychosocial risk factors, which predicted poorer mother-infant dyadic functioning. Compromised dyadic functioning during infancy was associated with later maternal mental health and child behavior problems. We conclude with discussion of prevention and treatment strategies that can buffer against proposed risk pathways, including perinatal assessment of maternal ACEs and psychosocial risk, perinatal treatment of maternal distress, and mother-infant therapy in the postpartum period. It is our hope that the proposed conceptual model will serve as a guide for future research to examine the lasting consequences of childhood adversities within and across generations among high-risk populations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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81
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Wells MB, Aronson O. Paternal postnatal depression and received midwife, child health nurse, and maternal support: A cross-sectional analysis of primiparous and multiparous fathers. J Affect Disord 2021; 280:127-135. [PMID: 33212403 DOI: 10.1016/j.jad.2020.11.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/21/2020] [Accepted: 11/07/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Fathers want more professional and social support during the transition to fatherhood. It is unclear if these supports are associated with decreased depressive symptoms in fathers of infants. AIM The aim of the current study was to assess if fathers' self-reported received professional and social support were related to changes in the odds for having depressive symptoms, with interaction terms focusing on differences of support based on the fathers' parity. METHODS In total, 612 fathers from Sweden completed a Facebook-advertised anonymous online survey. The Edinburgh Postnatal Depression Scale was used to detect depressive symptoms (≥10 points). Multiple imputation of missing data was performed. Logistic regressions were used, with interaction terms for fathers' parity. RESULTS Around 21% of fathers had depressive symptoms. There were no associations between depressive symptoms frequencies and paternal parity. Fathers reported fewer depressive symptoms when they received professional support from the prenatal midwife (OR = .39, p = .007), labor/birth midwife/nurse team (OR = .42, p = .021), and child health nurse (OR = .25, p = .001), as well as social support from their partner and if they had a higher income (odds ratios vary in different models). Multiparous fathers received significantly less professional and social support and were less frequently invited to child health visits than primiparous fathers. LIMITATIONS The data collected was cross-sectional; therefore, causal links cannot be determined. CONCLUSIONS Both primiparous and multiparous fathers should receive postnatal depression screenings and interventions to help reduce their depressive symptoms.
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Affiliation(s)
- Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet.
| | - Olov Aronson
- School of Health and Welfare, Jönköping University
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82
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Dagher RK, Bruckheim HE, Colpe LJ, Edwards E, White DB. Perinatal Depression: Challenges and Opportunities. J Womens Health (Larchmt) 2021; 30:154-159. [PMID: 33156730 PMCID: PMC7891219 DOI: 10.1089/jwh.2020.8862] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Perinatal depression (PND) is a major depressive episode during pregnancy or within 4 weeks after childbirth up to a year. Risk factors for PND include stressful life events, history of depression, poor social support, unplanned and unwanted pregnancies, poor relationship quality, current or previous abuse, and low socioeconomic status. This mental disorder has been shown to have negative effects on mothers' quality of life and their intimate relationships, birth outcomes, and breastfeeding likelihood, as well as long-term effects on children's cognitive and emotional development. To date, no nationally representative study has examined whether there are socioeconomic and/or racial/ethnic differences in PND. This study discusses the prevalence and risk factors for PND, as well as its health consequences for mothers and children, the reasons for its underreporting and undertreatment, the evidence for different screening instruments and different treatment options, and the existing supportive policies to address this disorder in the United States. We conclude with outlining next steps in addressing the gaps in the literature on PND.
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Affiliation(s)
- Rada K. Dagher
- Division of Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Lisa J. Colpe
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Emmeline Edwards
- Division of Extramural Research, National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Della B. White
- Division of Extramural Research, National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland, USA
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83
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Abstract
Perinatal care, including the management of mental health issues, often falls under the auspices of primary care providers. Postpartum depression (PPD) is a common problem that affects up to 15% of women. Most women at risk can be identified before delivery based on psychiatric history, symptoms during pregnancy, and recent psychosocial stressors. Fortunately, there have been a variety of treatment studies using antidepressants, nonpharmacologic interactions, and most recently, allopregnanolone (Brexanolone) infusion that have shown benefits. The most commonly used screening scale, Edinburgh Postnatal Depression Scale, a 10-item self-rated scale, has been translated into a variety of languages.
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84
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Öksüz EE. Postpartum Depression Among Women With Disabilities: A Multicultural Counseling Perspective. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jmcd.12205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Elif Emir Öksüz
- School of Human Services University of Cincinnati
- Now at Department of Psychology Ankara Yıldırım Beyazıt University
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85
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Jacques N, Mesenburg MA, Murray J, Bertoldi AD, Domingues MR, Stein A, Silveira MF. Antenatal and Postnatal Maternal Depressive Symptoms and Trajectories and Child Hospitalization up to 24 Months of Life: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study. THE JOURNAL OF PEDIATRICS: X 2021; 6:100065. [PMID: 33898965 PMCID: PMC8047811 DOI: 10.1016/j.ympdx.2021.100065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 01/03/2023] Open
Abstract
Objective To examine the association between antenatal and postnatal maternal depression symptoms, and child hospitalization during the first 2 years of life in the 2015 Pelotas Birth Cohort Study. Study design This is an observational study. Maternal depressive symptoms of 4275 mothers were measured using the Edinburgh Postnatal Depression Scale. Hospitalization of the child for any reason was assessed using maternal report. Bivariate analysis and multivariate Poisson regressions were used to assess the association between maternal depressive symptoms and child hospitalization. Results Compared with children of mothers with low depressive symptoms, children whose mothers experienced significant antenatal depressive symptoms were 1.74 (95% CI, 1.16-2.60) times more likely to be hospitalized by 3 months of age, and 2.14 (95% CI, 1.46-3.14) times more likely up to 24 months. For children whose mothers experienced severe postnatal depressive symptoms at 3 months, the risks for hospitalization by age 12 months were 1.84 (95% CI, 1.39-2.45) higher than children whose mothers had low depressive symptoms. There was an increased risk of hospitalization for children according to the severity of depressive trajectories across time. Conclusions Maternal depressive symptoms are a risk factor for hospitalization in children up to 2 years of age, and this risk increases with increased severity of depression. These results have public health relevance for decreasing the risk factors in mothers that can lead to hospitalization in children.
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Affiliation(s)
- Nadège Jacques
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Marilia Arndt Mesenburg
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Alan Stein
- Department of Psychiatry, University of Oxford and 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
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86
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Ollivier R, Aston DM, Price DS, Sim DM, Benoit DB, Joy DP, Iduye D, Nassaji NA. Mental Health & Parental Concerns during COVID-19: The Experiences of New Mothers Amidst Social Isolation. Midwifery 2020; 94:102902. [PMID: 33421662 DOI: 10.1016/j.midw.2020.102902] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in an unprecedented situation for new parents, with public health orders greatly affecting daily life as well as various aspects of parenting and new parent wellbeing. OBJECTIVES To understand the impact of the COVID-19 pandemic on mothers/parents across Nova Scotia who are caring for a child 0-12 months of age. DESIGN This study utilized an online qualitative survey to collect data. Feminist poststructuralism and discourse analysis guided the analysis and discussion. SETTING Nova Scotia, Canada PARTICIPANTS: : 68 participants were recruited from across the province of Nova Scotia. FINDINGS Mental health and socialization were both major concerns for new mothers/parents, as many expressed feelings of worry, anxiety, loneliness, isolation, and stress. KEY CONCLUSIONS Online support was sought by many new mothers/parents as a way of supporting their own mental health. Some found ways to make it meaningful for them, while others believed that it could not replace or offer the same benefits as in-person interaction and support. IMPLICATIONS FOR PRACTICE Informal and formal support systems are both essential for new mothers. As public health systems and health care services learn to adapt to COVID-19, further research is required to examine how health services may best meet the needs of new mothers/parents.
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Affiliation(s)
- Rachel Ollivier
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Megan Aston
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Sheri Price
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Meaghan Sim
- Nova Scotia Health Authority, Healthy Populations Institute, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Britney Benoit
- Rankin School of Nursing, St. Francis Xavier University, C251, Camden Hall, PO Box 5000, 2340 Notre Dame Avenue, Antigonish, Nova Scotia, Canada B2G 2W5.
| | - Dr Phillip Joy
- Applied Human Nutrition, Mount Saint Vincent University, 166 Bedford Highway, Halifax, Nova Scotia, Canada B3M 2J6.
| | - Damilola Iduye
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Neda Akbari Nassaji
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
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87
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Does Perceived Quality of Care Moderate Postpartum Depression? A Secondary Analysis of a Two-Stage Survey. Matern Child Health J 2020; 25:613-625. [PMID: 33249546 DOI: 10.1007/s10995-020-03103-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The purpose of this study was to examine if women's perceptions of the quality of hospital care during childbirth moderate their risks for symptoms of postpartum depression (PPD). METHODS This cross-sectional secondary analysis analyzed data from the Listening to Mothers III (2013) series surveys with a weighted sample size of 1057 of women surveyed from across the United States. PPD symptoms were defined according the Patient Health Questionnaire-2. Associations between risk factors and PPD symptoms were tested using logistic regressions with the moderating variable of perceived quality of care then added to models with significant risk factors. RESULTS Of the 22 potential risk factors for PPD symptoms, 10 were found to be significantly associated with PPD symptoms in this sample of women. Very good perceived quality of care moderated the following risk factors for PPD symptoms in a protective direction: relationship status (p = 0.01), pre-pregnancy BMI (p = 0.02), and pain that interfered with routine activities 2 months postpartum (p = 0.003). CONCLUSIONS These findings suggest risk factors for PPD symptoms are moderated by perceived quality of care and therefore, maternity providers can influence women's psychological wellbeing postpartum by providing very good perceived quality of care during the hospital stay for birth. However, these findings should be interpreted cautiously due to a lack of a direct, proven relationship between provider action and women's perceived quality of care.
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88
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Spinola O, Liotti M, Speranza AM, Tambelli R. Effects of COVID-19 Epidemic Lockdown on Postpartum Depressive Symptoms in a Sample of Italian Mothers. Front Psychiatry 2020; 11:589916. [PMID: 33312140 PMCID: PMC7704433 DOI: 10.3389/fpsyt.2020.589916] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/08/2020] [Indexed: 12/31/2022] Open
Abstract
The extraordinary health emergency of the COVID-19 pandemic represents a new challenge for mental health researchers and clinical practitioners. The related containment measures may be a risk factor for psychological distress and mood disorders, especially in at-risk populations. This study aims to explore the impact of COVID-19 on postpartum depressive symptoms in mothers with children below 1 year of age. An online questionnaire survey was therefore conducted in Italy between May and June 2020. The survey consisted of several self-administered questionnaires: besides some ad-hoc questionnaires, the Edinburgh Postnatal Depression Scale (EPDS), the Scale of Perceived Social Support (SPSS) and the Maternity Social Support Scale (MSSS) were used. Two hundred forty-three Italian women were included in the study. The prevalence of postpartum depression symptomatology among mothers was 44%, as measured through the EPDS (cut-off >12). Women who spent the isolation in northern Italy adopted maladaptive coping strategies significantly more than women living in areas at lower risk. The analysis highlighted a significant difference between the group that was not directly affected by the virus and women who have had a direct or indirect contact with it. Besides situational factors specific to the pandemic, the results show that there are some risk factors tied to the personal history of the mother (e.g., having had a previous abortion). These data should inform and enlighten future protocols of intervention.
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Affiliation(s)
| | - Marianna Liotti
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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89
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Pilkington PD, Whelan TA, Milne LC. A review of partner‐inclusive interventions for preventing postnatal depression and anxiety. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12054] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Pamela D. Pilkington
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia,
| | - Thomas A. Whelan
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia,
| | - Lisa C. Milne
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia,
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90
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Ross KM, Letourneau N, Climie E, Giesbrecht G, Dewey D. Perinatal Maternal Anxiety and Depressive Symptoms and Child Executive Function and Attention at Two-years of Age. Dev Neuropsychol 2020; 45:380-395. [PMID: 33081504 DOI: 10.1080/87565641.2020.1838525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective was to investigate whether perinatal maternal anxiety and depressive symptoms predicted child attention and executive function (EF). Mothers (N = 614) reported pregnancy and three-months postnatal anxiety and depressive symptoms. Attention and EF were measured at two-years-of-age. Covariates were demographics, alcohol use, mood disorder history, and pregnancy factors. Higher prenatal anxiety, b(SE) =.020(.005), p<.001, and postnatal depressive symptoms, b(SE) =.009(.004), p=.04, predicted poorer child attention. A prenatal-by-postnatal depressive symptom interaction emerged, b(SE) = -.005(.003), p=.04: When pregnancy depressive symptoms were low, higher postnatal symptoms predicted poorer attention. No distress variables predicted EF, p's>.22. Perinatal distress timing, kind, and change were important for child attention.
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Affiliation(s)
- Kharah M Ross
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Nicole Letourneau
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Emma Climie
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Gerald Giesbrecht
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Deborah Dewey
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
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91
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Holopainen A, Hakulinen T. New parents' experiences of postpartum depression: a systematic review of qualitative evidence. ACTA ACUST UNITED AC 2020; 17:1731-1769. [PMID: 31021977 DOI: 10.11124/jbisrir-2017-003909] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The objective of the review was to synthesize the evidence on new mothers' and fathers' experiences of postpartum depression (PPD). INTRODUCTION Postpartum depression is a form of clinical depression that affects women and, less frequently, men, typically during the first months after childbirth. It has been estimated that 10% to 20% of women and 10% of men suffer from PPD and it may have serious consequences for mothers, fathers and their children. Therefore, this review covers the experiences of both mothers and fathers. INCLUSION CRITERIA This qualitative review considered studies that included new mothers and fathers who had any number of children and who experienced PPD within a one-year postpartum period. The phenomenon of interest was the lived experience of new mothers and fathers with PPD. Qualitative studies including, but not limited to, phenomenology, grounded theory, ethnography, action research and feminist research were considered. METHODS The review systematically searched the following databases: MEDLINE, CINAHL, PsycINFO, Scopus and the Finnish database MEDIC. In addition, the search for unpublished articles included ProQuest Dissertations and Theses. The methodological quality of the included studies was assessed independently by two reviewers, and qualitative data were extracted from papers by two independent reviewers using a standardized data extraction tool. Qualitative research findings were pooled using the JBI methodology. RESULTS Thirteen papers that considered mothers' (n = 199) experiences of PPD were included in the review. A total of 98 findings were extracted and aggregated into 14 categories, and from them, four synthesized findings were developed: i) Depressed mothers feel unable to control their own lives due to low resilience; ii) The ambivalent feelings depressed mothers experience towards their babies, partners and in-laws cause distress and suffering; iii) Depressed mothers experience anger and despair if they perceive imbalances between their support needs and the support they get from healthcare providers and significant others; and iv) Depressed mothers experience hopelessness and helplessness resulting from their new-found motherhood and financial worries. Two papers that considered fathers' (n = 20) experiences of PPD were included in the review. A total of 19 findings were extracted and aggregated into six categories, and from them, two synthesized findings were developed: i) Depressed fathers experience disappointment arising from perceived imbalances between their support needs and the support they get from their partner and significant others; and ii) Depressed fathers are more imbalanced after childbirth than fathers who are not suffering from PPD, so they feel unable to control their own lives due to low resilience. CONCLUSIONS The qualitative studies concerning new parents' experiences of PPD have focused on the mother's perspective, and studies of the father's perspective, especially of the father's own experiences of PPD, are scarce. Both mothers and fathers do not receive enough support from their significant others. In addition, mothers want more support from health professionals. Because PPD has a great influence on the well-being of mothers and fathers, as well as children, it is important to understand what parents undergo after childbirth.
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Affiliation(s)
- Arja Holopainen
- Nursing Research Foundation, Helsinki, Finland.,Finnish Centre for Evidence-Based Health Care: a Joanna Briggs Institute Affiliated Group
| | - Tuovi Hakulinen
- Finnish Centre for Evidence-Based Health Care: a Joanna Briggs Institute Affiliated Group.,National Institute for Health and Welfare, Helsinki, Finland
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92
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Exploring care from extended family through rural women's accounts of perinatal mental illness - a qualitative study with implications for policy and practice. Health Place 2020; 66:102427. [PMID: 32980675 DOI: 10.1016/j.healthplace.2020.102427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 11/24/2022]
Abstract
Extended family often have an important role in caring for women experiencing perinatal mental illness; but rural women's perspectives are under-researched. We explored women's experiences of living in rural northern England and receiving care from extended family during periods of perinatal mental illness through 21 qualitative interviews. Key findings were that companionship, practical support - informal childcare and transport, and emotional support were important forms of care - filling gaps in formal service provision. Findings highlight women's needs for support from extended families in rural areas. The rural infrastructure and inequity in formal services can create vulnerability for women.
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Bradley HA, Campbell SA, Mulder RT, Henderson JMT, Dixon L, Boden JM, Rucklidge JJ. Can broad-spectrum multinutrients treat symptoms of antenatal depression and anxiety and improve infant development? Study protocol of a double blind, randomized, controlled trial (the 'NUTRIMUM' trial). BMC Pregnancy Childbirth 2020; 20:488. [PMID: 32842983 PMCID: PMC7448485 DOI: 10.1186/s12884-020-03143-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 07/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Untreated antenatal depression and anxiety can be associated with short and long term health impacts on the pregnant woman, her infant and the rest of the family. Alternative interventions to those currently available are needed. This clinical trial aims to investigate the efficacy and safety of a broad-spectrum multinutrient formula as a treatment for symptoms of depression and anxiety in pregnant women and to determine the impact supplementation has on the general health and development of the infant. METHODS This randomised, controlled trial will be conducted in Canterbury, New Zealand between April 2017 and June 2022. One hundred and twenty women aged over 16 years, between 12 and 24 weeks gestation and who score ≥ 13 on the Edinburgh Postnatal Depression Scale (EPDS) will be randomly assigned to take the intervention (n = 60) or an active control formula containing iodine and riboflavin (n = 60) for 12 weeks. After 12 weeks, participants can enter an open-label phase until the birth of their infant and naturalistically followed for the first 12 months postpartum. Infants will be followed until 12 months of age. Randomisation will be computer-generated, with allocation concealment by opaque sequentially numbered envelopes. Participants and the research team including data analysts will be blinded to group assignment. The EPDS and the Clinical Global Impressions Scale of Improvement (CGI-I) will be the maternal primary outcome measures of this study and will assess the incidence of depression and anxiety and the improvement of symptomatology respectively. Generalized linear mixed effects regression models will analyse statistical differences between the multinutrient and active control group on an intent-to-treat basis. A minimum of a three-point difference in EPDS scores between the groups will identify clinical significance. Pregnancy outcomes, adverse events and side effects will also be monitored and reported. DISCUSSION Should the multinutrient formula be shown to be beneficial for both the mother and the infant, then an alternative treatment option that may also improve the biopsychosocial development of their infants can be provided for pregnant women experiencing symptoms of depression and anxiety. TRIAL REGISTRATION Trial ID: ACTRN12617000354381 ; prospectively registered at Australian New Zealand Clinical Trials Registry on 08/03/2017.
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Affiliation(s)
- Hayley A. Bradley
- School of Psychology, Speech and Hearing, University of Canterbury, Private Bag 4800, Christchurch, 8041 New Zealand
| | - Siobhan A. Campbell
- School of Psychology, Speech and Hearing, University of Canterbury, Private Bag 4800, Christchurch, 8041 New Zealand
| | - Roger T. Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jaqueline M. T. Henderson
- School of Psychology, Speech and Hearing, University of Canterbury, Private Bag 4800, Christchurch, 8041 New Zealand
| | - Lesley Dixon
- New Zealand College of Midwives, Christchurch, New Zealand
| | - Joseph M. Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Julia J. Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, Private Bag 4800, Christchurch, 8041 New Zealand
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94
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Albanese AM, Geller PA, Steinkamp JM, Barkin JL. In Their Own Words: A Qualitative Investigation of the Factors Influencing Maternal Postpartum Functioning in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176021. [PMID: 32824941 PMCID: PMC7504078 DOI: 10.3390/ijerph17176021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 01/13/2023]
Abstract
During the first twelve months postpartum, infants require intensive care and mothers are susceptible to physical and mental health concerns as they undergo a period of tremendous psychological and physiological adjustment. The mother’s level of postpartum functioning not only impacts her experience as a mother but also the infant and family unit. However, efforts to bolster functioning are lacking, and previous literature has identified a gap between what experts recommend and what mothers desire during the postpartum period. To address this, we conducted structured interviews with a diverse sample of 30 postpartum mothers to identify factors that mothers report are most influential to their postpartum functioning. In total, we identified 23 clinically actionable factors, all of which are backed by existing literature. In addition to an in-depth presentation of the qualitative findings, we also present a heat map to visualize the relevance of these factors to each of seven established domains of maternal functioning. Lastly, based on our findings, we offer a taxonomy of interventional strategies that could bolster maternal functioning during this critical period.
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Affiliation(s)
- Ariana M. Albanese
- Department of Psychology, Drexel University, Philadelphia, PA 19104, USA;
- Correspondence:
| | - Pamela A. Geller
- Department of Psychology, Drexel University, Philadelphia, PA 19104, USA;
| | | | - Jennifer L. Barkin
- Mercer University School of Medicine Department of Community Medicine, Macon, GA 31207, USA;
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95
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Wells MB, Kerstis B, Andersson E. Impacted family equality, self‐confidence and loneliness: a cross‐sectional study of first‐time and multi‐time fathers’ satisfaction with prenatal and postnatal father groups in Sweden. Scand J Caring Sci 2020; 35:844-852. [DOI: 10.1111/scs.12900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 06/18/2020] [Accepted: 07/15/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Michael B. Wells
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Birgitta Kerstis
- School of Health, Care and Social Welfare Mälardalen University Vasteras Sweden
| | - Ewa Andersson
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
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96
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Moore D, Drey N, Ayers S. A meta-synthesis of women's experiences of online forums for maternal mental illness and stigma. Arch Womens Ment Health 2020; 23:507-515. [PMID: 31646392 DOI: 10.1007/s00737-019-01002-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
Abstract
Perinatal mental illness affects 15% of women; however, only half of these women access treatment. Some women with untreated perinatal mental illness may continue to suffer with mental illness after the perinatal period. Evidence suggests that one barrier to accessing treatment is stigma. Forums may provide an acceptable place for women to converse about the stigmatised symptoms of maternal mental illness. Reducing stigma may increase treatment uptake. This study aimed to review and synthesise the qualitative research on maternal mental illness forums and stigma so that stigma can be addressed and treatment improved. A meta-synthesis was conducted to describe and interpret qualitative studies regarding forum use and maternal mental illness stigma. A systematic search of seven electronic databases and Google Scholar was performed. Additional references were collected through screening references of the identified studies. Five studies were identified that reported women's experiences of online forums for maternal mental illness and stigma. The synthesis identified four key themes: (1) a safe place to talk; (2) virtual support; (3) stigma and identity; and (4) repair of the mother identity. Stigma maybe reduced by forum discourse that reconceptualises what is to be a "good mother" and separates stigma and maternal identity. This synthesis provides a novel and more detailed framework for the stigma of maternal mental illness and forum use. This suggests forums may enable women to explore their dual identity and repair their maternal identity, and this may reduce stigma. Healthcare providers could discuss forum use with their clients.
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Affiliation(s)
- D Moore
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK. .,The Open University, Walton Hall, Milton Keynes, UK.
| | - N Drey
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - S Ayers
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
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97
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Winstone LK, Luecken LJ, Crnic KA, Gonzales NA. Patterns of family negativity in the perinatal period: Implications for mental health among Mexican-origin women. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:642-651. [PMID: 32162941 PMCID: PMC7373671 DOI: 10.1037/fam0000648] [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] [Indexed: 06/10/2023]
Abstract
Negativity in the family environment during the perinatal period is likely to have detrimental effects on maternal well-being, especially among low-income ethnic minority mothers who are at increased risk for experiencing postpartum depressive symptoms. With a sample of 322 Mexican and Mexican American families, this study used latent class growth analysis to identify meaningful subgroups of women based on their perceived family negativity reported prenatally and at 6, 12, 18, and 24 weeks postpartum. A 4-trajectory model of family negativity fit the data well: low-stable (58%), moderate-increasing (26%), high-decreasing (8%), and high-increasing (8%). Higher prenatal depressive symptomatology predicted membership in the moderate-increasing, high-decreasing, and high-increasing trajectories, relative to the low-stable trajectory. Findings suggest substantial heterogeneity in family negativity, identifying three significant growth patterns during the perinatal period with differential implications for maternal depressive symptomatology at 24 weeks and 12 months after delivery. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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98
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Schaber R, Karl M, Kopp M, Kress V, Weidner K, Martini J, Garthus-Niegel S. My job, my child, my house: the predictive value of job- and housework-related factors on depressive symptoms during the postpartum period. J Affect Disord 2020; 272:388-397. [PMID: 32553382 DOI: 10.1016/j.jad.2020.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/18/2020] [Accepted: 04/18/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Many mothers combine two sides of their life: They are both educated employees and family organizers. The aim of this study is to investigate risk and protective factors of depressive symptoms during the postpartum period (PPD symptoms) on both those sides of mothers' life, including education, job-, and housework-related factors. METHODS Data (n = 689) were drawn from the prospective-longitudinal cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Education, job satisfaction, job burden, and the housework-related factor ministering to family needs (MTFN) were measured during pregnancy. Depressive symptoms were measured 8 weeks postpartum. Multiple linear regression analyses were conducted. RESULTS While education was not significantly associated with PPD symptoms, low job satisfaction, high job burden, and low MTFN levels were significant risk factors for PPD symptoms. When controlling for further potential confounders, job satisfaction and job burden remained significant predictors. LIMITATIONS Generalization of findings might be limited due to participation bias and some systematic dropout. CONCLUSIONS Job characteristics should be considered in future research on postpartum mental health. For the prevention of PPD symptoms, it seems important to ensure satisfying and less burdensome working conditions during pregnancy. Additionally, the results indicate that further research on the effects of housework-related factors on PPD symptoms is worthwhile.
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Affiliation(s)
- Ronja Schaber
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany.
| | - Marlene Karl
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Marie Kopp
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Victoria Kress
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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99
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Recto P, Champion JD. Psychosocial Factors Associated with Paternal Perinatal Depression in the United States: A Systematic Review. Issues Ment Health Nurs 2020; 41:608-623. [PMID: 32286093 DOI: 10.1080/01612840.2019.1704320] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Paternal perinatal depression can occur in approximately one out of ten fathers. However, research within this population is limited. A previous systematic review suggested that United States had higher rates of paternal perinatal depression compared to other countries. Therefore, this systematic review identified psychosocial factors for depression during the perinatal period in fathers who live in the United States. A literature search was conducted from multiple databases using keywords and MeSH terms to retrieve articles up to the year 2019. Twenty five articles were included in this review. A social-ecological framework was applied to identify psychosocial factors associated with paternal depression. Individual factors include prior history of depression, having maladaptive cognitive coping styles, fathers who self-identified as African-American or Hispanic, parenting stress, substance use, and history of criminal conviction. Interpersonal factors include lack of social support, quality of relationship with the mother of the baby, coparenting conflict, quality of current and childhood relationships with their own parents, and maternal depression. Community factors include frequent daily experiences with racism, and limited access to transportation and housing. These findings underscore the importance of assessing depression and developing father-inclusive interventions that address the psychological needs of fathers.
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Affiliation(s)
- Pamela Recto
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Jane Dimmitt Champion
- Lee and Joseph D. Jamail Endowed Professorship in Nursing, School of Nursing, University of Texas at Austin, Austin, Texas, USA
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100
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Mattheß J, Eckert M, Richter K, Koch G, Reinhold T, Vienhues P, Berghöfer A, Roll S, Keil T, Schlensog-Schuster F, von Klitzing K, Ludwig-Körner C, Kuchinke L. Efficacy of Parent-Infant-Psychotherapy with mothers with postpartum mental disorder: study protocol of the randomized controlled trial as part of the SKKIPPI project. Trials 2020; 21:490. [PMID: 32503611 PMCID: PMC7275538 DOI: 10.1186/s13063-020-04443-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/23/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND After the birth of a child, many mothers and fathers experience postpartum mental disorders like depression, anxiety, obsessive-compulsive disorder, stress or other illnesses. This endangers the establishment of a secure attachment between the children and their primary caregivers. Early problems in parent-child interaction can have adverse long-term effects on the family and the child's well-being. In order to prevent a transgenerational transmission of mental disorders, it is necessary to evaluate psychotherapeutic interventions that target psychologically burdened parents of infants or toddlers. The aim of this trial is to investigate the efficacy of Parent-Infant-Psychotherapy (PIP) for mothers with postpartum mental disorder and their infants (0-12 months). METHODS/DESIGN In this open, randomized controlled intervention trial 180 mother-infant-dyads will be included and randomly allocated to 12 sessions of PIP or care as usual. The interventions take place either in inpatient adult psychiatric departments or in outpatient settings with home visits. The primary outcome is the change in maternal sensitivity assessed by the Sensitivity subscale of the Emotional Availability Scale (EAS) through videotaped dyadic play-interactions after 6 weeks. Secondary outcomes are maternal psychopathology, stress, parental reflective functioning, infant development and attachment after 6 weeks and 12 months. In addition, maternal attachment (AAI) and reflective functioning (AAI) will be analyzed as potential moderators, and resource usage in the German health system as well as associated costs will be evaluated. DISCUSSION There is increasing demand for well-controlled studies on psychotherapeutic interventions in the postpartum period that do not only focus on particular risk groups. This randomized controlled trial (RCT) represents one of the first studies to investigate the efficacy of PIP in inpatient psychiatric departments and outpatient care centers in Germany. The results will fill knowledge gaps on the factors contributing to symptom reduction in postpartum mental disorders and improvements in mother-child relationships and help in developing preventive and therapeutic strategies for the fragmented German health care system. TRIAL REGISTRATION German Register for Clinical Trials, ID: DRKS00016353.
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Affiliation(s)
- J Mattheß
- International Psychoanalytic University, Stromstr. 3b, 10555, Berlin, Germany.
| | - M Eckert
- International Psychoanalytic University, Stromstr. 3b, 10555, Berlin, Germany
| | - K Richter
- Department of Psychiatry, Psychosomatics and Psychotherapy, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - G Koch
- International Psychoanalytic University, Stromstr. 3b, 10555, Berlin, Germany
| | - T Reinhold
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin, Berlin, Germany
| | - P Vienhues
- Department of Psychiatry, Psychosomatics and Psychotherapy, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - A Berghöfer
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin, Berlin, Germany
| | - S Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin, Berlin, Germany
| | - T Keil
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin, Berlin, Germany
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - F Schlensog-Schuster
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - K von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - C Ludwig-Körner
- Department of Psychiatry, Psychosomatics and Psychotherapy, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - L Kuchinke
- Department of Psychiatry, Psychosomatics and Psychotherapy, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
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