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Itoshima R, Tuura K, Toome L, Varendi H, Saik P, Axelin A, Lehtonen L, Ahlqvist-Björkroth S. Depressive symptoms in mothers of preterm infants before and during COVID-19 restrictions in neonatal intensive care units. Acta Paediatr 2023; 112:2164-2171. [PMID: 37354112 DOI: 10.1111/apa.16886] [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: 03/17/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 06/26/2023]
Abstract
AIM Little is known about the specific restriction measures used in intensive care units (NICUs) during the COVID-19 pandemic and their impact on parental well-being. Hence, this study aimed to assess the association between restriction measures and mothers' post-partum depressive symptoms. METHODS This comparative cohort study included mothers who gave birth before 35 weeks of gestation in Estonia. The outcome measure was mothers' post-partum depressive symptoms at the time of infant discharge, evaluated using the Edinburgh Postnatal Depression Scale (EPDS). In addition to the pandemic itself, the number of restriction measures in the NICUs was analysed as a potential explanatory factor for depressive symptoms. RESULTS The study included 55 mothers before the pandemic in 2018-2019 and 54 mothers during the COVID-19 pandemic in 2021. No significant difference was found in the median EPDS scores between the cohorts: 7.0 [interquartile range (IQR): 4.0-12.0] and 8.0 (IQR: 5.0-12.8) respectively. The number of restriction measures was not associated with mothers' EPDS scores in either unadjusted or adjusted models. CONCLUSION The COVID-19 pandemic or the number of restriction measures used in Estonian NICUs did not associate with mothers' post = partum depressive symptoms.
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Affiliation(s)
- Ryo Itoshima
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
- Division of Neonatology, Nagano Children's Hospital, Azumino, Japan
| | - Kirsi Tuura
- Department of Psychology and Language Pathology, University of Turku, Turku, Finland
| | - Liis Toome
- Department of Neonatal and Infant Medicine, Tallinn Children's Hospital, Tallinn, Estonia
| | - Heili Varendi
- Neonatal Unit, Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - Pille Saik
- Department of Neonatology, West-Tallinn Central Hospital, Tallinn, Estonia
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Liisa Lehtonen
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Sari Ahlqvist-Björkroth
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Language Pathology, University of Turku, Turku, Finland
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Ahmed N, Barnett P, Greenburgh A, Pemovska T, Stefanidou T, Lyons N, Ikhtabi S, Talwar S, Francis ER, Harris SM, Shah P, Machin K, Jeffreys S, Mitchell L, Lynch C, Foye U, Schlief M, Appleton R, Saunders KRK, Baldwin H, Allan SM, Sheridan-Rains L, Kharboutly O, Kular A, Goldblatt P, Stewart R, Kirkbride JB, Lloyd-Evans B, Johnson S. Mental health in Europe during the COVID-19 pandemic: a systematic review. Lancet Psychiatry 2023; 10:537-556. [PMID: 37321240 PMCID: PMC10259832 DOI: 10.1016/s2215-0366(23)00113-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic caused immediate and far-reaching disruption to society, the economy, and health-care services. We synthesised evidence on the effect of the pandemic on mental health and mental health care in high-income European countries. We included 177 longitudinal and repeated cross-sectional studies comparing prevalence or incidence of mental health problems, mental health symptom severity in people with pre-existing mental health conditions, or mental health service use before versus during the pandemic, or between different timepoints of the pandemic. We found that epidemiological studies reported higher prevalence of some mental health problems during the pandemic compared with before it, but that in most cases this increase reduced over time. Conversely, studies of health records showed reduced incidence of new diagnoses at the start of the pandemic, which further declined during 2020. Mental health service use also declined at the onset of the pandemic but increased later in 2020 and through 2021, although rates of use did not return to pre-pandemic levels for some services. We found mixed patterns of effects of the pandemic on mental health and social outcome for adults already living with mental health conditions.
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Affiliation(s)
- Nafiso Ahmed
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK.
| | - Phoebe Barnett
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK; Centre for Outcomes Research and Effectiveness, University College London, London, UK; National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
| | - Anna Greenburgh
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Tamara Pemovska
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Theodora Stefanidou
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Natasha Lyons
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Sarah Ikhtabi
- Division of Psychiatry, University College London, London, UK
| | - Shivangi Talwar
- Division of Psychiatry, University College London, London, UK
| | - Emma R Francis
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Samantha M Harris
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Prisha Shah
- Lived Experience Working Group, University College London, London, UK
| | - Karen Machin
- Lived Experience Working Group, University College London, London, UK
| | - Stephen Jeffreys
- Lived Experience Working Group, University College London, London, UK
| | - Lizzie Mitchell
- Lived Experience Working Group, University College London, London, UK
| | - Chris Lynch
- Lived Experience Working Group, University College London, London, UK
| | - Una Foye
- National Institute of Health and Care Research Mental Health Policy Research Unit, King's College London, London, UK
| | - Merle Schlief
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Rebecca Appleton
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Katherine R K Saunders
- National Institute of Health and Care Research Mental Health Policy Research Unit, King's College London, London, UK
| | - Helen Baldwin
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Sophie M Allan
- Cambridgeshire and Peterborough National Health Service Foundation Trust, South London and Maudsley National Health Service Foundation Trust, London, UK
| | - Luke Sheridan-Rains
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | | | - Ariana Kular
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Peter Goldblatt
- Institute of Health Equity, University College London, London, UK
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, London, UK
| | | | - Brynmor Lloyd-Evans
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Sonia Johnson
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
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Prevalence of and factors associated with postnatal depression and anxiety among parents of preterm infants: A systematic review and meta-analysis. J Affect Disord 2023; 322:235-248. [PMID: 36400151 DOI: 10.1016/j.jad.2022.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/24/2022] [Accepted: 11/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study aimed to determine the prevalence of and factors associated with postpartum depression and anxiety among mothers and fathers of preterm infants and to examine the relationships between maternal and paternal symptoms. METHODS Six electronic databases were searched to identify eligible studies reporting parental depression and anxiety within 1 year postpartum. Data were extracted for a random-effects meta-analysis to estimate the prevalence with 95 % confidence intervals (CIs). Subgroup and meta-regression analyses were conducted to analyze associations between study characteristics and prevalence estimates. RESULTS In total, 79 studies were included. The meta-analysis of studies on mothers generated estimates of prevalence for depression (29.2 %, 95 % CI, 21.8 %-37.9 %) and anxiety (37.7 %, 95 % CI, 24.1 %-53.6 %). The meta-analysis of fathers indicated a pooled depression prevalence of 17.4 % (95 % CI, 12.5 %-23.8 %) and an anxiety estimate of 18.3 % (95 % CI, 8.1 %-36.3 %). Assessment time points and methods as well as the geographic continent in which the study was conducted were significant moderators of depression and anxiety. Significant inter-correlations were found between mothers' and fathers' depression and anxiety symptoms (p < 0.05). LIMITATIONS Limited data from specific geographic continents, including Africa and Asia. CONCLUSIONS Prevalence of depression and anxiety among preterm infants' parents was high, highlighting the need for early psychological screening and assessment. Further research is required to improve services that focus on parents' postpartum psychological needs in the family context.
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Zhang X, Wang C, Zuo X, Aertgeerts B, Buntinx F, Li T, Vermandere M. Study characteristical and regional influences on postpartum depression before vs. during the COVID-19 pandemic: A systematic review and meta-analysis. Front Public Health 2023; 11:1102618. [PMID: 36875385 PMCID: PMC9975262 DOI: 10.3389/fpubh.2023.1102618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/23/2023] [Indexed: 02/17/2023] Open
Abstract
Background While the public is under serious pressure from the coronavirus disease 2019 (COVID-19), the final impact and possible contributing factors to postpartum depression symptoms (PPDS) remain unknown. Therefore, a meta-analysis to investigate the association between PPDS and the COVID-19 pandemic was carried out by comparing the data between pre-pandemic and post-pandemic timeframes and exploring the influencing factors. Methods This systematic review was prospectively registered and recorded in a study protocol (Prospero CRD42022336820, http://www.crd.york.ac.uk/PROSPERO). A comprehensive search of PubMed, Embase, Web of Science, CINALH, Cochrane and Scopus was cmpleted on June 6, 2022. Studies that compared the prevalence of PPD before and during the COVID-19 pandemic period were included. Results Of 1766 citations identified, 22 studies were included with 15,098 participates before the COVID-19 pandemic and 11,836 participants during the COVID-19 pandemic. Overall, the analysis showed that the epidemic crisis was associated with an increased prevalence of PPDS (OR: 0.81 [0.68, 0.95], P = 0.009, I 2 = 59%). Subgroup analysis was conducted according to the study characteristics and regions. Within the study characteristics classification, results showed an obvious increase in the prevalence of PPDS during the COVID-19 pandemic if PPDS cutoff was defined as Edinburgh postpartum depression score (EPDS) ≥13 points (OR: 0.72 [0.52, 0.98], P = 0.03, I 2 = 67%) and an increased prevalence in follow-ups that happened after 2 weeks (≥ 2 weeks postpartum) (OR: 0.81 [0.68, 0.97], P = 0.02, I 2 = 43%). Selected studies that were high-quality (OR: 0.79 [0.64, 0.97], P = 0.02, I 2 = 56%) demonstrated an increased prevalence of PPDS during the COVID-19 pandemic period. Sorting by regional factors, studies conducted in Asia (OR: 0.81 [0.70, 0.93], P = 0.003, I 2 = 0%) showed an increase of PPDS prevalence rates during the COVID-19 period, while studies conducted in Europe (OR: 0.82 [0.59, 1.13], P = 0.23, I 2 = 71%) and North America (OR: 0.66 [0.42, 1.02], P = 0.06, I 2 = 65%) showed no significant difference. All studies conducted in the developed (OR: 0.79 [0.64, 0.98], P = 0.03, I 2 = 65%) and developing countries (OR: 0.81 [0.69, 0.94], P = 0.007, I 2 = 0%) showed an increase of PPDS during the COVID-19 period. Conclusions The COVID-19 pandemic is associated with an increased prevalence of PPDS, especially after long-term follow-up and among the group with a high possibility of depression. The negative influence from the pandemic, causing more PPDS was significant in studies from Asia.
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Affiliation(s)
- Xiaoqian Zhang
- Department of Public Health and Primary Care, Academic Center for General Practice, Katholieke Universiteit Leuven, Leuven, Belgium.,Department of Family Medicine, Qingdao United Family Hospital, Qingdao, China
| | - Chun Wang
- Department of Obstetrics and Gynecology, Qingdao Municipal Hospital, Qingdao, China
| | - Xiaoli Zuo
- Department of Family Medicine, Qingdao United Family Hospital, Qingdao, China
| | - Bert Aertgeerts
- Department of Public Health and Primary Care, Academic Center for General Practice, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Frank Buntinx
- Department of Public Health and Primary Care, Academic Center for General Practice, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Tang Li
- Department of Pediatrics, Qingdao University Medical College, Qingdao, China
| | - Mieke Vermandere
- Department of Public Health and Primary Care, Academic Center for General Practice, Katholieke Universiteit Leuven, Leuven, Belgium
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Lin C, Chen B, Yang Y, Li Q, Wang Q, Wang M, Guo S, Tao S. Association between depressive symptoms in the postpartum period and COVID-19: A meta-analysis. J Affect Disord 2023; 320:247-253. [PMID: 36195169 PMCID: PMC9526510 DOI: 10.1016/j.jad.2022.09.129] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND With the pandemic of COVID, the public are faced with tremendous threatens both physically and mentally. Postpartum depression (PPD) is one of the most serious complications of childbearing, bringing severe impact on a woman's mental state and mood after birth. Research has shown that maternal mental state is closely correlated with PPD, those undergo the emergency or significant life changes during the postpartum period are more likely to suffer from PPD. In this study, we conducted the meta-analysis to estimate the association between PPD and COVID-19 pandemic. METHODS PubMed, Web of Science, PsycINFO, ScienceDirect, CNKI, China Science and Technology Journal Database, and WANFANG Database were searched for potentially relevant articles published before April 2022. Review Manager 5.2 was used to perform a meta-analysis and subgroup analysis to compute the pooled odds ratio. RESULTS A total of 26 studies were included in this review. The overall pooled prevalence of PPD in the review was 24 % (95 % CI: 0.19-0.29), with China's at 22 % (95 % CI 0.16-0.28) and other countries at 25 % (95 % CI 0.18-0.32) during the COVID-19 pandemic. Moreover, compared to those who did not experience COVID-19, those who experienced it had an increased risk of PPD[OR:1.83(95 % CI 1.70-1.97)]. CONCLUSIONS According to this analysis, there was a significantly higher prevalence and odds of PPD in those who suffered from the COVID-19 pandemic. Additionally, we also found that China had a lower prevalence of postpartum depression than other countries during the COVID-19 pandemic. Our study may provide the instruction for the care of new mother under the situation of COVID-19 prevalence.
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Affiliation(s)
- Chenxinzi Lin
- Medical College of Soochow University, 199 Ren'ai Road, Suzhou 215123, China
| | - Bin Chen
- Suzhou New District Center for Disease Control and Prevention, Suzhou 215123, China
| | - Youjing Yang
- Chongqing University Central Hospital & Chongqing Emergency Medical Center, No. 1 Jiankang Road, Yuzhong District, Chongqing 400014, China
| | - Qianmin Li
- Medical College of Soochow University, 199 Ren'ai Road, Suzhou 215123, China
| | - Qiuguo Wang
- Medical College of Soochow University, 199 Ren'ai Road, Suzhou 215123, China
| | - Minmin Wang
- Medical College of Soochow University, 199 Ren'ai Road, Suzhou 215123, China
| | - Shiying Guo
- Medical College of Soochow University, 199 Ren'ai Road, Suzhou 215123, China
| | - Shasha Tao
- Chongqing University Central Hospital & Chongqing Emergency Medical Center, No. 1 Jiankang Road, Yuzhong District, Chongqing 400014, China; Medical College of Soochow University, 199 Ren'ai Road, Suzhou 215123, China.
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Safi-Keykaleh M, Aliakbari F, Safarpour H, Safari M, Tahernejad A, Bardsiri HS, Sahebi A. Prevalence of postpartum depression in women amid the COVID-19 pandemic: A systematic review and meta-analysis. Int J Gynaecol Obstet 2022; 157:240-247. [PMID: 35122433 PMCID: PMC9087783 DOI: 10.1002/ijgo.14129] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 02/02/2022] [Indexed: 11/06/2022]
Abstract
COVID‐19 outbreaks appear to be related to exacerbation of psychological problems such as depression and anxiety in high‐risk population such as pregnant women and the postpartum period due to stress and life‐threatening illnesses. The aim of this study was to evaluate the prevalence of postpartum depression (PPD) during COVID‐19. This study protocol is registered in PROSPERO with CRD42021278425 code. Data sources including Google Scholar, ISC, Magiran, Scopus, PubMed, Embase, and Web of Science and reference list of included articles were used to identify related studies. Observational studies that reported the prevalence of PPD in both Persian and English during COVID‐19 between January 20, 2020 and August 31, 2021 were included. Data were collected and analyzed with a random effects model for meta‐analysis. In this study, 671 initial articles were identified and after removing duplicates, 454 studies were screened and finally 24 studies entered the meta‐analysis stage. According to this study results PPD based on Edinburgh Postnatal Depression Scale (EPDS) ≥9, EPDS ≥10, EPDS ≥11, EPDS ≥12, EPDS ≥13, Postpartum Depression Screening Scale‐Short Form (PDSS‐SF) ≥17 and total prevalence was reported 12% (95% confidence interval [CI] = 0.07–17, I2 = 97%), 27% (95% CI = 15–39, I2 = 99%), 44% (95% CI = 40–49, I2 = 0.0%), 27% (95% CI = 0.06–49, I2 = 97.4%), 28% (95% CI = 18–39, I2 = 98.5%), 37% (95% CI = 32–42), 28% (95% CI = 23–33, I2 = 98.5%). The findings of this study showed that the prevalence of PPD in women is relatively high during COVID‐19. Therefore, considering the psychological consequences of the COVID‐19 pandemic and the importance of pregnancy and the postpartum period in terms of the emergence of mental disorders, especially depression, it seems necessary to perform interventions and physical and psychological support. The present study found that the prevalence of postpartum depression( PPD) in women is relatively high during COVID‐19.
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Affiliation(s)
- Meysam Safi-Keykaleh
- Nahavand School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Aliakbari
- Community-Oriented Nursing and Midwifery Research, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hamid Safarpour
- Non - Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran.,Department of Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Mehdi Safari
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Tahernejad
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hojjat Sheikh Bardsiri
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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