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Ravaldi C, Mosconi L, Crescioli G, Lombardo G, Russo I, Morese A, Ricca V, Vannacci A. Are midwives trained to recognise perinatal depression symptoms? Results of MAMA (MAternal Mood Assessment) cross-sectional survey in Italy. Arch Womens Ment Health 2024; 27:567-576. [PMID: 38308142 PMCID: PMC11230996 DOI: 10.1007/s00737-024-01439-z] [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: 09/06/2023] [Accepted: 01/29/2024] [Indexed: 02/04/2024]
Abstract
PURPOSE To assess the knowledge, clinical experience, and attitudes of Italian midwives toward perinatal depression (PND) and to explore how these factors impact the quality of care. METHODS We conducted a cross-sectional online survey among 152 midwives employed in public hospitals across Italy. The questionnaire covered a range of topics, including demographic data, professional experience, knowledge of PND symptoms, risk factors, and clinical management, as well as communication skills and personal experiences with PND cases. RESULTS A concerning 76.3% of midwives displayed inadequate knowledge of PND based on current scientific literature. Those with a more comprehensive understanding were notably more confident in their practice, expressing significantly fewer apprehensions about communicating with mothers (25.8% vs 74.2%) and lesser concerns about the mothers' future well-being (38.9% vs 62.95%). The survey results also emphasised the midwives' call for specialised guidelines and formal training in PND management and underscored the value of communication skills, continuity of care, and family engagement in supporting affected mothers. CONCLUSION This inaugural study sheds light on the current state of knowledge and attitudes among Italian midwives regarding PND. It pinpoints crucial areas for educational enhancement and practice improvement, suggesting that elevated levels of midwife expertise in PND could significantly elevate the standard of care and expedite early diagnosis and treatment.
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Affiliation(s)
- Claudia Ravaldi
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Laura Mosconi
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Giada Crescioli
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Giulia Lombardo
- Unit of Obstetrics and Gynecology, Parma University Hospital, Parma, Italy
| | - Ilenia Russo
- Unit of Obstetrics and Gynecology, "S. Marta E S. Verera" Hospital, ASP Catania, Acireale, Italy
| | - Angelo Morese
- Section of Pediatrics, Obstetrics and Gynecology and Nursing, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Section of Psychiatry, Department of Health Sciences, University of Florence, Florence, Italy
| | - Alfredo Vannacci
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy.
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Gu Y, Waters TEA, Zhu V, Jamieson B, Lim D, Schmitt G, Atkinson L. Attachment expectations moderate links between social support and maternal adjustment from 6 to 18 months postpartum. Dev Psychopathol 2024:1-13. [PMID: 38273665 DOI: 10.1017/s0954579423001657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Significant links exist between one's perception of available social support and mental health outcomes, including during the transition to motherhood. Yet, attachment theory posits that individuals do not benefit equally from social support. As such, we examined the influence of attachment representations (i.e., secure base script knowledge) as they potentially moderate links between social support and psychological distress in a 1-year longitudinal study of an ethnically diverse (56% White) sample of infant-mother dyads. We hypothesized that higher social support would predict lower maternal psychological distress and this relation would be strongest in those with higher secure base script knowledge. Results indicated that maternal perceptions of social support were significantly negatively correlated with psychological distress. Analyses revealed that secure base script scores significantly moderated these associations. Interestingly, for those high in script knowledge, low social support predicted greater psychological distress. For those low in script knowledge, social support was unrelated to psychological distress. This pattern suggested that those who expect care (i.e., high secure base script knowledge) but receive minimal support (i.e., low perceived social support) find motherhood uniquely dysregulating. Practitioners may do well to examine individuals' attachment expectations in relation to their current social support.
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Affiliation(s)
- Yufei Gu
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Theodore E A Waters
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Victoria Zhu
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Brittany Jamieson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Danielle Lim
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Gabrielle Schmitt
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
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Miranda AR, Cortez MV, Scotta AV, Soria EA. COVID-19-related stress in postpartum women from Argentina during the second wave in 2021: Identification of impairing and protective factors. Midwifery 2022; 108:103290. [PMID: 35235890 PMCID: PMC8860463 DOI: 10.1016/j.midw.2022.103290] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 02/07/2022] [Accepted: 02/20/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Postpartum women are a vulnerable population to pandemic stressors that challenge their psychological well-being. Thus, reliable and valid instruments are necessary to measure pandemic-related stress and to identify risk and protective factors. This work aimed to assess psychometric properties of the COVID-19 Pandemic-Related Stress Scale (PSS-10-C) and associations of maternal pandemic stress with demographic, reproductive and pandemic factors of Argentinian postpartum women during the second COVID-19 wave. DESIGN An online cross-sectional survey was conducted from April to June 2021. SETTING Online recruitment of postpartum women was carried out during the second wave of COVID-19 in Argentina. This study was conducted in accordance with the Declaration of Helsinki and had the corresponding ethical approval. PARTICIPANTS This study was performed on 300 women, aged 18-49 years, up to 12 months postpartum in Argentina. MEASUREMENTS AND FINDINGS Stress was assessed with PSS-10-C, with a sociodemographic questionnaire being used to collect demographic, reproductive and pandemic variables. Statistical analysis included psychometric procedures, structural equation modeling, and multiple regressions. PSS-10-C was a reliable and structurally valid instrument with two subscales, with entire scale, Stress and Coping subscales scoring 17.31 (6.52), 9.70 (4.61) and 7.61 (2.77), respectively. History of mood disorders, pregnancy loss, and unhealthy child during the pandemic predisposed to increased stress (β > 0.10, p < 0.05), whereas having work and practicing breastfeeding promoted coping to face it (β < -0.13, p < 0.05). This situation was impaired by mood changes, loss of happiness, economic changes, fear of contracting COVID-19 -own or by a loved one- (β > 0.11, p < 0.05). KEY CONCLUSIONS The study highlighted the vulnerability of postpartum women's mental health in the pandemic context, with PSS-10-C being a useful instrument for clinicians and researchers to assess perceived stress. Targeting interventions toward women at higher risk can be highly beneficial for maternal and child health.
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Affiliation(s)
- Agustín R Miranda
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología, Universidad Nacional de Córdoba, Ciudad Universitaria, Bv. de la Reforma, Córdoba 5014, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA, Ciudad Universitaria, Bv. de la Reforma, Córdoba 5014, Argentina
| | - Mariela V Cortez
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología, Universidad Nacional de Córdoba, Ciudad Universitaria, Bv. de la Reforma, Córdoba 5014, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA, Ciudad Universitaria, Bv. de la Reforma, Córdoba 5014, Argentina
| | - Ana V Scotta
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología, Universidad Nacional de Córdoba, Ciudad Universitaria, Bv. de la Reforma, Córdoba 5014, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA, Ciudad Universitaria, Bv. de la Reforma, Córdoba 5014, Argentina
| | - Elio A Soria
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA, Ciudad Universitaria, Bv. de la Reforma, Córdoba 5014, Argentina; Facultad de Ciencias Médicas, Cátedra de Biología Celular, Histología y Embriología, Instituto de Biología Celular, Universidad Nacional de Córdoba, Ciudad Universitaria, Bv. de la Reforma, Córdoba 5014, Argentina.
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Hairol MI, Ahmad S, Sharanjeet-Kaur S, Hum Wee L, Abdullah F, Ahmad M. Incidence and predictors of postpartum depression among postpartum mothers in Kuala Lumpur, Malaysia: A cross-sectional study. PLoS One 2021; 16:e0259782. [PMID: 34752486 PMCID: PMC8577760 DOI: 10.1371/journal.pone.0259782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/27/2021] [Indexed: 11/19/2022] Open
Abstract
Postpartum depression (PPD) is one of the mental health complications that may arise following childbirth. This cross-sectional study explores the association between socioeconomic factors and PPD literacy with PPD incidence in 350 participants (mean age: 30.58±4.72 years) at one to six months postpartum, who attended the Kuala Lumpur Health Clinic from May to October 2020. PPD incidence and literacy were assessed using the validated Malay versions of the Edinburgh Postpartum Depression Scale (EPDS) and the Postpartum Depression Literacy Scale (PoDLiS), respectively. The participants' socioeconomic characteristics were collected using a self-administered questionnaire. Chi-square tests were performed to determine the association between these factors and PPD incidence. Binary logistic regression models were used to determine the odds ratios (OR). The incidence of postpartum depressive symptoms was 14.29%. Those with low household income were twice likely to have PPD symptoms (OR:2.58, 95% CI:1.23-5.19; p = 0.01) than those with higher incomes. Unemployment (i.e., participants who were housewives/homemakers) was associated with higher PPD incidence (Χ2(2, 350) = 6.97, p = 0.03), but it was not a significant PPD predictor. In conclusion, PPD incidence in the sample of Kuala Lumpur postpartum mothers is significantly associated with low household income. Other socioeconomic characteristics, including PPD literacy, were not significant predictors of PPD incidence.
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Affiliation(s)
- Mohd Izzuddin Hairol
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sha’ari Ahmad
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sharanjeet Sharanjeet-Kaur
- Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Fauziah Abdullah
- Jabatan Kesihatan Wilayah Persekutuan Kuala Lumpur & Putrajaya (The Federal Territory of Kuala Lumpur & Putrajaya Health Department), Kuala Lumpur, Malaysia
| | - Mahadir Ahmad
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Guan Z, Wang Y, Hu X, Chen J, Qin C, Tang S, Sun M. Postpartum depression and family function in Chinese women within 1 year after childbirth: A cross-sectional study. Res Nurs Health 2021; 44:633-642. [PMID: 34101868 DOI: 10.1002/nur.22159] [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] [Received: 09/02/2020] [Revised: 05/03/2021] [Accepted: 05/15/2021] [Indexed: 01/13/2023]
Abstract
Family-related factors are reported to influence the development of postpartum depression (PPD), but limited studies have considered the role of family function in this condition. This study aimed to describe the proportion of people with probable or suspected PPD and to determine the relationships among PPD, family function, and obstetric factors. A cross-sectional study was conducted with 630 women who attended six integrated teaching and scientific research communities in Changsha, China. Instruments included the Edinburgh Postpartum Depression Scale and the Family Assessment Device (FAD). A multivariate logistic regression model was used to determine the risk factors of PPD. The prevalence of probable or suspected PPD was 37% in this sample. We found communication (odds ratio [OR] = 3.795, 95% confidence interval [CI] = 1.619-8.897), affective responsiveness (OR = 2.685, 95% CI = 1.642-4.301), role (OR = 2.483, 95% CI = 1.041-5.922), and general functioning (OR = 5.704,95% CI = 2.233-14.569) dimensions of FAD, and type of feeding (OR = 2.700, 95% CI = 1.285-5.671) influenced PPD in the context of Chinese culture. To decrease the prevalence of PPD, interventions such as health education programs and cognitive behavior therapy to strengthen family function are recommended among couples during and after pregnancy.
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Affiliation(s)
- Ziyao Guan
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Yuwei Wang
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Xin Hu
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Jiarui Chen
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Chunxiang Qin
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China.,Department of Obstetrical, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Siyuan Tang
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Mei Sun
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China.,Hunan Women's Research Association, Changsha, China
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Atuhaire C, Brennaman L, Cumber SN, Rukundo GZ, Nambozi G. The magnitude of postpartum depression among mothers in Africa: a literature review. Pan Afr Med J 2020; 37:89. [PMID: 33244352 PMCID: PMC7680231 DOI: 10.11604/pamj.2020.37.89.23572] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/21/2020] [Indexed: 11/12/2022] Open
Abstract
Introduction postpartum depression (PPD) continues to become one of the major maternal health challenges across the globe but there is a paucity of recent data on its magnitude in Africa. This study was motivated by the need to update the current magnitude of PPD in Africa based on various assessment tools. Methods a total of 21 articles met the study criteria. Fifteen articles used the EPDS and six used other assessment tools. Postpartum depression among studies that used EPDS tool ranged from 6.9% in Morocco to 43% in Uganda and 6.1% in Uganda to 44% in Burkina Faso among studies that used other depression assessment tools. Sensitivity and specificity results of the EPDS ranged from 75%-100% and 87%-98% respectively. Results a total of 21 articles met the study criteria. Fifteen articles used the EPDS and six used other assessment tools. Postpartum depression among studies that used EPDS tool ranged from 6.9% in Morocco to 43% in Uganda and 6.1% in Uganda to 44% in Burkina Faso among studies that used other depression assessment tools. Sensitivity and specificity results of the EPDS ranged from 75%-100% and 87%-98% respectively. Conclusion despite the limited dearth of literature, the magnitude of PPD in Africa remains high which suggests that PPD is still a neglected illness and calls for immediate interventions. EPDS is an effective tool with high sensitivity and specify in varying study contexts.
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Affiliation(s)
- Catherine Atuhaire
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Laura Brennaman
- Nova Southeastern University College of Nursing, Fort Myers Campus, 3650 Colonial Court, Fort Myers, Florida, United State of America
| | - Samuel Nambile Cumber
- Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, South Africa.,Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Institute of Health and Care Sciences, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Godfrey Zari Rukundo
- Faculty of Medicine, Department of Psychiatry, Mbarara University of Science and Technology, Uganda
| | - Grace Nambozi
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda
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UZUN ÇİÇEK A, GULTEKİN K, DEMİREL G. Understanding the psycho-social differences between mothers of infants who do and do not have dyschezia. KONURALP TIP DERGISI 2020. [DOI: 10.18521/ktd.761549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Boran P, Waqas A, Aşkan ÖÖ, Topçu İ, Dogan T, Rahman A. Screening of postpartum depression among new mothers in Istanbul: a psychometric evaluation of the Turkish Edinburgh Postnatal Depression Scale. BMC Res Notes 2020; 13:355. [PMID: 32723389 PMCID: PMC7390134 DOI: 10.1186/s13104-020-05196-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study is the first concerted effort to ascertain factor structure of EPDS using evidence based analytical techniques. It is the most widely used scale for assessing postpartum depression in Turkey, and yet no investigations have been conducted to assess it factor structure. This study was conducted from April 2012 to April 2018 at the Marmara University Hospital operating under the name of Marmara University Pendik Training and Research Hospital in Istanbul Turkey. RESULTS A total of 1700 women were included in this study, who responded to the EPDS, in addition to demographic characteristics and well-being of their offspring. A total of 1615 mothers provided adequate data for inclusion in analysis. Standardized Chronbach's alpha for EPDS was 0.81 with corrected item-total correlations ranging from 0.35 to 0.62. Parallel analysis, MAP Velicer Test and Hull's method dictated retaining of one factor structure. All the items revealed adequate communalities (> 0.20) except item 2 (enjoyment) and item 10 (self-harm). Their communalities were 0.16 and 0.19, however, these items were not dropped. All of the items yielded moderate to strong factor loadings. Minimum factor loading was for item 2 (0.40) and highest for item 8 (0.71).
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Affiliation(s)
- Perran Boran
- Division of Social Pediatrics, Department of Pediatrics, School of Medicine, Marmara University, İstanbul, Turkey
| | - Ahmed Waqas
- Human Development Research Foundation, F-7/4, Islamabad, Pakistan.
| | - Öykü Özbörü Aşkan
- Division of Social Pediatrics, Department of Pediatrics, School of Medicine, Marmara University, İstanbul, Turkey
| | - İrem Topçu
- Division of Social Pediatrics, Department of Pediatrics, School of Medicine, Marmara University, İstanbul, Turkey
| | - Tugay Dogan
- Division of Social Pediatrics, Department of Pediatrics, School of Medicine, Marmara University, İstanbul, Turkey
| | - Atif Rahman
- Institute of Population Health, University of Liverpool, The Waterhouse Building, Dover St, Liverpool, L3 5DA, UK
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Dadi AF, Miller ER, Mwanri L. Postnatal depression and its association with adverse infant health outcomes in low- and middle-income countries: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:416. [PMID: 32698779 PMCID: PMC7374875 DOI: 10.1186/s12884-020-03092-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 07/03/2020] [Indexed: 02/08/2023] Open
Abstract
Background Postnatal Depression (PND) is a mood disorder that steals motherhood and affects the health and development of a newborn. While the impact of PND on motherhood and newborn in developed countries are well described, its epidemiology and health consequences in infant is not well known in middle-and low-income countries. The objective of this review was to determine the burden and association of PND with adverse infant health outcomes in low-and middle- income countries. Methods We searched observational studies written in the English language and conducted in middle-and low-income countries between December 1st, 2007, and December 31st, 2017. The CINHAL, MEDLINE, Emcare, PubMed, Psych Info, and Scopus databases were searched for the following search terms: PND, acute respiratory infection, pneumonia, diarrhea, exclusive breastfeeding, common infant illnesses, and malnutrition. We excluded studies in which the primary outcomes were not measured following a standardized approach. We have meta-analyzed the estimates from primary studies by adjusting for possible publication bias and heterogeneity. The analysis was conducted in Stata 14. The study was registered in PROSPERO protocol number CRD42017082624. Result Fifty-eight studies on PND prevalence (among 63,293 women) and 17 studies (among 32,454 infants) on infant health outcomes were included. PND prevalence was higher in the low-income countries (Pooled prevalence (PP) = 25.8%; 95%CI: 17.9–33.8%) than in the middle-income countries (PP = 20.8%; 95%CI: 18.4–23.1%) and reached its peak in five to ten weeks after birth. Poor obstetric history and social support, low economic and educational status, and history of exposure to violence were associated with an increased risk of PND. The risk of having adverse infant health outcomes was 31% higher among depressed compared to non-depressed postnatal mothers (Pooled relative risk (PRR) = 1.31; 95%CI: 1.17–1.48). Malnutrition (1.39; 1.21–1.61), non-exclusive breastfeeding (1.55; 1.39–1.74), and common infant illnesses (2.55; 1.41–4.61) were the main adverse health outcomes identified. Conclusions One in four and one in five postnatal mothers were depressed in low and middle-income countries, respectively. Causes of depression could be explained by social, maternal, and psychological constructs. High risk of adverse infant health outcomes was associated with PND. Timely screening of PND and evidence-based interventions were a pressing need in low and middle-income countries.
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Affiliation(s)
- Abel Fekadu Dadi
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. .,College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia.
| | - Emma R Miller
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
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Palumbo G, Mirabella F, Gigantesco A. Positive screening and risk factors for postpartum depression. Eur Psychiatry 2020; 42:77-85. [DOI: 10.1016/j.eurpsy.2016.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 11/15/2016] [Accepted: 11/19/2016] [Indexed: 11/29/2022] Open
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Matsumura K, Hamazaki K, Tsuchida A, Kasamatsu H, Inadera H. Education level and risk of postpartum depression: results from the Japan Environment and Children's Study (JECS). BMC Psychiatry 2019; 19:419. [PMID: 31882000 PMCID: PMC6935197 DOI: 10.1186/s12888-019-2401-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/09/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Lower socioeconomic status is often thought to be associated with an elevated risk of postpartum depression; however, this relationship exhibits noticeable heterogeneity between studies. The present study examined this relationship in Japan. METHODS Data were obtained from 90,194 mothers in an ongoing birth cohort of the Japan Environment and Children's Study. Socioeconomic status was assessed based on the mothers' highest education level during pregnancy. Postpartum depression was identified at 1 and 6 months postpartum based on an Edinburgh Postnatal Depression Scale score of ≥9, and analyses were also performed based on the sub-scores for anxiety, depression, and anhedonia symptoms. Logistic and generalized linear regression model analyses were used to calculate odds ratios for postpartum depression according to education level with the highest education group (≥16 years of education) defined as the reference group, while controlling for covariates in a stepwise fashion. RESULTS Univariate analysis revealed that a lower education level was associated with a higher prevalence of postpartum depression and related symptoms. Although these relationships weakened in the fully adjusted models, odds ratios for cases and related symptoms remained significant at 1 and 6 months postpartum. Among three symptom dimensions, the relationship was strongest and weakest in the depressive and anxiety symptoms, respectively. CONCLUSIONS A lower education level was an independent risk factor for postpartum depression. In view of the low mobility of the education level, this finding suggests the potential importance of collecting information regarding education levels at the earliest opportunity.
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Affiliation(s)
- Kenta Matsumura
- Toyama Regional Center for Japan Environment and Children’s Study, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Kei Hamazaki
- Toyama Regional Center for Japan Environment and Children’s Study, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Akiko Tsuchida
- Toyama Regional Center for Japan Environment and Children’s Study, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Haruka Kasamatsu
- Toyama Regional Center for Japan Environment and Children’s Study, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
| | - Hidekuni Inadera
- Toyama Regional Center for Japan Environment and Children’s Study, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194 Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
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Hollins Martin CJ, Anderson L, Martin CR. A scoping review to determine themes that represent perceptions of self as mother ('ideal mother' vs 'real mother'). J Reprod Infant Psychol 2018; 37:224-241. [PMID: 30554526 DOI: 10.1080/02646838.2018.1556786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Postnatal depression (PND) is a key cause of maternal morbidity, with current systems of initial recognition in the UK detecting only 50% of cases. In attempts to predict those potentially at risk, this review suggests a novel approach. Aim: Implementing the concept of 'ideal mother' versus 'real mother', and asking the woman to compare their 'ideal self' against 'existent self', the aim of this instrument development review was to determine themes from the literature that relate to women's perceptions of self as a mother, and from this identification develop questions for inclusion within a proposed new measure entitled the Self-Image as Mother Scale (SIMS). Method: A scoping review of the literature was carried out to identify themes considered to affect perception of self as mother, and from this identification, evidence-based questions for inclusion in the SIMS were developed. Findings: Themes identified included (1) marital dissatisfaction, (2) inadequate partner support, (3) lack of family support, (4) socioeconomic status and associated poverty, (5) concern about infant, (6) antenatal/postnatal complications, (7) acceptance of infant gender, (8) history of mental health problems, (9) unplanned pregnancy. Conclusions: From this scoping review 18 questions were developed for inclusion in the SIMS, which will then be evaluated for psychometric properties, scale refinement and validation.
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Affiliation(s)
- Caroline J Hollins Martin
- a Maternal Health, School of Nursing, Midwifery and Social Care , Edinburgh Napier University (ENU), Sighthill Campus , Edinburgh , UK
| | - Lara Anderson
- b School of Nursing, Midwifery and Social Care , Edinburgh Napier University (ENU), Sighthill Campus , Edinburgh , UK
| | - Colin R Martin
- c Perinatal Mental Health , Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull , UK
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Karaçam Z, Çoban A, Akbaş B, Karabulut E. Status of postpartum depression in Turkey: A meta-analysis. Health Care Women Int 2018; 39:821-841. [DOI: 10.1080/07399332.2018.1466144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Zekiye Karaçam
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Ayden Çoban
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Burcu Akbaş
- Department of Midwifery, Institute of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Erdem Karabulut
- Medical Faculty Department of Biostatistics, Hacettepe University, Ankara, Turkey
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Yanıkkerem E, Esmeray N, Karakuş A, Üstgörül S, Baydar Ö, Göker A. Factors affecting readiness for discharge and perceived social support after childbirth. J Clin Nurs 2018; 27:2763-2775. [DOI: 10.1111/jocn.14248] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Emre Yanıkkerem
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Nicole Esmeray
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Aslı Karakuş
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Sema Üstgörül
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Özge Baydar
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Aslı Göker
- Faculty of Medicine Obstetrics and Gynecology Department Manisa Celal Bayar University Hafsa Sultan Hospital Manisa Turkey
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Ashford MT, Ayers S, Olander EK. Interest in web-based treatments for postpartum anxiety: an exploratory survey. J Reprod Infant Psychol 2018. [PMID: 29517373 DOI: 10.1080/02646838.2017.1320364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aimed to explore women's interest in web-based treatments for postpartum anxiety and determine the feasibility of reaching women with postpartum anxiety online. BACKGROUND Anxiety in the postpartum period is common and often untreated. One innovative approach of offering treatment during this period is through web-based self-help. Assessing women's interest in new treatments, such as a web-based self-help, is an important step prior to development efforts. METHODS A cross-sectional online survey was created and promoted for 4 months via unpaid social media posts (Facebook and Twitter). To be eligible, women had to be over the age of 18, live in England, fluent in English, be within 12 months postpartum and self-report at least mild levels of anxiety. RESULTS A sample of 114 eligible women were recruited. The majority were Caucasian, well-educated, middle-class women. Seventy percent reported moderate or severe anxiety. Sixty-one percent of women expressed interest in web-based postpartum anxiety treatments. Women preferred treatment in a smartphone/tablet application format, presented in brief modules and supported by a therapist via email or chat/instant messaging. CONCLUSIONS Based on the stated preferences of participating women it is recommended that postpartum anxiety web-based treatments include different forms of therapist support and use a flexibly accessible smartphone/tablet application format with content split into short sections. The findings also suggest that unpaid social media can be feasible in reaching women with postpartum anxiety, but additional efforts are needed to reach a more diverse population.
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Affiliation(s)
- Miriam T Ashford
- a Centre for Maternal and Child Health Research, School of Health Sciences , City, University of London , London , United Kingdom
| | - Susan Ayers
- a Centre for Maternal and Child Health Research, School of Health Sciences , City, University of London , London , United Kingdom
| | - Ellinor K Olander
- a Centre for Maternal and Child Health Research, School of Health Sciences , City, University of London , London , United Kingdom
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Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries. Front Psychiatry 2018; 8:248. [PMID: 29449816 PMCID: PMC5799244 DOI: 10.3389/fpsyt.2017.00248] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/07/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD and a meta-regression to identify economic, health, social, or policy factors associated with national PPD prevalence. METHODS We conducted a systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To test for country level predictors, we drew on data from UNICEF, WHO, and the World Bank. Random effects meta-regression was used to test national predictors of PPD prevalence. FINDINGS 291 studies of 296284 women from 56 countries were identified. The global pooled prevalence of PPD was 17.7% (95% confidence interval: 16.6-18.8%), with significant heterogeneity across nations (Q = 16,823, p = 0.000, I2 = 98%), ranging from 3% (2-5%) in Singapore to 38% (35-41%) in Chile. Nations with significantly higher rates of income inequality (R2 = 41%), maternal mortality (R2 = 19%), infant mortality (R2 = 16%), or women of childbearing age working ≥40 h a week (R2 = 31%) have higher rates of PPD. Together, these factors explain 73% of the national variation in PPD prevalence. INTERPRETATION The global prevalence of PPD is greater than previously thought and varies dramatically by nation. Disparities in wealth inequality and maternal-child-health factors explain much of the national variation in PPD prevalence.
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Affiliation(s)
- Jennifer Hahn-Holbrook
- Department of Psychology, University of California, Merced, Merced, CA, United States
- Center for Excellence in Biopsychosocial Approaches to Health, Chapman University, Orange, CA, United States
| | | | - Itzel Anaya
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
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Shafaie FS, Mirghafourvand M, Rahmati M, Nouri P, Bagherinia M. Association between psychological status with perceived social support in pregnant women referring to Tabriz health centers. J Matern Fetal Neonatal Med 2017; 31:1554-1560. [PMID: 28460552 DOI: 10.1080/14767058.2017.1319934] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to determine the relationship between the psychological status of pregnant women with perceived social support. METHOD In this cross-sectional study, 372 Iranian women were selected randomly via a two-stage cluster sampling method at the third trimester of pregnancy in healthcare centers of Tabriz-Iran. Data were collected using the socio-demographic characteristics questionnaire, perceived social support (PRQ-85) and the short form of depression, anxiety, and stress (DASS-21). The statistical tests including Spearman's correlation, Mann-Whitney, Kruskal Wallis, and linear regression model were used for data. RESULTS The mean (SD) score of perceived social support 131.5 (18.9) with a range of 25-175 was achieved. In terms of the scale of mental health, median (25-75 percentile) of the score of anxiety 4.0 (3.0-7.0), depression 1.0 (0.0-6.0), and stress 8.0 (0.6-10.0) was achieved. There was a significant negative correlation between perceived social support with anxiety (r = -.355, p < .001), depression (r = -.541, p < .001), and stress in women (r = -.302, p < .001). CONCLUSIONS The results of this study showed that social support affects the mental state of women in the third trimester of pregnancy and the levels of anxiety, depression, and stress decrease in pregnant women with increasing of social support.
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Affiliation(s)
- Fahimeh Sehhatie Shafaie
- a Department of Midwifery, Nursing and Midwifery Faculty , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mojgan Mirghafourvand
- a Department of Midwifery, Nursing and Midwifery Faculty , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mahbubeh Rahmati
- b Department of Midwifery, Students' Research Committee, Faculty of Nursing and Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Parviz Nouri
- c Drug Control Headquarters , Master of clinical psychology , Tabriz , Iran
| | - Marzieh Bagherinia
- b Department of Midwifery, Students' Research Committee, Faculty of Nursing and Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
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Matthews J, Huberty JL, Leiferman JA, McClain D, Larkey LK. Perceptions, Uses of, and Interests in Complementary Health Care Approaches in Depressed Pregnant Women: The PAW Survey. J Evid Based Complementary Altern Med 2017; 22:81-95. [PMID: 27071640 PMCID: PMC5871209 DOI: 10.1177/2156587216641829] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 02/23/2016] [Accepted: 03/05/2016] [Indexed: 01/14/2023] Open
Abstract
Depression affects up to 23% of pregnant women and is associated with adverse physical/mental health outcomes for both the mother and baby. Depressed pregnant women may be more likely to engage in unhealthy lifestyle behaviors that contribute to an increased risk for chronic disease. Little is known regarding depressed pregnant women's perceptions, uses of, and interests in complementary health approaches. Study participants (mean age 28.7 ± 6.8; n = 1032) included pregnant women ≥8 weeks gestation who responded to a survey assessing physical and mental health and wellness practices. Of those completing the survey, depressed pregnant women (n = 272) had significantly higher levels of anxiety (P < .001) and stress (P < .001) and had poorer sleep quality (P < .001), mindfulness (P < .001), and social support (P < .001) compared to nondepressed pregnant women (n = 760). A majority (84%) of depressed pregnant women would consider using a complementary health approach for weight and/or stress management during pregnancy, and more than 50% were interested in yoga.
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Norhayati MN, Nik Hazlina NH, Aniza AA, Asrenee AR. Severe Maternal Morbidity and Postpartum Depressive Symptomatology: A Prospective Double Cohort Comparison Study. Res Nurs Health 2016; 39:415-425. [DOI: 10.1002/nur.21741] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Mohd Noor Norhayati
- Associate Professor; Department of Family Medicine; School of Medical Sciences; Universiti Sains Malaysia; 16150 Kota Bharu Kelantan Malaysia
| | - Nik Hussain Nik Hazlina
- Women's Health Development Unit; School of Medical Sciences; Universiti Sains Malaysia; Kota Bharu Kelantan Malaysia
| | - Abd Aziz Aniza
- Faculty of Medicine; Universiti Sultan Zainal Abidin; Kuala Terengganu Terengganu Malaysia
| | - Ab Razak Asrenee
- Department of Psychiatry; School of Medical Sciences; Universiti Sains Malaysia; Kota Bharu Kelantan Malaysia
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21
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Changes in the Relationship Between Socioeconomic Position and Maternal Depressive Symptoms: Results from the Panel Study on Korean Children (PSKC). Matern Child Health J 2016; 19:2057-65. [PMID: 25652067 DOI: 10.1007/s10995-015-1718-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Maternal depression is a common health problem during the perinatal period. The purpose of this study was to examine changes in the relationship between socioeconomic position and maternal depressive symptoms from prenatal to 3 years postpartum in Korean women. Prospective cohort data were collected from the Panel Study on Korean Children between 2008 and 2011. Maternal depression was assessed using the Kessler 6-Item Psychological Distress Scale. Socioeconomic position indicators used were maternal education, paternal education, maternal occupation, paternal occupation, and household income. Repeated-measures analyses with a generalized estimating equation approach were used to investigate relationships between socioeconomic position and maternal depressive symptoms during the study period. Low socioeconomic position was associated with greater levels of maternal depressive symptoms between 4 months after childbirth and 3 years postpartum, but the association was not evident between 1 month before and after childbirth. The magnitude of the significant association between socioeconomic position and maternal depression was the greatest at 1 year postpartum but then became smaller. Among the five socioeconomic position indicators included, maternal education, paternal education, and household income showed graded inverse relationships with maternal depressive symptoms, while no significant relationship was found for paternal occupation over the study period. Socioeconomic inequalities in maternal depressive symptoms emerged in early childhood in a prospective study of Korean mothers. These emerging inequalities may contribute to socioeconomic inequalities in childhood health and development.
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Morikawa M, Okada T, Ando M, Aleksic B, Kunimoto S, Nakamura Y, Kubota C, Uno Y, Tamaji A, Hayakawa N, Furumura K, Shiino T, Morita T, Ishikawa N, Ohoka H, Usui H, Banno N, Murase S, Goto S, Kanai A, Masuda T, Ozaki N. Relationship between social support during pregnancy and postpartum depressive state: a prospective cohort study. Sci Rep 2015; 5:10520. [PMID: 26022720 PMCID: PMC4448522 DOI: 10.1038/srep10520] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 04/16/2015] [Indexed: 12/29/2022] Open
Abstract
Although the association between social support and postpartum depression has been previously investigated, its causal relationship remains unclear. Therefore, we examined prospectively whether social support during pregnancy affected postpartum depression. Social support and depressive symptoms were assessed by Japanese version of Social Support Questionnaire (J-SSQ) and Edinburgh Postnatal Depression Scale (EPDS), among 877 pregnant women in early pregnancy and at one month postpartum. First, J-SSQ was standardized among peripartum women. The J-SSQ was found to have a two-factor structure, with Number and Satisfaction subscales, by exploratory and confirmatory factor analyses. Analysis of covariance was performed to examine how EPDS and J-SSQ scores during pregnancy affected the EPDS score at postpartum. Significant associations were found between postpartum EPDS score and both EPDS and total scores on the Number subscales during pregnancy (β = 0.488 and -0.054, ps < 0.001). Specifically, this negative correlation was stronger in depressive than non-depressive groups. Meanwhile, total score on Satisfaction subscales was not significantly associated with postpartum EPDS score. These results suggest that having a larger number of supportive persons during pregnancy helps protect against postpartum depression, and that this effect is greater in depressive than non-depressive pregnant women. This finding is expected to be vitally important in preventive interventions.
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Affiliation(s)
- Mako Morikawa
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Okada
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shohko Kunimoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukako Nakamura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chika Kubota
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yota Uno
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ai Tamaji
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Kaori Furumura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoko Shiino
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tokiko Morita
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoko Ishikawa
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Harue Ohoka
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hinako Usui
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naomi Banno
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | | - Atsuko Kanai
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
| | - Tomoko Masuda
- Graduate School of Law, Nagoya University, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Norhayati MN, Hazlina NHN, Asrenee AR, Emilin WMAW. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord 2015; 175:34-52. [PMID: 25590764 DOI: 10.1016/j.jad.2014.12.041] [Citation(s) in RCA: 452] [Impact Index Per Article: 50.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 12/15/2014] [Accepted: 12/15/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND The prevalence of postpartum depression worldwide varies from 0.5% to 60.8% in the first 12 months postpartum using self-reported questionnaire. This review aims to update the current magnitude of postpartum depression based on self-reported questionnaire and clinical interview and explore its associated factors in developed and developing countries. METHODS A literature search conducted between 2005 and 2014 identified 203 studies, of which 191 used self-reported questionnaire in 42 countries and 21 used structured clinical interview in 15 countries. Nine studies used a combination of self-reported questionnaire and clinical interview. RESULT The prevalence of postpartum depression varies from 1.9% to 82.1% in developing countries and from 5.2% to 74.0% in developed countries using self-reported questionnaire. Structured clinical interview shows a much lower prevalence range from 0.1% in Finland to 26.3% in India. Antenatal depression and anxiety, previous psychiatric illness, poor marital relationship, stressful life events, negative attitude towards pregnancy, and lack of social support are significant contributors to postpartum depression. LIMITATION All studies are included irrespective of the methodological quality, such as small sample size and their inclusion could affect the generalizability of the results. CONCLUSION The current prevalence of postpartum depression is much higher than that previously reported, and similar risk factors are documented. A culturally sensitive cut-off score with adequate psychometric properties of the screening instruments should be available. In future studies, examining the physical, biological, and cultural factors in qualitative studies and in those with adequate methodological qualities is recommended.
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Affiliation(s)
- M N Norhayati
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
| | - N H Nik Hazlina
- Women Health Development Unit, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - A R Asrenee
- Department of Psychiatry, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - W M A Wan Emilin
- Perpustakaan Hamdan Tahir, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
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Babb JA, Deligiannidis KM, Murgatroyd CA, Nephew BC. Peripartum depression and anxiety as an integrative cross domain target for psychiatric preventative measures. Behav Brain Res 2015; 276:32-44. [PMID: 24709228 PMCID: PMC4185260 DOI: 10.1016/j.bbr.2014.03.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 03/21/2014] [Accepted: 03/24/2014] [Indexed: 11/20/2022]
Abstract
Exposure to high levels of early life stress has been identified as a potent risk factor for neurodevelopmental delays in infants, behavioral problems and autism in children, but also for several psychiatric illnesses in adulthood, such as depression, anxiety, autism, and posttraumatic stress disorder. Despite having robust adverse effects on both mother and infant, the pathophysiology of peripartum depression and anxiety are poorly understood. The objective of this review is to highlight the advantages of using an integrated approach addressing several behavioral domains in both animal and clinical studies of peripartum depression and anxiety. It is postulated that a greater focus on integrated cross domain studies will lead to advances in treatments and preventative measures for several disorders associated with peripartum depression and anxiety.
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Affiliation(s)
- Jessica A Babb
- Department of Biomedical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA 01536, USA.
| | - Kristina M Deligiannidis
- Departments of Psychiatry and Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, MA 01605, USA.
| | | | - Benjamin C Nephew
- Department of Biomedical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA 01536, USA.
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Denis A, Callahan S, Bouvard M. Evaluation of the French Version of the Multidimensional Scale of Perceived Social Support During the Postpartum Period. Matern Child Health J 2014; 19:1245-51. [DOI: 10.1007/s10995-014-1630-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Stewart RC, Umar E, Tomenson B, Creed F. Validation of the multi-dimensional scale of perceived social support (MSPSS) and the relationship between social support, intimate partner violence and antenatal depression in Malawi. BMC Psychiatry 2014; 14:180. [PMID: 24938124 PMCID: PMC4074419 DOI: 10.1186/1471-244x-14-180] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/04/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Lack of social support is an important risk factor for antenatal depression and anxiety in low- and middle-income countries. We translated, adapted and validated the Multi-dimensional Scale of Perceived Social Support (MSPSS) in order to study the relationship between perceived social support, intimate partner violence and antenatal depression in Malawi. METHODS The MSPSS was translated and adapted into Chichewa and Chiyao. Five hundred and eighty-three women attending an antenatal clinic were administered the MSPSS, depression screening measures, and a risk factor questionnaire including questions about intimate partner violence. A sub-sample of participants (n = 196) were interviewed using the Structured Clinical Interview for DSM-IV to diagnose major depressive episode. Validity of the MSPSS was evaluated by assessment of internal consistency, factor structure, and correlation with Self Reporting Questionnaire (SRQ) score and major depressive episode. We investigated associations between perception of support from different sources (significant other, family, and friends) and major depressive episode, and whether intimate partner violence was a moderator of these associations. RESULTS In both Chichewa and Chiyao, the MSPSS had high internal consistency for the full scale and significant other, family, and friends subscales. MSPSS full scale and subscale scores were inversely associated with SRQ score and major depression diagnosis. Using principal components analysis, the MSPSS had the expected 3-factor structure in analysis of the whole sample. On confirmatory factor analysis, goodness-of-fit indices were better for a 3-factor model than for a 2-factor model, and met standard criteria when correlation between items was allowed. Lack of support from a significant other was the only MSPSS subscale that showed a significant association with depression on multivariate analysis, and this association was moderated by experience of intimate partner violence. CONCLUSIONS The MSPSS is a valid measure of perceived social support in Malawi. Lack of support by a significant other is associated with depression in pregnant women who have experienced intimate partner violence in this setting.
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Affiliation(s)
- Robert C Stewart
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Oxford Road, Manchester, UK
- Department of Mental Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Eric Umar
- Department of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Barbara Tomenson
- Biostatistics Unit, Institute of Population Health, University of Manchester, Oxford Road, Manchester, UK
| | - Francis Creed
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Oxford Road, Manchester, UK
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Chen HH, Hwang FM, Tai CJ, Chien LY. The Interrelationships Among Acculturation, Social Support, and Postpartum Depression Symptoms Among Marriage-Based Immigrant Women in Taiwan: A Cohort Study. J Immigr Minor Health 2012; 15:17-23. [DOI: 10.1007/s10903-012-9697-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Parsons CE, Young KS, Rochat TJ, Kringelbach ML, Stein A. Postnatal depression and its effects on child development: a review of evidence from low- and middle-income countries. Br Med Bull 2012; 101:57-79. [PMID: 22130907 DOI: 10.1093/bmb/ldr047] [Citation(s) in RCA: 226] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION OR BACKGROUND It is well established that postnatal depression (PND) is prevalent in high-income countries and is associated with negative personal, family and child developmental outcomes. SOURCES OF DATA Here, studies on the prevalence of maternal PND in low- and middle-income countries are reviewed and a geographical prevalence map is presented. The impact of PND upon child outcomes is also reviewed. AREAS OF AGREEMENT The available evidence suggests that rates of PND are substantial, and in many regions, are higher than those reported for high-income countries. An association between PND and adverse child developmental outcomes was identified in many of the countries examined. AREAS OF CONTROVERSY Significant heterogeneity in prevalence rates and impact on child outcomes across studies means that the true extent of the disease burden is still unclear. AREAS TIMELY FOR DEVELOPING RESEARCH Nonetheless, there is a compelling case for the implementation of interventions to reduce the impact of PND on the quality of the mother-infant relationship and improve child outcomes.
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Mbekenga CK, Pembe AB, Christensson K, Darj E, Olsson P. Informal support to first-parents after childbirth: a qualitative study in low-income suburbs of Dar es Salaam, Tanzania. BMC Pregnancy Childbirth 2011; 11:98. [PMID: 22126899 PMCID: PMC3252242 DOI: 10.1186/1471-2393-11-98] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 11/29/2011] [Indexed: 11/12/2022] Open
Abstract
Background In Tanzania, and many sub-Saharan African countries, postpartum health programs have received less attention compared to other maternity care programs and therefore new parents rely on informal support. Knowledge on how informal support is understood by its stakeholders to be able to improve the health in families after childbirth is required. This study aimed to explore discourses on health related informal support to first-time parents after childbirth in low-income suburbs of Dar es Salaam, Tanzania. Methods Thirteen focus group discussions with first-time parents and female and male informal supporters were analysed by discourse analysis. Results The dominant discourse was that after childbirth a first time mother needed and should be provided with support for care of the infant, herself and the household work by the maternal or paternal mother or other close and extended family members. In their absence, neighbours and friends were described as reconstructing informal support. Informal support was provided conditionally, where poor socio-economic status and non-adherence to social norms risked poor support. Support to new fathers was constructed as less prominent, provided mainly by older men and focused on economy and sexual matters. The discourse conveyed stereotypic gender roles with women described as family caretakers and men as final decision-makers and financial providers. The informal supporters regulated the first-time parents' contacts with other sources of support. Conclusions Strong and authoritative informal support networks appear to persist. However, poverty and non-adherence to social norms was understood as resulting in less support. Family health in this context would be improved by capitalising on existing informal support networks while discouraging norms promoting harmful practices and attending to the poorest. Upholding stereotypic notions of femininity and masculinity implies great burden of care for the women and delimited male involvement. Men's involvement in reproductive and child health programmes has the potential for improving family health after childbirth. The discourses conveyed contradicting messages that may be a source of worry and confusion for the new parents. Recognition, respect and raising awareness for different social actors' competencies and limitations can potentially create a health-promoting environment among families after childbirth.
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Affiliation(s)
- Columba K Mbekenga
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
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