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Butler JL, Johnson CM, Hardison-Moody A, Bowen SK. Food Insecurity Associated with Higher Stress, Depressive Symptoms, and Lower Diet Quality among Women Caregivers in North Carolina. Nutrients 2024; 16:2491. [PMID: 39125371 PMCID: PMC11314069 DOI: 10.3390/nu16152491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/23/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Research suggests a bidirectional relationship between food insecurity and stress, but few studies have examined associations of food insecurity with stress and other indicators of cardiometabolic health, including depression, diet quality, and body weight, among lower-income women in the U.S. METHODS This cross-sectional study analyzed data from lower-income women caregivers living in North Carolina (n = 100): 42% Black/African American, 25% Hispanic/Latina, and 33% White women. Multivariable linear regression models were used to determine associations of food insecurity status with perceived stress, depressive symptoms, diet quality, and body mass index (BMI). Multivariable logistic regression models were used to determine associations of food insecurity with clinical depression and BMI ≥ 30 kg/m2. Associations were examined with and without adjustment for perceived stress. RESULTS Forty-two percent of the sample were experiencing food insecurity. Compared to food secure caregivers, food-insecure caregivers had significantly higher perceived stress (β: +7.51; 95%CI: 4.19, 10.84) and depressive symptoms (β: +3.55; 95%CI: 0.54, 6.56) and lower diet quality (β: -9.10; 95%CI: -15.81, -2.40). Associations with BMI outcomes were not statistically significant. CONCLUSION Findings support removing stigma in nutrition assistance programs and clinical interactions, motivate future longitudinal studies, and inform the development of destigmatizing interventions for health promotion or disease prevention.
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Affiliation(s)
- J. Lauren Butler
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, 601 University Drive, San Marcos, TX 78666, USA;
- Nutrition and Dietetics Department, University of North Florida, Jacksonville, FL 32224, USA
| | - Cassandra M. Johnson
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, 601 University Drive, San Marcos, TX 78666, USA;
| | - Annie Hardison-Moody
- Department of Agricultural and Human Sciences, North Carolina University, Raleigh, NC 27695, USA;
| | - Sarah K. Bowen
- Department of Sociology and Anthropology, North Carolina University, Raleigh, NC 27695, USA;
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Rosen F, Settel L, Irvine F, Koselka EPD, Miller JD, Young SL. Associations between food insecurity and child and parental physical, nutritional, psychosocial and economic well-being globally during the first 1000 days: A scoping review. MATERNAL & CHILD NUTRITION 2024; 20:e13574. [PMID: 37828823 PMCID: PMC10750018 DOI: 10.1111/mcn.13574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
Food insecurity affects billions of individuals annually and contributes to myriad poor health outcomes. Experiences of food insecurity may be particularly harmful during the first 1000 days, but literature on the topic has not been synthesized. We therefore aimed to characterize all available studies examining associations between food insecurity and nutritional, psychosocial, physical and economic well-being among parents and children during this period. We implemented a standardized search strategy across 11 databases. Four researchers screened 10,257 articles, 120 of which met the inclusion criteria. Most studies were conducted in Sub-Saharan Africa (43.3%), followed by North America (20.8%). Studies were primarily quantitative (95.8%), cross-sectional (70.0%) and focused on women (pregnant or post-partum, 48.3%) or women and children (15.8%). Physical health outcomes were the most investigated (n = 87 studies), followed by nutritional (n = 69), psychosocial (n = 35) and economic well-being (n = 2). The most studied associations were between food insecurity and stunting (n = 15), maternal depression (n = 12), child dietary diversity (n = 7) and maternal body mass index (n = 6). The strength of evidence for the observed associations varied across populations as well as within and between examined outcomes. We recommend that future studies recruit more diverse study populations, consider temporality of relationships, use instruments that facilitate cross-site comparisons, measure individual-level food insecurity and outcomes most likely to be impacted by food insecurity, evaluate contextual factors that may modify the effects of food insecurity and employ analytic techniques that permit assessment of causal pathways.
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Affiliation(s)
- Francesca Rosen
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
| | - Lily Settel
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
| | - Faith Irvine
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
| | | | - Joshua D. Miller
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Sera L. Young
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
- Institute for Policy ResearchNorthwestern UniversityEvanstonIllinoisUSA
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Al-Abri K, Edge D, Armitage CJ. Prospective analysis of factors associated with perinatal depression. Midwifery 2024; 128:103871. [PMID: 37967499 DOI: 10.1016/j.midw.2023.103871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 09/13/2023] [Accepted: 11/01/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Perinatal depression is a significant public health problem that has adverse effects on both mothers and infants. Little research has been conducted on how depressive symptoms change throughout the perinatal period, especially in the Middle East. This study examines changes in depressive symptoms from pregnancy to the postnatal period, and what explains these changes. METHODS This prospective study recruited 306 Omani women in the third trimester of pregnancy and followed them up two to eight weeks after delivery. The Edinburgh Postnatal Depression Scale (EPDS), with a cut-off of ≥12, was used to assess depressive symptoms in both the antenatal and postnatal periods. Independent t-tests, one-way ANOVA, Tukey's honestly significant difference test and Chi-square tests were used to analyse the data. RESULTS The prevalence of depressive symptoms was 27.12 % (n = 83) during late pregnancy and 29.30 % (n = 81) during the postnatal period. Four groups of women were identified based on the EPDS scores: 1) antenatal depression group (8.82 %; n = 27); 2) ante- and postnatal depression group (14.38 %; n = 44); 3) postnatal depression group (12.09 %; n = 37); and 4) non-depression group (54.90 %; n = 168). Depressive symptoms were associated with low birth weight babies (d = 0.50), which confirms the negative effects of depression on perinatal health outcomes. When compared to the non-depression group, the three depressed groups had higher antenatal Perceived Stress Scale (PSS) scores (ds > 0.52), while the non-depression group had higher antenatal and postnatal Maternity Social Support Scale (MSSS) scores (ds > 0.63), and better relationships with the mother-in-law antenatally (d= 0.57). CONCLUSION The present study of this Middle Eastern cohort shows that there were distinct groups of women experiencing perinatal depressive symptoms, influenced by various psychosocial and obstetric factors, which were comparable to those identified in more regularly studied populations. However, this study also identified other novel factors, such as the quality of family relationships. There is a need for additional research into the factors associated with these groups in order to develop appropriate interventions.
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Affiliation(s)
- Khalood Al-Abri
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK; Department of Community and Mental Health, College of Nursing, Sultan Qaboos University, Oman.
| | - Dawn Edge
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK; Equality, Diversity & Inclusion Research Unit, Greater Manchester Mental Health NHS Trust, UK
| | - Christopher J Armitage
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK; Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, UK; NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK
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Zinga J, van der Pligt P, Lindberg R, Vasilevski V, Lee A, McKay F. Food insecurity screening procedures used in reproductive healthcare settings. Nutr Rev 2023; 82:76-89. [PMID: 37120152 DOI: 10.1093/nutrit/nuad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
CONTEXT Food insecurity is an important determinant of health and should be identified by clinicians during routine reproductive healthcare. The procedures used in reproductive healthcare settings to identify people experiencing food insecurity have not been fully researched. OBJECTIVE The objective of this study was to synthesize evidence from published studies that describe the procedures implemented by clinicians in healthcare settings to identify food insecurity in pregnant women, or women of reproductive age (15 years-49 years). DATA SOURCES Four databases were searched in April 2022 to identify studies that met the eligibility criteria. DATA EXTRACTION Studies that used tools that were both validated or newly developed were considered, as were studies that incorporated food insecurity screening as part of a multidomain screening tool. Two authors completed the screening, data extraction, and quality assessment independently. DATA ANALYSIS There were 1075 studies identified; after screening, 7 studies were included in the narrative synthesis, including studies relating to women who were pregnant or in the postpartum period; none of the included studies related to women in the preconception stage. Four screening tools were identified: 2- and 6-item tools specifically focused on food insecurity, a 58-item multidomain tool incorporating 4 food insecurity items, and a modified version of the 2-item tool. Methods of implementing screening varied across studies. Three described subsequent processes that supported food-insecure patients once identified. CONCLUSION Few published studies have investigated optimal screening tools and their implementation within reproductive healthcare settings to address food insecurity for this priority population group. Further research is required to determine: the optimal tool, preferable screening methods from the perspectives of both patients and clinicians, and potential strategies for implementation in countries outside of the United States. An additional evidence gap remains about referral pathways and appropriate supports for this population once food insecurity is identified. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022319687.
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Affiliation(s)
- Julia Zinga
- are with the School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
- are with the Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- are with the Nutrition and Dietetics Department, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Paige van der Pligt
- are with the School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- are with the Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- is with the Department of Nutrition, Western Health, Footscray, Victoria, Australia
| | - Rebecca Lindberg
- are with the School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- are with the Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - Vidanka Vasilevski
- are with the Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- is with the School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Amelia Lee
- are with the Nutrition and Dietetics Department, Royal Women's Hospital, Parkville, Victoria, Australia
- are with the School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Fiona McKay
- are with the School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
- are with the Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
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Scandurra C, Mezzalira S, Aviani S, Lastra V, Bochicchio V, Zapparella R, Saccone G, Maldonato NM, Locci M. Perinatal depression during the fourth wave of the COVID-19 outbreak in a single prenatal clinic in Southern Italy: The role of loneliness, anxiety, and maternal support. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 13:100585. [PMID: 37152681 PMCID: PMC10141786 DOI: 10.1016/j.jadr.2023.100585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/15/2023] [Accepted: 04/27/2023] [Indexed: 05/09/2023] Open
Abstract
Background The current study aimed at assessing the levels of perinatal depression (i.e., both antenatal and postnatal) during the fourth wave of the COVID-19 outbreak in a group of Italian women, as well as to evaluate the role of loneliness, anxiety, and lack of maternal support in cumulatively predicting perinatal depression. Methods A cross-sectional study was conducted with 200 Italian women recruited during a peak of the COVID-19 pandemic in Italy (i.e., from September to December 2021) from a single prenatal clinic in Southern Italy. A non-parametric binomial test was conducted to assess whether the perinatal depression frequencies of the current sample differed from those found in a pre-Covid reference group. Additionally, hierarchical multiple linear regression analyses assessing whether loneliness, anxiety, and maternal support affected women's perinatal depression were also conducted. Results The general prevalence of perinatal depression was significantly higher in participants recruited during the fourth wave of the COVID-19 pandemic compared to the pre-Covid reference group (29% vs. 9.2%). However, results showed that, contrary to postnatal depression (18.2% vs. 19.9%), only the prevalence of antenatal depression was significantly higher compared to the pre-Covid reference group (39.6% vs. 6.4%). Furthermore, loneliness and anxiety, but not maternal support, were associated with higher levels of PD. Limitations Limitations concerned the cross-sectional nature of the study and the relatively small sample size. Conclusions This study sheds light on the need to address perinatal mental health of women during major stressful events, such as the COVID-19 pandemic.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Selene Mezzalira
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy
| | - Silvia Aviani
- Intradepartmental Program of Clinical Psychology, Federico II University Hospital, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Valeria Lastra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy
| | - Rosanna Zapparella
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
| | - Mariavittoria Locci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy
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Surace T, Quitadamo C, Caldiroli A, Capuzzi E, Colmegna F, Nosari G, Borroni E, Fedrizzi L, Bollati V, Pesatori AC, Carugno M, Clerici M, Buoli M. Air Pollution and Perinatal Mental Health: A Comprehensive Overview. J Clin Med 2023; 12:jcm12093146. [PMID: 37176587 PMCID: PMC10179699 DOI: 10.3390/jcm12093146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/21/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The aim of the present study was to summarise the available data about the link between air pollution exposure and the new-onset and severity of psychiatric disorders in pregnant women during the perinatal period. MATERIALS AND METHODS We selected articles published until June 2022 on PubMed and the Web of Science. Pollutants included were PM2.5 (particulate matter 2.5 micrometres and smaller), PM10 (particulate matter 10 micrometres and smaller), NO2 (nitrogen dioxide), O3 (ozone), SO2 (sulphur dioxide), CO (carbon monoxide), PBDEs (polybrominated diphenyl ethers), PFAS (per- and polyfluoroalkyl substances), lead, and cadmium. The perinatal period was considered as the time of pregnancy until one year after childbirth. RESULTS Nine studies were included; most of them evaluated the association between exposure to air pollutants and the onset of Postpartum Depression (PPD). Two studies showed an association between, respectively, only PM2.5 and both PM2.5 and NO2 exposure and PPD onset 12 months after childbirth, while another study found a significant association between NO2 exposure and PPD occurrence 6 months after childbirth. PBDE blood levels were associated with more severe depressive symptoms. Lastly, one study observed a link between stressful symptoms and exposure to PM2.5, PM10 during pregnancy. CONCLUSION More comprehensive and uniform studies are required to make a roadmap for future interventions, given the growing relevance of issues such pollution and mental health, particularly during the perinatal period.
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Affiliation(s)
- Teresa Surace
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Cecilia Quitadamo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Alice Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Enrico Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Fabrizia Colmegna
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Elisa Borroni
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Luca Fedrizzi
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
| | - Valentina Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Angela Cecilia Pesatori
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
| | - Michele Carugno
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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Tabb KM, Simonovich SD, Wozniak JD, Barton JM, Hsieh WJ, Klement C, Ostrowski ME, Lakhani N, Meline BS, Huang H. WIC Staff Views and Perceptions on the Relationship between Food Insecurity and Perinatal Depression. Healthcare (Basel) 2022; 11:healthcare11010068. [PMID: 36611527 PMCID: PMC9819437 DOI: 10.3390/healthcare11010068] [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: 11/19/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Food insecurity and perinatal depression are significant public health concerns for perinatal services, however descriptive research examining their association is limited. The purpose of this study was to examine the views and perspectives of staff from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program on the relationship between food insecurity and perinatal depression among their WIC clients. Four, semi-structured focus groups with WIC staff (n = 24) were conducted across four diverse nonmetropolitan public health districts in Midwestern counties in the United States. WIC staff included social workers, nurses, nutritionists and ancillary staff. All interviews were audio-recorded, transcribed, and verified, and data were organized using NVivo 11.4.2. Thematic networking analysis was employed as the qualitative analysis to identify organizing themes. Three themes emerged including (1) depression experienced by clients; (2) food insecurity experienced by clients; and (3) barriers preventing clients from accessing services for themselves and their children. Research on food insecurity and perinatal depression is sparse, with fewer studies having included health staff of low-income women. Our findings suggest that the association between food insecurity and mental health needs among WIC clients is a significant public health issue to which policy change and interventions are required.
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Affiliation(s)
- Karen M. Tabb
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Beckman Institute for the Advancement of Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Correspondence:
| | - Shannon D. Simonovich
- School of Nursing, College of Science & Health, DePaul University, Chicago, IL 60614, USA
| | - Jana D. Wozniak
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02139, USA
| | - Jennifer M. Barton
- Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Wan-Jung Hsieh
- Department of Social Work, National Taiwan University, Taipei 10617, Taiwan
| | - Claire Klement
- School of Nursing, College of Science & Health, DePaul University, Chicago, IL 60614, USA
| | - Mary Ellen Ostrowski
- School of Nursing, College of Science & Health, DePaul University, Chicago, IL 60614, USA
| | - Noreen Lakhani
- School of Nursing, College of Science & Health, DePaul University, Chicago, IL 60614, USA
| | - Brandon S. Meline
- Maternal and Child Health Division, Champaign-Urbana Public Health District, Champaign, IL 61820, USA
| | - Hsiang Huang
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02139, USA
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Qiu X, Sun X, Li HO, Wang DH, Zhang SM. Maternal alcohol consumption and risk of postpartum depression: a meta-analysis of cohort studies. Public Health 2022; 213:163-170. [PMID: 36423494 DOI: 10.1016/j.puhe.2022.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 06/30/2022] [Accepted: 08/30/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The relationship between maternal alcohol consumption and postpartum depression (PPD) is still controversial. The objective of the present study was to assess the association between maternal alcohol consumption and the risk of developing PPD by means of a meta-analysis of cohort studies. STUDY DESIGN This was a meta-analysis. METHODS PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases were searched up to February 4, 2021, to identify relevant studies that evaluated the association between maternal alcohol consumption and PPD. Meta-analysis was conducted using RevMan software and Stata software. Subgroup and sensitivity analyses were performed to explore the potential heterogeneity source, and Begg's funnel plots and Begg's linear regression test were conducted to assess the potential publication bias. RESULTS A total of 12 studies involving 50,377 participants were identified in our study. Overall, pregnant women who were exposed to alcohol were at a significantly greater risk of developing PPD compared with those who did not consume alcohol (odds ratio = 1.21; 95% confidence interval: 1.04-1.41; P = 0.020). CONCLUSIONS Maternal alcohol consumption is significantly associated with the risk of developing PPD. These results emphasize the necessity of enhancing health awareness, improving the public health policies and regulations concerning alcohol use, and strengthening the prevention and intervention of maternal alcohol consumption to promote maternal mental health.
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Affiliation(s)
- X Qiu
- Department of Nursing, Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - X Sun
- Department of Humanistic Nursing, School of Nursing, Changsha Medical University, Changsha, Hunan, China
| | - H O Li
- Department of Humanistic Nursing, School of Nursing, Changsha Medical University, Changsha, Hunan, China
| | - D H Wang
- Department of Humanistic Nursing, School of Nursing, Changsha Medical University, Changsha, Hunan, China
| | - S M Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
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9
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Jigeer G, Tao W, Zhu Q, Xu X, Zhao Y, Kan H, Cai J, Xu Z. Association of residential noise exposure with maternal anxiety and depression in late pregnancy. ENVIRONMENT INTERNATIONAL 2022; 168:107473. [PMID: 35994797 DOI: 10.1016/j.envint.2022.107473] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Noise is one of the most important environmental risk factors that adversely affects human health. Residential noise exposure has been associated with increased risk of anxiety and depression in the general population. However, limited study has been conducted in pregnant women. OBJECTIVE To examine the associations of residential noise exposure with prenatal anxiety and depression. METHODS Self-Rating Anxiety Scale (SAS) and Center for Epidemiological Survey Scale (CES-D) were used to assess the status of prenatal anxiety and depression for 2,018 pregnant women in Shanghai, China. Residential noise exposure was represented by a land use regression model. Multivariate logistic regression model was used to estimate the associations of noise exposure with prenatal anxiety and depression. RESULTS The prevalence rates of prenatal anxiety and depression were 7.5 % and 8.1 %, respectively. The mean (±standard deviation) residential noise exposure during the whole pregnancy was 60.69 (±3.31) dB (A). Higher residential noise exposure was associated with increased odds of both prenatal anxiety and depression. Compared with low level of noise exposure group (<65 dB(A)), the odds of prenatal anxiety and depression increased 69 % (OR = 1.69, 95 % CI, 1.01-2.82) and 71 % (OR = 1.71, 95 % CI, 1.05-2.80) in higher noise exposure group (≥65 dB(A)), respectively. Stratified analyses showed that the associations were stronger among pregnant women with lower socioeconomic status. CONCLUSION Residential noise exposure during pregnancy might be a risk factor for prenatal anxiety and depression.
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Affiliation(s)
- Guliyeerke Jigeer
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Weimin Tao
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qingqing Zhu
- The Maternal and Child Healthcare Institute of Songjiang District, Shanghai, China
| | - Xueyi Xu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yan Zhao
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
| | - Zhendong Xu
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
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Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Acad Pediatr 2022; 22:1105-1114. [PMID: 35577282 PMCID: PMC10153634 DOI: 10.1016/j.acap.2022.04.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 04/07/2022] [Accepted: 04/30/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Food insecurity affects 13.7 million US households and is linked to poor mental health. Families shield children from food insecurity by sacrificing their nutritional needs, suggesting parents and children experience food insecurity differentially. OBJECTIVE To identify the associations of food insecurity and mental health outcomes in parents and children DATA SOURCES: PubMed, Embase, Web of Science, and PsycInfo STUDY ELIGIBILITY CRITERIA: We included original research published in English from January 1990 to June 2020 that examined associations between food insecurity and mental health in children or parents/guardians in the United States. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers screened studies for inclusion. Data extraction was completed by one reviewer and checked by a second. Bias and confounding were assessed using the Agency for Healthcare Research and Quality RTI Item Bank. Studies were synthesized qualitatively, grouped by mental health outcome, and patterns were assessed. Meta-analyses were not performed due to high variability between studies. RESULTS We included 108 studies, assessing 250,553 parents and 203,822 children in total. Most studies showed a significant association between food insecurity and parental depression, anxiety, and stress, and between food insecurity and child depression, externalizing/internalizing behaviors, and hyperactivity. LIMITATIONS Most studies were cross-sectional and many were medium- or high-risk for bias or confounding. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Food insecurity is significantly associated with various mental health outcomes in both parents and children. The rising prevalence of food insecurity and mental health problems make it imperative that effective public health and policy interventions address both problems.
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Affiliation(s)
- Kathryn S Cain
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Stephanie C Meyer
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Elaina Cummer
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Kishan K Patel
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Nicholas J Casacchia
- Clinical and Translational Science Institute (NJ Casacchia), Wake Forest University, Winston-Salem, NC
| | - Kimberly Montez
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Deepak Palakshappa
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC; Department of Internal Medicine (D Palakshappa), Wake Forest School of Medicine, Winston-Salem, NC; Department of Epidemiology and Prevention (D Palakshappa, CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Callie L Brown
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC; Department of Epidemiology and Prevention (D Palakshappa, CL Brown), Wake Forest School of Medicine, Winston-Salem, NC.
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11
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Elrassas H, Taha GR, Soliman AEDM, Madbole SAEK, Mahmoud DAM. Prevalence and related factors of perinatal depression in Egyptian mothers. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00203-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Early detection of perinatal depression and its cultural determinants could reduce its sequalae on mothers and their babies. This study investigated the prevalence of perinatal depression in Egyptian mothers and compare women with and without perinatal depression regarding the psychosocial factors.
Three-hundred one women were recruited (166 were pregnant and 135 were in postpartum period) from a primary healthcare unit. Full sociodemographic data, Social Classification Scale, Dyadic Adjustment Scale (DAS), and the Edinburgh Postnatal Depression Scale (EPDS) were completed. Subjects with EPDS score > 9 answered the structured clinical interview (SCID-I) for diagnosis of depression and Hamilton Rating Scale for Depression (HRSD) for depression severity.
Results
Depression with mild to moderate severity was reported in 5.4% and 3.7% of women during pregnancy and postpartum period, respectively. There was a statistically significant association between depression and employment (p = 0.031), mother-in-law disputes (p = 0.002), stigma of being the second wife (p = 0.047), and having financial burdens (p = 0.001). Marital satisfaction was a protective factor for depression (p < 0.001).
Conclusions
Prevalence of perinatal depression was comparable to other developing countries. It was strongly linked to culturally related factors including marital women’s employment, mother-in-law disputes, being the second wife, and socioeconomic burdens. Early detection of perinatal depression and its culturally related factors is important for its management.
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Hu M, Zhou Y, Xue M, Ren Y, Li S, Wang R, Qi L, Zeng L, Liu Z, Qian W, Yang J, Zhou X, Chen L, Zhang X. The prevalence and correlates of peripartum depression in different stages of pregnancy during COVID-19 pandemic in China. BMC Pregnancy Childbirth 2022; 22:114. [PMID: 35148708 PMCID: PMC8832077 DOI: 10.1186/s12884-022-04428-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/26/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Peripartum depression in and after pregnancy are common, reported by 11.9% of women worldwide, and the proportion was even higher during the outbreak of coronavirus disease 2019 (COVID-19). We aimed to investigate the prevalence and risk factors of peripartum depression under the influence of COVID-19 in China. METHODS Using a cross-sectional design, 2026 pregnant and postpartum women residing in Beijing, Wuhan, and Lanzhou of China were recruited from February 28 to April 9, 2020. The Patient Health Questionnaire-9 was used to assess their depressive symptoms. The women were divided into four subgroups based on pregnancy stage, and a binary logistic regression analysis was conducted on each subgroup. RESULTS Under the influence of COVID-19, the prevalence rate of peripartum depression among Chinese women was 9.7%. It was 13.6, 10.8, 7.9 and 7.3% in the first, second, third trimester and puerperium, respectively. Regression analysis showed that the influence of current pregnancy status on movement (Mild vs. No, aORs were 3.89, P < 0.001, 2.92, P = 0.003, 1.58, P = 0.150 in the three trimesters, respectively; Severe vs. No, aORs were 13.00, 20.45, 5.38 in the three trimesters, respectively, all P < 0.05), and worries and fears about childbirth (aORs were 2.46, 2.96, 2.50 in the three trimesters, respectively, all P < 0.05) were associated with depression throughout pregnancy. CONCLUSIONS The prevalence rate of peripartum depression during the COVID-19 outbreak in China was not higher than usual. The influence of current pregnancy status on movement, as well as worries and fears about childbirth were independent risk factors for peripartum depression throughout pregnancy during COVID-19. The stage of pregnancy should be considered when implementing interventions.
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Affiliation(s)
- Manji Hu
- Shanghai Pudong New Area Mental Health Centre, Shanghai, China
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Mei Xue
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | - Yali Ren
- Department of Medical Affairs, Liyuan Hospital of Tongji Medical College, Huazhong University of Science and Technology, 39 Yanhu Road, Wuchang District, Wuhan, 430077, Hubei, China.
| | - Shen Li
- Department of Psychiatry, College of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Lingyun Zeng
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Wei Qian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jiezhi Yang
- Shenzhen Health Development Research Center, Shenzhen, China
| | - Xin Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Lijuan Chen
- School of Literature, Journalism & Communication, South-Central University for Nationalities, Wuhan, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Barnett KS, Banks AR, Morton T, Sander C, Stapleton M, Chisolm DJ. "I just want us to be heard": A qualitative study of perinatal experiences among women of color. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221123439. [PMID: 36168990 PMCID: PMC9523856 DOI: 10.1177/17455057221123439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/23/2022] [Accepted: 08/16/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Long-standing racial disparities, particularly between White and Black women, in maternal and birth outcomes necessitate an examination of the factors influencing these disparities. This study aimed to understand the experiences of women of color as they relate to pregnancy and/or birth complications to inform policy and strategy to decrease racial and ethnic health disparities. METHODS Six focus groups were conducted with women (n = 31) who were identified as a woman of color, were 18 years or older, self-identified as having experienced pregnancy or birth complications after 2016, and who spoke English. A focus group guide co-created with the research team, community partners, and peer researchers from the local community was utilized to elicit discussions related to barriers, successes, and existing opportunities to provide equitable care and services to families throughout the perinatal period. An inductive and iterative approach to qualitative analyses of the focus group transcripts was used to identify key themes. RESULTS The seven themes identified include: lack of knowledge, mental health, communication with providers, support systems, representation, social determinants of health, and discrimination and stigma. Women shared a variety of experiences related to their health care from before pregnancy into their post-partum period, revealing many areas for improvement to extant systems. CONCLUSION The inclusion of voices of the populations most deeply affected by health disparities is crucial to understanding how care and services provided can be improved. This analysis suggests the need for change at multiple levels of the health care and social services systems. These experiences provide valuable insight into some of the many struggles and barriers that women of color face during pregnancy and beyond.
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Affiliation(s)
- Kierra S Barnett
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Ashley R Banks
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Tiffany Morton
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Christine Sander
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | | | - Deena J Chisolm
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
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14
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Fan HSL, Choi EPH, Ko RWT, Kwok JYY, Wong JYH, Fong DYT, Shek NWM, Ngan HYS, Li J, Huang YY, Ouyang YQ, Lok KYW. COVID-19 related fear and depression of pregnant women and new mothers. Public Health Nurs 2021; 39:562-571. [PMID: 34902184 DOI: 10.1111/phn.13035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/15/2021] [Accepted: 11/28/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To explore factors associated with depression and COVID-19 related fear among pregnant women and new mothers. DESIGN A cross-sectional survey was conducted in China from July 2020 to July 2021. SAMPLE A total of 3027 pregnant and new mothers were recruited. MEASUREMENT Sociodemographic characteristics and the perceptions of the COVID-19 pandemic were collected. The Patient Health Questionnaire-9 (PHQ-9) and the Fear Scale was used to assess the depressive and fear level towards the COVID-19 pandemic, respectively. RESULTS Approximately 17.2% of the participants had depression (PHQ-9 ≥10). In Hong Kong, participants who perceived that they have increased knowledge to prevent infection were less likely to have depression (adjusted odds ratio [aOR] = 0.83; 95% confidence interval [CI] = 0.74-0.94). There was no association between perceived severity if infected and severity of spread and the depression level in our sample. An inverse relationship was found between the COVID-19 related fear level and perceived knowledge to prevent infection (Beta-coefficient [β] = -0.20; 95% CI = -0.38 to -0.02). CONCLUSION Public health nurses need to promote accurate and up to date COVID-19 related information at clinical and community settings and implement effective screening for depression and fear symptoms to identify these high-risk groups to improve women's psychological well-being.
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Affiliation(s)
- Heidi Sze Lok Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Rachel Wai Tung Ko
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Noel Wan Man Shek
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynecology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Junyan Li
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yi-Yan Huang
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yan-Qiong Ouyang
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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15
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Lamichhane DK, Jung DY, Shin YJ, Lee KS, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Association between ambient air pollution and perceived stress in pregnant women. Sci Rep 2021; 11:23496. [PMID: 34873215 PMCID: PMC8648786 DOI: 10.1038/s41598-021-02845-4] [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: 06/06/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
Air pollution may influence prenatal maternal stress, but research evidence is scarce. Using data from a prospective cohort study conducted on pregnant women (n = 2153), we explored the association between air pollution and perceived stress, which was assessed using the 14-item Perceived Stress Scale (PSS), among pregnant women. Average exposures to particulate matter with an aerodynamic diameter of < 2.5 µm (PM2.5) or < 10 µm (PM10), nitrogen dioxide (NO2), and ozone (O3) for each trimester and the entire pregnancy were estimated at maternal residential addresses using land-use regression models. Linear regression models were applied to estimate associations between PSS scores and exposures to each air pollutant. After adjustment for potential confounders, interquartile-range (IQR) increases in whole pregnancy exposures to PM2.5, PM10, and O3 in the third trimester were associated with 0.37 (95% confidence interval [CI] 0.01, 0.74), 0.54 (95% CI 0.11, 0.97), and 0.30 (95% CI 0.07, 0.54) point increases in prenatal PSS scores, respectively. Furthermore, these associations were more evident in women with child-bearing age and a lower level of education. Also, the association between PSS scores and PM10 was stronger in the spring. Our findings support the relationship between air pollution and prenatal maternal stress.
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Affiliation(s)
- Dirga Kumar Lamichhane
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Dal-Young Jung
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yee-Jin Shin
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sook Lee
- grid.444037.00000 0000 9208 7123Department of Rehabilitation, Hanshin University, Osan, Gyeonggi-do Republic of Korea
| | - So-Yeon Lee
- grid.413967.e0000 0001 0842 2126Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- grid.414964.a0000 0001 0640 5613Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ,grid.414964.a0000 0001 0640 5613Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- grid.15444.300000 0004 0470 5454Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- grid.413793.b0000 0004 0624 2588Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- grid.31501.360000 0004 0470 5905Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
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16
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Wenzel ES, Gibbons RD, O’Hara MW, Duffecy J, Maki PM. Depression and anxiety symptoms across pregnancy and the postpartum in low-income Black and Latina women. Arch Womens Ment Health 2021; 24:979-986. [PMID: 33970310 PMCID: PMC8667769 DOI: 10.1007/s00737-021-01139-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
Underserved women of color experience high rates of perinatal affective disorders, but most research to date on the natural history of these disorders has been conducted on White women. The present study investigated longitudinal changes in anxiety and depression in a sample of perinatal non-Hispanic Black and Latina women. Categorical (yes/no) measures of positive anxiety and depression screens, as well as total symptom scores, were measured longitudinally across the perinatal period in 178 women (115 non-Hispanic Black, 63 Latina) using the CAT-MH™, a computerized adaptive test. Time (up to 4 visits) and race/ethnicity effects were assessed in linear mixed effects models. Rates of positive anxiety screenings were 13.6%, 3.2%, 8.5%, and 0% in Latina women and 2.6%, 4.2%, 6.1%, and 5.8% in non-Hispanic Black women in the 1st, 2nd, and 3rd trimesters, and postpartum, respectively. Rates of positive anxiety screenings overall were highest in the first trimester (OR = 0.20; 95% CI 0.04-0.98), and there was a significant time-by-race/ethnicity interaction for positive anxiety screens (OR = 8.88; 95% CI 1.42-55.51), as positive screens were most frequent in the first trimester and sharply declined for Latina women, while rates were relatively consistent across the perinatal period in non-Hispanic Black women. Rates of positive depression screens did not change over time, but there was a trend (OR = 1.93; 95% CI 0.93-4.03) for a time-by-race/ethnicity interaction in a direction similar to that seen for anxiety. The odds of positive anxiety screens vary by race/ethnicity and trimester, suggesting that anxiety screening and anxiety interventions may be most resourcefully used in the first trimester for Latina women in particular.
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Affiliation(s)
- Elizabeth S. Wenzel
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Robert D. Gibbons
- Center for Health Statistics and Departments of Medicine and Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Michael W. O’Hara
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Jennifer Duffecy
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Pauline M. Maki
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA,Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA,Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL, USA
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Keeping Parent, Child, and Relationship in Mind: Clinical Effectiveness of a Trauma-informed, Multigenerational, Attachment-Based, Mother-Baby Partial Hospital Program in an Urban Safety Net Hospital. Matern Child Health J 2021; 25:1776-1786. [PMID: 34427835 DOI: 10.1007/s10995-021-03221-4] [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] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The Hennepin Healthcare Mother-Baby Day Hospital is a partial hospital program for pregnant and postpartum women with moderate to severe psychiatric illness. Based in an urban safety net hospital, the Day Hospital provides trauma-informed, multigenerational, group-based therapy and psychiatric care. This report describes the program and preliminary data regarding maternal mental health and functioning at treatment entry and discharge. METHODS Data include information on pregnant and postpartum women who were admitted to the Day Hospital between April 2013 and September 2019 and completed at least 4 days of treatment. We describe patient demographics and changes in mental health and maternal functioning. RESULTS 328 women consented to participation in research, representing 364 unique admissions. Primary diagnoses included major depression (55.6%; n = 202); generalized anxiety (36.4%; n = 132); bipolar spectrum (28%; n = 102); and trauma-related disorders (20.6%; n = 75). Patients reported significant improvements (p < 0.001) in self-report scales assessing depression, anxiety, and maternal functioning. CONCLUSIONS A mother-baby day hospital based in an urban safety net hospital is effective in improving mental health and parenting functioning in perinatal women with moderate to severe psychiatric illness. The high acuity and prevalence of comorbid depression, anxiety, bipolar spectrum, and trauma-related disorders support the need for trauma-informed, multigenerational approaches that address perinatal mental health and attachment-based parenting support.
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Abstract
This article provides an overview of the prevalence and cause of postpartum depression in women and postnatal depression among their male partners, as well as a review of related symptoms, risk factors, and effects on children. Evidence-based screening tools, management options, and resources for patients and providers are also presented.
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Toledo-Corral CM, Gao L, Chavez T, Grubbs B, Habre R, Dunton GF, Bastain T, Breton CV. Role of Race, Ethnicity, and Immigration in Perceived Stress and Depressive Symptomatology Trends During Pregnancy. J Immigr Minor Health 2021; 24:561-569. [PMID: 34218341 DOI: 10.1007/s10903-021-01235-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2021] [Indexed: 11/25/2022]
Abstract
Our goal was to examine the role of race, ethnicity, and immigration status on prenatal perceived stress and depressive symptomatology trends across pregnancy in a low-income, minority population of pregnant women in urban Los Angeles. Longitudinal data on 442 Hispanic and Black women were analyzed using mixed effects models with a random intercept for participant were employed to evaluate predictors of higher perceived stress levels and probable depression across pregnancy. Compared to U.S. born Hispanic women, Black women had higher perceived stress (β 2.24; 95% CI 0.41, 4.07) and higher odds of probable depression (OR 2.38; 95% CI 0.95, 5.95) while Hispanic immigrants with greater than 20 years of residency in the U.S. had higher odds of probable depression (OR 2.93; 95% CI 1.10, 7.79). Maternal mental health among Hispanic immigrants with longer U.S. residency and Black race warrants increased attention from public health and clinical agencies.
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Affiliation(s)
| | - Lu Gao
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Thomas Chavez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Brendan Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Genevieve F Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Theresa Bastain
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Carrie V Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA.
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20
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O'Leary N, Jairaj C, Nixon E, Quigley J, O'Keane V. Antenatal depression and maternal infant directed speech during the first postnatal year. Infant Behav Dev 2021; 64:101605. [PMID: 34229207 DOI: 10.1016/j.infbeh.2021.101605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/28/2021] [Accepted: 06/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Antenatal depression is emerging as a potential risk factor for lower maternal sensitivity during postnatal mother-infant interactions. The present study investigated the relationship between both antenatal and postnatal depression and features of infant directed speech, a key indicator of maternal sensitivity during the first postnatal year. METHODS Pregnant women with either a clinical diagnosis of Major Depressive disorder (MDD; n = 20) or a history of MDD (n = 26) and a control group (n = 34) were recruited to the study and followed up at two, six and twelve months postpartum. A free-play mother-infant interaction was recorded at each time-point and the lexical and syntactic complexity of the mothers' speech was measured from the transcript. RESULTS No significant group differences were observed at either two, six or twelve months. However, mediation analyses indicated that antenatal depression was indirectly associated with maternal syntactic complexity at two and twelve months through concurrent maternal depression scores. LIMITATIONS The findings of this study are limited by its small sample size. The sample also comprised predominantly well-resourced women which limits the generalisability of the findings to wider or less advantaged populations. CONCLUSIONS This study contributes to the emerging evidence base concerning the impact of antenatal depression and postnatal depression on early mother-infant interactive behaviour, specifically infant-directed speech. These findings further highlight the importance of identifying women with antenatal depression in order to support them to engage in therapeutic interventions at the earliest possible opportunity.
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Affiliation(s)
- Niamh O'Leary
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland.
| | - Chaitra Jairaj
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | | | - Jean Quigley
- School of Psychology, Trinity College Dublin, Ireland
| | - Veronica O'Keane
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
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Stigger RS, Martins CDSR, de Matos MB, Trettim JP, da Cunha GK, Scholl CC, Ramos MP, Motta JVDS, Ghisleni G, Pinheiro RT, Quevedo LDA. Is maternal exposure to childhood trauma associated with maternal-fetal attachment? INTERPERSONA: AN INTERNATIONAL JOURNAL ON PERSONAL RELATIONSHIPS 2020. [DOI: 10.5964/ijpr.v14i2.3983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Adults with childhood maltreatment history can face a difficult experience in transitioning to parenthood. Women with a history of emotional neglect in childhood tend to experience problematic attachment. The study's aim was to evaluate the relationship between childhood trauma and maternal-fetal attachment in pregnant women in a population-based study in Southern Brazil. This is a longitudinal study with pregnant women who were interviewed in two moments: before 24-weeks of pregnancy and 60 days after the first interview. We used the Childhood Trauma Questionnaire and the Maternal-Fetal Attachment Scale. The mean of maternal-fetal attachment in the general sample was 99.8 (± 10.8). The mean of emotional neglect was 8.9 (± 4.7); physical neglect 6.7 (± 2.8); sexual abuse 5.9 (± 3.0); physical abuse 6.8 (± 3.1) and emotional abuse 8.0 (± 4.1). After adjusted analysis, we found that pregnant women who suffered emotional neglect had 0.4 points less on the average on the maternal-fetal attachment, β = -0.4, CI 95% [-0.6, -0.2], and pregnant women who suffered emotional abuse had 0.2 points less on the average on the maternal-fetal attachment, β = -0.2, CI 95% [-0.5, -0.0]. Only emotional neglect and emotional abuse were associated with maternal-fetal attachment. This study showed that a history of childhood trauma can have a negative impact during the prenatal period, and can impair maternal-fetal attachment. The data found can assist health professionals in identifying factors that can protect and contribute to pregnant women who were victims of childhood trauma to face the transition to parenthood in the best possible way.
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Koh K, Kaiser ML, Sweeney G, Samadi K, Hyder A. Explaining Racial Inequality in Food Security in Columbus, Ohio: A Blinder-Oaxaca Decomposition Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5488. [PMID: 32751387 PMCID: PMC7432289 DOI: 10.3390/ijerph17155488] [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: 06/10/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 12/02/2022]
Abstract
Food insecurity is a leading public health challenge in the United States. In Columbus, Ohio, as in many American cities, there exists a great disparity between Black and White households in relation to food insecurity. This study investigates the degree to which this gap can be attributed to differences in food shopping behavior, neighborhood perception, and socioeconomic characteristics. A Blinder-Oaxaca decomposition method is used to analyze a household survey dataset collected in 2014. We find a 34.2 percent point difference in food security between White and Black households. Variables related to food shopping behavior, neighborhood perception, and socioeconomic characteristics explain 13.8 percent, 11.6 percent, and 63.1 percent of the difference, respectively. These independent variables combined can explain 68.2 percent of the food security gap between White and Black households. Most of this is attributable to socioeconomic variables. Sense of friendship in neighborhood, use of private vehicles, and satisfaction of neighborhood food environment also partially contribute to the food security gap.
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Affiliation(s)
- Keumseok Koh
- Department of Geography, University of Hong Kong, Hong Kong, China
| | - Michelle L. Kaiser
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
| | - Glennon Sweeney
- Kirwan Institute for the Study of Race and Ethnicity; Department of City and Regional Planning, The Ohio State University, Columbus, OH 43210, USA;
| | - Karima Samadi
- College of Food, Agricultural, and Environmental Sciences, The Ohio State University, Columbus, OH 43210, USA;
| | - Ayaz Hyder
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA;
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Yu M, Qiu T, Liu C, Cui Q, Wu H. The mediating role of perceived social support between anxiety symptoms and life satisfaction in pregnant women: a cross-sectional study. Health Qual Life Outcomes 2020; 18:223. [PMID: 32650793 PMCID: PMC7348126 DOI: 10.1186/s12955-020-01479-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/03/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Pregnancy can be stressful for women and families, so the life satisfaction of pregnant women may face significant challenges. This study aimed to identify the relationship among anxiety symptoms, perceived social support and life satisfaction, and to further explore whether perceived social support can play a mediating role. METHODS This cross-sectional study was conducted from June to September in Shenyang City, China in 2019. 290 effective questionnaires were collected. The Satisfaction with Life Scale (SWLS), the Zung's Self-Rating Anxiety Scale (SAS), the Multi-Dimensional Scale of Perceived Social Support (MSPSS) as well as demographic variables were included in each questionnaire. Hierarchical multiple regression was conducted to explore the mediating role of perceived social support in the relationship between anxiety symptoms and life satisfaction. Then the mediation model was examined by the PROCESS macro for SPSS. RESULTS After adjusting control variables, anxiety symptoms were negatively associated with life satisfaction and explained 14.7% of the variance. Higher level of perceived social support was related to higher level of life satisfaction, explaining 21.0% of the variance. Perceived social support partly mediated the relationship between anxiety symptoms and life satisfaction for pregnant women. CONCLUSIONS Perceived social support played a mediating role between anxiety symptoms and life satisfaction among pregnant women. Strategies and measures to improve perceived social support may be expected to buffer the impact of anxiety symptoms on pregnant women's life satisfaction.
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Affiliation(s)
- Mingli Yu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Tian Qiu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Chunli Liu
- Library, China Medical University, Shenyang, 110122, China
| | - Qi Cui
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Hui Wu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, China.
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Augusto ALP, de Abreu Rodrigues AV, Domingos TB, Salles-Costa R. Household food insecurity associated with gestacional and neonatal outcomes: a systematic review. BMC Pregnancy Childbirth 2020; 20:229. [PMID: 32303221 PMCID: PMC7164154 DOI: 10.1186/s12884-020-02917-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 04/01/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Food insecurity (FI) occurs when people lack secure access to sufficient amounts of safe and nutritious food. FI has been associated with negative effects on human health, including during the prenatal and neonatal periods. The objective of this study is to evaluate the consequences of FI for pregnant women's and newborns' health. METHODS A literature search was performed with three independent researchers based on the PRISMA guidelines; the search covered the period of November 2008 to July 2019 and was conducted in the following databases: the US National Library of Medicine at the National Institutes of Health (PubMed), Latin American and Caribbean Health Sciences (LILACS), Cochrane Library, Web of Science, Embase, Scopus and OpenGrey. The terms and descriptors were defined by consulting the Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS) platforms and mainly included "food security", "food insecurity", "pregnancy" and "newborn". The studies were selected through a title and abstract review and then a reading of the full text. The quality of the studies and the risk of bias were analysed based on the criteria defined in the "Joanna Briggs Institute Reviewers' Manual" and by Guyatt and colleagues for interventional studies. The population, study design, FI measurement instruments, FI proportions, outcomes, confounders and results were extracted from the 37 studies that were selected according to the eligibility and quality criteria. RESULTS FI proportions ranged from 5.2 to 87%. Most studies were conducted with African populations (42.2%) and applied globally used scales to assess FI (56.7%); 27% of the studies adapted scales. There were wide variations in the instruments used to estimate FI. The main outcomes related to FI included stress, anxiety and depression during pregnancy, followed by dietary quality and dietary diversity. Associations of FI with birth defects, neonatal mortality and the early introduction of animal milk to the infant's diet were also observed. CONCLUSIONS It is necessary to pay attention to the diversity of FI measurement instruments before FI results are compared. FI can be a risk factor for depression and stress during pregnancy, as well as for neonatal mortality, newborn health problems and breastfeeding interruption. TRIAL REGISTRATION This systematic review was registered on PROSPERO (CRD42018109478).
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Affiliation(s)
- Ana Lucia Pires Augusto
- Nutrition Faculty Emília de Jesus Ferreiro, Federal Fluminense University, Mário Santos Braga St., 30, 4th floor, 24020-140 - Niterói, Rio de Janeiro, Brazil. .,Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Carlos Chagas Filho Av, 373, CCS. 2 andar. Bloco J. 21941-902 - Ilha do Fundão, Rio de Janeiro, Brazil.
| | - Aléxia Vieira de Abreu Rodrigues
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Carlos Chagas Filho Av, 373, CCS. 2 andar. Bloco J. 21941-902 - Ilha do Fundão, Rio de Janeiro, Brazil
| | - Talita Barbosa Domingos
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Carlos Chagas Filho Av, 373, CCS. 2 andar. Bloco J. 21941-902 - Ilha do Fundão, Rio de Janeiro, Brazil
| | - Rosana Salles-Costa
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Carlos Chagas Filho Av, 373, CCS. 2 andar. Bloco J. 21941-902 - Ilha do Fundão, Rio de Janeiro, Brazil
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Chan CY, Lee AM, Koh YW, Lam SK, Lee CP, Leung KY, Tang CSK. Associations of body dissatisfaction with anxiety and depression in the pregnancy and postpartum periods: A longitudinal study. J Affect Disord 2020; 263:582-592. [PMID: 31744745 DOI: 10.1016/j.jad.2019.11.032] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/27/2019] [Accepted: 11/09/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Pregnancy is a time of increasing vulnerability to the development of body dissatisfaction, anxiety, and depression. The present study aims to examine associations of body dissatisfaction with anxiety and depression at the following points: 6 months before pregnancy (retrospective report); in the first, second, and third trimesters of pregnancy; and up to 6 weeks postpartum. METHODS A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 1,371 Chinese pregnant women in Hong Kong was assessed using standardized instruments at four time points. RESULTS A mixed-effects model with repeated measures revealed that body dissatisfaction and depression symptoms changed across different stages of pregnancy. Hierarchical multiple regressions showed that, after adjusting for the identified risk factors, body dissatisfaction before and during pregnancy were positively associated with antenatal anxiety and depression symptoms. Concurrent body dissatisfaction was positively associated with postpartum depression symptoms. LIMITATIONS There was a high attrition rate in the follow-up assessments. Antenatal anxiety symptoms were assessed using the scale for general anxiety, which may not adequately capture the experience of anxiety among pregnant women. CONCLUSIONS Primary healthcare practitioners should be made aware of body dissatisfaction among pregnant women in order to facilitate early intervention for anxiety and depression, because untreated psychological disturbance during pregnancy may persist into the postpartum period.
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Affiliation(s)
- Chui Yi Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China; The Felizberta Lo Padilla Tong School of Social Sciences, Caritas Institute of Higher Education, Hong Kong, China
| | - Antoinette Marie Lee
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China; Department of Psychology, The University of Hong Kong, Hong Kong, China.
| | - Yee Woen Koh
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China; Centre of Family and Population Research, The National University of Singapore, Singapore City, Singapore
| | - Siu Keung Lam
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | - Chin Peng Lee
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | - Kwok Yin Leung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | - Catherine So Kum Tang
- Department of Psychology, The National University of Singapore, Singapore City, Singapore
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A Systematic Review and Meta-analysis of Depression, Anxiety, and Sleep Disorders in US Adults with Food Insecurity. J Gen Intern Med 2019; 34:2874-2882. [PMID: 31385212 PMCID: PMC6854208 DOI: 10.1007/s11606-019-05202-4] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 07/09/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION A large number of peer-reviewed studies, with various methodologies and populations, have addressed the effects of food insecurity (FIS) on mental health conditions such as depression, anxiety, and sleep disorders. There are currently, however, no published systematic assessments or meta-analyses of this literature. METHODS A systematic search of the literature was conducted in PubMed, PsycInfo, Embase, Scopus, and Web of Science. Cross-sectional studies assessing the association between food insecurity and depression, anxiety, or sleep disorders were identified. For each of the three health outcomes, we extracted (or calculated when possible) the following effect sizes: odds ratio (OR), Hedges' g, Pearson correlation coefficients r, or bivariate coefficients. Then, for each mental health-outcome/effect-size pair, the available studies were combined using the random effect model. Heterogeneity, publication bias, and subgroup dependence, for each meta-analysis, were also assessed. RESULTS Fifty-seven studies provided cross-sectional data on the relationship between FIS and depression (n = 169,433), 13 on anxiety and psychological distress (n = 91,957), and 8 studies provided data on sleep disorders (n = 85,788). Meta-analysis showed that FIS is associated with an increased risk of testing positive for depression OR = 2.74 [95% CI 2.52-2.97, n = 135,500, Q(df = 41) = 69, I2 = 40%], anxiety OR = 2.41 [95% CI 1.81-3.22, n = 51,541, Q(df = 3) = 8, I2 = 63%], and sleep disorders OR = 1.80 [95% CI 1.51-2.15, n = 84,800, Q(df = 5) = 13, I2 = 62%]. The highest risks were found for depression and anxiety which had statistically similar values. The results were robust to covariates and population groups. DISCUSSION This systematic review and meta-analysis demonstrates a strong association between FIS and depression, anxiety, and sleep disorders, for which more longitudinal studies addressing effect sizes are warranted to further study causation.
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Coates D, Foureur M. The role and competence of midwives in supporting women with mental health concerns during the perinatal period: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:e389-e405. [PMID: 30900371 DOI: 10.1111/hsc.12740] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 06/09/2023]
Abstract
Perinatal mental health problems are linked to poor outcomes for mothers, babies and families. Despite a recognition of the significance of this issue, women often do not receive the care they need and fall between the gap of maternity and mental health services. To address this, there is a call for reform in the way in which perinatal mental healthcare is delivered. This paper responds to this by exploring the role and competence of midwives in delivering mental healthcare. Using a scoping review methodology, quantitative and qualitative evidence were considered to answer the research question 'what is the nature of the evidence relevant to the provision of mental health interventions by midwives?' To identify studies, the databases PubMed, Maternity and Infant Care, Science Citation Index, Social Sciences Citation Index, Medline, Science Direct and CINAHL were searched from 2011 to 2018, and reference lists of included studies were examined. Studies relevant to the role of midwives in the management and treatment of perinatal mental health issues were included; studies focussed on screening and referral were excluded. Thirty papers met inclusion criteria, including studies about the knowledge, skills, and attitudes of midwives and student midwives; the effectiveness of educational interventions in improving knowledge and skills; the delivery of counselling or psychosocial interventions by midwives; and barriers and enablers to embedding midwife-led mental healthcare in practice. Synthesis of the included studies indicates that midwives are interested in providing mental health support, but lack the confidence, knowledge and training to do so. This deficit can be addressed with appropriate training and organisational support, and there is some evidence that midwife-led counselling interventions are effective. Further research is needed to test midwife-led interventions for women with perinatal mental health problems , and to develop and evaluate models of integrated perinatal mental healthcare.
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Affiliation(s)
- Dominiek Coates
- Faculty of Health, Centre for Midwifery and Child and Family Health, University of Technology, Sydney, New South Wales, Australia
| | - Maralyn Foureur
- Faculty of Health, Centre for Midwifery and Child and Family Health, University of Technology, Sydney, New South Wales, Australia
- Hunter New England Nursing and Midwifery Research Centre, Newcastle, Australia
- University of Newcastle, Faculty of Health and Medicine, Newcastle, Australia
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28
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Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal Stress, anxiety and depression in early pregnancy among women in Chongqing, China. J Affect Disord 2019; 253:292-302. [PMID: 31077972 DOI: 10.1016/j.jad.2019.05.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/29/2019] [Accepted: 05/01/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prenatal mental disorders are associated with maternal and fetal adverse outcomes, while few studies have been performed in mainland China. This study aimed to investigate the prevalence and influencing factors of maternal stress, anxiety and depression in early pregnancy and provide scientific basis for reducing prenatal mental disorders. METHODS Data were obtained from 1220 women with < 15 weeks gestation in a cohort study conducted in Chongqing, China. Prenatal stress, anxiety and depression were assessed using the pregnancy pressure scale, the Hamilton anxiety scale, and the self-rating depression scale, respectively. RESULTS The prevalence of prenatal stress, anxiety and depression in early pregnancy was 91.86%, 15.04% and 5.19%, respectively. Logistic regression analysis revealed that the risk factors for prenatal stress include housewife/unemployment, presence of anxiety and low- and moderate-level social support, besides, the protective factors were exercise, active smoking and no suggestion from parents. Housewife/unemployment, primiparity, presence of stress and depression and low-level social support were found to be associated with the development of anxiety symptoms, whereas exercise had a protective effect on it. Group-oriented personality, presence of anxiety, no suggestion from husband, low- and moderate-level family care, and low-level social support were risk factors for prenatal depression. LIMITATIONS All participants were recruited from one region of China, and none of them have a history of cesarean section. CONCLUSION Early screening and intervention may have great significance for reducing mental disorders of pregnant women, and the family and society support should be brought into the intervention as well.
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Affiliation(s)
- Xian Tang
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Zhuo Lu
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Dihui Hu
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Xiaoni Zhong
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China.
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Katzow M, Messito MJ, Mendelsohn AL, Scott MA, Gross RS. The Protective Effect of Prenatal Social Support on Infant Adiposity in the First 18 Months of Life. J Pediatr 2019; 209:77-84. [PMID: 30879731 PMCID: PMC6535345 DOI: 10.1016/j.jpeds.2019.02.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/22/2019] [Accepted: 02/13/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To determine whether prenatal social support was associated with infant adiposity in the first 18 months of life in a low-income, Hispanic sample, known to be at high risk of early child obesity. STUDY DESIGN We performed a longitudinal analysis of 262 low-income, Hispanic mother-infant pairs in the control group of the Starting Early child obesity prevention trial. Prenatal social support was measured using an item from the Maternal Social Support Index. We used multilevel modeling to predict weight-for-length z-score trajectories from birth to age 18 months and logistic regression to predict macrosomia and overweight status at ages 6, 12, and 18 months. RESULTS High prenatal social support was independently associated with lower infant adiposity trajectories from birth to age 18 months (B = -0.40; 95% CI, -0.63 to -0.16), a lower odds of macrosomia (aOR = 0.35; 95% CI, 0.15-0.80), and a lower odds of overweight at ages 12 (aOR = 0.28; 95% CI, 0.10-0.74) and 18 months (aOR = 0.35; 95% CI, 0.14-0.89). Prenatal social support was not significantly associated with overweight status at age 6 months. CONCLUSIONS Prenatal social support may protect against excessive infant adiposity and overweight in low-income, Hispanic families. Further research is needed to elucidate mechanisms underlying these associations and to inform preventive strategies beginning in pregnancy.
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Affiliation(s)
- Michelle Katzow
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, New York, NY.
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Alan L Mendelsohn
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Marc A Scott
- Department of Applied Statistics, Social Science, and Humanities, New York University Steinhardt School of Culture, Education, and Human Development, New York, NY
| | - Rachel S Gross
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, New York, NY
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Tambelli R, Trentini C, Trovato A, Volpi B. Role of psychosocial risk factors in predicting maternal and paternal depressive symptomatology during pregnancy. Infant Ment Health J 2019; 40:541-556. [PMID: 31062378 DOI: 10.1002/imhj.21791] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The aim of the present study was to investigate the role of several psychosocial risk factors in predicting depressive symptomatology during pregnancy in mothers and fathers, respectively. A total of 146 primiparous mothers and 105 primiparous fathers reporting a psychosocial risk condition were recruited independently from maternity and child health services, during the second trimester of pregnancy. All parents were evaluated for depressive symptomatology, anxiety, and perceived social support. Two hierarchical multiple regression analyses were performed to determine the role of psychosocial factors in predicting depressive symptomatology during pregnancy, in mothers and fathers. Marital dissatisfaction, personal history of depression, and personal trait anxiety were identified as significant predictors of depressive symptomatology during pregnancy, both in mothers and in fathers. Family history of substance abuse, conflictual relationship with the parents in the past year, and bereavement in the past year were identified as significant factors contributing to elevated depressive symptoms during pregnancy in mothers, but not fathers. In this study, several psychosocial risk factors were consistently related to an increase in maternal and paternal depressive symptoms during pregnancy; some of these factors seem to be specifically related to maternal depressive mood.
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Affiliation(s)
- Renata Tambelli
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Cristina Trentini
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Annamaria Trovato
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Barbara Volpi
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
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Magliarditi AT, Lua LL, Kelley MA, Jackson DN. Maternal Depression Scale: Do "Drop-In" Laborist Patients Have Increased Postpartum Screening Risks Compared to Patients with Adequate Prenatal Care? Matern Child Health J 2019; 23:54-60. [PMID: 30019156 DOI: 10.1007/s10995-018-2593-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objectives The Edinburgh Postnatal Depression Scale (EPDS) identifies women with depressive symptoms in pregnancy. Our primary objective was to determine the prevalence of EPDS screen-positive women delivering on our no prenatal care (laborist) service and to compare these patients to private patients delivering with prenatal care. Methods Retrospective cohort analysis of EPDS scores during January 1, 2015 to June 18, 2015 was conducted. Scores ≥ 10 were considered at-risk. Results were analyzed as an aggregate and then as no prenatal care versus prenatal care. Characteristics for patients with at-risk scores (EPDS ≥ 10) versus low-risk scores (EPDS < 10) were quantified. Results Analysis occurred on 970 women. EPDS ≥ 10 occurred in 12.4% (n = 120/970). Positive EPDS score was 21.1% without prenatal care versus 10.9% with adequate prenatal care (P = 0.003). Maternal demographics and delivery characteristics were clinically similar in patients with prenatal care compared to no prenatal care. Private insurance was more common in patients with prenatal care compared to no prenatal care (23.5 versus 8.1%, P = 0.0001). However, analysis of patients with EPDS > 10 showed non-significant distributions of ethnicity, private insurance, Medicaid, or no insurance compared to patients with EPDS < 10. Conclusion for Practice Patients without prenatal care who arrive solely for urgent "drop-in" delivery have a measurable increased risk factor for postpartum depressive symptoms. Ethnicity and payor status were related to adequacy of prenatal care but were not significant variables when analyzing patients with EPDS > 10. Laborist services providing care to "drop-in" patients should recognize this increased risk and develop policies for screening, referral and follow-up of at-risk patients.
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Affiliation(s)
- Alexandra T Magliarditi
- University of Nevada Reno School of Medicine, 1664 North Virginia Street, Reno, NV, 89557, USA
| | - Lannah L Lua
- Department of Obstetrics and Gynecology, University of Nevada Las Vegas School of Medicine, 1707 West Charleston Boulevard Suite 120, Las Vegas, NV, 89102, USA
| | - Melissa A Kelley
- University of Nevada Reno School of Medicine, 1664 North Virginia Street, Reno, NV, 89557, USA
| | - David N Jackson
- Department of Obstetrics and Gynecology, University of Nevada Las Vegas School of Medicine, 1707 West Charleston Boulevard Suite 120, Las Vegas, NV, 89102, USA.
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Shamblaw AL, Cardy RE, Prost E, Harkness KL. Abuse as a risk factor for prenatal depressive symptoms: a meta-analysis. Arch Womens Ment Health 2019; 22:199-213. [PMID: 30196369 DOI: 10.1007/s00737-018-0900-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 08/08/2018] [Indexed: 10/28/2022]
Abstract
Depression is the most common mental disorder in pregnancy. An important risk factor in the development of prenatal depression is lifetime history of abuse. The current review quantitatively synthesized research on the association between history of abuse and prenatal depressive symptoms using a meta-analytic technique. A total of 3322 articles were identified through electronic searches of the following databases: PsycINFO, PubMed, CINAHL, and EMBASE Cochrane Collaboration databases between the years of 1980 and 2016. All were independently screened against the following inclusion criteria: articles reporting on original data that included measures of prenatal depression and abuse. Data were extracted by the first and second authors. Descriptive analyses were conducted using Excel version 15.32, and all analyses involving effect sizes were conducted using comprehensive meta-analysis (CMA) version 3.0. Seventy articles met the inclusion criteria and were included in the meta-analyses. Meta-bias detected no publication bias. Abuse had a significant positive relation with prenatal depressive symptoms, with effect sizes in the moderate range for any abuse ([Formula: see text] = 0.287), physical abuse ([Formula: see text] = 0.271), sexual abuse ([Formula: see text] = 0.259), and emotional abuse ([Formula: see text] = 0.340; Cohen 1969. Statistical power analysis for the behavioral sciences. Academic Press, New York). The meta-analyses found a robust relation between abuse and prenatal depressive symptoms holding across a variety of demographic and study design characteristics. These results reinforce the established association between trauma victimization and subsequent psychopathology, extending current knowledge to specifically address the under-studied area of prenatal depression. These findings highlight the need for women who have survived child or adulthood abuse to receive appropriate referral and psychological treatment to mitigate their risk for prenatal depression.
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Affiliation(s)
- Amanda L Shamblaw
- Department of Psychology, Queen's University, Kingston, Ontario, Canada.
| | - Robyn E Cardy
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Eric Prost
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
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Kimmel MC, Bauer A, Meltzer-Brody S. Toward a framework for best practices and research guidelines for perinatal depression research. J Neurosci Res 2019; 98:1255-1267. [PMID: 30924191 PMCID: PMC10127524 DOI: 10.1002/jnr.24425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/09/2018] [Accepted: 10/26/2018] [Indexed: 02/06/2023]
Abstract
This review article highlights the current state of perinatal depression (PND) research including established standards of care and innovative research in progress. PND can have a significant adverse impact on mother, child, and family; however, to date, wide-scale identification, prevention, and treatment have been limited. PND is heterogenous in presentation with likely multifactorial etiologies for each woman. Challenges in PND research are discussed including a need for universal tools, standardized measures, benchmarks, and best practices. Current examples are reviewed that highlight approaches to novel treatment paradigms and interventions. This includes reviewing epidemiologic studies in PND research, examining the biological underpinnings of PND, and discussing examples from this field and other fields currently developing translational research that spans from bench to bedside. Current and future challenges and opportunities in developing best practices for the treatment of PND are outlined. We also discuss the use of the NIMH Research Domain Criteria approach for PND research and provide recommendations for future directions in PND research collaboration. In conclusion, greater precision in perinatal psychiatry can be possible in the future with the development of guidelines and best practices that build on current work and apply innovative and collaborative approaches of scientists, providers, patients, community members, and government officials.
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Affiliation(s)
- Mary C Kimmel
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Anna Bauer
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Samantha Meltzer-Brody
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
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Predictors of Postpartum Depression: A Comprehensive Review of the Last Decade of Evidence. Clin Obstet Gynecol 2019; 61:591-603. [PMID: 29596076 DOI: 10.1097/grf.0000000000000368] [Citation(s) in RCA: 182] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Postpartum depression (PPD) is one of the most frequent complications of childbirth affecting ~500,000 women annually (prevalence 10% to 15%). Despite the documented adverse outcomes for mother and child, there remains a great need to develop prospective approaches to identify women at risk. This review examines some of the best-characterized molecular and clinical risk factors for PPD. We illustrate that this is a growing literature but there remains a lack of reliable molecular predictors for PPD. Current best predictors are clinical assessments for psychiatric history and adverse life events, highlighting the need for increased depression screening across the perinatal period.
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Herbell K. Identifying psychophysiological stress targets for the promotion of mental health in pregnant women. Arch Psychiatr Nurs 2019; 33:46-50. [PMID: 30663624 DOI: 10.1016/j.apnu.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/18/2018] [Accepted: 10/03/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Kayla Herbell
- Postdoctoral Fellow at the University of Missouri Sinclair School of Nursing S235 School of Nursing, University of Missouri, Columbia, MO 65211, United States of America.
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Johnson JE, Wiltsey-Stirman S, Sikorskii A, Miller T, King A, Blume JL, Pham X, Moore Simas TA, Poleshuck E, Weinberg R, Zlotnick C. Protocol for the ROSE sustainment (ROSES) study, a sequential multiple assignment randomized trial to determine the minimum necessary intervention to maintain a postpartum depression prevention program in prenatal clinics serving low-income women. Implement Sci 2018; 13:115. [PMID: 30134941 PMCID: PMC6106826 DOI: 10.1186/s13012-018-0807-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND More research on sustainment of interventions is needed, especially return on investment (ROI) studies to determine cost-benefit trade-offs for effort required to sustain and how much is gained when effective programs are sustained. The ROSE sustainment (ROSES) study uses a sequential multiple assignment randomized (SMART) design to evaluate the effectiveness and cost-effectiveness of a stepwise approach to sustainment of the ROSE postpartum depression prevention program in 90 outpatient clinics providing prenatal care to pregnant women on public assistance. Postpartum depression (PPD) is common and can have lasting consequences. Outpatient clinics offering prenatal care are an opportune place to provide PPD prevention because most women visit while pregnant. The ROSE (Reach Out, Stay Strong, Essentials for mothers of newborns) program is a group educational intervention to prevent PPD, delivered during pregnancy. ROSE has been found to reduce cases of PPD in community prenatal settings serving low-income pregnant women. METHODS All 90 prenatal clinics will receive enhanced implementation as usual (EIAU; initial training + tools for sustainment). At the first time at which a clinic is determined to be at risk for failure to sustain (i.e., at 3, 6, 9, 12, and 15 months), that clinic will be randomized to receive either (1) no additional implementation support (i.e., EIAU only), or (2) low-intensity coaching and feedback (LICF). If clinics receiving LICF are still at risk at subsequent assessments, they will be randomized to either (1) EIAU + LICF only, or (2) high-intensity coaching and feedback (HICF). Additional follow-up interviews will occur at 18, 24, and 30 months, but no implementation intervention will occur after 18 months. Outcomes include (1) percent sustainment of core program elements at each time point, (2) health impact (PPD rates over time at each clinic) and reach, and (3) ROI (costs and cost-effectiveness) of each sustainment step. Hypothesized mechanisms include sustainment of capacity to deliver core elements and engagement/ownership. DISCUSSION This study is the first randomized trial evaluating the ROI of a stepped approach to sustainment, a critical unanswered question in implementation science. It will also advance knowledge of implementation mechanisms and clinical care for an at-risk population. TRIAL REGISTRATION Clinicaltrials.gov, NCT03267563 . Registered June 14, 2018.
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Affiliation(s)
- Jennifer E. Johnson
- Division of Public Health, Michigan State University, 200 East 1st St Room 366, Flint, MI 48502 USA
| | - Shannon Wiltsey-Stirman
- National Center for PTSD, Dissemination and Training Division and Stanford University Department of Psychiatry and Behavioral Sciences, 795 Willow Road (NC-PTSD 334), Menlo Park, CA 94025 USA
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, 909 Fee Rd Room 321, East Lansing, MI 48824 USA
| | - Ted Miller
- Pacific Institute for Research and Evaluation, 11720 Beltsville Drive Suite 900, Calverton, MD 20705 USA
| | - Amanda King
- Mayo Clinic, 200 First St, Rochester, MN 55901 USA
| | - Jennifer L. Blume
- Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109 USA
| | - Xuan Pham
- Spectrum Health, 221 Michigan Street, Suite 402 MC 118, Grand Rapids, 49503 USA
| | - Tiffany A. Moore Simas
- University of Massachusetts Medical School/UMass Memorial Health Care, Memorial campus - 119 Belmont Street - Jaquith 2.008, Worcester, MA 01605 USA
| | - Ellen Poleshuck
- University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY 14642 USA
| | - Rebecca Weinberg
- Allegheny Health Network, 4815 Liberty Avenue, Mellon Pavilion, Suite GR4, Pittsburgh, PA 15224 USA
| | - Caron Zlotnick
- Butler Hospital and Brown University, 345 Blackstone Blvd, Providence, RI 02906 USA
- University of Cape Town, Cape Town, South Africa
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Impact of Prenatal Depressive Symptoms on Postpartum Depressive Symptoms: Mediation Effect of Perinatal Health. SPANISH JOURNAL OF PSYCHOLOGY 2018; 21:E28. [DOI: 10.1017/sjp.2018.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractTo analyze the mediation effect of perinatal health on the association between prenatal depressive symptoms and postpartum depressive symptoms 180 women filled the Edinburgh Postnatal Depressive Scale (EPDS) at 35 weeks of gestation and two months after childbirth. Perinatal health data was collected during the first 4 days after childbirth, using the Optimality Index. 25.6% of the mothers-to-be presented clinically significant depressive symptoms, and of these, 80.4% still show clinically significant depressive symptoms at 2-months postpartum. Prenatal depressive symptoms predict higher postpartum depressive symptoms. Additionally, results also showed that the effect of prenatal depressive symptoms on postnatal depressive symptoms is not mediated by perinatal health. Mothers-to-be with prenatal depressive symptoms seem to be at risk for postnatal depression, even when perinatal health is not compromised. This highlights the importance of early screening of prenatal depressive symptoms in order to promote an early intervention on women’s mental health, leading to a better transition to parenthood and to a decrease of the burden of this public health problem on children and families.
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Arifin SRM, Cheyne H, Maxwell M. Review of the prevalence of postnatal depression across cultures. AIMS Public Health 2018; 5:260-295. [PMID: 30280116 PMCID: PMC6141558 DOI: 10.3934/publichealth.2018.3.260] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 07/12/2018] [Indexed: 12/15/2022] Open
Abstract
The purpose of this review was to examine articles related to recent epidemiological evidence of the prevalence of maternal postnatal depression (PND) across different countries and cultures and to identify specific epidemiological studies that have been carried out exclusively in Malaysia on the prevalence of maternal PND. The review was undertaken in two stages, an initial review and an updated review. At both stages systematic literature searches of online databases were performed to identify articles on the prevalence of maternal PND. A total of 124 articles concerning research conducted in more than 50 countries were included in the final analysis. There were wide variations in the screening instruments and diagnostic tools used although the Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument applied to identify PND. The prevalence of maternal PND ranged from 4.0% to 63.9%, with Japan and America recording the lowest and highest rates, respectively. Within continents, a wide variation in reported prevalence was also found. The reported rates of maternal PND in Malaysia were much higher than that previously documented with a range of 6.8–27.3%. This review indicated that the widely cited prevalence of maternal PND of 10–15% underestimates rates of PND worldwide. The reasons for this variability may not be fully explained by review methods. Future studies should evaluate the nature of women's PND experiences across cultures to explain these wide variations.
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Affiliation(s)
- Siti Roshaidai Mohd Arifin
- Department of Special Care Nursing, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling Scotland, United Kingdom
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling Scotland, United Kingdom
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Food Insecurity and Mental Health among Females in High-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071424. [PMID: 29986420 PMCID: PMC6068629 DOI: 10.3390/ijerph15071424] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/01/2018] [Accepted: 07/04/2018] [Indexed: 12/23/2022]
Abstract
Food insecurity is a persistent concern in high-income countries, and has been associated with poor mental health, particularly among females. We conducted a scoping review to characterize the state of the evidence on food insecurity and mental health among women in high-income countries. The research databases PubMed, EMBASE, and psycINFO were searched using keywords capturing food insecurity, mental health, and women. Thirty-nine articles (representing 31 unique studies/surveys) were identified. Three-quarters of the articles drew upon data from a version of the United States Department of Agriculture Household Food Security Survey Module. A range of mental health measures were used, most commonly to measure depression and depressive symptoms, but also anxiety and stress. Most research was cross-sectional and showed associations between depression and food insecurity; longitudinal analyses suggested bidirectional relationships (with food insecurity increasing the risk of depressive symptoms or diagnosis, or depression predicting food insecurity). Several articles focused on vulnerable subgroups, such as pregnant women and mothers, women at risk of homelessness, refugees, and those who had been exposed to violence or substance abuse. Overall, this review supports a link between food insecurity and mental health (and other factors, such as housing circumstances and exposure to violence) among women in high-income countries and underscores the need for comprehensive policies and programs that recognize complex links among public health challenges.
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Park HJ, Shim HS, Lee S, Hahm DH, Lee H, Oh CT, Han HJ, Ji HJ, Shim I. Anti-stress effects of human placenta extract: possible involvement of the oxidative stress system in rats. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:149. [PMID: 29739458 PMCID: PMC5941529 DOI: 10.1186/s12906-018-2193-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 03/29/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Human placenta hydrolysate (hPH) has been utilized to improve menopausal, fatigue, liver function. Its high concentration of bioactive substances is known to produce including antioxidant, anti-inflammatory and anti-nociceptive activities. However, its mechanisms of stress-induced depression remain unknown. METHODS The present study examined the effect of hPH on stress-induced depressive behaviors and biochemical parameters in rats. hPH (0.02 ml, 0.2 ml or 1 ml/rat) was injected intravenously 30 min before the daily stress session in male Sprague-Dawley rats exposed to repeated immobilization stress (4 h/day for 7 days). The depressive-like behaviors of all groups were measured by elevated plus maze (EPM) and forced swimming test (FST). After the behavior tests, brain samples of all groups were collected for the analysis of glutathione peroxidase (GPx) and nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) staining. RESULTS Treatment with hPH produced a significant decrease of immobility time in the FST compared to the controls. Additionally, hPH treatment elicited a slightly decreasing trend in anxiety behavior on the EPM. Furthermore, hPH increased the level of GPx protein in the hippocampus, and decreased the expression of NADPH-d in the paraventricular nucleus (PVN). CONCLUSION This study demonstrated that hPH has anti-stress effects via the regulation of nitric oxide (NO) synthase and antioxidant activity in the brain. These results suggest that hPH may be useful in the treatment of stress-related diseases such as chronic fatigue syndrome.
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Mukherjee S, Trepka MJ, Pierre-Victor D, Bahelah R, Avent T. Racial/Ethnic Disparities in Antenatal Depression in the United States: A Systematic Review. Matern Child Health J 2017; 20:1780-97. [PMID: 27016352 DOI: 10.1007/s10995-016-1989-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objectives More than 10 % of pregnant women in the United States (U.S.) suffer from depression, which has far-reaching consequences on maternal and fetal well-being. There is conflicting evidence regarding the prevalence of antenatal depression among different race and ethnic groups. This systematic review aimed to summarize the existing literature concerning racial/ethnic disparities in the prevalence and correlates of antenatal depression in the U.S. Methods PubMed, CINAHL and PsycINFO databases were searched online for research studies published in English in peer-reviewed journals until March 2015, using a pre-designed search strategy. Eligibility was determined using pre-specified criteria; and quality was assessed. Results Forty-one (41) articles met the criteria; 13 were cross-sectional, and 21 were longitudinal studies. Overall, the prevalence of antenatal depression was 10-30 %; it was higher among non-Hispanic blacks (NHBs) and Hispanics, compared to non-Hispanic whites (NHWs). Few studies looked at the correlates of depression by race/ethnicity. Among employed women, higher depression scores were observed among NHBs, compared to NHWs; while there was no racial difference among unemployed women. Racial difference and race-employment interaction disappeared once discrimination was accounted for. In another study, higher parity, higher stress, and lower self-esteem were significant correlates of depression among NHBs, while less satisfaction with social support, and higher stress predicted higher depression scores among NHWs and Hispanics respectively. Conclusions The findings of our review suggest that not only is antenatal depression a major public health issue that needs to be addressed, but different racial/ethnic groups seem to differ in their vulnerability and risk factors.
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Affiliation(s)
- Soumyadeep Mukherjee
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Dudith Pierre-Victor
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Raed Bahelah
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Tenesha Avent
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
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The effects of trauma on perinatal depression: Examining trajectories of depression from pregnancy through 24 months postpartum in an at-risk population. J Affect Disord 2017; 218:269-276. [PMID: 28477506 DOI: 10.1016/j.jad.2017.04.051] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 01/24/2017] [Accepted: 04/24/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Research suggests that trauma exposure is associated with perinatal depression; however, little is known about the nature of the relation between trauma history and trajectory of depression, as well as the predictive power of trauma history beyond other risk factors. Additionally, more research is needed in at-risk samples that are likely to experience severe traumatic exposure. METHODS Secondary data analysis was conducted using demographic and depression data from the Healthy Start and Empowerment Family Support programs in Des Moines, Iowa. Hierarchical linear modeling was used to examine trajectories of perinatal depressive symptoms, from pregnancy to 24 months postpartum, and clarify whether trauma exposure, relationship status, and substance use uniquely contribute to trajectories of symptoms over time. RESULTS On average, depressive symptoms decreased from pregnancy to 24 months postpartum; however, trajectories varied across women. Single relationship status, substance use, and trauma history were each predictors of higher depression levels at several points in time across the observed perinatal period. Single relationship status was also associated with decline in depressive symptoms followed by a rebound of symptoms at 22 months postpartum. LIMITATIONS These data were not collected for research purposes and thus did not undergo the rigorous data collection strategies typically implemented in an established research study. CONCLUSIONS History of trauma, substance use and single relationship status represent unique risk factors for perinatal depression. For single women, depressive symptoms rebound late in the postpartum period. Single women are at greater risk for substance use and traumatic exposure and represent a sample with cumulative risk. Eliciting social support may be an important intervention for women presenting with these risk factors.
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Li Y, Long Z, Cao D, Cao F. Social support and depression across the perinatal period: A longitudinal study. J Clin Nurs 2017; 26:2776-2783. [PMID: 28334472 DOI: 10.1111/jocn.13817] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To report changes in the prevalence of depression and the level of social support at three different time points in the perinatal period (late pregnancy, 1 week postpartum and 4 weeks postpartum) and to examine the relationship between depression and social support at these points in time. BACKGROUND Social support is a modifiable factor for depression. Existing research is limited to examining social support at a single time point in relation to antepartum or postpartum depression. DESIGN A longitudinal study. METHODS In total, 240 pregnant women were recruited from the prenatal clinic at a general hospital in China between June-September 2013. The Edinburgh Postnatal Depression Scale and Perceived Social Support Scale were used to measure the risk of depression and perceived social support at late pregnancy, within the first week postpartum, and at 4 weeks postpartum. RESULTS The Perceived Social Support Scale scores within the first week after birth were higher than scores at the late pregnancy and postpartum week 4, while the Edinburgh Postnatal Depression Scale scores at late pregnancy were higher than scores at the two postpartum times. Women who had higher Perceived Social Support Scale scores at late pregnancy had less likelihood of developing antepartum depression, and women with higher Perceived Social Support Scale scores at postpartum week 4 were less likely to have postpartum depression. However, the Perceived Social Support Scale scores at late pregnancy did not predict the risk of postpartum depression. CONCLUSION The study revealed that social support perceived by women changed over the perinatal period. Social support at each stage of the perinatal period was an important buffer against depression at this stage. RELEVANCE TO CLINICAL PRACTICE An increased focus on the relationship between social support and depression at each stage of the perinatal period is necessary for future research and practice.
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Affiliation(s)
- Yang Li
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Zhouting Long
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Danfeng Cao
- Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Fenglin Cao
- School of Nursing, Shandong University, Jinan, Shandong, China
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Tuthill EL, Pellowski JA, Young SL, Butler LM. Perinatal Depression Among HIV-Infected Women in KwaZulu-Natal South Africa: Prenatal Depression Predicts Lower Rates of Exclusive Breastfeeding. AIDS Behav 2017; 21:1691-1698. [PMID: 27752868 DOI: 10.1007/s10461-016-1557-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Exclusive breastfeeding (EBF) provides infants with optimal nutrition, and together with appropriate antiretroviral therapy has also been shown to decrease mother-to-child transmission of HIV from 45 to less than 1 %. However, rates of EBF are particularly low in South Africa, where rates of HIV are some of the highest in the world. Although perinatal depression has been identified as a potential barrier to EBF, little is known about its impact on EBF among HIV-infected women. A cohort study was conducted as part of a pilot randomized controlled trial (RCT) examining the effect of an Information, Motivation and Behavioral skills-based intervention promoting EBF among South African women living with HIV in their third trimester (28-42 weeks) of pregnancy. At baseline and follow-up, participants were interviewed on depression symptoms (PHQ-9), and breastfeeding intentions and behavior. Multivariate logistic regressions were conducted to determine predictors of EBF at 6-weeks postpartum. A total of 68 women were enrolled and 58 women completed both baseline and follow-up assessments. Most (80.9 %) of the sample reported at least some symptoms of depression prenatally. Rates of depression were lower postpartum (47.1 %). In multivariate models, higher prenatal depression scores significantly predicted lower likelihood of EBF at 6-weeks postpartum after adjusting for demographics, condition, and intentions (AOR = 0.68, p < 0.05). Postpartum depression was not a significant predictor of EBF rates (AOR = 0.99, p = 0.96). These findings demonstrate the negative impact of prenatal depression on breastfeeding behavior. Future interventions focused on depression are warranted to identify those at risk for sub-optimal EBF. Improving maternal psychosocial well-being could be a new frontier to improving infant and young child feeding and reducing pre/postnatal transmission.
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Affiliation(s)
- Emily L Tuthill
- UCSF School of Nursing, University of California San Francisco, 2 Koret Way, Box 0608, San Francisco, CA, 94143-0608, USA.
| | - Jennifer A Pellowski
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sera L Young
- Department of Anthropology, Institute for Policy Research Northwestern University, Evanston, IL, USA
| | - Lisa M Butler
- Department of Pediatrics, Harvard Medical School, Boston, USA
- Department of Medicine, Division of General Pediatrics, Boston Children's Hospital, Boston, USA
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Underwood L, Waldie KE, D’Souza S, Peterson ER, Morton SMB. A Longitudinal Study of Pre-pregnancy and Pregnancy Risk Factors Associated with Antenatal and Postnatal Symptoms of Depression: Evidence from Growing Up in New Zealand. Matern Child Health J 2016; 21:915-931. [DOI: 10.1007/s10995-016-2191-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ceballos M, Wallace G, Goodwin G. Postpartum Depression among African-American and Latina Mothers Living in Small Cities, Towns, and Rural Communities. J Racial Ethn Health Disparities 2016; 4:10.1007/s40615-016-0295-z. [PMID: 27761728 DOI: 10.1007/s40615-016-0295-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/13/2016] [Accepted: 10/03/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND The presence of postpartum depression can lead to poor maternal-child attachment, failure to thrive, and even infant death. Postpartum depression affects 13-19 % of parturients. However, among racial and ethnic minority parturients, postpartum depression rates have been shown to reach up to 35-67 % (as reported by O'Hara and McCabe, Annu Rev Clin Psychol 9:379-407, 2013; Boury et al., Women Health. 39(3):19-34, 2004; Ramos-Marcuse et al.. J Affect Disord. 122(1-2):68-75, 2010; Lucero et al., J Am Acad Nurse Pract. 24(12):726-34, 2012). This is more concerning when considering the fact that these mothers are also hardest to reach because they are usually marginalized and displaced within mainstream US society. The current study assesses potential risk factors that contribute to postpartum depression among African-American and Latina mothers. METHODS We analyze data from 3317 Healthy Start participants living in small cities, towns, and rural areas in Pennsylvania using a logistic regression analysis controlling for known contributing risk factors, including maternal health, family life, social support, socioeconomic and demographic characteristics, and community of residence. We use a multiple imputation multivariate analysis to account for the potential effects of missing data. RESULTS The results show that the odds of a risk of postpartum depression is nearly 80 and 40 % greater for African-American (OR = 1.80, p < .001) and Latina mothers (OR = 1.41, p < .01), respectively, as compared to white mothers. While the higher risks of postpartum depression for Latinas is explained in part by socioeconomic status, community of residence, and immigrant status, the significantly higher risk among African-American mothers cannot be completely ameliorated by the controlled variables. Our study highlights the need for further research into the impact of social and environmental stressors on postpartum depression among racial and ethnic minority populations living in small cities, towns, and rural areas.
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Affiliation(s)
- Miguel Ceballos
- Department of Anthropology and Sociology, West Chester University of Pennsylvania, 102 Old Library Building, West Chester, PA, 19380, USA.
| | - Gail Wallace
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
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Abstract
PURPOSE This study examined the relationships among father of the baby involvement during pregnancy, depressive symptoms, and psychological well-being in African American women. STUDY DESIGN AND METHODS Using a prospective study design, a sample of 95 pregnant African American women receiving prenatal care at a medical center in Chicago completed the self-report instruments about father of the baby involvement, depressive symptoms, and psychological well-being twice during pregnancy, once at between 15 and 25 weeks and once between 25 and 37 weeks. RESULTS Eighty percent of women reported that the father of the baby was involved during their pregnancy. Twenty-eight percent of women had clinically relevant depressive symptoms (CES-D scores ≥16) at the first data collection and 25% of women had clinically relevant depressive symptoms at the second data collection. Compared with women who reported no father involvement during pregnancy, women who reported father involvement during pregnancy had lower levels of depressive symptoms and higher levels of psychological well-being. CLINICAL IMPLICATIONS Fathers' involvement is important during pregnancy; nurses should encourage fathers to participate at prenatal visits and ask questions, and educate fathers on pregnancy process and procedures during prenatal care.
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Glasser S, Hadad L, Bina R, Boyko V, Magnezi R. Rate, risk factors and assessment of a counselling intervention for antenatal depression by public health nurses in an Israeli ultra-orthodox community. J Adv Nurs 2016; 72:1602-15. [DOI: 10.1111/jan.12938] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2015] [Indexed: 01/13/2023]
Affiliation(s)
- Saralee Glasser
- Women and Children's Health Research Unit; Gertner Institute for Epidemiology and Health Policy Research; Sheba Medical Center; Tel Hashomer Israel
| | - Lea Hadad
- Women Health Clinic; Maccabi Health Services; Elad Israel
| | - Rena Bina
- School of Social Work; Bar Ilan University; Ramat Gan Israel
| | - Valentina Boyko
- Women and Children's Health Research Unit; Gertner Institute for Epidemiology and Health Policy Research; Sheba Medical Center; Tel Hashomer Israel
| | - Racheli Magnezi
- Public Health and Health Systems Management Program; Department of Management; Bar Ilan University; Ramat Gan Israel
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Kassada DS, Waidman MAP, Miasso AI, Marcon SS. Prevalência de transtornos mentais e fatores associados em gestantes. ACTA PAUL ENFERM 2015. [DOI: 10.1590/1982-0194201500084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Identificar a prevalência de transtornos mentais e fatores associados em gestantes. Métodos Estudo transversal realizado com 394 gestantes, selecionadas de forma aleatória e proporcional. Os dados foram coletados nos domicílios, com aplicação de questionário semiestruturado. Para a análise foi utilizada a regressão logística bivariada. Resultados Referiram diagnóstico de transtorno mental 51 gestantes (12,94%) e isto foi significativamente maior entre aquelas com idade entre 19 e 30 anos, sem companheiro, de cor branca, que estavam no segundo trimestre de gestação, tinha alguma doença crônica associada e foi internada na gestação atual. Nove delas faziam uso de psicofármacos, sendo os antidepressivos os mais utilizados. Conclusão A prevalência de transtornos mentais foi de 12,94% e os fatores associados foram: idade, situação conjugal, cor, trimestre de gestação, internação durante a gestação e doença crônica.
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Orsolini L, Bellantuono C. Serotonin reuptake inhibitors and breastfeeding: a systematic review. Hum Psychopharmacol 2015; 30:4-20. [PMID: 25572308 DOI: 10.1002/hup.2451] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 10/15/2014] [Accepted: 10/30/2014] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The postnatal period represents a critical phase for mothers because of physiological hormonal changes, the increase of emotional reactions and a greater susceptibility for the onset/recrudescence of psychiatric disorders. Despite the evidence of an increasing utilization of antidepressant drugs during breastfeeding, there is still few reliable information on the neonatal safety of the selective serotonin reuptake inhibitors (SSRIs) and selective noradrenergic reuptake inhibitors (SNRIs) [serotonin reuptake inhibitors (SRIs)] in nursing mothers. The aim of this study is to provide a systematic review on the neonatal safety profile of these drugs during breastfeeding, also assessing the limits of available tools. METHODS MEDLINE and PubMed databases were searched without any language restrictions by using the following set of keywords: ((SSRIs OR selective serotonin inhibitor reuptake OR SNRIs OR selective serotonin noradrenaline inhibitor reuptake) AND (breastfeeding OR lactation OR breast milk)). A separate search was also performed for each SSRIs (paroxetine, fluvoxamine, fluoxetine, sertraline, citalopram and escitalopram) and SNRIs (venlafaxine and duloxetine). RESULTS Sertraline and paroxetine show a better neonatal safety profile during breastfeeding as compared with other SRIs. Less data are available for fluvoxamine, escitalopram and duloxetine. Few studies followed up infants breastfeed for assessing the neurodevelopmental outcomes. CONCLUSIONS Literature review clearly indicates paroxetine and sertraline as the drugs that should be preferred as first line choice in nursing women who need an antidepressant treatment.
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Affiliation(s)
- Laura Orsolini
- Psychiatric Unit and DEGRA Center, United Hospital of Ancona and Academic Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
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