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San Martín-González N, Moya-Higueras J, Eixarch E, Castro-Quintas Á, Marques-Feixa L, Crispi F, Daura-Corral M, de la Fuente-Tomás L, Monteserín-García JL, García-Portilla MP, Fañanás L. Intergenerational effects of maternal childhood maltreatment on newborns' stress regulation: The role of maternal depressive symptoms. CHILD ABUSE & NEGLECT 2024; 155:106968. [PMID: 39116554 DOI: 10.1016/j.chiabu.2024.106968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/19/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Maternal childhood maltreatment (CM) has been repeatedly associated with negative offspring's emotional outcomes. The dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis has emerged as the main underlying physiological mechanism. OBJECTIVE To explore the association between maternal CM and newborns' physiological and neurobehavioral stress responses, considering the role of perinatal maternal depression and bonding. PARTICIPANTS AND SETTING 150 healthy women were followed throughout pregnancy. 79 mother-infant dyads were included in the final analyses. Maternal CM was evaluated using the Childhood Trauma Questionnaire and depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS) at each trimester. At 7 weeks postpartum, the EPDS and the Postpartum Bonding Questionnaire were administered. Newborns' behavioral responses were assessed using "States Organization" (SO) and "States Regulation" (SR) subdomains of the Neonatal Behavioral Assessment Scale (NBAS). Newborns' salivary samples were collected before and after the NBAS to study cortisol reactivity. METHODS A cross-lagged panel model was employed. RESULTS Infants born to mothers with higher CM presented more optimal scores on SO (β (0.635) = 0.216, p 〈001) and SR (ß (0.273) = 0.195, p = .006), and a higher cortisol reactivity after NBAS handling (β(0.019) = 0.217, p = .009). Moreover, newborns of mothers with higher CM and postpartum depressive symptoms exhibited a poorer performance on SR (ß (0.156 = -0.288,p = .002). Analyses revealed non-significant relationships between mother-infant bonding, newborns' cortisol reactivity and SO. CONCLUSIONS Newborns from mothers with greater CM present higher cortisol reactivity and more optimal behavioral responses, which may reflect a prenatal HPA axis sensitization. However, those exposed to maternal postnatal depressive symptoms present poorer stress recovery.
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Affiliation(s)
- Nerea San Martín-González
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - Jorge Moya-Higueras
- Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Department of Psychology, Sociology and Social Work, Faculty of Education, Psychology and Social Work, University of Lleida, Spain
| | - Elisenda Eixarch
- BCNatal - Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Rare Diseases (CIBER-ER), Institute of Health Carlos III, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Águeda Castro-Quintas
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - Laia Marques-Feixa
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - Fátima Crispi
- BCNatal - Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Rare Diseases (CIBER-ER), Institute of Health Carlos III, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Maria Daura-Corral
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | | | - José Luis Monteserín-García
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - María Paz García-Portilla
- Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
| | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain.
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Nshimyumukiza M, Niyonsenga J, Kanazayire C, Sebatukura SG, Mutabaruka J. Perinatal intimate partner violence among teen mothers and children's attachment disorders in Rwanda: potential mediating factors. Eur J Psychotraumatol 2024; 15:2387521. [PMID: 39165197 PMCID: PMC11340234 DOI: 10.1080/20008066.2024.2387521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/24/2024] [Accepted: 07/22/2024] [Indexed: 08/22/2024] Open
Abstract
Background: The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs.Method: This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1).Results: IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs.Conclusion: These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.
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Affiliation(s)
- Martin Nshimyumukiza
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
| | - Japhet Niyonsenga
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
| | - Clementine Kanazayire
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
| | - Simeon Gitimbwa Sebatukura
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Mutabaruka
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
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Finnbogadóttir HR, Henriksen L, Hegaard HK, Halldórsdóttir S, Paavilainen E, Lukasse M, Broberg L. The Consequences of A History of Violence on Women's Pregnancy and Childbirth in the Nordic Countries: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241253044. [PMID: 38805432 DOI: 10.1177/15248380241253044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Violence against women (VAW) is a global challenge also in the childbearing period. Despite high gender equality, there is a high prevalence of VAW in the Nordic countries. This scoping review aims to explore predictors for and consequences of a history of violence on women's pregnancy and childbirth in the Nordic countries, including women's experience of the impact of violence and the interventions used to detect, address consequences, and prevent further violence. The framework by Arksey and O'Malley was followed, and English, Finnish, Icelandic, Norwegian, Danish, and Swedish literature was included. The population was women aged ≥18 residing in the Nordic countries during the perinatal period. Eight databases were searched: MEDLINE, CINAHL, PubMed, PsycINFO, Web of Science, ASSIA, Social Services-, and Sociological abstracts. There was no limitation of the search time frame. The initial screening resulted in 1,104 records, and after removing duplicates, 452 remained. Finally, 61 papers met the inclusion criteria. The results covering the past 32 years indicated that childbearing women with a history of violence are at greater risk of common complaints and hospitalization during pregnancy, fear of childbirth, Cesarean section, breastfeeding difficulties, and physical and mental health problems. While extensive research was found on the associations between a history of and current violence and outcomes related to pregnancy, there was a lack of intervention studies and studies from Finland. Efforts must be made to scientifically test the methods used to reduce and treat the adverse effects of a history of violence and prevent further violence.
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Affiliation(s)
| | | | - Hanne Kristine Hegaard
- Copenhagen University Hospital-Rigshospitalet, Denmark
- The University of Copenhagen, Denmark
| | | | | | | | - Lotte Broberg
- Bispebjerg and Frederiksberg Hospital, Denmark
- Slagelse Hospital, Denmark
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Akintunde TY, Chen S, Isangha SO, Di Q. Adverse childhood experiences, emotional distress and dissatisfaction with motherhood among first-time mothers: Mediations and child differences. Glob Ment Health (Camb) 2024; 11:e18. [PMID: 38414725 PMCID: PMC10897492 DOI: 10.1017/gmh.2024.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/27/2023] [Accepted: 01/28/2024] [Indexed: 02/29/2024] Open
Abstract
Despite the challenges associated with motherhood, studies have not consistently identified factors contributing to first-time mothers' dissatisfaction with motherhood in resource-limited regions. To fill this research gap, this study investigates how adverse childhood experiences (ACEs) result in first-time mothers' dissatisfaction with motherhood through emotional distress in Nigeria. Results from the partial least square structural equation model suggests that ACEs are associated with dissatisfaction with motherhood ( = 0.092; p < 0.01) and emotional distress ( = 0.367; p < 0.001). There is also a significant association between emotional distress and dissatisfaction with motherhood ( = 0.728; p < 0.001). Indirect path from first-time mothers' ACEs to dissatisfaction with motherhood through emotional distress shows significance ( = 0.267; 95% CI (0.213, 0.323); p < 0.001). In addition, the indirect path from first-time mothers' ACEs to dissatisfaction with motherhood through child emotional closeness showed significant dampening effects ( = 0.044; 95% CI (0.025, 0.066); p < 0.001). No serial impact of emotional distress and child emotional closeness was found in the study. The findings based on child gender indicated that only among first-time mothers of female children are ACEs predictors of dissatisfaction with motherhood. Trauma-informed interventions should be introduced in primary care settings to screen for ACEs and emotional dysfunctions among first-time mothers.
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Affiliation(s)
- Tosin Yinka Akintunde
- Department of Sociology, School of Public Administration, Hohai University, Nanjing, China
| | - Shaojun Chen
- Department of Sociology, School of Public Administration, Hohai University, Nanjing, China
| | - Stanley Oloji Isangha
- Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Qi Di
- Department of Sociology, School of Public Administration, Hohai University, Nanjing, China
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Al-abri K, Edge D, Armitage CJ. Prevalence and correlates of perinatal depression. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1581-1590. [PMID: 36646936 PMCID: PMC9842219 DOI: 10.1007/s00127-022-02386-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/14/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE This systematic review of systematic reviews aims to provide the first global picture of the prevalence and correlates of perinatal depression, and to explore the commonalities and discrepancies of the literature. METHODS Seven databases were searched from inception until April 2022. Full-text screening and data extraction were performed independently by two researchers and the AMSTAR tool was used to assess the methodological quality. RESULTS 128 systematic reviews were included in the analysis. Mean overall prevalence of perinatal depression, antenatal depression and postnatal depression was 26.3%, 28.5% and 27.6%, respectively. Mean prevalence was significantly higher (27.4%; SD = 12.6) in studies using self-reported measures compared with structured interviews (17.0%, SD = 4.5; d = 1.0) and among potentially vulnerable populations (32.5%; SD = 16.7, e.g. HIV-infected African women) compared to the general population (24.5%; SD = 8.1; d = 0.6). Personal history of mental illness, experiencing stressful life events, lack of social support, lifetime history of abuse, marital conflicts, maternity blues, child care stress, chronic physical health conditions, preeclampsia, gestational diabetes mellitus, being exposed to second-hand smoke and sleep disturbance were among the major correlates of perinatal depression. CONCLUSION Although the included systematic reviews were all of medium-high quality, improvements in the quality of primary research in this area should be encouraged. The standardisation of perinatal depression assessment, diagnosis and measurement, the implementation of longitudinal designs in studies, inclusions of samples that better represent the population and better control of potentially confounding variables are encouraged.
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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, Muscat, Oman
| | - Dawn Edge
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK
- Equality, Diversity and Inclusion Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Christopher J. Armitage
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
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6
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Bind RH, Sawyer K, Hazelgrove K, Rebecchini L, Miller C, Ahmed S, Dazzan P, Sevdalis N, Bakolis I, Davis R, Lopez MB, Woods A, Crane N, Manoharan M, Burton A, Dye H, Osborn T, Greenwood L, Perkins R, Fancourt D, Pariante CM, Estevao C. Feasibility, clinical efficacy, and well-being outcomes of an online singing intervention for postnatal depression in the UK: SHAPER-PNDO, a single-arm clinical trial. Pilot Feasibility Stud 2023; 9:131. [PMID: 37501172 PMCID: PMC10373337 DOI: 10.1186/s40814-023-01360-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Postnatal depression (PND) affects over 12% of mothers, with numbers rising during COVID-19. Singing groups can support mothers with PND; however, online delivery has never been evaluated. SHAPER-PNDO, a single-arm clinical trial, evaluated the feasibility, clinical efficacy, and well-being outcomes of a 6-week online version of Breathe Melodies for Mums (M4M) singing intervention developed for mothers with PND during COVID-19 lockdowns. METHODS The primary objective of this study was to assess the feasibility of a group online singing intervention for new mothers with postnatal depression. This was ascertained through recruitment rates, study retention rates, attendance rates to the singing sessions, and study completion rates. The secondary objective of the study was to assess the clinical efficacy and well-being outcomes of the singing intervention. Specifically, we measured change in Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), and Office for National Statistics Wellbeing Scale (ONS) scores from baseline to end-of-intervention (week 6); follow-up assessments were completed at weeks 3, 16, and 32. Mothers were eligible if they scored ≥10 on the baseline EPDS. RESULTS Eighty-seven percent of the 37 recruited mothers completed the study, attending, on average, 5 of the 6 group singing sessions. With regard to secondary outcomes, at end-of-treatment, mothers experienced significant reductions in depression (EPDS, 16.6 ± 3.7 to 11.2 ± 5.3, 95% CI [0.79,1.65]), anxiety (STAI-S, 48.4 ± 27.1 to 41.7 ± 26.8, 95% CI [4.96, 17.65]) and stress (PSS, 29.0 ± 5.7 to 19.7 ± 5.3, 95% CI [1.33, 7.07]); and, furthermore, significant improvements in life satisfaction (ONS, 50.5 ± 23.0 to 72.8 ± 11.7, 95% CI [- 39.86, - 4.64]) and feelings of worthwhileness (ONS, 51.7 ± 30.4 to 78.6 ± 15.1, 95% CI [- 52.79, - 0.85]). Reduction on the EPDS correlated with a reduction on the BDI and the STAI-S and maternal childhood maltreatment was predictive of a smaller treatment response. CONCLUSIONS M4M online was feasible to mothers who partook in the programme. Furthermore, M4M online supports the mental health and well-being of new mothers experiencing PND, especially when barriers to in-person treatment are present. TRIAL REGISTRATION ClinicalTrials.gov NCT04857593 . Registered 22 April 2021, retrospectively registered.
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Affiliation(s)
- Rebecca H Bind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK.
| | - Kristi Sawyer
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Lavinia Rebecchini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Celeste Miller
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Subeyda Ahmed
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Ioannis Bakolis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Rachel Davis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Maria Baldellou Lopez
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Anthony Woods
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Nikki Crane
- Culture Team, King's College London, Somerset House East Wing, London, WC2R 2LS, Strand, UK
| | - Manonmani Manoharan
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Hannah Dye
- Breathe Arts Health Research, The Clarence Centre, 6 St George's Circus, London, SE1 6FE, UK
| | - Tim Osborn
- Breathe Arts Health Research, The Clarence Centre, 6 St George's Circus, London, SE1 6FE, UK
| | - Lorna Greenwood
- Breathe Arts Health Research, The Clarence Centre, 6 St George's Circus, London, SE1 6FE, UK
| | - Rosie Perkins
- Centre for Performance Science, Royal College of Music, London, UK
- Faculty of Medicine, Imperial College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
| | - Carolina Estevao
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Rd, Brixton, London, SE5 9RT, UK
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Stockman D, Haney L, Uzieblo K, Littleton H, Keygnaert I, Lemmens G, Verhofstadt L. An ecological approach to understanding the impact of sexual violence: a systematic meta-review. Front Psychol 2023; 14:1032408. [PMID: 37292501 PMCID: PMC10244654 DOI: 10.3389/fpsyg.2023.1032408] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
Aim A systematic meta-review was conducted to examine (1) the broad range of negative and positive individual and interpersonal changes following adult sexual violence, as well as (2) the risk/protective factors at multiple levels of the social ecology (e.g., individual, assault, and micro/meso/exo/macro/chronosystem factors)-influencing the impact of sexual violence. Methods Searches of Web of Science, Pubmed, and ProQuest resulted in inclusion of 46 systematic reviews or meta-analyses. Review findings were extracted for summary and a deductive thematic analysis was conducted. Results Experiencing sexual violence is associated with many negative individual and sexual difficulties as well as revictimization risk. Only a limited number of reviews reported on interpersonal and positive changes. Factors at multiple levels of the social ecology play a role in the intensity of these changes. Reviews including macrolevel factors were non-existent, however. Conclusion Reviews on sexual violence are fragmented in nature. Although the use of an ecological approach is often lacking, adopting such a perspective in research is necessary for a fuller understanding of the multiple influences on survivor outcomes. Future research should evaluate the occurrence of social and positive changes following sexual violence, as well as the role of macrolevel factors in influencing post-assault outcomes.
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Affiliation(s)
- Dagmar Stockman
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Laura Haney
- Department of Psychology, East Carolina University, Greenville, NC, United States
| | - Kasia Uzieblo
- Department of Criminology, Vrije Universiteit Brussel, Brussel, Belgium
- Forensic Care Specialists, Van der Hoeven Clinic, Utrecht, Netherlands
| | - Heather Littleton
- Lyda Hill Institute for Human Resilience, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Ines Keygnaert
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Gilbert Lemmens
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Lesley Verhofstadt
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Swales DA, Davis EP, Mahrer NE, Guardino CM, Shalowitz MU, Ramey SL, Schetter CD. Preconception maternal posttraumatic stress and child negative affectivity: Prospectively evaluating the intergenerational impact of trauma. Dev Psychopathol 2023; 35:619-629. [PMID: 35074031 PMCID: PMC9309186 DOI: 10.1017/s0954579421001760] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The developmental origins of psychopathology begin before birth and perhaps even prior to conception. Understanding the intergenerational transmission of psychopathological risk is critical to identify sensitive windows for prevention and early intervention. Prior research demonstrates that maternal trauma history, typically assessed retrospectively, has adverse consequences for child socioemotional development. However, very few prospective studies of preconception trauma exist, and the role of preconception symptoms of posttraumatic stress disorder (PTSD) remains unknown. The current study prospectively evaluates whether maternal preconception PTSD symptoms predict early childhood negative affectivity, a key dimension of temperament and predictor of later psychopathology. One hundred and eighteen women were recruited following a birth and prior to conception of the study child and were followed until the study child was 3-5 years old. Higher maternal PTSD symptoms prior to conception predicted greater child negative affectivity, adjusting for concurrent maternal depressive symptoms and sociodemographic covariates. In exploratory analyses, we found that neither maternal prenatal nor postpartum depressive symptoms or perceived stress mediated this association. These findings add to a limited prospective literature, highlighting the importance of assessing the mental health of women prior to conception and providing interventions that can disrupt the intergenerational sequelae of trauma.
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Affiliation(s)
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA
| | | | | | - Madeleine U. Shalowitz
- Department of Pediatrics, NorthShore University HealthSystem Research Institute, Evanston, IL
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Psychosocial Risk Factors and Psychopathological Outcomes: Preliminary Findings in Italian Pregnant Women. WOMEN 2023. [DOI: 10.3390/women3010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
The perinatal period may represent a particularly challenging time for expecting parents. Previous studies have highlighted an association between several perinatal risk conditions (e.g., childhood maltreatment, poor social support, and stress levels) and the development of psychopathological symptoms in pregnant women, especially depression symptoms. The current study examined the effects of psychosocial risk factors (childhood maltreatment, poor social support, and stressful events) on anxiety, depression, perceived stress, irritability/anger, relationship problems, psychosomatic symptoms, specific physiological problems, and addiction/at-risk behaviors. Sixty-one pregnant women (age range = 24–45) participating in a larger study completed questionnaires about childhood maltreatment (CECA Q.), Maternity Social Support Scale (MSSS), questionnaire on stressful events, and the Perinatal Assessment of Maternal Affectivity (PAMA) during their pregnancy. Results from regression analysis indicated that the presence of childhood maltreatment predicted elevated depressive symptoms, elevated irritability and anger, and elevated relationship problems. Further, stressful events in the year prior to pregnancy predicted elevated psychosomatic symptoms during pregnancy. No other significant associations were found. In this study, traumatic childhood events were strongly associated with mental health symptoms during pregnancy. This is an important finding that suggests the importance of screening and targeting psychotherapeutic interventions for vulnerable women during pregnancy.
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Lombardi BN, Jensen TM, Parisi AB, Jenkins M, Bledsoe SE. The Relationship Between a Lifetime History of Sexual Victimization and Perinatal Depression: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:139-155. [PMID: 34132148 PMCID: PMC9660263 DOI: 10.1177/15248380211021611] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND The association between a lifetime history of sexual victimization and the well-being of women during the perinatal period has received increasing attention. However, research investigating this relationship has yet to be systematically reviewed or quantitatively synthesized. AIM This systematic review and meta-analysis aims to calculate the pooled effect size estimate of the statistical association between a lifetime history of sexual victimization and perinatal depression (PND). METHOD Four bibliographic databases were systematically searched, and reference harvesting was conducted to identify peer-reviewed articles that empirically examined associations between a lifetime history of sexual victimization and PND. A random effects model was used to ascertain an overall pooled effect size estimate in the form of an odds ratio and corresponding 95% confidence intervals (CIs). Subgroup analyses were also conducted to assess whether particular study features and sample characteristic (e.g., race and ethnicity) influenced the magnitude of effect size estimates. RESULTS This review included 36 studies, with 45 effect size estimates available for meta-analysis. Women with a lifetime history of sexual victimization had 51% greater odds of experiencing PND relative to women with no history of sexual victimization (OR = 1.51, 95% CI [1.35, 1.67]). Effect size estimates varied considerably according to the PND instrument used in each study and the racial/ethnic composition of each sample. CONCLUSION Findings provide compelling evidence for an association between a lifetime history of sexual victimization and PND. Future research should focus on screening practices and interventions that identify and support survivors of sexual victimization perinatally.
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Affiliation(s)
- Brooke N. Lombardi
- School of Social Work, University of North Carolina at Chapel Hill,
NC, USA
| | - Todd M. Jensen
- School of Social Work, University of North Carolina at Chapel Hill,
NC, USA
| | - Anna B. Parisi
- School of Social Work, University of North Carolina at Chapel Hill,
NC, USA
| | - Melissa Jenkins
- School of Social Work, University of North Carolina at Chapel Hill,
NC, USA
| | - Sarah E. Bledsoe
- School of Social Work, University of North Carolina at Chapel Hill,
NC, USA
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11
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González-Ortiz M, Castro P, Vergara-Barra P, Huerta P, Escudero C. COVID-19 on Pregnancy Outcomes, Mental Health and Placenta: Focus in Latin America. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1428:269-285. [PMID: 37466778 DOI: 10.1007/978-3-031-32554-0_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
The COVID-19 pandemic has impacted many aspects of health and society worldwide. One vulnerable group that faced SARS-CoV-2 infection is pregnant women, who were considered to have potentiated risk factors. In physiological pregnancy, maternal systems have several changes and adaptations to support fetal development. These changes involve regulations of cardiovascular, respiratory, and immunologic systems, among others, which SARS-CoV-2 could severely alter. Furthermore, the systemic effects of viral infection could be associated with placental dysfunction and adverse pregnancy outcomes, which have been studied from the start of the pandemic to date. Additionally, pregnancy is a condition of more significant mental health vulnerability, especially when faced with highly stressful situations. In this chapter, we have collected information on the effect of COVID-19 on maternal mortality, the SARS-CoV-2 infection rate in pregnancy, and the impact on pregnancy outcomes, maternal mental health, and placental function, with a particular focus on studies that consider the Latin American population.
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Affiliation(s)
- Marcelo González-Ortiz
- Laboratorio de Investigación Materno-Fetal (LIMaF), Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Concepción, Concepción, Chile.
- Group of Research and Innovation in Vascular Health (GRIVAS), Chillán, Chile.
| | - Patricio Castro
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Pablo Vergara-Barra
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Programa de Neurociencias, Psiquiatría y Salud Mental (NEPSAM), Universidad de Concepción, Concepción, Chile
| | - Patricia Huerta
- Departamento de Salud Pública, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Carlos Escudero
- Group of Research and Innovation in Vascular Health (GRIVAS), Chillán, Chile
- Group of Research and Innovation in Vascular Health (GRIVAS), Chillán, Chile
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12
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Gentry SV, Paterson BA. Does screening or routine enquiry for adverse childhood experiences (ACEs) meet criteria for a screening programme? A rapid evidence summary. J Public Health (Oxf) 2022; 44:810-822. [PMID: 34231848 DOI: 10.1093/pubmed/fdab238] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are traumatic events in childhood that can have impacts throughout life. It has been suggested that ACEs should be 'screened' for, or routinely enquired about, in childhood or adulthood. The aim of this work is to review evidence for this against the United Kingdom National Screening Committee (UKNSC) programme criteria. METHODS A rapid review of evidence on ACEs screening was conducted using the approach of the UKNSC. RESULTS Good quality evidence was identified from meta-analyses for associations between ACEs and a wide range of adverse outcomes. There was no consistent evidence on the most suitable screening tool, setting of administration, and time or frequency of use. Routine enquiry among adults was feasible and acceptable to service users and professionals in various settings. A wide range of potentially effective interventions was identified. Limited evidence was available on the potential for screening or routine enquiry to reduce morbidity and mortality or possible harms of screening. CONCLUSIONS Based on the application of available evidence to UKNSC screening criteria, there is currently insufficient evidence to recommend the implementation of a screening programme for ACEs. Further research is needed to determine whether routine enquiry can improve morbidity, mortality, health and wellbeing.
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Affiliation(s)
- S V Gentry
- Public Health England East of England Centre, Fulbourn, Cambridge CB21 5XA, UK.,Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - B A Paterson
- Public Health England East of England Centre, Fulbourn, Cambridge CB21 5XA, UK
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13
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Burtchen N, Alvarez-Segura M, Urben S, Giovanelli C, Mendelsohn AL, Guedeney A, Schechter DS. Effects of maternal trauma and associated psychopathology on atypical maternal behavior and infant social withdrawal six months postpartum. Attach Hum Dev 2022; 24:1-27. [PMID: 36371796 DOI: 10.1080/14616734.2022.2142894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022]
Abstract
Maternal psychopathology given a history of maltreatment and domestic violence exposure increases the risk for child psychopathology. Infant social withdrawal is one warning sign of adverse developmental outcomes including child anxiety and depression. It remains unclear how maternal trauma-related psychopathology might affect infant social withdrawal six-months postpartum. METHODS One-hundred ninety-five women and their six-month-old infants were studied in an at-risk community sample. Maternal trauma history, posttraumatic stress (PTSD) and major depressive (MDD) disorders were assessed. Maternal and infant behaviors were coded from videotaped interactions. RESULTS Maternal trauma was correlated with atypical maternal behavior (AMB) and infant social withdrawal (p ≤ .001). PTSD and MDD, and comorbid PTSD/MDD predicted increased AMB (p ≤ .001) but only maternal MDD was predictive of infant social withdrawal (p ≤ .001). Effects of maternal MDD on infant withdrawal were mediated by AMB. CONCLUSIONS At six-months postpartum, maternal MDD was associated with infant withdrawal. AMB is an important target for early intervention.
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Affiliation(s)
- Nina Burtchen
- Clinic for Psychosomatic Medicine and Psychotherapy, Freiburg University Medical Center, Freiburg, Germany
- Department of Pediatrics, New York University, New York University Grossman School of Medicine, New York, NY, USA
| | - Mar Alvarez-Segura
- Child and Adolescent Psychiatry Service, Department of Psychiatry, Abat Oliba CEU University, Barcelona, Spain
- Department of Child & Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Sébastien Urben
- Child & Adolescent Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Alan L Mendelsohn
- Department of Pediatrics, New York University, New York University Grossman School of Medicine, New York, NY, USA
| | - Antoine Guedeney
- Child & Adolescent Psychiatry Service, Hôpital Bichat-Claude
- Bernard Faculty of Medicine, University of Paris Diderot, Paris, France
| | - Daniel S Schechter
- Department of Child & Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Child & Adolescent Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and Faculty of Biology and Medicine, Lausanne, Switzerland
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14
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Jermy BS, Hagenaars S, Coleman JRI, Vassos E, Lewis CM. Risk factor profiles for depression following childbirth or a chronic disease diagnosis: case-control study. BJPsych Open 2022; 8:e182. [PMID: 36205003 PMCID: PMC9634597 DOI: 10.1192/bjo.2022.586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Progress towards understanding the aetiology of major depression is compromised by its clinical heterogeneity. The variety of contexts underlying the development of a major depressive episode may contribute to such heterogeneity. AIMS To compare risk factor profiles for three subgroups of major depression according to episode context. METHOD Using self-report questionnaires and administrative records from the UK Biobank, we characterised three contextual subgroups of major depression: postpartum depression (3581 cases), depression following diagnosis of a chronic disease (409 cases) and a more typical (named heterogeneous) major depression phenotype excluding the two other contexts (34 699 cases). Controls with the same exposure were also defined. We tested each subgroup for association with the polygenic risk scores (PRS) for major depression and with other risk factors previously associated with major depression (bipolar disorder PRS, neuroticism, reported trauma in childhood and adulthood, socioeconomic status, family history of depression, education). RESULTS Major depression PRS was associated with all subgroups, but postpartum depression cases had higher PRS than heterogeneous major depression cases (OR = 1.06, 95% CI 1.02-1.10). Relative to heterogeneous depression, postpartum depression was more weakly associated with adulthood trauma and neuroticism. Depression following diagnosis of a chronic disease had weaker association with neuroticism and reported trauma in adulthood and childhood relative to heterogeneous depression. CONCLUSIONS The observed differences in risk factor profiles according to the context of a major depressive episode help provide insight into the heterogeneity of depression. Future studies dissecting such heterogeneity could help reveal more refined aetiological insights.
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Affiliation(s)
- Bradley S. Jermy
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
- Correspondence: Bradley Jermy.
| | - Saskia Hagenaars
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Jonathan R. I. Coleman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
| | - Cathryn M. Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK; and Department of Medical & Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, UK
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15
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Gastaldon C, Solmi M, Correll CU, Barbui C, Schoretsanitis G. Risk factors of postpartum depression and depressive symptoms: umbrella review of current evidence from systematic reviews and meta-analyses of observational studies. Br J Psychiatry 2022; 221:591-602. [PMID: 35081993 DOI: 10.1192/bjp.2021.222] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Evidence on risk factors for postpartum depression (PPD) are fragmented and inconsistent. AIMS To assess the strength and credibility of evidence on risk factors of PPD, ranking them based on the umbrella review methodology. METHOD Databases were searched until 1 December 2020, for systematic reviews and meta-analyses of observational studies. Two reviewers assessed quality, credibility of associations according to umbrella review criteria (URC) and evidence certainty according to Grading of Recommendations-Assessment-Development-Evaluations criteria. RESULTS Including 185 observational studies (n = 3 272 093) from 11 systematic reviews, the association between premenstrual syndrome and PPD was the strongest (highly suggestive: odds ratio 2.20, 95%CI 1.81-2.68), followed by violent experiences (highly suggestive: odds ratio (OR) = 2.07, 95%CI 1.70-2.50) and unintended pregnancy (highly suggestive: OR=1.53, 95%CI 1.35-1.75). Following URC, the association was suggestive for Caesarean section (OR = 1.29, 95%CI 1.17-1.43), gestational diabetes (OR = 1.60, 95%CI 1.25-2.06) and 5-HTTPRL polymorphism (OR = 0.70, 95%CI 0.57-0.86); and weak for preterm delivery (OR = 2.12, 95%CI 1.43-3.14), anaemia during pregnancy (OR = 1.47, 95%CI 1.17-1.84), vitamin D deficiency (OR = 3.67, 95%CI 1.72-7.85) and postpartum anaemia (OR = 1.75, 95%CI 1.18-2.60). No significant associations were found for medically assisted conception and intra-labour epidural analgesia. No association was rated as 'convincing evidence'. According to GRADE, the certainty of the evidence was low for Caesarean section, preterm delivery, 5-HTTLPR polymorphism and anaemia during pregnancy, and 'very low' for remaining factors. CONCLUSIONS The most robust risk factors of PDD were premenstrual syndrome, violent experiences and unintended pregnancy. These results should be integrated in clinical algorithms to assess the risk of PPD.
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Affiliation(s)
- Chiara Gastaldon
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; and Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA
| | - Marco Solmi
- Department of Neuroscience, University of Padua, Italy; and Padua Neuroscience Center, University of Padua, Italy
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA; Department of Psychiatry and Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, New York, USA; and Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Germany
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Georgios Schoretsanitis
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA; and Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
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16
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Do HP, Vo TV, Murray L, Baker PRA, Murray A, Valdebenito S, Eisner M, Tran BX, Luong-Thanh BY, Nguyen LH, Dunne MP. The influence of childhood abuse and prenatal intimate partner violence on childbirth experiences and breastfeeding outcomes. CHILD ABUSE & NEGLECT 2022; 131:105743. [PMID: 35738070 DOI: 10.1016/j.chiabu.2022.105743] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite the detrimental effects and life-course health consequences of violence exposure, relatively few studies have adequate capacity to investigate the evolution of violence from childhood to motherhood. OBJECTIVE This study aims to examine the cyclical nature of childhood abuse and prenatal inter-partner violent victimization (p-IPV) and its adverse impact on childbirth trauma and exclusive breastfeeding (EBF) practice in Vietnam. METHOD Using a prospective birth cohort, 150 pregnant women were recruited in the third trimester of pregnancy in Hue city in central Vietnam (Wave 1-Baseline) and re-interviewed approximately three months after delivery (Wave 2-Follow-up). The direct and indirect effects of violent victimization on subsequent childbirth experience (measured by Birth Memories and Recall Questionnaire) and EBF practice were estimated by using augmented-inverse-probability-weighted models, sensitivity analysis, and structural equation model. RESULTS Detrimental and prolonged effects of the inter-generational cycle of violence transverse childhood to motherhood. Women who experienced either childhood abuse or p-IPV violence were more likely to experience negative emotional childbirth memories [ARR 1.21, 95 % CI (1.04, 1.39)]. Evidence also suggested that not continuing to exclusively breastfeed at 3 months post-partum was strongly associated with prenatal depression, young age, and perceived low social status during pregnancy. Perceived strong connectedness among extended family members and social networks (i.e. nexus among family, friends, and neighborhood) provided a buffering effect by preventing EBF termination. CONCLUSION This research provides insights into the protective role of social connectedness in improving breastfeeding practice. It is vital to establish wholistic antenatal care and social service system to offer specialized support and response for victims of violence and mitigate the long-term sequelae of traumatic events.
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Affiliation(s)
- Huyen Phuc Do
- Queensland University of Technology (QUT), Faculty of Health, School of Public Health and Social Work, Brisbane, Australia; Institute of Health Economics and Technology, Hanoi, Viet Nam.
| | - Thang Van Vo
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue city, Viet Nam.
| | - Linda Murray
- College of Health Sciences, Massey University, New Zealand.
| | - Philip R A Baker
- Queensland University of Technology (QUT), Faculty of Health, School of Public Health and Social Work, Brisbane, Australia.
| | - Aja Murray
- Department of Psychology, University of Edinburgh, United Kingdom.
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, United Kingdom.
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, United Kingdom.
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Viet Nam; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Bao-Yen Luong-Thanh
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue city, Viet Nam.
| | - Lan Hoang Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue city, Viet Nam.
| | - Michael P Dunne
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Australian Centre for Health Law Research, Faculty of Business and Law, Queensland University of Technology (QUT), Australia.
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Kiewa J, Meltzer-Brody S, Milgrom J, Bennett E, Mackle T, Guintivano J, Hickie IB, Colodro-Conde L, Medland SE, Martin N, Wray N, Byrne E. Lifetime prevalence and correlates of perinatal depression in a case-cohort study of depression. BMJ Open 2022; 12:e059300. [PMID: 35973706 PMCID: PMC9621163 DOI: 10.1136/bmjopen-2021-059300] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study sought to evaluate the prevalence, timing of onset and duration of symptoms of depression in the perinatal period (PND) in women with depression, according to whether they had a history of depression prior to their first perinatal period. We further sought to identify biopsychosocial correlates of perinatal symptoms in women with depression. DESIGN AND SETTING The Australian Genetics of Depression Study is an online case cohort study of the aetiology of depression. For a range of variables, women with depression who report significant perinatal depressive symptoms were compared with women with lifetime depression who did not experience perinatal symptoms. PARTICIPANTS In a large sample of parous women with major depressive disorder (n=7182), we identified two subgroups of PND cases with and without prior depression history (n=2261; n=878, respectively). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was a positive screen for PND on the lifetime version of the Edinburgh Postnatal Depression Scale. Descriptive measures reported lifetime prevalence, timing of onset and duration of PND symptoms. There were no secondary outcome measures. RESULTS The prevalence of PND among parous women was 70%. The majority of women reported at least one perinatal episode with symptoms both antenatally and postnatally. Of women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.15 per additional depression episode, 95% CI 1.13 to 1.17, p<0.001), non-European ancestry (OR 1.5, 95% CI 1.0 to 2.1, p=0.03), severe nausea during pregnancy (OR 1.3, 95% CI 1.1 to 1.6, p=0.006) and emotional abuse (OR 1.4, 95% CI 1.1 to 1.7, p=0.005). CONCLUSIONS The majority of parous women with lifetime depression in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.
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Affiliation(s)
- Jacqueline Kiewa
- Child Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Brisbane, Queensland, Australia
| | | | - Jeannette Milgrom
- Parent-Infant Research Institute, Heidelberg Heights, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Jerry Guintivano
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Nick Martin
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Naomi Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Enda Byrne
- Child Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Brisbane, Queensland, Australia
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Melby TC, Sørensen NB, Henriksen L, Lukasse M, Flaathen EME. Antenatal depression and the association of intimate partner violence among a culturally diverse population in southeastern Norway: A cross-sectional study. Eur J Midwifery 2022; 6:44. [PMID: 35935753 PMCID: PMC9289962 DOI: 10.18332/ejm/150009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Antenatal depression and intimate partner violence (IPV) are independently associated with adverse short- and long-term health effects for women and their children. The main aim of the study was to investigate the prevalence of antenatal depression and the association between symptoms of antenatal depression and physical, emotional and sexual abuse in a culturally diverse population attending antenatal care. METHODS A cross-sectional study was conducted with 1812 culturally diverse pregnant women from Safe Pregnancy, a randomized controlled trial to test the effect of an intimate partner violence intervention for abused women in southeastern Norway. RESULTS More than one in ten women (14%) reported symptoms of antenatal depression. Women with symptoms of antenatal depression were significantly younger and single, had lower educational level, more limited economic resources and were more likely to use tobacco and to report negative experiences regarding alcohol consumption, including that of her partner, compared to women with no symptoms of depression. A total of 15.4% of the women reported experiences of some form of IPV during their lifetime. Most women reported previous experiences of IPV rather than recent experiences. Women with a history of IPV were significantly more likely to report symptoms of antenatal depression, after adjusting for confounding factors (AOR=1.96; 95% CI: 1.35–2.83). CONCLUSIONS Women who reported symptoms of antenatal depression were significantly more likely to have experienced physical, emotional and sexual IPV than women with no history of IPV. It is important to identify women at risk of antenatal depression in order to offer appropriate services during pregnancy.
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Affiliation(s)
- Thea Cathrine Melby
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Nina Benedicte Sørensen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Division of General Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Eva Marie E Flaathen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Dang TAT, Vo TV, Dunne MP, Eisner M, Luong-Thanh BY, Hoang TD, Nguyen LH. Effect of intimate partner violence during pregnancy on maternal mental health: a cohort study in central Vietnam. Women Health 2022; 62:205-213. [DOI: 10.1080/03630242.2022.2043984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Thi Anh Thu Dang
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thang Van Vo
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Michael P. Dunne
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia
| | - Manuel Eisner
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Bao-Yen Luong-Thanh
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Tuyen Dinh Hoang
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Lan Hoang Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
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Hendrix CL, Brown AL, McKenna BG, Dunlop AL, Corwin EJ, Brennan PA. Prenatal distress links maternal early life adversity to infant stress functioning in the next generation. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:117-129. [PMID: 35230857 PMCID: PMC9031909 DOI: 10.1037/abn0000688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Maternal stress in pregnancy exerts powerful programming effects into the next generation. Yet it remains unclear whether and how adversity from other times in the woman's life influences her prenatal stress and her offspring's stress functioning. In a sample of 217 Black American mother-infant dyads, we examined whether different types of maternal stress were differentially related to her infant's stress functioning within the first few months after birth. We prospectively assessed maternal distress (perceived stress, depression, and anxiety) early and late in pregnancy, infant behavioral adaption in the context of a mild stressor at 2 weeks of age, and infant diurnal cortisol at 3-6 months of age. We additionally collected retrospective reports of maternal experiences of lifetime discrimination and childhood adversity. Maternal distress experienced late, but not early, in pregnancy predicted lower infant attention in the context of a stressor. Moreover, lifetime experiences of discrimination indirectly impacted infant attention by increasing maternal distress late in pregnancy. These effects were specific to infant behavioral adaptation and were not related to infant diurnal cortisol levels. However, infant diurnal cortisol levels were associated with maternal experiences of discrimination from prior to pregnancy and adversity from the mother's childhood even after controlling for prenatal distress. Our results underscore the cascading nature of stress across the mother's life span and across generations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Taylor BL, Sweeney A, Potts LC, Trevillion K, Howard LM. Factors associated with re-admission in the year after acute postpartum psychiatric treatment. Arch Womens Ment Health 2022; 25:975-983. [PMID: 36006457 PMCID: PMC9492555 DOI: 10.1007/s00737-022-01255-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/03/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To examine factors associated with being re-admitted in the year after discharge from acute postpartum psychiatric treatment. METHODS Secondary data analysis of information collected from mothers who were admitted to acute psychiatric services in the year after childbirth between 2013 and 2017. We carried out univariable analyses and multivariable hierarchical logistic regression to examine risk factors for women's re-admission to acute psychiatric care (inpatient or community crisis care) in the year following discharge. RESULTS Sixty-seven (24.1%) of 278 women were re-admitted in the year after discharge from acute care; the median number of days to re-admission was 86 (IQR 35-214), and women who were re-admitted accessed a median of two further acute services (IQR 1-3). In adjusted analyses, reporting a history of childhood trauma (aOR 1.02; 95% CI 1.00- 1.03, p = 0.036), a higher level of difficulties in the mother-infant bond (aOR 1.03; 95% CI 1.01-1.06, p = 0.009) and younger age (aOR 0.95; 95% CI 0.90-1.00, p = 0.066) were associated with re-admission. CONCLUSION This study confirms that the role of childhood adverse experiences on mental health is relevant for outcomes in women experiencing acute postpartum psychiatric episodes. Ongoing parent-infant bonding difficulties are also independently associated with re-admission. Perinatal mental health services therefore need to offer evidence-based interventions to address histories of trauma and to support parent-infant bonding to optimise mental health in women following discharge from acute psychiatric services. However, further research is needed to explore what other factors, not measured in our study, are also influential to re-admission.
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Affiliation(s)
- Billie Lever Taylor
- Section of Women's Mental Health, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.
| | - Angela Sweeney
- grid.13097.3c0000 0001 2322 6764Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Laura C. Potts
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Kylee Trevillion
- grid.13097.3c0000 0001 2322 6764Section of Women’s Mental Health, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Louise M. Howard
- grid.13097.3c0000 0001 2322 6764Section of Women’s Mental Health, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
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Racial Differences in the Risk of Prenatal Depression Among Women Experiencing Childhood and Adult Stressors. Matern Child Health J 2021; 26:614-622. [PMID: 34854028 DOI: 10.1007/s10995-021-03322-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Stress exposure during a woman's own childhood and adulthood likely elevate risk of prenatal depression (PND). However, most PND screening tools fail to assess for events prior to conception. This study examined the differential effects of adverse childhood experiences (ACE) and adult life stressors on PND. METHODS This cross-sectional study was conducted among 199 racially diverse pregnant women, ages 18 to 43, recruited from clinics and ongoing university-based studies between 2012 and 2018. The ACE Scale assessed maternal childhood trauma exposure. Validated scales examining subjective stressors assessed for chronic adult stressors. PND was assessed with the Edinburgh Depression Scale, with the Rini Pregnancy-Related Anxiety Scale as a covariate. Associations were measured using multivariable linear regression modeling. Results were stratified by self-identified Black or white race. RESULTS Among 199 participants, mean age was 26.8 years and 67.8% were Black. Controlling for age, race, education, and prenatal anxiety, all participants reporting both childhood trauma and adult stressors were at increased risk for PND (p < 0.0001). PND risk was increased among Black women with childhood stressors (p < 0.01) or three or more adult stressors (p < 0.0001) and among White women following any number of adult stressors (p < 0.001). DISCUSSION These findings highlight the importance of cumulative exposure to stress and trauma across the life span as indicators of risk for PND. Black and white participants had differential development of risk, depending on timing and number of exposures. Prenatal depression risk screening during routine prenatal care should include an assessment of current and historical trauma and stressors.
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The impact of maternal adverse childhood experiences and prenatal depressive symptoms on foetal attachment: Preliminary evidence from expectant mothers across eight middle-income countries. J Affect Disord 2021; 295:612-619. [PMID: 34509077 DOI: 10.1016/j.jad.2021.08.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 08/02/2021] [Accepted: 08/25/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Mothers from middle-income countries (MIC) are estimated to have higher rates of adverse childhood experiences (ACEs) and depression during pregnancy compared to mothers from high income countries. Prenatal depression can adversely impact on a mother's feelings towards her foetus and thus may be partially responsible for intergenerational transmission of risk associated with maternal ACEs. However, the extent to which prenatal depressive symptoms mediate the association between maternal ACEs and foetal attachment is unknown. METHODS Data on foetal attachment, ACEs, and prenatal depression came from mothers in their third trimester of pregnancy (n = 1,185) located across eight MICs, participating in the prospective birth cohort Evidence for Better Lives Study - Foundational Research (EBLS-FR). Data were from the baseline measurement. RESULTS Full-sample path mediation analyses, adjusting for relevant covariates, suggested a full mediating effect of prenatal depression. However, at the individual-country level, both positive and negative effects of ACEs on foetal attachment were observed after the inclusion of depressive symptoms as a mediator, suggesting cultural and geographical factors may influence a mother's empathic development after ACE exposure. LIMITATIONS As no follow-up measurements of depressive symptoms or postnatal attachment were included in the analyses, the findings cannot be extrapolated to the postnatal period and beyond. Further, causality cannot be inferred as the study was observational. CONCLUSIONS The findings reinforce the importance of screening for prenatal depression during antenatal care in MICs. Addressing prenatal depression within maternal health care may support foetal attachment and contribute to reducing the intergenerational transmission of disadvantage.
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Postnatal depression: identification of risk factors in the short-stay maternity program in Belgium. A cross-sectional study. BJGP Open 2021; 5:BJGPO.2021.0127. [PMID: 34465576 PMCID: PMC9447299 DOI: 10.3399/bjgpo.2021.0127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/18/2021] [Indexed: 12/03/2022] Open
Abstract
Background Postnatal depression (PND) is one of the most frequent complications in women of childbearing age in the developed world. The onset of PND is influenced by several risk factors. In an attempt to avoid unnecessary long maternity stays, the Short Stay Maternity programme was launched, shifting care from the hospital environment to the outpatient setting. Aim In order to develop an efficient programme to trace vulnerable women after childbirth and to provide support within primary care, the aim was to create an inventory of the risk factors for PND within the population of women participating in the short-stay programme. Design & setting This study is a cross-sectional study without follow-up. Women in Belgium were invited by email to participate in the Short Stay Maternity programme within 3 months of delivery. Method The questionnaire addressed background features and feelings during the maternity period, supplemented with the validated Dutch version of the Edinburgh Postnatal Depression Scale (EPDS). The primary outcome measure of the questionnaire was the score on the EPDS. Results A total of 131 (27.46%) of the invited women participated. Sixteen participants (12.21%) presented with a positive score on the EPDS. The odds ratio (OR) for a positive score on the EPDS when experiencing negative feelings was 13.5 (95% confidence interval [CI] = 4.14 to 44.01). If only material support was provided, the OR for a positive EPDS score was OR 11.2 (95% CI = 2.72 to 55.5). Conclusion In this study, two risk factors were identified for PND: negative feelings during pregnancy and the provision of only material support by the partner.
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25
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Barboza GE, Schiamberg L. Dual trajectories of parenting self-efficacy and depressive symptoms in new, postpartum mothers and socioemotional adjustment in early childhood: A growth mixture model. Infant Ment Health J 2021; 42:636-654. [PMID: 34378809 DOI: 10.1002/imhj.21937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 07/05/2021] [Indexed: 11/08/2022]
Abstract
Postpartum depression and low parental self-efficacy (PSE) are risk factors for poor child behavior. Little is known, however, about the course of dual trajectories of cooccurring depressive symptoms and PSE or its impact on children's socioemotional development. This study sought to identify trajectories of postpartum PSE and depressive symptoms in new, first-time mothers using growth mixture modeling. Results demonstrated a class of women with "low risk" (88.8%) who manifested low levels of depression and high levels of PSE during the postpartum period; a second group of women, labeled "early risk" (6.3%) with high levels of depression that decreased over time but lower levels of PSE that remained fairly stable; and a final trajectory group deemed the "late-risk" class (4.9%) with initially low levels of depression and high levels of PSE that significantly increased and decreased, respectively, over the period. Early childhood trauma, parenting stress, and poor parenting practices were associated membership in a high-risk class. Mothers in the high-risk groups reported children with more aggressive and defiant behavior at age 3. We conclude by discussing the implications of our findings for developing effective and sensitive interventions.
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Affiliation(s)
- Gia Elise Barboza
- School of Public Affairs, University of Colorado Colorado Springs, Colorado, USA
| | - Lawrence Schiamberg
- Human Development and Family Studies, Michigan State University, Michigan, USA
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Okunola TO, Awoleke JO, Olofinbiyi B, Rosiji B, Olubiyi AO, Omoya S. Predictors of postpartum depression among an obstetric population in South-Western Nigeria. J Reprod Infant Psychol 2021; 40:420-432. [PMID: 33641549 DOI: 10.1080/02646838.2021.1886259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Perinatal maternal depression is the most common mood disturbance associated with pregnancy. It has grave consequences on both maternal health and wellbeing of offsprings, albeit usually neglected in low- and middle-income countries.Objective: To evaluate the relationship between antenatal depression(APD) and postpartum depression(PPD) and predictors of postpartum depression among an obstetric population in South-western Nigeria.Methods: This was a prospective longitudinal cohort study involving272 pregnant women recruited between 34 and 36 weeks of pregnancy and followed up to till 6 weeks after delivery. Edinburgh Postnatal Depression Scale (EPDS) questionnaires were administered to collect data. Data were analysed with SPSS version 23.A p-value < 0.05 was taken as statistically significant.Results: The prevalences of antepartum and postpartum depression were 6.3%, (95% CI 3.4%-9.2%) and 8.8% (95% CI 5.4%-12.1%) respectively. The Spearman correlation coefficient for antepartum EPDS and postpartum EPDS scores was 0.52, p < 0.001.The predictors of postpartum depression were antepartum depression (adjusted OR 10.6, 95% CI 8.33-48.60, p < 0.001), puerperal sepsis (adjusted OR 4.33, 95% CI 3.89-8.69, p = 0.03), domestic violence (adjusted OR 3.40, 95% CI 1.94-15.67, p = 0.01) and age group 25-34 years (adjusted OR 0.11, 95% CI 0.02-0.75, p = 0.02), and household income $1671-$3330 (adjusted OR 0.10, 95% CI 0.02-0.56, p = 0.01).Conclusion: There was a positive association between the antenatal EPDS and postnatal EPDS scores. Screening for maternal depression should be considered in prenatal period. Further studies are necessary to explore the novel finding of predictive role of puerperal sepsis in PPD.
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Affiliation(s)
| | - Jacob Olumuyiwa Awoleke
- Department of Obstetrics and Gynaecology, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
| | - Babatunde Olofinbiyi
- Department of Obstetrics and Gynaecology, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
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Cao H, Zhou N, Leerkes EM, Su J. The etiology of maternal postpartum depressive symptoms: Childhood emotional maltreatment, couple relationship satisfaction, and genes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2021; 35:44-56. [PMID: 32463265 PMCID: PMC8336932 DOI: 10.1037/fam0000722] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There is a call for integrative studies examining the roles of biological and psychosocial factors and their interrelations in shaping maternal postpartum psychopathology. Using longitudinal data from 198 primiparous mothers, we tested a biopsychosocial model for the etiology of maternal postpartum depressive symptoms that integrated childhood emotional maltreatment, couple relationship satisfaction, and oxytocin and dopamine D4 receptor genes (i.e., OXTR rs53576 and DRD4). Results indicate (a) two indirect effects from childhood emotional maltreatment and DRD4 to depressive symptoms at 1 year postpartum through couple relationship satisfaction at 6 months postpartum; (b) an interactive effect between DRD4 and couple relationship satisfaction at 6 months postpartum in predicting depressive symptoms at 1 year postpartum, which is in concert with the differential susceptibility hypotheses; and (c) no mediating effects or moderating effects (after adjusting for multiple testing with Bonferroni correction) involving OXTR rs53576. Notably, all associations were identified after controlling for several key covariates (e.g., maternal prenatal depressive symptoms). Last, robustness of the currently identified interactive effect involving DRD4 was demonstrated by an extensive set of additional analyses considering the effects of rGE, G × Covariates, and/or E × Covariates. Taken altogether, this study represents one of the initial efforts for a more sophisticated portrayal of how nature and nurture forces may work in conjunction with each other to shape new mothers' psychopathology. Yet given the current modest sample size and candidate gene approach, our findings are preliminary, should be cautiously interpreted, and need to be replicated with more rigorous designs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Carroll H, Rondon MB, Sanchez SE, Fricchione GL, Williams MA, Gelaye B. Resilience mediates the relationship between household dysfunction in childhood and postpartum depression in adolescent mothers in Peru. Compr Psychiatry 2021; 104:152215. [PMID: 33242712 PMCID: PMC8210750 DOI: 10.1016/j.comppsych.2020.152215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/02/2020] [Accepted: 10/16/2020] [Indexed: 01/09/2023] Open
Affiliation(s)
- Haley Carroll
- Department of Psychiatry, Boston University Medical Center, Boston, MA, United States of America.
| | - Marta B Rondon
- Departamento Académico Clínica del Adulto, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Sixto E Sanchez
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Gregory L Fricchione
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
| | - Michelle A Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
| | - Bizu Gelaye
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
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Akinbode TD, Pedersen C, Lara-Cinisomo S. The Price of Pre-adolescent Abuse: Effects of Sexual Abuse on Perinatal Depression and Anxiety. Matern Child Health J 2020; 25:1083-1093. [PMID: 33206305 DOI: 10.1007/s10995-020-03088-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Childhood abuse is a major public health concern and a risk factor for subsequent poor maternal mental health. This study of 176 racially diverse women explored the associations between the histories of childhood sexual abuse and depression and anxiety during pregnancy, at six weeks postpartum, and 12 weeks postpartum. METHODS Data on depressive and anxiety symptoms were gathered during pregnancy, at six weeks postpartum, and 12 weeks postpartum. Sociodemographic data were collected during pregnancy, while data on childhood sexual abuse were gathered during the 12-week postpartum period. Bivariate analyses and repeated mixed-effects linear regression with bootstrapping were used to assess the association between childhood sexual abuse and perinatal depressive and anxiety symptoms. RESULTS Childhood sexual abuse was significantly associated with depressive symptoms (β = 2.52, 95% CI 1.72, 3.32, p < .001) and anxiety symptoms (β = 4.44, 95% CI 3.70, 5.81, p < .001) over time, while controlling for demographic characteristics and lifetime major depression and anxiety. Depressive and anxiety symptoms decreased over the perinatal period and were highest during pregnancy. Black women were more likely to report higher depressive symptoms (β = 1.35, 95% CI 0.51, 2.19, p = .002) and anxiety symptoms (β = 3.29 95% CI 1.72, 4.87, p < .001) over time compared to White women. DISCUSSION The results highlight the importance of assessing the long-term effects of childhood sexual abuse on perinatal depressive and anxiety symptoms to help inform the development of interventions for women, particularly Black women.
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Affiliation(s)
- Tanitoluwa Demilade Akinbode
- College of Agricultural, Consumer & Environmental Sciences, Department of Human Development & Family Studies, University of Illinois at Urbana-Champaign, 222 Bevier Hall, 905 S. Goodwin Avenue, Urbana, 61801, IL, USA.
| | - Cort Pedersen
- Department of Psychiatry, The University of North Carolina at Chapel Hill, CB #7160, Chapel Hill, 27599, NC, USA
| | - Sandraluz Lara-Cinisomo
- College of Applied Health Sciences, Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 1206 S. Fourth St, Champaign, 61820, IL, USA
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Zhao XH, Zhang ZH. Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses. Asian J Psychiatr 2020; 53:102353. [PMID: 32927309 DOI: 10.1016/j.ajp.2020.102353] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Postpartum depression (PPD) is the most common psychiatric condition after childbirth which not only effects the mother's health, but also might have impact on child's development and parenting behaviors. Because the etiology of PPD has not been fully cleared, the efforts towards identification of risk factors are crucial for both the children and mother's health. METHOD PubMed, EMBASE and PsycINFO databases were searched since inception until July 2019 to collect data about the risk factors of PPD and only systematic review and meta-analysis can be included. RESULT To identify the real risk factors, protective factors and controversial factors, nineteen parts of the interpretation were adopted. The risk factors are mainly concentrated in the following aspects: violence and abuse, immigration status, gestational diabetes, cesarean section, depressive history, vitamin D deficiency, obese and overweight, postpartum sleep disruption and poor postpartum sleep, lack of social support, traditional dietary pattern (Japanese, Indian, United Kingdom, and Brazilian dietary pattern), multiple births, preterm and low-birth-weight infants, postpartum anemia, negative birth experience. The controversial factors are serum level of cortisol, thyroid peroxidase autoantibodies status, acculturation, traditional confinement practices. Skin-to-skin care, higher concentrations of DHA in mothers' milk, greater seafood consumption, healthy dietary patterns, multivitamin supplementation, fish and PUFA intake, calcium, Vitamin D, zinc and possibly selenium are protective factors. CONCLUSION Thirteen risk factors were identified, but five factors still controversial due to the insufficient of the evidence. What's more, skin-to-skin care and some nutrition related factors are protective factors against PPD.
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Affiliation(s)
- Xiao-Hu Zhao
- Second Clinical Medical College, Anhui Medical University, Hefei, China
| | - Zhi-Hua Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
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Carr A, Duff H, Craddock F. A Systematic Review of Reviews of the Outcome of Noninstitutional Child Maltreatment. TRAUMA, VIOLENCE & ABUSE 2020; 21:828-843. [PMID: 30249161 DOI: 10.1177/1524838018801334] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The aim of the systematic review described in this article was to synthesize available high-quality evidence on the outcomes of noninstitutional child maltreatment across the life span. A systematic review of previous systematic reviews and meta-analyses was conducted. Ten databases were searched. One hundred eleven papers which met stringent inclusion and exclusion criteria were selected for review. Papers were included if they reported systematic reviews and meta-analyses of longitudinal or cross-sectional controlled studies, or single-group cohort primary studies of the outcomes of child maltreatment in the domains of physical and mental health and psychosocial adjustment of individuals who were children lived mainly with their families. Using AMSTAR criteria, selected systematic reviews and meta-analyses were found to be of moderate or high quality. Searches, study selection, data extraction, and study quality assessments were independently conducted by two researchers, with a high degree of interrater reliability. The 111 systematic reviews and meta-analyses reviewed in this article covered 2,534 independent primary studies involving 30,375,962 participants, of whom more than 518,022 had been maltreated. The magnitude and quality of this evidence base allow considerable confidence to be placed in obtained results. Significant associations were found between a history of child maltreatment and adjustment in the domains of physical health, mental health, and psychosocial adjustment in a very wide range of areas. The many adverse outcomes associated with child maltreatment documented in this review highlight the importance of implementing evidence-based child protection policies and practices to prevent maltreatment and treat child abuse survivors.
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Affiliation(s)
- Alan Carr
- University College Dublin, Dublin, Ireland
- Clanwilliam Institute, Dublin, Ireland
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Russotti J, Handley ED, Rogosch FA, Toth SL, Cicchetti D. The Interactive Effects of Child Maltreatment and Adolescent Pregnancy on Late-Adolescent Depressive Symptoms. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1223-1237. [PMID: 32594294 PMCID: PMC7395875 DOI: 10.1007/s10802-020-00669-w] [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] [Indexed: 12/27/2022]
Abstract
Adolescent females are disproportionately at risk for depression, which is expected to represent the leading cause of disability in 2030 (National Institute of Mental Health [NIMH] 2019). Although prior research has suggested that both child maltreatment and adolescent pregnancy increase the risk for depressive symptoms, less is known about how these two interact to influence depression in late adolescence. The present study tested the unique and interactive effects of adolescent pregnancy and child maltreatment on late-adolescent depressive symptomatology (N = 186) with a prospective, longitudinal design that utilized documented records of maltreatment and included demographically comparable (i.e., economically disadvantaged), nonmaltreated and non-pregnant comparisons. Participants were assessed at ages 10-12 and 18-21. Structural equation modeling was used to test whether adolescent pregnancy amplified the effect of child maltreatment on late-adolescent depressive symptoms. In the context of economic disadvantage, results indicated that the effect of child maltreatment on late-adolescent depressive symptoms was significantly enhanced for those who experienced an adolescent pregnancy. This effect remained after controlling for prior depressive symptoms, peer and maternal relationship quality, and romantic relationship violence. The findings are translated to preliminary guidance for practitioners regarding precision depression screening and tailored preventive interventions..
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Affiliation(s)
- Justin Russotti
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA.
| | - Elizabeth D Handley
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA
| | - Fred A Rogosch
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Finnbogadóttir H, Baird K, Thies-Lagergren L. Birth outcomes in a Swedish population of women reporting a history of violence including domestic violence during pregnancy: a longitudinal cohort study. BMC Pregnancy Childbirth 2020; 20:183. [PMID: 32216780 PMCID: PMC7098079 DOI: 10.1186/s12884-020-02864-5] [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: 09/26/2019] [Accepted: 03/09/2020] [Indexed: 11/26/2022] Open
Abstract
Background Victimisation of women is encountered in all countries across the world, it damages the mental and physical health of women. During pregnancy and the postpartum period, women are at a greater risk of experiencing violence from an intimate partner. The aim of this study was to explore childbirth outcomes in a Swedish population of women reporting a history of violence including domestic violence during pregnancy. Methods A longitudinal cohort design was used. In total, 1939 pregnant women ≥18 years were recruited to answer two questionnaires, both questionnaires were administered in the early and late stages of their pregnancy. The available dataset included birth records of 1694 mothers who gave birth between June 2012 and April 2014. Statistical analyses included descriptive statistics, T-test and bivariate logistic regression. Results Of 1694 mothers 38.7% (n = 656) reported a history of violence and 2% (n = 34) also experienced domestic violence during pregnancy. Women who were single, living apart from their partner, unemployed, smoked and faced financial distress were at a higher risk of experiencing violence (p = 0.001). They also had significant low scores on the SOC-scale and high EDS-scores ≥13 (p = 0.001) when compared to women without a history of violence (p = 0.001). Having a history of violence increased the woman’s risk of undergoing a caesarean section (OR 1.33, 95% CI 1.02–1.70). A history of emotional abuse also significantly increased the risk of having a caesarean section irrespective of whether it was a planned or an emergency caesarean section (OR 1.50, 95% CI 1.09–2.06). Infants born to a mother who reported a history of violence, were at significant risk of being born premature < 37 weeks of gestation compared to infants born by mothers with no history of violence (p = 0,049). Conclusions A history of violence and/or exclusively a history of emotional abuse has a negative impact on childbirth outcomes including caesarean section and premature birth. Therefore, early identification of a history of or ongoing violence is crucial to provide women with extra support which may have positive impact on her birth outcomes.
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Affiliation(s)
- Hafrún Finnbogadóttir
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.
| | - Kathleen Baird
- School of Nursing and Midwifery, Transforming Maternity Care Collaborative, Griffith University, & Gold Coast University Hospital, Griffith, Australia
| | - Li Thies-Lagergren
- The Department of Health Science: Midwifery research - reproductive, perinatal and sexual health, Health Science Center, Lund University, Lund, Sweden
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Ben Salah A, Lemieux A, Mlouki I, Amor I, Bouanene I, Ben Salem K, al'Absi M, El Mhamdi S. Impact of social violence and childhood adversities on pregnancy outcomes: a longitudinal study in Tunisia. J Glob Health 2020; 9:020435. [PMID: 31893035 PMCID: PMC6925971 DOI: 10.7189/jogh.09.020435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Accumulating research suggests that exposure to intra-familial adversities are significant risk factors for adverse pregnancy outcomes. However, the relationship between social violence (peer violence, witnessing community violence and exposure to collective violence) and pregnancy outcomes has not been extensively investigated. Our study aims to examine the association between social Adverse Childhood Experiences (ACEs) and pregnancy outcomes and to explore the role of depression during pregnancy as a mediator of this association. Methods We performed a prospective follow-up study of pregnant women in five Primary Health care Centers (PHC) in the region of Monastir (Tunisia) from September 2015 to August 2016. Enrolled women were followed during the second trimester, third trimester of pregnancy and during the postnatal period. Exposure to violence was assessed retrospectively using the validated Arabic version of the World Health Organization (WHO) ACE questionnaire. The Self Reporting Questionnaire 20-Item (SRQ-20) was used as a screening tool for depression during pregnancy. Results We recruited and followed a total of 593 women during the study period. Witnessing community violence was the most frequently reported social ACE among pregnant women (237; 40%), followed by peer violence (233; 39.3%). After adjustment for high risk pregnancies, environmental tobacco smoke, and intra-familial ACEs, the risk of premature birth was significantly associated with exposure to collective violence (P < 0.001) and witnessing community violence (P < 0.05). The risk of low birth weight was significantly associated with witnessing community violence (P < 0.001). In the mediation analysis, depression mediated significant proportions of the relationship between the cumulative number of ACEs and pregnancy outcomes. Conclusions Social ACEs may have a long-term effect on maternal reproductive health, as manifested by offspring that were of reduced birth weight and shorter gestational age. A public health framework based on the collaboration between pediatric, psychiatric obstetrical health professionals, education professionals and policy makers could be applied to ensure primary prevention of childhood adversities and pay attention to expected mothers with history of exposure to such adversities.
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Affiliation(s)
- Arwa Ben Salah
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir, Tunisia.,Research laboratory "Epidemiology Applied to Maternal and Child Health", Monastir, Tunisia
| | - Andrine Lemieux
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minnesota, USA
| | - Imen Mlouki
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir, Tunisia.,Research laboratory "Epidemiology Applied to Maternal and Child Health", Monastir, Tunisia.,Department of Preventive and Community Medicine, University Hospital Tahar Sfar, Mahdia Tunisia
| | - Ines Amor
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Ines Bouanene
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir, Tunisia.,Research laboratory "Epidemiology Applied to Maternal and Child Health", Monastir, Tunisia
| | - Kamel Ben Salem
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir, Tunisia.,Research laboratory "Epidemiology Applied to Maternal and Child Health", Monastir, Tunisia
| | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minnesota, USA
| | - Sana El Mhamdi
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir, Tunisia.,Research laboratory "Epidemiology Applied to Maternal and Child Health", Monastir, Tunisia.,Department of Preventive and Community Medicine, University Hospital Tahar Sfar, Mahdia Tunisia
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35
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A pilot feasibility study of mindfulness childbirth education for women with a history of sexual trauma. Complement Ther Clin Pract 2019; 37:102-108. [DOI: 10.1016/j.ctcp.2019.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 11/21/2022]
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36
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Powers A, Woods-Jaeger B, Stevens JS, Bradley B, Patel MB, Joyner A, Smith AK, Jamieson DJ, Kaslow N, Michopoulos V. Trauma, psychiatric disorders, and treatment history among pregnant African American women. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2019; 12:138-146. [PMID: 31464464 DOI: 10.1037/tra0000507] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Pregnant African American women living in low-income urban communities have high rates of trauma exposure and elevated risk for the development of trauma-related disorders, including posttraumatic stress disorder (PTSD) and depression. Yet, engagement in behavioral health services is lower for African American women than Caucasian women. Limited attention has been given to identifying trauma exposure and PTSD, especially within at-risk communities. The present study examined rates of trauma exposure, PTSD, depression, and behavioral health treatment engagement in an obstetrics/gynecology (OB/GYN) clinic within an urban hospital. METHOD The study included 633 pregnant African American women screened within the OB/GYN clinic waiting room; 55 of the women also participated in a subsequent detailed clinical assessment based on eligibility for a separate study of intergenerational risk for trauma and PTSD in African American mother-child dyads. RESULTS Overall, 98% reported trauma exposure, approximately one third met criteria for probable current PTSD, and one third endorsed moderate-or-severe depression based on self-report measures. Similar levels were found based on clinical assessments in the subsample. While 18% endorsed depression treatment, only 6% received treatment for PTSD. In a subsample of women with whom chart reviews were conducted (n = 358), 15% endorsed a past psychiatric diagnosis but none shared their PTSD diagnosis with their OB/GYN provider. CONCLUSION Results of the current study highlight elevated levels of trauma exposure, PTSD, and depression in low-income, African American pregnant women served by this urban clinic, and demonstrate the need for better identification of trauma-related disorders and appropriate linkage to culturally responsive care especially for PTSD. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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37
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Abel KM, Heuvelman H, Rai D, Timpson NJ, Sarginson J, Shallcross R, Mitchell H, Hope H, Emsley R. Intelligence in offspring born to women exposed to intimate partner violence: a population-based cohort study. Wellcome Open Res 2019; 4:107. [PMID: 31681855 PMCID: PMC6820818 DOI: 10.12688/wellcomeopenres.15270.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Intimate partner violence (IPV) is a risk factor for developmental problems in offspring. Despite a high prevalence of IPV in the UK and elsewhere, the longer-term outcomes of offspring born to exposed mothers remain under-researched. Methods: Population-based cohort study. We assessed IPV prevalence by type and timing for 3,153 mother-child pairs with complete data within our study population and examined associations between IPV and offspring IQ. We used multiple-imputation to evaluate bias due to our exclusion of observations with missing covariate data. Results: Nearly one in five mothers reported IPV during the study period, with 17.6% reporting emotional violence and 6.8% reporting physical violence. Taking into account potential confounders, the IQ scores of children born to mothers exposed to physical violence remained lower than those of maternally unexposed children (full-scale IQ = -2.8 points [95%CI -4.9 to -0.7], verbal IQ = -2.2 [95%CI -4.4 to -0.1], performance IQ = -2.7 [95%CI -5.0 to -0.5]) and odds of below-average intelligence (IQ<90) remained increased for full-scale (OR 1.48 [95%CI 1.03 to 2.14] and performance IQ (OR 1.48 [95%CI 1.08 to 2.04]) but not verbal IQ (OR 1.06 [95%CI 0.69 to 1.64]). Most physical violence occurred postnatally, and relative odds were most substantial when mothers were exposed to violence across pre-/perinatal and postnatal study periods (OR performance IQ<90 = 2.97 [95%CI 1.30 to 6.82]). Conclusions: Maternal exposure to physical IPV is associated with lower offspring IQ at age 8. Associations persisted after adjusting for potential confounders and were driven by violence occurring postnatally.
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Affiliation(s)
- Kathryn M Abel
- Centre for Women’s Mental Health, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Bury New Rd, Prestwich, Manchester, M25 3BL, UK
| | - Hein Heuvelman
- Centre for Women’s Mental Health, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Avon & Wiltshire Mental Health Partnership NHS Trust, Jenner House, Langley Park, Chippenham, SN15 1GG, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Jane Sarginson
- Centre for Women’s Mental Health, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
- School of Healthcare Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK
| | - Rebekah Shallcross
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Heather Mitchell
- Centre for Women’s Mental Health, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Bury New Rd, Prestwich, Manchester, M25 3BL, UK
| | - Holly Hope
- Centre for Women’s Mental Health, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Richard Emsley
- Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
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Aktar E, Qu J, Lawrence PJ, Tollenaar MS, Elzinga BM, Bögels SM. Fetal and Infant Outcomes in the Offspring of Parents With Perinatal Mental Disorders: Earliest Influences. Front Psychiatry 2019; 10:391. [PMID: 31316398 PMCID: PMC6610252 DOI: 10.3389/fpsyt.2019.00391] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/17/2019] [Indexed: 12/16/2022] Open
Abstract
Mental illness is highly prevalent and runs in families. Mental disorders are considered to enhance the risk for the development of psychopathology in the offspring. This heightened risk is related to the separate and joint effects of inherited genetic vulnerabilities for psychopathology and environmental influences. The early years of life are suggested to be a key developmental phase in the intergenerational psychopathology transmission. Available evidence supports the idea that early exposure to parental psychopathology, during the pregnancy and first postpartum year, may be related to child psychological functioning beyond the postpartum period, up to adulthood years. This not only highlights the importance of intervening early to break the chain of intergenerational transmission of psychopathology but also raises the question of whether early interventions targeting parental mental disorders in this period may alleviate these prolonged adverse effects in the infant offspring. The current article focuses on the specific risk of psychopathology conveyed from mentally ill parents to the offspring during the pregnancy and first postpartum year. We first present a summary of the available evidence on the associations of parental perinatal mental illness with infant psychological outcomes at the behavioral, biological, and neurophysiological levels. Next, we address the effects of early interventions and discuss whether these may mitigate the early intergenerational transmission of risk for psychopathology. The summarized evidence supports the idea that psychopathology-related changes in parents' behavior and physiology in the perinatal period are related to behavioral, biological, and neurophysiological correlates of infant psychological functioning in this period. These alterations may constitute risk for later development of child and/or adult forms of psychopathology and thus for intergenerational transmission. Targeting psychopathology or mother-infant interactions in isolation in the postnatal period may not be sufficient to improve outcomes, whereas interventions targeting both maternal psychopathology and mother-infant interactions seem promising in alleviating the risk of early transmission.
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Affiliation(s)
- Evin Aktar
- Clinical Psychology Unit, Department of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Jin Qu
- Department of Psychology, Clarion University of Pennsylvania, Clarion, PA, United States
| | - Peter J Lawrence
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Marieke S Tollenaar
- Clinical Psychology Unit, Department of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Bernet M Elzinga
- Clinical Psychology Unit, Department of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Susan M Bögels
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
- Developmental Psychology, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
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Haritonova NK, Kachaeva MA, Kazakovtsev BA, Vasianina VI, Shishkina OA. [Depression in women - the victims of domestic violence (forensic psychiatry aspects)]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:34-38. [PMID: 31006789 DOI: 10.17116/jnevro20191191234] [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: 11/17/2022]
Abstract
AIM To study the development of depressive disorders in women, the victims of domestic violence, who committed aggressive acts. MATERIAL AND METHODS Patients (n=12) were divided into two groups depending on acute depressive reaction in response to violence from husbands, which resulted in criminal acts. The first group included 4 women who killed their children and the second group included 8 women who killed their husbands. A psychopathological method was used in the study. RESULTS AND CONCLUSION Women of both groups shared the same features of the development of depression: the transition from a neurotic stage to a psychotic stage (with aggression) and then to the prolonged depression. Every stage had its own features, in particular during the criminal act, which are described in the article.
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Affiliation(s)
- N K Haritonova
- Serbsky National Medical Research Centre for Psychiatry and Narcology Ministry of Health of RF, Moscow, Russia
| | - M A Kachaeva
- Serbsky National Medical Research Centre for Psychiatry and Narcology Ministry of Health of RF, Moscow, Russia
| | - B A Kazakovtsev
- Serbsky National Medical Research Centre for Psychiatry and Narcology Ministry of Health of RF, Moscow, Russia
| | - V I Vasianina
- Serbsky National Medical Research Centre for Psychiatry and Narcology Ministry of Health of RF, Moscow, Russia
| | - O A Shishkina
- Serbsky National Medical Research Centre for Psychiatry and Narcology Ministry of Health of RF, Moscow, Russia
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40
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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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41
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Sunnqvist C, Sjöström K, Finnbogadóttir H. Depressive symptoms during pregnancy and postpartum in women and use of antidepressant treatment - a longitudinal cohort study. Int J Womens Health 2019; 11:109-117. [PMID: 30799960 PMCID: PMC6369851 DOI: 10.2147/ijwh.s185930] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study was to investigate whether women, who reported “symptoms of depression” during pregnancy and up to 1.5 years postpartum, who reported domestic violence or not, were treated with antidepressant medication. Patients and methods A prospective longitudinal cohort study recruited primi- and multiparous women (n=1,939). The Edinburgh Postnatal Depression Scale (EPDS), the NorVold Abuse Questionnaire, and a questionnaire about medication during pregnancy were distributed and administered three times, during early pregnancy, late pregnancy, and the postpartum period. Antidepressant medication was compared between women with EPDS scores <13 and EPDS scores ≥13 as the optimal cutoff for symptoms of depression. Results EPDS scores ≥13 were detected in 10.1% of the women during the whole pregnancy, of those 6.2% had depressive symptoms already in early pregnancy and 10.0 % during the postpartum period. Women with EPDS scores ≥13 and non-exposure to domestic violence were more often non-medicated (P<0.001). None of the women with EPDS scores ≥13 exposed to domestic violence had received any antidepressant medication, albeit the relationship was statistically nonsignificant. Conclusion Pregnant women who experienced themselves as having several depressive symptoms, social vulnerability, and even a history of domestic violence, did not receive any antidepressant treatment during pregnancy nor postpartum. This study shows the importance of detecting depressive symptoms during early pregnancy and a need for standardized screening methods.
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Affiliation(s)
- Charlotta Sunnqvist
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden,
| | - Karin Sjöström
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden,
| | - Hafrún Finnbogadóttir
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden,
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42
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Lydsdottir LB, Howard LM, Olafsdottir H, Einarsson H, Steingrimsdottir T, Sigurdsson JF. Adverse life experiences and common mental health problems in pregnancy: a causal pathway analysis. Arch Womens Ment Health 2019; 22:75-83. [PMID: 30056536 DOI: 10.1007/s00737-018-0881-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 06/22/2018] [Indexed: 11/27/2022]
Abstract
Risk factors for antenatal common mental problems include a history of depression, lack of social support and a history of both childhood and adulthood sexual and physical abuse. However, it is less clear whether pregnancy is a time of particular susceptibility to mental disorders due to prior childhood experiences. The aim of the paper was to investigate the potential pathways to antenatal mental health problems. A total of 521 women attending prenatal care attended a clinical interview and answered psychological questionnaires. Univariate analysis, sequential binary logistic regression and structural equation modelling (SEM) were used to analyse the relationships between variables. Having experienced parental maladjustment, maltreatment and serious physical illness in childhood and domestic violence, financial difficulties and serious spousal substance abuse in adulthood significantly predicted antenatal common mental health symptoms. SEM showed that history of depression and adverse experiences in adulthood had mediating effects on the relationship between adverse childhood events and symptoms of antenatal common mental disorders. Adverse childhood experiences are distal risk factors for antenatal common mental health problems, being significant indicators of history of depression and adverse experiences in adulthood. We therefore conclude that pregnancy is not a time of particular susceptibility to common mental health problems as a result of childhood abuse, but rather, these childhood experiences have increased the risk of adulthood trauma and prior mental disorders. Women at risk for antenatal common mental disorders include those with a history of depression, domestic violence, financial difficulties, spousal substance abuse and lack of social support.
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Affiliation(s)
- Linda Bara Lydsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland. .,Department of Psychology, Reykjavik University, Menntavegur 1, 101, Reykjavik, Iceland.
| | - Louise M Howard
- Section of Women's Mental Health, King's College London, Institute of Psychiatry, London, UK
| | - Halldora Olafsdottir
- Mental Health Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Hjalti Einarsson
- Mental Health Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Thora Steingrimsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Obstetrics and Gynecology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Jon Fridrik Sigurdsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Psychology, Reykjavik University, Menntavegur 1, 101, Reykjavik, Iceland.,Mental Health Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
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Ghosn F, Almansa B, Moreno-Giménez A, Sahuquillo-Leal R, Serrano-Lozano E, Hervás D, Diago V, Cháfer-Pericás C, Vento M, García Blanco A. Trajectories of stress biomarkers and anxious-depressive symptoms from pregnancy to postpartum period in women with a trauma history. Eur J Psychotraumatol 2019; 10:1601990. [PMID: 31069025 PMCID: PMC6493226 DOI: 10.1080/20008198.2019.1601990] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/11/2019] [Accepted: 03/15/2019] [Indexed: 01/14/2023] Open
Abstract
Background: Cross-sectional studies have found that a trauma history can be associated with anxious-depressive symptomatology and physiological stress dysregulation in pregnant women. Methods: This prospective study examines the trajectories of both anxiety and depressive symptoms and salivary cortisol and α-amylase biomarkers from women with (n = 42) and without (n = 59) a trauma history at (i) 38th week of gestation (T1), (ii) 48 hours after birth (T2), and (iii) three months after birth (T3). Results: The quantile regression model showed that trauma history was associated with higher cortisol levels at T1 and this difference was sustained along T2 and T3. Conversely, there were no significant differences in α-amylase levels between groups across the three time points and both groups showed an increase in α-amylase levels from T2 to T3. The ordinal mixed model showed that trauma history was associated with higher anxiety symptoms at T1 and this remained constant from T1 to T2 but was reversed from T2 to T3. In contrast, both groups showed similar depressive symptoms across the three time points. Conclusions: Whereas physiological stress dysregulation (in terms of higher cortisol levels) was maintained from pregnancy to postpartum period, pregnancy and childbirth were the most vulnerable stages for developing anxious symptoms in mothers with trauma history.
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Affiliation(s)
- Farah Ghosn
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Belén Almansa
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Alba Moreno-Giménez
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Rosa Sahuquillo-Leal
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Elena Serrano-Lozano
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - David Hervás
- Biostatistics Unit, Health Research Institute La Fe, Valencia, Spain
| | - Vicente Diago
- Division of Obstetrics and Gynaecology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Máximo Vento
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
| | - Ana García Blanco
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.,Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
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The impact of childhood trauma and psychophysiological reactivity on at-risk women's adjustment to parenthood. Dev Psychopathol 2018; 31:127-141. [PMID: 30585566 DOI: 10.1017/s0954579418001591] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Adverse childhood experiences (ACEs) have an impact on women's adaptation to parenthood, but mechanisms are poorly understood. Autonomic nervous system reactivity was tested as a potential mediating mechanism in a sample of 193 at-risk primiparous women. ACEs were measured retrospectively during pregnancy. A baby cry-response task was administered during pregnancy while indicators of sympathetic reactivity (pre-ejection period; PEP) and parasympathetic reactivity (respiratory sinus arrhythmia; RSA) were recorded. Parenting self-efficacy, anxiety, and depressive symptoms were measured during pregnancy and 1 year after giving birth. Harsh discipline was measured 2 years after giving birth. Structural equation modeling was employed to test whether baseline PEP and RSA and reactivity mediated links between ACEs and postnatal outcomes, adjusted for prenatal variables. High ACEs predicted less RSA reactivity (p = .02), which subsequently predicted increases in depressive symptoms (p = .03). The indirect effect was not significant (p = .06). There was no indirect link between high ACEs and harsh parenting through PEP nor RSA (n = 98). The parasympathetic nervous system may be involved in negative affective responses in the transition to parenthood among women exposed to childhood trauma.
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45
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Zhou H, Li W, Ren Y. Poor sleep quality of third trimester exacerbates the risk of experiencing postnatal depression. PSYCHOL HEALTH MED 2018; 25:229-238. [PMID: 30450954 DOI: 10.1080/13548506.2018.1549738] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study sought to investigate the effects of subjectively-determined poor prenatal sleep quality on postnatal depression (PND), after adjusting for prenatal psychological distress and perceived stress. From March 2016 to December 2017, we conducted a prospective longitudinal study using a convenience sample of 228 perinatal women. The participants completed the Pittsburgh Sleep Quality Index (PSQI), the 10-item Kessler Psychological Distress Scale (K10) and the Perceived Stress Scale (PSS) during the third trimester (Time 1 or T1), and completed the Edinburgh Postnatal Depression Scale (EPDS) at 1 months postpartum (Time 2 or T2). Logistic regression analyses were used to analyze the associations between subjective prenatal sleep quality and postnatal depression. The results showed that prenatal psychological distress (OR = 2.551, 95% CI = 1.221 ~ 5.329, P = 0.013) and perceived stress (OR = 2.881, 95% CI = 1.398 ~ 5.938, P= 0.007) were the strongest predictors of PND. Independent of this, poor subjective sleep quality (OR = 2.391, 95% CI = 1.072 ~ 5.556, P = 0.044) during pregnancy also predicted postnatal depressive symptoms. Treatment of psychological distress and perceived stress appears important for reducing the incidence of PND. Nonetheless, future studies might explore treatments to improve prenatal sleep quality.
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Affiliation(s)
- Haiyan Zhou
- People' Hospital of Liaocheng, Liaocheng, China
| | - Wei Li
- People' Hospital of Liaocheng, Liaocheng, China
| | - Yanbei Ren
- Qilu Hospital, Shandong University, Jinan, China
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Karaçam Z, Çoban A, Akbaş B, Karabulut E. Status of postpartum depression in Turkey: A meta-analysis. Health Care Women Int 2018; 39:821-841. [DOI: 10.1080/07399332.2018.1466144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Zekiye Karaçam
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Ayden Çoban
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Burcu Akbaş
- Department of Midwifery, Institute of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Erdem Karabulut
- Medical Faculty Department of Biostatistics, Hacettepe University, Ankara, Turkey
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Maternal depression in the intergenerational transmission of childhood maltreatment and its sequelae: Testing postpartum effects in a longitudinal birth cohort. Dev Psychopathol 2018; 31:143-156. [PMID: 29562945 DOI: 10.1017/s0954579418000032] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Mothers who have experienced childhood maltreatment are more likely to have children also exposed to maltreatment, a phenomenon known as intergenerational transmission. Factors in the perinatal period may contribute uniquely to this transmission, but timing effects have not been ascertained. Using structural equation modeling with 1,016 mothers and their 2,032 children in the Environmental Risk Longitudinal Twin Study, we tested the mediating role of postpartum depression between maternal childhood maltreatment and a cascade of negative child outcomes, specifically child exposure to maltreatment, internalizing symptoms, and externalizing symptoms: (a) adjusting for later maternal depression, (b) comparing across sex differences, and (c) examining the relative role of maltreatment subtypes. Mothers who had been maltreated as children, especially those who had experienced emotional or sexual abuse, were at increased risk for postpartum depression. In turn, postpartum depression predicted children's exposure to maltreatment, followed by emotional and behavioral problems. Indirect effects from maternal childhood maltreatment to child outcomes were robust across child sex and supported significant mediation through postpartum depression; however, this appeared to be carried by mothers' depression beyond the postpartum period. Identifying and treating postpartum depression, and preventing its recurrence, may help interrupt the intergenerational transmission of maltreatment and its sequelae.
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Brazeau N, Reisz S, Jacobvitz D, George C. UNDERSTANDING THE CONNECTION BETWEEN ATTACHMENT TRAUMA AND MATERNAL SELF-EFFICACY IN DEPRESSED MOTHERS. Infant Ment Health J 2018; 39:30-43. [PMID: 29281747 PMCID: PMC5814850 DOI: 10.1002/imhj.21692] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy is associated with a higher incidence of postpartum depression. Maternal self-efficacy and postpartum depression can both be buffered by social support. Maternal self-efficacy and postpartum depression have both been linked independently, albeit in separate studies, to the experience of violent trauma, childhood maltreatment, and spousal abuse. This study proposed a model in which postpartum depression mediates the relation between attachment trauma and maternal self-efficacy, with emotional support as a moderator. Participants were 278 first-time mothers of infants under 14 months. Cross-sectional data were collected online. Mothers completed questionnaires on attachment trauma, maternal self-efficacy, postpartum depression, and emotional support. A moderated mediation model was tested in a structural equation modeling framework using Mplus' estimate of indirect effects. Postpartum depression fully mediated the relation between trauma and maternal self-efficacy. Emotional support moderated only the pathway between postpartum depression and maternal self-efficacy. Attachment trauma's implications for maternal self-efficacy should be understood in the context of overall mental health. Mothers at the greatest risk for low maternal self-efficacy related to attachment trauma also are those suffering from postpartum depression. Emotional support buffered mothers from postpartum depression, though, which has implications for intervention and future research.
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Nagl M, Lehnig F, Stepan H, Wagner B, Kersting A. Associations of childhood maltreatment with pre-pregnancy obesity and maternal postpartum mental health: a cross-sectional study. BMC Pregnancy Childbirth 2017; 17:391. [PMID: 29166875 PMCID: PMC5700738 DOI: 10.1186/s12884-017-1565-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/06/2017] [Indexed: 12/31/2022] Open
Affiliation(s)
- Michaela Nagl
- Leipzig University Medical Center, IFB AdiposityDiseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweissstr. 10, 04103, Leipzig, Germany
| | - Franziska Lehnig
- Leipzig University Medical Center, IFB AdiposityDiseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweissstr. 10, 04103, Leipzig, Germany
| | - Holger Stepan
- Department of Obstetrics, University of Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Birgit Wagner
- Department of Clinical Psychology and Psychotherapy, MSB Medical School Berlin, Calandrellistraße 1-9, 12247, Berlin, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweissstr. 10, 04103, Leipzig, Germany.
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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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