Optimistic outlook regarding maternity protects against depressive symptoms postpartum

The concept analysis of parent-infant bonding during pregnancy and infancy: a systematic review and meta-synthesis

INTRODUCTION

Despite the emerging body of literature on mother-to-infant bonding and the associated variables, there are various definitions of bonding construct. Also, there is a lack of a comprehensive conceptual framework of antecedents and consequences of bonding that would guide empirical work.

OBJECTIVE

Aim of the study was to provide a systematic review and synthesis of concept analysis studies on maternal-foetal, mother-infant, or father-infant bonding.

METHOD

A systematic search was performed in PubMed, EBSCOHost (including PsycINFO), ProQuest, and CINAHL. In addition, a hand search was conducted. Papers were eligible for inclusion if they conducted concept analyses on mother or father to foetus/infant bonding. A qualitative meta-synthesis was applied to synthesise the findings.

RESULTS

Eight papers on concept analyses were eligible for inclusion. In meta-synthesis, six aspects of parent-to-(unborn) child bonding emerged, including direction, domain, process, timing, endurance, and parental gender. Defining attributes are (i) a close relationship, (ii) filled with positive parental affection, (iii) manifested during pregnancy as monitoring foetal development and behaviour and after childbirth in proximity and interaction. Antecedents, affecting factors, and consequences of the parent-child bonding have been summarised.

CONCLUSION

Parent-infant bonding refers to an emotional, behavioural, cognitive, and neurobiological tie of the parent to the (unborn) child, as a process from intention to have a child throughout infancy. This is a parental-driven process which can continue to evolve throughout child's and parent's life, characterised as enduring, committed, and engaged. Based on meta-synthesis, a conceptual structure of parent-infant bonding has been provided, which needs further empirical testing.

Impact of pregnancy/childbirth on dispositional optimism in the context of risk of depression, mental health status and satisfaction with life

Introduction

Life optimism is an inseparable element accompanying every human being. It takes different values depending on the life situation. The present study aimed to measure the level of dispositional optimism in postpartum and pregnant women, compared to women who are not pregnant and have never given birth in Poland, Greece, Turkey, Belarus, and Russia, depending on the level of life satisfaction, risk of depression and mental health.

Materials and methods

A case-control study was carried out among 2017 women, including 584 pregnant women, 528 postpartum women, and 906 women who had never been pregnant and had never given birth (control group) from Poland, Greece, Turkey, Belarus, and Russia.The study used the LOT-R Life Orientation Test, the Beck Depression Scale (BDI), the Satisfaction With Life Scale (SWLS), the GHQ- 28, and the Edinburgh Postnatal Depression Scale (EPDS) - only in the postpartum group.

Results

Women from the control group showed an average level of optimism, obtaining an average of 16 points in Belarus, 13.4 points in Poland, 13.3 points in Greece, 13.5 points in Turkey, and Russia - 16.3 points. Pregnant women from Belarus had a high level of optimism (17 points), and in other countries, an average level of optimism was in Poland - 14.5 points, Greece - 14.0 points, Turkey - 14.3 points, and Russia - 16.5 points. Women after childbirth had a high level of optimism in Belarus (17.4 points) and Russia (17.2 points), and in other countries had the average level of optimism. In these countries, the lowest level of optimism was found in non-pregnant women. No significant correlation between age and life optimism was found in any group. In Poland, life optimism increased with age in women who had never been pregnant, and in Turkey, in women who were pregnant and after childbirth.

Conclusion

Pregnant women from Belarus had a higher level of optimism than other countries. Non-pregnant women had an average level of optimism. Future studies should include larger groups of women and consider other factors that may additionally contribute to dispositional optimism.

Early pregnancy dispositional optimism and pregnancy outcomes among nulliparous people

BACKGROUND

Dispositional optimism, the expectation of positive outcomes after personal challenges, is a resilience factor associated with widespread health benefits. However, the data on pregnancy-related outcomes are more limited.

OBJECTIVE

This study aimed to assess the association of early pregnancy dispositional optimism with adverse perinatal outcomes.

STUDY DESIGN

This was a prospective cohort study completed between May 2019 and February 2022 at a single, large tertiary medical center. Nulliparous pregnant people were recruited from outpatient obstetrical care sites. Participants completed a validated assessment of dispositional optimism at <20 weeks of gestation and were followed up until delivery. The primary outcome was an adverse maternal outcome composite that included gestational diabetes mellitus, hypertensive disorders of pregnancy, and/or cesarean delivery. The secondary outcomes included individual composite components and a neonatal morbidity composite. Bivariate analyses compared characteristics and primary and secondary outcomes by dispositional optimism score quartile. Multivariable logistic regression compared outcomes by dispositional optimism score quartile with the highest quartile serving as the referent, controlling for confounders determined a priori.

RESULTS

Overall, 491 pregnant people were approached for participation, and 135 pregnant people (27.5%) declined participation. Among the 284 individuals who enrolled and had complete outcome data, the median dispositional optimism score was 16.0 (interquartile range, 14-18), and 47.9% of individuals experienced at least 1 adverse maternal outcome 135 (47.9%). After adjusting for confounders, the odds of adverse maternal outcomes were significantly higher in the lowest 2 optimism quartiles: quartile 1 (adjusted odds ratio, 3.33; 95% confidence interval, 1.57-7.36) and quartile 2 (adjusted odds ratio, 2.22; 95% confidence interval, 1.05-4.79) than the highest quartile. This was driven by significantly higher rates of hypertension (quartile 1: adjusted odds ratio, 2.62; 95% confidence interval, 1.12-6.29) and cesarean delivery (quartile 1: adjusted odds ratio, 2.75; 95% confidence interval, 1.20-6.55). There was no difference noted when quartile 3 was compared with quartile 4.

CONCLUSION

Lower early pregnancy dispositional optimism was associated with significantly higher odds of adverse maternal outcomes. Interventions targeting improvements in optimism may be a novel mechanism for reducing perinatal morbidity.

Dispositional Optimism, Mode of Delivery, and Perceived Labor Control among Recently Delivered Parturients

OBJECTIVE

Dispositional optimism (DO) is an understudied transdiagnostic resilience factor among peripartum individuals. Low DO is associated with increased fear and pain in labor and increased rates of emergent cesarean delivery, but it is unknown whether DO is associated with perceived control over the labor process.

STUDY DESIGN

This a planned secondary analysis of a prospective observational cohort of term parturients (n = 164) who were recruited in July and August 2021 during their delivery hospitalization at a single, tertiary medical center. Participants completed a baseline demographic survey prior to delivery and then completed evaluations of DO (Revised Life-Orientation Test [LOT-R]) and control over the labor process (Labor Agentry Scale [LAS]) during their postpartum hospitalization. DO was dichotomized into low and high by score of ≤14 or >14 on LOT-R, respectively, and labor agentry scores were compared between groups. Maternal demographics, pregnancy, and delivery characteristics were compared by DO status. Multivariable regression was performed, adjusting for known confounders (induction, labor analgesia, and mode of delivery).

RESULTS

Demographic, pregnancy, and neonatal characteristics were similar between those with low compared with high DO. People with low DO had significantly higher rates of cesarean section (44 vs. 24%, p = 0.02) and overall had lower LAS scores (139.4 vs. 159.4, p < 0.001), indicating that they felt less control over their labor process than those with high DO. In the multivariable regression, those with low DO had higher odds of a low LAS score after controlling for induction, labor analgesia, and mode of delivery (adjusted odds ratio = 1.29, 95% confidence interval: 1.20-1.39).

CONCLUSION

People with low DO had significantly lower perceived control over their labor, even after controlling for differences in mode of delivery. Interventions to alter DO may be an innovative way to improve birth experience and its associated perinatal mental health morbidities.

KEY POINTS

· It is unknown if there is an association between DO and perceived labor control.. · People with low DO had higher rates of cesarean delivery and lower perceived labor control.. · Altering DO may be a novel mechanism for improving birth experience..

Just as they expected: How parents' expectations about their unborn child's characteristics provide a context for early transactions between parenting and child temperament

Prenatal expectations about what children will be like after birth may provide a context for how parents perceive their infant's actual temperament. We examined how these expectations and perceptions are associated and together predict early parenting behavior, with parenting behavior in turn predicting changes in temperament. Reports of 125 families (N = 122 fathers; N = 123 mothers; sample 1) about their expectations of their unborn child's temperament (negative affectivity, surgency, regulation, T1), their infant's temperament at 4 and 12 months post-partum (T2 and T3), and their hostile, responsive, warm, and overprotective parenting (T2) were included. We also included data from an independent sample of 168 mothers (sample 2), with the same measures, except that mothers reported on Big Five personality traits at T1. Results indicated that in both samples, parents' expectations were positively associated with perceptions of infant temperament. Prenatal expectations and newborn temperament independently predicted parenting behavior, and maternal and paternal parenting in turn predicted infant temperament at T3, controlling for infant temperament at T2. Although overall findings indicated associations between (expectations of) a more difficult temperament and more negative/less positive parenting, significant combinations of specific traits and parenting behaviors were sample-specific—indicating that more research is necessary to draw a conclusion about specific links. Both maternal and paternal expectations about their unborn child's temperament appear to carry over into the postpartum reality and provide a context for shaping early interactions between caregivers and their children, which may further shape the developing temperament of the child.

Prevalence of Bipolar Disorder in Perinatal Women: A Systematic Review and Meta-Analysis

Objective: To estimate overall prevalence of bipolar disorder (BD) and the prevalence and timing of bipolar-spectrum mood episodes in perinatal women.

Data Sources: Databases (PubMed, Scopus, PsycINFO, CINAHL, Cochrane, ClincalTrials.gov) were searched from inception to March 2020.

Study Selection: Included studies were original research in English that had (1) populations of perinatal participants (pregnant or within 12 months postpartum), aged ≥ 18 years, and (2) a screening/diagnostic tool for BD. Search terms described the population (eg, perinatal), illness (eg, bipolar disorder), and detection (eg, screen, identify).

Data Extraction: Study design data, rates, and timing of positive screens/diagnoses and mood episodes were extracted by 3 independent reviewers. Pooled prevalences were estimated using random-effects meta-analyses.

Results: Twenty-two articles were included in qualitative review and 12 in the meta-analysis. In women with no known psychiatric illness preceding the perinatal period, pooled prevalence of BD was 2.6% (95% CI, 1.2%-4.5%) and prevalence of bipolar-spectrum mood episodes (including depressed, hypomanic/manic, mixed) during pregnancy and the postpartum period was 20.1% (95% CI, 16.0%-24.5%). In women with a prior BD diagnosis, 54.9% (95% CI, 39.2%-70.2%) were found to have at least one bipolar-spectrum mood episode occurrence in the perinatal period.

Conclusions: Our review suggests that the perinatal period is associated with high rates of bipolar-spectrum mood episodes and that pregnant and postpartum women represent a special risk population. This review may help to inform clinical care recommendations, thus helping to identify those who may have.

The complex effects of maternal expectations on postpartum depressive symptoms: when does a protective factor become a risk factor?

PURPOSE

The present study assessed the effects of several prenatal maternal expectations on postpartum depression (PPD), while considering two relevant factors - incongruence between planned and actual birth and the rigidity of the birth plan - that can affect whether maternal expectations act as protective factors or risk factors for PPD.

METHODS

Primiparous women (N = 527) were recruited to a longitudinal study about women's birth choices and experiences. At time 1, during pregnancy, women completed a questionnaire assessing prenatal depression, preferred birth plan, birth plan flexibility-rigidity and maternal expectations (i.e. Natural-Fulfillment, Infant-Reflects-Mothering, Sacrifice). At time 2, two-months post-partum, they reported their actual birth mode and answered a questionnaire assessing their PPD symptoms.

RESULTS

Natural-fulfillment maternal expectations were negatively related to PPD symptoms. Yet, the interaction of high natural-fulfillment expectations with an unfulfilled birth plan and the rigidity of the birth plan, served as a risk factor for PPD symptomatology.

CONCLUSIONS

Understanding the conditions under which specific prenatal maternal expectations serve as a risk factor for PPD, can help healthcare providers identify women who are at high risk for developing PPD symptoms and plan preemptive interventions.

Maternal Psychological and Biological Factors Associated to Gestational Complications

Early detection of gestational complications is a priority in obstetrics. In our social context, this is linked to maternity age. Most studies are focused on biological factors. However, pregnancy is also influenced by social and psychological factors, which have not been deeply explored. We aimed to identify biopsychosocial risk and protective factors associated with the development of maternal and fetal complications. We enrolled 182 healthy pregnant women, and plasma melatonin and cortisol levels were measured in the first trimester by chemiluminescent immunoassays. At different time points along gestation, women answered several questionnaires (positive and negative affect schedule, hospital anxiety and depression scale, pregnancy concerns scale, life orientation test, resilience scale, life satisfaction scale and life-work conflicts scale). They were followed up until delivery and categorized as normal pregnancy, maternal or fetal complications. Maternal complications were associated with low melatonin (OR = 0.99 [0.98; 1.00]; p-value = 0.08) and life satisfaction (OR = 0.64 [0.41; 0.93]; p-value = 0.03) and fetal complications were associated with high cortisol (OR = 1.06 [1.02; 1.13]; p-value = 0.04), anxiety (OR = 2.21 [1.10; 4.55]; p-value = 0.03) and life-work conflicts (OR = 1.92 [1.04; 3.75]; p-value = 0.05). We conclude that psychological factors influence pregnancy outcomes in association with melatonin and cortisol alterations. High maternal melatonin and life satisfaction levels could be potential protective factors against the development of maternal complications during pregnancy. Low anxiety and cortisol levels and reduced work-life conflicts could prevent fetal complications.

Maternal personality and postnatal bonding disorder in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

BACKGROUND

Despite much knowledge of the effects of maternal psychopathology on bonding, the effects of personality have received less attention. We aimed to examine the association between maternal personality and postnatal bonding disorder.

METHODS

We analyzed data from 15,654 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Personality was assessed in middle pregnancy using the short-form Eysenck Personality Questionnaire-Revised, with the score for each subscale categorized into four levels. Bonding disorder was defined as the Mother-to-Infant Bonding Scale score of ≥5 one month after delivery. Multiple logistic regression analyses were conducted to examine the association between personality and bonding disorder after adjusting for age, education, parity, feelings towards pregnancy, social isolation, as well as the Edinburgh Postpartum Depression Scale (EPDS) score.

RESULTS

Higher extraversion was associated with a decreased risk of bonding disorder (p for trend <0.001). Higher neuroticism was associated with an increased risk of bonding disorder (p for trend <0.001), and this association disappeared after further adjustment for EPDS score (p for trend 0.39). No association between psychoticism and bonding disorder was observed (p for trend 0.83), and the association appeared after further adjustment for EPDS score (p for trend 0.0017). Higher lie was associated with a decreased risk of bonding disorder (p for trend <0.001).

LIMITATIONS

Maternal personality and bonding were self-reported.

CONCLUSIONS

Lower extraversion, higher psychoticism, and lower lie were associated with bonding disorder. The association between higher neuroticism and bonding disorder was explained by postnatal depressive symptoms.

Associations of rooming-in with maternal postpartum bonding: the impact of mothers' pre-delivery intentions

OBJECTIVE

Full rooming-in, that is, mother and baby staying together for 24 hours per day after birth in the hospital, has been suggested as beneficial for positive maternal bonding. However, it has never been studied directly. We aimed to examine the association of full versus partial rooming-in and maternal bonding to her infant during the post-childbirth hospital stay.

STUDY DESIGN

Longitudinal questionnaire study.

SETTING

Maternity ward of a large tertiary health care center in Israel.

PARTICIPANTS

The sample consisted of postpartum women (N = 293) in a maternity ward of a tertiary health care center who were fully or partially rooming-in.

MEASUREMENTS AND FINDINGS

Questionnaires were administered at two time points, immediately after childbirth (T1; days 1-4) and 2 months postpartum (T2). The Childbirth Experience Questionnaire (CEQ), breastfeeding questions, and the Postpartum Bonding Questionnaire (PBQ) were administered at T1; the PBQ was repeated at T2. Regression analysis revealed that the rooming-in mode did not significantly predict bonding at 1-4 days postpartum. However, the rooming-in mode was a significant predictor of bonding at two months postpartum only for women who practiced the rooming-in mode they had initially planned (Beta = 0.12, p < .05), while controlling for other demographic as well as obstetric variables. Women who chose and practiced partial rooming-in manifested more bonding difficulties than those who chose and practiced full rooming-in. These distinctions in bonding were not manifested when including in the analysis women who partially rooming-in, but not in accordance with their intentions.

CONCLUSIONS

Mother-infant bonding may be optimally supported when women's pre-labor desires to participate in full rooming-in are fulfilled.

IMPLICATIONS FOR PRACTICE

Hospital staff should be aware of the mothers' intentions regarding full rooming-in requests and make sincere efforts to accommodate and support their wishes.

Comparing Web-Based Mindfulness With Loving-Kindness and Compassion Training for Promoting Well-Being in Pregnancy: Protocol for a Three-Arm Pilot Randomized Controlled Trial

BACKGROUND

Promoting psychological well-being and preventing distress among pregnant women is an important public health goal. In addition to adversely impacting the mother's health and well-being, psychological distress in pregnancy increases the risk of poor pregnancy outcomes, compromises infant socioemotional development and bonding, and heightens maternal and child vulnerability in the postpartum period. Mindfulness and compassion-based interventions show potential for prevention and early intervention for perinatal distress. As there is an established need for accessible, scalable, flexible, and low-cost interventions, there is increased interest in the delivery of these programs on the web. This project aims to pilot a three-arm randomized controlled trial (RCT) to determine the feasibility of a full-scale RCT comparing 2 web-based interventions (mindfulness vs loving-kindness and compassion) with a web-based active control condition (progressive muscle relaxation).

OBJECTIVE

The primary objective of this study is to assess the feasibility of an RCT protocol comparing the 3 conditions delivered on the web as a series of instructional materials and brief daily practices over a course of 8 weeks. The second objective is to explore the experiences of women in the different intervention conditions. The third objective is to estimate SD values for the outcome measures to inform the design of an adequately powered trial to determine the comparative efficacy of the different conditions.

METHODS

Pregnant women (n=75) participating in a longitudinal birth cohort study (the ORIGINS project) will be recruited to this study from 18 weeks of gestational age. We will assess the acceptability and feasibility of recruitment and retention strategies and the participants' engagement and adherence to the interventions. We will also assess the experiences of women in each of the 3 intervention conditions by measuring weekly changes in their well-being and engagement with the program and by conducting a qualitative analysis of postprogram interviews.

RESULTS

This project was funded in September 2019 and received ethics approval on July 8, 2020. Enrollment to the study will commence in September 2020. Feasibility of a full-scale RCT will be assessed using ADePT (a process for decision making after pilot and feasibility trials) criteria.

CONCLUSIONS

If the study is shown to be feasible, results will be used to inform future full-scale RCTs. Evidence for flexible, scalable, and low-cost interventions could inform population health strategies to promote well-being and reduce psychological distress among pregnant women.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry Number 12620000672954p; http://anzctr.org.au/ACTRN12620000672954p.aspx.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/19803.

Perinatal Predictors of Postpartum Depression: Results of a Retrospective Comparative Study

Postpartum mood disorders occur in a considerable number of women with the most common postpartum disorder being baby blues. The study aimed at the identification of the risk factors present before delivery, which may be comprised in prophylactic programs concerning postpartum mood disorders. The research material includes data retrieved from the medical record of patients delivering in Warsaw in the years 2010–2017 who routinely completed Edinburgh Postnatal Depression Scale (EPDS) after delivery. Data of 604 patients were analyzed. The study group included 75 women who obtained at least 12 points in EPDS, which constituted 12.4% of the whole group (mean = 14.92, SD = 3.05). The control group was made up of 75 women who obtained no more than 5 points in EPDS. A significant correlation was reported between the parity and their order vs. the risk of developing postpartum mood disorders. Women with an increased risk delivered at about 37 gestational weeks, while women in whom the risk of such disorders was low delivered at about 39 gestational weeks. No increased risk was noted in women with premature rupture of membranes. Primigravidas and women who delivered prematurely were the most predisposed to developing postpartum depression and should undergo screening tests in the perinatal period.

Experiences of participation in supervised group exercise among pregnant women with depression or low psychological well-being: A qualitative descriptive study

OBJECTIVE

To explore experiences with supervised group exercise during pregnancy in women with depression or low psychological well-being.

DESIGN

A qualitative descriptive study based on semi-structured, individual, in-depth interviews analyzed by means of thematic analysis.

SETTING

The Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Denmark.

PARTICIPANTS

Through a purposeful, criterion-based sampling strategy, women with a current diagnosis of depression with prescribed antidepressant and/or a score ≤50 on the five-item World Health Organization Well-being Index were included. The women were recruited from a randomized controlled trial on the effects of supervised group exercise (the EWE study) and participated in the exercise program during the period 26 January 2017-8 March 2018. A total of 282 pregnant women participated in the RCT, of which 143 women were allocated to the intervention group. Of these, 27 women were eligible and were invited; 19 accepted the invitation and were included in the current qualitative descriptive study. Diversity of age, parity, level of education and employment status was seen in the sample. The average time from completing the exercise program to conducting the interview was 6.5 months, ranging from 1 week to 13 months.

INTERVENTION

The participants were offered an in-hospital supervised group exercise program twice weekly for 12 weeks from 17-22 weeks gestation in addition to standard antenatal care.

MEASUREMENTS AND FINDINGS

Qualitative thematic analysis of the interviews resulted in the identification of the overarching theme: Vulnerable yet strong. This theme was comprised from three main themes (1) From judging the body to feeling it, (2) A "we" is created, and (3) Taking responsibility and succeeding, together with nine sub-themes.

KEY CONCLUSIONS

The supervised group exercise intervention provided experiences of peer support and increased body awareness, which contributed to an experience of improved psychological equilibrium and preparedness for the coming birth and motherhood. The findings suggest that participation in group-based supervised exercise during pregnancy in women with depression or low psychological well-being contributes to psychological resilience, which may persist as a positive influence postpartum and beyond.

IMPLICATIONS FOR PRACTICE

In-hospital supervised group-based exercise can be a safe means to health promotion in a secure environment that supports pregnant women's physical and mental well-being while also preparing them for birth and the transition to motherhood.

Increased systemic microbial translocation is associated with depression during early pregnancy

Plasma level of microbial translocation is a marker of mucosal permeability. Increased mucosal permeability ignites elevated microbial translocation and as a consequence of systemic inflammation. Pregnant women with depression have higher levels of inflammatory markers relative to pregnant women without depression, however, no studies have reported whether systemic microbial translocation will change in depressed women during pregnancy. In this study, we examined the plasma LPS level of depressed women during pregnancy. The results showed that the plasma LPS level was significantly increased in depressed mothers during their 8-12 weeks gestation compared to healthy controls. Compared to 8-12 weeks gestation, the plasma LPS levels were significantly decreased at 24-28 weeks gestation and 6-8 weeks postpartum in both depressed subjects and healthy controls. Furthermore, the plasma levels of pro-inflammatory cytokines (TNF-α and MCP/CCL2) associated with microbial translocation were significantly increased in depressed subjects during 8-12 weeks gestation compared to healthy controls. These results indicate that the level of microbial translocation is increased in depressed women during early pregnancy.

Differentiating between Transient and Enduring distress on the Edinburgh Depression Scale within screening contexts

BACKGROUND

Research has shown that women screened as being 'possibly depressed' on the Edinburgh Depression Scale consist of two distinct duration types: those with Transient distress, and those with Enduring distress. This paper reports on the exploration of antenatal data to ascertain if information from the initial EDS screening can help determine which women may have Transient, and which Enduring, distress after just a few weeks.

METHODS

Data from three antenatal studies were explored, where the EDS had been given twice within a psychosocial screening setting. Repeat testing of the EDS, together with a diagnostic interview, was conducted 2-5 weeks later.

RESULTS

Women with Enduring distress (those scoring high on both occasions) were significantly more likely to meet criteria for a depressive disorder than those with Transient distress. They also scored significantly and clinically meaningfully higher on their initial EDS, though no cut-off score was optimal in discriminating between the two duration categories. Differentiation could also not be made from the endorsement of the self-harm question, but was best when women were asked to predict how they would be feeling, and why.

LIMITATIONS

The data come from three studies just with English-speaking women with slightly different methodologies, producing information on a fairly small number of women with Transient (n=12-29) and Enduring (n=14-25) distress. In addition the EDS re-test interval of between 2 and 5 weeks was quite wide.

CONCLUSIONS

Clinical implications are that women who score high initially on the EDS are most likely to continue to score high (have Enduring distress) if they themselves think this will be the case, or if they only give wishful thinking as the reason as to why they think they will feel better. Research studies should also therefore analyse their data taking into account this duration category.

Perinatal characteristics and mother's personality profile associated with increased likelihood of postpartum depression occurrence in a Romanian outpatient sample

BACKGROUND

Postpartum depression represents an increasingly recognized psychiatric condition in new mothers, and even more so in recent years as its detection has improved.

AIMS

This study aimed to reveal those maternal and perinatal parameters that are significantly associated with increased likelihood of postpartum depression in delivering mothers from our region.

METHODS

A cross-sectional survey was conducted in 163 women between 6 and 8 weeks after delivery. Postnatal depression was assessed by the Edinburgh Postnatal Depression Scale (EPDS) using a cut-off of >12.

RESULTS

Postnatal depression was detected in 39 (23.93%) new mothers. The preterm delivery [odds ratio (OR) 7.233; 95% confidence interval (CI) 1.631-32.078; p = 0.009], presence of complications during pregnancy (OR 4.579; 95% CI 1.314-15.953; p = 0.017) and being primiparous (OR 3.388; 95% CI 1.430-8.025; p = 0.006) have been associated with an increased likelihood of subsequent postpartum depression. Anxiety traits of personality were the most represented in depressive mothers.

CONCLUSIONS

Postpartum depression is a frequent psychiatric condition in new mothers from our region. These results outline the critical role of mother's profile of personality which in a particular context of perinatal events could result in an increased likelihood of postpartum depression requiring a multidisciplinary approach.