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Colombage RL, Holden S, Lamport DJ, Barfoot KL. The effects of flavonoid supplementation on the mental health of postpartum parents. Front Glob Womens Health 2024; 5:1345353. [PMID: 38577523 PMCID: PMC10993701 DOI: 10.3389/fgwh.2024.1345353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction During the postpartum period, parents face psychological challenges and consequently, changes in mood and associated mood disorders have become increasingly prevalent in the 6-months following birth. Dietary flavonoids have been found to benefit mood and are therefore an appealing non-pharmacological option for potentially treating mood disorders in the postpartum. The aim of this study was to investigate whether a two-week dietary flavonoid intervention would improve mothers' and fathers' mental health in the immediate 6-month postpartum period. Method The study employed a randomised, parallel groups, controlled design to explore the effects of a flavonoid intervention vs. control group on several outcomes, including mood (PANAS), postpartum depression (EPDS), postpartum anxiety (PSAS-RSF-C) and quality of life (WHOQOL). Sixty participants (mothers n = 40, fathers n = 20) in the 6-month post-partum period were randomised to either a "flavonoid" or "control" condition. The flavonoid group were asked to add two flavonoid-rich foods (approximate flavonoid intake 218 mg/day) into their daily diet whilst controls (n = 23) were asked to continue with their usual diet for two-weeks (ClinicalTrials.gov (NCT04990622). Results Significant effects were found in the flavonoid group where mothers reported higher positive affect and lower postpartum depression after the two-week intervention relative to baseline. This finding is especially relevant as a clinical reduction in postpartum depression scores in the flavonoid group by an average 2.6 scoring points was observed, which equated to a reduction from "possible depression" at baseline to "little or no depression" at 2-weeks, which was not observed in the control group. Fathers' data was not analysed due to non-compliance with the intervention. Discussion This study provides evidence for the benefits of a dietary flavonoid intervention for mood and mental health in new mothers, supporting the utility of non-pharmacological, self-administrable changes to the diet for improving positive mood outcomes and reducing symptoms of postpartum depression in mothers during an especially challenging time. Further research for the effect of dietary interventions on paternal mental health is needed. Clinical Trial Registration ClinicalTrials.gov, identifier NCT04990622.
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Affiliation(s)
| | | | | | - Katie Louise Barfoot
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
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Turner SE, Roos L, Nickel N, Pei J, Mandhane PJ, Moraes TJ, Turvey SE, Simons E, Subbarao P, Azad MB. Examining psychosocial pathways to explain the link between breastfeeding practices and child behaviour in a longitudinal cohort. BMC Public Health 2024; 24:675. [PMID: 38439033 PMCID: PMC10910759 DOI: 10.1186/s12889-024-17994-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE Breastfeeding is associated with reduced postpartum depression, stronger parent-child relationships, and fewer behavioral disorders in early childhood. We tested the mediating roles of postpartum depression and parent-child relationship in the association between breastfeeding practices and child behavior. STUDY DESIGN We used standardized questionnaire data from a subset of the CHILD Cohort Study (n = 1,573) to measure postpartum depression at 6 months, 1 year and 2 years, parent-child relationship 1 year and 2 years, and child behavior at 5 years using the Child Behavior Checklist (range 0-100). Breastfeeding practices were measured at 3 months (none, partial, some expressed, all direct at the breast), 6 months (none, partial, exclusive), 12 months, and 24 months (no, yes). Confounders included birth factors, maternal characteristics, and socioeconomic status. RESULTS Breast milk feeding at 3 or 6 months was associated with - 1.13 (95% CI: -2.19-0.07) to -2.14 (95% CI: -3.46, -0.81) lower (better) child behavior scores. Reduced postpartum depression at 6 months mediated between 11.5% and 16.6% of the relationship between exclusive breast milk feeding at 3 months and better child behavior scores. Together, reduced postpartum depression at 1 year and reduced parent-child dysfunction at 2 years mediated between 21.9% and 32.1% of the relationship between breastfeeding at 12 months and better child behavior scores. CONCLUSION Postpartum depression and parent-child relationship quality partially mediate the relationship between breastfeeding practices and child behavior. Breastfeeding, as well as efforts to support parental mental health and parent-child relationships, may help to improve child behavior.
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Affiliation(s)
- Sarah E Turner
- Manitoba Interdisciplinary Lactation Centre (MILC), Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Leslie Roos
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Nathan Nickel
- Manitoba Interdisciplinary Lactation Centre (MILC), Winnipeg, MB, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Kinesiology and the Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
| | | | - Theo J Moraes
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Stuart E Turvey
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Elinor Simons
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, Physiology & Dalla Lana School of Public Health, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre (MILC), Winnipeg, MB, Canada.
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
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Goddard-Durant SK, Doucet A, Tizaa H, Sieunarine JA. "I don't have the energy": Racial stress, young Black motherhood, and Canadian social policies. CANADIAN REVIEW OF SOCIOLOGY = REVUE CANADIENNE DE SOCIOLOGIE 2023; 60:542-566. [PMID: 37698323 DOI: 10.1111/cars.12457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Significant socio-economic, health, and mental health disparities due to highly entrenched and systemic anti-Black racism in Canadian institutions, policies, and practices are now well documented in research and policy reports. Yet, few in-depth studies have addressed the mental health impacts of anti-Black racism on Canadian populations. This article is rooted in a community-based, qualitative research project with young first and second-generation Black Caribbean-Canadian mothers and is informed by Black Feminist epistemologies and intersectional theories and methodologies. Our research demonstrates how participants' childhood experiences with xenophobic and racist immigration policies and educational, child welfare, and childcare systems caused their future mental health challenges as young Black mothers, and how these struggles were exacerbated by their encounters with the racist, ageist, xenophobic medical, social, and mental health services they had to access as young mothers. Based on these findings, we recommend enhancements to current social policies to minimize the differential mental health impacts on young Black Canadian mothers.
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Affiliation(s)
| | - Andrea Doucet
- Department of Sociology, Brock University, St. Catharines, Ontario, Canada
| | - Helena Tizaa
- Department of Sociology, Brock University, St. Catharines, Ontario, Canada
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Suharwardy S, Ramachandran M, Leonard SA, Gunaseelan A, Lyell DJ, Darcy A, Robinson A, Judy A. Feasibility and impact of a mental health chatbot on postpartum mental health: a randomized controlled trial. AJOG GLOBAL REPORTS 2023; 3:100165. [PMID: 37560011 PMCID: PMC10407813 DOI: 10.1016/j.xagr.2023.100165] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Perinatal mood disorders are common yet underdiagnosed and un- or undertreated. Barriers exist to accessing perinatal mental health services, including limited availability, time, and cost. Automated conversational agents (chatbots) can deliver evidence-based cognitive behavioral therapy content through text message-based conversations and reduce depression and anxiety symptoms in select populations. Such digital mental health technologies are poised to overcome barriers to mental health care access but need to be evaluated for efficacy, as well as for preliminary feasibility and acceptability among perinatal populations. OBJECTIVE To evaluate the acceptability and preliminary efficacy of a mental health chatbot for mood management in a general postpartum population. STUDY DESIGN An unblinded randomized controlled trial was conducted at a tertiary academic center. English-speaking postpartum women aged 18 years or above with a live birth and access to a smartphone were eligible for enrollment prior to discharge from delivery hospitalization. Baseline surveys were administered to all participants prior to randomization to a mental health chatbot intervention or to usual care only. The intervention group downloaded the mental health chatbot smartphone application with perinatal-specific content, in addition to continuing usual care. Usual care consisted of routine postpartum follow up and mental health care as dictated by the patient's obstetric provider. Surveys were administered during delivery hospitalization (baseline) and at 2-, 4-, and 6-weeks postpartum to assess depression and anxiety symptoms. The primary outcome was a change in depression symptoms at 6-weeks as measured using two depression screening tools: Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale. Secondary outcomes included anxiety symptoms measured using Generalized Anxiety Disorder-7, and satisfaction and acceptability using validated scales. Based on a prior study, we estimated a sample size of 130 would have sufficient (80%) power to detect a moderate effect size (d=.4) in between group difference on the Patient Health Questionnaire-9. RESULTS A total of 192 women were randomized equally 1:1 to the chatbot or usual care; of these, 152 women completed the 6-week survey (n=68 chatbot, n=84 usual care) and were included in the final analysis. Mean baseline mental health assessment scores were below positive screening thresholds. At 6-weeks, there was a greater decrease in Patient Health Questionnaire-9 scores among the chatbot group compared to the usual care group (mean decrease=1.32, standard deviation=3.4 vs mean decrease=0.13, standard deviation=3.01, respectively). 6-week mean Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 scores did not differ between groups and were similar to baseline. 91% (n=62) of the chatbot users were satisfied or highly satisfied with the chatbot, and 74% (n=50) of the intervention group reported use of the chatbot at least once in 2 weeks prior to the 6-week survey. 80% of study participants reported being comfortable with the use of a mobile smartphone application for mood management. CONCLUSION Use of a chatbot was acceptable to women in the early postpartum period. The sample did not screen positive for depression at baseline and thus the potential of the chatbot to reduce depressive symptoms in this population was limited. This study was conducted in a general obstetric population. Future studies of longer duration in high-risk postpartum populations who screen positive for depression are needed to further understand the utility and efficacy of such digital therapeutics for that population.
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Affiliation(s)
- Sanaa Suharwardy
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Maya Ramachandran
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Stephanie A. Leonard
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Anita Gunaseelan
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Deirdre J. Lyell
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
| | - Alison Darcy
- Woebot Health, San Francisco, CA (Drs Darcy and Robinson)
| | | | - Amy Judy
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Obstetrics, Stanford University, Stanford, CA (Dr. Suharwardy, Dr. Ramachandran, Dr. Leonard, Dr Gunaseelan, Dr Lyell, and Dr Judy)
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Saravanan V, Desai G, Satyanarayana VA. Antenatal predictors of postnatal maternal attachment and competence after assisted conception-a prospective cohort study in South India. Arch Womens Ment Health 2023:10.1007/s00737-023-01340-1. [PMID: 37393349 DOI: 10.1007/s00737-023-01340-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/17/2023] [Indexed: 07/03/2023]
Abstract
The aim of this study is to examine the influence of antenatal factors such as anxiety, depression, perceived stress, marital satisfaction, maternal antenatal attachment, and social support on postnatal maternal attachment and competence in women who received assisted reproductive treatment. A prospective longitudinal cohort design was adopted with two groups-50 women who received assisted reproductive treatment and 50 women who had natural conception. Both the groups were assessed using self-report measures over three time points: T1, 7th month of pregnancy; T2, 2 weeks postpartum; and T3, 3 months postpartum. A final sample of 44 women who had assisted conception and 47 women who had natural conception completed assessments across all three time points. Descriptive, bivariate analyses, and stepwise multiple linear regression analyses were carried out. In the assisted conception group, maternal antenatal attachment, depression, and marital satisfaction significantly predicted postnatal maternal-infant attachment. Perceived social support, depression, and duration of marriage significantly predicted postnatal maternal competence. In the naturally conceived group, maternal antenatal attachment and social support significantly predicted postnatal maternal-infant attachment; perceived stress significantly predicted postnatal maternal competence. Antenatal depressive symptoms and relational factors significantly influenced postnatal maternal attachment and competence highlighting the need for screening and targeted psychological interventions during pregnancy.
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Affiliation(s)
- Vaishalee Saravanan
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, 560029, Karnataka, India
| | - Geetha Desai
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Veena A Satyanarayana
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, 560029, Karnataka, India.
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The global burden of perinatal common mental health disorders and substance use among migrant women: a systematic review and meta-analysis. Lancet Public Health 2023; 8:e203-e216. [PMID: 36841561 DOI: 10.1016/s2468-2667(22)00342-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 02/25/2023]
Abstract
BACKGROUND There are one billion migrants globally, of whom 82 million are forced migrants. Pregnant migrants face pre-migration stressors such as conflict, transit stressors including poverty, and post-migration stressors including navigating the immigration system; these stressors can make them vulnerable to mental illness. We aimed to assess the global prevalence of and risk factors for perinatal mental health disorders or substance use among women who are migrants. METHODS In this systematic review and meta-analysis, we searched OVID MEDLINE, Embase, PsycINFO, CENTRAL, Global Health, Scopus, and Web of Science for studies published from database inception until July 8, 2022. Cohort, cross-sectional, and interventional studies with prevalence data for any mental illness in pregnancy or the postnatal period (ie, up to a year after delivery) or substance use in pregnancy were included. The primary outcome was the prevalence of perinatal common mental health disorders among women who are migrants, globally. Data for study quality and risk factors were also extracted. A random-effects meta-analysis was used to calculate pooled prevalence estimates, when appropriate. Sensitivity analyses were conducted according to study quality, sample representativeness, and method of outcome assessment. Risk factor data were synthesised narratively. This study is registered with PROSPERO, CRD42021226291. FINDINGS 18 650 studies were retrieved, of which 135 studies comprising data from 621 995 participants met the inclusion criteria. 123 (91%) of 135 studies were conducted in high-income host countries. Five (4%) of 135 studies were interventional, 40 (30%) were cohort, and 90 (66%) were cross-sectional. The most common regions of origin of participants were South America, the Middle East, and north Africa. Only 26 studies presented disaggregated data for forced migrants or economic migrants. The pooled prevalence of perinatal depressive disorders was 24·2% (range 0·5-95·5%; I2 98·8%; τ2 0·01) among all women who are migrants, 32·5% (1·5-81·6; 98·7%; 0·01) among forced migrants, and 13·7% (4·7-35·1; 91·5%; 0·01) among economic migrants (p<0·001). The pooled prevalence of perinatal anxiety disorders was 19·6% (range 1·2-53·1; I2 96·8%; τ2 0·01) among all migrants. The pooled prevalence of perinatal post-traumatic stress disorder (PTSD) among all migrant women was 8·9% (range 3·2-33·3; I2 97·4%; τ2 0·18). The pooled prevalence of perinatal PTSD among forced migrants was 17·1% (range 6·5-44·3; I2 96·6%; τ2 0·32). Key risk factors for perinatal depression were being a recently arrived immigrant (ie, approximately within the past year), having poor social support, and having a poor relationship with one's partner. INTERPRETATION One in four women who are migrants and who are pregnant or post partum experience perinatal depression, one in five perinatal anxiety, and one in 11 perinatal PTSD. The burden of perinatal mental illness appears higher among women who are forced migrants compared with women who are economic migrants. To our knowledge, we have provided the first pooled estimate of perinatal depression and PTSD among women who are forced migrants. Interpreting the prevalence estimate should be observed with caution due to the very wide range found within the included studies. Additionally, 66% of studies were cross-sectional representing low quality evidence. These findings highlight the need for community-based routine perinatal mental health screening for migrant communities, and access to interventions that are culturally sensitive, particularly for forced migrants who might experience a higher burden of disease than economic migrants. FUNDING UK National Institute for Health Research (NIHR); March of Dimes European Preterm Birth Research Centre, Imperial College; Imperial College NIHR Biomedical Research Centre; and Nuffield Department of Population Health, University of Oxford.
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Aylward P, Sved Williams A. Holistic community-based group parenting programs for mothers with maternal mental health issues help address a growing public health need for a diversity of vulnerable mothers, children and families: Findings from an action research study. Front Glob Womens Health 2023; 3:1039527. [PMID: 36733300 PMCID: PMC9887053 DOI: 10.3389/fgwh.2022.1039527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
Background Maternal mental illness is a major growing global concern which can affect parenting with serious negative implications for offspring. Group-based parenting programs for mothers which both enhance the parent-child relationship and address mental health symptoms in a supportive social setting may optimise better outcomes for mothers and children. The Acorn program in South Australia draws on attachment theory to integrate dance play, reflective diary keeping and therapeutic letters in a holistic program for a diversity of vulnerable mothers and children aged 1-36 months. The program seeks to nurture and enhance parental wellbeing and the quality of the parent-child relationship for mothers experiencing identified mental health illnesses that impinge upon their parenting. This study presents the evaluation of the program and its effectiveness. Methods Action research approach for continuous monitoring and program improvement engaging Acorn program staff in evaluation data collection and interpretation of pre and post self-completion measures and standardized observations. Additional data was collected through a telephone interview of attending mothers 6-8 months after program completion to address sustainable impacts on parenting and wellbeing. Results The program engaged 353 diverse vulnerable mothers with their children. Many had profound overlapping mental health issues including borderline personality disorder (BPD) and depression. The quality of the parent-child interaction, parental confidence, competence and enjoyment were enhanced; mothers' wellbeing, ability to cope and lasting social supports were augmented. This occurred for a number of "most vulnerable" subgroups including single mothers, mothers with BPD, mothers from non-English speaking households and those with lower levels of education or household income. Mothers reported sustained improvements in their wellbeing, parenting, social and family lives, and feeling closer to their child as a result of participating in the program. Conclusions Given the high prevalence of maternal mental health issues and substantial potential negative consequences for mothers and offspring, the Acorn parenting program offers an effective means of addressing this pressing public health issue potentially helping large numbers of vulnerable mothers and their children. This has additional gravitas in the shadow of COVID-19 due to expanded numbers of those experiencing greater parental stress, isolation and mental illness.
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Affiliation(s)
- Paul Aylward
- Action Research Partnerships, Adelaide, SA, Australia,Torrens University Australia, Public Health, Equity and Human Flourishing, Adelaide, SA, Australia,Correspondence: Paul Aylward ;
| | - Anne Sved Williams
- Department of Psychiatry, Women’s and Children’s Health Network, SA, Australia,Faculty of Health and Medical Sciences, University of Adelaide, SA, Australia
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Polycystic ovary syndrome and postpartum depression among Hispanics and non-Hispanics: a population-based study. AJOG GLOBAL REPORTS 2022; 2. [PMID: 36060826 PMCID: PMC9438401 DOI: 10.1016/j.xagr.2022.100070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Xayyabouapha A, Sychareun V, Quyen BTT, Thikeo M, Durham J. Prevalence and Risk Factors Associated With Postpartum Depressive Symptoms Among Women in Vientiane Capital, Lao PDR. Front Public Health 2022; 10:791385. [PMID: 35592080 PMCID: PMC9110677 DOI: 10.3389/fpubh.2022.791385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
Postpartum depression (PPD), the onset of depressive episodes after childbirth, is the most common psychological condition following childbirth, and a global public health concern. If undiagnosed and/or untreated, postpartum depression can have negative effects on maternal and child health, however, there are few studies on the prevalence of postpartum depression in low- and middle-income countries. To contribute to filling this gap, this study examined the prevalence and risk factors associated with postpartum depressive symptoms among women after delivery in Vientiane Capital, Lao PDR. The study was a cross-sectional design, with multistage sampling used to identify women between 4 and 24 weeks after giving birth (N = 521). The Edinburgh Postnatal Depression Scale was used to identify women with postpartum depressive symptoms. Univariate and multivariate logistic regressions identified risk factors associated with postpartum depressive symptoms. The prevalence of postpartum depressive symptoms among participants was 21.3%. Associated factors were having at least 2-3 living children (AOR: 1.9, 95% CI: 1.1-3.0), experiencing mental health problems during pregnancy (AOR: 3.3, 95% CI: 1.4-7.6), experiencing conflicts with family members (AOR: 2.5, 95% CI: 1.5-4.0), the experience of intimate partner violence (AOR: 2.6, 95% CI: 1.3-5.5), and receiving moderate social support (AOR: 5.6, 95% CI: 3.2-10.0). In contexts where access to mental health specialists has severely constrained maternal and child healthcare providers at primary health care must be supported to develop the necessary skills to identify risk factors and symptoms and offer basic essential services for postpartum depressive symptom (PDS). The study identified a high proportion of mothers with postnatal depressive symptoms, highlighting the need to screen and treat mothers who present with PDS, as not doing so exposes mother and their children to a range of negative health and social outcomes. Addressing the stigma associated with mental health illness and mental health illness and domestic violence that prevents women from seeking healthcare, must also be developed, implemented, and evaluated.
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Affiliation(s)
- Amkha Xayyabouapha
- Faculty of Public Health, University of Health Sciences and Hanoi University of Public Health, Vientiane, Laos
| | | | - Bui Thi Tu Quyen
- Biostatistics Department, Faculty of Fundamental Sciences, Hanoi University of Public Health, Vietnam, Laos
| | - Manivone Thikeo
- Faculty of Public Health, University of Health Sciences, Vientiane, Laos
| | - Jo Durham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Fatin Imtithal A, Norhayati MN, Nor Akma Y. Comparison of labour and postnatal satisfaction between women with and without severe maternal morbidity: a double-cohort study. BMJ Open 2022; 12:e049757. [PMID: 35418419 PMCID: PMC9014019 DOI: 10.1136/bmjopen-2021-049757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To compare labour and postnatal satisfaction between women with and without severe maternal morbidity in a tertiary hospital in Kelantan, Malaysia. DESIGN A prospective double-cohort study. SETTING Hospital and community based. PARTICIPANTS Women at childbirth and 1-month post partum. OUTCOME MEASURES Labour satisfaction measured using the Malay version of the Women's Views of Birth Labour Satisfaction Questionnaire and postnatal satisfaction measured using the Malay version of the Women's Views of Birth Postnatal Satisfaction Questionnaire. RESULTS A total of 198 participants responded following childbirth, while 193 responded 1-month post partum. Accordingly, although no significant difference in labour satisfaction scores following childbirth was observed between women with and without severe maternal morbidity, a significant difference in postnatal satisfaction score 1-month post partum had been noted (adjusted mean difference [95% CI]: 3 [0.54 to 5.45]; p=0.019). Moreover, domains for nursing a baby (0.08 [0.024] vs 0.06 [0.029]; p=0.022) and professional support (0.03 [0.022] vs 0.03 [0.029]; p=0.023) differed significantly between women with and without severe maternal morbidity. CONCLUSIONS Healthcare professional support and nursing of babies influenced the relationship between satisfaction and severe maternal morbidity during the later postpartum period.
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Affiliation(s)
- Adnan Fatin Imtithal
- Department of Family Medicine, Universiti Sains Malaysia, Kampus Kesihatan, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia, Kampus Kesihatan, Kubang Kerian, Kelantan, Malaysia
| | - Yunus Nor Akma
- Department of Family Medicine, Universiti Sains Malaysia, Kampus Kesihatan, Kubang Kerian, Kelantan, Malaysia
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Yang K, Wu J, Chen X. Risk factors of perinatal depression in women: a systematic review and meta-analysis. BMC Psychiatry 2022; 22:63. [PMID: 35086502 PMCID: PMC8793194 DOI: 10.1186/s12888-021-03684-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/29/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Perinatal depression in women is associated with high morbidity and mortality, and has attracted increasing attention. The investigation of risk factors of perinatal depression in women may contribute to the early identification of depressed or depression-prone women in clinical practice. MATERIAL AND METHODS A computerized systematic literature search was made in Cochrane Library, PubMed, Web of Science, and EMBASE from January 2009 to October 2021. All included articles were published in English, which evaluated factors influencing perinatal depression in women. Based on the recommendations of the Cochrane Collaboration protocols, Review Manager 5.3 was used as a statistical platform. RESULTS Thirty-one studies with an overall sample size of 79,043 women were included in the review. Educational level (P = 0.0001, odds ratio [OR]: 1.40, 95% CI: [1.18,1.67]), economic status of families (P = 0.0001, OR: 1.69, 95%CI: [1.29,2.22]), history of mental illness (P < 0.00001, OR: 0.29, 95% CI: [0.18, 0.47]), domestic violence (P < 0.00001, OR: 0.24, 95% CI: [0.17,0.34]), perinatal smoking or drinking (P = 0.005, OR: 0.63; 95% CI [0.45, 0.87]; P = 0.008, OR: 0.43, 95% CI, [0.23 to 0.80]; respectively), and multiparity(P = 0.0003, OR: 0.74, 95% CI: [0.63, 0.87]) were correlated with perinatal depression in women. The stability of our pooled results was verified by sensitivity analysis and publication bias was not observed based on funnel plot results. CONCLUSION Lower educational level, poor economic status of families, history of mental illness, domestic violence, perinatal smoking or drinking, and multiparity serve as risk factors of perinatal depression in women.
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Affiliation(s)
- Kai Yang
- grid.33199.310000 0004 0368 7223Department of Anesthesiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Jing Wu
- grid.33199.310000 0004 0368 7223Department of Anesthesiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Xiangdong Chen
- Department of Anesthesiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430022, China.
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12
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Owens B, Libertus K. Are There Postnatal Benefits to Prenatal Kick Counting? A Quasi-Experimental Longitudinal Study. Front Psychol 2022; 13:712562. [PMID: 35153948 PMCID: PMC8825801 DOI: 10.3389/fpsyg.2022.712562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 01/04/2022] [Indexed: 11/17/2022] Open
Abstract
Mild signs of postpartum depression or anxiety are present in up to half of all new mothers. However, the impact of having the "baby blues" on infant development remains largely unknown. The current study explores a potential relation between mother's self-reported depression or anxiety symptoms and infant's motor development in a longitudinal sample of 50 mother-infant dyads. Further, we examine whether engaging in fetal kick counting during pregnancy may reduce maternal psychopathology symptoms and thereby positively influence infant motor development and parent-child engagement during the first months of life. We hypothesized that subclinical maternal psychopathology would negatively impact infant motor development, and that completing a fetal kick count activity during the third trimester would reduce overall signs of maternal psychopathology. Results only partially support these hypotheses. Postpartum maternal anxiety seems to negatively affect the emergence of infants' fine motor skills. However, engaging in fetal kick counting during pregnancy did not reduce maternal depression or anxiety symptoms. Nevertheless, preliminary evidence suggests that engaging in fetal kick counting may impact early child development by altering the mother's attitudes toward the child. Future research is needed to examine the value of this low-cost intervention strategy more closely.
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Affiliation(s)
| | - Klaus Libertus
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
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Toledo C, Cianelli R, Villegas Rodriguez N, De Oliveira G, Gattamorta K, Wojnar D, Ojukwu E. The significance of breastfeeding practices on postpartum depression risk. Public Health Nurs 2021; 39:15-23. [PMID: 34510526 DOI: 10.1111/phn.12969] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Examine the relationship between breastfeeding practices (breastfeeding status and breastfeeding length) and postpartum depression (PPD) risk, after controlling for significant risk factors for PPD. DESIGN A cross-sectional, correlational study design was used. Data was used from a national dataset using a subsample of women (n = 29,682) residing in 26 states in the United States that answered the 2016 Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire. A secondary analysis was conducted using descriptive and bivariate analyses, and a multiple logistic regression model. RESULTS Women currently breastfeeding (AOR = 0.87 CI: 0.79-0.95, p = .001), and women who breastfed for longer periods of time (p = < .002) had a statistically significantly lower PPD risk compared to their counterparts, even after accounting for significant covariates. CONCLUSIONS Study findings suggest breastfeeding as a cost efficient and healthy behavior that can decrease a woman's risk for PPD. Nurses should educate and promote the maternal mental health benefits of breastfeeding in addition to the health benefits for the infant.
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Affiliation(s)
- Christine Toledo
- Florida Atlantic University Christine E. Lynn College of Nursing, Boca Raton, Florida
| | - Rosina Cianelli
- University of Miami School of Nursing, Coral Gables, Florida
| | | | | | | | - Danuta Wojnar
- Seattle University College of Nursing, Seattle, Washington
| | - Emmanuela Ojukwu
- The University of British Columbia School of Nursing, BC, Canada
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14
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Weingarten S, Diop S, Specht C, Turmes L, Juckel G, Mavrogiorgou P. Differences in interactional behaviour in postpartum depression with and without pre-existing mental disorder. Compr Psychiatry 2021; 108:152248. [PMID: 34044326 DOI: 10.1016/j.comppsych.2021.152248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 04/29/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Mothers with postpartum depression (PPD) show impaired affects and behaviour patterns in the mother-child interaction, which affects an infant's emotional and cognitive development and the maternal course of disease. However, impairment of the mother-child relationship does not occur in every case of PPD. AIM The aim of this exploratory-descriptive video-based study was to investigate the possible associations between mother-child interactions and aspects of maternal biography and clinical history, with a focus on pre-existing mental disorder. METHODS Sixty-two mother-child dyads (31 mothers with PPD and pre-existing mental disorders and 31 mothers with PPD but no further mental disorder) hospitalized at the mother and baby unit (MBU) of the LWL-Hospital Herten were included in this study. The Marcé Clinical Checklist and the "Mannheimer Beurteilungsskala zur Erfassung der Mutter-Kind-Interaktion im Säuglingsalter" (MBS-MKI-S) were used to explore sociodemographic and clinical parameters, and video-based interaction behaviour was examined. RESULTS Mother-infant interaction behaviour showed a significant group difference on the MBS-MKI-S-Vm subscale (variability in maternal behaviour) before psychiatric treatment (exact Mann-Whitney U test: U = 555, p = 0.023), with higher scores in mothers with a pre-existing mental disorder. Furthermore, significant differences were shown on the MBS-MKI-S-RSm (maternal reactivity/sensitivity) (U = 259, p = 0.019) and MBS-MKI-S-Rc (child's reactivity) subscales at discharge (U = 251, p = 0.021). Among mothers with a pre-existing diagnosis, the MBS-MKI-S-Tm (maternal tenderness) and MBS-MKI-S-Rc (child's reactivity) subscales were significantly correlated after treatment. CONCLUSIONS Mothers with PPD and a pre-existing mental disorder displayed significantly more behavioural variability than mothers with only PPD. Maternal behaviour seems to influence the child's responsive behaviour; thus, mothers and their children can benefit from inpatient treatment at an MBU. Further investigations with larger samples should be conducted.
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Affiliation(s)
- Sina Weingarten
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany
| | - Shirin Diop
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany
| | - Christina Specht
- Department of Psychiatry, Psychotherapy, Psychosomatic Medicine and Preventive Medicine, LWL-Hospital Herten, Im Schloßpark 20, 45699 Herten, Germany
| | - Luc Turmes
- Department of Psychiatry, Psychotherapy, Psychosomatic Medicine and Preventive Medicine, LWL-Hospital Herten, Im Schloßpark 20, 45699 Herten, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany.
| | - Paraskevi Mavrogiorgou
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany
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15
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Peng K, Zhou L, Liu X, Ouyang M, Gong J, Wang Y, Shi Y, Chen J, Li Y, Sun M, Wang Y, Lin W, Yuan S, Wu B, Si L. Who is the main caregiver of the mother during the doing-the-month: is there an association with postpartum depression? BMC Psychiatry 2021; 21:270. [PMID: 34034695 PMCID: PMC8147344 DOI: 10.1186/s12888-021-03203-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine the relationship between the main caregiver during the "doing-the-month" (a traditional Chinese practice which a mother is confined at home for 1 month after giving birth) and the risk of postpartum depression (PPD) in postnatal women. METHODS Participants were postnatal women stayed in hospital and women who attended the hospital for postpartum examination, at 14-60 days after delivery from November 1, 2013 to December 30, 2013. Postpartum depression status was assessed using the Edinburgh Postnatal Depression Scale. Univariate and multivariable logistic regressions were used to identify the associations between the main caregiver during "doing-the-month" and the risk of PPD in postnatal women. RESULTS One thousand three hundred twenty-five postnatal women with a mean (SD) age of 28 (4.58) years were included in the analyses. The median score (IQR) of PPD was 6.0 (2, 10) and the prevalence of PPD was 27%. Of these postnatal women, 44.5% were cared by their mother-in-law in the first month after delivery, 36.3% cared by own mother, 11.1% by "yuesao" or "maternity matron" and 8.1% by other relatives. No association was found between the main caregivers and the risk of PPD after multiple adjustments. CONCLUSIONS Although no association between the main caregivers and the risk of PPD during doing-the-month was identified, considering the increasing prevalence of PPD in Chinese women, and the contradictions between traditional culture and latest scientific evidence for some of the doing-the-month practices, public health interventions aim to increase the awareness of PPD among caregivers and family members are warranted.
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Affiliation(s)
- Ke Peng
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China ,grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lin Zhou
- Shenzhen Centre for Disease Control and Prevention, Shenzhen, China
| | - Xiaoying Liu
- grid.1013.30000 0004 1936 834XSchool of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Menglu Ouyang
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Jessica Gong
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Yuanyuan Wang
- grid.48815.300000 0001 2153 2936Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yu Shi
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Jiani Chen
- grid.259384.10000 0000 8945 4455University International College, Macau University of Science and Technology, Macau, China
| | - Yichong Li
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Mingfan Sun
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Yueyun Wang
- Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.
| | - Wei Lin
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shixin Yuan
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bo Wu
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lei Si
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia ,grid.89957.3a0000 0000 9255 8984School of Health Policy & Management, Nanjing Medical University, Nanjing, China
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McPhail J, Loitz CC, Zaychkowsky C, Valeroso G, McNeil DA, McDonald SW, Edwards SA. Opportunistic postpartum depression symptom screening at well-child clinics in Alberta, 2012-2016. Canadian Journal of Public Health 2021; 112:938-946. [PMID: 34021493 DOI: 10.17269/s41997-021-00521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/29/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The study objective was to assess the reach and delivery of opportunistic postpartum depression (PPD) symptom screening at well-child clinic (WCC) immunization appointments in Alberta. The relationship between socio-demographic factors and PPD symptom screening status, and PPD symptom scores was explored. METHOD In this retrospective population-based cohort study, administrative health data from WCC immunization appointments were used to assess the PPD symptom screening delivery and scores from January 1, 2012 to December 31, 2016. The associations with maternal age and area-level material deprivation were determined by multivariable statistics. RESULTS The number of births ranged from 51,537 to 55,787 annually. The percentage of mothers screened for PPD symptoms using the Edinburgh Postnatal Depression Scale decreased between 2012 and 2016, from 80.1% to 69.7%. Of those screened, 3-3.2% of the mothers were identified to be at high risk for PPD, annually. Screening status varied according to maternal age: mothers ≤29 years were more likely to be screened than mothers 30-34 years, while mothers ≥35 years were the least likely to be screened. Logistic regression analyses, adjusting for age, found the odds of not being screened increased with increases in area-level material deprivation. Language/cultural barriers were the most commonly reported reasons for not screening. CONCLUSION Opportunistic PPD symptom screening at WCCs can be an efficient method to identify mothers who need postpartum support and to inform population-level public health surveillance. Additional work is needed to further understand barriers to PPD symptom screening, especially language, cultural, and socio-demographic factors.
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Affiliation(s)
- Juliana McPhail
- Public Health and Social Policy, University of Victoria, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada
| | - Christina C Loitz
- Alberta Health Services, 10909 Jasper Avenue, Edmonton, AB, T5J 4J3, Canada.
| | - Carol Zaychkowsky
- Alberta Health Services, 10101 Southport Road SW, Calgary, AB, T2W 3N2, Canada
| | - Germaeline Valeroso
- Alberta Health Services, 10101 Southport Road SW, Calgary, AB, T2W 3N2, Canada
| | - Deborah A McNeil
- Alberta Health Services, 10101 Southport Road SW, Calgary, AB, T2W 3N2, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.,Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Sheila W McDonald
- Alberta Health Services, 10101 Southport Road SW, Calgary, AB, T2W 3N2, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Sarah A Edwards
- Alberta Health Services, 10101 Southport Road SW, Calgary, AB, T2W 3N2, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
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17
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Lee AHX, Wen B, Walter M, Hocaloski S, Hodge K, Sandholdt N, Hultling C, Elliott S, Krassioukov AV. Prevalence of postpartum depression and anxiety among women with spinal cord injury. J Spinal Cord Med 2021; 44:247-252. [PMID: 31549939 PMCID: PMC7952069 DOI: 10.1080/10790268.2019.1666239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective: To examine the prevalence of postpartum depression (PPD) and postpartum anxiety (PPA) in mothers with spinal cord injury (SCI).Design: Retrospective, cross-sectional study.Setting: Online multi-national study.Participants: We surveyed an international sample of 102 women who gave birth following cervical SCI (C1-C8, n = 30), upper thoracic SCI (T1-T6, n = 12) or lower level SCI (T7 & below, n = 60). Participants were primarily from Canada and Sweden, and mean age at childbirth was 30 ± 6 years.Outcome Measures: Subscales from the Pregnancy Risk Assessment Monitoring System (PRAMS) were used to measure PPD (PRAMS-3D) and PPA (PRAMS-2A).Results: PPD and PPA were most prevalent in women with cervical SCI, followed by upper thoracic SCI then lower SCI. Self-reported PPD was more prevalent than clinically diagnosed PPD in women with cervical SCI (P = 0.03) and upper thoracic SCI (P = 0.03). With cervical SCI, 75% of women diagnosed with MDD before pregnancy scored >9 on the PRAMS PPD subscale, indicating clinically relevant PPD. However, only 10% were diagnosed with PPD. Of women with lower SCI diagnosed with MDD before pregnancy, 25% had a clinically relevant score for self-reported PPD; 7% were diagnosed.Conclusions: This is currently the largest study examining PPD and PPA after SCI. Clinicians should be aware that mothers with SCI (particularly high-level SCI) may have increased risk of PPD and PPA. PPD is poorly understood in women with SCI and may even be underdiagnosed. SCI-related risk factors for PPD and PPA should be explored.
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Affiliation(s)
- Amanda H. X. Lee
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada,International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Betty Wen
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Karen Hodge
- Sunny Hill Health Centre, Vancouver, BC, Canada
| | - Nora Sandholdt
- Spinalis SCI Research Unit, Karolinska Institutet, Department of Neurobiology, Care Science and Society, Division of Neurodegeneration, Neurorehabilitation Section, Stockholm, Sweden
| | - Claes Hultling
- Spinalis SCI Research Unit, Karolinska Institutet, Department of Neurobiology, Care Science and Society, Division of Neurodegeneration, Neurorehabilitation Section, Stockholm, Sweden
| | - Stacy Elliott
- Vancouver Coastal Health, B.C. Centre for Sexual Medicine, Vancouver, BC, Canada,Departments of Psychiatry and Urological Sciences, University of British Columbia, Vancouver, BC, Canada,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada,GF Strong Rehabilitation Centre, Vancouver, BC, Canada,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada,Correspondence to: Dr. Andrei V. Krassioukov, International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada; Ph: 604 675 8819.
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18
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Benasi G, Fava GA, Rafanelli C. Kellner's Symptom Questionnaire, a Highly Sensitive Patient-Reported Outcome Measure: Systematic Review of Clinimetric Properties. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:74-89. [PMID: 32050199 DOI: 10.1159/000506110] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Patient-reported outcomes (PROs) are of increasing importance in clinical medicine. However, their evaluation by classic psychometric methods carries considerable limitations. The clinimetric approach provides a viable framework for their assessment. OBJECTIVE The aim of this paper was to provide a systematic review of clinimetric properties of the Symptom Questionnaire (SQ), a simple, self-rated instrument for the assessment of psychological symptoms (depression, anxiety, hostility, and somatization) and well-being (contentment, relaxation, friendliness, and physical well-being). METHODS The PRISMA guidelines were used. Electronic databases were searched from inception up to March 2019. Only original research articles, published in English, reporting data about the clinimetric properties of the SQ, were included. RESULTS A total of 284 studies was selected. The SQ has been used in populations of adults, adolescents, and older individuals. The scale significantly discriminated between subgroups of subjects in both clinical and nonclinical settings, and differentiated medical and psychiatric patients from healthy controls. In longitudinal studies and in controlled pharmacological and psychotherapy trials, it was highly sensitive to symptoms and well-being changes and discriminated between the effects of psychotropic drugs and placebo. CONCLUSIONS The SQ is a highly sensitive clinimetric index. It may yield clinical information that similar scales would fail to provide and has a unique position among the PROs that are available. Its use in clinical trials is strongly recommended.
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Affiliation(s)
- Giada Benasi
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Chiara Rafanelli
- Department of Psychology, University of Bologna, Bologna, Italy,
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19
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Premji S, McDonald SW, McNeil DA, Spackman E. Maximizing maternal health and value for money in postpartum depression screening: a cost-effectiveness analysis using the All Our Families cohort and administrative data in Alberta, Canada. J Affect Disord 2021; 281:839-846. [PMID: 33239243 DOI: 10.1016/j.jad.2020.11.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/08/2020] [Accepted: 11/08/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Postpartum depression (PPD) affects 10-15% of women, is costly and debilitating, yet often remains undiagnosed. Within Alberta, Canada, screening is conducted at public health well child clinics using the Edinburgh Postnatal Depression Scale. If screened high-risk, women are offered referral to their family physicians for follow up diagnosis and treatment. METHODS We developed a decision tree to estimate the cost-effectiveness of PPD screening versus not screening in Alberta over a two-year time horizon using a public healthcare payer perspective. Both the current practice (51% attending referral) and a scenario analysis (100% attending referral) are presented. RESULTS Current practice results suggest screening leads to an incremental cost-effectiveness ratio (ICER) of $17,644 USD per quality adjusted life year (QALY). At a population-level, this resulted in an annual 813 (11%) additional cases diagnosed, 120 additional QALYs gained, and an additional cost of $2.1 million relative to not screening. With 100% attending referral, the ICER fell to $13,908 per QALY, resulting in an annual 1997 (27%) additional cases diagnosed, 249 additional QALYs gained, and an additional cost of $3.5 million relative to not screening. LIMITATIONS We were unable to explore the cost-effectiveness of PPD screening versus not screening for secondary populations, including children. CONCLUSIONS The results suggest screening may be most valuable when participation and compliance are maximized, where all women screened high-risk attend referral. This leads to greater value for money and increased maternal health gains across the population. Collaboration among public health and primary care services is encouraged to improve outcomes.
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Affiliation(s)
- Shainur Premji
- Population, Public and Indigenous Health, Alberta Health Services; Community Health Sciences, Cumming School of Medicine, University of Calgary.
| | - Sheila W McDonald
- Population, Public and Indigenous Health, Alberta Health Services; Community Health Sciences, Cumming School of Medicine, University of Calgary; Paediatrics, Cumming School of Medicine, University of Calgary
| | - Deborah A McNeil
- Population, Public and Indigenous Health, Alberta Health Services; Community Health Sciences, Cumming School of Medicine, University of Calgary; Faculty of Nursing, University of Calgary
| | - Eldon Spackman
- Community Health Sciences, Cumming School of Medicine, University of Calgary
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20
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Qouta SR, Vänskä M, Diab SY, Punamäki RL. War trauma and infant motor, cognitive, and socioemotional development: Maternal mental health and dyadic interaction as explanatory processes. Infant Behav Dev 2021; 63:101532. [PMID: 33588286 DOI: 10.1016/j.infbeh.2021.101532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Taking care of infants in conditions of war is highly demanding and a few studies reveal the negative impact of war trauma on maternal and infant well-being. Yet, little is known regarding the influence of trauma on infant development and the potential explanatory mechanisms. First, the present study examines how mothers' prenatal exposure to traumatic war events is associated with infant cognitive, motor, and socioemotional development. Second, it analyses the mediating roles of maternal postpartum mental health problems, quality of dyadic mother-infant interaction, and earlier infant development (at six months) in the association between prenatal traumatic war events and infants' developmental skills at 18 months. METHOD This prospective three-wave study involved 502 Palestinian pregnant females in their first trimester during the 2014 Gaza War and participated at delivery (T1) and when the child was six (T2;N = 392) and eighteen (T3; N = 386) months of age. Mothers reported their exposure to traumatic war events (human and material losses, horrors, and threat to life) at T1 and T2, and researchers photo-documented the extent of destruction at T1. Mothers reported infants' language, fine- and gross-motor, and socioemotional skills at T2 and researchers tested infants' motor, cognitive-language and socioemotional skills using the Bayley Scales of Infant development (BSID-II) at T3. Mothers reported their mental health problems (symptoms of post-traumatic stress disorder [PTSD], depression and somatization) at T2 and T3 as well as dyadic interaction quality (the emotional availability self-report, [EA-SR] brief) at T2. RESULTS First, the structural equation model (SEM) on direct effects indicated, in contrast to our hypotheses, that maternal prenatal exposure to traumatic war events did not associate with infants' developmental skills at T2 and predicted higher level of developmental skills at T3. Second, as hypothesized, we found two negative underlying mechanisms (paths) between high exposure and low levels of motor, cognitive-language, and socioemotional skills at T3: (1) through increased maternal mental health problems at T2, which then were associated with problems at T3, and (2) through increased maternal mental health problems at T2, which then were associated with a low quality of mother-infant-interaction and low level of infant developmental skills at T2. CONCLUSION Improving maternal mental health and encouraging close and positive dyadic interaction can be critical for infant sensorimotor, cognitive, and socioemotional development in war conditions.
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Affiliation(s)
- Samir R Qouta
- Doha Institut for Graduate Studies, School of Social Sciences and Humanities, Qatar
| | - Mervi Vänskä
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
| | - Safwat Y Diab
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
| | - Raija-Leena Punamäki
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland.
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21
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Chrzan-Dętkoś M, Walczak-Kozłowska T, Lipowska M. The need for additional mental health support for women in the postpartum period in the times of epidemic crisis. BMC Pregnancy Childbirth 2021; 21:114. [PMID: 33557768 PMCID: PMC7869073 DOI: 10.1186/s12884-021-03544-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/05/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND This retrospective study aimed to identify possible intensification of mental health difficulties among women seeking support in the postpartum period during the epidemic state in Poland. We assumed that the epidemic crisis, social isolation, and restrictions in hospitals which affect pregnant and postpartum women - lack of family labors, lack of the possibility to be with the newborn when he/she is hospitalized, may increase fear and reduce psychosocial resources of women, hinder their normal process of transition to motherhood and thus contribute to the intensified severity of depressive symptoms. METHODS The study participants were women seeking support at the on-line platform of the project 'Next Stop: Mum', which is a part of the postpartum depression prevention's program implemented by the Ministry of Health in Poland, and enables remote self-screening for the severity of the postpartum depression symptoms with the Edinburgh Postnatal Depression Scale developed by Cox and collaborators. The analyzed data in this study were obtained from 139 women: 61 filled forms from October 1 - November 10, 2019 (non-epidemic period), and 78 filled forms from February 20-March 30 (beginning of the COVID-19 epidemic), 2020. RESULTS A statistically significant difference in the severity of postpartum depression symptoms were observed among women making a self-assessment with EPDS scale at the beginning of the COVID-19 epidemic in Poland (M = 15.71; SD = 6.23), compared to the pre-epidemic neutral period (M = 13.56; SD = 6.46). CONCLUSIONS The results of this study indicate that the epidemic crisis may be associated with an increased need for additional caution and support of women's mental health in the postpartum period. We believe that recommendations for medical staff, policy, and families of women struggling with postpartum depression symptoms during crisis should be widespread as the second wave of COVID-19 disease may develop in the autumn-winter 2020 and spring 2021.
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Affiliation(s)
| | - Tamara Walczak-Kozłowska
- Institute of Psychology, University of Gdansk, Jana Bażyńskiego 8, 80-309, Gdańsk, Poland.
- Department of Psychology, Gdansk University of Physical Education and Sport, Kazimierza Górskiego 1, 80-336, Gdańsk, Poland.
| | - Małgorzata Lipowska
- Institute of Psychology, University of Gdansk, Jana Bażyńskiego 8, 80-309, Gdańsk, Poland
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Wen T, Fein AW, Wright JD, Mack WJ, Attenello FJ, D'Alton ME, Friedman AM. Postpartum Psychiatric Admissions in the United States. Am J Perinatol 2021; 38:115-121. [PMID: 31412407 DOI: 10.1055/s-0039-1694759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study aimed to assess risk for postpartum psychiatric admissions in the United States. STUDY DESIGN This study used the 2010 to 2014 Nationwide Readmissions Database to identify psychiatric admissions during the first 60 days after delivery hospitalization. Timing of admission after delivery discharge was determined. We fit multivariable log-linear regression models to assess the impact of psychiatric comorbidity on admission risk, adjusting for patient, obstetrical, and hospital factors. RESULTS Of 15.7 million deliveries from 2010 to 2014, 11,497 women (0.07%) were readmitted for a primary psychiatric diagnosis within 60 days postpartum. Psychiatric admissions occurred relatively consistently across 10-day periods after delivery hospitalization discharge. Psychiatric diagnoses were present among 5% of women at delivery but 40% of women who were readmitted postpartum for a psychiatric indication. In the adjusted model, women with psychiatric diagnoses at delivery hospitalization were 9.7 times more likely to be readmitted compared with those without psychiatric comorbidity. Women at highest risk for psychiatric admission were those with Medicare and Medicaid, in lower income quartiles, and of younger age. CONCLUSION While a large proportion of psychiatric admissions occurred among a relatively small proportion of at-risk women, admissions occurred over a broad temporal period relative to other indications for postpartum admission.
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Affiliation(s)
- Timothy Wen
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York
| | - Arielle W Fein
- Vagelos College of Physicians and Surgeons, Columbia University, New York
| | - Jason D Wright
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York
| | - William J Mack
- Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Frank J Attenello
- Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Mary E D'Alton
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York
| | - Alexander M Friedman
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York
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Chrzan-Dętkoś M, Walczak-Kozłowska T, Pietkiewicz A, Żołnowska J. Improvement of the breastfeeding self-efficacy and postpartum mental health after lactation consultations - Observational study. Midwifery 2020; 94:102905. [PMID: 33360178 DOI: 10.1016/j.midw.2020.102905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/24/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Maternal self-efficacy in breastfeeding may be undermined by common mental health difficulties in the postpartum, leading to an early breastfeeding cessation. The relationship may also be the opposite: problems with effective breastfeeding and breastfeeding cessation may increase the postpartum mental health difficulties. The purpose of this study was the assessment of the effectiveness of lactation consultations in strengthening the breastfeeding self-efficacy and maternal postpartum mental health. DESIGN AND PARTICIPANTS 160 Polish women (90 consultation participants and 70 controls) completed a structured interview, the General Health Questionnaire, and the Breastfeeding Self-Efficacy Scale twice: before lactation consultation and one month later. SETTING Research was conducted in the city of Gdańsk, Poland. FINDINGS Study revealed that women seeking lactation support exhibited greater mental health difficulties while their breastfeeding self-efficacy was similar to the control group. Initial breastfeeding self-efficacy was negatively correlated with the severity of the postpartum mental health problems. One month after lactation consultations, a significant increase in the breastfeeding self-efficacy and significantly reduced symptoms of mental health difficulties (somatic symptoms, functional disorders, and anxiety and insomnia) were observed among mothers. KEY CONCLUSIONS Women willing to benefit from the lactation consultations may exhibit symptoms of mental health difficulties that may be associated with difficulties in breastfeeding. Strengthening the breastfeeding confidence during lactation consultations, may reflect in the improvement of the woman's mental health. IMPLICATIONS FOR PRACTICE Midwives and lactation consultants can make a difference in the mental health promotion by offering breastfeeding interventions which address the emotional needs of a mother.
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Affiliation(s)
| | - Tamara Walczak-Kozłowska
- Institute of Psychology, University of Gdansk, Jana Bażyńskiego 4, 80-309 Gdańsk, Poland; Department of Psychology, Gdansk University of Physical Education and Sport, Kazimierza Górskiego 1, 80-336, Gdańsk, Poland.
| | | | - Joanna Żołnowska
- St. Wojciech Hospital in Gdańsk, aleja Jana Pawła II 50, 80-462 Gdańsk, Poland.
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Nakano M, Sourander A, Luntamo T, Chudal R, Skokauskas N, Kaneko H. Early risk factors for postpartum depression: A longitudinal Japanese population-based study. J Affect Disord 2020; 269:148-153. [PMID: 32339130 DOI: 10.1016/j.jad.2020.03.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Postpartum depression (PPD) negatively impacts maternal health, parenting and development of children. Most previous studies on PPD risk factors are based on Western populations. Additionally, little is known about the association between psychosocial factors during early pregnancy period and PPD. We aimed to identify early risk factors for PPD until three months after delivery using a longitudinal population-based sample from Japan. METHODS The data was collected from 1050 mothers at four time points: first trimester, after the birth, and one and three months post-delivery. Mothers who had a Japanese Edinburgh Postnatal Depression Scale (EPDS) cutoff score above 9 at one or 3 months after delivery were recognized as having PPD (n = 91/8.7%). RESULTS Negative feelings about pregnancy, combined breast and bottle feeding, first-time motherhood, motherhood 24 or less years old, perceived maternal mental illness before pregnancy, and lack of social support were all significantly associated with PPD at three months after delivery. LIMITATIONS The data was collected from one city in Japan, which limits the generalization of the findings. Additionally, PPD was assessed by an EPDS questionnaire, and not by a clinical interview. CONCLUSIONS Even after controlling for the perceived mental illness before pregnancy, several risk factors as early as in the first trimester were associated with PPD. These risk factors should be identified and the mothers should be offered a suitable intervention, in order to prevent the development of PPD.
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Affiliation(s)
- Mami Nakano
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan.
| | - Andre Sourander
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, Turku 20014, Finland.
| | - Terhi Luntamo
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, Turku 20014, Finland.
| | - Roshan Chudal
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, Turku 20014, Finland.
| | - Norbert Skokauskas
- Centre for Child and Adolescent Mental Health and Child Protection, Faculty of Medicine, NTNU, NO-7491, Trondheim, Norway.
| | - Hitoshi Kaneko
- Psychological Support and Research Center for Human Development, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan.
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Mikšić Š, Uglešić B, Jakab J, Holik D, Milostić Srb A, Degmečić D. Positive Effect of Breastfeeding on Child Development, Anxiety, and Postpartum Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2725. [PMID: 32326485 PMCID: PMC7216213 DOI: 10.3390/ijerph17082725] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/10/2020] [Accepted: 04/10/2020] [Indexed: 12/03/2022]
Abstract
BACKGROUND Postpartum depression is a psychiatric disorder that starts from the second to the sixth week after birth. Breastfeeding is considered a protective factor for postpartum mood swings. This paper aims to examine the effect of breastfeeding on postpartum depression and anxiety, and how it affects child development. METHODS The study included 209 pregnant women, 197 puerperea, and 160 women at the end of the third month after delivery, followed through three time-points. The instruments used in the study were the Edinburgh Postpartum Depression Scale (EPDS), Beck's Depression Inventory (BDI), and Beck's Anxiety Inventory (BAI). RESULTS Postpartum mothers with low risk of PPD breastfed their children more often than mothers with a mild or severe risk of perinatal depression. Mean values on the BDI scale three months after giving birth were higher in mothers who did not breastfeed their child (M = 3.53) than those who did breastfeed their child (M = 2.28). Postpartum anxiety measured by BAI was statistically negatively correlated (rs-, 430) with the duration of breastfeeding. CONCLUSION Nonbreastfeeding mothers are more depressed and anxious compared to breastfeeding mothers.
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Affiliation(s)
- Štefica Mikšić
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia; (Š.M.); (D.H.); (A.M.S.)
| | - Boran Uglešić
- School of medicine, University of Split, Šoltanska 2, 21000 Split, Croatia;
- University Hospital Split, Spinčićeva 1, 21000 Split, Croatia
| | - Jelena Jakab
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia; (Š.M.); (D.H.); (A.M.S.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31 000 Osijek, Croatia;
| | - Dubravka Holik
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia; (Š.M.); (D.H.); (A.M.S.)
| | - Andrea Milostić Srb
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia; (Š.M.); (D.H.); (A.M.S.)
| | - Dunja Degmečić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31 000 Osijek, Croatia;
- University hospital Osijek, Josipa Huttlera 4, 31 000 Osijek, Croatia
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Ebina A, Sawa R, Kondo Y, Murata S, Takada M, Fujii H, Okuyama Y, Tanikawa Y, Souke K, Ono R. Influence of kinesiophobia with pregnancy-related lumbopelvic pain at late pregnancy on postpartum depressive symptoms. Phys Ther Res 2020; 23:92-98. [PMID: 32995108 PMCID: PMC7344362 DOI: 10.1298/ptr.e9999] [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: 07/11/2019] [Accepted: 12/06/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate whether kinesiophobia with pregnancy-related lumbopelvic pain at late pregnancy influenced depressive symptoms at 1 month after delivery. METHOD Final participants were 43 pregnant women who experienced pregnancy-related lumbopelvic pain at late pregnancy and completed self-reported questionnaires at late pregnancy and 1 month after delivery. The Tampa Scale for Kinesiophobia was used to evaluate kinesiophobia, and depressive symptoms were assessed using the Self-Rating Depression Scale. We divided participants into two groups (depression and no-depression) using the score of the Self-Rating Depression Scale at 1 month after delivery. Univariate analysis and multiple logistic regression analysis identified kinesiophobia at late pregnancy as an independent predictor of depression at 1 month after delivery. RESULTS In univariate analysis, kinesiophobia at late pregnancy was significantly higher in the depression group than in the no-depression group (P= .033). In multiple logistic regression analysis, kinesiophobia at late pregnancy were significantly associated with depression at 1 month after delivery even after adjusting for confounding factors (Odds Ratio, 1.25; 95% Confidence Interval, 1.03-1.52). CONCLUSION Results found that kinesiophobia at late pregnancy negatively influenced depressive symptoms at 1 month after delivery, suggesting that approaches to treat kinesiophobia at late pregnancymight reduce the risk of onset of postpartum depressive symptoms.
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Affiliation(s)
- Aoi Ebina
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, Kobe, Japan
| | - Ryuichi Sawa
- Japan Center for International Exchange, Tokyo, Japan
- Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Yuki Kondo
- Department of Rehabilitation, Takatsuki General Hospital, Osaka, Japan
| | - Shunsuke Murata
- Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | | | | | | | | | | | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Punamäki RL, Qouta SR, Diab SY. The role of maternal attachment in mental health and dyadic relationships in war trauma. Heliyon 2019; 5:e02867. [PMID: 31890934 PMCID: PMC6926227 DOI: 10.1016/j.heliyon.2019.e02867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/01/2019] [Accepted: 11/12/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Infant care is a demanding task in dangerous war conditions, but research on the wellbeing of mother-infant dyads is mainly available in peaceful conditions. Knowledge on protective versus risking processes is especially vital for tailoring effective help, and the present study proposes the maternal attachment style to play an important role in dangerous war conditions. OBJECTIVE The study analyses, first, how various traumatic war events, such as losses, horrors and life-threat, are associated with maternal mental health and dyadic mother-infant interaction quality, indicated by maternal emotional availability (EA). Second, it tests a hypothesis that maternal insecure attachment risks and secure attachment protects good mental health and optimal EA from negative impacts of traumatic war events. METHOD The prospective three-wave study involved 502 Palestinian mothers, who were pregnant during the 2014 War on Gaza, and participated at delivery (T1), and when the infant was seven (T2; N = 392) and eighteen (T3; N = 386) months. Mothers reported about war events at T1 and T2 (death and losses, witnessing horrors and life-threat), and posttraumatic stress disorder (PTSD) and depression symptoms at T2 and T3. Dyadic interaction quality was assessed by mother-perceived emotional availability (EA) scale at T2 and T3, and attachment styles by mothers' self-reports at T3. RESULTS Death and losses, witnessing horrors, and life-threat were all associated with a high level of maternal PTSD, but only at T2, whereas death and losses were associated with her depressive symptoms both at T2 and T3. Witnessing horrors was associated with a low close and positive and a high distant and negative emotional availability at T2 and T3. As hypothesized, maternal avoidant attachment was associated with a low level of close and positive EA in general, and especially when the dyads were exposed to a high level of traumatic war events, thus indicating a risking function. Against the hypothesis, secure attachment did not show any protective function on emotional availability, while, unexpectedly, maternal preoccupied attachment was associated with close and positive emotional availability, when dyads were exposed to a high level of traumatic war events. CONCLUSION Mothering in conditions of war and military violence is an overwhelmingly demanding task, and mother-infant dyads need legal, social, and psychological assistance. Knowledge and reflection of unique responses and meanings of different attachment styles would be fruitful in tailoring effective help.
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Affiliation(s)
- Raija-Leena Punamäki
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
| | - Samir R. Qouta
- Doha Institute For Graduate Studies, Qatar
- Islamic University Gaza, Department of Education and Psychology, Gaza, Palestine
| | - Safwat Y. Diab
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
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Grigoriadis S, Graves L, Peer M, Mamisashvili L, Tomlinson G, Vigod SN, Dennis CL, Steiner M, Brown C, Cheung A, Dawson H, Rector NA, Guenette M, Richter M. A systematic review and meta-analysis of the effects of antenatal anxiety on postpartum outcomes. Arch Womens Ment Health 2019; 22:543-556. [PMID: 30523416 DOI: 10.1007/s00737-018-0930-2] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/13/2018] [Indexed: 01/14/2023]
Abstract
To systematically review and meta-analyze research investigating the association between maternal anxiety during pregnancy and outcomes for mother and baby following the immediate delivery period. MEDLINE, Medline In-Process & Other Non-Indexed Citations, PsycINFO, Embase, CINAHL, and the Cochrane library were searched. English-language, prospective studies providing data on outcomes following delivery in women with and without antenatal anxiety (defined by clinical diagnosis or score on validated scale) were included. Three-hundred-fifty-eight articles were retrieved and 13 were included. Titles and abstracts were screened; two reviewers independently reviewed full text articles, conducted quality assessments, extracted, and checked the data. Where available for > 2 studies, random effect meta-analysis was conducted and heterogeneity was quantified. Subanalyses explored moderators, regardless of heterogeneity, including type of anxiety assessment and timing, among others. There were two outcomes that were amenable to meta-analysis. Antenatal anxiety was significantly associated with postpartum depression (PPD) measured within 6 months postpartum (pooled odds ratio [OR] = 2.64, 95% CI 2.02-3.46; 8 studies), regardless of restricting analyses to those studies controlling for prenatal depression (2.45, 1.77-3.39; 6 studies). Associations were also significant when PPD was measured at 1-3 months (2.57, 1.94-3.40; 7 studies) and 6-10 months (4.42, 1.45-13.49; 3 studies). Maternal anxiety was also associated with reduced odds of breastfeeding (0.63, 0.53-0.74; 5 studies). Antenatal anxiety is associated with PPD up to the first 10 months, independent of prenatal depression, and with lower odds of breastfeeding.
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Affiliation(s)
- Sophie Grigoriadis
- Department of Psychiatry, Sunnybrook Health Sciences Centre and the University of Toronto, FG29 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. .,Women's Mood and Anxiety Clinic: Reproductive Transitions, Department of Psychiatry, FG 29, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada.
| | - Lisa Graves
- Department of Family and Community Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, 49008-8017, USA
| | - Miki Peer
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, F111 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Lana Mamisashvili
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, F111 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - George Tomlinson
- Biostatistics and Department of Medicine, Toronto General Hospital and the University of Toronto, Eaton North 13th Fl., Rm. 238 - 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada
| | - Simone N Vigod
- Department of Psychiatry, Women's College Hospital and the University of Toronto, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
| | - Meir Steiner
- Departments of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, West 5th Campus, 100 West 5th St., Level 1 - Room G112, Hamilton, ON, L8N 3K7, Canada
| | - Cara Brown
- Department of Psychiatry, University of Toronto, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada
| | - Amy Cheung
- Department of Psychiatry, Sunnybrook Health Sciences Centre and the University of Toronto, FG29 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Hiltrud Dawson
- Health Promotion Consultant, Health Nexus, 180 Dundas Street West, Suite 301, Toronto, ON, M5G 1Z8, Canada
| | - Neil A Rector
- Department of Psychiatry, Sunnybrook Health Sciences Centre and the University of Toronto, FG29 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Melanie Guenette
- Division of Neurology, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Margaret Richter
- Department of Psychiatry, Sunnybrook Health Sciences Centre and the University of Toronto, FG29 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
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Daoud N, O'Brien K, O'Campo P, Harney S, Harney E, Bebee K, Bourgeois C, Smylie J. Postpartum depression prevalence and risk factors among Indigenous, non-Indigenous and immigrant women in Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2019; 110:440-452. [PMID: 30767191 PMCID: PMC6964473 DOI: 10.17269/s41997-019-00182-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/16/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The social position of different minority groups in contemporary societies suggests different risk factors for postpartum depression (PPD). In this study, we used two cut-offs of the Edinburgh Postpartum Depression Scale (EPDS) to examine prevalence and risk factors for PPD among mothers participating in the Canadian Maternity Experiences Survey (MES), and to compare Indigenous, Canadian-born non-Indigenous and immigrant mothers. METHODS We used cross-sectional nationwide data from the 2006 MES (unweighted N = 6237, weighted N = 74,231) and conducted multivariate logistic regression models for EPDS ≥ 10 and EPDS ≥ 13 to explore risk factors for the total sample of mothers and in each study group. RESULTS Prevalence (%, 95 % CI) of EPDS ≥ 10 and EPDS ≥ 13 was significantly higher among immigrant (12.2 %, 10.2-14.2 and 24.1 %, 21.5-26.7) and Indigenous (11.1 %, 7.5-14.7 and 21.2 %, 16.5-25.9) compared to Canadian-born non-Indigenous mothers (5.6 %, 4.9-6.3 and 12.9 %, 11.9-13.9). Multivariate analysis of the total sample showed similar risk factors for EPDS ≥ 10 and EPDS ≥ 13 (ethnicity, low education, ≥ low income cut-off, taking antidepressants, experiencing abuse, low social support). Stratification by study group revealed differing risk factors in each group for EPDS ≥ 10 and EPDS ≥ 13. Indigenous mothers had the most distinct risk factors, followed by immigrant mothers. Non-indigenous Canadian-born mothers had risk factors most similar to the total sample. CONCLUSION Differing prevalence and risk factors for PPD within and across study groups suggest that instead of a universal approach, tailored programs and services to prevent PPD in Indigenous, immigrant and non-Indigenous Canadian-born groups could better protect the mental health of Canadian mothers.
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Affiliation(s)
- Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84015, Beer Sheva, Israel.
| | - Kristen O'Brien
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
| | - Patricia O'Campo
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
- Dalla Lana School of Public Health, Toronto, Canada
| | - Sarah Harney
- Native Women's Association of Canada (NWAC), Ottawa, Canada
| | - Evelyn Harney
- National Aboriginal Council of Midwives (NACM), Montréal, Canada
| | - Kerry Bebee
- National Aboriginal Council of Midwives (NACM), Montréal, Canada
| | | | - Janet Smylie
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
- Dalla Lana School of Public Health, Toronto, Canada
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King L, Feeley N, Gold I, Hayton B, Zelkowitz P. The healthy migrant effect and predictors of perinatal depression. Women Birth 2019; 32:e341-e350. [DOI: 10.1016/j.wombi.2018.07.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/22/2018] [Accepted: 07/23/2018] [Indexed: 12/20/2022]
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Abstract
Objectives: Postpartum depression (PPD) is a common emotional distress among many women in diversified cultures. The aim of this study was to examine the relationship between prenatal smoking and PPD. Methods: We systematically searched PubMed, ISI Web of Science, EMBASE, Elsevier ScienceDirect, OVID and Springer databases up to 15 March 2017. The pooled odds ratio (OR) of PPD was compared between prenatal smoking women and the ones who did not smoke during pregnancy. The fixed effect model or random effect models were chosen according to heterogeneity between studies. Results: A total of 13 studies with 1,476,922 women were included in the meta-analysis. The average incidence of PPD was 3.0% (1717/57,997) in women with smoke exposure and 1.3% (6571/488,225) in women without smoke exposure. The pooled OR was 2.325 (95% CI 1.925-2.808; Z = 8.76, p < .0001) by random-effect model. The funnel plot was symmetrical, and either the Begg's test (Z = 0.92, p=.360) or the Egger's test (t = 0.04, p = .9700) suggested no publication bias among included studies. Sensitivity analysis indicated that the result was robust. Conclusion: Our meta-analysis indicated that prenatal smoking was associated with postpartum depression.
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Affiliation(s)
- Hong-Lin Chen
- a School of Nursing, Nantong University , Nantong , Jiangsu , PR China
| | - Ji-Yu Cai
- a School of Nursing, Nantong University , Nantong , Jiangsu , PR China
| | - Man-Li Zha
- a School of Nursing, Nantong University , Nantong , Jiangsu , PR China
| | - Wang-Qin Shen
- a School of Nursing, Nantong University , Nantong , Jiangsu , PR China
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Premji S, McDonald SW, Metcalfe A, Faris P, Quan H, Tough S, McNeil DA. Examining postpartum depression screening effectiveness in well child clinics in Alberta, Canada: A study using the All Our Families cohort and administrative data. Prev Med Rep 2019; 14:100888. [PMID: 31193116 PMCID: PMC6517566 DOI: 10.1016/j.pmedr.2019.100888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 04/28/2019] [Accepted: 05/02/2019] [Indexed: 12/20/2022] Open
Abstract
Affecting 10-15% of women, postpartum depression (PPD) can be debilitating and costly. While early identification has the potential to improve timely care, recommendations regarding the implementation of routine screening are inconsistent. In Alberta, screening is completed using the Edinburgh Postnatal Depression Scale during public health well child clinic visits. The objective of this study was to examine the effectiveness of screening in identifying, diagnosing and treating women at increased risk for PPD over the first year postpartum, compared to those unscreened. The All Our Families prospective pregnancy cohort was linked to public health, inpatient, outpatient, physician claims and community pharmaceutical data over the first year postpartum. Descriptive statistics and bivariate analyses examined differences in sample characteristics and PPD and non-PPD related utilization by screening category. Odds ratios and 95% confidence intervals for PPD diagnosis and mental health drugs dispensed were generated using crude and multivariable logistic regression models. Within our sample, 87% of the eligible population were screened, with 3% receiving a high-risk score, and 13% were unscreened. Compared to those unscreened, women screened high-risk had higher odds of being diagnosed with PPD (OR: 3.88, 95% CI: 2.18-6.92) and women screened low/moderate-risk had reduced odds of receiving a diagnosis (OR: 0.51, 95% CI: 0.35-0.74). High-risk women had an increased likelihood of diagnosis, higher PPD-related utilization and drugs dispensed compared to those unscreened. This information suggests that screening was effective at streamlining resources in Alberta. Future work should focus on evaluating the cost-effectiveness of PPD screening.
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Key Words
- 1H2P, 1 hospitalization, 2 physician claims
- ANOVA, analysis of variance
- AOF, All Our Families
- CI, confidence interval
- EPDS, Edinburgh Postnatal Depression Scale
- Evaluation
- IQR, interquartile range
- OR, odds ratio
- PPD, postpartum depression
- Perinatal depression
- Public health
- SD, standard deviation
- Screening
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Affiliation(s)
- Shainur Premji
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada.,Alberta Health Services, 10101 Southport Road SW, Calgary, AB T2W3N2, Canada
| | - Sheila W McDonald
- Alberta Health Services, 10101 Southport Road SW, Calgary, AB T2W3N2, Canada.,Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Amy Metcalfe
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada.,Department of Obstetrics and Gyneacology, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Peter Faris
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada.,Alberta Health Services, 10101 Southport Road SW, Calgary, AB T2W3N2, Canada
| | - Hude Quan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Suzanne Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada.,Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Deborah A McNeil
- Alberta Health Services, 10101 Southport Road SW, Calgary, AB T2W3N2, Canada.,Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB T2N1N4, Canada
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Albanese AM, Russo GR, Geller PA. The role of parental self-efficacy in parent and child well-being: A systematic review of associated outcomes. Child Care Health Dev 2019; 45:333-363. [PMID: 30870584 DOI: 10.1111/cch.12661] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/09/2019] [Accepted: 03/09/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND For decades, parental self-efficacy (PSE), or parents' belief in their ability to influence their child in a healthy and success-promoting manner, has been understood as a key factor in promoting healthy functioning for parents and their children. In that time, an extensive collection of research examining the specific impact of PSE on parents and their children has developed. However, to the authors' knowledge, no comprehensive and systematic review of the outcomes linked to this factor exists, and the two most closely related non-systematic reviews were published over 10 years ago. METHODS Therefore, by utilizing an iteratively optimized set of search terms applied across four databases, the current review sought to systematically collect, synthesize, and present the extant literature concerning the role of PSE in parent and child well-being. RESULTS This search strategy yielded a total of 115 studies, the results of which were organized into three broad thematic categories relating to: the parent and child relationship, parental mental health, or child development. CONCLUSIONS These results recapitulate the clinical relevance of PSE, and provide an updated and comprehensive understanding of both the role PSE plays in the welfare of parents and children, as well as the gaps in the literature as it currently stands.
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Affiliation(s)
- Ariana M Albanese
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
| | - Gabrielle R Russo
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
| | - Pamela A Geller
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania.,Department of Obstetrics and Gynecology, Drexel University College of Medicine
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Postpartum depression and social support in a racially and ethnically diverse population of women. Arch Womens Ment Health 2019; 22:105-114. [PMID: 29968129 PMCID: PMC6800248 DOI: 10.1007/s00737-018-0882-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 06/22/2018] [Indexed: 01/07/2023]
Abstract
Lack of social support is an important risk factor for postpartum depression (PPD), whereas the presence of social support can buffer against PPD. However, the relationship between social support and PPD in racial/ethnic minority women is still largely unknown. Our purpose was to examine the role of social support in a large, diverse population of PPD cases and controls. Participants (N = 1517) were recruited at the routine 6-week postpartum visit (± 1-2 weeks) from four different outpatient clinics in North Carolina. Case status was determined using the MINI International Neuropsychiatric Interview. Social support was measured using the Medical Outcomes Social (MOS) Support survey and the Baby's Father Support Scale (DAD). We found that higher levels of social support had a strong protective association against PPD (MOS total score OR, 0.23; 95% CI, 0.19-0.27; p = 6.92E-90; DAD total score OR, 0.89; 95% CI, 0.88-0.92; p = 1.69E-29), and the effects of social support did not differ when accounting for race/ethnicity. Additionally, PPD symptom severity is significantly and negatively correlated with the degree of social support. Our findings suggest that multi-dimensional aspects of social support may be protective for racial/ethnic minority women. We believe this study is currently the largest and most robust characterizing PPD case status and its association with social support in a diverse cohort of mothers. Future work is required to understand how best to implement culturally sensitive interventions to increase social support in minority perinatal women.
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Pampaka D, Papatheodorou SI, AlSeaidan M, Al Wotayan R, Wright RJ, Buring JE, Dockery DW, Christophi CA. Postnatal depressive symptoms in women with and without antenatal depressive symptoms: results from a prospective cohort study. Arch Womens Ment Health 2019; 22:93-103. [PMID: 29971553 DOI: 10.1007/s00737-018-0880-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 06/22/2018] [Indexed: 01/01/2023]
Abstract
Evidence exists that the risk factors for depression in the antenatal and postnatal period may differ, but only a handful of studies looked at depression longitudinally. The aims of this study were (1) to estimate the prevalence of postnatal depressive symptoms in Kuwait where data about postnatal depression are scarce and identify its determinants and (2) to compare these risk factors between women who had experienced antenatal depressive symptoms and those that did not. Data collected in the TRansgenerational Assessment of Children's Environmental Risk (TRACER) Study in Kuwait were used in this analysis. The sample was restricted to the 1348 women who answered the Edinburgh Postnatal Depression Scale (EPDS) both antenatally and postnatally. The prevalence of postnatal depressive symptoms, defined by an EPDS score ≥ 10, was 11.7%. Overall, antenatal depressive symptoms were the strongest determinant of postnatal depressive symptoms. Multivariable logistic regression analysis showed that in women with depressive symptoms in pregnancy, having a lower household income was the most significant risk factor for postnatal depressive symptoms. Among women without antenatal depressive symptoms, those who had lower income, were Kuwaitis, experienced other problems in pregnancy such as perceived stress, PTSD symptoms and social isolation, and those who delivered a boy had higher odds of postnatal depressive symptoms. Antenatal depressive symptoms and other psychosocial characteristics can predict postnatal depressive symptoms. Therefore, maternal mental health issues should be detected during the antenatal period and support should be provided in order to lower the risk of postnatal depression and its sequelae.
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Affiliation(s)
- Despina Pampaka
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.
| | - Stefania I Papatheodorou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus
| | | | | | - Rosalind J Wright
- Department of Pediatrics and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Douglas W Dockery
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Light AE, Holt-Lunstad J, Porter CL, Light KC. Early life trauma: An exploratory study of effects on OXTR and NR3C1 gene expression and nurturing self-efficacy in mothers of infants. Int J Psychophysiol 2019; 136:64-72. [DOI: 10.1016/j.ijpsycho.2018.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/09/2018] [Accepted: 03/22/2018] [Indexed: 12/14/2022]
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Hollins Martin CJ, Anderson L, Martin CR. A scoping review to determine themes that represent perceptions of self as mother ('ideal mother' vs 'real mother'). J Reprod Infant Psychol 2018; 37:224-241. [PMID: 30554526 DOI: 10.1080/02646838.2018.1556786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Postnatal depression (PND) is a key cause of maternal morbidity, with current systems of initial recognition in the UK detecting only 50% of cases. In attempts to predict those potentially at risk, this review suggests a novel approach. Aim: Implementing the concept of 'ideal mother' versus 'real mother', and asking the woman to compare their 'ideal self' against 'existent self', the aim of this instrument development review was to determine themes from the literature that relate to women's perceptions of self as a mother, and from this identification develop questions for inclusion within a proposed new measure entitled the Self-Image as Mother Scale (SIMS). Method: A scoping review of the literature was carried out to identify themes considered to affect perception of self as mother, and from this identification, evidence-based questions for inclusion in the SIMS were developed. Findings: Themes identified included (1) marital dissatisfaction, (2) inadequate partner support, (3) lack of family support, (4) socioeconomic status and associated poverty, (5) concern about infant, (6) antenatal/postnatal complications, (7) acceptance of infant gender, (8) history of mental health problems, (9) unplanned pregnancy. Conclusions: From this scoping review 18 questions were developed for inclusion in the SIMS, which will then be evaluated for psychometric properties, scale refinement and validation.
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Affiliation(s)
- Caroline J Hollins Martin
- a Maternal Health, School of Nursing, Midwifery and Social Care , Edinburgh Napier University (ENU), Sighthill Campus , Edinburgh , UK
| | - Lara Anderson
- b School of Nursing, Midwifery and Social Care , Edinburgh Napier University (ENU), Sighthill Campus , Edinburgh , UK
| | - Colin R Martin
- c Perinatal Mental Health , Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull , UK
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Blais L, Salah Ahmed SI, Beauchesne MF, Forget A, Kettani FZ, Lavoie KL. Risk of Postpartum Depression Among Women with Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 7:925-933.e2. [PMID: 30292921 DOI: 10.1016/j.jaip.2018.09.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several epidemiological studies have suggested that the risk of depression is increased in patients with asthma, but the impact of asthma during pregnancy on postpartum depression remains unknown. OBJECTIVE To assess the association between maternal asthma and postpartum depression in a population-based cohort study retrieved from administrative databases. METHODS A cohort of 35,520 pregnancies in women with asthma during pregnancy and 197,057 pregnancies in women without asthma who delivered between 1998 and 2009 was extracted from the Quebec Asthma and Pregnancy Database. They were followed from the day of delivery up to 1 year postpartum. A generalized estimating equation model was used to estimate the adjusted odds ratios of postpartum depression with 95% CIs in women with asthma during pregnancy versus women without asthma. RESULTS Postpartum depression within 1 year after delivery occurred in 6.1% of women with asthma versus 2.9% of women without asthma. After adjusting for several potential confounders, including depression/postpartum depression up to 10 years before pregnancy, we found that women with asthma were 58% more likely to experience postpartum depression within 1 year after delivery than women without asthma during pregnancy (adjusted odds ratio, 1.58; 95% CI, 1.50-1.67). CONCLUSIONS Our findings suggest that women with asthma are more likely to suffer from postpartum depression. A close monitoring of signs of depression for pregnant women with asthma is indicated, allowing prompt and efficient interventions if needed.
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Affiliation(s)
- Lucie Blais
- Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Ile-de-Montréal, Montréal, Québec, Canada.
| | | | - Marie-France Beauchesne
- Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada; Research Center, CIUSSS de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Amélie Forget
- Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
| | | | - Kim L Lavoie
- Research Center, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Ile-de-Montréal, Montréal, Québec, Canada; Montreal Behavioral Medicine Center, Montréal, Québec, Canada; Psychology Department, Université du Québec à Montréal, Montréal, Québec, Canada
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Arrais ADR, Araujo TCCFD, Schiavo RDA. Fatores de Risco e Proteção Associados à Depressão Pós-Parto no Pré-Natal Psicológico. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2018. [DOI: 10.1590/1982-3703003342016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo: Esta investigação teve por objetivos gerais: a) identificar fatores de risco e de proteção associados à Depressão Pós-Parto (DPP); e b) avaliar a contribuição do Pré-Natal Psicológico (PNP) como programa de prevenção em Saúde da Mulher. Para tanto, empreendeu-se uma pesquisa-ação organizada em três fases, reunindo um total de 198 gestantes. Na última fase, as participantes foram distribuídas em Grupo Intervenção – GI (n = 47) e Grupo Controle – GC (n = 29). Para coleta de dados, utilizaram-se: Questionário Gestacional, BAI, BDI-II e EPDS. Os dados foram submetidos a análises estatísticas descritivas e comparativas. Não foi possível relacionar variáveis socioeconômicas, participação no PNP e desejo de gravidez com maior risco de DPP. Em contrapartida, verificou-se tal associação quanto a gravidez não planejada e a falta de apoio do pai do bebê. Contrariamente ao GC, não se constatou associação entre ansiedade e depressão gestacionais com a DPP no GI. Nesse grupo, 10,64% das puérperas revelaram tendência para DPP, ao passo que, em GC, 44,83% mostraram tal propensão. Em suma, considera-se que o PNP, somado a fatores de proteção, constitui ação preventiva a ser desenvolvida pelo profissional de Psicologia no contexto do acompanhamento pré e pós-natal.
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Song C, Li W, Leng J, Wang L, Li W, Shi F, Liu G, Zhou J, Yang X. Passive smoking and postpartum depression among Chinese women: A prospective cohort study in Tianjin, China. Women Health 2018; 59:281-293. [PMID: 29924720 DOI: 10.1080/03630242.2018.1478365] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Smoking has been associated with depression in the general population. Whether passive smoking is also associated with postpartum depression (PPD) is uncertain. From 2010 to 2012, we recruited 8,842 pregnant women in Tianjin, China. The mainland Chinese version of the Edinburgh Postnatal Depression Scale was used to evaluate postpartum depressive symptoms after birth, with a score of >9 defining PPD. Data were collected using specially designed questionnaires or data from the electronic database of Tianjin Maternal and Child Health Information System. Odds ratios (OR) and 95 percent confidence intervals (CI) were obtained for the association of smoking status with PPD using binary logistic regression. Passive smoke exposure rates before and during pregnancy were 40.9 percent and 52.1 percent, respectively. A total of 8.5% (n = 747) of participants had PPD. Compared with those not exposed, women passively exposed to smoke before and during pregnancy had higher odds of PPD (before pregnancy: OR: 1.24, 95 percent CI: 1.03-1.50; during pregnancy: OR: 1.43, 95 percent CI: 1.16-1.77) after adjustment for confounding factors. Passive smoking before and during pregnancy were associated with PPD in Chinese women. Reducing passive smoke exposure may reduce PPD in Chinese women; further longitudinal studies are warranted to replicate these findings.
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Affiliation(s)
- Chunhua Song
- a Department of Epidemiology and Biostatistics, School of Public Health , Tianjin Medical University , Tianjin , China.,b Center for Disease Control and Prevention of Tianjin Economic-Technological Development Area (TEDA) , Tianjin , China
| | - Wei Li
- c Tianjin Women and Children's Health Center , Tianjin , China
| | - Junhong Leng
- c Tianjin Women and Children's Health Center , Tianjin , China
| | - Leishen Wang
- c Tianjin Women and Children's Health Center , Tianjin , China
| | - Weiqin Li
- c Tianjin Women and Children's Health Center , Tianjin , China
| | - Fenglan Shi
- d Tianjin He Ping Women and Children's Health Centre , Tianjin , China
| | - Guifeng Liu
- e Tianjin Nan Kai Women and Children's Health Centre , Tianjin , China
| | - Juan Zhou
- f Tianjin Hong Qiao Disease Control and Prevention Center , Tianjin , China
| | - Xilin Yang
- a Department of Epidemiology and Biostatistics, School of Public Health , Tianjin Medical University , Tianjin , China
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Feasibility of a mindfulness-based cognitive therapy group intervention as an adjunctive treatment for postpartum depression and anxiety. J Affect Disord 2018; 235:61-67. [PMID: 29653295 DOI: 10.1016/j.jad.2017.12.065] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/23/2017] [Accepted: 12/31/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Many women experience moderate-to-severe depression and anxiety in the postpartum period for which pharmacotherapy is often the first-line treatment. Many breastfeeding mothers are reticent to increase their dose or consider additional medication, despite incomplete response, due to potential adverse effects on their newborn. These mothers are amenable to non-pharmacological intervention for complete symptom remission. The current study evaluated the feasibility of an eight-week mindfulness-based cognitive therapy (MBCT) intervention as an adjunctive treatment for postpartum depression and anxiety. METHODS Women were recruited at an outpatient reproductive mental health clinic based at a maternity hospital. Participants had a diagnosis of postpartum depression/anxiety within the first year following childbirth. They were enrolled in either the MBCT intervention group (n = 14) or the treatment-as-usual control group (n = 16), and completed the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and the Mindful Attention Awareness Scale (MAAS) at baseline and at 4 weeks, 8 weeks, and 3 months following baseline. RESULTS Multivariate analyses demonstrated that depression and anxiety levels decreased, and mindfulness levels increased, in the MBCT group, but not in the control group. Many of the between-group and over time comparisons displayed trends towards significance, although these differences were not always statistically significant. Additionally, the effect sizes for anxiety, depression, and mindfulness were frequently large, indicating that the MBCT intervention may have had a clinically significant effect on participants. LIMITATIONS Limitations include small sample size and the non-equivalent control group design. CONCLUSIONS We demonstrated that MBCT has potential as an adjunctive, non-pharmacological treatment for postpartum depression/anxiety that does not wholly remit with pharmacotherapy. (249 words).
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Prevalence of Antenatal Depression and Associated Factors among Pregnant Women Attending Antenatal Care at Dubti Hospital: A Case of Pastoralist Region in Northeast Ethiopia. DEPRESSION RESEARCH AND TREATMENT 2018; 2018:1659089. [PMID: 30906594 PMCID: PMC6398073 DOI: 10.1155/2018/1659089] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 08/25/2018] [Accepted: 09/18/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Globally, depression affects an estimated 10 % to 20% of women during pregnancy. There is limited evidence on antenatal depression in Northeast Ethiopia. This study aimed to assess prevalence of antenatal depression and associated factors among Dubti Hospital Antenatal care attendants. METHODS Institution based cross-sectional study was conducted among 363 Antenatal care attendants at Dubti Hospital from March 07 to May 07, 2016. Beck's Depression Inventory tool was used to collect data. Data were entered into Epi-Data 3.1 and analyzed using SPSS 20. Bivariable and multivariable logistic regression analyses were fitted. Variables having p value < 0.05 were considered as statistically significant. RESULTS A total of 357 pregnant women were interviewed. The prevalence of antenatal depression was 17.9% [95% CI (14.0, 22.0%). Pregnancy planning [AOR: 0.04; 95% CI (0.014, 0.114), social support [AOR: 0.21; 95% CI (0.07, 0.66), and marital conflict [AOR: 6.45; 95% CI (2.1, 17.9)] were significantly associated with antenatal depression. CONCLUSIONS Nearly one in five pregnant women had depression. Marital conflict, pregnancy planning, and social support were significant predictors of antenatal depression. Dubti Hospital should strengthen its effort on prevention of unplanned pregnancy. Healthcare workers in antenatal care unit have to deal with marital conflict and social support as part of their routine investigation to avoid complications through early detection of antenatal depression.
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Zheng X, Morrell J, Watts K. A quantitative longitudinal study to explore factors which influence maternal self-efficacy among Chinese primiparous women during the initial postpartum period. Midwifery 2017; 59:39-46. [PMID: 29353690 DOI: 10.1016/j.midw.2017.12.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 10/15/2017] [Accepted: 12/21/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND parenting during infancy is highly problematic for Chinese primiparous women. As an important determinant of good parenting, maternal self-efficacy (MSE) should be paid more attention by researchers. At present, the limitations of previous research about MSE during infancy are that the factors which influence MSE remained poorly explored, there were few studies with Chinese women, and the studies did not consider the effect of different cultures. OBJECTIVES to explore factors which influence MSE in primiparous women in China in the first three months postnatally. METHODS a quantitative longitudinal study using questionnaires was conducted. In total, 420 Chinese primiparous women were recruited in obstetric wards at three hospitals in Xiamen City, Fujian Province of China. Initial baseline questionnaires to measure socio-demographic and clinical characteristics were distributed to participants face-to-face by the researcher on the postnatal ward at three days postnatally. Follow-up questionnaires at six and 12 weeks postnatally were sent via e-mail by the researcher to participants, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Social Support Scale (PSSS) to measure MSE, postnatal depression symptoms and social support, respectively. These were returned by participants via e-mail. Quantitative data were analysed using SPSS. RESULTS the variables: social support, women's satisfaction with 'Doing the month', postnatal depression, maternal education, baby health, and maternal occupation had an influence on MSE at six weeks postnatally (Adjusted R2 = 0.510, F = 46.084, P<0.01); and the variables: postnatal depression, social support, baby health, women's satisfaction with 'Doing the month', and baby fussiness were the factors influencing MSE at 12 weeks postnatally (Adjusted R2 = 0.485, F = 41.082, P<0.01). CONCLUSIONS obstetric nurses and women's family members need to be aware of the significant contribution of social support, women's satisfaction with 'Doing the month' in positively influencing primiparous women's MSE, and the significant effect of postnatal depression symptoms in negatively impacting on first-time mothers' MSE; they should pay more attention to primiparous women with less education, unemployed mothers, women with unskilled occupations, women with an unhealthy baby, and women with a baby with a difficult temperament to improve their comparatively lower MSE levels during the initial postnatal period.
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Affiliation(s)
- Xujuan Zheng
- Shenzhen University, Health Science Center, China.
| | - Jane Morrell
- School of Health Sciences, The University of Nottingham, UK
| | - Kim Watts
- Florence Nightingale School of Nursing and Midwifery, King's College London, UK
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Norhayati MN, Azman Yacob M. Long-term postpartum effect of severe maternal morbidity on sexual function. Int J Psychiatry Med 2017; 52:328-344. [PMID: 29117756 DOI: 10.1177/0091217417738933] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There was limited knowledge on the sexual function in women who have survived severe obstetric complications. The aim of this study was to compare the level of sexual functioning among women with and without severe morbidity at six months postpartum and to identify the factors associated with sexual function scores of women. A prospective double-cohort study design was applied at two tertiary hospitals over a six-month period. Postpartum women with and without severe maternal morbidity were selected as the exposed and the non-exposed group, respectively. The study included 145 exposed and 187 non-exposed women. Those with severe maternal morbidity were significantly ( P < 0.001) older (mean (SD): 31.6 years (6.26) vs. 29.2 years (5.65)) and had longer hospital stays (mean (SD): 5.9 days (3.79) vs. 3.6 days (2.23)). They were also more likely to have delivered preterm (75.9 vs. 93.0) and to have had a caesarean section (80.7 vs. 67.9) than those without severe maternal morbidity. After adjusting for age and mental health, there was no significant difference in Female Sexual Function Index scores ( P = 0.895) between the two groups. Both groups showed the highest sexual dysfunction in pain and the lowest dysfunction in orgasm. Linear regression analyses showed no association between Female Sexual Function Index scores and sociodemographic characteristics, reproductive history, or quality of life. Sexual function in women with severe maternal morbidity did not differ from that in women without severe maternal morbidity. In-depth qualitative studies of women who have experienced potentially life-threatening conditions may improve the understanding of their sexual function.
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Affiliation(s)
- Mohd Noor Norhayati
- 1 Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohd Azman Yacob
- 2 Hospital Raja Perempuan Zainab II Hospital, Kelantan, Malaysia
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Fellmeth G, Fazel M, Plugge E. Migration and perinatal mental health in women from low- and middle-income countries: a systematic review and meta-analysis. BJOG 2017; 124:742-752. [PMID: 27320110 DOI: 10.1111/1471-0528.14184] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Migrant women are at risk of perinatal mental disorders due to stressors experienced before, during and after migration. OBJECTIVES This systematic review and meta-analysis summarises the prevalence, associated factors and interventions for perinatal mental disorders in migrant women from low- and middle-income countries (LMIC). SEARCH STRATEGY We systematically searched nine electronic databases and the grey literature using a predefined search strategy. SELECTION CRITERIA Studies were included if they assessed pregnant or postpartum migrants from LMIC, used a structured tool and a case-control, cross-sectional, cohort or intervention study design. DATA COLLECTION AND ANALYSIS Data was double-extracted. We calculated pooled prevalence of depression and weighted mean anxiety and depression scores. We calculated crude odds ratios from risk factor studies and summarised intervention studies descriptively. MAIN RESULTS Forty studies were identified from 10 123 references. Pooled prevalence was 31% [95% condidence interval (CI) 23%-40%] for any depressive disorder and 17% (95% CI 12-23%) for major depressive disorder. Previous depression and lower social support were associated with perinatal depression. There were insufficient data to assess the burden of anxiety, post-traumatic stress disorder or psychosis in this population. CONCLUSIONS One in three migrant women from LMIC experiences symptoms of perinatal depression. Social support is an important protective factor. Evidence on LMIC women relocating to other LMIC is lacking. Given the adverse consequences of perinatal mental illness on women and their children, further research in low-resource settings is a priority. TWEETABLE ABSTRACT One in three migrant women from low- and middle-income countries has symptoms of perinatal depression.
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Affiliation(s)
- G Fellmeth
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - M Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - E Plugge
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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Khajehei M, Doherty M. Exploring postnatal depression, sexual dysfunction and relationship dissatisfaction in Australian women. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/bjom.2017.25.3.162] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Marjan Khajehei
- Clinical midwifery consultant – women's health research, Westmead Hospital, Westmead, Sydney, Australia
| | - Maryanne Doherty
- Associate professor, Curtin University, Perth, Western Australia
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Baka J, Csakvari E, Huzian O, Dobos N, Siklos L, Leranth C, MacLusky NJ, Duman RS, Hajszan T. Stress induces equivalent remodeling of hippocampal spine synapses in a simulated postpartum environment and in a female rat model of major depression. Neuroscience 2017; 343:384-397. [PMID: 28012870 PMCID: PMC5421158 DOI: 10.1016/j.neuroscience.2016.12.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 12/11/2016] [Accepted: 12/13/2016] [Indexed: 12/24/2022]
Abstract
Stress and withdrawal of female reproductive hormones are known risk factors of postpartum depression. Although both of these factors are capable of powerfully modulating neuronal plasticity, there is no direct electron microscopic evidence of hippocampal spine synapse remodeling in postpartum depression. To address this issue, hormonal conditions of pregnancy and postpartum period were simulated in ovariectomized adult female Sprague-Dawley rats (n=76). The number of hippocampal spine synapses and the depressive behavior of rats in an active escape task were investigated in untreated control, hormone-withdrawn 'postpartum', simulated proestrus, and hormone-treated 'postpartum' animals. After 'postpartum' withdrawal of gonadal steroids, inescapable stress caused a loss of hippocampal spine synapses, which was related to poor escape performance in hormone-withdrawn 'postpartum' females. These responses were equivalent with the changes observed in untreated controls that is an established animal model of major depression. Maintaining proestrus levels of ovarian hormones during 'postpartum' stress exposure did not affect synaptic and behavioral responses to inescapable stress in simulated proestrus animals. By contrast, maintaining pregnancy levels of estradiol and progesterone during 'postpartum' stress exposure completely prevented the stress-induced loss of hippocampal spine synapses, which was associated with improved escape performance in hormone-treated 'postpartum' females. This protective effect appears to be mediated by a muted stress response as measured by serum corticosterone concentrations. In line with our emerging 'synaptogenic hypothesis' of depression, the loss of hippocampal spine synapses may be a novel perspective both in the pathomechanism and in the clinical management of postpartum affective illness.
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Affiliation(s)
- Judith Baka
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Eszter Csakvari
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Orsolya Huzian
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Nikoletta Dobos
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Laszlo Siklos
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary
| | - Csaba Leranth
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States; Department of Neuroscience, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States
| | - Neil J MacLusky
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, 50 Stone Road E, Guelph, Ontario N1G 2W1, Canada
| | - Ronald S Duman
- Department of Neuroscience, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States; Department of Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, CT 06508, United States
| | - Tibor Hajszan
- Institute of Biophysics, Biological Research Center, Hungarian Academy of Sciences, Temesvari Krt 62, 6726 Szeged, Hungary; Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States.
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Gauthreaux C, Negron J, Castellanos D, Ward-Peterson M, Castro G, Rodríguez de la Vega P, Acuña JM. The association between pregnancy intendedness and experiencing symptoms of postpartum depression among new mothers in the United States, 2009 to 2011: A secondary analysis of PRAMS data. Medicine (Baltimore) 2017; 96:e5851. [PMID: 28178128 PMCID: PMC5312985 DOI: 10.1097/md.0000000000005851] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Postpartum depression (PPD) is a form of major depressive disorder affecting approximately 13% of women worldwide. Unintended pregnancies, reaching close to 50% of the pregnancies in the United States, have become a major health concern. While many physiologic and psychosocial causes have been analyzed, few studies have examined the relationship between unintended pregnancy and symptoms of PPD.A cross-sectional study was conducted using surveillance data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) from 2009 to 2011. The PRAMS population-based random sample included women who have had recent live births and is representative of 78% of the United States population. The chi-squared test was used to examine bivariate associations. Binary logistic regression was utilized to study unadjusted and adjusted associations between PPD and pregnancy intendedness, as well as other demographic and clinical characteristics of mothers in the sample. Multicollinearity in the adjusted model was evaluated using variance inflation factors. Sampling weights were used to account for PRAMS' complex sampling design.Of the 110,231 mothers included in the sample, only 32.3% reported desiring the pregnancy at the time of conception. Women with pregnancies categorized as mistimed: desired sooner, mistimed: desired later, or unwanted were 20% (adjusted odds ratio [AOR] = 1.2; 95% confidence interval [CI]: 1.1-1.3), 30% (AOR = 1.3; 95% CI: 1.2-1.4), and 50% (AOR = 1.5; 95% CI: 1.3-1.7) more likely to experience symptoms of PPD, respectively, compared to women with desired pregnancies. Other factors found to be associated with experiencing symptoms of PPD were a gestational age of <27 weeks (AOR = 3.1; 95% CI: 2.5-4.0), having a previous history of depression (AOR = 1.8; 95% CI: 1.6-2.0), and being abused during or before pregnancy (AOR = 1.6; 95% CI: 1.4-2.0).We found that women with mistimed or unwanted pregnancies were more likely to experience symptoms of PPD. Our findings support the current US Preventive Services Task Force and American Academy of Pediatrics recommendations for an integrated approach to screening for depression, aiding in the maximization of intervention and early referral for women at risk for PPD.
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Affiliation(s)
| | - Jenesis Negron
- Herbert Wertheim College of Medicine, Florida International University
| | - Daniel Castellanos
- Department of Psychiatry and Behavioral Health, Herbert Wertheim College of Medicine, Florida International University
| | - Melissa Ward-Peterson
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University
| | - Grettel Castro
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University
| | - Pura Rodríguez de la Vega
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University
| | - Juan Manuel Acuña
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University
- Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
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Norhayati MN, Nik Hazlina NH, Aniza AA. Immediate and long-term relationship between severe maternal morbidity and health-related quality of life: a prospective double cohort comparison study. BMC Public Health 2016; 16:818. [PMID: 27538506 PMCID: PMC4990872 DOI: 10.1186/s12889-016-3524-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/15/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Given the growing interest in severe maternal morbidity (SMM), the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia. METHODS A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12). RESULTS The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA) showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534) between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674) between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031), role limitations due to physical health subscale at 6-month (P = 0.019), vitality subscale at 1-month (P = 0.007) and 6-month (P = 0.008), and role limitations due to emotional problems subscales at 6-month (P = 0.008). CONCLUSIONS Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity.
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Affiliation(s)
- Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia.
| | - Nik Hussain Nik Hazlina
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
| | - Abd Aziz Aniza
- Faculty of Medicine, Universiti Sultan Zainal Abidin, 20400, Kuala Terengganu, Terengganu, Malaysia
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50
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Pope CJ, Mazmanian D, Bédard M, Sharma V. Breastfeeding and postpartum depression: Assessing the influence of breastfeeding intention and other risk factors. J Affect Disord 2016; 200:45-50. [PMID: 27126139 DOI: 10.1016/j.jad.2016.04.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 04/11/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Risk and protective factors for postpartum depression have been extensively studied, and in recent studies an association between breastfeeding and maternal mood has been reported. The present retrospective, cross-sectional study was conducted to evaluate the association between breastfeeding-related variables and postpartum depression (based on Edinburgh Postnatal Depression Scale threshold criteria) within the context of other known risk factors. METHOD Breastfeeding information, demographic information, and scores on the Edinburgh Postnatal Depression Scale were examined from the Canadian Maternity Experience Survey. This survey contains data collected from 6421 Canadian mothers between October 2006 and January 2007, and 2848 women between five and seven months postpartum were included in the current analyses. RESULTS In contrast to previous research, logistic regression analyses revealed that when considered within the context of other risk factors, breastfeeding attempt and duration were not associated with postpartum depression at five to seven months postpartum. Although a relationship between the prenatal intention to combination feed and postpartum depression was observed, these variables were no longer related once other potential risk factors were controlled for. Factors that were associated with postpartum depression included lower income, higher perceived stress, lower perceived social support, no history of depression, or no recent history of abuse. LIMITATIONS A clinical diagnostic instrument was not used and variable selection was restricted to data collected as part of this survey. CONCLUSION These findings suggest that the association between breastfeeding and postpartum depression reported by previous researchers may in fact be due to alternative risk factors.
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Affiliation(s)
- Carley J Pope
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada.
| | - Dwight Mazmanian
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Michel Bédard
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Verinder Sharma
- Mood & Anxiety Program, Regional Mental Health Care, London, Ontario, Canada; Psychiatry and Obstetrics & Gynecology, Western University, London, Ontario, Canada
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