Depression, Anxiety, and Pharmacotherapy Around the Time of Pregnancy in Hawaii

Influencing factors of sleep quality in pregnant: a structural equation model approach

BACKGROUND

To describe the changes in the level of sleep quality during pregnancy among pregnant women in Urumqi; also to construct a structural equation model of the factors influencing the sleep quality of pregnant women, to analyze the path relationship between the influencing factors, and to take reasonable interventions to prevent and reduce the occurrence of sleep disorders among pregnant women.

METHODS

986 pregnant women who gave birth in Urumqi Maternal and Child Health Hospital and Urumqi Youai Hospital between August 2021 and May 2023 were selected. The Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Edinburgh Postpartum Depression Scale (EPDS) were used to assess the sleep, anxiety, and depression of pregnant women, Building a structural equation model based on AMOS 23.0 Tools.

RESULTS

The results of structural equation modeling showed that: basic characteristics, obstetrical characteristics, tocolysis, lifestyle, psychological had a direct effect on the PSQI, with path coefficients of 0.243, 0.106, 0.140, 0.174, 0.658, the corresponding T-values for each path are 4.585, 2.677, 2.578, 2.297, and 9.036. The indirect effect of basic characteristics, obstetric characteristics and lifestyle on PSQI was 0.123, 0.020, 0.027.

CONCLUSIONS

The high incidence of sleep disorders in pregnant women and their close association with psychological symptoms in pregnant women should focus on screening and counseling regarding psychological disorders in pregnant women, thus improving the quality of sleep in pregnant women.

Changing patterns of prenatal depression and anxiety status in different trimesters and modified form of Zung scales for pregnant women

BACKGROUND

We described the changing patterns of depression and anxiety status in different trimesters among Chinese pregnant women, and identified the modified form of SDS/SAS for pregnant women and assessed its reliability and validity.

METHODS

Changing patterns of depression/ anxiety status in different trimesters were described. The modified form of SDS/SAS was identified for pregnant women. Cohen's Kappa to measure agreement with SDS/SAS, and the ROC analysis was performed to assess its validity.

RESULTS

The SDS score in 1st trimester was higher than 2nd and 3rd trimester; there was no significant difference between SDS score in 2nd and 3rd trimester. Modified form of SDS evaluated the depression; the areas under the curve (AUC) in testing group were up to 0.988, 0.989 and 0.992 for 1st, 2nd and 3rd trimester, respectively. Modified form of SAS evaluated the anxiety, the AUC in testing group were up to 0.987, 0.985, 0.987 for 1st, 2nd and 3rd trimester, respectively.

CONCLUSION

Pregnant women had higher severity of depression and anxiety status in 1st trimester than that in 2nd and 3rd trimester. The modified form of SDS/SAS may be more brief and suitable to assess the depression and anxiety status in pregnant women.KEY POINTSPregnant women had a higher severity of depression and anxiety status in the 1st trimester than that in the 2nd and 3rd trimester.The present study suggests that prenatal depression and anxiety status are prevalent in Chinese pregnant women.Prevention or treatments focus on high-score items of SDS and SAS would be beneficial for rectifying prenatal depression and anxiety.

The Perinatal Mental Health of Indigenous Women: A Systematic Review and Meta-Analysis

OBJECTIVE

Although Indigenous women are exposed to high rates of risk factors for perinatal mental health problems, the magnitude of their risk is not known. This lack of data impedes the development of appropriate screening and treatment protocols, as well as the proper allocation of resources for Indigenous women. The objective of this systematic review and meta-analysis was to compare rates of perinatal mental health problems among Indigenous and non-Indigenous women.

METHODS

We searched Medline, EMBASE, PsycINFO, CINAHL, and Web of Science from their inceptions until February 2019. Studies were included if they assessed mental health in Indigenous women during pregnancy and/or up to 12 months postpartum.

RESULTS

Twenty-six articles met study inclusion criteria and 21 were eligible for meta-analysis. Indigenous identity was associated with higher odds of mental health problems (odds ratio [OR] 1.62; 95% confidence interval [CI], 1.25 to 2.11). Odds were higher still when analyses were restricted to problems of greater severity (OR 1.95; 95% CI, 1.21 to 3.16) and young Indigenous women (OR 1.86; 95% CI, 1.51 to 2.28).

CONCLUSION

Indigenous women are at increased risk of mental health problems during the perinatal period, particularly depression, anxiety, and substance misuse. However, resiliency among Indigenous women, cultural teachings, and methodological issues may be affecting estimates. Future research should utilize more representative samples, adapt and validate diagnostic and symptom measures for Indigenous groups, and engage Indigenous actors, leaders, and related allies to help improve the accuracy of estimates, as well as the well-being of Indigenous mothers, their families, and future generations.

TRIAL REGISTRATION

PROSPERO-CRD42018108638.

Depression, Anxiety, and Substance Use Disorders and Treatment Receipt Among Pregnant Women in the United States: A Systematic Review of Trend and Population-Based Studies

The objective of this systematic review was to synthesize findings of trend and population-based studies on depression, anxiety, and substance use disorders and treatment receipt among pregnant women in the United States. Twenty-eight articles (nine trend studies and 19 population-based studies) were included for review. Two trend studies showed that illicit drug use disorder increased in pregnant women over the past decade, particularly opioid and marijuana use disorders. Three studies reported an increase in treatment admissions for these disorders from 1992 to 2012; however, the overall treatment admission rate for pregnant women remained relatively stable at 4%. Three studies identified an increase in antidepressant use from 1995 to 2010 in pregnant women. Nine of 19 population-based studies revealed that White ethnicity, older reproductive age, college education, and health insurance coverage were associated with mental health and substance use treatment receipt among pregnant women. Further studies are warranted among a nationally representative sample of pregnant women.