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Ito Y, Nishi D. Antenatal and postpartum depression in women who conceived after infertility treatment: a longitudinal study. J Reprod Infant Psychol 2024:1-13. [PMID: 39044629 DOI: 10.1080/02646838.2024.2380416] [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: 12/12/2023] [Accepted: 06/30/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Although the association between a history of infertility treatment and perinatal depression has been investigated, most research has been cross-sectional and has not used diagnostic assessment tools. AIMS This study investigates longitudinally the association between a history of infertility treatment and perinatal depression using WHO-Composite International Diagnostic Interview 3.0 (WHO-CIDI 3.0) and the Edinburgh Postnatal Depression Scale (EPDS). METHODS This study used data (N = 2,435) from the control group of a randomised controlled trial on a sample of pregnant women. Survival analysis was used to examine the influence of infertility treatment on perinatal depressive disorder evaluated by WHO-CIDI 3.0. The EPDS scores at four time points (T1 [baseline]: 18 ± 2 weeks gestation, T2: 32 weeks gestation, T3: 1 week postpartum, T4: 3 months postpartum) were analysed using generalised mixed model analysis. RESULTS The risk of experiencing a major depressive episode evaluated by WHO-CIDI 3.0 did not significantly differ between women conceiving through infertility treatment and those conceiving spontaneously (adjusted hazard ratio = 1.64, p = 0.109). The longitudinal analysis demonstrated that EPDS scores significantly increased at T3 and T4 among women conceiving through infertility treatment compared with those conceiving spontaneously (adjusted estimates of fixed effect from T1 to T3: 1.17, p < 0.01; from T1 to T4: 0.71, p = 0.022). CONCLUSION Women conceiving through infertility treatment were not found to have a higher risk of diagnosable perinatal depressive disorder than those conceiving naturally. However, a history of infertility treatment can marginally increase sub-clinical postpartum depressive symptoms.
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Affiliation(s)
- Yuka Ito
- Department of Mental Health, Graduate School of Medicine, the University of Tokyo, Tokyo , Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, the University of Tokyo, Tokyo , Japan
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Gupta M, Patra M, Hamiduzzaman M, McLaren H, Patmisari E. Social Support Postpartum: Bengali Women from India on Their Coping Experiences following Childbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:557. [PMID: 38791772 PMCID: PMC11121678 DOI: 10.3390/ijerph21050557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
Undertaken in Kolkata, India, our study aimed to explore the experiences of Bengali middle-class women on perceived stressful events, social support, and coping experiences following childbirth. Becoming a mother following childbirth is a shared phenomenon irrespective of culture, social strata, or country, while stress during the postpartum period or depression is not. Discrete medical intervention does not sufficiently address the complexities of postpartum experiences since influencing factors also include economic, political, cultural, and social backgrounds. Adopting a feminist and phenomenological approach, individual in-person interviews were conducted with twenty women recruited via snowball sampling. Our findings revealed that events experienced as stressful may lead to poor postpartum well-being. Underpinned by gendered discourse and biases, stressful events included familial imperatives for a male child, poor social and emotional support from the family, mostly partners and fathers, and systemic workplace barriers. The women in our study commonly resided with their mothers postpartum. They expressed feeling sheltered from these experiences, cared for, and supported. We discuss the women's experiences from a feminist pragmatic worldview, which advocates for a flexible feminism recognizant of the unique and nurturing relationship experiences between Bengali middle-class women and their mothers. In conclusion, we advocate for culturally sensitive, women-centered postpartum care practices that may entail the inclusion of intergenerational care during this critical phase of maternal well-being. These insights underscore the necessity of tailoring postpartum support systems to align with the cultural and familial contexts of the individuals they serve.
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Affiliation(s)
- Moumita Gupta
- Department of Anthropology, Dr. A.P.J. Abdul Kalam Government College, West Bengal State University, Rajarhat, Kolkata 7000163, India;
| | - Mahua Patra
- Department of Sociology, Maulana Azad College, University of Calcutta, Kolkata 700013, India;
| | - Mohammad Hamiduzzaman
- University Centre for Rural Health, School of Health Sciences, Faculty of Medicine & Health, The University of Sydney, Lismore, NSW 2480, Australia
| | - Helen McLaren
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA 5042, Australia
| | - Emi Patmisari
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA 5042, Australia
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3
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Ding X, Liang M, Wang H, Song Q, Guo X, Su W, Li N, Liu H, Ma S, Zhou X, Sun Y. Prenatal stressful life events increase the prevalence of postpartum depression: Evidence from prospective cohort studies. J Psychiatr Res 2023; 160:263-271. [PMID: 36889197 DOI: 10.1016/j.jpsychires.2023.02.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 03/10/2023]
Abstract
Postpartum depression (PPD) occurs frequently among postpartum women. Stressful life events (SLE) have gradually been recognized as risk factors for PPD. However, research on this topic has produced equivocal results. The purpose of this study was to explore whether women who experienced prenatal SLE had a higher prevalence of PPD. Electronic databases were systematically searched until October 2021. Only prospective cohort studies were included. Pooled prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using random effects models. This meta-analysis included 17 studies involving 9822 individuals. Women who experienced prenatal SLE had a higher prevalence for PPD (PR = 1.82, 95%CI = 1.52-2.17). In subgroup analyses, a 112% and 78% higher prevalence of depressive disorders (PR = 2.12, 95%CI = 1.34-3.38) and depressive symptoms (PR = 1.78, 95%CI = 1.47-2.17) were detected in women who experienced prenatal SLE. The effect of SLE on PPD at postpartum different time points differed: PR = 3.25 (95%CI = 2.01-5.25) for ≤6 weeks, PR = 2.01 (95%CI = 1.53-2.65) for 7-12 weeks, PR = 1.17 (95%CI = 0.49-2.31) for >12 weeks. No obvious publication bias was detected. The findings support that prenatal SLE increase the prevalence of PPD. The effect of SLE on PPD tends to slightly decrease during the postpartum period. Furthermore, these findings highlight the importance of screening for PPD as early as possible, particularly among postpartum women who have experienced SLE.
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Affiliation(s)
- Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiaoqin Zhou
- Department of Psychiatry, Chaohu Hospital/Anhui Psychiatric Center, Anhui Medical University, Hefei, 238000, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Chaohu Hospital, Anhui Medical University, Hefei, 238000, China; Centre for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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Nwoke CN, Awosoga OA, McDonald S, Bonifacio GT, Leung BMY. Prevalence and Associated Factors of Maternal Depression and Anxiety Among African Immigrant Women in Alberta, Canada: Quantitative Cross-sectional Survey Study. JMIR Form Res 2023; 7:e43800. [PMID: 36808093 PMCID: PMC9989913 DOI: 10.2196/43800] [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: 10/25/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Although there is a significant body of evidence on maternal mental health, an inadequate focus has been placed on African immigrant women. This is a significant limitation given the rapidly changing demographics in Canada. The prevalence of maternal depression and anxiety among African immigrant women in Alberta and Canada, as well as the associated risk factors, are not well understood and remain largely unknown. OBJECTIVE The purpose of this study was to investigate the prevalence and associated factors of maternal depression and anxiety among African immigrant women living in Alberta, Canada up to 2 years postpartum. METHODS This cross-sectional study surveyed 120 African immigrant women within 2 years of delivery in Alberta, Canada from January 2020 to December 2020. The English version of the Edinburgh Postnatal Depression Scale-10 (EPDS-10), the Generalized Anxiety Disorder-7 (GAD-7) scale, and a structured questionnaire regarding associated factors were administered to all participants. A cutoff score of 13 on the EPDS-10 was indicative of depression, while a cutoff score of 10 on the GAD-7 scale was indicative of anxiety. Multivariable logistic regression was used to determine the factors significantly associated with maternal depression and anxiety. RESULTS Among the 120 African immigrant women, 27.5% (33/120) met the EPDS-10 cutoff score for depression and 12.1% (14/116) met the GAD-7 cutoff score for anxiety. The majority of respondents with maternal depression were younger (18/33, 56%), had a total household income of CAD $60,000 or more (US $45,000 or more; 21/32, 66%), rented their homes (24/33, 73%), had an advanced degree (19/33, 58%), were married (26/31, 84%), were recent immigrants (19/30, 63%), had friends in the city (21/31, 68%), had a weak sense of belonging in the local community (26/31, 84%), were satisfied with their settlement process (17/28, 61%), and had access to a regular medical doctor (20/29, 69%). In addition, the majority of respondents with maternal anxiety were nonrecent immigrants (9/14, 64%), had friends in the city (8/13, 62%), had a weak sense of belonging in the local community (12/13, 92%), and had access to a regular medical doctor (7/12, 58%). The multivariable logistic regression model identified demographic and social factors significantly associated with maternal depression (maternal age, working status, presence of friends in the city, and access to a regular medical doctor) and maternal anxiety (access to a regular medical doctor and sense of belonging in the local community). CONCLUSIONS Social support and community belonging initiatives may improve the maternal mental health outcomes of African immigrant women. Given the complexities immigrant women face, more research is needed on a comprehensive approach for public health and preventive strategies regarding maternal mental health after migration, including increasing access to family doctors.
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Affiliation(s)
| | | | - Sheila McDonald
- Department of Pediatrics and Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Glenda T Bonifacio
- Department of Women and Gender Studies, University of Lethbridge, Lethbridge, AB, Canada
| | - Brenda M Y Leung
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
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Postpartum depression and ADHD in the offspring: Systematic review and meta-analysis. J Affect Disord 2022; 318:314-330. [PMID: 36096371 DOI: 10.1016/j.jad.2022.08.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/08/2022] [Accepted: 08/21/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is a disorder that has a severe impact on a woman's mental state and mood after birth. Research has shown that postnatal levels of family adversity and maternal psychopathology are associated with Attention Deficit Hyperactivity Disorder (ADHD). This paper is intended to examine the association among maternal PPD and the risk of ADHD in the offspring. METHODS Keyword search was conducted for PsycINFO, PubMed, Google Scholar, and Embase up to Feb 28, 2021; studies in English were deemed eligible. Random-effects meta-analysis and meta-regression analysis took place. Subgroup analyses by study design, geographical region, level of adjustment and study setting were performed. RESULTS Nine cohort studies and two case-control studies published from 2003 to 2019 were included in the qualitative synthesis; among them, eight studies were synthesized in the meta-analysis. Overall, maternal PPD was associated with an increased risk of ADHD in the offspring (pooled relative risk, RR = 1.69, 95%CI: 1.27-2.26). Significant associations were noted in the subsets of cohort studies, studies implementing multivariate analyses and registry-based surveys. LIMITATIONS Overall, a larger number of studies of the field are needed. Data collection relied on self-report and attrition bias limited the validity of eligible studies. Studies from developing countries were underrepresented. There was significant publication bias (p = 0.035, Egger's test). CONCLUSIONS The relationship between PPD and ADHD in children was found to be significant in this systematic review and meta-analysis and reveals the need for further investigation in various geographical regions.
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Simoni MK, Gilstad-Hayden K, Naqvi SH, Pal L, Yonkers KA. Progression of depression and anxiety symptoms in pregnancies conceived by assisted reproductive technology in the United States. J Psychosom Obstet Gynaecol 2022; 43:214-223. [PMID: 34472405 PMCID: PMC10116357 DOI: 10.1080/0167482x.2021.1971193] [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] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Women who utilize assisted-reproductive technology (ART) to achieve pregnancy experience unique circumstances before and during their pregnancy. This study aims to examine the progression of mental health in pregnant women who conceived via various methods of ART to understand gestational time periods of emotional stability or risk specific to these populations. METHODS Secondary analysis of the Yale Pink and Blue Study - a prospective cohort involving women from 137 obstetrical practices in the northeastern United States between 2005-2009. Depressive and anxiety symptoms among spontaneous, planned pregnancies were compared to ART pregnancies using the Edinburgh Postnatal Depression Scale (EPDS) and its anxiety subscale (EPDS-3A), respectively. Generalized Estimating Equations were used to compare group changes (EPDS and EPDS-3A score threshold ≥10) at timepoints of <17 weeks (T1), 28(±2) weeks (T2), and 8(±4) weeks postpartum (T3). RESULTS 1,466 spontaneous, planned pregnancies were compared to 191 pregnancies conceived via ART. Prevalence of depressive symptoms were similar between conception groups. Change in prevalence over time differed significantly between those groups (from T1 to T3 (β 0.59), as well as between spontaneous pregnancies compared to autologous gamete ART pregnancies (from T1 to T2 (β 0.48) and T1 to T3 (β 0.65). Course of anxiety did not differ between conception groups. CONCLUSIONS Women who conceive via ART have different rates of change in depressive symptoms throughout gestation compared to women with spontaneous pregnancies.
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Affiliation(s)
- Michael K Simoni
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT USA
| | | | - Syed H Naqvi
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT USA
| | - Lubna Pal
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT USA
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Li S, Wang L, Wang W, Hou S, Xie C, Zeng M, Xian J, Cai Z, Zhao Y. Comparison of sleep quality among puerperal women before and during the COVID-19 pandemic: a cross-sectional survey in Lanzhou, China. Sleep Breath 2022; 26:1829-1836. [PMID: 35059980 PMCID: PMC8776371 DOI: 10.1007/s11325-021-02553-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/10/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
Purpose Methods Results Conclusions
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Affiliation(s)
- Shengping Li
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Lianlian Wang
- The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenling Wang
- Perinatology Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China
| | - Shengzhe Hou
- The Second Clinical College, Chongqing Medical University, Chongqing, China
| | - Changxiao Xie
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Mao Zeng
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Jinli Xian
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Zhengjie Cai
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Yi xueyuan Road, Yu zhong District, Chongqing, 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, Chongqing, China.
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Putnick DL, Sundaram R, Bell EM, Ghassabian A, Goldstein RB, Robinson SL, Vafai Y, Gilman SE, Yeung E. Trajectories of Maternal Postpartum Depressive Symptoms. Pediatrics 2020; 146:peds.2020-0857. [PMID: 33109744 PMCID: PMC7772818 DOI: 10.1542/peds.2020-0857] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To identify homogenous depressive symptom trajectories over the postpartum period and the demographic and perinatal factors linked to different trajectories. METHODS Mothers (N = 4866) were recruited for Upstate KIDS, a population-based birth cohort study, and provided assessments of depressive symptoms at 4, 12, 24, and 36 months postpartum. Maternal demographic and perinatal conditions were obtained from vital records and/or maternal report. RESULTS Four depression trajectories were identified: low-stable (74.7%), characterized by low symptoms at all waves; low-increasing (8.2%), characterized by initially low but increasing symptoms; medium-decreasing (12.6%), characterized by initially moderate but remitting symptoms; and high-persistent (4.5%), characterized by high symptoms at all waves. Compared with the high-persistent group, older mothers (maximum odds ratio [OR] of the 3 comparisons: 1.10; 95% confidence interval [CI]: 1.05 to 1.15) or those with college education (maximum OR: 2.52; 95% CI: 1.36 to 4.68) were more likely to be in all other symptom groups, and mothers who had a history of mood disorder (minimum OR: 0.07; 95% CI: 0.04 to 0.10) or gestational diabetes mellitus diagnosis (minimum OR: 0.23; 95% CI: 0.08 to 0.68) were less likely to be in other symptom groups. Infertility treatment, multiple births, prepregnancy BMI, gestational hypertension, and infant sex were not differentially associated with depressive symptom trajectories. CONCLUSIONS One-quarter of mothers in a population-based birth cohort had elevated depressive symptoms in 3 years postpartum. Screening for maternal depression beyond the postpartum period may be warranted, particularly after mood and diabetic disorders.
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Affiliation(s)
| | | | - Erin M. Bell
- Department of Environmental Health Sciences, School of Public Health, University at Albany, Albany, New York
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, Grossman School of Medicine, New York University, New York, New York; and
| | - Risë B. Goldstein
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | | | | | - Stephen E. Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland;,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Association between infertility treatment and perinatal depressive symptoms: A meta-analysis of observational studies. J Psychosom Res 2019; 120:110-117. [PMID: 30929701 DOI: 10.1016/j.jpsychores.2019.03.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/15/2019] [Accepted: 03/16/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Recent reports have shown a considerable number of couples received infertility treatment, raising new concerns about the association between infertility treatment and perinatal depressive symptoms. However, the conclusions of existing studies were inconsistent. Therefore, we conducted a meta-analysis to determine whether infertility treatment increase the risk of developing perinatal depressive symptoms. METHODS A systematic literature search was performed in several databases up to July 2018 for relevant articles. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup and sensitivity analyses were performed to explore possible sources of heterogeneity. RESULTS Twenty-two studies with a total of 69,201 individuals were included in this study. The pooled OR of the association between infertility treatment and perinatal depressive symptoms was 1.01(95% CI: 0.83, 1.23), with substantial heterogeneity (I2 = 63%, P < .001). However, in subgroup analyses, a significantly positive association between infertility treatment and depressive symptoms was observed only in some Asian countries (six studies), and the pooled OR was 1.73 (95% CI:1.07, 2.81). An inverse association was found in 6-12 months after delivery (OR = 0.56, 95% CI:0.33, 0.96). Sensitivity analyses validated evidence of the robustness of the findings. CONCLUSION The results show that women who receive infertility treatment do not appear to be at increased risk of significant perinatal depressive symptoms compared with those after spontaneous conception.
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Affiliation(s)
- Dinah F. Meyer
- Department of Psychology, Muskingum University, New Concord, Ohio, USA
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11
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Kaseke T, January J, Tadyanemhandu C, Chiwaridzo M, Dambi JM. A structural equation modelling of the buffering effect of social support on the report of common mental disorders in Zimbabwean women in the postnatal period. BMC Res Notes 2019; 12:110. [PMID: 30819242 PMCID: PMC6394011 DOI: 10.1186/s13104-019-4151-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/22/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Globally, 13-20% of women experience a common mental disorder (CMD) postnatally. Unfortunately, the burden of CMDs is disproportionally substantial in women from low-income countries. Nevertheless, there is a growing recognition of the buffering effect of social support (SS) on psychiatric morbidity and the need for mental well-being support services/interventions. This study evaluated the relationship between psychiatric morbidity and SS levels, and factors influencing the mental health functioning of Zimbabwean women postnatally. Data were collected from 340 mothers and were analysed through structural equation modelling. RESULTS The mothers' mean age was 26.6 (SD 5.6) years. The mean Multidimensional Scale of Perceived Social Support score was 42.7 (SD 10.8), denoting high levels of SS. Additionally, 29.1% of the population reported excessive psychiatric morbidity, the median Shona Symptoms Questionnaire score was 5 (IQR: 2-8). The structural equation model demonstrated the buffering effects of SS on psychiatric morbidity (r = - 0.585, p = 0.01), and accounted for 70% of the variance. Being unmarried, increased maternal age, lower educational and income levels were associated with poorer maternal mental health. There is a need for routine; surveillance and treatment of CMDs in women in the postnatal period, including integration of low-cost, evidenced-based and task-shifting SS interventions.
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Affiliation(s)
- Tanaka Kaseke
- Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
| | - James January
- Department of Community Medicine, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
| | - Catherine Tadyanemhandu
- Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Matthew Chiwaridzo
- Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town Observatory, Cape Town, 7700 South Africa
| | - Jermaine M. Dambi
- Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town Observatory, Cape Town, 7700 South Africa
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12
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Cheung CWC, Saravelos SH, Chan TYA, Sahota DS, Wang CC, Chung PW, Li TC. A prospective observational study on the stress levels at the time of embryo transfer and pregnancy testing following in vitro fertilisation treatment: a comparison between women with different treatment outcomes. BJOG 2018; 126:271-279. [DOI: 10.1111/1471-0528.15434] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2018] [Indexed: 11/28/2022]
Affiliation(s)
- CWC Cheung
- Assisted Reproductive Technology Unit Department of Obstetrics and Gynaecology Faculty of Medicine The Chinese University of Hong Kong Hong Kong China
| | - SH Saravelos
- Assisted Reproductive Technology Unit Department of Obstetrics and Gynaecology Faculty of Medicine The Chinese University of Hong Kong Hong Kong China
| | - TYA Chan
- Department of Psychology The Chinese University of Hong Kong Hong Kong China
| | - DS Sahota
- Assisted Reproductive Technology Unit Department of Obstetrics and Gynaecology Faculty of Medicine The Chinese University of Hong Kong Hong Kong China
| | - CC Wang
- Assisted Reproductive Technology Unit Department of Obstetrics and Gynaecology Faculty of Medicine The Chinese University of Hong Kong Hong Kong China
| | - PW Chung
- Assisted Reproductive Technology Unit Department of Obstetrics and Gynaecology Faculty of Medicine The Chinese University of Hong Kong Hong Kong China
| | - TC Li
- Assisted Reproductive Technology Unit Department of Obstetrics and Gynaecology Faculty of Medicine The Chinese University of Hong Kong Hong Kong China
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Arifin SRM, Cheyne H, Maxwell M. Review of the prevalence of postnatal depression across cultures. AIMS Public Health 2018; 5:260-295. [PMID: 30280116 PMCID: PMC6141558 DOI: 10.3934/publichealth.2018.3.260] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 07/12/2018] [Indexed: 12/15/2022] Open
Abstract
The purpose of this review was to examine articles related to recent epidemiological evidence of the prevalence of maternal postnatal depression (PND) across different countries and cultures and to identify specific epidemiological studies that have been carried out exclusively in Malaysia on the prevalence of maternal PND. The review was undertaken in two stages, an initial review and an updated review. At both stages systematic literature searches of online databases were performed to identify articles on the prevalence of maternal PND. A total of 124 articles concerning research conducted in more than 50 countries were included in the final analysis. There were wide variations in the screening instruments and diagnostic tools used although the Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument applied to identify PND. The prevalence of maternal PND ranged from 4.0% to 63.9%, with Japan and America recording the lowest and highest rates, respectively. Within continents, a wide variation in reported prevalence was also found. The reported rates of maternal PND in Malaysia were much higher than that previously documented with a range of 6.8–27.3%. This review indicated that the widely cited prevalence of maternal PND of 10–15% underestimates rates of PND worldwide. The reasons for this variability may not be fully explained by review methods. Future studies should evaluate the nature of women's PND experiences across cultures to explain these wide variations.
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Affiliation(s)
- Siti Roshaidai Mohd Arifin
- Department of Special Care Nursing, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling Scotland, United Kingdom
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling Scotland, United Kingdom
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Mori E, Iwata H, Maehara K, Sakajo A, Tamakoshi K. Relationship between the mode of conception and depressive symptoms during the first 6 months post-partum in Japan. Reprod Med Biol 2018; 17:275-282. [PMID: 30013429 PMCID: PMC6046529 DOI: 10.1002/rmb2.12101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 03/08/2018] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To determine whether conventional treatment and assisted reproductive technology for infertility are associated with depressive symptoms and to identify the predictors of depressive symptoms during the first 6 months' post-partum. METHODS A prospective cohort design was used, with the participants being recruited from 13 Japanese hospitals. Using self-report questionnaires, a total of 2709 women (response rate: 71.9%) provided longitudinal data at five time points: during their hospital stay and at 1, 2, 4, and 6 months' post-partum. The depressive symptoms were measured by using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS). A logistic regression analysis was used to examine the association between the mode of conception and depressive symptoms and to identify the predictors of the depressive symptoms. RESULTS There was no significant association between the mode of conception and the depressive symptoms at any time point. Six factors that were associated with the EPDS score were first-time childbirth, emergency cesarean delivery, infant feeding, financial burden, having a male infant, and dissatisfaction with social support. CONCLUSION There was no significant relationship between the mode of conception and depressive symptoms. Nursing care should be based on individual assessments that focus on parity, the delivery method, infant feeding method, financial burden, the infant's sex, and social support, rather than on the mode of conception.
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Affiliation(s)
- Emi Mori
- Department of Health Promotion NursingGraduate School of NursingChiba UniversityChibaJapan
| | - Hiroko Iwata
- Department of Health Promotion NursingGraduate School of NursingChiba UniversityChibaJapan
| | - Kunie Maehara
- Department of Health Promotion NursingGraduate School of NursingChiba UniversityChibaJapan
| | - Akiko Sakajo
- Department of Health Promotion NursingGraduate School of NursingChiba UniversityChibaJapan
| | - Koji Tamakoshi
- Department of NursingGraduate School of MedicineNagoya UniversityNagoyaJapan
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Upadhyay RP, Chowdhury R, Aslyeh Salehi, Sarkar K, Singh SK, Sinha B, Pawar A, Rajalakshmi AK, Kumar A. Postpartum depression in India: a systematic review and meta-analysis. Bull World Health Organ 2017; 95:706-717C. [PMID: 29147043 PMCID: PMC5689195 DOI: 10.2471/blt.17.192237] [Citation(s) in RCA: 144] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 07/14/2017] [Accepted: 07/17/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To provide an estimate of the burden of postpartum depression in Indian mothers and investigate some risk factors for the condition. METHODS We searched PubMed®, Google Scholar and Embase® databases for articles published from year 2000 up to 31 March 2016 on the prevalence of postpartum depression in Indian mothers. The search used subject headings and keywords with no language restrictions. Quality was assessed via the Newcastle-Ottawa quality assessment scale. We performed the meta-analysis using a random effects model. Subgroup analysis and meta-regression was done for heterogeneity and the Egger test was used to assess publication bias. FINDINGS Thirty-eight studies involving 20 043 women were analysed. Studies had a high degree of heterogeneity (I2 = 96.8%) and there was evidence of publication bias (Egger bias = 2.58; 95% confidence interval, CI: 0.83-4.33). The overall pooled estimate of the prevalence of postpartum depression was 22% (95% CI: 19-25). The pooled prevalence was 19% (95% CI: 17-22) when excluding 8 studies reporting postpartum depression within 2 weeks of delivery. Small, but non-significant differences in pooled prevalence were found by mother's age, geographical location and study setting. Reported risk factors for postpartum depression included financial difficulties, presence of domestic violence, past history of psychiatric illness in mother, marital conflict, lack of support from husband and birth of a female baby. CONCLUSION The review shows a high prevalence of postpartum depression in Indian mothers. More resources need to be allocated for capacity-building in maternal mental health care in India.
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Affiliation(s)
- Ravi Prakash Upadhyay
- Department of Community Medicine, Room 517, 5th floor, College Building, Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
| | | | - Aslyeh Salehi
- School of Health and Human Sciences, Southern Cross University, Queensland, Australia
| | - Kaushik Sarkar
- Directorate of National Vector Borne Disease Control Programme, New Delhi, India
| | - Sunil Kumar Singh
- Department of Community Medicine, Room 517, 5th floor, College Building, Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
| | - Bireshwar Sinha
- Department of Community Medicine, Lady Hardinge Medical College, New Delhi, India
| | - Aditya Pawar
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, United States of America
| | | | - Amardeep Kumar
- Department of Psychiatry, Patna Medical College, Patna, Bihar, India
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Gambadauro P, Iliadis S, Bränn E, Skalkidou A. Conception by means of in vitro fertilization is not associated with maternal depressive symptoms during pregnancy or postpartum. Fertil Steril 2017; 108:325-332. [DOI: 10.1016/j.fertnstert.2017.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/04/2017] [Accepted: 06/06/2017] [Indexed: 12/16/2022]
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Xu H, Ding Y, Ma Y, Xin X, Zhang D. Cesarean section and risk of postpartum depression: A meta-analysis. J Psychosom Res 2017; 97:118-126. [PMID: 28606491 DOI: 10.1016/j.jpsychores.2017.04.016] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/22/2017] [Accepted: 04/22/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The association of cesarean section (CS) with the risk of postpartum depression (PPD) remains controversial. Therefore, we conducted a meta-analysis to explore the association between CS and the risk of PPD. METHODS A systematic literature search was performed in PubMed, Web of Science and Embase databases for relevant articles up to November 2016. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with fixed-effects model or random-effects model. RESULTS A total of 28 studies from 27 articles involving 532,630 participants were included in this meta-analysis. The pooled OR of the association between CS and PPD risk was 1.26 (95% CI: 1.16-1.36). In subgroup analyses stratified by study design [cohort studies: (1.25, 95% CI: 1.10-1.41); case-control studies: (1.25, 95% CI: 1.00-1.56); cross-sectional studies: (1.44, 95% CI: 1.14-1.82)] and adjustment status of complications during pregnancy [adjusted for: (1.29, 95% CI: 1.12-1.48); not-adjusted for: (1.24, 95% CI: 1.13-1.36)], the above-mentioned associations remained consistent. The pooled ORs of PPD were 1.15 (95% CI: 0.92-1.43) for elective cesarean section (ElCS) and 1.47 (95% CI: 1.33-1.62) for emergency cesarean section (EmCS). CONCLUSION This meta-analysis suggests that CS and EmCS increase the risk of PPD. Further evidence is needed to explore the associations between the specific types of CS and the risk of PPD.
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Affiliation(s)
- Hui Xu
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Yu Ding
- Department of Reproduction, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Yue Ma
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Xueling Xin
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
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Mori E, Tsuchiya M, Maehara K, Iwata H, Sakajo A, Tamakoshi K. Fatigue, depression, maternal confidence, and maternal satisfaction during the first month postpartum: A comparison of Japanese mothers by age and parity. Int J Nurs Pract 2017; 23. [DOI: 10.1111/ijn.12508] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 11/07/2016] [Accepted: 11/16/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Emi Mori
- Graduate School of Nursing; Chiba University; Chiba Japan
| | - Miyako Tsuchiya
- Division of Cancer Survivorship Research; National Cancer Center; Tokyo Japan
| | - Kunie Maehara
- Graduate School of Nursing; Chiba University; Chiba Japan
| | - Hiroko Iwata
- Graduate School of Nursing; Chiba University; Chiba Japan
| | - Akiko Sakajo
- Graduate School of Nursing; Chiba University; Chiba Japan
| | - Koji Tamakoshi
- Graduate School of Medicine; Nagoya University; Nagoya Japan
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19
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Iwata H, Mori E, Sakajo A, Aoki K, Maehara K, Tamakoshi K. Prevalence of postpartum depressive symptoms during the first 6 months postpartum: Association with maternal age and parity. J Affect Disord 2016; 203:227-232. [PMID: 27295378 DOI: 10.1016/j.jad.2016.06.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 06/03/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Depressive symptoms are common in postpartum women. The present study aimed to describe changes in the prevalence of depressive symptoms during the first 6 months postpartum, and their association with maternal age and parity. METHODS A prospective cohort study was conducted with 3769 women at 13 hospitals in Japan. Depressive symptoms were measured during hospital stay and at 1, 2, 4, and 6 months postpartum, using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS). The effects of maternal age and parity were assessed by comparing four groups: younger primiparas (aged <35 years); older primiparas (≥35 years); younger multiparas (<35 years); and older multiparas (≥35 years). Data were analyzed using a mixed between/within-subjects analysis of variance, Cochran's Q tests, and chi-square tests. RESULTS Mean EPDS scores significantly decreased from 1 to 2 months postpartum in all groups. The proportion of women with EPDS scores ≥9 significantly decreased during the same period for primiparas but not for multiparas. Primiparas also had significantly higher EPDS scores than multiparas during hospital stay and at 1 month postpartum. LIMITATIONS As we used convenience sampling, our study sample was not fully representative of Japanese mothers. This study was also limited by our focus on the postpartum period. CONCLUSIONS The first month postpartum represented peak prevalence for depressive symptoms. Primiparity was a risk factor for depressive symptoms only during the first month postpartum. Healthcare professionals should be sensitive to postpartum duration and parity when monitoring depressive symptoms.
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Affiliation(s)
- Hiroko Iwata
- Graduate School of Nursing, Chiba University, Chiba, Japan.
| | - Emi Mori
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Akiko Sakajo
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Kyoko Aoki
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Kunie Maehara
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Koji Tamakoshi
- Graduate School of Medicine, Nagoya University, Aichi, Japan
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20
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Sonobe M, Usui M, Hiroi K, Asai H, Hiramatsu M, Nekoda Y, Hirose T. Influence of older primiparity on childbirth, parenting stress, and mother-child interaction. Jpn J Nurs Sci 2016; 13:229-39. [PMID: 26782086 DOI: 10.1111/jjns.12110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 08/18/2015] [Indexed: 11/30/2022]
Abstract
AIM Delivery at 35 years and above has increased in Japan. While there is much research concerning obstetrical risk and delivery at advanced age, little research addresses child-rearing after birth. This study seeks to identify how older primiparas' characteristics of child-rearing, parenting stress, and mother-child interaction differ from those of younger mothers. METHODS Participants were primipara women aged 35 years and above and primiparas aged 20-29 years; all delivered in the hospital. Questionnaires were distributed during hospitalization after birth and during home visits at 3 months, 1 year, and 2 years post-partum. Mother-child interactions during home visits were assessed using the Nursing Child Assessment Teaching Scale (NCATS). RESULTS The older group included 13 primiparas, and the control group included seven primiparas at the study's end. Some older primiparas used fertility treatment and cesarean section, but primiparas in their 20s used neither. There were no significant differences in terms of depression, psychological health, size of networks, and number of daytime or night-time feedings. Statistically significant differences were as follows. Older primiparas experienced more social isolation and overall stress, and their children exhibited greater hypersensitivity/lack of adaptability at 3 months. Older mothers were more likely to report little effort by their children to please them at 1 and 2 years after birth. Under observation, older primiparas received higher NCATS caregiver scores, but children of primiparas in their 20s received higher child scores. CONCLUSION Mothers and child-care specialists should recognize that older primiparas interact more favorably with their children, but have more parenting stress.
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Affiliation(s)
- Mami Sonobe
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | | | - Kayoko Hiroi
- Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiromi Asai
- Department of Nursing, School of Health and Social Service, Saitama Prefectural University, Koshigaya, Japan
| | | | - Yasutoshi Nekoda
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Taiko Hirose
- Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Vikström J, Sydsjö G, Hammar M, Bladh M, Josefsson A. Risk of postnatal depression or suicide after in vitro fertilisation treatment: a nationwide case-control study. BJOG 2015; 124:435-442. [PMID: 26663705 DOI: 10.1111/1471-0528.13788] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine whether women who undergo in vitro fertilisation (IVF) treatment are at greater risk of postnatal suicide or postnatal depression (PND) requiring psychiatric care, compared with women who conceive spontaneously. DESIGN Case-control study using data from national registers. SETTING Sweden during the period 2003-2009. POPULATION Cases were 3532 primiparous women who had given birth following IVF treatment. An aged-matched control group of 8553 mothers was randomly selected from the medical birth register. METHODS Logistic regression analyses were performed with PND as the outcome, and with known risk factors of PND as well as IVF/spontaneous birth as covariates. MAIN OUTCOME MEASURES Postnatal depression (PND), defined as diagnoses F32-F39 of the tenth edition of the International Classification of Diseases (ICD-10), within 12 months of childbirth. RESULTS Initial analyses showed that PND was more common in the control group than in the IVF group (0.8 versus 0.4%; P = 0.04); however, these differences disappeared when confounding factors were controlled for. A history of any psychiatric illness (P = 0.000; odds ratio, OR = 25.5; 95% confidence interval, 95% CI = 11.7-55.5), any previous affective disorder (P = 0.000; OR = 26.0; 95% CI = 10.5-64.0), or specifically a personality disorder (P = 0.028; OR = 3.8; 95% CI = 1.2-12.7) increased the risk of PND. No woman in either group committed suicide during the first year after childbirth. CONCLUSIONS Whereas mothers who receive IVF treatment are not at increased risk of PND, the risk is increased among mothers with a history of mental illness. TWEETABLE ABSTRACT A Swedish study on 3532 women showed that IVF treatment does not increase the risk of postnatal depression.
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Affiliation(s)
- J Vikström
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - G Sydsjö
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - M Hammar
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - M Bladh
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - A Josefsson
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
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Gressier F, Letranchant A, Cazas O, Sutter-Dallay A, Falissard B, Hardy P. Post-partum depressive symptoms and medically assisted conception: a systematic review and meta-analysis. Hum Reprod 2015; 30:2575-86. [DOI: 10.1093/humrep/dev207] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 07/31/2015] [Indexed: 11/13/2022] Open
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Guedes M, Canavarro MC. PERSONAL COMPETENCIES, SOCIAL RESOURCES, AND PSYCHOSOCIAL ADJUSTMENT OF PRIMIPAROUS WOMEN OF ADVANCED MATERNAL AGE AND THEIR PARTNERS. Infant Ment Health J 2015; 36:506-21. [DOI: 10.1002/imhj.21528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Sejbaek CS, Pinborg A, Hageman I, Forman JL, Hougaard CØ, Schmidt L. Are repeated assisted reproductive technology treatments and an unsuccessful outcome risk factors for unipolar depression in infertile women? Acta Obstet Gynecol Scand 2015; 94:1048-55. [PMID: 26234480 DOI: 10.1111/aogs.12705] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 06/23/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Previous studies have shown conflicting results as to whether unsuccessful medically assisted reproduction is a risk factor for depression among women. This study therefore investigated if women with no live birth after assisted reproductive technology (ART) treatment had a higher risk of unipolar depression compared with women with a live birth after ART treatment. MATERIAL AND METHODS The Danish National ART-Couple (DANAC) Cohort is a national register-based cohort study that consists of women who received ART treatment from 1 January 1994 to 30 September 2009, in Denmark (n = 41 050). Information on unipolar depression was obtained from the Danish Psychiatric Central Research Register. The analyses were conducted in Cox regression analysis. RESULTS During the 308 494 person-years of follow up, 552 women were diagnosed with unipolar depression. A Cox proportional hazards model showed that women in ART treatment, with no live birth yet, had a lower risk of unipolar depression compared with women with a live birth. Women had the highest risk of unipolar depression 0-42 days after a live birth (adjusted hazard ratio 5.08, 95% CI 3.11-8.29) compared with women with no live birth. A lower, but still increased, risk of unipolar depression, was found in women 43 days to 1 year and >1 year after a live birth compared with women with no live birth yet. CONCLUSIONS Motherhood is an important trigger of unipolar depression in women conceiving after ART treatment.
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Affiliation(s)
- Camilla S Sejbaek
- Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | - Ida Hageman
- Psychiatric Center Copenhagen, Copenhagen University Hospital, Rigshopitalet University Hospital, Copenhagen, Denmark
| | - Julie L Forman
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Ø Hougaard
- Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lone Schmidt
- Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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McMahon CA, Boivin J, Gibson FL, Hammarberg K, Wynter K, Fisher JRW. Older maternal age and major depressive episodes in the first two years after birth: findings from the Parental Age and Transition to Parenthood Australia (PATPA) study. J Affect Disord 2015; 175:454-62. [PMID: 25679200 DOI: 10.1016/j.jad.2015.01.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 12/10/2014] [Accepted: 01/14/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study examines whether (1) older maternal age is associated with increased risk of depressive episodes between four months and two years after first birth and (2) the role of subsequent reproductive, social and child factors in vulnerability to later onset depression. METHOD 592 women were recruited in the third trimester of pregnancy in three age-groups (≤ 30 years; 31-36 years,≥37 years); 434 (73%) completed all assessments at four months and two years after birth. Major Depression episodes (MDE) were assessed at four months and two years using the Mini International Neuropsychiatric Interview (MINI). Maternal (age, mode of conception, prior mood symptoms, health), child (temperament, health), reproductive (subsequent fertility treatment, pregnancy, birth, pregnancy loss) and social contextual variables (language background, paid work, practical support, life stresses) were assessed in pregnancy and postnatally using validated questionnaires and structured interview questions. RESULTS Maternal age was not related to prevalence or timing of MDE. Depression symptoms, poor child health, low practical support at four months and a non-English language background predicted episodes of depression between four months and two years, ps <0.05. LIMITATIONS Life history risks for depression were not considered, nor symptom profiles over time. CONCLUSIONS Findings indicate that despite a more complex reproductive context, older first time mothers are not more likely to report major depressive episodes in the first two years after birth. Prevalence for the whole sample was at the lower end of reported community ranges and was comparable early and later in the postpartum period. Screening for depression after childbirth should not be restricted to the early months.
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Affiliation(s)
- Catherine A McMahon
- Centre for Emotional Health, Department of Psychology, Macquarie University North Ryde, NSW, 2109, Australia.
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, UK
| | | | - Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia
| | - Karen Wynter
- Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia
| | - Jane R W Fisher
- Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia
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26
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Muraca GM, Joseph KS. The association between maternal age and depression. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2015; 36:803-810. [PMID: 25222359 DOI: 10.1016/s1701-2163(15)30482-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Postpartum depression is a relatively common and potentially debilitating condition but its relationship with advanced maternal age has not been adequately studied. We evaluated the relationship between age and depression in a population-based sample of Canadian women. METHODS Data on women aged 20 to 44 years were obtained from the Canadian Community Health Survey, 2007 to 2008. Depression was defined using the Short-Form score from the Composite International Diagnostic Interview (depression defined as a score of ≥ 5). Women were stratified according to whether they had a live birth within five years preceding the interview. Logistic regression was used to compare the prevalence of depression among women of advanced maternal age versus younger women after adjusting for education, marital status, and chronic disease. RESULTS Among women who had delivered recently, 8.0% (207 of 2326) were depressed compared with 10% (597 of 5610) of women who had not recently delivered. The prevalence of depression in women who had recently delivered was significantly higher in women aged 40 to 44 years than in women aged 30 to 35 years (adjusted OR 3.72; 95% CI 2.15 to 6.41). Depression rates were not higher among older women who had not had a recent delivery (adjusted OR among women 40 to 44 years 0.75; 95% CI 0.56 to 1.01). CONCLUSION Women of advanced maternal age have significantly higher rates of depression than younger women. Research is required to determine if a program of targeted depression screening and prevention will help reduce the burden of illness among older mothers.
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Affiliation(s)
- Giulia M Muraca
- School of Population and Public Health, and the Department of Obstetrics and Gynaecology University of British Columbia, Vancouver, BC; Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC
| | - K S Joseph
- School of Population and Public Health, and the Department of Obstetrics and Gynaecology University of British Columbia, Vancouver, BC; Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC
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Guedes M, Canavarro MC. Psychosocial adjustment of couples to first-time parenthood at advanced maternal age: an exploratory longitudinal study. J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2014.962015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Listijono DR, Mooney S, Chapman M. A comparative analysis of postpartum maternal mental health in women following spontaneous or ART conception. J Psychosom Obstet Gynaecol 2014; 35:51-4. [PMID: 24766532 DOI: 10.3109/0167482x.2014.911281] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine whether conception following assisted reproductive technology (ART) predisposes women to increased risk of postnatal depression (PND), compared to women who conceived naturally, when controlling for such factors as: multiple birth, previous maternal psychiatric history and sociodemographic status. PARTICIPANTS A total of 200 women who attended the private antenatal and fertility clinics of a fertility specialist in a large Australian city between January 2009 and December 2011 were contacted via telephone. RESULTS There was no difference in the rate of PND between the two groups (7.5% versus 7.4%, p = ns). Aside from the slightly older maternal age in the ART group (35.4 versus 33, p < 0.05), baseline socio-demographics were similar. There was a significantly higher rate of previous maternal clinical depression in the ART group compared to the controls (17% versus 5%, p < 0.05); however, other known risk factors for PND, including previous PND (10.6% versus 13.7%, p = ns), multiple births (2.1% versus 4.2%, p = ns) and low infant birth weight (3.3 kg versus 3.4 kg, p = ns), were not different in the two cohorts. Women who conceived naturally were also more likely to breastfeed for a longer duration (78% versus 89%, p < 0.05). CONCLUSION Our study demonstrates that when accounting for well-known risk and protective factors for postpartum depression, women who conceive using ART are not at an increased risk PND. In addition, the low rate of multiple births in the ART group further validates the practice of single embryo transfer.
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MacCallum (Professor) F, Lopes (Professor) RDCS, Piccinini (Professor) CA, Passos (Professor) EP. ‘Living each week as unique’: Maternal fears in assisted reproductive technology pregnancies. Midwifery 2014; 30:e115-20. [DOI: 10.1016/j.midw.2013.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 10/09/2013] [Accepted: 12/03/2013] [Indexed: 10/25/2022]
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Schmied V, Johnson M, Naidoo N, Austin MP, Matthey S, Kemp L, Mills A, Meade T, Yeo A. Maternal mental health in Australia and New Zealand: A review of longitudinal studies. Women Birth 2013; 26:167-78. [DOI: 10.1016/j.wombi.2013.02.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 01/03/2013] [Accepted: 02/12/2013] [Indexed: 10/26/2022]
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Experience of childbirth in first-time mothers of advanced age - a Norwegian population-based study. BMC Pregnancy Childbirth 2013; 13:53. [PMID: 23445518 PMCID: PMC3599661 DOI: 10.1186/1471-2393-13-53] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 02/14/2013] [Indexed: 11/10/2022] Open
Abstract
Background Delaying the first childbirth to an advanced age has increased significantly during the last decades, but little is known about older first time mothers’ experience of childbirth. This study investigates the associations between advanced maternal age in primiparous women and the postnatal assessment of childbirth. Methods The study was based on the National Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Data on 30 065 nulliparous women recruited in the second trimester 1999–2008 were used. Three questionnaires were completed: around gestational week 17 and 30, and at 6 months postpartum. Medical data were retrieved from the national Medical Birth Register. Advanced age was defined as ≥32 years and the reference group as 25–31 years. Descriptive and multiple logistic regression analyses were conducted. Results Primiparous women aged 32 years and above expressed more worry about the upcoming birth than the younger women (adjusted OR 1.13; 95% CI 1.06-1.21), and 6 months after the birth they had a slightly higher risk of having experienced childbirth as ‘worse than expected’ (adjusted OR 1.09; 95% CI 1.02-1.16). The difference in birth experience was explained by mode of delivery. Comparisons within subgroups defined by the same mode of delivery showed that the risk of a more negative birth experience in the older women only applied to those with a spontaneous vaginal birth (adjusted OR 1.12; 95% CI 1.02-1.22). In women delivered by cesarean section, the older more often than younger women rated childbirth as ‘better than expected’ (elective cesarean delivery: adjusted OR 1.36; 95% CI 1.01-1.85, emergency cesarean delivery: adjusted OR 1.38; 95% CI 1.03-1.84). Conclusion Postponing childbirth to ≥32 years of age only marginally affected the experience of childbirth. Older women seemed to manage better than younger with having an operative delivery.
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