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Zou W, Huang L, Yan Y. "It Slowly Drained the Life Out of Me, Leaving Me Dead Inside": Coping and Response Patterns Among Chinese Women Experiencing Postpartum Depression. HEALTH COMMUNICATION 2023:1-12. [PMID: 38009473 DOI: 10.1080/10410236.2023.2288382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
The prevalence of postpartum depression (PPD) exceeds 20% in China. In this article, we unpack the coping strategies and involuntary responses to PPD among Chinese women and how such patterns are shaped by family communication dynamics and reflect distinct social, structural, and cultural contexts. Drawing upon the communication accommodation theory and the generic stress and coping model, we analyzed 661 posts collected under the hashtag #PPD (chanhou yiyuzheng) on Zhihu using the phronetic iterative approach. The analysis reveals that women self-identifying as having PPD often find themselves situated within a family environment marked by non-adaptive communication, culminating in insufficient support from their social circles. Furthermore, a significant number of these women lack effective coping mechanisms to manage PPD. Instead, they tend to stifle their expressions and needs through automatic responses, dedicating themselves to constant self-monitoring without practicing self-care. Our findings contribute to informed policymaking for postpartum support, addressing nuanced challenges encountered by new mothers in China.
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Affiliation(s)
- Wenxue Zou
- Department of Communication, Media, & Culture, Coastal Carolina University
| | - Liyao Huang
- School of Journalism and Communication, Xiamen University
| | - Yan Yan
- School of Journalism and Communication, Renmin University of China
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Yang X, Qiu M, Yang Y, Yan J, Tang K. Maternal postnatal confinement practices and postpartum depression in Chinese populations: A systematic review. PLoS One 2023; 18:e0293667. [PMID: 37903136 PMCID: PMC10615300 DOI: 10.1371/journal.pone.0293667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/14/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The postpartum period is critical for maternal health status after childbirth. The traditional Chinese postpartum confinement practice, "doing-the-month", is considered especially effective in helping mothers recover during the postpartum period. However, research has not provided evidence to confirm its benefits. Postpartum depression is a common postpartum disease that seriously threatens maternal health. The systematic review aims to explore the association between "doing-the-month" and postpartum depression in the Chinese female population and to provide a scientific foundation for evidence-based postpartum maternal care. METHODS Five databases (PubMed, Embase, Web of Science, Scopus, Cochrane, PsycINFO, and Web of Science) were searched according to the protocol (INPALSY202320102). The JBI assessment tool was used to assess the quality of the included studies. RESULTS Sixteen quantitative studies from China and Chinese female immigrants in other countries, including 15 cross-sectional studies and 1 randomized controlled study, were identified. Four studies indicated that "doing-the-month" rituals reduced postpartum depression risk while 2 studies showed opposite results; 10 studies did not show a significant association between "doing-the-month" practices and postpartum depression. CONCLUSION There is conflicting evidence regarding the association between "doing-the-month" and the likelihood of developing postpartum depression. Some studies have explored the impact of family ties, particular rituals, and specific stressors during the postpartum period on the occurrence of postpartum depression in Chinese women. According to current research, "doing-the-month" practice failed to show a significant protective effect on postpartum depression in the Chinese maternal population. Evidence-based medical health education for the Chinese postpartum female community is urgently needed.
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Affiliation(s)
- Xiao Yang
- Health Policy and Management Department, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Mujie Qiu
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yichun Yang
- Department of Obstetrics, Longgang District Central Hospital of Shenzhen, Shenzhen, China
| | - Junlin Yan
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Yang X, Li L, Zhou R, Xia J, Li M, Zhang C, Guo H. Effects of the online and offline hybrid continuous group care on maternal and infant health: a randomized controlled trial. BMC Pregnancy Childbirth 2023; 23:629. [PMID: 37658338 PMCID: PMC10472587 DOI: 10.1186/s12884-023-05882-1] [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: 11/09/2022] [Accepted: 07/29/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND The group care is a well-established maternal care model that has been widely used in many developed countries, but in China, it is confined to prenatal care services. In addition, affected by traditional birth culture, Chinese women tend to focus more on their fetuses and newborns but lack attention to their own intrapartum and postpartum care. The aim of this study was to construct and implement a prenatal, intrapartum, and the postpartum continuous group care model that combines online and offline service in Hainan Province, China, and to evaluate the effect on maternal women and newborns. METHODS This study was a randomized controlled trial involving 144 pregnant women in a first-class tertiary general hospital in Hainan Province, China. Women were divided into an intervention group and a control group using the random number table, with 72 women in each group. The control group received routine maternal care services, and the intervention group received the continuous group care based on the routine maternal care services. Count data such as rate of cesarean section and incidence rate of fetal macrosomia were analyzed with the chi-square test or Fisher's exact test, and the General Self-efficacy Scale scores were analyzed by repeated measures ANOVA. P < 0.05 was considered statistically significant, with two-sided probability values. RESULTS Compared with the control group, the rate of excessive prenatal weight gain, cesarean section, and 42-day postpartum depression were significantly lower in the intervention group (P < 0.05), and higher General Self-efficacy Scale scores (in the expectant period and 42 days postpartum) and exclusive breastfeeding rate (42 days postpartum) (P < 0.05). The incidence of fetal macrosomia was significantly lower in the intervention group (P < 0.05). But there was no significant difference in birth weight, preterm birth, the incidence of low-birth-weight infants and 1-min Apgar score (P > 0.05). CONCLUSION The continuous group care with online and offline service can effectively control the gestational weight gain, reduce the rate of cesarean section, macrosomia, and postpartum depression. It can improve the self-efficacy of women and the rate of exclusive breastfeeding effectively. TRIAL REGISTRATION Chinese Clinical Trial Regestry (ChiCTR2200065765, 04/11/2022, Retrospectively registered).
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Affiliation(s)
- Xiaoli Yang
- International Nursing school, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China
| | - Linwei Li
- International Nursing school, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China
- Jiangsu Health Vocational College, Nanjing, China
| | - Rong Zhou
- International Nursing school, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China
| | - Jieqiong Xia
- International Nursing school, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China
| | - Minxiang Li
- The Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Caihong Zhang
- International Nursing school, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China.
| | - Honghua Guo
- International Nursing school, Hainan Medical University, 3 Xueyuan Road, Longhua District, Haikou, China.
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Zhang X, Zuo X, Matheï C, Aertgeerts B, Afnan M, Li T, Buntinx F, Vermandere M. Impact of a postpartum care rehabilitation program to prevent postpartum depression at a secondary municipal hospital in Qingdao China: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:239. [PMID: 37041524 PMCID: PMC10088113 DOI: 10.1186/s12884-023-05547-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/25/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The emerging postpartum rehabilitation (PPR) program in Chinese hospitals characterized by applying ongoing medical care through traditional cultural practices shows a protective effect in early puerperium in China. This study explores the benefit of PPR program practices to postpartum depression (PPD) and the influencing factors for PPD among Chinese women during the first postnatal six weeks. METHODS The cross-sectional study included 403 participants and was conducted in a Secondary Municipal Hospital in Qingdao, China, from 01 to 2018 to 31 December 2021. Information on this PPR program was collected during the six-weeks postpartum consultation, including the Edinburgh postnatal depression scale (EPDS) scores, the measurement results for diastasis recti abdominis, and the international physical activity questionnaire (long form) (IPAQ-L) scores. Logistic regression models were used to examine the effect of the PPR program on PPD among the local population. The secondary aim of this study was to investigate possible influencing factors for PPD, such as coronavirus disease 2019 (COVID-19), physical exercises, etc. RESULTS: PPR program has shown a positive effect in preventing PPD (p < 0.001) and diastasis recti prevalence (p < 0.001) during the six-weeks postnatal control in Qingdao, China. Better post-pregnancy weight reduction (p = 0.04) and higher metabolic equivalent of task (MET) value (p < 0.001) were noticed in the non-PPR group. Furthermore, lower PPD risk was associated with factors such as longer relationship duration years (2-5 years) (p = 0.04) and exercising one to three times a week (p = 0.01). A higher PPD risk was related to factors such as urinary incontinence during the postpartum period (p = 0.04) and subjective insomnia (p < 0.001). No significant effect was shown between COVID-19 and the EPDS score in this study (p = 0.50). CONCLUSION Our results suggested that the PPR program provided protection against PPD and diastasis recti during the first six weeks after delivery. Urinary incontinence and subjective insomnia were the main risk factors for PPD, while longer relationship duration years and exercising one to three times a week gave protective effects to PPD. This study emphasized that a comprehensive ongoing medical care program, such as the PPR program, effectively improves women's mental and physical health in the early postpartum in China.
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Affiliation(s)
- Xiaoqian Zhang
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium.
- Qingdao United Family Hospital, Qingdao, China.
| | - Xiaoli Zuo
- Qingdao United Family Hospital, Qingdao, China
| | - Catharina Matheï
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | - Bert Aertgeerts
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | | | - Tang Li
- Qingdao University Medical College, Qingdao, China
| | - Frank Buntinx
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | - Mieke Vermandere
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
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Chen Y, Wu Y, Dill SE, Guo Y, Westgard CM, Medina A, Weber AM, Darmstadt GL, Zhou H, Rozelle S, Sylvia S. Effect of the mHealth-supported Healthy Future programme delivered by community health workers on maternal and child health in rural China: study protocol for a cluster randomised controlled trial. BMJ Open 2023; 13:e065403. [PMID: 36669837 PMCID: PMC9872510 DOI: 10.1136/bmjopen-2022-065403] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Millions of young rural children in China still suffer from poor health and malnutrition, partly due to a lack of knowledge about optimal perinatal and child care among rural mothers and caregivers. Meanwhile, there is an urgent need to improve maternal mental health in rural communities. Comprehensive home visiting programmes delivered by community health workers (CHWs) can bridge the caregiver knowledge gap and improve child health and maternal well-being in low-resource settings, but the effectiveness of this approach is unknown in rural China. Additionally, grandmothers play important roles in child care and family decision-making in rural China, suggesting the importance of engaging multiple caregivers in interventions. The Healthy Future programme seeks to improve child health and maternal well-being by developing a staged-based curriculum that CHWs deliver to mothers and caregivers of young children through home visits with the assistance of a tablet-based mHealth system. This protocol describes the design and evaluation plan for this programme. METHODS AND ANALYSIS We designed a cluster-randomised controlled trial among 119 rural townships in four nationally designated poverty counties in Southwestern China. We will compare the outcomes between three arms: one standard arm with only primary caregivers participating in the intervention, one encouragement arm engaging primary and secondary caregivers and one control arm with no intervention. Families with pregnant women or infants under 6 months of age are invited to enrol in the 12-month study. Primary outcomes include children's haemoglobin levels, exclusive breastfeeding rates and dietary diversity in complementary feeding. Secondary outcomes include a combination of health, behavioural and intermediate outcomes. ETHICS AND DISSEMINATION Ethical approval has been provided by Stanford University, Sichuan University and the University of Nevada, Reno. Trial findings will be disseminated through national and international peer-reviewed publications and conferences. TRIAL REGISTRATION NUMBER ISRCTN16800789.
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Affiliation(s)
- Yunwei Chen
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yuju Wu
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Sarah-Eve Dill
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Yian Guo
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Christopher Michael Westgard
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexis Medina
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Ann M Weber
- Department of Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Huan Zhou
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Scott Rozelle
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Sean Sylvia
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Zhang X, Ma P, Li M. The association between paternal childcare involvement and postpartum depression and anxiety among Chinese women-a path model analysis. Arch Womens Ment Health 2023; 26:99-106. [PMID: 35982294 PMCID: PMC9387876 DOI: 10.1007/s00737-022-01256-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/04/2022] [Indexed: 11/10/2022]
Abstract
Depression and anxiety are among the most common morbidities during the perinatal period. Very few studies have been conducted to examine the association between paternal childcare involvement and postpartum depression (PPD) and anxiety (PPA) in East Asian cultures. This study aims to examine the association between fathers' involvement in childcare and mothers' mental health and explores the potential mediating effects of the mother and child's health among a national sample of Chinese women. This is a cross-sectional, self-administered online survey of maternal women (N = 778) within 1 year after childbirth in China. The questionnaire comprised of sociodemographics, fathers' childcare involvement, child and mother's physical health, and mothers' postpartum mental health status. A path analysis model was constructed to examine the correlation between paternal childcare involvement and maternal depression and anxiety within 1-year postpartum. The mediating effect of the mother and child's physical health was also explored in the model. Paternal involvement in childcare was significantly associated with lower PPD (β = - .36, p < 0.001) and PPA (β = - .29, p < 0.001) levels of mothers after covariates were adjusted. Furthermore, women's physical health partially mediated the association between paternal involvement and PPD, and child's health partially mediated the association between paternal involvement and PPA and PPD. Our findings emphasize the essential role of father's childcare involvement and the need to promote culturally tailored intervention programs, which may improve the mental health status among Chinese postpartum mothers.
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Affiliation(s)
- Xiaoying Zhang
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, 200124, China.
| | - Ping Ma
- grid.264756.40000 0004 4687 2082Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Ming Li
- grid.265122.00000 0001 0719 7561Department of Health Sciences, Towson University, Towson, MD 21252 USA
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Chung EO, Hagaman A, Bibi A, Frost A, Haight SC, Sikander S, Maselko J. Mother-in-law childcare and perinatal depression in rural Pakistan. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221141288. [PMID: 36468464 PMCID: PMC9726850 DOI: 10.1177/17455057221141288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Mothers-in-law often provide key childcare support to daughters-in-law during the perinatal period that may enhance maternal mental health. Yet, poor mother-in-law/daughter-in-law relationships may be associated with maternal depression. The extent to which mother-in-law childcare involvement affects perinatal depression may differ across contexts of family conflict. OBJECTIVE We explored the relationship between mother-in-law childcare and daughter-in-law perinatal depression in rural Pakistan across contexts of family conflict. METHODS Data on 783 women came from the Bachpan Cohort, a birth cohort in Pakistan. Maternally-reported mother-in-law childcare was assessed at 3 and 12 months postpartum using a 24-h recall and categorized into no, low, and high involvement. Major depression was captured at 3 and 12 months using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV. Family conflict was captured using three items from the Life Events Checklist. Log-Poisson models were used to estimate cross-sectional associations between mother-in-law childcare and perinatal depression, stratified by family conflict. RESULTS Mother-in-law childcare was common in the first year postpartum. The association between mother-in-law childcare and perinatal depression differed by the presence of family conflict and postpartum timing. At 3 months postpartum, low and high mother-in-law childcare (vs no involvement) were associated with a lower prevalence of depression regardless of family conflict. At 12 months postpartum, among families with no conflict, low mother-in-law childcare (vs no involvement) was associated with lower perinatal depression; however, among families with conflict, high mother-in-law childcare was associated with increased perinatal depression. CONCLUSION Our findings highlight the complexities of associations between mother-in-law childcare support and perinatal depression in the first year after birth. Mother-in-law childcare in the immediate postpartum period was beneficial for mothers. Understanding the source, amount, timing, and context of social support is necessary to inform research and interventions that aim to improve maternal mental health.
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Affiliation(s)
- Esther O Chung
- Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Esther O Chung, Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
| | - Ashley Hagaman
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA,Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA
| | - Amina Bibi
- Global Institute of Human Development, Shifa Tameer-e-Millat University, Islamabad, Pakistan,Human Development Research Foundation, Islamabad, Pakistan
| | - Allison Frost
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah C Haight
- Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Siham Sikander
- Global Institute of Human Development, Shifa Tameer-e-Millat University, Islamabad, Pakistan,Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Joanna Maselko
- Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Anato A, Baye K, Stoecker B. Determinants of depressive symptoms among postpartum mothers: a cross-sectional study in Ethiopia. BMJ Open 2022; 12:e058633. [PMID: 36100298 PMCID: PMC9472115 DOI: 10.1136/bmjopen-2021-058633] [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: 11/04/2022] Open
Abstract
OBJECTIVE This study aims to assess the determinants of depressive symptoms among postpartum mothers. DESIGN A community-based cross-sectional study was conducted. SETTING Ten randomly selected rural kebeles of Meket district of Ethiopia. PARTICIPANTS A random sample of 232 mothers with infants 5-10 months was included in this study. DATA ANALYSIS Forward multivariable logistic regression analysis. RESULTS The factors significantly associated with increased odds of maternal postpartum depressive symptoms were: moderate (adjusted OR (AOR) 4.44, 95% CI 1.34 to 14.72) and severe (AOR 12.98, 95% CI 5.24 to 32.14) household food insecurity; infant underweight (AOR 2.99, 95% CI: 1.21 to 7.37) and infant acute respiratory infection (ARI) (AOR 7.0, 95% CI: 3.09 to 15.99). Maternal education, workload and age, household socioeconomic status, distance to the health facility, and child stunting, diarrhoea and fever were not significantly associated with postpartum depressive symptoms in adjusted logistic regression. CONCLUSION Household food insecurity, infant ARI and infant underweight had significant associations with postpartum depressive symptoms. Therefore, interventions that address infant nutrition and health and household food insecurity within the framework of the productive safety net programmes (PSNPs) as well as programmes focused on preventing, detecting and solving maternal mental health challenges may be helpful to improve maternal mental well-being and promote graduation from the PSNP.
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Affiliation(s)
- Anchamo Anato
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Kaleab Baye
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Barbara Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
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Tan ML, Ng KL, Loh LWL, Haugan G, Wang W, He HG. A descriptive qualitative study exploring the postpartum confinement experiences among first-time mothers from the three major ethnic groups in Singapore. Midwifery 2022; 114:103463. [PMID: 36054950 DOI: 10.1016/j.midw.2022.103463] [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: 03/22/2021] [Revised: 05/18/2022] [Accepted: 08/17/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Modern Singaporean mothers still embrace traditional confinement practices after childbirth, which often marks a significant milestone in maternal experiences. However, limited studies have explored in-depth the collective confinement experiences of mothers in Singapore. This study hence aimed to explore the postpartum confinement experiences of first-time mothers from the three major ethnic groups in Singapore, namely Chinese, Malay, and Indian. DESIGN A descriptive qualitative study was conducted. Purposive sampling was adopted to recruit participants. Individual semi-structured face-to-face/telephone interviews were used to collect data, which were analysed using thematic analysis. SETTING AND PARTICIPANTS Sixteen first-time mothers were recruited from two obstetric clinics in a tertiary hospital in Singapore. FINDINGS Five themes emerged: "Specific diets adopted and avoided for different purposes", "Complexity of various traditional confinement practices (TCPs) adopted", "Reasons for adopting TCPs", "Reasons for modifying TCPs", and "Postpartum challenges". KEY CONCLUSIONS Our study provided unique insights about Singapore's Chinese, Malay and Indian first-time mothers' postpartum confinement experiences. While confinement practices were still observed, many mothers no longer subscribed to guidelines followed by previous generations and were modifying or forgoing practices they deemed impractical. Mothers faced challenges adapting to new motherhood and often felt restrained or stressed by confinement practices. IMPLICATIONS FOR PRACTICE Healthcare professionals should take the lead to educate mothers and their families on harmful traditional confinement practices and their misconceptions. Future studies could explore alternative methods of postpartum check-up to improve first-time mothers' confinement experiences, and focus specifically on lower-income families to explore their unique confinement experiences.
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Affiliation(s)
- Meng Lynn Tan
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore; Department of Nursing, National University Hospital, Singapore
| | - Kai Lin Ng
- National University Health System, Singapore; Department of Nursing, National University Hospital, Singapore
| | - Leta Wei Ling Loh
- National University Health System, Singapore; Department of Nursing, National University Hospital, Singapore
| | - Gørill Haugan
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Faculty of Nursing and Health Science, Nord University, Levanger, Norway
| | - Wenru Wang
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore
| | - Hong-Gu He
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore.
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Li J, Gray HL, Kim S, Park H, Lee Y, Lee H, Song K. Postpartum Diet and the Lifestyle of Korean and Chinese Women: A Comparative Study. Front Public Health 2022; 10:803503. [PMID: 35462835 PMCID: PMC9019053 DOI: 10.3389/fpubh.2022.803503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The study investigated and compared postpartum diet and behaviors, nutrition education, and psychological health status among Korean and Chinese postpartum women (0-6 months after delivery). Methods A total of 221 Korean mothers in Gyeonggi-do (South Korea) and 221 mothers in Jinhua (China) participated in the survey between November and December 2018, and the results were statistically analyzed using the SPSS Statistics 25.0 software. Results Many postpartum behaviors, such as postpartum diet pattern and care duration differed between Korean and Chinese mothers. The former showed a stronger desire for nutrition education compared with the latter (p < 0.001). Korean mothers' life and meal satisfaction, and contentment with their husband's support were all ~0.5 points higher compared with Chinese mothers, particularly regarding spousal support (p < 0.001). Postpartum depression stresses positively correlated with postpartum infant care stress and negatively correlated with life satisfaction. In addition, primipara mothers were more in need of infant care support and guidance concerning appropriate baby-feeding techniques compared with multipara mothers. Conclusion Traditional culture was a crucial factor that influenced the perceptions of postpartum women in South Korea and China. Culturally tailored nutrition education and exercise programs may benefit Korean and Chinese women after childbirth.
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Affiliation(s)
- Jia Li
- Department of Nutrition, Jinhua People's Hospital, Jinhua, China.,Department of Food and Nutrition, Myongji University, Seoul, South Korea
| | - Heewon L Gray
- Department of Community and Family Health, University of South Florida, Tampa, FL, United States
| | - Sohyun Kim
- Department of Food and Nutrition, Myongji University, Seoul, South Korea
| | - Haeryun Park
- Department of Food and Nutrition, Myongji University, Seoul, South Korea
| | - Youngmi Lee
- Department of Food and Nutrition, Myongji University, Seoul, South Korea
| | - Hongmie Lee
- Department of Food Science and Nutrition, Daejin University, Pocheon, South Korea.,Graduate School of Education, Nutrition Education Major, Daejin University, Pocheon, South Korea
| | - Kyunghee Song
- Department of Food and Nutrition, Myongji University, Seoul, South Korea
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The Association between Postpartum Practice and Chinese Postpartum Depression: Identification of a Postpartum Depression-Related Dietary Pattern. Nutrients 2022; 14:nu14040903. [PMID: 35215552 PMCID: PMC8880681 DOI: 10.3390/nu14040903] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 01/27/2023] Open
Abstract
Conflicting results of Chinese traditional postpartum practices have aroused concerns over their health effects. The role of postpartum practices in postpartum depression (PPD) is still a matter of discussion, especially from a dietary practice point of view. The current study was designed to (1) explore the association between postpartum practices and PPD, (2) to identify the dietary pattern related to PPD, and (3) to identify the possible pathways among postpartum practices and PPD. This study is part of the YI Study, which was a cross-sectional study conducted in 10 cities in China. Data for 955 postpartum women were used in the current analysis. The Edinburgh Postnatal Depression Scale (EPDS-10) was used to evaluate PPD with a cutoff value of 9. Postpartum practice was based on the participants’ self-reported practices. Individual practices were recorded and categorized as dietary and non-dietary practices. The dietary pattern was identified based on the food intake frequencies of 25 food groups using the method of reduced rank regression. Structural equation modeling was used to explore the potential pathways between postpartum practices and PPD. The current study observed significant associations between postpartum practices and PPD (Adjusted OR = 1.41, 95% CI: 1.04–1.90). A similar trend was also found between dietary postpartum practices and PPD (Adjusted OR = 1.39, 95%CI: 1.03–1.88) but not for non-dietary practices and PPD (Adjusted OR = 1.26, 95%CI: 0.92–1.75). A PPD-related dietary pattern was identified with the characteristics of a high intake of meat and eggs and a lower intake of vegetables, mushrooms, and nuts. This dietary pattern was significantly associated with a higher chance of adhering to postpartum practice (Adjusted OR = 1.26, 95% CI: 1.10–1.44). Based on the pathway analysis, this study also observed the association between postpartum practices and PPD, and the association between dietary practices and PPD were both mediated by sleep quality. In conclusion, this study demonstrated that a substantial proportion of women in modern China experience traditional postpartum Chinese practices and that either overall or dietary-related postpartum practices are associated with a higher risk of PPD. The current dietary practices in postpartum rituals may play an important role in developing PPD. A culturally embedded, science-based dietary guideline is required to help women to achieve both physical and psychological health in the postpartum period.
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12
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Jiang Q, Guo Y, Zhang E, Cohen N, Ohtori M, Sun A, Dill SE, Singh MK, She X, Medina A, Rozelle SD. Perinatal Mental Health Problems in Rural China: The Role of Social Factors. Front Psychiatry 2021; 12:636875. [PMID: 34950062 PMCID: PMC8688533 DOI: 10.3389/fpsyt.2021.636875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 11/08/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Perinatal mental health is important for the well-being of the mother and child, so the relatively high prevalence of perinatal mental health problems in developing settings poses a pressing concern. However, most studies in these settings focus on the demographic factors associated with mental health problems, with very few examing social factors. Hence, this study examines the prevalence of the depressive, anxiety and stress symptoms among pregnant women and new mothers in rural China, and the associations between these mental health problems and social factors, including decision-making power, family conflicts, and social support. Methods: Cross-sectional data were collected from 1,027 women in their second trimester of pregnancy to 6 months postpartum in four low-income rural counties in Sichuan Province, China. Women were surveyed on symptoms of mental health problems using the Depression, Anxiety, and Stress Scale (DASS-21) and social risk factors. Multivariate logistic regression analyses were conducted to examine social risk factors associated with maternal mental health problems, with results reported as odds ratios (OR) and 95% confidence intervals (CI). Results: Among all respondents, 13% showed symptoms of depression, 18% showed symptoms of anxiety, 9% showed symptoms of stress, and 23% showed symptoms of any mental health problem. Decision-making power was negatively associated with showing symptoms of depression (OR = 0.71, CI: 0.60-0.83, p < 0.001) and stress (OR = 0.76, CI: 0.63-0.90, p = 0.002). Family conflict was positively associated with depression (OR = 1.53, CI: 1.30-1.81, p < 0.001), anxiety (OR = 1.34, CI: 1.15-1.56, p < 0.001), and stress (OR = 1.68, CI: 1.41-2.00, p < 0.001). In addition, social support was negatively associated with depression (OR = 0.56, CI: 0.46-0.69, p < 0.001), anxiety (OR = 0.76, CI: 0.63-0.91, p = 0.002), and stress (OR = 0.66, CI: 0.53-0.84, p < 0.001). Subgroup analyses revealed that more social risk factors were associated with symptoms of anxiety and stress among new mothers compared to pregnant women. Conclusion: Perinatal mental health problems are relatively prevalent among rural women in China and are strongly associated with social risk factors. Policies and programs should therefore promote individual coping methods, as well as target family and community members to improve the social conditions contributing to mental health problems among rural women.
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Affiliation(s)
- Qi Jiang
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Yian Guo
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Evelyn Zhang
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Nourya Cohen
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Mika Ohtori
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Adrian Sun
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Sarah-Eve Dill
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Manpreet Kaur Singh
- Stanford Pediatric Mood Disorders Program, Stanford University, Stanford, CA, United States
| | - Xinshu She
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Alexis Medina
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Scott D. Rozelle
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
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13
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Guo P, Xu D, Liew Z, He H, Brocklehurst P, Taylor B, Zhang C, Jin X, Gong W. Adherence to Traditional Chinese Postpartum Practices and Postpartum Depression: A Cross-Sectional Study in Hunan, China. Front Psychiatry 2021; 12:649972. [PMID: 34385937 PMCID: PMC8353075 DOI: 10.3389/fpsyt.2021.649972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/25/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The relationship between adherence to traditional Chinese postpartum practices (known as "doing-the-month") and postpartum depression (PPD) remains unknown. Practices including restrictions on diet, housework and social activity, personal hygiene, and cold contact, could introduce biological, psychological, and socio-environmental changes during postpartum. Methods: The cross-sectional study included 955 postpartum women in obstetric clinics in Hunan Province of China between September 2018 to June 2019. Thirty postpartum practices were collected by a self-report online structured questionnaire. Postpartum depression symptoms were assessed by the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear regression was used to estimate the differences in EPDS scores according to adherence to postpartum practices. Firth's bias-reduced logistic regression was employed to analyze the binary classification of having PPD symptoms (EPDS ≥ 10). Results: Overall, both moderate and low adherence to postpartum practices appeared to be associated with higher EPDS scores (adjusted difference 1.07, 95% CI 0.20, 1.94 for overall moderate adherence; and adjusted difference 1.72, 95% CI 0.84, 2.60 for overall low adherence). In analyses by practice domain, low adherence to housework-related and social activity restrictions was associated with having PPD symptoms compared with high adherence (OR 1.61, 95% CI 1.07, 2.43). Conclusions: Low adherence to traditional Chinese postpartum practices was associated with higher EPDS scores indicating PPD symptoms, especially in the domain of housework-related and social activity restrictions. Psychosocial stress and unsatisfactory practical support related to low adherence to postpartum practices might contribute to PPD. Longitudinal study and clinical assessment would be needed to confirm these findings.
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Affiliation(s)
- Pengfei Guo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Dong Xu
- School of Health Management, Southern Medical University, Guangzhou, China
- Center for WHO Studies, Southern Medical University, Guangzhou, China
- Institute for Health Management, Southern Medical University, Guangzhou, China
- ACACIA Labs, Institute for Global Health and Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Hua He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Peter Brocklehurst
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | - Beck Taylor
- Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Chao Zhang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Xin Jin
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Wenjie Gong
- Xiangya School of Public Health, Central South University, Changsha, China
- Department of Psychiatry, University of Rochester, Rochester, NY, United States
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14
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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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15
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Ruohomäki A, Toffol E, Airaksinen V, Backman K, Voutilainen R, Hantunen S, Tuomainen TP, Lampi J, Kokki H, Luoma I, Kumpulainen K, Heinonen S, Keski-Nisula L, Pekkanen J, Pasanen M, Lehto SM. The impact of postpartum depressive symptoms on self-reported infant health and analgesic consumption at the age of 12 months: A prospective cohort study. J Psychiatr Res 2021; 136:388-397. [PMID: 33640540 DOI: 10.1016/j.jpsychires.2021.02.036] [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: 04/14/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/26/2022]
Abstract
The infants of mothers with elevated depressive symptoms (EDS) postpartum appear to be at increased risk of somatic health problems during their first 12 months of life in low- and lower-middle-income countries. However, in higher-income countries, knowledge of this association is scarce. We sought to examine whether maternal reports of infant health problems, adherence to vaccination schedules and analgesic supply to the infant during the first 12 months of life differ between mothers with and without postpartum EDS. Altogether, 969 women who were enrolled in the Kuopio Birth Cohort study (www.kubico.fi) during 2012-2017 were included in this investigation. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale during pregnancy (1st and/or 3rd trimester) and at eight weeks postpartum. Infant health data were collected as a part of a 12-month online follow-up questionnaire for mothers and were based on self-reports of either maternal observations or physician-determined diagnoses. Postpartum EDS were associated with a 2- to 5-fold increased likelihood of abnormal crying and paroxysmal wheezing (based on parental observations), as well as gastroesophageal reflux and food allergy (based on physician-determined diagnoses). Mothers with postpartum EDS also supplied their infants with analgesic medication for longer periods. Adherence to vaccination schedules was similar between the examined groups. In conclusion, infants of mothers with postpartum EDS may be more likely to experience health problems or to be perceived by their mother as having health problems, and thus receive more medications.
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Affiliation(s)
- Aleksi Ruohomäki
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland.
| | - Elena Toffol
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, P.O. Box 20, FI, 00014, Helsinki, Finland
| | - Ville Airaksinen
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Katri Backman
- Institute of Clinical Medicine / Pediatrics, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Raimo Voutilainen
- Institute of Clinical Medicine / Pediatrics, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Jussi Lampi
- Department of Health Security, National Institute for Health and Welfare, P.O. Box 95, FI, 70701, Kuopio, Finland
| | - Hannu Kokki
- Institute of Clinical Medicine / Anaesthesiology, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Ilona Luoma
- Institute of Clinical Medicine / Child Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland; Department of Child Psychiatry, Kuopio University Hospital, P.O. Box 100, FI, 70029, Kuopio, Finland
| | - Kirsti Kumpulainen
- Institute of Clinical Medicine / Child Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynaecology, University of Helsinki, P.O. Box 22, FI, 00014, Helsinki, Finland; Department of Obstetrics and Gynaecology, Helsinki University Hospital, P.O. Box 140, FI, 00029, Helsinki, Finland
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynaecology, Kuopio University Hospital, P.O. Box 100, FI, 70029, Kuopio, Finland; Institute of Clinical Medicine / Obstetrics and Gynaecology, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Juha Pekkanen
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, P.O. Box 20, FI, 00014, Helsinki, Finland; Department of Health Security, National Institute for Health and Welfare, P.O. Box 95, FI, 70701, Kuopio, Finland
| | - Markku Pasanen
- Faculty of Health Sciences, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland; Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, FI, 00014, Helsinki, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, FI, 00014, Helsinki, Finland
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Yu Y, Zhu X, Xu H, Hu Z, Zhou W, Zheng B, Yin S. Prevalence of depression symptoms and its influencing factors among pregnant women in late pregnancy in urban areas of Hengyang City, Hunan Province, China: a cross-sectional study. BMJ Open 2020; 10:e038511. [PMID: 32873680 PMCID: PMC7467533 DOI: 10.1136/bmjopen-2020-038511] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To evaluate the prevalence of depressive symptoms and its influencing factors in late pregnancy. DESIGN Cross-sectional study. SETTING Fourteen community in urban areas of Hengyang City. PARTICIPANTS The study conducted from July to October 2019, and surveyed 813 women in late pregnancy who lived in urban areas of Hengyang for more than 6 months, signed an informed consent and were without cognitive disorders, severe mental illnesses or other serious diseases. MEASURES Perinatal depression symptoms were evaluated using the Patient Health Questionnaire-9, and perinatal anxiety symptoms were evaluated using the Generalised Anxiety Disorder-7 Scale. Sociodemographic variables, obstetric characteristics, lifestyle behaviours, family factors, social support, sleep quality and self-efficacy were obtained through structured questionnaires. RESULTS The prevalence of depression symptoms among pregnant women in late pregnancy was 9.2% (95% CI 7.2%-11.2%). Protective factor: age between 25 and 29 years (OR=0.398; 95% CI 0.16-0.991). RISK FACTORS a normal relationship with her mother-in-law (OR=5.309; 95% CI 1.122-4.184), artificial insemination (OR=4.339; 95% CI 1.492-12.623), no exercise during pregnancy (OR=2.666; 95% CI 1.177-6.039), low self-efficacy (OR=4.253; 95% CI 1.518-11.916), low social support (OR=2.371; 95% CI 1.206-4.661), poor sleep quality (OR=2.134; 95% CI 1.131-4.027), existence of anxiety symptoms (OR=17.654; 95% CI 8.494-36.689). CONCLUSION The prevalence of depression symptoms is lower than that in developing countries, but due to the large population base of China, the problem should still be taken seriously. To prevent mental disorders of pregnant women, early screening for mental disorders, promotion of healthy lifestyles, mental healthcare during pregnancy and improved family and social support should be implemented during pregnancy nursing.
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Affiliation(s)
- Yunhan Yu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Xidi Zhu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Wensu Zhou
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Baohua Zheng
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Shilin Yin
- Department of Social Medicine and Health Management, Central South University Xiangya School of Public Health, Changsha, Hunan, China
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17
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Dadi AF, Miller ER, Mwanri L. Postnatal depression and its association with adverse infant health outcomes in low- and middle-income countries: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:416. [PMID: 32698779 PMCID: PMC7374875 DOI: 10.1186/s12884-020-03092-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 07/03/2020] [Indexed: 02/08/2023] Open
Abstract
Background Postnatal Depression (PND) is a mood disorder that steals motherhood and affects the health and development of a newborn. While the impact of PND on motherhood and newborn in developed countries are well described, its epidemiology and health consequences in infant is not well known in middle-and low-income countries. The objective of this review was to determine the burden and association of PND with adverse infant health outcomes in low-and middle- income countries. Methods We searched observational studies written in the English language and conducted in middle-and low-income countries between December 1st, 2007, and December 31st, 2017. The CINHAL, MEDLINE, Emcare, PubMed, Psych Info, and Scopus databases were searched for the following search terms: PND, acute respiratory infection, pneumonia, diarrhea, exclusive breastfeeding, common infant illnesses, and malnutrition. We excluded studies in which the primary outcomes were not measured following a standardized approach. We have meta-analyzed the estimates from primary studies by adjusting for possible publication bias and heterogeneity. The analysis was conducted in Stata 14. The study was registered in PROSPERO protocol number CRD42017082624. Result Fifty-eight studies on PND prevalence (among 63,293 women) and 17 studies (among 32,454 infants) on infant health outcomes were included. PND prevalence was higher in the low-income countries (Pooled prevalence (PP) = 25.8%; 95%CI: 17.9–33.8%) than in the middle-income countries (PP = 20.8%; 95%CI: 18.4–23.1%) and reached its peak in five to ten weeks after birth. Poor obstetric history and social support, low economic and educational status, and history of exposure to violence were associated with an increased risk of PND. The risk of having adverse infant health outcomes was 31% higher among depressed compared to non-depressed postnatal mothers (Pooled relative risk (PRR) = 1.31; 95%CI: 1.17–1.48). Malnutrition (1.39; 1.21–1.61), non-exclusive breastfeeding (1.55; 1.39–1.74), and common infant illnesses (2.55; 1.41–4.61) were the main adverse health outcomes identified. Conclusions One in four and one in five postnatal mothers were depressed in low and middle-income countries, respectively. Causes of depression could be explained by social, maternal, and psychological constructs. High risk of adverse infant health outcomes was associated with PND. Timely screening of PND and evidence-based interventions were a pressing need in low and middle-income countries.
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Affiliation(s)
- Abel Fekadu Dadi
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. .,College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia.
| | - Emma R Miller
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
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18
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Professional support during the postpartum period: primiparous mothers' views on professional services and their expectations, and barriers to utilizing professional help. BMC Pregnancy Childbirth 2020; 20:402. [PMID: 32652965 PMCID: PMC7353719 DOI: 10.1186/s12884-020-03087-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 07/02/2020] [Indexed: 12/30/2022] Open
Abstract
Background Primiparous mothers who lack of experience and knowledge of child caring, are usually overwhelmed by multifarious stressors and challenges. Although professional support is needed for primiparas, there is a gap between the necessary high-quality services and the currently provided poor services. This study aimed to explore Chinese primiparous mothers’ views on professional services, identify barriers to utilizing professional support, and further understand mothers’ expectations of and preferences for the delivery of professional services. Method A descriptive phenomenological study design was utilized in this study, and semi-structured interviews were conducted with 28 primiparous mothers who had given birth in the first year period before the interview and were selected from two community health centres in Xi’an city, Shaanxi Province, Northwest China. Each conversational interview lasted between 20 and 86 min. Colaizzi’s seven-step phenomenological approach was used to analyse the data. Results Three major themes were identified: (a) dissatisfaction with current professional services for postpartum mothers, (b) likelihood of health care professional help-seeking behaviour, (c) highlighting the demands for new health care services. The related seven sub-themes included being disappointed with current hospital services; distrusting services provided by community health centres, private institutes and commercial online platforms; preferring not seeking help from professionals as their first choice; hesitating to express their inner discourse to professionals; following confinement requirement and family burden prevents mothers from seeking professional help; experiencing urgent needs for new baby-care-related services; and determining the importance of mothers’ needs. The necessity of professional support in the first month after childbirth was strongly emphasized by the participants. Online professional guidance and support were perceived as the best way to receive services in this study. Conclusion The results of this descriptive phenomenological study suggested that the current maternal and child health care services were insufficient and could not meet primiparous mothers’ need. The results also indicated that identifying barriers and providing services focused on mothers’ needs may be an effective strategy to enhance primiparous mothers’ well-being, and further suggested that feasibility, convenience, and the cultural adaptability of health care services should be considered during the delivery of postpartum interventions.
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Ni Q, Cheng G, Chen A, Heinonen S. Early detection of mental illness for women suffering high-risk pregnancies: an explorative study on self-perceived burden during pregnancy and early postpartum depressive symptoms among Chinese women hospitalized with threatened preterm labour. BMC Psychiatry 2020; 20:250. [PMID: 32434583 PMCID: PMC7240988 DOI: 10.1186/s12888-020-02667-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/13/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed the mental health of pregnant women with threatened preterm labour (TPL). This study investigated the prevalence of self-perceived burden (SPB) among Chinese women hospitalized due to TPL during pregnancy and early postpartum depressive disorders, exploring the effect of SPB and other potential risk factors on the early signs of postpartum depressive disorders. METHODS A self-reported survey was conducted in the obstetrics department of Anhui Provincial Hospital, China. Women hospitalized with TPL were approached 1 week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. The Self-Perceived Burden Scale (SPBS) and Edinburgh Postnatal Depression Scale (EPDS) were the main measures. Descriptive statistics, Spearman correlations, and a multiple logistic regression were employed for data analysis. RESULTS SPB and early postpartum depressive disorders were commonly experienced by Chinese women hospitalized with TPL, and SPB was positively and significantly correlated with depressive symptoms. A multiple logistic regression analysis revealed that for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.42, 95% CI = 1.11-1.83, p = 0.006), age (OR = 1.14, 95% CI = 1.02-1.27, p = 0.023), occupation (OR = 3.48, 95% CI = 1.18-10.20, p = 0.023), the history of scarred uterus (OR = 7.96, 95% CI = 1.49-42.48, p = 0.015), the delivery mode of the present birth (OR = 6.19, 95% CI = 1.72-22.30, p = 0.005), and family support during pregnancy (OR = 0.60, 95% CI = 0.45-0.82, p = 0.001) were significant factors predicting early postpartum depressive symptoms. CONCLUSION This study indicates that SPB and early postpartum depressive disorders are prevalent mental issues among Chinese women hospitalized with TPL, and that SPB, especially perceived emotional burden, is a strong predictor of early postpartum depressive disorders. Our study suggests the necessity of paying attention to mental health issues, e.g. SPB and postpartum depressive symptoms among hospitalized women with TPL, and providing appropriate interventions at the prenatal stage to prevent adverse consequences.
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Affiliation(s)
- Qianqian Ni
- grid.59053.3a0000000121679639The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China
| | - Guizhi Cheng
- grid.59053.3a0000000121679639The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China
| | - An Chen
- Institute of Healthcare Engineering, Management and Architecture (HEMA), Department of Industrial Engineering and Management, Aalto University, Maarintie 8, 02150, Espoo, Finland.
| | - Seppo Heinonen
- grid.15485.3d0000 0000 9950 5666Department of Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 2, 00290 Helsinki, Finland
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Scelza BA, Hinde K. Crucial Contributions : A Biocultural Study of Grandmothering During the Perinatal Period. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 2020; 30:371-397. [PMID: 31802396 PMCID: PMC6911617 DOI: 10.1007/s12110-019-09356-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Maternal grandmothers play a key role in allomaternal care, directly caring for and provisioning their grandchildren as well as helping their daughters with household chores and productive labor. Previous studies have investigated these contributions across a broad time period, from infancy through toddlerhood. Here, we extend and refine the grandmothering literature to investigate the perinatal period as a critical window for grandmaternal contributions. We propose that mother-daughter co-residence during this period affords targeted grandmaternal effort during a period of heightened vulnerability and appreciable impact. We conducted two focus groups and 37 semi-structured interviews with Himba women. Interviews focused on experiences from their first and, if applicable, their most recent birth and included information on social support, domains of teaching and learning, and infant feeding practices. Our qualitative findings reveal three domains in which grandmothers contribute: learning to mother, breastfeeding support, and postnatal health and well-being. We show that informational, emotional, and instrumental support provided to new mothers and their neonates during the perinatal period can aid in the establishment of the mother-infant bond, buffer maternal energy balance, and improve nutritional outcomes for infants. These findings demonstrate that the role of grandmother can be crucial, even when alloparenting is common and breastfeeding is frequent and highly visible. Situated within the broader anthropological and clinical literature, these findings substantiate the claim that humans have evolved in an adaptive sociocultural perinatal complex in which grandmothers provide significant contributions to the health and well-being of their reproductive-age daughters and grandchildren.
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Affiliation(s)
- Brooke A Scelza
- Department of Anthropology, UCLA, Los Angeles, CA, 90095-1553, USA. .,Center for Behavior, Evolution and Culture, UCLA, Los Angeles, CA, 90095-1553, USA.
| | - Katie Hinde
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, 85287, USA.,Center for Evolution and Medicine, Arizona State University, Tempe, AZ, 85287, USA
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21
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Zhang H, Liu S, Si Y, Zhang S, Tian Y, Liu Y, Li H, Zhu Z. Natural sunlight plus vitamin D supplementation ameliorate delayed early motor development in newborn infants from maternal perinatal depression. J Affect Disord 2019; 257:241-249. [PMID: 31301627 DOI: 10.1016/j.jad.2019.07.010] [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: 05/02/2018] [Revised: 07/04/2019] [Accepted: 07/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Increased cortisol has been shown to be negatively correlated with infant motor development. Sunlight help decrease the level of cortisol. Vitamin D is associated with infant motor development. The present study aimed to determine whether natural sunlight exposure plus vitamin D supplements could ameliorate delayed early motor development in little infants from maternal perinatal depression. METHODS The term pregnant women waiting for delivery from the department of gynecology and obstetrics were assessed depressive symptoms by Hamilton Rating Scale for Depression (HAMD). 120 normal and 229 depressed subjects were recruited. During 2 days postpartum, infant motor development were assessed by Neonatal Behavioral Assessment Scale (NBAS). Infants of 2-day-old in maternal depression group were divided into four groups: control group, conventional vitamin D supplements (400IU/d) group, high dose of vitamin D supplements group (1000IU/d), sunlight plus conventional vitamin D supplement group (400IU/d). Serum and hair cortisol (HairF) in mothers and infants were measured. RESULTS The infants of perinatal depressed mothers displayed early motor developmental delay accompanied by increased cortisol. Sunlight plus conventional vitamin D supplement (400IU/d) were better than exclusive vitamin D supplements for the amelioration delayed early motor development in infants (p < 0.05). The infants exposure to sunlight 7-14 h/week plus conventional vitamin D supplement reached the best scores of motor development and the lowest HairF (p < 0.05). LIMITATIONS We should have measured the serum 25OH-vitamin D concentrations. CONCLUSIONS Sunlight plus vitamin D supplements could ameliorate delayed early motor development in little infants by decreasing cortisol from perinatal depression.
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Affiliation(s)
- Huiping Zhang
- Medical college of Northwest University, Shaanxi, China; Shaanxi Institute of Pediatric Diseases, The Affiliated Children Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Si Liu
- Medical college of Northwest University, Shaanxi, China
| | - Yufang Si
- Medical college of Northwest University, Shaanxi, China
| | - Sisi Zhang
- Medical college of Northwest University, Shaanxi, China
| | - Ying Tian
- Department of Neonatology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yan Liu
- Department of pediatrics, The first hospital of yulin, China
| | - Hui Li
- Department of Neonatology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhongliang Zhu
- Medical college of Northwest University, Shaanxi, China.
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22
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Shi P, Ren H, Li H, Dai Q. Maternal depression and suicide at immediate prenatal and early postpartum periods and psychosocial risk factors. Psychiatry Res 2018; 261:298-306. [PMID: 29331710 DOI: 10.1016/j.psychres.2017.12.085] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 07/01/2017] [Accepted: 12/31/2017] [Indexed: 01/27/2023]
Abstract
Maternal depression has been intensively explored; however, less attention has been paid to maternal suicide. No studies to date have observed maternal depression and suicide at immediate prenatal and early postpartum stages. In total, 213 Chinese women were recruited in hospitals after they were admitted for childbirth. All completed a short-term longitudinal survey at perinatal stages. Women reported lower depression scores (6.65) and higher suicidal ideation incidence (11.74%) after childbirth. Prenatal depression raised the possibility of prenatal suicidal ideation, while prenatal depression and suicidal ideation increased postpartum depression and suicidal ideation. At immediate prenatal stage, marital satisfaction protected women from depression, while miscarriage experiences and self-esteem increased the risk. At early postpartum stage, in contrast, being first-time mother, marital satisfaction, and harmony with mother-in-law prevented them from depression. Our study is among the first to confirm that women have decreased depression but increased suicidal ideation at early postpartum, and a causal relationship between them, which are worthy of public attention. Potential protective (marital satisfaction, being first-time mother, and harmony with mother-in-law) or risk factors (miscarriage experiences and self-esteem) of maternal depression and suicidal ideation are identified at perinatal stages. This offers reliable guidance for clinical practice of health care.
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Affiliation(s)
- Peixia Shi
- Department of nursing psychology, the Third Military Medical University, Chong qing 400038, China
| | - Hui Ren
- Department of nursing, the Third Military Medical University, Chong qing 400038, China
| | - Hong Li
- Psychology & Social College, Shenzhen University, Shenzhen 518060, China
| | - Qin Dai
- Department of nursing psychology, the Third Military Medical University, Chong qing 400038, China; Psychology & Social College, Shenzhen University, Shenzhen 518060, China.
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Xiong R, Deng A, Wan B, Liu Y. Prevalence and factors associated with postpartum depression in women from single-child families. Int J Gynaecol Obstet 2018; 141:194-199. [PMID: 29412451 DOI: 10.1002/ijgo.12461] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/29/2017] [Accepted: 02/05/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the prevalence of postpartum depression (PPD) and its associated factors among women without siblings from south China. METHODS A cross-sectional study was conducted involving 468 mothers from single-child families who were assessed at 6 weeks after childbirth at a tertiary hospital in Guangzhou, China, from June 2015 to July 2016. The Chinese version of the Edinburgh Postnatal Depression Scale and a self-designed questionnaire regarding risk factors were administered to all participants. RESULTS The prevalence of PPD in women from single-child families was 56.2%. A multivariate logistic regression model identified the following pregnancy-related and psychological risk factors: unplanned pregnancy (odds ratio [OR] 2.35, 95% confidence interval [CI] 1.73-3.32), being a first-time mother (OR 3.00, 95% CI 1.73-4.93), poor mother-in-law relationship (OR 3.15, 95% CI 2.93-3.36), and poor family support (OR 2.13, 95% CI 1.84-2.45). Sociodemographic characteristics were not associated with the development of PPD. CONCLUSION The development of PPD in women from single-child families is an important public health concern. Health practitioners should offer psychoeducation and culturally sensitive counseling during the postpartum period, and the screening of mood disorders from the prenatal to the postpartum period should be covered by maternity insurance.
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Affiliation(s)
- Ribo Xiong
- Department of Rehabilitation, The Third Affiliated Hospital of Southern Medical, University, Guangzhou, China.,Department of Rehabilitation, Nanhai Hospital of Southern Medical University, Foshan, China
| | - Aiwen Deng
- Department of Rehabilitation, The Third Affiliated Hospital of Southern Medical, University, Guangzhou, China.,Department of Rehabilitation, Nanhai Hospital of Southern Medical University, Foshan, China
| | - Bo Wan
- Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yan Liu
- Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
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Chen L, Ding L, Qi M, Jiang C, Mao XM, Cai WZ. Incidence of and social-demographic and obstetric factors associated with postpartum depression: differences among ethnic Han and Kazak women of Northwestern China. PeerJ 2018; 6:e4335. [PMID: 29404223 PMCID: PMC5793707 DOI: 10.7717/peerj.4335] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/17/2018] [Indexed: 01/08/2023] Open
Abstract
Background Studies on postpartum depression (PPD) in China have focused primarily on women of Han ethnicity, whereas work on other ethnic groups has proven limited. This study explored the ethnic differences of associated social-demographic and obstetric factors for PPD between Han-majority and Kazak-minority women in northwestern China. Methods Han and Kazak women who received routine examinations at four hospitals in a multi-ethnic area of China six weeks after childbirth between March 2016 and December 2016 were included in the study. Data on the women’s socio-demographic characteristics, obstetric factors, and possible depression at six weeks after childbirth were collected. We examined the associated factors of PPD using multivariable logistic regression analyses by ethnic group. Results The overall incidence of PPD was 14.6% (184/1,263) at six weeks after childbirth. PPD was detected more frequently among Kazak (16.1%) than Han women (13.1%). Kazak women exhibited a higher risk of PPD (adjusted OR = 1.561, 95% CI [1.108–2.198], P = 0.011). Urinary incontinence (UI) represented a significant risk factor of PPD for Kazak compared with Han women (OR = 1.720, 95% CI [1.056–2.804], P = 0.003). In contrast, the presence of the mother-in-law as a caregiver after childbirth demonstrated a positive association with PPD among Han (OR = 2.600, 95% CI [1.499–4.512], P = 0.001), but not with Kazak women. Conclusions Kazak women were more likely to develop PPD than Han women, even after controlling for confounders. Moreover, distinct risk factors for PPD existed for Han and Kazak women. Future research that explores the relationships between Han women and their mothers-in-law as well as Kazak women’s attitudes toward UI could help us further understand PPD in these populations.
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Affiliation(s)
- Ling Chen
- Department of Nursing, Shenzhen hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Li Ding
- Department of Cardiology, Xinjiang Medical University Affiliated Second Hospital, Urumqi, China
| | - Ming Qi
- Department of Rehabilitation and Psychology, First Affiliated Hospital of College of Medicine, Shihezi University, Shihezi, China
| | - Chao Jiang
- Nursing Department, Fuyun People's Hospital, Altay, China
| | - Xin-Min Mao
- Reproductive Medicine Center, Xinjiang Medical University Affiliated First Hospital, Urumqi, China
| | - Wen-Zhi Cai
- Department of Nursing, Shenzhen hospital, Southern Medical University, Shenzhen, Guangdong, China
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25
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Jin Q, Mori E, Sakajo A. Risk factors, cross-cultural stressors and postpartum depression among immigrant Chinese women in Japan. Int J Nurs Pract 2017; 22 Suppl 1:38-47. [PMID: 27184701 DOI: 10.1111/ijn.12438] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The purpose of this mixed-method design study was to examine factors contributing to depression among immigrant Chinese women (primipara and multipara) (n = 22) delivering a child for the first time in Japan. Data were obtained just after hospital discharge by using the Edinburgh Postnatal Depression Scale (EPDS), the Social Support Scale, a new scale to measure cross-cultural stressors in the postpartum setting and a visual analogue scale for stress and a demographic survey. The average EPDS score was 9.0 (SD ± 3.7) at 1-3 weeks postpartum; yet, more than half of the subjects (n = 12; 54.5%) were high risk for depression (EPDS ≥ 10). Low household income and primiparous status were associated with depression scores. New mothers with depression also reported more general stress and more cross-cultural stress in the postpartum setting, although social support appeared to mediate cross-cultural stressors. Semi-structured interviews were held with two immigrant women at high risk for depression; these new mothers described additional stress because they could not follow Zuoyuezi, an important postpartum Chinese tradition, in the Japanese hospital. These findings suggest that immigrant Chinese women are at higher risk for postpartum depression when they give birth for the first time in Japan.
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Affiliation(s)
- Qiongai Jin
- 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
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Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry 2016; 3:973-982. [PMID: 27650773 PMCID: PMC5155709 DOI: 10.1016/s2215-0366(16)30284-x] [Citation(s) in RCA: 596] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/19/2016] [Accepted: 08/22/2016] [Indexed: 12/11/2022]
Abstract
Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries.
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Affiliation(s)
- Bizu Gelaye
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Marta B Rondon
- Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru
| | - Ricardo Araya
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Michelle A Williams
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
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Prevalencia de tamiz positivo para Depresión Postparto en un Hospital de tercer nivel y posibles factores asociados. ACTA ACUST UNITED AC 2016; 45:253-261. [DOI: 10.1016/j.rcp.2016.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/24/2016] [Accepted: 03/07/2016] [Indexed: 11/22/2022]
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Top ED, Karaçam Z. Effectiveness of Structured Education in Reduction of Postpartum Depression Scores: A Quasi-Experimental Study. Arch Psychiatr Nurs 2016; 30:356-62. [PMID: 27256941 DOI: 10.1016/j.apnu.2015.12.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 09/16/2015] [Accepted: 12/17/2015] [Indexed: 12/21/2022]
Abstract
The aim of this study was to evaluate effectiveness of structured education in reduction of postpartum depression scores among women. This was a quasi-experimental study with a pre-post tests and a control group. Non-random sampling was used and the study included a total of 103 Turkish women, 52 of whom were in the intervention group and 51 were in the control group. The women in the intervention group were offered structured education for postpartum depression and given structured education material. Effectiveness of the education given was evaluated by comparing scores for Edinburg Postpartum Depression Scale obtained before and after delivery between the intervention and the control groups. Before education, median score (8.0±4.8) for Edinburg Postpartum Depression Scale of the intervention group were significantly higher the than the control group (6.0±6.0, p=0.010), but the groups were statistically similar in terms of having depression (intervention: 17.3%, control: 11.8%, p=0.425). After education, the median score for Edinburg Postpartum Depression Scale and the ratio of the women having depression in the intervention group were significantly lower than in the control group (respectively intervention: 4.0±3.0, control: 10.0±4.0, p=0.000; intervention: 7.7%, control: 25.5%, p=0.015). Besides, the median score (8.0±4.8) of the intervention group before education were significantly higher than the score (4.0±3.0) obtained after education (p=0.000), while the median score (6.0±6.0) of the control group before education were lower than the score (10.0±4.0) obtained after education (p=0.000). This study revealed that structured education offered to women by nurses was effective in reducing the postpartum depression scores and the numbers of women having depression.
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Affiliation(s)
- Ekin Dila Top
- İzmir Katip Çelebi University Faculty of Health Sciences, Division of Nursing, İzmir, Turkey
| | - Zekiye Karaçam
- Adnan Menderes University Aydın School of Health, Division of Midwifery, Aydın, Turkey.
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Abdollahi F, Etemadinezhad S, Lye MS. Postpartum mental health in relation to sociocultural practices. Taiwan J Obstet Gynecol 2016; 55:76-80. [DOI: 10.1016/j.tjog.2015.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2014] [Indexed: 11/16/2022] Open
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Atif N, Lovell K, Rahman A. Maternal mental health: The missing "m" in the global maternal and child health agenda. Semin Perinatol 2015; 39:345-52. [PMID: 26164538 DOI: 10.1053/j.semperi.2015.06.007] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
While the physical health of women and children is emphasized, the mental aspects of their health are often ignored by maternal and child health programs, especially in low- and middle-income countries. We review the evidence of the magnitude, impact, and interventions for common maternal mental health problems with a focus on depression, the condition with the greatest public health impact. The mean prevalence of maternal depression ranges between 15.6% in the prenatal and 19.8% in the postnatal period. It is associated with preterm birth, low birth weight, and poor infant growth and cognitive development. There is emerging evidence for the effectiveness of interventions, especially those that can be delivered by non-specialists, including community health workers, in low-income settings. Strategies for integrating maternal mental health in the maternal and child health agenda are suggested.
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Affiliation(s)
- Najia Atif
- Human Development Research Foundation, Islamabad, Pakistan
| | | | - Atif Rahman
- Institute of Psychology, Health & Society, University of Liverpool, UK.
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31
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Khalifa DS, Glavin K, Bjertness E, Lien L. Postnatal depression among Sudanese women: prevalence and validation of the Edinburgh Postnatal Depression Scale at 3 months postpartum. Int J Womens Health 2015; 7:677-84. [PMID: 26185471 PMCID: PMC4501244 DOI: 10.2147/ijwh.s81401] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Postnatal depression (PND) rates in low-resource countries have reached levels between 4.9% and 59%. Maternal mental health has not been researched in Sudan, and there are no existing statistics on prevalence or significant risk factors for PND. Consequently, no screening test has been validated to screen for PND at the primary health care level. This study investigates the 3 months prevalence of PND and validates the Edinburgh Postnatal Depression Scale (EPDS) against the Mini-International Neuropsychiatric Interview (MINI). Methodology Pregnant Sudanese women in the second and third trimesters were recruited to the study during routine antenatal care visits in two major maternity hospitals in Khartoum state. They were screened for PND at 3 months postpartum using the EPDS. Test positive women were matched with test negative women according to nearest date of birth. A clinical psychologist verified their depression status using the MINI. Results The follow-up rate was 79%. At a cutoff point of ≥12, the 3 months prevalence of PND was 9.2%. The sensitivity and specificity of the EPDS were 89% and 82%, respectively. The EPDS and MINI showed a strong positive relationship (odds ratio =36). The positive predictive value and negative predictive value, using this study’s prevalence, were 33% and 98.7%, respectively. The receiver operator characteristic analysis showed an area under the curve of 0.89. The cut-off point ≥12 was the most acceptable point as it had the lowest number needed to diagnose (1.4) and a false-positive rate of 18%. Conclusion The EPDS is a valid tool for screening for PND on a Sudanese population. It was accepted, easily administered, and understood by postnatal women. Health care personnel, especially village midwives, should be trained on screening and referral of depressed women for clinical evaluation and management. Due to limited resources available in Sudan, shorter screening tests need to be validated in the future.
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Affiliation(s)
- Dina Sami Khalifa
- Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway ; Faculty of Health Sciences, Ahfad University for Women, Omdurman, Sudan
| | | | - Espen Bjertness
- Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway
| | - Lars Lien
- National Advisory Board on Dual Diagnosis, Innlandet Hospital Trust, Hamar, Norway ; Department of Public Health, Hedmark University College, Elverum, Norway
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Yargawa J, Leonardi-Bee J. Male involvement and maternal health outcomes: systematic review and meta-analysis. J Epidemiol Community Health 2015; 69:604-12. [PMID: 25700533 PMCID: PMC4453485 DOI: 10.1136/jech-2014-204784] [Citation(s) in RCA: 241] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 01/05/2015] [Accepted: 01/18/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND The developing world accounts for 99% of global maternal deaths. Men in developing countries are the chief decision-makers, determining women's access to maternal health services and influencing their health outcomes. At present, it is unclear whether involving men in maternal health can improve maternal outcomes. This systematic review and meta-analysis aimed to investigate the impact of male involvement on maternal health outcomes of women in developing countries. METHODS Four electronic databases and grey literature sources were searched (up to May 2013), together with reference lists of included studies. Two reviewers independently screened and assessed the quality of studies based on prespecified criteria. Measures of effects were pooled and random effect meta-analysis was conducted, where possible. RESULTS Fourteen studies met the inclusion criteria. Male involvement was significantly associated with reduced odds of postpartum depression (OR=0.36, 95% CI 0.19 to 0.68 for male involvement during pregnancy; OR=0.34, 95% CI 0.19 to 0.62 for male involvement post partum), and also with improved utilisation of maternal health services (skilled birth attendance and postnatal care). Male involvement during pregnancy and at post partum appeared to have greater benefits than male involvement during delivery. CONCLUSIONS Male involvement is associated with improved maternal health outcomes in developing countries. Contrary to reports from developed countries, there was little evidence of positive impacts of husbands' presence in delivery rooms. However, more rigorous studies are needed to improve this area's evidence base.
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Affiliation(s)
- Judith Yargawa
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Nottingham, UK
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Nottingham, UK
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Liu YQ, Petrini M, Maloni JA. “Doing the month”: Postpartum practices in Chinese women. Nurs Health Sci 2014; 17:5-14. [DOI: 10.1111/nhs.12146] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/21/2014] [Accepted: 03/26/2014] [Indexed: 12/16/2022]
Affiliation(s)
- Yan Qun Liu
- HOPE School of Nursing; Wuhan University; Wuchang China
| | | | - Judith A. Maloni
- School of Nursing; Case Western Reserve University; Chagrin Falls OH USA
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Deng AW, Xiong RB, Jiang TT, Luo YP, Chen WZ. Prevalence and risk factors of postpartum depression in a population-based sample of women in Tangxia Community, Guangzhou. ASIAN PAC J TROP MED 2014; 7:244-9. [DOI: 10.1016/s1995-7645(14)60030-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 01/15/2014] [Accepted: 02/15/2014] [Indexed: 11/29/2022] Open
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Shorey S, Chan SWC, Chong YS, He HG. Maternal parental self-efficacy in newborn care and social support needs in Singapore: a correlational study. J Clin Nurs 2013; 23:2272-82. [DOI: 10.1111/jocn.12507] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2013] [Indexed: 12/14/2022]
Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Sally Wai-Chi Chan
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Yap Seng Chong
- Department of Obstetrics and Gynaecology; National University Hospital; Singapore Singapore
- Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
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Mamisachvili L, Ardiles P, Mancewicz G, Thompson S, Rabin K, Ross LE. Culture and postpartum mood problems: similarities and differences in the experiences of first- and second-generation Canadian women. J Transcult Nurs 2013; 24:162-70. [PMID: 23460457 DOI: 10.1177/1043659612472197] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Few studies have examined the role of culture in a woman's experience of postpartum mood problems (PPMP). This study explored differences and similarities in experiences of PPMP between first- and second-generation Canadian women. DESIGN In this exploratory qualitative study, we interviewed nine first-generation and eight second-generation women who were clients of the Women's Health Centre at St. Joseph's Health Centre in Toronto, Canada. Using semistructured interviews, we explored how women perceived and experienced PPMP. FINDINGS Four themes reflected cultural issues: PPMP stigma, relationship with parents/in-laws, internalization of society's expectations of motherhood, and identity issues/relationship with self. DISCUSSION The results of this study contribute to a limited literature on possible contributing factors to PPMP and can inform development of resources for delivering culturally appropriate mental health care for women dealing with PPMP.
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Use of Herbal Dietary Supplement Si-Wu-Tang and Health-Related Quality of Life in Postpartum Women: A Population-Based Correlational Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:790474. [PMID: 23476705 PMCID: PMC3586461 DOI: 10.1155/2013/790474] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 01/17/2013] [Indexed: 11/17/2022]
Abstract
Objective. The aim of the study was to explore the association between women's use of herbal dietary supplement Si-Wu-Tang during the postpartum period and their health-related quality of life. Methods. This is a population-based correlational study. We used multistage, stratified, systematic sampling to recruit 24,200 pairs of postpartum women and newborns from the Taiwan National Birth Registry in 2005. A structured questionnaire was successfully administered to 87.8% of the sampled population. Trained interviewers performed home interviews 6 months after the women's deliveries between June 2005 and July 2006. The Medical Outcomes Study 36-item Short-Form (SF-36) was used to measure the quality of life of the women along with the frequency of Si-Wu-Tang use. Results. Si-Wu-Tang use after delivery improved women's score for bodily pain and also improved their score for mental health when used more than 10 times. In addition, there were increases in general health and vitality scores in the group who continuously used Si-Wu-Tang more than 10 times after using Sheng-Hua-Tang. Conclusion. Use of Si-Wu-Tang after delivery may be associated with women's health-related quality of life especially for those who previously used Sheng-Hua-Tang. These results are exploratory and need to be replicated.
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Silva R, Jansen K, Souza L, Quevedo L, Barbosa L, Moraes I, Horta B, Pinheiro R. Sociodemographic risk factors of perinatal depression: a cohort study in the public health care system. BRAZILIAN JOURNAL OF PSYCHIATRY 2012; 34:143-8. [PMID: 22729409 DOI: 10.1590/s1516-44462012000200005] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 10/18/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess the sociodemographic risk factors for the prevalence and incidence of relevant postpartum depressive symptoms. METHOD We studied a cohort of women in their perinatal period with the assistance of the public health system in the city of Pelotas-RS, Brazil. We assessed depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) in the prenatal and postnatal periods. RESULTS We interviewed 1,109 women. The prevalence of meaningful depressive symptoms during pregnancy was 20.5% and postpartum was 16.5%. Women with prenatal depression were at higher risk for postpartum depression. CONCLUSION The mother's poverty level, psychiatric history, partner absence and stressful life events should be considered important risk factors for relevant postpartum depressive symptoms.
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Mao HJ, Li HJ, Chiu H, Chan WC, Chen SL. Effectiveness of antenatal emotional self-management training program in prevention of postnatal depression in Chinese women. Perspect Psychiatr Care 2012; 48:218-24. [PMID: 23005589 DOI: 10.1111/j.1744-6163.2012.00331.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to study the effectiveness of an emotional self-management training program to antenatal women in the prevention of postnatal depression. DESIGN AND METHODS The sample comprised 240 women who were at 32 weeks antenatal. They were randomly assigned into the intervention group and the control group. FINDINGS On completion of the program, the intervention group reported significantly lower mean Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale scores than the control group. Fewer participants from the intervention group were diagnosed as having postnatal depression using the Structured Clinical Interview for DSM-IV. PRACTICE IMPLICATIONS An antenatal emotional self-management training that may lower the risk of developing postnatal depression among Chinese women is recommended.
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Affiliation(s)
- Hong-Jing Mao
- Department of Psychiatry, The Seventh Hospital of HangZhou, HangZhou, ZheJiang, China
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Poverty and postnatal depression: a systematic mapping of the evidence from low and lower middle income countries. Health Place 2012; 18:1188-97. [DOI: 10.1016/j.healthplace.2012.05.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 02/10/2012] [Accepted: 05/19/2012] [Indexed: 02/07/2023]
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No relationship between maternal iron status and postpartum depression in two samples in China. J Pregnancy 2012; 2012:521431. [PMID: 22900184 PMCID: PMC3413960 DOI: 10.1155/2012/521431] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 04/27/2012] [Accepted: 04/30/2012] [Indexed: 11/19/2022] Open
Abstract
Maternal iron status is thought to be related to postpartum depressive symptoms. The purpose of the present study was to evaluate the relationship between pre- and postnatal maternal iron status and depressive symptoms in pilot (n = 137) and confirmatory (n = 567) samples of Chinese women. Iron status was evaluated at mid- and late pregnancy and 3 days postpartum. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess maternal postpartum depression 24–48 hours after delivery and 6 weeks later. In the pilot sample, correlations between early- and late-pregnancy maternal Hb and EPDS scores at 6 weeks were r = 0.07 and −0.01, respectively (nonsignificant). In the confirmatory sample, the correlations between maternal iron measures (Hb, MCV, ZPP, ferritin, sTfR, and sTfR Index) in mid- or late pregnancy or 3 days postpartum and EPDS scores shortly after delivery or at 6 weeks were also low (r values < 0.10). EPDS scores in anemic and nonanemic mothers did not differ, regardless of sample or timing of maternal iron status assessment. In addition, women with or without possible PPD were similar in iron status in both samples. Thus, there was no relationship between maternal iron status and postpartum depression in these samples.
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Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, Holmes W. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ 2012; 90:139G-149G. [PMID: 22423165 PMCID: PMC3302553 DOI: 10.2471/blt.11.091850] [Citation(s) in RCA: 1001] [Impact Index Per Article: 83.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 10/23/2011] [Accepted: 10/24/2011] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low- and lower-middle-income countries. METHODS Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. FINDINGS Thirteen papers covering 17 low- and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8%) countries, and on disorders in the postnatal period, for 17 (15%). Weighted mean prevalence was 15.6% (95% confidence interval, CI: 15.4-15.9) antenatally and 19.8% (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95% CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95% CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95% CI: 0.3-0.9). CONCLUSION CPMDs are more prevalent in low- and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.
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Affiliation(s)
- Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, Australia 3168.
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Parsons CE, Young KS, Rochat TJ, Kringelbach ML, Stein A. Postnatal depression and its effects on child development: a review of evidence from low- and middle-income countries. Br Med Bull 2012; 101:57-79. [PMID: 22130907 DOI: 10.1093/bmb/ldr047] [Citation(s) in RCA: 226] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION OR BACKGROUND It is well established that postnatal depression (PND) is prevalent in high-income countries and is associated with negative personal, family and child developmental outcomes. SOURCES OF DATA Here, studies on the prevalence of maternal PND in low- and middle-income countries are reviewed and a geographical prevalence map is presented. The impact of PND upon child outcomes is also reviewed. AREAS OF AGREEMENT The available evidence suggests that rates of PND are substantial, and in many regions, are higher than those reported for high-income countries. An association between PND and adverse child developmental outcomes was identified in many of the countries examined. AREAS OF CONTROVERSY Significant heterogeneity in prevalence rates and impact on child outcomes across studies means that the true extent of the disease burden is still unclear. AREAS TIMELY FOR DEVELOPING RESEARCH Nonetheless, there is a compelling case for the implementation of interventions to reduce the impact of PND on the quality of the mother-infant relationship and improve child outcomes.
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Loo KK, Li Y, Tan Y, Luo X, Presson A, Shih W. Prenatal anxiety associated with male child preference among expectant mothers at 10-20 weeks of pregnancy in Xiangyun County, China. Int J Gynaecol Obstet 2011; 111:229-32. [PMID: 20817176 DOI: 10.1016/j.ijgo.2010.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 06/26/2010] [Accepted: 08/05/2010] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To examine the relationship between male child preference and maternal prenatal psychological distress among expectant mothers from Xiangyun County, Yunnan Province, China. METHODS Child gender preference, state-trait anxiety and depression, relationships with the husband and mother-in-law, and self-esteem were measured in a sample of 198 women between 10 and 20 weeks of pregnancy. Multivariate logistic regression analysis was used to identify risk factors for prenatal anxiety. RESULTS Prenatal anxiety was correlated with male child preference (r=0.15, P<0.05), maternal age (r=-0.17, P<0.05), level of education (r=-0.23, P<0.01), self-esteem (r=-0.36, P<0.01), relationship with mother-in-law (r=-0.34, P<0.01), and relationship with husband (r=-0.35, P<0.01). Significant relationships were maintained in multivariate analysis that included gender preference, maternal education, pregnancy anxiety, self-esteem, number of people in the household, and relationship with husband as predictors (adjusted r(2)=0.28, P<0.001). CONCLUSION Male child preference was associated with prenatal anxiety in this sample. Younger maternal age, lower self-esteem, lower level of education, worse relationship with husband, and less family cohesiveness were also related to prenatal anxiety. Expectant mothers experienced prenatal anxiety when there was strong family preference for sons.
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Affiliation(s)
- Kek Khee Loo
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
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Use of Sheng-Hua-Tang and health-related quality of life in postpartum women: A population-based cohort study in Taiwan. Int J Nurs Stud 2010; 47:13-9. [DOI: 10.1016/j.ijnurstu.2009.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Revised: 06/03/2009] [Accepted: 06/07/2009] [Indexed: 11/24/2022]
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Moyer CA, Yang H, Kwawukume Y, Gupta A, Zhu Y, Koranteng I, Elsayed Y, Wei Y, Greene J, Calhoun C, Ekpo G, Beems M, Ryan M, Adanu R, Anderson F. Optimism/pessimism and health-related quality of life during pregnancy across three continents: a matched cohort study in China, Ghana, and the United States. BMC Pregnancy Childbirth 2009; 9:39. [PMID: 19723332 PMCID: PMC2744663 DOI: 10.1186/1471-2393-9-39] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Accepted: 09/01/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about how optimism/pessimism and health-related quality of life compare across cultures. METHODS Three samples of pregnant women in their final trimester were recruited from China, Ghana, and the United States (U.S.). Participants completed a survey that included the Life Orientation Test - Revised (LOT-R, an optimism/pessimism measure), the Short Form 12 (SF-12, a quality of life measure), and questions addressing health and demographic factors. A three-country set was created for analysis by matching women on age, gestational age at enrollment, and number of previous pregnancies. Anovas with post-hoc pairwise comparisons were used to compare results across the cohorts. Multivariate regression analysis was used to create a model to identify those variables most strongly associated with optimism/pessimism. RESULTS LOT-R scores varied significantly across cultures in these samples, with Ghanaian pregnant women being the most optimistic and least pessimistic and Chinese pregnant women being the least optimistic overall and the least pessimistic in subscale analysis. Four key variables predicted approximately 20% of the variance in overall optimism scores: country of origin (p = .006), working for money (p = .05); level of education (p = .002), and ever being treated for emotional issues with medication (p < .001). Quality of life scores also varied by country in these samples, with the most pronounced difference occurring in the vitality measure. U.S. pregnant women reported far lower vitality scores than both Chinese and Ghanaian pregnant women in our sample. CONCLUSION This research raises important questions regarding what it is about country of origin that so strongly influences optimism/pessimism among pregnant women. Further research is warranted exploring underlying conceptualization of optimism/pessimism and health related quality of life across countries.
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Affiliation(s)
- Cheryl A Moyer
- Global REACH, University of Michigan, Ann Arbor, MI 48104, USA.
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