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Che X, Hong X, Gross S, Pearson C, Bartell T, Wang X, Wang G. Maternal Mediterranean-Style Diet Adherence during Pregnancy and Metabolomic Signature in Postpartum Plasma: Findings from the Boston Birth Cohort. J Nutr 2024; 154:846-855. [PMID: 38278216 PMCID: PMC10942856 DOI: 10.1016/j.tjnut.2024.01.022] [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: 10/15/2023] [Revised: 12/11/2023] [Accepted: 01/19/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND The health benefits of a Mediterranean-style diet (MSD) are well observed, but the underlying mechanisms are unclear. Metabolomic profiling offers a systematic approach for identifying which metabolic biomarkers and pathways might be affected by an MSD. OBJECTIVES This study aimed to identify postpartum plasma metabolites that are associated with MSD adherence during pregnancy and to further test whether these identified metabolites may vary by maternal characteristics. METHODS We analyzed data from 1410 mothers enrolled in the Boston Birth Cohort (BBC). A maternal food frequency questionnaire (FFQ) was administered and epidemiologic information was obtained via an in-person standard questionnaire interview within 24-72 h postpartum. Maternal clinical information was extracted from electronic medical records. A Mediterranean-style diet score (MSDS) was calculated using responses to the FFQ. Metabolomic profiling in postpartum plasma was conducted by liquid chromatography-MS. Linear regression models were used to assess the associations of each metabolite with an MSDS, adjusting for covariates. RESULTS Among the 380 postpartum plasma metabolites analyzed, 24 were associated with MSDS during pregnancy (false discovery rate < 0.05). Of 24 MSDS-associated metabolites, 19 were lipids [for example, triacylglycerols, phosphatidylcholines (PCs), PC plasmalogen, phosphatidylserine, and phosphatidylethanolamine]; others were amino acids (methionine sulfoxide and threonine), tropane (nor-psi-tropine), vitamin (vitamin A), and nucleotide (adenosine). The association of adenosine and methionine sulfoxide with MSDS differed by race (P-interaction = 0.033) and maternal overweight or obesity status (P-interaction = 0.021), respectively. CONCLUSIONS In the BBC, we identified 24 postpartum plasma metabolites associated with MSDS during pregnancy. The associations of the 2 metabolites varied by maternal race and BMI. This study provides a new insight into dietary effects on health under the skin. More studies are needed to better understand the metabolic pathways underlying the short- and long-term health benefits of an MSD during pregnancy.
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Affiliation(s)
- Xiaoyu Che
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Xiumei Hong
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Susan Gross
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Colleen Pearson
- Department of Pediatrics, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, United States
| | - Tami Bartell
- Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
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Bhusal CK, Bhattarai S, Shrestha A, Sharma HR. Depression and Its Determinants among Postpartum Mothers Attending at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Rupandehi, Nepal. Int J Pediatr 2023; 2023:1331641. [PMID: 37538262 PMCID: PMC10396550 DOI: 10.1155/2023/1331641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Abstract
Background Postpartum depression is a serious mental health issue linked to maternal morbidity and negative effects for infant's normal growth, development, and well-being. This study is aimed at assessing the prevalence and factors associated with postpartum depression among mothers attending a tertiary hospital in Nepal. Methods A hospital-based cross-sectional study was conducted among 173 postpartum mothers (<6 weeks postdelivery) who were receiving care either at the postnatal ward or immunization clinic of Universal College of Medical Sciences and Teaching Hospital in Bhairahawa, Rupandehi district, Nepal. The study was carried out from October 2020 to February 2021 by using purposive sampling technique for selecting respondents. The variables that showed significant association with the dependent variable having p value < 0.05 in bivariate analysis were entered into multivariate logistic regression model to find the final associated factors. Results The prevalence of postpartum depression was 20.2% among mothers attending a tertiary hospital in Nepal. The mean age of the respondents was 24.77 ± 3.47. Factors such as mothers having female child (AOR = 6.39, CI = 1.54 - 26.46), unplanned pregnancy (AOR = 10.08, CI = 2.91 - 34.94), pregnancy-induced health problems (AOR = 9.68, CI: 3.51-26.64) were associated with an increased risk of postpartum depression. Similarly, mothers having formal education (AOR = 0.28, CI: 0.08-0.91), whose spouses have secondary and above education (AOR = 0.16, CI: 0.03-0.85), and who have ≥4 ANC visits (AOR = 0.15, CI = 0.05 - 0.40) were significantly associated but have a protective effect with postpartum depression. Conclusions Sex of newborn, mother's and spouse's education, intention of pregnancy, ANC visits, and pregnancy-induced health problems were found to be significantly associated with postpartum depression. Hence, specific health education program regarding maternal and child health integrating mental health should be provided to pregnant women, mothers, and their husbands, focusing on gender discrimination. Similarly specific orientation program should be provided to local health worker about the importance of planned pregnancy, in order to reduce pregnancy related health problems during ANC visits and to mothers after their delivery to reduce further chances of postpartum depression.
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Affiliation(s)
- Chet Kant Bhusal
- Department of Community Medicine, Universal College of Medical Sciences and Teaching Hospital Affiliated to Tribhuvan University, Bhairahawa, Rupandehi, Nepal
| | - Sigma Bhattarai
- Department of Nursing, Universal College of Medical Sciences and Teaching Hospital Affiliated to Tribhuvan University, Bhairahawa, Rupandehi, Nepal
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Tomita Y, Kiriya J, Silwal RC, Ong KIC, Shibanuma A, Jimba M. Association between the person-centered maternity care experience and mental health after delivery in urban and rural Dhading, Nepal: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:398. [PMID: 37254041 DOI: 10.1186/s12884-023-05709-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 05/16/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Person-centered maternity care is a component of quality care, which includes effective communication, respect, and dignity. Supportive care has a positive effect on mothers' perinatal experience. In contrast, negative childbirth experiences can cause psychological problems. However, the impact of person-centered maternity care experience on mothers' mental health after delivery remains unknown. Therefore, in this study, we examined the association between person-centered maternity care experience at healthcare facilities and maternal mental health after delivery among Nepali women. METHODS We conducted a cross-sectional study in urban and rural areas in Dhading District, Nepal. Participants were women who gave birth at public healthcare facilities, and their baby's age was between 1 and 12 months. After purposively selecting the target areas, we recruited the women from July to August 2019 and interviewed them using questionnaires. We conducted multiple regression analyses to analyze the association between delivery care experience and depressive symptoms and the association between delivery care experience and mental well-being. RESULTS In total, 595 women were included in the data analysis. The experience of better person-centered maternity care was associated with lower depressive symptom scores in urban (unstandardized coefficient [B]= - 0.09, p < 0.001) and rural areas (B= - 0.10, p < 0.001). Moreover, the experience of better person-centered maternity care was associated with higher mental well-being scores in both urban (B= 0.30, p < 0.001) and rural areas (B= 0.15, p = 0.017). CONCLUSIONS Person-centered maternity care was associated with lower depressive symptom scores and higher mental well-being, regardless of the setting in Nepal. Person-centered maternity care during childbirth can potentially improve mental health after delivery. Maternity care should be improved with more attention to person-centered maternity care aspects.
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Affiliation(s)
- Yuri Tomita
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Kiriya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Ram Chandra Silwal
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Green Tara Nepal, Kathmandu, Nepal
| | - Ken Ing Cherng Ong
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Alzahrani J, Al-Ghamdi S, Aldossari K, Al-Ajmi M, Al-Ajmi D, Alanazi F, Aldossary A, Alharbi A. Postpartum Depression Prevalence and Associated Factors: An Observational Study in Saudi Arabia. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1595. [PMID: 36363552 PMCID: PMC9696672 DOI: 10.3390/medicina58111595] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 08/05/2023]
Abstract
Background and Objectives: Postpartum depression (PPD) is a psychological disorder in women who recently gave birth. It can present as mild to severe depression. Multiple studies across the globe have used the Edinburgh Postnatal Depression Scale to reveal the factors that affect the prevalence of PPD. Results from various published studies showed a high prevalence of PPD in Saudi Arabia. The objective of this study is to investigate the major factors that increase PPD and other associated factors. Materials and Methods: An observational cross-sectional study was carried out at primary healthcare centres and military hospitals in Al Kharj. The study measured the rate of PPD among Saudi women during the postpartum period. We studied 279 women aged 19-45 (mean age 31.91, SD ± 6.45) in their postpartum period and followed up to 2 months after delivery. Results: The prevalence of PPD in our cohort was 32.8%. Multivariate logistic regression analysis showed that previous depression diagnosis (p = 0.001), lower education status (p = 0.029), unemployment (p = 0.014), and delivery disposition of C-section (p = 0.002) remained associated with an increased risk of developing PPD. Conclusions: The increasing number of Saudi women with PPD demonstrates that it is a highly prevalent condition. PPD affects not only the health of the mother but also that of her baby and other family members. Our results showed that the history of diagnosed depression, lower education status, unemployment, and delivery disposition of C-sections were independent predictors of PPD development. Raising awareness and controlling the vulnerable factors could decrease the high risk of its effects.
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Affiliation(s)
- Jamaan Alzahrani
- Department of Family & Community Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Sameer Al-Ghamdi
- Department of Family & Community Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Khaled Aldossari
- Department of Family & Community Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Mansour Al-Ajmi
- Department of Family & Community Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Dhafer Al-Ajmi
- Family Medicine Resident, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Faisal Alanazi
- Pediatric Resident, Security Forces Hospital, Riyadh 11481, Saudi Arabia
| | - Abdullah Aldossary
- Family Medicine Resident, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Ahmed Alharbi
- General Surgery Resident, King Khalid Hospital, Al Kharj 16271, Saudi Arabia
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Singh DR, Sunuwar DR, Adhikari S, Singh S, Karki K. Determining factors for the prevalence of depressive symptoms among postpartum mothers in lowland region in southern Nepal. PLoS One 2021; 16:e0245199. [PMID: 33481863 PMCID: PMC7822291 DOI: 10.1371/journal.pone.0245199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022] Open
Abstract
Background Postpartum depression is the most common mental health problem among women of childbearing age in resource-poor countries. Poor maternal mental health is linked with both acute and chronic negative effects on the growth and development of the child. This study aimed to assess the prevalence and factors associated with depressive symptoms among postpartum mothers in the lowland region in southern Nepal. Methods A hospital-based analytical cross-sectional study was conducted from 1st July to 25th August 2019 among 415 randomly selected postpartum mothers attending the child immunization clinic at Narayani hospital. The postpartum depressive symptoms were measured using the validated Nepalese version of the Edinburg Postnatal Depression Scale (EPDS). The data were entered into EpiData software 3.1v and transferred into Stata version 14.1 (StataCorp LP, College Station, Texas) for statistical analyses. To identify the correlates, backward stepwise binary logistic regression models were performed separately for the dichotomized outcomes: the presence of postpartum depressive symptoms. The statistical significance was considered at p-value <0.05 with 95% confidence intervals (CIs). Results Among the total 415 study participants, 33.7% (95% CI: 29.2–38.5%) of postpartum mothers had depressive symptoms. Study participant’s whose family monthly income <150 USD compared to ≥150 USD (aOR = 13.76, 95% CI: 6.54–28.95), the husband had migrated for employment compared to not migrated (aOR = 8.19, 95% CI:4.11–15.87), nearest health facility located at more than 60 minutes of walking distance (aOR = 4.52, 95% CI: 2.26–9.03), delivered their last child by cesarean section compared to normal (vaginal) delivery (aOR = 2.02, 95% CI: 1.12–3.59) and received less than four recommended antenatal care (ANC) visits (aOR = 2.28, 95% CI:1.25–4.15) had higher odds of depressive symptoms. Participants who had planned pregnancy (aOR = 0.44, 95% CI: 0.25–0.77) were associated with 56% lower odds of depressive symptoms. Conclusions One-third of the mothers suffered from postpartum depressive symptoms. The participant’s husband migrated for employment, family income, distance to reach a health facility, delivery by cesarean section, not receiving recommended ANC visits, and plan of pregnancy were independent predictors for postpartum depressive symptoms. The study results warranted the urgency for clinical diagnosis of PPD and implementation of preventive package in study settings. Mental health education to pregnant women during ANC visits and proper counseling during the antepartum and postpartum period can also play a positive role in preventing postpartum depression.
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Affiliation(s)
- Devendra Raj Singh
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
- Research and Innovation Section, Southeast Asia Development Actions Network (SADAN), Lalitpur, Nepal
- Research Section, Swadesh Development Foundation (SDF), Province-2, Siraha, Nepal
- * E-mail:
| | - Dev Ram Sunuwar
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
- Department of Nutrition and Dietetics, Armed Police Force Hospital, Kathmandu, Nepal
| | - Shraddha Adhikari
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
| | - Sunita Singh
- Central Department of Home Science, Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Kshitij Karki
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal
- Group for Technical Assistance, Lalitpur, Nepal
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Labrague LJ, McEnroe-Petitte D, Tsaras K, Yboa BC, Rosales RA, Tizon MM, D'souza MS. Predictors of postpartum depression and the utilization of postpartum depression services in rural areas in the Philippines. Perspect Psychiatr Care 2020; 56:308-315. [PMID: 31355473 DOI: 10.1111/ppc.12428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/07/2019] [Accepted: 07/14/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study explored the prevalence and predictors of postpartum depression (PPD) as well as the utilization and evaluation of PPD services among postpartum women in rural areas of the Philippines. DESIGN AND METHODS A cross-sectional study was conducted. One hundred sixty-five women who visited maternal facilities in the rural areas of the Central Philippines completed the Edinburgh Postnatal Depression Scale (EPDS). FINDINGS The prevalence of PPD was 16.4% at the sixth postpartum week. Occupation and marital status had significant direct influences on PPD. PPD services were not routinely provided by doctors and nurses. PRACTICE IMPLICATIONS Our results highlight a greater need to intensify government programs relative to PPD services, specifically related to the early detection and screening of PPD among high-risk pregnancies.
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Affiliation(s)
- Leodoro J Labrague
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | | | - Konstantinos Tsaras
- Department of Nursing, Technological Educational Institute of Thessaly, Larissa, Greece
| | - Begonia C Yboa
- College of Nursing and Health Sciences, Catbalogan, Philippines
| | | | - Maricel M Tizon
- College of Nursing and Health Sciences, Catbalogan, Philippines
| | - Melba S D'souza
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
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Koirala P, Chuemchit M. Depression and Domestic Violence Experiences Among Asian Women: A Systematic Review. Int J Womens Health 2020; 12:21-33. [PMID: 32021490 PMCID: PMC6970613 DOI: 10.2147/ijwh.s235864] [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: 10/24/2019] [Accepted: 01/03/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the association of postpartum depression with domestic violence experiences among women in Asia. Background Postpartum depression (PPD) is an important cause of maternal morbidity as well as mortality. There is increasing evidence that domestic violence (DV) increases the risk of PPD. Methods We performed literature searches using the databases PUBMED, SCOPUS, Web of Science and Google Scholar, for studies published between January 2010 and May 2019. The keywords “postpartum”, “postnatal”, “depression”, and “violence” were used. Observational studies conducted within Asia, and written in the English language, were included. Results In the 38 studies included in this review (with 37,087 participants), the prevalence of PPD ranged between 8.2% to 70% and that of DV between 6.1% to 67.4%. There were 1.6 to 7.1 higher odds of PPD among sufferers of DV. Intimate partner violence (IPV) was the most relevant factor that women experiencing psychological abuse (which was the most prevalent form of IPV) were more at risk for, and violence/intimidation by other family members was also associated with PPD. Domestic violence increased the risk of suicidal ideation in PPD. Discussion The findings of the review unequivocally shows the association between domestic violence and PPD. Maternal mental health is a neglected area of healthcare in many parts of Asia. Likewise, domestic violence is a readily recognized, but inadequately addressed social issue. We recommend that healthcare workers be trained to recognize and support the women who are vulnerable to violence and depression during pregnancy and postpartum. Policies need to be developed at national and global levels to tackle these issues with utmost urgency.
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Affiliation(s)
- Pallavi Koirala
- College of Public Health Sciences, Chulalongkorn University, Patumwan, Bangkok 10330, Thailand
| | - Montakarn Chuemchit
- College of Public Health Sciences, Chulalongkorn University, Patumwan, Bangkok 10330, Thailand
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