1
|
Ståhl A, Salonen M, Hakanen E, Mikkola S, Sulkama S, Lahti J, Lohi H. Development and validation of the puppy blues scale measuring temporary affective disturbance resembling baby blues. NPJ MENTAL HEALTH RESEARCH 2024; 3:27. [PMID: 38849543 PMCID: PMC11161525 DOI: 10.1038/s44184-024-00072-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/30/2024] [Indexed: 06/09/2024]
Abstract
It has been described that many puppy owners experience a state called puppy blues involving stress, worry, anxiety, strain, frustration, or regret. While puppy blues is a commonly used term among dog owners, the term is nearly nonexistent in scientific literature. In turn, analogous phenomenon, postpartum affective disturbance of infant caregivers, is well described in the literature. This study aimed to develop and validate the first questionnaire to evaluate puppy blues. The methodology involved generating scale items based on a qualitative review of 135 pilot survey responses from people who had experienced distress during the puppy period, conducting exploratory factor analysis for the final scale items from a dataset of 1801 answers from Finnish dog owners (92% women), and collecting test-retest data from 265 individuals to assess the consistency of the measurement of items and factor structure across time. In addition, we collected an independent sample of 326 owners of 1-2-year-old dogs who answered the survey both regarding puppy period and current moment. The results indicate that the scale is a valid and reliable tool for measuring dog owners' negative experiences and feelings related to puppyhood. We discovered three factors that describe different aspects of puppy blues: Frustration, Anxiety, and Weariness, which accounted for a significant proportion of the variance in puppy blues. The study demonstrated good internal consistency and consistency across two independent samples for the three identified factors. The test-retest reliability of the factors was good. Responses for the current timeframe compared to puppyhood experiences revealed significantly lower current scores across all factors for the current period, validating that the scale captures distress during puppyhood that diminishes over time. Interestingly, we found a fading affect bias where recollections of the experiences in the puppy period became more positive with time. Our findings shed light on the characteristics of puppy blues and provide a useful retrospective tool for measuring it.
Collapse
Affiliation(s)
- Aada Ståhl
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland.
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland.
- Folkhälsan Research Center, Helsinki, Finland.
| | - Milla Salonen
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Biology, University of Turku, Turku, Finland
| | - Emma Hakanen
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Salla Mikkola
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Sini Sulkama
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Hannes Lohi
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland.
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland.
- Folkhälsan Research Center, Helsinki, Finland.
| |
Collapse
|
2
|
Fujii K, Tsuji S, Ono M, Yamazaki H, Murakami T, Ozeki Y. Management of Pregnant Women with Mental Disorders Requires Attention to Gestational Diabetes Mellitus. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:170-177. [PMID: 38414885 PMCID: PMC10898233 DOI: 10.1089/whr.2023.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 02/29/2024]
Abstract
Background Psychiatric interventions may be required during pregnancy. In the aspect of the management of psychiatric symptoms and the consideration of the need for pharmacotherapy, possibly to manage the effects on the fetus, pregnant women with mental disorders are considered high risk as other physical illnesses. Objective We investigated the characteristics of pregnant women with psychiatric disorders compared with high-risk pregnant women with physical illnesses at our university hospital and the effects of psychotropic drug use on pregnant women with mental disorders and their children. Materials and Methods In a multivariate analysis of 1282 pregnant women, excluding those with multiple pregnancies who gave birth at our hospital between January 2017 and the end of December 2019, we evaluated the effects of mental disorders and the use of psychotropic drugs throughout at least the third trimester up to the day of delivery on obstetric complications and infants. All data were collected retrospectively. Results Ninety-nine pregnant women had mental disorders and 62 took psychotropic drugs. Among multiple factors, pregnant women with mental disorders were associated with significantly higher rates of smoking and gestational diabetes mellitus (GDM) and significantly lower child abnormalities. The cause or effect was difficult to determine; however, the use of antipsychotics or antidepressants was also significantly associated with GDM, while psychotropic use was not related to any of the other factors investigated in this study. Conclusions Attention to GDM might be important in the management of pregnant women with mental disorders.
Collapse
Affiliation(s)
- Kumiko Fujii
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Shunichiro Tsuji
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Japan
| | - Mayuko Ono
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Haruka Yamazaki
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Takashi Murakami
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Japan
| | - Yuji Ozeki
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| |
Collapse
|
3
|
Ding Y, Li G, Shi X, Wang M, Peng Y, Deng H, Yang Z, Liang Q, Wang Z. Correlation of lifestyle behaviors during pregnancy with postpartum depression status of puerpera in the rural areas of South China. Front Public Health 2023; 11:1304226. [PMID: 38192564 PMCID: PMC10773618 DOI: 10.3389/fpubh.2023.1304226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
Background Postpartum depression (PPD) is among the most common postpartum complications. Its prevalence is associated with strong regional variability. Women in rural areas of China have a high risk of PPD. The aim of this study was to investigate the PPD status of women in rural South China and explore the effects of modifiable lifestyle behaviors during pregnancy on their PPD status, thereby providing a scientific basis for the prevention and intervention of PPD in rural China. Methods A cohort study was conducted on 261 women from four maternal health institutions situated in rural areas of Guangdong Province and the Guangxi Zhuang Autonomous Region from October 2021 to December 2022. The questionnaires were administered to these women to obtain data about sociodemographic characteristics, health literacy, physical activity during pregnancy, and sleep and dietary status during pregnancy, as well as depression status on the 42nd day after delivery. The lifestyle behaviors during pregnancy and the PPD status of the study population were analyzed. Multiple linear regression models were used to determine the correlation between lifestyle behaviors and PPD status. Path analysis was performed to explore the interaction between various lifestyle behaviors. Results A total of 14.6% of women had a PPD status. Women who continued to work during pregnancy had an Edinburgh Postpartum Depression Scale (EPDS) score of 1.386 points higher than that of women who did not (В = 1.386, β = 0.141, p = 0.029). For every 1-point increase in the infant feeding-related knowledge score and pregnancy diet diversity score, the EPDS score decreased by 0.188 and 0.484 points, respectively, and for every 1-point increase in the Pittsburgh sleep quality index score, the EPDS score increased by 0.288 points. Age was related to infant feeding-related knowledge (indirect path coefficient = 0.023). During pregnancy, sedentary time was correlated with sleep quality (indirect path coefficient = 0.031) and employment status (indirect path coefficient = 0.043). Conclusion Employment status, infant feeding-related knowledge, sleep quality, and diet diversity during pregnancy directly influenced the PPD status, while age and sedentary time during pregnancy indirectly influenced the PPD status. Promoting healthy lifestyle behaviors, including reducing sedentary time, improving sleep quality, and increasing dietary diversity, may be effective in reducing PPD occurrence.
Collapse
Affiliation(s)
- Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Genyuan Li
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Xi Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Mengyi Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Yanxia Peng
- Zijin Maternal and Child Health Hospital, Heyuan, China
| | - Huiqin Deng
- Longchuan Maternal and Child Health Hospital, Heyuan, China
| | - Ziqi Yang
- Tianyang Maternal and Child Health Hospital, Baise, China
| | - Qingfen Liang
- Lingshan Maternal and Child Health Hospital, Qinzhou, China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| |
Collapse
|
4
|
Modzelewski S, Oracz A, Iłendo K, Sokół A, Waszkiewicz N. Biomarkers of Postpartum Depression: A Narrative Review. J Clin Med 2023; 12:6519. [PMID: 37892657 PMCID: PMC10607683 DOI: 10.3390/jcm12206519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Postpartum depression (PPD) is a disorder that impairs the formation of the relationship between mother and child, and reduces the quality of life for affected women to a functionally significant degree. Studying markers associated with PPD can help in early detection, prevention, or monitoring treatment. The purpose of this paper is to review biomarkers linked to PPD and to present selected theories on the pathogenesis of the disease based on data from biomarker studies. The complex etiology of the disorder reduces the specificity and sensitivity of markers, but they remain a valuable source of information to help clinicians. The biggest challenge of the future will be to translate high-tech methods for detecting markers associated with postpartum depression into more readily available and less costly ones. Population-based studies are needed to test the utility of potential PPD markers.
Collapse
|
5
|
Allegri B, Brenna V, Confalonieri L, Puzzini A, Nichelatti M, Piccinini G, Mazza U, Percudani ME. The impact of the second COVID-19 lockdown on anxiety and depressive symptoms in pregnant women: A case study of pregnant women in northern Italy. Brain Behav Immun Health 2023; 30:100633. [PMID: 37206958 PMCID: PMC10182657 DOI: 10.1016/j.bbih.2023.100633] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/21/2023] Open
Abstract
Background the different lockdown phases due to COVID-19 may have negatively impacted pregnant women's mental health. Concerning antenatal stress, most studies focused more on the effect of pandemic onset than on the impact of the following phases and restrictions. Aim the present study aimed to assess levels of anxiety and depression in a group of Italian pregnant women during the second COVID-19 phase and possible risk factors. Method We recruited 156 pregnant women through our Perinatal Psychology Outpatient Clinic. We divided the sample into women recruited before the pandemic (N = 88) through a face-to-face antenatal class and pregnant women recruited during the second lockdown (Covid-19 study group) (November 2020-April 2021) through the same antenatal class via Skype (N = 68). To investigate depressive and anxiety symptoms, we administered the Edinburgh Postnatal Depression Scale (EPDS) and the State and Trait Anxiety Inventory (STAI-Y) scales; women's medical history and obstetric data were collected. Findings women belonging to the Covid-19 study group reported higher depressive and anxious levels than the pre-pandemic group. Moreover, during the second lockdown previous psychopathology and being close to childbirth were related to increased depression; a history of abortion was related to higher levels of trait anxiety instead. Conclusion recurrent restrictive measures due to COVID-19 negatively affected the antenatal mental well-being of pregnant women, particularly worsening depressive and anxious feelings. Pregnant women during the pandemic represented a vulnerable population to be monitored more closely and timely to prevent psychological problems in the postpartum period and their consequences on the child. Keywords anxiety, depression, pregnancy, COVID-19, mental health, lockdown.
Collapse
Affiliation(s)
- Beatrice Allegri
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Valeria Brenna
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Linda Confalonieri
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Alessandra Puzzini
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Michele Nichelatti
- Biostatistics Service, Department of Hematology, Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Gianluca Piccinini
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Umberto Mazza
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Mauro Emilio Percudani
- Department of Mental Health and Addiction Services Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| |
Collapse
|
6
|
Renugasundari M, Pal GK, Chaturvedula L, Nanda N, Harichandrakumar KT, Durgadevi T. Inflammation and decreased cardiovagal modulation are linked to stress and depression at 36th week of pregnancy in gestational diabetes mellitus. Sci Rep 2023; 13:10348. [PMID: 37365247 DOI: 10.1038/s41598-023-37387-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 06/21/2023] [Indexed: 06/28/2023] Open
Abstract
Stress and depression have been reported in gestational diabetes mellitus (GDM). Though inflammation and oxidative stress are associated with depression, there are no reports of link of cardiometabolic risks (CMR) to stress and depression in GDM. Normal pregnant women (control group, n = 164) and women with GDM (study group, n = 176) at 36th week of gestation were recruited for the study. Blood pressure (BP), body composition, heart rate variability (HRV), glycated hemoglobin (HbA1C), markers of insulin resistance, oxidative stress, inflammation and endothelial dysfunction, were assessed. Perceived stress score (PSS), quality of life (QoL) scale, Indian diabetic risk score (IDRS) and Edinburg postnatal depression score (EPDS) were assessed. Association of potential contributors to PSS and EDPS were assessed by correlation and regression analyses. There was significant increase in PSS, EPDS, IDRS scores, HbA1C, malondialdehyde (MDA) (oxidative stress marker) and high-sensitive C-reactive protein and interleukin-6 (inflammatory markers), and significant decrease in total power (TP) of HRV (marker of cardiovagal modulation), QoL and nitric oxide (endothelial dysfunction marker) in study group compared to control group. Though many cardiometabolic risk parameters were correlated with PSS and EPDS, the significant independent association was observed for TP, HbA1C, MDA and interleukin-6. However, interleukin-6 had maximum contribution to PSS (β = 0.550, p < 0.001) and EPDS (β = 0.393, p < 0.001) as demonstrated by multiple regression analysis. Inflammation, oxidative stress, glycation status and decreased cardiovagal modulation are associated with stress and depression at 36th week of gestation in GDM.
Collapse
Affiliation(s)
| | - Gopal Krushna Pal
- All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India.
| | | | | | | | | |
Collapse
|
7
|
Luan M, Yang F, Miao M, Yuan W, Gissler M, Arkema EV, Lu D, Li J, László KD. Rheumatoid arthritis and the risk of postpartum psychiatric disorders: a Nordic population-based cohort study. BMC Med 2023; 21:126. [PMID: 37013565 PMCID: PMC10071633 DOI: 10.1186/s12916-023-02837-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/17/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Postpartum psychiatric disorders (PPD) are common complications of childbirth. A common explanation for their development is that the psychological, hormonal, and immune changes associated with pregnancy and parturition may trigger psychiatric symptoms postpartum. Rheumatoid arthritis (RA) is characterized by abnormalities in the activity of the hypothalamic-pituitary-adrenal axis and of the immune system, but its association with PPD is unknown. We analyzed whether women with RA before childbirth have an increased risk of PPD. METHODS We conducted a large population-based cohort study including mothers of singleton births in the Danish (1995-2015), Finnish (1997-2013), and Swedish Medical Birth Registers (2001-2013) (N = 3,516,849). We linked data from the Medical Birth Registers with data from several national socioeconomic and health registers. Exposure was defined as having a diagnosis of RA before childbirth, while the main outcome was a clinical diagnosis of psychiatric disorders 90 days postpartum. We analyzed the association between RA and PPD using Cox proportional hazard models, stratified by a personal history of psychiatric disorders. RESULTS Among women without a history of psychiatric disorders, the PPD incidence rate was 32.2 in the exposed and 19.5 per 1000 person-years in the unexposed group; women with RA had a higher risk of overall PPD than their unexposed counterparts [adjusted hazard ratio (HR) = 1.52, 95% confidence intervals (CI) 1.17 to 1.98]. Similar associations were also observed for postpartum depression (HR = 1.65, 95% CI 1.09 to 2.48) and other PPD (HR = 1.59, 95% CI 1.13 to 2.24). Among women with a history of psychiatric disorders, the incidence rate of overall PPD was 339.6 in the exposed and 346.6 per 1000 person-years in the unexposed group; RA was not associated with PPD. We observed similar associations between preclinical RA (RA diagnosed after childbirth) and PPD to those corresponding to clinical RA. CONCLUSIONS Rheumatoid arthritis was associated with an increased PPD risk in women without, but not in those with a psychiatric history. If our findings are confirmed in future studies, new mothers with RA may benefit from increased surveillance for new-onset psychiatric disorders postpartum.
Collapse
Affiliation(s)
- Min Luan
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China.
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
- Clinical Research Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Fen Yang
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Maohua Miao
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Wei Yuan
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Mika Gissler
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Elizabeth V Arkema
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Donghao Lu
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jiong Li
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Krisztina D László
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|
8
|
Basirat Z, Ramaezani F, Sepidarkish M, Kashifard M, Faramarzi M. Psychiatric Symptoms in Women with High-risk Pregnancy in the Postpartum Period: A Case-control Study. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:186-191. [PMID: 37224840 PMCID: PMC10208729 DOI: 10.1055/s-0043-1768997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE Psychiatric symptoms are common mental issues in pregnancy and the postpartum period. There is limited information regarding the psychiatric symptoms of women with high-risk pregnancy in the postpartum period. This study aimed to compare the severity of psychiatric symptoms and psychological distress in women with high-risk and low-risk pregnancies in the postpartum period. METHODS This case-control study examined 250 women in the postpartum period in two groups with low-risk (n = 112) and high-risk (n = 138) pregnancies. Women completed the Brief Symptom Inventory-53 (BSI-53) and the Risk Postnatal Psychosocial Depression Risk Questionnaire (PPDRQ). RESULTS The mean severity of psychiatric symptoms in women with high-risk pregnancies was significantly higher than that in women with low-risk pregnancies (39.34 ± 17.51 vs. 30.26 ± 17.08). Additionally, the frequency of psychological distress in women with high-risk pregnancies was approximately twice higher than that in women with low-risk pregnancies (30.3% vs. 15.2%). Furthermore, the risk factors for depression in women with high-risk pregnancies were almost 1.5 times (59.8% vs. 39.8%) higher than the factors in women with low-risk pregnancies. The results of the logistic analysis indicated that high-risk pregnancies could be twice the odds ratio of developing postpartum psychological distress (ß = 2.14, 95% CI 1.4-6.3, p= 0.036). CONCLUSION Psychiatric symptoms and the psychological distress index are higher in postpartum women with high-risk pregnancies than in postpartum women with low-risk pregnancies. The study suggests that obstetricians and pregnant women's health care providers should strongly consider screening of psychiatric symptoms in women with high-risk pregnancies both during pregnancy and after delivery as the women's routine care priorities.
Collapse
|
9
|
The Bidirectional Relationship between Gestational Diabetes and Depression in Pregnant Women: A Systematic Search and Review. Healthcare (Basel) 2023; 11:healthcare11030404. [PMID: 36766979 PMCID: PMC9914262 DOI: 10.3390/healthcare11030404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/27/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
This systematic search and review aims to understand the two-way relationship between gestational diabetes and depression. This study assesses gestational diabetes in relation to a history of depression, depression during pregnancy and postpartum depression. Searches were conducted on PubMed and Scopus. Studies were excluded due to being duplicates, not available, published before 2015 or did not include both gestational diabetes and depression. Of the 915 articles initially identified, 22 articles were included for review. Of the included studies, 18 were cohorts, 2 were case-controls, 1 was cross-sectional and 1 was a claims analysis. A meta-ethnography was conducted, and a bidirectional relationship was observed between a history of depression, depression during pregnancy, postpartum depression and gestational diabetes. Differing methodologies between studies were a limiting factor throughout this review. A two-way relationship between gestational diabetes and depression was observed; the diagnosis of gestational diabetes may lead to an increased risk of depression, both during the pregnancy and in the postpartum period, and a history of depression or symptoms of depression during pregnancy may lead to an increased risk of gestational diabetes.
Collapse
|
10
|
Application of machine learning in predicting the risk of postpartum depression: A systematic review. J Affect Disord 2022; 318:364-379. [PMID: 36055532 DOI: 10.1016/j.jad.2022.08.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/08/2022] [Accepted: 08/22/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Postpartum depression (PPD) presents a serious health problem among women and their families. Machine learning (ML) is a rapidly advancing field with increasing utility in predicting PPD risk. We aimed to synthesize and evaluate the quality of studies on application of ML techniques in predicting PPD risk. METHODS We conducted a systematic search of eight databases, identifying English and Chinese studies on ML techniques for predicting PPD risk and ML techniques with performance metrics. Quality of the studies involved was evaluated using the Prediction Model Risk of Bias Assessment Tool. RESULTS Seventeen studies involving 62 prediction models were included. Supervised learning was the main ML technique employed and the common ML models were support vector machine, random forest and logistic regression. Five studies (30 %) reported both internal and external validation. Two studies involved model translation, but none were tested clinically. All studies showed a high risk of bias, and more than half showed high application risk. LIMITATIONS Including Chinese articles slightly reduced the reproducibility of the review. Model performance was not quantitatively analyzed owing to inconsistent metrics and the absence of methods for correlation meta-analysis. CONCLUSIONS Researchers have paid more attention to model development than to validation, and few have focused on improvement and innovation. Models for predicting PPD risk continue to emerge. However, few have achieved the acceptable quality standards. Therefore, ML techniques for successfully predicting PPD risk are yet to be deployed in clinical environments.
Collapse
|
11
|
Aldridge E, Schubert KO, Pathirana M, Sierp S, Leemaqz SY, Roberts CT, Dekker GA, Arstall MA. A prospective registry analysis of psychosocial and metabolic health between women with and without metabolic syndrome after a complicated pregnancy. BMC Womens Health 2022; 22:461. [PMID: 36404332 PMCID: PMC9677702 DOI: 10.1186/s12905-022-02035-y] [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: 05/13/2022] [Accepted: 10/27/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Pregnancy complications affect over one quarter of Australian pregnancies, and this group of mothers is vulnerable and more likely to experience adverse cardiometabolic health outcomes in the postpartum period. Metabolic syndrome is common in this population and may be associated with postpartum mental health issues. However, this relationship remains poorly understood. To compare the differences in psychosocial parameters and mental health outcomes between women with metabolic syndrome and women without metabolic syndrome 6 months after a complicated pregnancy. METHODS This study is prospective registry analysis of women attending a postpartum healthy lifestyle clinic 6 months following a complicated pregnancy. Mental health measures included 9-item Patient Health Questionnaire (PHQ-9), 7-item Generalised Anxiety Disorder questionnaire (GAD-7), self-reported diagnosed history of depression, anxiety and/or other psychiatric condition, and current psychotropic medication use. RESULTS Women with metabolic syndrome reported significantly more subjective mental health concerns, were more likely to have a history of depression and other psychiatric diagnoses and were more likely prescribed psychotropic medications. However, there were no significant differences in PHQ-9 and GAD-7 scores. CONCLUSION Amongst new mothers who experienced complications of pregnancy, those with metabolic syndrome represent a particularly vulnerable group with regards to psychosocial disadvantage and mental health outcomes. These vulnerabilities may not be apparent when using common standardised cross-sectional mental health screening tools such as PHQ-9 and GAD-7.
Collapse
Affiliation(s)
- Emily Aldridge
- grid.1010.00000 0004 1936 7304Adelaide Medical School, University of Adelaide, Adelaide, South Australia Australia ,grid.1010.00000 0004 1936 7304Robinson Research Institute, University of Adelaide, Adelaide, South Australia Australia ,Department of Cardiology, Northern Adelaide Local Health Network, Elizabeth Vale, South Australia Australia
| | - K. Oliver Schubert
- grid.1010.00000 0004 1936 7304Adelaide Medical School, University of Adelaide, Adelaide, South Australia Australia ,Division of Mental Health, Northern Adelaide Local Health Network, Elizabeth Vale, South Australia Australia ,Headspace Early Psychosis, Sonder, Adelaide, South Australia Australia
| | - Maleesa Pathirana
- grid.1010.00000 0004 1936 7304Adelaide Medical School, University of Adelaide, Adelaide, South Australia Australia ,grid.1010.00000 0004 1936 7304Robinson Research Institute, University of Adelaide, Adelaide, South Australia Australia
| | - Susan Sierp
- Department of Cardiology, Northern Adelaide Local Health Network, Elizabeth Vale, South Australia Australia
| | - Shalem Y. Leemaqz
- grid.1014.40000 0004 0367 2697Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia Australia
| | - Claire T. Roberts
- grid.1010.00000 0004 1936 7304Adelaide Medical School, University of Adelaide, Adelaide, South Australia Australia ,grid.1010.00000 0004 1936 7304Robinson Research Institute, University of Adelaide, Adelaide, South Australia Australia ,grid.1014.40000 0004 0367 2697Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia Australia
| | - Gustaaf A. Dekker
- grid.1010.00000 0004 1936 7304Adelaide Medical School, University of Adelaide, Adelaide, South Australia Australia ,grid.1010.00000 0004 1936 7304Robinson Research Institute, University of Adelaide, Adelaide, South Australia Australia ,Department of Obstetrics & Gynaecology, Northern Adelaide Local Health Network, Elizabeth Vale, South Australia Australia
| | - Margaret A. Arstall
- grid.1010.00000 0004 1936 7304Adelaide Medical School, University of Adelaide, Adelaide, South Australia Australia ,Department of Cardiology, Northern Adelaide Local Health Network, Elizabeth Vale, South Australia Australia
| |
Collapse
|
12
|
Diagnosis and Management of Perinatal Depression. Nurs Womens Health 2022; 26:318-330. [PMID: 35714763 DOI: 10.1016/j.nwh.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 04/27/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022]
Abstract
Perinatal depression is a mood disorder that may occur during pregnancy or within a year after childbirth. It can be disabling for the birthing parent and cause attachment and developmental problems for the infant. A host of risk factors, including genetics, reproductive history, and life experiences, are associated with perinatal depression. With validated screening tools, health care providers can assess individuals, initiate treatment, and/or refer as appropriate. Successful treatment, which may include modalities such as cognitive behavioral therapy and/or pharmacologic therapies, helps individuals maintain a sense of control, develop self-confidence, take control of their thinking, and learn coping skills. Integrative therapies and lifestyle changes have some success but may not be adequate for many individuals. Patients may benefit from providers learning and initiating cognitive behavioral therapy techniques while awaiting therapy.
Collapse
|
13
|
Guintivano J, Aberg KA, Clark SL, Rubinow DR, Sullivan PF, Meltzer-Brody S, van den Oord EJCG. Transcriptome-wide association study for postpartum depression implicates altered B-cell activation and insulin resistance. Mol Psychiatry 2022; 27:2858-2867. [PMID: 35365803 PMCID: PMC9156403 DOI: 10.1038/s41380-022-01525-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/08/2022] [Accepted: 03/09/2022] [Indexed: 12/12/2022]
Abstract
Postpartum depression (PPD) affects 1 in 7 women and has negative mental health consequences for both mother and child. However, the precise biological mechanisms behind the disorder are unknown. Therefore, we performed the largest transcriptome-wide association study (TWAS) for PPD (482 cases, 859 controls) to date using RNA-sequencing in whole blood and deconvoluted cell types. No transcriptional changes were observed in whole blood. B-cells showed a majority of transcriptome-wide significant results (891 transcripts representing 789 genes) with pathway analyses implicating altered B-cell activation and insulin resistance. Integration of other data types revealed cell type-specific DNA methylation loci and disease-associated eQTLs (deQTLs), but not hormones/neuropeptides (estradiol, progesterone, oxytocin, BDNF), serve as regulators for part of the transcriptional differences between cases and controls. Further, deQTLs were enriched for several brain region-specific eQTLs, but no overlap with MDD risk loci was observed. Altogether, our results constitute a convergence of evidence for pathways most affected in PPD with data across different biological mechanisms.
Collapse
Affiliation(s)
- Jerry Guintivano
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Karolina A Aberg
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Shaunna L Clark
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, College Station, TX, USA
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Patrick F Sullivan
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Samantha Meltzer-Brody
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Edwin J C G van den Oord
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
14
|
Li H, Yu X, Qiang W, Lu M, Jiang M, Hou Y, Gu Y, Tao F, Zhu B. A longitudinal cohort study of gestational diabetes mellitus and perinatal depression. BMC Pregnancy Childbirth 2022; 22:337. [PMID: 35440070 PMCID: PMC9017412 DOI: 10.1186/s12884-022-04667-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 04/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background The association between gestational diabetes mellitus (GDM) and perinatal depression (PND) remains controversial. Our study aimed to comprehensively assess this association in a longitudinal cohort study with repeated measurements of depression. Methods Our cohort study was nested in a pilot study of an implementation study aiming to screen and manage perinatal depression within the primary health system in China. Women were recruited in the first trimester from May–September 2019 and followed four times up to 1 year postpartum. Data on sociodemographic characteristics and depression were collected using self-developed questionnaires incorporating the Edinburgh Postnatal Depression Scale (EPDS). Oral glucose tolerance test at 24 ~ 28 weeks and fasting plasma glucose (FPG) data were extracted from medical records. Depression throughout the whole period was divided into different trajectories. Associations of GDM with PND at different time periods and PND of different trajectories were determined by logistic regression. The path of association between blood glucose and depression over time was estimated with an autoregressive cross-lagged model. Results In total, 1043 women were included in this analysis and 313 (30.0%) were diagnosed with GDM. The prevalence of depression in the first, second, and third trimesters and postpartum period were 17.2, 6.9, 6.8 and 9.0%, respectively. GDM was neither significantly associated with PND at any time point nor with any specific trajectory of depression. Except for autoregressive paths, no cross-lagged path of FPG and scores of EPDS was significant. Conclusions Our study indicates no association between GDM/blood glucose and PND. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04667-2.
Collapse
Affiliation(s)
- Haiyan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiayan Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wenjing Qiang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Mengjuan Lu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Minmin Jiang
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yanyan Hou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yue Gu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Beibei Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| |
Collapse
|
15
|
Jensen NH, Nielsen KK, Dahl-Petersen IK, Maindal HT. The experience of women with recent gestational diabetes during the COVID-19 lockdown: a qualitative study from Denmark. BMC Pregnancy Childbirth 2022; 22:84. [PMID: 35093021 PMCID: PMC8800544 DOI: 10.1186/s12884-022-04424-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/20/2022] [Indexed: 12/17/2022] Open
Abstract
Background Following COVID-19 and the lockdowns, maternity care and support for women after delivery have been temporary restructured. Studies show that COVID-19 adversely impacts pregnant and peripartum women in the general population, but experiences among women in the first year after delivery/in the wider postpartum period remain unexplored. Moreover, experiences among women with recent gestational diabetes mellitus (GDM) are lacking; though it is a group with a potential high need for support after delivery. The aim of our study was to investigate (i) how women with recent GDM experienced COVID-19 and the first lockdown in Denmark, and (ii) the women’s risk perception and health literacy in terms of interaction with the healthcare system in relation to COVID-19. Methods We performed a qualitative study among 11 women with recent GDM (infants aged 2-11 months old). Semi-structured interviews were conducted in April-May 2020 by telephone or Skype for Business, when Denmark was under lockdown. We analysed data using a thematic qualitative content analysis. Results Three themes emerged: i) Everyday life and family well-being, ii) Worries about COVID-19 and iii) Health literacy: Health information and access to healthcare. The women were generally not worried about their own or their infant’s risk of COVID-19. The lockdown had a negative impact on everyday life e.g. routines, loneliness, breastfeeding uncertainties and worries for the infant’s social well-being; but better family dynamics were also described. It was challenging to maintain healthy behaviours and thus the women described worries for the risk of type 2 diabetes and GDM in subsequent pregnancies. The women missed peer support and face-to-face visits from health visitors and found it difficult to navigate the restructured care with online/telephone set-ups. Conclusions COVID-19 and the lockdown affected everyday life among women with recent GDM both positively and negatively. Our findings suggest a need for care that are responsive to psychological and social aspects of health throughout the COVID-19 pandemic and support to limit worries about adaptation to motherhood and the infant’s social well-being. Communication focusing on the importance and relevance of contacting healthcare providers should also be strengthened.
Collapse
|
16
|
Yu CY, Hung CH, Wang YY. The impact of prenatal depression and diabetes management self-efficacy on postpartum stress and depression in women with gestational diabetes mellitus. J Clin Nurs 2021; 31:2867-2873. [PMID: 34738289 DOI: 10.1111/jocn.16113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 02/06/2023]
Abstract
AIMS The study aimed to examine the impact of prenatal depression and diabetes management self-efficacy on postpartum stress and postpartum depression in women with gestational diabetes mellitus. BACKGROUND Poor perinatal mental health is linked to various adverse pregnancy outcomes in women with gestational diabetes mellitus. DESIGNS A predictive study design and the guidelines for the STROBE checklist were used for the study. METHODS A total of 119 pregnant women with a positive 75 g-glucose challenge test were recruited at a medical centre. The Taiwanese depression questionnaire (TDQ), the diabetes management self-efficacy scale (DMSES) and the Hung postpartum stress scale (Hung PSS) were used for data collection at the 24th week of pregnancy and the first week after childbirth. RESULTS Diabetes management self-efficacy was correlated with postpartum stress in women with gestational diabetes mellitus. Moreover, prenatal depression was a predictor of postpartum stress and postpartum depression, respectively, in women with gestational diabetes mellitus. CONCLUSIONS Healthcare providers should assess those women's diabetes management self-efficacy and mood status during prenatal visits and offer the needed intervention to reduce the levels of postpartum stress and postpartum depression of those women after childbirth. RELEVANCE TO CLINICAL PRACTICE A holistic care approach integrated diabetic care and mental health for women with gestational diabetes mellitus in a timely manner is warranted to promote perinatal mental health in women with gestational diabetes mellitus.
Collapse
Affiliation(s)
- Ching-Yun Yu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Ying Wang
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
17
|
Psychosocial stratification of antenatal indicators to guide population-based programs in perinatal depression. BMC Pregnancy Childbirth 2021; 21:277. [PMID: 33823838 PMCID: PMC8025384 DOI: 10.1186/s12884-021-03722-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is increasing awareness that perinatal psychosocial adversity experienced by mothers, children, and their families, may influence health and well-being across the life course. To maximise the impact of population-based interventions for optimising perinatal wellbeing, health services can utilise empirical methods to identify subgroups at highest risk of poor outcomes relative to the overall population. METHODS This study sought to identify sub-groups using latent class analysis within a population of mothers in Sydney, Australia, based on their differing experience of self-reported indicators of psychosocial adversity. This study sought to identify sub-groups using latent class analysis within a population of mothers in Sydney, Australia, based on their differing experience of self-reported indicators of psychosocial adversity. Subgroup differences in antenatal and postnatal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. RESULTS Latent class analysis identified four distinct subgroups within the cohort, who were distinguished empirically on the basis of their native language, current smoking status, previous involvement with Family-and-Community Services (FaCS), history of child abuse, presence of a supportive partner, and a history of intimate partner psychological violence. One group consisted of socially supported 'local' women who speak English as their primary language (Group L), another of socially supported 'migrant' women who speak a language other than English as their primary language (Group M), another of socially stressed 'local' women who speak English as their primary language (Group Ls), and socially stressed 'migrant' women who speak a language other than English as their primary language (Group Ms.). Compared to local and not socially stressed residents (L group), the odds of antenatal depression were nearly three times higher for the socially stressed groups (Ls OR: 2.87 95%CI 2.10-3.94) and nearly nine times more in the Ms. group (Ms OR: 8.78, 95%CI 5.13-15.03). Antenatal symptoms of depression were also higher in the not socially stressed migrant group (M OR: 1.70 95%CI 1.47-1.97) compared to non-migrants. In the postnatal period, Group M was 1.5 times more likely, while the Ms. group was over five times more likely to experience suboptimal mental health compared to Group L (OR 1.50, 95%CI 1.22-1.84; and OR 5.28, 95%CI 2.63-10.63, for M and Ms. respectively). CONCLUSIONS The application of empirical subgrouping analysis permits an informed approach to targeted interventions and resource allocation for optimising perinatal maternal wellbeing.
Collapse
|
18
|
Gilbert L, Nikolaou A, Quansah DY, Rossel JB, Horsch A, Puder JJ. Mental health and its associations with glucose-lowering medication in women with gestational diabetes mellitus. A prospective clinical cohort study. Psychoneuroendocrinology 2021; 124:105095. [PMID: 33321330 DOI: 10.1016/j.psyneuen.2020.105095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 11/09/2020] [Accepted: 11/26/2020] [Indexed: 01/23/2023]
Abstract
AIMS Mental health symptoms are frequent in women with gestational diabetes mellitus (GDM) and may influence glycemic control. We therefore investigated if mental health symptoms (high depression and low well-being scores) predicted a need for glucose-lowering medication and if this use of medication influenced the trajectory of mental health during pregnancy and in the postpartum period. METHODS We included 341 pregnant women from a cohort of GDM women in a Swiss University Hospital. The World Health Organization Well-being Index-Five was collected at the first and last GDM and at the postpartum clinical visits and the Edinburgh Postnatal Depression Scale at the first GDM and the postpartum clinical visits. Medication intake was extracted from participants' medical records. We conducted linear and logistic regressions with depression as an interaction factor. RESULTS Mental health symptoms did not predict a need for medication (all p ≥ 0.29). Mental health improved over time (both p ≤ 0.001) and use of medication did not predict this change (all p ≥ 0.40). In women with symptoms of depression, medication was associated with less improvement in well-being at the postpartum clinical visit (p for interaction=0.013). CONCLUSIONS Mental health and glucose-lowering medication did not influence each other in an unfavourable way in this cohort of women with GDM.
Collapse
Affiliation(s)
- Leah Gilbert
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland.
| | - Argyro Nikolaou
- Clinical Pharmacology and Toxicology Division, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland.
| | - Dan Yedu Quansah
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland.
| | - Jean-Benoît Rossel
- Clinical Trials Unit, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland; Neonatology Service, Woman-Mother-Child Department, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland.
| | - Jardena J Puder
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland.
| |
Collapse
|
19
|
OuYang H, Chen B, Abdulrahman AM, Li L, Wu N. Associations between Gestational Diabetes and Anxiety or Depression: A Systematic Review. J Diabetes Res 2021; 2021:9959779. [PMID: 34368368 PMCID: PMC8337159 DOI: 10.1155/2021/9959779] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022] Open
Abstract
Gestational diabetes mellitus (GDM) pregnant women are under more psychological stress than normal pregnant women. With the deepening of the study of gestational diabetes mellitus, research has shown that anxiety and depression are also an important cause of gestational diabetes mellitus. Anxiety and depression can cause imbalances in the hormone levels in the body, which has a serious impact on the pregnancy outcome and blood glucose control of pregnant women with GDM. Therefore, the main purpose of this paper is to provide a systematic review of the association between anxiety, depression, and GDM, as well as the adverse effects on pregnant women with GDM. To this end, we searched the PubMed, CNKI, Embase, Cochrane Library, Wanfang, and Weipu databases. Studies on the incidence of anxiety, depression, and GDM, blood glucose in pregnant women with GDM, delivery mode, and maternal and infant outcomes were included to be analyzed, and the source of anxiety and depression in pregnant women with GDM and related treatment measures were discussed.
Collapse
Affiliation(s)
- Hong OuYang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bo Chen
- Department of Endocrinology, The First People's Hospital of Kerqin District, Tongliao City, Inner Mongolia, China
| | - Al-Mureish Abdulrahman
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ling Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Na Wu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Skills Practice Teaching Center, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
20
|
Dickens MJ, Pawluski JL, Romero LM. Moving Forward From COVID-19: Bridging Knowledge Gaps in Maternal Health With a New Conceptual Model. Front Glob Womens Health 2020; 1:586697. [PMID: 34816162 PMCID: PMC8593985 DOI: 10.3389/fgwh.2020.586697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/01/2020] [Indexed: 11/17/2022] Open
Abstract
As the world faces the health crisis of a global pandemic—with healthcare protocols in overhaul, and patients and care teams experiencing unprecedented levels of stress and unpredictability—we predict that current knowledge gaps in maternal health will inevitably have a lasting impact on the health of women giving birth now and in the near future. Since we are decades away from closing the knowledge gaps we need filled today, we recommend shifting thinking toward a comprehensive conceptual model that merges knowledge of stress physiology, neurobiology, and pregnancy physiology. The model we present here, the Maternal Reactive Scope Model, is an expansion of the Reactive Scope Model built upon the concept of Homeostasis and Allostasis. The model provides a framework to consider pathways and interactions across physiological systems to attribute a physiological basis for considering stress exposure and bridge research gaps on mechanisms to measure or target for treatment. Our intention is to provide an adaptable, heuristic framework for discussion of research considerations and new healthcare models that aim to provide the best care for new mothers during and after the COVID-19 pandemic.
Collapse
Affiliation(s)
- Molly J. Dickens
- &Mother Foundation, Berkeley, CA, United States
- *Correspondence: Molly J. Dickens
| | - Jodi L. Pawluski
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Rennes, France
| | | |
Collapse
|
21
|
Putnick DL, Sundaram R, Bell EM, Ghassabian A, Goldstein RB, Robinson SL, Vafai Y, Gilman SE, Yeung E. Trajectories of Maternal Postpartum Depressive Symptoms. Pediatrics 2020; 146:peds.2020-0857. [PMID: 33109744 PMCID: PMC7772818 DOI: 10.1542/peds.2020-0857] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To identify homogenous depressive symptom trajectories over the postpartum period and the demographic and perinatal factors linked to different trajectories. METHODS Mothers (N = 4866) were recruited for Upstate KIDS, a population-based birth cohort study, and provided assessments of depressive symptoms at 4, 12, 24, and 36 months postpartum. Maternal demographic and perinatal conditions were obtained from vital records and/or maternal report. RESULTS Four depression trajectories were identified: low-stable (74.7%), characterized by low symptoms at all waves; low-increasing (8.2%), characterized by initially low but increasing symptoms; medium-decreasing (12.6%), characterized by initially moderate but remitting symptoms; and high-persistent (4.5%), characterized by high symptoms at all waves. Compared with the high-persistent group, older mothers (maximum odds ratio [OR] of the 3 comparisons: 1.10; 95% confidence interval [CI]: 1.05 to 1.15) or those with college education (maximum OR: 2.52; 95% CI: 1.36 to 4.68) were more likely to be in all other symptom groups, and mothers who had a history of mood disorder (minimum OR: 0.07; 95% CI: 0.04 to 0.10) or gestational diabetes mellitus diagnosis (minimum OR: 0.23; 95% CI: 0.08 to 0.68) were less likely to be in other symptom groups. Infertility treatment, multiple births, prepregnancy BMI, gestational hypertension, and infant sex were not differentially associated with depressive symptom trajectories. CONCLUSIONS One-quarter of mothers in a population-based birth cohort had elevated depressive symptoms in 3 years postpartum. Screening for maternal depression beyond the postpartum period may be warranted, particularly after mood and diabetic disorders.
Collapse
Affiliation(s)
| | | | - Erin M. Bell
- Department of Environmental Health Sciences, School of Public Health, University at Albany, Albany, New York
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, Grossman School of Medicine, New York University, New York, New York; and
| | - Risë B. Goldstein
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | | | | | - Stephen E. Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland;,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | |
Collapse
|
22
|
Perspectives on the psychological and emotional burden of having gestational diabetes amongst low-income women in Cape Town, South Africa. BMC WOMENS HEALTH 2020; 20:231. [PMID: 33046050 PMCID: PMC7552378 DOI: 10.1186/s12905-020-01093-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 09/30/2020] [Indexed: 01/28/2023]
Abstract
Background The diagnosis of gestational diabetes mellitus (GDM) may affect women’s mental wellbeing, functioning and quality of life, with potentially negative effects on treatment adherence. Identifying and addressing the psychological and emotional needs of women with GDM, could have benefits for sustainable long-term behavioural change following the affected pregnancy. This study explored the lived experiences of women with GDM and the impact of GDM on their experience of pregnancy and sense of well-being. Methods Purposive sampling was used to recruit women who had been diagnosed with GDM in their previous pregnancy and received antenatal care at a tertiary hospital in Cape Town, South Africa. This was a descriptive qualitative study using a combination of focus groups and in-depth interviews for an in- depth exploration of women’s lived experiences of GDM, their context and perceived needs. Data analysis followed an iterative thematic analysis approach. Results Thirty-five women participated in nine focus groups and five in-depth interviews. Women discussed the emotional and psychological burden of having GDM, highlighting (i) their initial emotional reactions to receiving a GDM diagnosis, (ii) their experience of adjusting to the constraints of living with GDM (iii) their feelings of apprehension about childbirth and their maternal role and (iv) their feelings of abandonment in the post-partum period once the intensive support from both health system and family ends. Conclusions The current biomedical model used in the management of GDM, is highly foetal-centric and fails to acknowledge important psychological factors that contribute to women’s overall wellbeing and experience of pregnancy. These results demonstrate the importance of incorporating mental health support in the management and care for women with GDM in public health services, along with facilitating emotional support from partners and family members. Based on our findings, we recommend routine mental health and psychosocial vulnerability screening and monitoring for women diagnosed with GDM throughout pregnancy and postpartum to improve prognoses.
Collapse
|
23
|
Association Between Gestational Diabetes and Mental Illness. Can J Diabetes 2020; 44:566-571.e3. [PMID: 32792108 DOI: 10.1016/j.jcjd.2020.06.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/19/2022]
Abstract
The rates of both gestational diabetes mellitus (GDM) and mental illness in pregnancy are rising. There is an association between type 2 diabetes and major depressive disorder, anxiety and schizophrenia, thus there is a need for greater understanding of the relationship between GDM and mental illness. This review suggests that there is a bidirectional and complex relationship between antenatal depression, gestational diabetes and postpartum depression. The combined effect of both a history of depression and gestational diabetes significantly increases the risk of postpartum depression. There is an association between severe mental illness and GDM; however, it is strongly mediated by antipsychotic medications and psychosocial factors, in addition to the disease itself. Medication has a major role in treating mental illness during pregnancy and is not directly linked with GDM in either depression or psychosis. Health-care providers should be mindful of the association between GDM and mental illness to appropriately screen and treat both disorders.
Collapse
|
24
|
Packer CH, Pilliod RA, Chatroux LR, Caughey AB, Valent AM. Increased rates of adverse perinatal outcomes in women with gestational diabetes and depression. J Matern Fetal Neonatal Med 2019; 34:3862-3866. [PMID: 31851552 DOI: 10.1080/14767058.2019.1701647] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: We sought to examine the impact of depression on adverse perinatal outcomes in women with Gestational Diabetes Mellitus (GDM).Methods: We performed a retrospective cohort study comparing the rates of perinatal complications among singleton, nonanomalous births to women with GDM and the diagnosis of depression compared to GDM women without depression between 2007 and 2011 in California. Perinatal outcomes were analyzed using chi-square and multivariable logistic regression to compare frequencies of characteristics and outcomes and to determine the strength of association of depression and adverse perinatal outcomes among women with GDM. Statistical comparisons with a p-value of less than .05 and 95% CI that did not cross the null were considered statistically significant.Results: Among the cohort of 170,572 women with GDM, 2090 (1.22%) were diagnosed with antenatal depression. Women with GDM and depression had significantly higher rates of preeclampsia (adjusted Odds Ratio [aOR] 1.28, 95% CI 1.11-1.49) and gestational hypertension (aOR 1.23, 95% CI 1.05-1.44). Women with GDM and depression also had higher rates of preterm delivery at <37, and <34 weeks gestational age (aOR 1.33, 95% CI 1.18-1.50 and 1.36, 95% CI 1.15-1.61, respectively).Conclusion: Women with GDM and a diagnosis of depression have higher rates of adverse perinatal outcomes than women with GDM alone. Identifying and managing depression among women with GDM has the potential to improve the care and health of this high-risk population.
Collapse
Affiliation(s)
- Claire H Packer
- Department of Obstetrics & Gynecology, Oregon Health & Sciences University, Portland, OR, USA
| | - Rachel A Pilliod
- Department of Obstetrics & Gynecology, Oregon Health & Sciences University, Portland, OR, USA
| | - Louisa R Chatroux
- Department of Obstetrics & Gynecology, Oregon Health & Sciences University, Portland, OR, USA
| | - Aaron B Caughey
- Department of Obstetrics & Gynecology, Oregon Health & Sciences University, Portland, OR, USA
| | - Amy M Valent
- Department of Obstetrics & Gynecology, Oregon Health & Sciences University, Portland, OR, USA
| |
Collapse
|
25
|
Karina IM, Zhou K. Links Between Childhood Obesity, Gestational Diabetes, and Infant Temperament. JAMA Pediatr 2019; 173:999-1000. [PMID: 31449291 DOI: 10.1001/jamapediatrics.2019.2743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Katie Zhou
- School of Medicine, Imperial College London, London, United Kingdom
| |
Collapse
|
26
|
Arafa A, Dong JY. Depression and risk of gestational diabetes: A meta-analysis of cohort studies. Diabetes Res Clin Pract 2019; 156:107826. [PMID: 31449873 DOI: 10.1016/j.diabres.2019.107826] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 08/14/2019] [Accepted: 08/22/2019] [Indexed: 12/13/2022]
Abstract
AIMS To systematically assess the association between depression and risk of gestational diabetes by a meta-analysis of cohort studies. METHODS We searched multiple electronic databases for cohort studies investigating depression and risk of gestational diabetes before December 31th, 2018. Pooled odds ratios (ORs) and confidence intervals (CIs) of the included articles were calculated using a fixed- or random-effect model. Publication bias was detected using the Egger's and Begg's tests. RESULTS We obtained 5 cohort studies with a total number of 122,197 women. Women with a history of depression compared with those without it had a significantly increased risk of gestational diabetes (pooled OR = 1.20, 95% CI: 1.09, 1.33) but borderline significant evidence of heterogeneity was observed (I2 = 45.1%, P for heterogeneity = 0.12). Subgroup analysis by study design showed a stronger association in prospective cohort studies than that in retrospective cohort studies (pooled OR: 1.61 [1.17, 2.21] vs. 1.16 [1.05, 1.29]), though the difference was not statistically significant (P for interaction = 0.26). We observed some evidence of publication bias; however, correction for such bias using "trim-and-fill" analysis yielded similar results. CONCLUSION Women with a history of depression may be at an increased risk of gestational diabetes. Future prospective studies of high quality are needed to confirm our findings.
Collapse
Affiliation(s)
- Ahmed Arafa
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
| |
Collapse
|
27
|
Schmidt CB, Voorhorst I, van de Gaar VHW, Keukens A, Potter van Loon BJ, Snoek FJ, Honig A. Diabetes distress is associated with adverse pregnancy outcomes in women with gestational diabetes: a prospective cohort study. BMC Pregnancy Childbirth 2019; 19:223. [PMID: 31269913 PMCID: PMC6610799 DOI: 10.1186/s12884-019-2376-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/24/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Around 12% of pregnant women develop gestational diabetes mellitus (GDM), which is associated with increased health risks for both mother and child and pre- and postpartum depression. Little is known about the relationship of GDM with diabetes-specific emotional distress (diabetes distress). The aims of this study are to assess the prevalence of diabetes distress in GDM and its association with adverse pregnancy outcomes. METHODS A prospective cohort study was carried out in an Amsterdam based teaching hospital with an ethnic diverse population. Women diagnosed with GDM completed a set of questionnaires at three time points. Questionnaires consisted of Problem Areas in Diabetes Scale 5 (PAID-5) for diabetes distress (T0-T1), Patient Health Questionnaire 9 (PHQ-9) for depressive symptoms (T0-T2), and questions to assess adverse pregnancy outcomes (T2). Adverse pregnancy outcomes (collected via self-report and if feasible from the medical records) were defined as hypertension, pre-eclampsia, caesarean section, severe perineal tearing, postpartum hemorrhage, postpartum depression, shoulder dystocia, neonatal hospitalization, macrosomia, jaundice, hypoglycemia and other (among which low heart rate, fever, hypoxia). Adverse pregnancy outcomes were dichotomized into none and 1 or more. Additional information was collected from the medical charts. Missing data were imputed via predictive mean matching and a multivariable logistic regression analysis was performed with diabetes distress, depressive symptoms, socioeconomic status, parity and ethnicity as predictors and age, HbA1c, and BMI as covariates. RESULTS A total of 100 women were included, mean age 32.5 (4.1), mean BMI 26.7 (4.8), 71% were of non-Dutch ethnic background. Elevated diabetes distress (PAID score ≥ 8) was reported by 36% of the women. Multivariable logistic regression analyses revealed that both high diabetes distress (OR 4.70, p = .02) and parity (OR 0.21, p = .02) but not antepartum depressive symptoms were related to adverse pregnancy outcomes. CONCLUSIONS Diabetes distress is likely in women with GDM and our findings suggest an association between both diabetes distress, parity and adverse pregnancy outcomes in women with GDM. This warrants replication and further research into the underlying mechanisms explaining the impact of diabetes distress in GDM and potential interventions to reduce distress.
Collapse
Affiliation(s)
- Charlotte B. Schmidt
- Department of Psychiatry, OLVG, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Ilse Voorhorst
- Department of Psychiatry, OLVG, Amsterdam, the Netherlands
| | | | - Anne Keukens
- Department of Gynaecology, OLVG, Amsterdam, the Netherlands
| | | | - Frank J. Snoek
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Adriaan Honig
- Department of Psychiatry, OLVG, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
28
|
Arafa A, Dong JY. Gestational diabetes and risk of postpartum depressive symptoms: A meta-analysis of cohort studies. J Affect Disord 2019; 253:312-316. [PMID: 31078830 DOI: 10.1016/j.jad.2019.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/04/2019] [Accepted: 05/01/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Previous studies suggested that gestational diabetes may increase the risk of postpartum depression, but the results are inconclusive. We aimed to systematically assess the association between gestational diabetes and risk of postpartum depressive symptoms by a meta-analysis of cohort studies. METHODS We searched multiple electronic databases for studies that investigated gestational diabetes and risk of postpartum depressive symptoms (including diagnosis of postpartum depression) on December 21, 2018. Pooled relative risks (RRs) and confidence intervals (CIs) of the included articles were calculated using the random-effect model and publication bias was detected using the Egger's and Begg's tests. RESULTS We obtained 10 cohort studies with a total population of 2,000,002. Women with gestational diabetes compared with those without it had a significantly increased risk of developing postpartum depressive symptoms (pooled RR = 1.32, 95% CI: 1.09-1.60). There was a high degree of heterogeneity across studies (I2 = 69.1%, P for heterogeneity = 0.001). The association appeared to be remarkably modified by study design, and the pooled RRs for prospective and retrospective cohort studies were 1.95 (95% CI: 1.48, 2.57) and 1.16 (95% CI: 1.12, 1.21), respectively (P for interaction = 0.003). In addition, no evidence of heterogeneity was observed in either retrospective cohort studies (I2 = 0%, P for heterogeneity = 0.55) or prospective cohort studies (I2 = 22.1%, P for heterogeneity = 0.27). CONCLUSION Women with gestational diabetes are at an increased risk of developing postpartum depressive symptoms. Future well-designed prospective studies are needed to confirm our results.
Collapse
Affiliation(s)
- Ahmed Arafa
- Public health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Jia-Yi Dong
- Public health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| |
Collapse
|
29
|
Clark CE, Rasgon NL, Reed DE, Robakis TK. Depression precedes, but does not follow, gestational diabetes. Acta Psychiatr Scand 2019; 139:311-321. [PMID: 30561785 DOI: 10.1111/acps.12998] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To determine whether past history of depression is associated with increased rates of gestational diabetes, and whether history of gestational diabetes is associated with increased rates of postpartum depression. RESEARCH DESIGN Data for this case-control study consisted of de-identified chart records for 1439 women who received pregnancy care at a large university hospital between 1998 and 2017. RESULTS A history of depression prior to pregnancy was associated with gestational diabetes requiring insulin, although not with subtler degrees of gestational hyperglycemia. Diabetes in pregnancy was not associated with an increased risk of postpartum depression. Trauma history was associated with both impaired glucose tolerance in pregnancy and postpartum depression. CONCLUSIONS Past episodes of depression increase risk for the most severe form of gestational diabetes; however, gestational diabetes does not contribute significantly to risk for postpartum depression. This suggests a unidirectional association, unlike the bidirectional association of diabetes with depression among the general population. History of trauma increases risk for both gestational hyperglycemia and postpartum depression, suggesting important health effects of trauma that may differ measurably from those associated with depression.
Collapse
Affiliation(s)
- Claire E Clark
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Natalie L Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - David E Reed
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Thalia K Robakis
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
30
|
Development of Postpartum Depression in Pregnant Women with Preeclampsia: A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9601476. [PMID: 30937313 PMCID: PMC6415313 DOI: 10.1155/2019/9601476] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/11/2019] [Accepted: 02/05/2019] [Indexed: 12/17/2022]
Abstract
Background Postpartum depression (PPD) and preeclampsia (PE) are both common diseases in obstetrics that affect maternal health and infant development. However, the relationship between the two diseases still requires clarification. Objective The purpose of this study was to (1) determine the incidence rate of PPD in patients with PE and (2) identify the association between the prevalence of PPD and the severity of PE. Methods We conducted a retrospective analysis of women with and without PE who delivered between January 1, 2017, and August 30, 2018, in the First Affiliated Hospital of Chongqing Medical University. We used a questionnaire survey methodology that included the Edinburgh Postnatal Depression Scale (EPDS) to test the influence of PE on the development of new-onset PPD in the 6 weeks after delivery. We determined PPD based on a score ≥10 on the EPDS. Bivariate analysis was used to compare data between the two groups. Results A total of 180 women participated in this study. Thirty-five people screened positive for PPD, while the remaining 145 screened negative. The prevalence of PPD was 26.67% (24/90) in patients with PE, which was two times the prevalence in normal women (12.22%). Multiple logistic regression showed that women who had PE had nearly 3-fold increased odds of PPD compared to normal women and the risk of PPD increased with the aggravation of PE. Patients with severe PE had a more than 4-fold increased risk of screening positive for PPD. Conclusion PE was independently associated with PPD. Furthermore, the risk of PPD seemed to increase with the aggravation of PE. Thus, additional prevention efforts and support methods should be provided for women with PE to reduce the incidence of PPD.
Collapse
|
31
|
Clinical News. Br J Hosp Med (Lond) 2018; 79:548-551. [DOI: 10.12968/hmed.2018.79.10.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|