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Nshimyumukiza M, Niyonsenga J, Kanazayire C, Sebatukura SG, Mutabaruka J. Perinatal intimate partner violence among teen mothers and children's attachment disorders in Rwanda: potential mediating factors. Eur J Psychotraumatol 2024; 15:2387521. [PMID: 39165197 PMCID: PMC11340234 DOI: 10.1080/20008066.2024.2387521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/24/2024] [Accepted: 07/22/2024] [Indexed: 08/22/2024] Open
Abstract
Background: The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs.Method: This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1).Results: IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs.Conclusion: These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.
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Affiliation(s)
- Martin Nshimyumukiza
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
| | - Japhet Niyonsenga
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
| | - Clementine Kanazayire
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
| | - Simeon Gitimbwa Sebatukura
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Mutabaruka
- Department of Clinical Psychology, College of Medicine and Health sciences, University of Rwanda, Kigali, Rwanda
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Yadesa G, Bala ET, Kolola T, Solbana LK. Intimate partner violence and its associated factors among married women at Jeldu district, Central Ethiopia: A community-based mixed cross-sectional study. Health Sci Rep 2024; 7:e2099. [PMID: 38817883 PMCID: PMC11136638 DOI: 10.1002/hsr2.2099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/07/2024] [Accepted: 04/15/2024] [Indexed: 06/01/2024] Open
Abstract
Background and Aims Intimate partner violence is a global threat, regardless of any religious, cultural, or economic differences. Few studies have been conducted before in rural areas of Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of intimate partner violence among married women in Jeldu district. Methods A community-based mixed cross-sectional study was conducted among 620 married women in Jeldu district, west Ethiopia. A systematic random sampling technique was employed to select study participants. The quantitative data were checked and entered into Epidata and STATA version 15.0 for analysis. Univariate and multivariate logistic regression was used to identify the associated factors of intimate partner violence. The finding of the quantitative study was triangulated with the findings of focused group discussion. Results Six hundred seven married women participated in the study making a response rate of 97.43%. The lifetime and past 12 months prevalence of intimate partner violence was 57.7% (95% confidence interval [CI]: 53.78%-61.62%) and 53.20% (95% CI: 49.28%-57.12%) respectively. Partner with lower education (adjusted odd ratio [AOR] = 3.64 (95% CI: 1.07-12.38), alcohol intake by partner (AOR = 1.92, 95% CI: 1.31-2.81), equal dominance on family affairs (AOR = 0.30, 95% CI: 0.18-0.51), and family size >5 (AOR = 4.54, 95% CI: 1.89-10.91) were factors significantly associated with intimate partner violence. Conclusion The prevalence of intimate partner violence was relatively higher among married women study area. Partner's lower educational status, alcohol intake of the partner, dominance on family issues, and family size were factors associated with intimate partner violence. So, gender offices, and district and regional educational sectors should design appropriate strategies and work hard to tackle the problem.
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Affiliation(s)
- Geremew Yadesa
- West Shoa Zonal Health DepartmentOromia Health BureauOromiaEthiopia
| | - Elias Teferi Bala
- Department of Public Health, College of Medicine and Health SciencesAmbo UniversityAmboEthiopia
| | - Tufa Kolola
- Department of Public Health, College of Medicine and Health SciencesAmbo UniversityAmboEthiopia
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Wei X, Wang W, Law YW, Zhang H. The Impacts of Intimate Partner Violence on Postpartum Depression: An Updated Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1531-1550. [PMID: 37480328 DOI: 10.1177/15248380231188068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
The associations between intimate partner violence (IPV) and postpartum depression (PPD) have been well established in previous reviews. However, none has explored potential differences between IPV subtypes or exposure times, which could help healthcare providers recognize the adverse impacts of various IPV subtypes and conduct comprehensive IPV screening. This study aimed to estimate the impacts of overall IPV and its subtypes (physical, psychological, and sexual) on PPD using an updated meta-analysis and to examine the potential role of IPV exposure time and regional income levels. Four English databases (Medline, PsycINFO, PubMed, and Web of Science) and two Chinese databases (China National Knowledge Infrastructure [CNKI] and Wanfang Database) were systematically searched. We included 76 studies with 388,966 samples. Random-effects models were used to pool the odds ratios (ORs) across studies. Overall, IPV and its subtypes had statistically significant impacts on PPD (overall: OR = 2.50, physical: OR = 2.31, psychological: OR = 2.22, sexual: OR = 1.75). A higher impact of IPV on PPD was observed in middle- and low-income regions (OR = 3.01) than in high-income regions (OR = 1.92). IPV during pregnancy (OR = 2.73) had a greater impact on PPD than lifetime IPV (OR = 2.24). This study provides updated evidence for the significant impact of IPV and its subtypes and exposure time on PPD. Women at risk of exposure to physical IPV, especially during pregnancy, are in urgent need of support to reduce the risk of PPD.
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Affiliation(s)
- Xinyi Wei
- The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Yik Wa Law
- The University of Hong Kong, Pokfulam, Hong Kong
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Wu L, Wang J, Lu Y, Huang Y, Zhang X, Ma D, Xiao Y, Cao F. Association of intimate partner violence with offspring growth in 32 low- and middle-income countries: a population-based cross-sectional study. Arch Womens Ment Health 2024; 27:179-190. [PMID: 37947903 DOI: 10.1007/s00737-023-01387-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Intimate partner violence (IPV) against women presents a major public health challenge, especially in low-income and middle-income countries (LMICs), and its relationship with poor offspring growth is emerging but remains understudied. This study aimed to explore the impact of maternal exposure to IPV on offspring growth based on different approaches in LMICs. We conducted a population-based cross-sectional study using the most recent Demographic and Health Surveys from 32 LMICs; 81,652 mother-child dyads comprising women aged from 15 to 49 years with children aged 0 to 59 months were included. We applied logistic regression models to explore the independent and cumulative relationship between IPV, including emotional, physical, and sexual IPV, with poor child growth status, including stunting and wasting; 52.6% of mothers were under the age of 30 years with a 36% prevalence of any lifetime exposure to IPV. Maternal exposure to any IPV increased the odds of stunting, but only physical and sexual IPV were independently associated with an increased risk of stunting. Three different types of IPV exhibited a cumulative effect on stunting. Maternal exposure to physical IPV was significantly associated with an increased risk of wasting. Significant associations between maternal exposure to emotional IPV with offspring stunting and physical IPV with wasting were only observed in children aged 0 to 36 months. IPV against women remains high in LMICs and has adverse effects on offspring growth. Policy and program efforts are needed to prioritize the reduction of widespread physical and sexual IPV and to mitigate the impact of such violence.
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Affiliation(s)
- Liuliu Wu
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Juan Wang
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, People's Republic of China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, People's Republic of China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, 310058, People's Republic of China
| | - Yan'e Lu
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Yongqi Huang
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Xuan Zhang
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Dandan Ma
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Yiping Xiao
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Fenglin Cao
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China.
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Ruan JM, Wu LJ. Postpartum depression and partner support during the period of lactation: Correlation research and its influencing factors. World J Psychiatry 2024; 14:119-127. [PMID: 38327897 PMCID: PMC10845228 DOI: 10.5498/wjp.v14.i1.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Postpartum depression (PPD) not only affects the psychological and physiological aspects of maternal health but can also affect neonatal growth and development. Partners who are in close contact with parturient women play a key role in communication and emotional support. This study explores the PPD support relationship with partners and its influencing factors, which is believed to establish psychological well-being and improve maternal partner support. AIM To explore the correlation between PPD and partner support during breastfeeding and its influencing factors. METHODS Convenience sampling was used to select lactating women (200 women) who underwent postpartum examinations at the Huzhou Maternity and Child Health Care Hospital from July 2022 to December 2022. A cross-sectional survey was conducted on the basic information (general information questionnaire), depression level [edinburgh postnatal depression scale (EPDS)], and partner support score [dyadic coping inventory (DCI)] of the selected subjects. Pearson's correlation analysis was used to analyze the correlation between PPD and DCI in lactating women. Factors affecting PPD levels during lactation were analyzed using multiple linear regression. RESULTS The total average score of EPDS in 200 lactating women was (9.52 ± 1.53), and the total average score of DCI was (115.78 ± 14.90). Dividing the EPDS, the dimension scores were: emotional loss (1.91 ± 0.52), anxiety (3.84 ± 1.05), and depression (3.76 ± 0.96). Each dimension of the DCI was subdivided into: Pressure communication (26.79±6.71), mutual support (39.76 ± 9.63), negative support (24.97 ± 6.68), agent support (6.87 ± 1.92), and joint support (17.39 ± 4.19). Pearson's correlation analysis demonstrated that the total mean score and individual dimension scores of EPDS during breastfeeding were inversely correlated with the total score of partner support, stress communication, mutual support, and co-support (P < 0.05). The total mean score of the EPDS and its dimensions were positively correlated with negative support (P < 0.05). Multiple linear regression analysis showed that the main factors affecting PPD during breastfeeding were marital harmony, newborn health, stress communication, mutual support, negative support, co-support, and the total score of partner support (P < 0.05). CONCLUSION PPD during breastfeeding was associated with marital harmony, newborn health, stress communication, mutual support, negative support, joint support, and the total DCI score.
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Affiliation(s)
- Ji-Ming Ruan
- Department of Obstetrics and Gynecology, Huzhou Maternity and Child Health Care Hospital, Huzhou 313000, Zhejiang Province, China
| | - Ling-Juan Wu
- Department of Obstetrics and Gynecology, Huzhou Maternity and Child Health Care Hospital, Huzhou 313000, Zhejiang Province, China
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De Risio L, Pettorruso M, Collevecchio R, Collacchi B, Boffa M, Santorelli M, Clerici M, Martinotti G, Zoratto F, Borgi M. Staying connected: An umbrella review of meta-analyses on the push-and-pull of social connection in depression. J Affect Disord 2024; 345:358-368. [PMID: 37852587 DOI: 10.1016/j.jad.2023.10.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/18/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Depression affects approximately 4 % of the global population and has huge social and economic implications. Social factors, including support, engagement, and stigma, play a crucial role in the development and severity of depression. METHODS We provide a synthesis of the consistency and magnitude of the association between measures of social connection and depression. We searched PubMed, PsycINFO, Cochrane Library, and EMBASE and 47 meta-analyses were included in the umbrella review. The strength of the associations was extracted and compared among different populations. The quality/certainty of evidence was assessed using AMSTAR-2 and GRADE tool. RESULTS Results indicate that social support serves as a protective factor against depression, particularly in peripartum populations, while its impact is weaker in clinical populations. No association was found between social support and depression in post-disaster populations. Stigma and discrimination favour the development and maintenance of depressive symptoms in clinical populations, but have a weaker effect in ethnic minorities. LIMITATIONS The quality and certainty of evidence should be taken into account when interpreting our findings. Further research with more rigorous methodology and higher-quality evidence is needed to better understand the complex relationship between depression and social connection across various populations and contexts. CONCLUSIONS Our findings confirm the role of social determinants in the emergence and severity of depression, particularly in the case of vulnerable populations. Efforts to counteract disconnection at the societal and individual levels and to reduce stigma should be central to an effective depression prevention agenda.
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Affiliation(s)
- Luisa De Risio
- Department of Psychiatry and Addiction, ASL Roma 5, Colleferro, Rome, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti-Pescara, Italy.
| | - Rebecca Collevecchio
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti-Pescara, Italy
| | - Barbara Collacchi
- Center for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marta Boffa
- Center for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Mario Santorelli
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy
| | - Massimo Clerici
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti-Pescara, Italy
| | - Francesca Zoratto
- Center for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marta Borgi
- Center for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
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Al-abri K, Edge D, Armitage CJ. Prevalence and correlates of perinatal depression. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1581-1590. [PMID: 36646936 PMCID: PMC9842219 DOI: 10.1007/s00127-022-02386-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/14/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE This systematic review of systematic reviews aims to provide the first global picture of the prevalence and correlates of perinatal depression, and to explore the commonalities and discrepancies of the literature. METHODS Seven databases were searched from inception until April 2022. Full-text screening and data extraction were performed independently by two researchers and the AMSTAR tool was used to assess the methodological quality. RESULTS 128 systematic reviews were included in the analysis. Mean overall prevalence of perinatal depression, antenatal depression and postnatal depression was 26.3%, 28.5% and 27.6%, respectively. Mean prevalence was significantly higher (27.4%; SD = 12.6) in studies using self-reported measures compared with structured interviews (17.0%, SD = 4.5; d = 1.0) and among potentially vulnerable populations (32.5%; SD = 16.7, e.g. HIV-infected African women) compared to the general population (24.5%; SD = 8.1; d = 0.6). Personal history of mental illness, experiencing stressful life events, lack of social support, lifetime history of abuse, marital conflicts, maternity blues, child care stress, chronic physical health conditions, preeclampsia, gestational diabetes mellitus, being exposed to second-hand smoke and sleep disturbance were among the major correlates of perinatal depression. CONCLUSION Although the included systematic reviews were all of medium-high quality, improvements in the quality of primary research in this area should be encouraged. The standardisation of perinatal depression assessment, diagnosis and measurement, the implementation of longitudinal designs in studies, inclusions of samples that better represent the population and better control of potentially confounding variables are encouraged.
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Affiliation(s)
- Khalood Al-abri
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK
- Department of Community and Mental Health, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Dawn Edge
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK
- Equality, Diversity and Inclusion Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Christopher J. Armitage
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
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Pearce E, Birken M, Pais S, Tamworth M, Ng Y, Wang J, Chipp B, Crane E, Schlief M, Yang J, Stamos A, Cheng LK, Condon M, Lloyd-Evans B, Kirkbride JB, Osborn D, Pitman A, Johnson S. Associations between constructs related to social relationships and mental health conditions and symptoms: an umbrella review. BMC Psychiatry 2023; 23:652. [PMID: 37667255 PMCID: PMC10478264 DOI: 10.1186/s12888-023-05069-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 07/31/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Loneliness and social isolation are increasingly recognised as prevalent among people with mental health problems, and as potential targets for interventions to improve quality of life and outcomes, as well as for preventive strategies. Understanding the relationship between quality and quantity of social relationships and a range of mental health conditions is a helpful step towards development of such interventions. PURPOSE Our aim was to give an overview of associations between constructs related to social relationships (including loneliness and social isolation) and diagnosed mental conditions and mental health symptoms, as reported in systematic reviews of observational studies. METHODS For this umbrella review (systematic review of systematic reviews) we searched five databases (PsycINFO, MEDLINE, EMBASE, CINAHL, Web of Science) and relevant online resources (PROSPERO, Campbell Collaboration, Joanna Briggs Institute Evidence Synthesis Journal). We included systematic reviews of studies of associations between constructs related to social relationships and mental health diagnoses or psychiatric symptom severity, in clinical or general population samples. We also included reviews of general population studies investigating the relationship between loneliness and risk of onset of mental health problems. RESULTS We identified 53 relevant systematic reviews, including them in a narrative synthesis. We found evidence regarding associations between (i) loneliness, social isolation, social support, social network size and composition, and individual-level social capital and (ii) diagnoses of mental health conditions and severity of various mental health symptoms. Depression (including post-natal) and psychosis were most often reported on, with few systematic reviews on eating disorders or post-traumatic stress disorder (PTSD), and only four related to anxiety. Social support was the most commonly included social construct. Our findings were limited by low quality of reviews and their inclusion of mainly cross-sectional evidence. CONCLUSION Good quality evidence is needed on a wider range of social constructs, on conditions other than depression, and on longitudinal relationships between social constructs and mental health symptoms and conditions.
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Affiliation(s)
- Eiluned Pearce
- Division of Psychiatry, University College London, London, UK
| | - Mary Birken
- Division of Psychiatry, University College London, London, UK
| | - Sarah Pais
- Division of Psychiatry, University College London, London, UK
| | - Millie Tamworth
- Division of Psychiatry, University College London, London, UK
| | - Yutung Ng
- Division of Psychiatry, University College London, London, UK
| | - Jingyi Wang
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Beverley Chipp
- Co-production Group, Loneliness and Social Isolation in Mental Health Research Network, Division of Psychiatry, University College London, London, UK
| | - Ellena Crane
- Division of Psychiatry, University College London, London, UK
| | - Merle Schlief
- Division of Psychiatry, University College London, London, UK
| | - Jinyan Yang
- Division of Psychiatry, University College London, London, UK
| | - Aggelos Stamos
- Division of Psychiatry, University College London, London, UK
| | - Lui Kwan Cheng
- Division of Psychiatry, University College London, London, UK
| | - Maria Condon
- Division of Psychiatry, University College London, London, UK
| | | | | | - David Osborn
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK.
- Camden and Islington NHS Foundation Trust, London, UK.
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Mulugeta Y, Mohammed AA, Ibrahim IM, Getachew G, Ahmed KY. Postpartum depression and associated factors in Afar Region, northeast Ethiopia. Heliyon 2023; 9:e19914. [PMID: 37809513 PMCID: PMC10559328 DOI: 10.1016/j.heliyon.2023.e19914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/11/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Background To effectively address the burden of postpartum depression (PPD), it is crucial to gain a comprehensive understanding of its magnitude and the factors associated with it in the pastoral and hot region of the Afar Region. This will help identify the progress made thus far and highlight areas that require further attention to accelerate efforts toward reducing the impact of PPD. Notably, no previous study has examined the prevalence and associated factors of PPD specifically in pastoral communities within Ethiopia, including the Afar Region. Accordingly, we investigated the prevalence and associated factors of PPD among postpartum women in the Afar Region, Northeast Ethiopia. Methods An institution-based cross-sectional study was conducted in the Awsi Rasu Zone of Afar Regional State from June to July 2021. The study employed a systematic random sampling method to select a total of 302 postpartum mothers who had visited the Expanded Program of Immunisation (EPI) clinics in public health facilities within the Awsi Rasu Zone of the Afar Region. The measurement of PPD was performed using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable binary logistic regression modelling was used to investigate associations between sociodemographic, obstetric and health service, and psychosocial factors with PPD. Results The overall prevalence of PPD was 37.4% with a 95% confidence interval (CI) from 32.0% to 43.0%. Postpartum women who attained high school education were associated with a lower odds of PPD compared to those who did not attain formal schooling (adjusted odds ratio [AOR] = 0.31; 95% CI: 0.12, 0.82). Postpartum women with a family history of mental illness (AOR = 2.34; 95% CI: 1.24, 4.41), those who had trouble in infant feeding (AOR = 4.26; 95% CI: 2.32, 7.83), and those who experienced intimate partner violence (AOR = 3.09; 95% CI: 1.58, 6.04) were positively associated with PPD. Conclusion The results of our study revealed that the prevalence of PPD in the Awsi Rasu Zone of the Afar Region is higher than both the national and global averages. The findings also highlighted the need for targeted interventions addressing the needs of pastoral postpartum women who experience various stressors, such as feeding difficulties and intimate partner violence.
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Affiliation(s)
| | - Ahmed Adem Mohammed
- Department of Nursing, College of Medicine and Health Science, Samara University, PO Box: 132, Samara, Ethiopia
| | - Ibrahim Mohammed Ibrahim
- Department of Midwifery, College of Medicine and Health Science, Samara University, PO Box: 132, Samara, Ethiopia
| | | | - Kedir Y. Ahmed
- Department of Public Health, College of Medicine and Health Science, Samara University, PO Box: 132, Samara, Ethiopia
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
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10
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Wedajo LF, Alemu SS, Jarso MH, Golge AM, Dirirsa DE. Late postpartum depression and associated factors: community-based cross-sectional study. BMC Womens Health 2023; 23:280. [PMID: 37221573 DOI: 10.1186/s12905-023-02444-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Late postpartum depression is the presence of depressive symptoms beyond the early postpartum period and is a significant mental health problem that has a devastating impact on mothers, infants, partners, family members, the healthcare system, and the world's economy. However, there is limited information regarding this problem in Ethiopia. OBJECTIVE To assess the prevalence of late postpartum depression and associated factors. METHOD the community-based cross-sectional study was employed among 479 postpartum mothers in Arba Minch town from May 21 to June 21, 2022. The pre-tested face-to-face interviewer administered a structured questionnaire used to collect the data. A bivariate and multivariable analysis was done using a binary logistic regression model to identify factors associated with late postpartum depression. Both crude and adjusted odds ratios with 95% CI were calculated, and a p-value of < 0.05 was used to declare statistically significant factors. RESULT The prevalence of late postpartum depression was 22.98% (95% CI: 19.16, 26.80). Husband Khat use (AOR = 2.64; 95% CI: 1.18, 5.91), partner dissatisfaction with the gender of the baby (AOR = 2.53; 95% CI: 1.22, 5.24), short inter-delivery interval (AOR = 6.80; 95% CI: 3.34, 13.84), difficulty to meet husband sexual need (AOR = 3.21; 95% CI: 1.62, 6.37), postpartum intimate partner violence (AOR = 4.08; 95% CI: 1.95, 8.54), and low social support (AOR = 2.50; 95% CI: 1.25, 4.50) were significantly associated factors at p-value < 0.05. CONCLUSION Overall, 22.98% of mothers suffered from late postpartum depression. Therefore, based on the identified factors, the Ministry of Health, Zonal Health Departments, and other responsible agencies should establish effective strategies to overcome this problem.
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Affiliation(s)
- Lema Fikadu Wedajo
- Department of Midwifery, Mattu University College of medical and Health Sciences, Mattu, Ethiopia.
| | - Solomon Seyife Alemu
- Department of Midwifery, Mattu University College of medical and Health Sciences, Mattu, Ethiopia
- Department of Midwifery, Madda Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Mohammedamin Hajure Jarso
- Department of Psychiatry, Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Aman Mamo Golge
- Department of Nursing, Madda Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Dejene Edosa Dirirsa
- College of Medicine and Health Sciences, Department of Midwifery, Salale University, Salale, Ethiopia
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11
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Liu H, Dai A, Zhou Z, Xu X, Gao K, Li Q, Xu S, Feng Y, Chen C, Ge C, Lu Y, Zou J, Wang S. An optimization for postpartum depression risk assessment and preventive intervention strategy based machine learning approaches. J Affect Disord 2023; 328:163-174. [PMID: 36758872 DOI: 10.1016/j.jad.2023.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Postpartum depression (PPD) is one of the most common psychiatric disorders for women after delivery. The establishment of an effective PPD prediction model helps to distinguish high-risk groups, and verifying whether such high-risk groups can benefit from drug intervention is very important for clinical guidance. METHODS We collected data of parturients that underwent a cesarean delivery. The Control group was divided into a training cohort and a testing cohort. Six different ML models were constructed and we compared their prediction performance in the testing cohort. For model interpretation, we introduced SHapley Additive exPlanations (SHAP). Then, training cohort, ketamine group and dexmedetomidine (DEX) group were classified as high or low risk for PPD by the model. A 1:1 propensity score matching (PSM) was performed to compare the incidence of PPD between two groups in different risk cohorts. RESULTS Extreme gradient enhancement (XGB) had the best recognition effect, with an area under the receiver operating characteristic curve (AUROC) of 0.789 (95 % CI 0.742-0.836) in the training cohort and 0.744 (95 % CI 0.655-0.823) in the testing cohort, respectively. A threshold of 21.5 % PPD risk probability was determined. After PSM, the results showed that the incidence of PPD in the two intervention groups was significantly different from the control group in the high-risk cohort (P < 0.001) but not in the low-risk cohort (P > 0.001). CONCLUSION Our study demonstrated that the XGB algorithm provided a more accurate in prediction of PPD risk, and it was beneficial to receive early intervention for the high-risk groups distinguished by the model.
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Affiliation(s)
- Hao Liu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 211198, China; Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
| | - Anran Dai
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 211198, China; Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
| | - Zhou Zhou
- Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
| | - Xiaowen Xu
- Office of Clinical Trials, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
| | - Kai Gao
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Qiuwen Li
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Shouyu Xu
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Yunfei Feng
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Chen Chen
- Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China; Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing 210006, China
| | - Chun Ge
- Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China; Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing 210006, China
| | - Yuanjun Lu
- Research and Development Department, Hangzhou Million Happy Deer Co. Ltd, Hangzhou 310012, China
| | - Jianjun Zou
- Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China; Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing 210006, China.
| | - Saiying Wang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, China.
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12
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Evaluation of the correlation between spousal support, postpartum depression, and breastfeeding self-efficacy in the postpartum period. JOURNAL OF CONTEMPORARY MEDICINE 2023. [DOI: 10.16899/jcm.1206828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Aim: This study aimed to determine the correlation between spousal support, postpartum depression (PPD), and breastfeeding self-efficacy (BSES) in the postpartum period.
Methods: This descriptive correlational study was performed on 300 postpartum women. Data collected with using The Perceived Spousal Support among Women in Early Postpartum Period Scale (PSSAWEPP), The Edinburgh Postpartum Depression Scale (EPDS) and Postpartum Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF).
Results: There was a negative correlation between women's perceived level of spousal support and their postpartum depression (PPD) status (p
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13
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Gribbin C, Achieng F, K’Oloo A, Barsosio HC, Kwobah E, Kariuki S, Nabwera HM. Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231189547. [PMID: 37551659 PMCID: PMC10411280 DOI: 10.1177/17455057231189547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/23/2023] [Accepted: 07/05/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality. OBJECTIVES To explore how PND influences neonatal feeding and care practices among women in the early postnatal period in rural Western Kenya. DESIGN A cross-sectional study. METHODS Semi-structured interviews were conducted at 2-weeks postpartum among mothers of newborn infants identified <72 h old from the postnatal wards and clinics across five health facilities in Kisumu County of Western Kenya. They were all screened for features suggestive of postnatal depression using the Edinburgh Postnatal Depression Scale. RESULTS Twenty-four mothers were interviewed, 13 of whom had features suggestive of PND. All mothers experienced health or socio-economic adversities in the perinatal period, including traumatic deliveries, financial constraints, and challenging relationships with partners/other family members. Feeding difficulties due to perceived insufficient breastmilk were a particular challenge for mothers with features of PND, who were more likely to introduce complementary feeds. Maternal health-seeking decisions were influenced by high financial cost, long waiting times and poor interactions with health care providers that induced stress and fear among mothers. Maternal caregiving capacity was influenced by her ability to juggle other household duties, which was difficult for mothers with features suggestive of PND. Support from friends and relatives positively impacted maternal mood and caregiving ability. CONCLUSION Mothers experienced many stress-inducing events in the perinatal period which potentially exacerbated features of PND in the immediate postnatal period. Women with features of PND were particularly vulnerable to these stressors that influenced infant caregiving practices. Addressing the socio-economic challenges and health system gaps that include scale up of compassionate and respectful care for women during pregnancy and childbirth, as well as early screening and intervention of PND, through enhanced referral pathways between health facilities and community support structures, could mitigate against the impact of PND on neonatal caregiving.
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Affiliation(s)
- Catherine Gribbin
- Liverpool School of Tropical Medicine, Liverpool, UK
- King’s Mill Hospital, Sutton-in-Ashfield, UK
| | - Florence Achieng
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Alloys K’Oloo
- Liverpool School of Tropical Medicine, Liverpool, UK
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Hellen C Barsosio
- Liverpool School of Tropical Medicine, Liverpool, UK
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Edith Kwobah
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
- Department of Psychiatry, Moi University, Eldoret, Kenya
| | - Simon Kariuki
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Helen M Nabwera
- Liverpool School of Tropical Medicine, Liverpool, UK
- The Aga Khan University, Nairobi, Kenya
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14
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Hanach N, Radwan H, Fakhry R, Dennis CL, issa WB, Faris ME, Obaid RS, Al Marzooqi S, Tabet C, De Vries N. Prevalence and risk factors of postpartum depression among women living in the United Arab Emirates. Soc Psychiatry Psychiatr Epidemiol 2023; 58:395-407. [PMID: 36239744 PMCID: PMC9971080 DOI: 10.1007/s00127-022-02372-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 10/02/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Postpartum depression received almost no attention in the United Arab Emirates (UAE). The aim was to examine the prevalence of depressive symptomatology and the associated risk factors among women in the UAE. METHODS A prospective cohort study recruited women from postpartum wards in hospitals across four emirates in the UAE. Women completed questionnaires immediately after childbirth and at 3 and 6 months postpartum. Depressive symptomatology was measured using the Edinburgh Postnatal Depression Scale (EPDS > 12). Risk factors were identified using the generalized estimating equation. A stratified analysis of the postpartum period was performed. RESULTS Among the 457 women recruited, 35% exhibited depressive symptomatology within the first 6 months postpartum. Younger women (< 25 years), part-time employment, the receipt of financial support from the family, and difficulty in managing monthly income were associated with a higher risk of postpartum depression. Husband's employment, husband's support, and living in own house were associated with a lower risk of postpartum depression. Maternity leave of more than 3 months increased the risk of depression during the first 3 months postpartum. From 3 to 6 months postpartum, Muslim women had a higher risk of depression whereas women who breastfed other children and in the past 7 days, and perceived their infant as healthy had a lower risk of depression. CONCLUSIONS The prevalence of maternal depressive symptomatology is considerable in the UAE. Risk factors change over the 6-month postpartum period suggesting the need for an innovative multidisciplinary approach to the management of postpartum depression, including follow-up screening.
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Affiliation(s)
- Nivine Hanach
- Faculty of Health, Medicine, and Life Sciences, CAPHRI, Maastricht University, P.O. Box 616, Maastricht, Netherlands.
| | - Hadia Radwan
- grid.412789.10000 0004 4686 5317Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Randa Fakhry
- grid.412789.10000 0004 4686 5317Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Cindy-Lee Dennis
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Wegdan Bani issa
- grid.412789.10000 0004 4686 5317Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E. Faris
- grid.412789.10000 0004 4686 5317Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- grid.412789.10000 0004 4686 5317Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Suad Al Marzooqi
- grid.43519.3a0000 0001 2193 6666Department of Psychology, Al Ain, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Charbel Tabet
- grid.450307.50000 0001 0944 2786CREG, Grenoble Alpes University, Paris, France
| | - Nanne De Vries
- grid.5012.60000 0001 0481 6099Faculty of Health, Medicine, and Life Sciences, CAPHRI, Maastricht University, P.O. Box 616, Maastricht, Netherlands
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15
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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.
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Alsabi RNS, Zaimi AF, Sivalingam T, Ishak NN, Alimuddin AS, Dasrilsyah RA, Basri NI, Jamil AAM. Improving knowledge, attitudes and beliefs: a cross-sectional study of postpartum depression awareness among social support networks during COVID-19 pandemic in Malaysia. BMC Womens Health 2022; 22:221. [PMID: 35690751 PMCID: PMC9187926 DOI: 10.1186/s12905-022-01795-x] [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: 10/27/2021] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Postpartum depression (PPD) is the most prevalent mental health disorder after childbirth, notably during the COVID-19 pandemic. In addition, PPD is known to have a long-term influence on the mother and the newborn, and the role of social support network is crucial in early illness recognition. This study aims to evaluate the social support networks’ level of knowledge, attitudes and beliefs regarding PPD and examine their sociodemographic variables and exposure to the public information relating to PPD during the COVID-19 pandemic in Malaysia. Methods A cross-sectional study was conducted via an online Google Form disseminated to people in Klang Valley through WhatsApp, Email, Facebook, Instagram and other available social media among postpartum women’s social support networks aged 18 years and living in the Klang Valley area (N = 394). Data were collected from 1 March to 5 July 2021 and analysed using the Mann–Whitney U-test and generalised linear mixed models. Results During the COVID-19 epidemic in Klang Valley, most participants had good knowledge, negative attitudes and awareness of PPD. Marital status, gender and parity all had significant correlations with the amount of awareness regarding PPD. Ethnicity, gender, parity and educational level showed significant association with attitude towards PPD. No significant relationship was noted between sociodemographic variables and PPD beliefs. Public awareness of PPD was also associated with knowledge and attitude towards it. Conclusions A significant positive knowledge, negative attitude and negative awareness level of PPD exist among social support networks for postnatal women. However, no significant effect of belief on PPD awareness level was noted. Implications Insight campaigns and public education about PPD should be conducted to enhance postnatal mothers’ awareness and knowledge. Postnatal care, mental check-ups and counselling sessions for the new mothers are recommended. In future studies, a closer assessment of postpartum social support, variances and similarities across women from diverse racial/ethnic origins is critical.
Strengths and limitations This cross-sectional study is one of the early studies on the area of PPD in the Malaysian region during COVID-19. Numerous data have been collected using low-cost approaches using self-administered surveys through Google Forms in this research.
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Kebede AA, Gessesse DN, Aklil MB, Temesgan WZ, Abegaz MY, Anteneh TA, Tibebu NS, Alemu HN, Haile TT, Seyoum AT, Tiguh AE, Yismaw AE, Mihret MS, Nenko G, Wondie KY, Taye BT, Tsega NT. Low husband involvement in maternal and child health services and intimate partner violence increases the odds of postpartum depression in northwest Ethiopia: A community-based study. PLoS One 2022; 17:e0276809. [PMID: 36288375 PMCID: PMC9604988 DOI: 10.1371/journal.pone.0276809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Background Depression is the most common mental health problem that affects women during pregnancy and after child-birth. Postpartum depression, in particular, has both short and long-term effects on the lives of mothers and children. Women’s health is a current global concern, but postpartum depression is a neglected issue in the maternal continuum of care and is rarely addressed. Therefore, this study aimed to assess postpartum depression and associated factors in Gondar city, northwest Ethiopia. Methods A community-based cross-sectional study was conducted from August 1st to 30th, 2021 in Gondar city. A cluster sampling technique was employed to select 794 postpartum women. Data were entered by EPI DATA version 4.6 and exported to SPSS version 25 for further analysis. The multivariable logistic regression analysis was carried out to identify factors associated with postpartum depression. The adjusted odds ratio with its 95% confidence interval at a p-value of ≤ 0.05 was used to declare the level of significance. Results A total of 794 women were included in the analysis, giving a response rate of 98.5%. The prevalence of postpartum depression was 17.25% (95% CI: 14.5, 20.2). Younger maternal age (AOR = 2.72, 95% CI: 1.23, 5.85), low average monthly income (AOR = 2.71, 95% CI: 1.24, 5.91), low decision-making power (AOR = 2.04, 95%CI: 1.31, 3.18), low husband/partner involvement in MNCH care service (AOR = 2.34, 95%CI: 1.44, 3.81), unplanned pregnancy (AOR = 3.16 95% CI: 1.77, 5.62), and experience of intimate partner violence (AOR = 3.13; 95% CI: 1.96, 4.99) were significantly associated with increased odds of postpartum depression. Conclusion In this study, nearly 1/5th of the study participants had postpartum depression. Thus, it is important to integrate maternal mental health services with the existing maternal health care services. It is also crucial to advocate the need for husband’s involvement in MNCH care services and ensure women’s decision-making power in the household. Moreover, community-based sexual and reproductive health education would be better to reduce risk factors of postpartum depression.
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Affiliation(s)
- Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dereje Nibret Gessesse
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mastewal Belayneh Aklil
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubedle Zelalem Temesgan
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Marta Yimam Abegaz
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tazeb Alemu Anteneh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Solomon Tibebu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haymanot Nigatu Alemu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsion Tadesse Haile
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmra Tesfahun Seyoum
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Agumas Eskezia Tiguh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Engida Yismaw
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muhabaw Shumye Mihret
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Goshu Nenko
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kindu Yinges Wondie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhan Tsegaw Taye
- Department of Midwifery, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nuhamin Tesfa Tsega
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
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Çankaya S, Alan Dikmen H. The effects of family function, relationship satisfaction, and dyadic adjustment on postpartum depression. Perspect Psychiatr Care 2022; 58:2460-2470. [PMID: 35362113 DOI: 10.1111/ppc.13081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To determine the effect of family function, relationship satisfaction, and dyadic adjustment on postpartum depression DESIGN AND METHODS: This descriptive, cross-sectional study was conducted in 337 postpartum mothers. FINDINGS Fifty-five mothers scored above the depression scale cutoff point (>13). Emotional violence from husband, poor problem solving and communication, low relationship satisfaction, dyadic adjustment, and consensus were important risk factors for postpartum depression (p < .0.05). PRACTICE IMPLICATIONS Family function and partner relationships should be a key focus for midwives and nurses in the postpartum period. Providing psychological interventions aimed at improving relationship functioning can help protect mothers against postpartum depression.
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Affiliation(s)
- Seyhan Çankaya
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Hacer Alan Dikmen
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
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Environmental risk factors, protective factors, and biomarkers for postpartum depressive symptoms: an umbrella review. Neurosci Biobehav Rev 2022; 140:104761. [PMID: 35803397 DOI: 10.1016/j.neubiorev.2022.104761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 05/27/2022] [Accepted: 06/28/2022] [Indexed: 11/24/2022]
Abstract
We performed an umbrella review on environmental risk/protective factors and biomarkers for postpartum depressive symptoms to establish a hierarchy of evidence. We systematically searched PubMed, Embase, and the Cochrane Database of Systematic Reviews from inception until 12 January 2021. We included systematic reviews providing meta-analyses related to our research objectives. Methodological quality was assessed by AMSTAR 2, and the certainty of evidence was evaluated by GRADE. This review was registered in PROSPERO (CRD42021230784). We identified 30 articles, which included 45 environmental risk/protective factors (154,594 cases, 7,302,273 population) and 9 biomarkers (2018 cases, 16,757 population). The credibility of evidence was convincing (class I) for antenatal anxiety (OR 2.49, 1.91-3.25) and psychological violence (OR 1.93, 1.54-2.42); and highly suggestive (class II) for intimate partner violence experience (OR 2.86, 2.12-3.87), intimate partner violence during pregnancy (RR 2.81, 2.11-3.74), smoking during pregnancy (OR 2.39, 1.78-3.2), history of premenstrual syndrome (OR 2.2, 1.81-2.68), any type of violence experience (OR 2.04, 1.72-2.41), primiparity compared to multiparity (RR 1.76, 1.59-1.96), and unintended pregnancy (OR 1.53, 1.35-1.75).
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Molgora S, Saita E, Barbieri Carones M, Ferrazzi E, Facchin F. Predictors of Postpartum Depression among Italian Women: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1553. [PMID: 35162574 PMCID: PMC8835615 DOI: 10.3390/ijerph19031553] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/12/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Postpartum depression is commonly experienced by mothers worldwide and is associated with anxiety disorders, parenting stress, and other forms of distress, which may lead to a complex illness condition. Several studies have investigated the risk factors for this disorder, including biological and socio-demographic variables, medical and obstetric factors, and psychological and relational dimensions. The present study aimed to describe the psychological status of mothers up to 12 months postpartum, and to investigate the predictors of depressive symptoms at 12 months postpartum, considering obstetric factors along with psychological and relational variables. METHODS A sample of 137 women completed a questionnaire composed of a sheet on anamnestic and obstetric information and the following scales: Wijma Delivery Experience Questionnaire; State-Trait Anxiety Inventory; Edinburgh Postnatal Depression Scale; Parenting Stress Index (Short Form); Dyadic Adjustment Scale; and Multidimensional Scale of Perceived Social Support. Data were collected at four assessment times: 2-3 days, 3 months, 6 months, and 12 months postpartum. RESULTS Findings showed that the highest percentage of women with clinically significant symptoms of anxiety (state and trait) and depression was found at 12 months postpartum, which indicated that this was the most critical time. The quality of childbirth experience and trait anxiety at three months postpartum emerged as significant predictors of postpartum depression at 12 months. CONCLUSION Our findings highlight the importance of providing stable programs (such as educational programs) to mothers in the first year postpartum. Furthermore, because the quality of the childbirth experience is one of the most important predictors of PPD at 12 months postpartum, effort should be made by healthcare professionals to guarantee a positive experience to all women to reduce possible negative long-term consequences of this experience.
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Affiliation(s)
- Sara Molgora
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (E.S.); (F.F.)
| | - Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (E.S.); (F.F.)
| | | | - Enrico Ferrazzi
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.C.); (E.F.)
- Department of Clinical Science and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Federica Facchin
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (E.S.); (F.F.)
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Nweke M, Ukwuoma M, Adiuku-Brown AC, Ugwu P, Nseka E. Characterization and stratification of the correlates of postpartum depression in sub-Saharan Africa: A systematic review with meta-analysis. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221118773. [PMID: 36039898 PMCID: PMC9434669 DOI: 10.1177/17455057221118773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/30/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
Postpartum depression (PPD) is a common mental health challenge in resource-constrained sub-Saharan Africa (SSA). Characterizing its correlates will aid prediction, early detection, and pre-emptive interventions. This review aimed to systematically synthesize and stratify PPD correlates in sub-Saharan Africa. The review was structured as per the Preferred Reporting Item for Systematic Reviews and Meta-Analyses. We included studies that reported the correlates of PPD in SSA. We searched PubMed, Medline, CINAHL, Academic Search Complete, and PsycINFO for relevant peer-reviewed literature. The correlates of PPD constituted the primary outcome. A random effect model was fitted to estimate the pooled correlation coefficient per correlate. The clinical relevance of correlates was stratified based on strength of correlation (r) and recurrence (f). The mean age of the participants was 27.0 ± 6.0 years, and 68.6% of participants had completed at least secondary education. The correlates of PPD in SSA were intimate partner violence (IPV) ((risk weight (rw) = 2.8; r = 0.212 (confidence interval (CI): 0.11-0.31), poor social support (PSS) (rw = 1.9; r = 0.250 (0.133-0.361)), unwanted pregnancy (UP) (rw = 1.6; r = 0.279 (CI: 0.14-0.41); I2 = 95.89), and maternal age (MA) (rw = 0.96; r = 0.27 (CI: 0.154-0.37)), among others. A cumulative risk weight of ⩾0.95 was predictive of PPD and marks the critical point at which preemptive interventions should be instituted. The stratification of risk PPD factors and computation of risk stability index are useful in identifying the clinical significant risk factors. The provision of critical risk point will simplify early detection thus facilitating cost-effectiveness. Of the correlates of PPD in SSA, IPV, PSS, UP, and MA are the most important. Targeted screening and pre-emptive interventions for women with high risk weight may be a reasonable strategy both in the short and long term.
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Affiliation(s)
- Martins Nweke
- Department of Physiotherapy, Evangel
University Akaeze, Ebonyi State, Nigeria
| | - Maryjane Ukwuoma
- Department of Physiotherapy, University
of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Ada C. Adiuku-Brown
- Department of Obstetrics and
Gynaecology, College of medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu,
Nigeria
| | - Princewill Ugwu
- Department of Physiology, University of
Nigeria Enugu Campus, Enugu, Nigeria
| | - Elizabeth Nseka
- Department of Medical Rehabilitation,
University of Nigeria Enugu Campus, Enugu, Nigeria
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Vila J. Social Support and Longevity: Meta-Analysis-Based Evidence and Psychobiological Mechanisms. Front Psychol 2021; 12:717164. [PMID: 34589025 PMCID: PMC8473615 DOI: 10.3389/fpsyg.2021.717164] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/17/2021] [Indexed: 11/13/2022] Open
Abstract
Over the past 60 years, evidence has accumulated on the fundamental role of supportive social relationships in individual health and longevity. This paper first summarizes the results of 23 meta-analyses published between 1994 and 2021, which include 1,187 longitudinal and cross-sectional studies with more than 1,458 million participants. The effect sizes reported in these meta-analyses are highly consistent with regard to the predicted link between social support and reduced disease and mortality; the meta-analyses also highlight various theoretical and methodological issues concerning the multi-dimensionality of the social support concept and its measurements, and the need to control potential confounding and moderator variables. This is followed by an analysis of the experimental evidence from laboratory studies on psychobiological mechanisms that may explain the effect of social support on health and longevity. The stress-buffering hypothesis is examined and extended to incorporate recent findings on the inhibitory effect of social support figures (e.g., the face of loved ones) on fear learning and defensive reactions alongside evidence on the effect of social support on brain networks that down-regulate the autonomic nervous system, HPA axis, and immune system. Finally, the paper discusses the findings in the context of three emerging research areas that are helping to advance and consolidate the relevance of social factors for human health and longevity: (a) convergent evidence on the effects of social support and adversity in other social mammals, (b) longitudinal studies on the impact of social support and adversity across each stage of the human lifespan, and (c) studies that extend the social support framework from individual to community and societal levels, drawing implications for large-scale intervention policies to promote the culture of social support.
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Affiliation(s)
- Jaime Vila
- Human Psychophysiology and Health Laboratory, Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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