Postpartum depression

The prediction of perceived parenting style on mother-infant bonding

BACKGROUND

There are limited studies on the associations among parenting style, postpartum depression, and mother-infant bonding.

OBJECTIVE

The aims of this study are investigating how the parenting style of maternal grandparents predicted the mothers' bonding with their infants. The mediating roles of postpartum depression were also explored.

PARTICIPANTS AND SETTING

A community sample of 227 postpartum women participated in this study. The participants primarily consisted of women who gave birth within six months (89.9%).

METHODS

A cross-sectional and convenient sampling strategy was applied. Instruments were Parental Bonding Instrument, Edinburgh Postnatal Depression Scale, Postpartum Bonding Questionnaire, and Background Form.

RESULTS

In the young infant group (i.e. mothers with infants not older than three months), the results indicated that maternal protection could predict "impaired bonding" (β = 0.20, p < .05). This prediction was mediated by postpartum depression (β = 0.32, p < .001). In the older infant group, paternal and maternal care could directly predict "rejection and anger" (β = -0.20, -0.22 respectively, p < .05). Maternal protection could predict three bonding factors (β = 0.25-0.29, p < .05, 0.01). Postpartum depression acted as total mediator for "impaired bonding"(β = 0.45, p <. 001), and acted as partial mediators in "rejection and anger" and "anxiety about care" (β = 0.45, 0.28, ps < .001, .01).

CONCLUSIONS

Perceived parenting style (especially maternal protection) has impacts on adverse mother-infant bonding. Furthermore, the impact is more prominent on mothers of older infants. "Rejection and anger" could be the most vulnerable bonding factor affected by parenting style. Since postpartum depression mediates the predictions, interventions could concurrently address maternal parenting style and postpartum depression.

Early detection of mental illness for women suffering high-risk pregnancies: an explorative study on self-perceived burden during pregnancy and early postpartum depressive symptoms among Chinese women hospitalized with threatened preterm labour

BACKGROUND

The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed the mental health of pregnant women with threatened preterm labour (TPL). This study investigated the prevalence of self-perceived burden (SPB) among Chinese women hospitalized due to TPL during pregnancy and early postpartum depressive disorders, exploring the effect of SPB and other potential risk factors on the early signs of postpartum depressive disorders.

METHODS

A self-reported survey was conducted in the obstetrics department of Anhui Provincial Hospital, China. Women hospitalized with TPL were approached 1 week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. The Self-Perceived Burden Scale (SPBS) and Edinburgh Postnatal Depression Scale (EPDS) were the main measures. Descriptive statistics, Spearman correlations, and a multiple logistic regression were employed for data analysis.

RESULTS

SPB and early postpartum depressive disorders were commonly experienced by Chinese women hospitalized with TPL, and SPB was positively and significantly correlated with depressive symptoms. A multiple logistic regression analysis revealed that for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.42, 95% CI = 1.11-1.83, p = 0.006), age (OR = 1.14, 95% CI = 1.02-1.27, p = 0.023), occupation (OR = 3.48, 95% CI = 1.18-10.20, p = 0.023), the history of scarred uterus (OR = 7.96, 95% CI = 1.49-42.48, p = 0.015), the delivery mode of the present birth (OR = 6.19, 95% CI = 1.72-22.30, p = 0.005), and family support during pregnancy (OR = 0.60, 95% CI = 0.45-0.82, p = 0.001) were significant factors predicting early postpartum depressive symptoms.

CONCLUSION

This study indicates that SPB and early postpartum depressive disorders are prevalent mental issues among Chinese women hospitalized with TPL, and that SPB, especially perceived emotional burden, is a strong predictor of early postpartum depressive disorders. Our study suggests the necessity of paying attention to mental health issues, e.g. SPB and postpartum depressive symptoms among hospitalized women with TPL, and providing appropriate interventions at the prenatal stage to prevent adverse consequences.

Impact of Postpartum Mental Illness Upon Infant Development

PURPOSE OF REVIEW

This review evaluates the state of the research regarding the effects of postpartum mental illness on the developing infant. It defines the scope of these disorders in the literature, and includes the impact of disorders referred to as perinatal mood and anxiety disorders (PMADs) on infants.

RECENT FINDINGS

New research reveals that PMADs apply to not only mothers, but that fathers can also experience perinatal depression and anxiety. When untreated in a primary caregiver, PMADs adversely affect parental cognitions and beliefs, attachment to the infant, and the growing caregiver-infant relationship. PMADs affect early developmental outcomes of infants including neurosynaptic development, regulatory development, and developmental milestones. Early identification and treatment for PMADs are critical to ensure optimal infant development. Standardized and routine screening for PMADs, especially in the first 6 months postpartum, and cross-disciplinary communication among medical providers afford the best opportunity for early identification and treatment.

Ask the Question: Screening for Postpartum Mood and Anxiety Disorders in Pediatric Primary Care

Postpartum mood and anxiety disorders (PMADs) are a significant source of toxic stress for young children and can disrupt developing brain architecture resulting in long-lasting deleterious effects. Thus, screening for PMADs must be considered as an essential task of a pediatric primary care provider (PCP) and the pediatric medical home. Problems in parenting capacity in mothers with PMADs can lead to disorders in attachment and a range of other emotional and developmental challenges for a young child. Therefore, all PCP office visits with mothers should include surveillance as well as formal screening at regular, pre-determined intervals. During surveillance, identification of psychosocial, maternal, infant, and maternal/infant risk factors is critical. There are a number of well researched, standardized, reliable, free and valid screening tools including the Patient Health Questionnaires (PHQ-2 and PHQ-9) and the Edinburgh Postnatal Depression Scale (EDPS). Office implementation includes availability of educational materials, resource information, and referrals so families can get appropriate treatment. Screening for PMADs is highly effective and helps to identify a common, underdiagnosed disorder in parents that without identification and appropriate treatment can lead to significant negative outcomes for a young child.

Postpartum depression in the NICU: an examination of the factor structure of the Postpartum Depression Screening Scale

PURPOSE

The purpose of this research was to examine the construct validity of scores from the Postpartum Depression Screening Scale administered to mothers of infants in a neonatal intensive care unit.

SUBJECTS

Two samples (n = 385 and n = 110) of mothers with infants in a neonatal intensive care unit in the south-central region of the United States completed the Postpartum Depression Screening Scale 2 weeks postpartum. Both samples were similar in race and education level but differed according to marital status.

DESIGN

Study 1 was retrospective and descriptive, whereas study 2 was prospective and descriptive.

METHODS

In study 1, confirmatory factor analysis was used to evaluate the originally proposed 7-factor structure and a 1-factor model. Because of overly high correlations between 3 of the factors, a revised 5-factor model was also tested. In study 2, confirmatory factor analysis was again used to test the construct validity or goodness of fit of the 7-factor and 5-factor models.

MAIN OUTCOME MEASURES

Goodness-of-fit indices and factor pattern coefficients.

PRINCIPAL RESULTS

In study 1, high correlations between 3 of the factors in the 7-factor model did not converge. Thus, a 5-factor model was also tested. This model had reasonable fit: χ= 1339.70 (550); P < 0.01; comparative fit index = 0.85; root mean square error of approximation = 0.06; and 90% confidence interval for root mean square error of approximation = 0.058 to 0.067. In study 2, confirmatory factor analysis was again used to test the construct validity or goodness of fit of the 7-factor and 5-factor models. Results for the 7-factor model indicated unacceptable fit: χ (539) = 959.10; P < 0.01; comparative fit index = 0.76; and root mean square error of approximation = 0.09. The 5-factor model was also poor: χ (550) = 992.95; P < 0.01; comparative fit index = 0.75; and root mean square error of approximation = 0.09.

CONCLUSIONS

Although the construct validity of the 7-factor model of the PDSS was not supported for this sample of mothers, additional factor analytic work was used to develop and provide initial validation of a 5-factor model. Future research should continue to explore the unique experiences of mothers in the NICU who experience postpartum depression.

Prevalence and characteristics of postpartum depression symptomatology among Canadian women: a cross-sectional study

Background

This study aims to look at the prevalence and characteristics of postpartum depression symptomatology (PPDS) among Canadian women. Studies have found that in developed countries, 10-15% of new mothers were affected by major postpartum depression. Mothers who suffer from postpartum depression may endure difficulties regarding their ability to cope with life events, as well as negative clinical implications for maternal-infant attachment.

Methods

An analysis based on 6,421 Canadian women, who had a live birth between 2005 and 2006 and were part of the Maternity Experience Survey (MES), was performed. PPDS was measured based on the Edinburgh Postnatal Depression Scale. Various factors that assessed socio-economic status, demographic factors, and maternal characteristics were considered for the multinomial regression model.

Results

The national prevalence of minor/major and major PPDS was found to be 8.46% and 8.69% respectively. A mother's stress level during pregnancy, the availability of support after pregnancy, and a prior diagnosis of depression were the characteristics that had the strongest significant association with the development of PPDS.

Conclusions

A significant number of Canadian women experience symptoms of postpartum depression. Findings from this study may be useful to increase both the attainment of treatment and the rate at which it can be obtained among new mothers. Interventions should target those with the greatest risk of experiencing PPDS, specifically immigrant and adolescent mothers.