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Dimcea DAM, Petca RC, Dumitrașcu MC, Șandru F, Mehedințu C, Petca A. Postpartum Depression: Etiology, Treatment, and Consequences for Maternal Care. Diagnostics (Basel) 2024; 14:865. [PMID: 38732283 PMCID: PMC11083152 DOI: 10.3390/diagnostics14090865] [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: 01/28/2024] [Revised: 03/18/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
Postpartum depression (PPD) is a disabling condition that has recently shown an increase in prevalence, becoming an essential public health problem. This study is a qualitative review summarizing the most frequent risk factors associated with PPD, evaluating molecular aspects of PPD and current approaches to detect and prevent PPD. The most prevalent risk factors were detected in the areas of economic and social factors, obstetrical history, lifestyle, and history of mental illness. Research on the genetic basis for PPD has taken place in recent years to identify the genes responsible for establishing targeted therapeutic methods and understanding its pathogenesis. The most frequently studied candidate gene was the serotonin transporter gene (SERT) associated with PPD. Among biological studies, antidepressants and psychological interventions provided the most evidence of successful intervention. The obstetrician can serve an essential role in screening for and treating PPD. Postpartum women with risk factors should be screened using the Edinburgh Postnatal Depression Scale (EPDS), but, at the moment, there are no prevention programs in Europe. In conclusion, data from this review increase concerns among this vulnerable population and can be used to design a screening tool for high-risk pregnant women and create a prevention program.
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Affiliation(s)
- Daiana Anne-Marie Dimcea
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (D.A.-M.D.); (M.C.D.); (C.M.); (A.P.)
| | - Răzvan-Cosmin Petca
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 050659 Bucharest, Romania
| | - Mihai Cristian Dumitrașcu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (D.A.-M.D.); (M.C.D.); (C.M.); (A.P.)
- Department of Obstetrics and Gynecology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Florica Șandru
- Department of Dermatology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Dermatology, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Claudia Mehedințu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (D.A.-M.D.); (M.C.D.); (C.M.); (A.P.)
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
| | - Aida Petca
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (D.A.-M.D.); (M.C.D.); (C.M.); (A.P.)
- Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 011461 Bucharest, Romania
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Robbins N, Harvey K, Moller MD. Emotional Freedom Techniques for Postpartum Depression, Perceived Stress, and Anxiety. Nurs Womens Health 2024; 28:41-49. [PMID: 38103574 DOI: 10.1016/j.nwh.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/10/2023] [Accepted: 11/09/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE To examine the effect of an Emotional Freedom Techniques (EFT) group intervention on perceived stress, depression, and anxiety symptoms in women in the postpartum period. DESIGN A one-group pre- and posttest quasi-experimental design. SETTING/LOCAL PROBLEM Postpartum depression (PPD) and anxiety affect nearly one in five women in the first 12 months after childbirth. The COVID-19 pandemic was associated with a significant worsening of symptoms of PPD, stress, and anxiety in this population. Mental health screening is the standard of care in perinatal settings. This practice has led to an increased rate of PPD and anxiety diagnoses and the need for evidence-based nonpharmacologic interventions to support mothers with PPD and anxiety. PARTICIPANTS Eleven mothers seeking care for lactation concerns who screened positive for PPD and anxiety symptoms. INTERVENTION/MEASUREMENTS A total of eight 1-hour group EFT sessions were offered to participants over a period of 4 weeks. During the group sessions, participants were taught how to perform the steps of EFT and apply it in a supportive group format. Measurement tools included the Subjective Unit of Distress Scale, Edinburgh Postnatal Depression Scale, and Generalized Anxiety Disorder-7. The preintervention and postintervention scores of these tools were compared using a paired-samples t test. RESULTS After implementing EFT as a group intervention, we observed a reduction in mental health burden experienced by women in the postpartum period. There was a statistically significant decrease in depression (p = .003), anxiety (p <.001), and perceived stress (p <.001) scores 1 month after the EFT intervention. CONCLUSION These findings suggest that EFT may be a viable adjunctive intervention for managing depression, anxiety, and stress in the postpartum period. Further research with larger and more diverse samples is needed to confirm these findings.
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Garafola S, Shiferaw E, Dev V. Safety of Brexanolone in Adults with Postpartum Depression: Postmarketing Surveillance Data. Drugs Real World Outcomes 2023; 10:351-356. [PMID: 37280463 PMCID: PMC10491550 DOI: 10.1007/s40801-023-00372-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Brexanolone is currently the only medication approved by the US FDA for the treatment of postpartum depression (PPD) in patients ≥15 years. Brexanolone is available commercially only through a restricted program (ZULRESSO® Risk Evaluation and Mitigation Strategy; REMS) due to risk of excessive sedation or sudden loss of consciousness during administration. OBJECTIVE The aim of this analysis was to assess the postmarketing safety of brexanolone in adults with PPD. METHODS The cumulative postmarketing adverse event (AE) listing from spontaneous and solicited individual case safety reports (ICSRs) received from March 19, 2019, through December 18, 2021, was analyzed. Clinical trial ICSRs were excluded. Reported AEs were classified as serious or nonserious as defined by FDA seriousness criteria and as listed or unlisted based on Table 2.0 within section 6 "Adverse Reactions" of the current brexanolone FDA-approved US Prescribing Information (PI). RESULTS Overall, 499 patients received brexanolone in this postmarketing surveillance analysis between June 2019 and December 2021 (postmarketing setting). There were 137 ICSRs with 396 total AEs: 15 serious unlisted, 2 serious listed, 346 nonserious unlisted, and 33 nonserious listed. In total, two serious and one nonserious listed excessive sedation AEs were reported-all resolved by stopping infusion and did not require any treatment; no loss of consciousness AEs were received. CONCLUSION Results from postmarketing surveillance data analysis are consistent with the safety profile of brexanolone for the treatment of PPD as described in the FDA-approved PI. No new safety concerns or new aspects of known risks requiring an update to the FDA-approved PI were identified.
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Affiliation(s)
| | | | - Vikram Dev
- Sage Therapeutics, Inc., Cambridge, MA, USA
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Bhusal CK, Bhattarai S, Shrestha A, Sharma HR. Depression and Its Determinants among Postpartum Mothers Attending at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Rupandehi, Nepal. Int J Pediatr 2023; 2023:1331641. [PMID: 37538262 PMCID: PMC10396550 DOI: 10.1155/2023/1331641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Abstract
Background Postpartum depression is a serious mental health issue linked to maternal morbidity and negative effects for infant's normal growth, development, and well-being. This study is aimed at assessing the prevalence and factors associated with postpartum depression among mothers attending a tertiary hospital in Nepal. Methods A hospital-based cross-sectional study was conducted among 173 postpartum mothers (<6 weeks postdelivery) who were receiving care either at the postnatal ward or immunization clinic of Universal College of Medical Sciences and Teaching Hospital in Bhairahawa, Rupandehi district, Nepal. The study was carried out from October 2020 to February 2021 by using purposive sampling technique for selecting respondents. The variables that showed significant association with the dependent variable having p value < 0.05 in bivariate analysis were entered into multivariate logistic regression model to find the final associated factors. Results The prevalence of postpartum depression was 20.2% among mothers attending a tertiary hospital in Nepal. The mean age of the respondents was 24.77 ± 3.47. Factors such as mothers having female child (AOR = 6.39, CI = 1.54 - 26.46), unplanned pregnancy (AOR = 10.08, CI = 2.91 - 34.94), pregnancy-induced health problems (AOR = 9.68, CI: 3.51-26.64) were associated with an increased risk of postpartum depression. Similarly, mothers having formal education (AOR = 0.28, CI: 0.08-0.91), whose spouses have secondary and above education (AOR = 0.16, CI: 0.03-0.85), and who have ≥4 ANC visits (AOR = 0.15, CI = 0.05 - 0.40) were significantly associated but have a protective effect with postpartum depression. Conclusions Sex of newborn, mother's and spouse's education, intention of pregnancy, ANC visits, and pregnancy-induced health problems were found to be significantly associated with postpartum depression. Hence, specific health education program regarding maternal and child health integrating mental health should be provided to pregnant women, mothers, and their husbands, focusing on gender discrimination. Similarly specific orientation program should be provided to local health worker about the importance of planned pregnancy, in order to reduce pregnancy related health problems during ANC visits and to mothers after their delivery to reduce further chances of postpartum depression.
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Affiliation(s)
- Chet Kant Bhusal
- Department of Community Medicine, Universal College of Medical Sciences and Teaching Hospital Affiliated to Tribhuvan University, Bhairahawa, Rupandehi, Nepal
| | - Sigma Bhattarai
- Department of Nursing, Universal College of Medical Sciences and Teaching Hospital Affiliated to Tribhuvan University, Bhairahawa, Rupandehi, Nepal
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Leng QL, Lo JO, Rakshe S, Hildebrand AD, Doyle OJ, Seghete KM, Graham A. The association between preconception cannabis use and depression and anxiety during pregnancy. Gen Hosp Psychiatry 2023; 83:148-155. [PMID: 37196406 PMCID: PMC10428863 DOI: 10.1016/j.genhosppsych.2023.05.006] [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: 01/31/2023] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Cannabis use among individuals of reproductive age has increased with cannabis legalization and heightened stress during the COVID-19 pandemic. Our study provides data on preconception cannabis use and cannabis use disorder (CUD) during the pandemic and models the association between preconception cannabis use and depression and anxiety during pregnancy. METHODS Data on substance use and depression and anxiety symptoms were collected from questionnaires and the Structured Clinical Interview for DSM-5 (SCID-5) from pregnant individuals in Oregon in 2019-2022. Linear regression was used to model the association between the frequency of preconception cannabis use and scores on the Center for Epidemiological Studies of Depression-Revised (CESD-R) and Beck Anxiety Inventory (BAI). RESULTS The prevalence of preconception cannabis use was 27.8% among 227 study participants. CUD was diagnosed in 19% of cannabis users, or 5.3% of the overall sample. Daily cannabis use, compared to rare/never use, was associated with increases in CESD-R (β = 6.22, p 0.029) and BAI (β = 4.71, p 0.045) scores. CONCLUSIONS Cannabis use and CUD are common among individuals of reproductive age. Given the association between preconception cannabis use and depression and anxiety during pregnancy, more attention is needed on screening and counseling of cannabis use among people of reproductive age.
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Affiliation(s)
- Qian Liya Leng
- Center for Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR, USA.
| | - Jamie O Lo
- Department of Obstetrics and Gynecology, Oregon Health & Science University; Portland, OR, USA
| | - Shauna Rakshe
- Knight Cancer Institute Biostatistics Shared Resource and OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Andrea D Hildebrand
- Biostatistics & Design Program, OHSU/PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Olivia J Doyle
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | | | - Alice Graham
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
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Rupanagunta GP, Nandave M, Rawat D, Upadhyay J, Rashid S, Ansari MN. Postpartum depression: aetiology, pathogenesis and the role of nutrients and dietary supplements in prevention and management. Saudi Pharm J 2023; 31:1274-1293. [PMID: 37304359 PMCID: PMC10250836 DOI: 10.1016/j.jsps.2023.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Postpartum depression (PPD) is a challenging psychological disorder faced by 10-30% of mothers across the globe. In India, it occurs among 22% of mothers. Its aetiology and pathophysiology aren't fully understood as of today but multiple theories on the interplay of hormones, neurotransmitters, genetics, epigenetics, nutrients, socio-environmental factors, etc. exist. Nutrients are not only essential for the synthesis of neurotransmitters, but they may also indirectly influence genomic pathways that methylate DNA, and there is evidence for molecular associations between nutritional quality and psychological well-being. Increased behavioural disorders have been attributed to macro- and micronutrient deficiencies, and dietary supplementation has been effective in treating several neuropsychiatric illnesses. Nutritional deficiencies occur frequently in women, especially during pregnancy and breastfeeding. The aim of this study was to perform a comprehensive literature review of evidence-based research in order to identify, gather and summarize existing knowledge on PPD's aetiology, pathophysiology, and the role of nutrients in its prevention as well as management. The possible mechanisms of action of nutrients are also presented here. Study findings show that the risk of depression increases when omega-3 fatty acid levels are low. Both fish oil and folic acid supplements have been used to effectively treat depression. Antidepressant efficacy is lowered by folate insufficiency. Folate, vitamin B12, iron, etc. deficiencies are more prevalent in depressed people than in non-depressed people. Serum cholesterol levels and plasma tryptophan levels are found to be inversely correlated with PPD. Serum vitamin D levels were associated inversely with perinatal depression. These findings highlight the importance of adequate nutrition in the antepartum period. Given that nutritional therapies can be affordable, safe, simple to use, and are typically well-accepted by patients, more focus should be placed on dietary variables in PPD.
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Affiliation(s)
- Gnana Prasoona Rupanagunta
- Department of Pharmaceutical Sciences, School of Health Sciences and Technology, University of Petroleum and Energy Studies, Energy Acres Campus, Bidholi, Dehradun 248007, Uttarakhand, India
| | - Mukesh Nandave
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University (DPSRU), MB Road, Pushp Vihar, Sector 3, New Delhi 110017, India
| | - Divya Rawat
- Department of Allied Health Sciences, School of Health Sciences and Technology, University of Petroleum and Energy Studies, Energy Acres Campus, Bidholi, Dehradun 248007, Uttarakhand, India
| | - Jyoti Upadhyay
- Department of Pharmaceutical Sciences, School of Health Sciences and Technology, University of Petroleum and Energy Studies, Energy Acres Campus, Bidholi, Dehradun 248007, Uttarakhand, India
| | - Summya Rashid
- Department of Pharmacology & Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mohd Nazam Ansari
- Department of Pharmacology & Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
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Li J, Li J, Shen L, Wang H, Zheng T, Hui Y, Li X. Investigating the causal association of postpartum depression with cerebrovascular diseases and cognitive impairment: a Mendelian randomization study. Front Psychiatry 2023; 14:1196055. [PMID: 37426101 PMCID: PMC10324563 DOI: 10.3389/fpsyt.2023.1196055] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/18/2023] [Indexed: 07/11/2023] Open
Abstract
Background Postpartum depression (PPD) is considered the most widespread puerperium complication. The associations of major depressive disorder with certain types of cerebrovascular diseases and cognitive function have been proposed, but the potential causal effects of PPD on these phenotypes are still unknown. Methods A Mendelian randomization (MR) research design with various methods (e.g., inverse-variance weighted method and MR pleiotropy residual sum and outlier test) was adopted to establish a causal relationship between PPD with cerebrovascular diseases and cognitive impairment. Results No causal relationship between PPD with carotid intima media thickness and cerebrovascular diseases (i.e., stroke, ischemic stroke, and cerebral aneurysm) was found. However, MR analyses indicated a causal association between PPD and decreased cognitive function (P = 3.55 × 10-3), which remained significant even after multiple comparison corrections using the Bonferroni method. Sensitivity analyses using weighted median and MR-Egger methods indicated a consistent direction of the association. Conclusion The causal association between PPD and cognitive impairment indicates that cognitive impairment is a critical aspect of PPD and thus cannot be regarded as an epiphenomenon. Addressing cognitive impairment and lessening the symptoms associated with PPD independently play significant roles in the treatment of PPD.
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Affiliation(s)
- Jia Li
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Jinqiu Li
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Lan Shen
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Huan Wang
- Department of Pediatrics, The Fifth Affiliated Hospital of Zunyi Medical University, Guangdong, China
| | - Tian Zheng
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Ying Hui
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Xiaoxuan Li
- Department of Obstetrics, Zhuhai Maternity and Child Health Care Hospital, Guangdong, China
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Mavragani A, Awosoga OA, McDonald S, Bonifacio GT, Leung BMY. African Immigrant Mothers' Views of Perinatal Mental Health and Acceptability of Perinatal Mental Health Screening: Quantitative Cross-sectional Survey Study. JMIR Form Res 2023; 7:e40008. [PMID: 36705944 PMCID: PMC9886220 DOI: 10.2196/40008] [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: 06/01/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Mental health disorders are the most common perinatal conditions. They affect mothers, babies, partners, and support networks. However, <15% of pregnant and postpartum women seek timely help for their mental health care. Low perinatal mental health knowledge and universal screening unacceptability are cited as important deterrents to obtaining timely mental health care. OBJECTIVE The purpose of this quantitative cross-sectional study was 2-fold: (1) to determine African immigrant mothers' views of perinatal mental health and to identify predictors of those views and (2) to identify African immigrant mothers' views regarding perinatal mental health screening and to determine factors associated with those views. METHODS A cross-sectional survey was conducted using a convenience sample of African immigrant women from the province of Alberta, Canada. Respondents were eligible to participate if they were aged ≥18 years, had a live birth, and the infant was aged ≤2 years. Questions were drawn from the Edinburgh Postnatal Depression Scale, the Generalized Anxiety Disorder-7 scale, and additional questions were developed using the Alberta Maternal Mental Health 2012 survey as a guide and tested to reflect the immigrant context. Descriptive and multivariable regression analyses were conducted. RESULTS Among the 120 respondents, 46.5% (53/114) were aged 31-35 years, 76.1% (89/117) were employed or on maternity leave, 92.5% (111/120) were married, and 55.6% (65/117) had younger infants aged 0 to 12 months. Significantly more respondents had higher levels of knowledge of postnatal (109/115, 94.8%) than prenatal (57/110, 51.2%) mental health (P<.001). Only 25.4% (28/110) of the respondents accurately identified that prenatal anxiety or depression could negatively impact child development. Personal knowledge of postpartum anxiety and depression was a significant predictor of prenatal and postnatal mental health knowledge. Most respondents strongly agreed or agreed that all women should be screened in the prenatal (82/109, 75.2%) and postnatal (91/110, 82.7%) periods. Respondents reported that their partner would be their first choice when seeking help and support. The acceptability of postnatal screening was a significant predictor of prenatal mental health knowledge (P<.001), whereas the acceptability of prenatal screening was a significant predictor of postnatal mental health knowledge (P=.03). Prenatal mental health knowledge was a significant predictor of both prenatal (P<.001) and postnatal (P=.001) screening acceptability. CONCLUSIONS Although African mothers' knowledge of postnatal mental health is high, their prenatal mental health knowledge and its influence on child development are limited. Perinatal mental health interventions for African immigrant mothers in Alberta should target these knowledge gaps. The high acceptability of universal perinatal mental health screening among African mothers provides a promising strategy for perinatal mental health literacy initiatives to achieve optimal perinatal mental health.
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Affiliation(s)
| | | | - Sheila McDonald
- Department of Pediatrics and Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Glenda T Bonifacio
- Department of Women and Gender Studies, University of Lethbridge, Lethbridge, AB, Canada
| | - Brenda M Y Leung
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
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Akaishi T, Tarasawa K, Fushimi K, Hamada H, Saito M, Kobayashi N, Kikuchi S, Tomita H, Ishii T, Fujimori K, Yaegashi N. Risk Factors Associated With Peripartum Suicide Attempts in Japan. JAMA Netw Open 2023; 6:e2250661. [PMID: 36633845 PMCID: PMC9857025 DOI: 10.1001/jamanetworkopen.2022.50661] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
IMPORTANCE Peripartum suicide attempt is a major psychiatric complication associated with pregnancy, but the risk factors remain largely uncertain. OBJECTIVE To identify the demographic characteristics and predisposing risks for peripartum suicide attempts and postpartum depression. DESIGN, SETTING, AND PARTICIPANTS This cohort study used retrospective data on pregnant women who delivered children between April 1, 2016, and March 31, 2021, at 712 hospitals in Japan. The nationwide Diagnosis Procedure Combination database was used. EXPOSURES Psychiatric and nonpsychiatric medical history, age, alcohol and tobacco use, and obstetric complications and procedures. MAIN OUTCOMES AND MEASURES Data on admissions for prepartum suicide attempt and delivery during the same hospital stay and readmissions for depression or suicide attempt within 1 year post partum were collected. Comparisons of prevalence of each study variable were performed, and multivariable logistic regression analyses were used to determine risk factors. RESULTS From a total of 39 908 649 hospitalization episodes, 804 617 cumulative pregnant women (median [IQR] age at childbirth, 33 [29-36] years) who delivered at the enrolled hospitals were identified, including 1202 who were admitted for suicide attempt and delivery during the same hospital stay and 111 readmitted for suicide attempt within 1 year post partum. Risk factors associated with prepartum suicide attempts included younger age (adjusted odds ratio [aOR], 0.99; 95% CI, 0.98-1.00) and histories of personality disorder (aOR, 10.81; 95% CI, 5.70-20.49), depression (aOR, 3.97; 95% CI, 2.35-6.70), schizophrenia (aOR, 2.89; 95% CI, 1.52-5.50), and adjustment disorder (aOR, 2.66; 95% CI, 1.07-6.58). Risk factors associated with postpartum suicide attempts included younger age (aOR, 0.96; 95% CI, 0.93-1.00), heavy tobacco use (aOR, 23.09; 95% CI, 5.46-97.62), and histories of alcohol use disorder (aOR, 163.54; 95% CI, 28.30-944.95), personality disorder (aOR, 10.28; 95% CI, 3.29-32.10), anxiety disorders (aOR, 8.13; 95% CI, 2.88-22.98), depression (aOR, 7.27; 95% CI, 2.95-17.91), schizophrenia (aOR, 5.77; 95% CI, 2.17-15.38), bipolar disorder (aOR, 3.98; 95% CI, 1.36-11.67), and insomnia (aOR, 3.17; 95% CI, 1.30-7.78). On sensitivity analysis, risk factors associated with postpartum depression after excluding those with prenatal depression included histories of personality disorder, adjustment disorder, bipolar disorder, insomnia, and anxiety disorders. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that histories of smoking and prenatal psychiatric disorders are potential risk factors for peripartum suicide attempts and may require additional treatment and prevention interventions.
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Affiliation(s)
- Tetsuya Akaishi
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
| | - Kunio Tarasawa
- Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Hirotaka Hamada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Natsuko Kobayashi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Saya Kikuchi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Tomita
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
| | - Kenji Fujimori
- Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Guo P, Cui N, Mao M, Zhang X, Chen D, Xu P, Wang X, Zhang W, Zheng Q, Zhang L, Xiang Z, Jin Y, Feng S. Cross-cultural adaptation and psychometric properties of the Chinese version of the postpartum depression literacy scale. Front Psychol 2022; 13:966770. [PMID: 36017447 PMCID: PMC9397490 DOI: 10.3389/fpsyg.2022.966770] [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: 06/13/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aim The postpartum depression literacy (PoDLi) of perinatal women is closely related to the occurrence, recognition, and treatment of postpartum depression, therefore valid instruments for evaluating the level of PoDLi are of great significance for both research and clinical practice. This study aimed to cross-culturally adapt the postpartum depression literacy scale (PoDLiS) into Chinese and to test its psychometric properties among Chinese perinatal women. Materials and methods A cross-sectional study was conducted from April to May 2022 in a tertiary hospital in Hangzhou, Zhejiang Province, China. 619 out of the 650 perinatal women that were approached via a convenience sampling method completed the Chinese version of the PoDLiS (C-PoDLiS). Content validity [the content validity index of items (I-CVI) and scale-level content validity index (S-CVI)] was evaluated by an expert panel. Psychometric properties, including item analysis, structure validity (exploratory factor analysis, confirmatory factor analysis), convergent and discriminant validity, reliability (internal consistency, test-retest reliability), criterion validity (concurrent validity, predictive validity), and floor/ceiling effect were examined. Results The final version of C-PoDLiS is a six-factor structure consisting of 27 items, which explained 61.00% of the total variance. Adequate content validity (I-CVI = 0.833–1.00, S-CVI = 0.920) was ensured by the expert panel. The modified confirmatory factor analysis model revealed that the 6-factor model fitted the data well (χ2/df = 1.532, root mean square error of approximation = 0.042, goodness of fit = 0.900, incremental fit index = 0.949, comparative fit index = 0.948, Tucker–Lewis index = 0.940). The total Cronbach’s α was 0.862, the total McDonald’s ω was 0.869, and the test-retest reliability coefficient was 0.856. Results of convergent validity (average variance extracted = 0.486–0.722) and discriminant validity provided good or acceptable psychometric support. Significant correlations between scores of the C-PoDLiS and Mental health literacy scale (r = 0.155–0.581, p < 0.01) and Attitudes toward seeking professional psychological help short form scale (r = 0.361–0.432, p < 0.01) supported good concurrent and predictive validity, respectively. No floor/ceiling effect was found. Conclusion The C-PoDLiS was demonstrated to be a sound instrument with good reliability and validity for evaluating Chinese perinatal women’s PoDLi levels. Its use in the future can facilitate data aggregation and outcome comparisons across different studies on this topic.
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Affiliation(s)
- Pingping Guo
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Nianqi Cui
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Minna Mao
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Xuehui Zhang
- School of Nursing, Jining Medical University, Jining, China
| | - Dandan Chen
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Ping Xu
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojuan Wang
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Zhang
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiong Zheng
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Le Zhang
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhenzhen Xiang
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yin Jin
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Suwen Feng
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Suwen Feng,
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11
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Li H. Affective Instability, Depression, and Anxiety Symptoms in a Community Sample of Pregnant and Postpartum Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063171. [PMID: 35328868 PMCID: PMC8951286 DOI: 10.3390/ijerph19063171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although perinatal women experience an elevated level of affective instability (AI), limited research has been conducted to examine perinatal AI and its relation to depression and anxiety. The current study investigated correlations between AI and depression, between AI and anxiety during the perinatal period, and between current depression and anxiety and the latent factors of the Affective Lability Scale-18 (ALS-18). METHODS 202 Canadian perinatal women participated in this cross-sectional study. The ALS-18 was used to assess AI, while the Depression, Anxiety, and Stress Scale-21 measured depression, anxiety, and stress. Multiple logistic regression was performed to investigate the relationship between AI and depression and anxiety, and multiple linear regression was conducted to examine the association between current depression and anxiety and the three latent factors of ALS-18. RESULTS The findings revealed a significant association between AI and depression and between AI and anxiety. Current depression and anxiety were correlated with ALS-18 factors of depression/anxiety shift and depression/elation shift, while current depression was linked to ALS-18 factor of anger. CONCLUSIONS The study findings have important implications for early detection and intervention of maternal anxiety and depression. In order to improve maternal mental health, AI should be included in routine perinatal check-ups.
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Affiliation(s)
- Hua Li
- College of Nursing, University of Saskatchewan, Health Sciences Building, E-Wing, Room 4248, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
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12
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Donadon MF, Martin-Santos R, L Osório F. Oxytocin effects on the cognition of women with postpartum depression: A randomized, placebo-controlled clinical trial. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110098. [PMID: 32937192 DOI: 10.1016/j.pnpbp.2020.110098] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/14/2020] [Accepted: 09/03/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND One of the most common mental disorders in the perinatal period is postpartum depression (PPD), which is associated with impaired emotional functioning due to alterations in different cognitive aspects including thought and facial emotion recognition (FER). Emotional impairments may affect the interaction and care offered to infants and their later development and therefore interventions with potential to minimize impairments associated with PPD are opportune. Oxytocin (OXT) was shown to have therapeutic properties associated with the promotion of affiliative and pro-social behaviors in different mental disorders. Few studies have assessed its therapeutic potential in PPD. OBJECTIVES To assess the effects of the acute administration of intranasal OXT (24 IU) on FER of baby faces and negative thoughts after delivery in mothers with and without PPD. METHODS We conducted a randomized double-blind, placebo-controlled trial with a crossover design involving mothers with PPD (N = 20) and without PPD (N = 35) in the puerperium. Participants completed a static task of FER of baby faces and a questionnaire of post-natal negative thoughts. RESULTS Mothers with PPD had increased scores of negative thoughts about motherhood/infants, but no impairments in FER, when compared to healthy mothers. OXT had no effects on the rates of correct judgments or response times in the FER task, but was associated with response biases to facial happiness and the reduction of negative thoughts in mothers with PPD. DISCUSSION/CONCLUSION OXT may have positive effects on maternal affiliative behavior, maternal care, and mother-infant interactions as suggested by changes found in different cognitive aspects, thus minimizing the deleterious effects of PPD on child development.
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Affiliation(s)
| | - Rocio Martin-Santos
- Servicio de Psiquiatria y Psicología, Hospital Clinic, Universidad de Barcelona, Barcelona, Spain
| | - Flávia L Osório
- Medical School of Ribeirão Preto, São Paulo University, Ribeirão Preto, SP, Brazil; National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil.
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Effect of Parenting Interventions on Perinatal Depression and Implications for Infant Developmental Outcomes: A Systematic Review and Meta-Analysis. Clin Child Fam Psychol Rev 2021; 25:316-338. [PMID: 34580804 DOI: 10.1007/s10567-021-00371-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
Considering the significant impact of perinatal depression on both maternal wellbeing and infant development, it is important to examine the effectiveness of interventions designed to prevent or reduce these risks. This systematic review and meta-analysis synthesised evidence on parenting intervention in relation to how such programs affect symptoms of perinatal depression and infant outcomes within 12 months of postpartum. We followed the Cochrane Collaboration guidelines on conducting systematic reviews and meta-analyses. A total of five electronic databases were searched for controlled trials that met pre-determined eligibility criteria. Outcomes of interest were maternal depressive symptoms and infants' language, motor and socioemotional development. Seventeen studies involving 1665 participants were included in the systematic review. Estimates from a random effects model of 15 studies in the final meta-analysis revealed statistically significant reductions in maternal depressive symptoms at post-intervention for mothers allocated to receive parenting interventions (SMD = - 0.34, 95%CI - 0.44, - 0.24; z = 5.97, p < 0.001; I2 = 0%). Data on infant development outcomes from the included studies were scarce, and therefore, infant outcomes were not analysed in this review. For individual study outcomes, the majority of studies reported a general trend for reductions in maternal depressive symptoms from pre- to post-intervention. Although parenting interventions are frequently considered preventive strategies that are designed to offer support to parents and impart skills that promote their physical and psychological wellbeing, our findings suggest that these interventions have a positive effect on perinatal depressive symptoms. Implications and recommendations for future research are addressed. The systematic review protocol was registered with PROSPERO 2020 CRD42020184491.
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Barkin JL, Beals L, Bridges CC, Ezeamama A, Serati M, Buoli M, Erickson A, Chapman M, Bloch JR. Maternal Functioning and Depression Scores Improve Significantly With Participation in Visiting Moms® Program. J Am Psychiatr Nurses Assoc 2021; 27:54-63. [PMID: 31561726 DOI: 10.1177/1078390319877444] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND: Postpartum depression is the most common complication of childbearing can affect the entire family unit. Health professionals must strive to identify and develop effective, feasible solutions for women during this critical period. AIMS: To determine whether postpartum maternal functioning (as measured by the Barkin Index of Maternal Functioning) and depression symptoms (as measured by the Patient Health Questionnaire-9) were improved after participation in the Visiting Moms program. METHOD: Paired data were collected from women at program intake and after completion of the Visiting Moms program. Visiting Moms provides services through eastern and central Massachusetts and was designed to support new mothers throughout the infant's first year of life. The study population was composed of adult women living in the Jewish Family and Children's Services geographic catchment area, who enrolled in Visiting Moms between January 1, 2013, and December 31, 2015. Descriptive statistics were calculated for all 402 women enrolled in this timeframe. Utilizing a pretest/posttest design, paired t tests were performed for the Barkin Index of Maternal Functioning (n = 149) and for the Patient Health Questionnaire-9 (n = 156), where women had complete scores at both intake and completion, to determine the program's potential impact on depressive symptoms and functional status. RESULTS: Functioning and depression scores were significantly improved after participation in the program. CONCLUSIONS: Visiting moms, and similar programs, aimed at delivery of enhanced social support, may be effective in promoting mental and emotional wellness among new mothers who are require additional support in the postpartum period.
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Affiliation(s)
| | - Laura Beals
- Laura Beals, PhD, Jewish Family & Children's Service, Waltham, MA, USA
| | | | - Amara Ezeamama
- Amara Ezeamama, PhD, Michigan State University, East Lansing, MI, USA
| | - Marta Serati
- Marta Serati, MD, ASST Rhodense, Rho, Milan, Italy
| | | | - Amber Erickson
- Amber Erickson, MPH, Georgia Department of Public Health, North Central Health District, Macon, GA, USA
| | - Megan Chapman
- Megan Chapman, BSN, RN, Georgia Department of Public Health, North Central Health District, Macon, GA, USA
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15
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Gheorghe M, Varin M, Wong SL, Baker M, Grywacheski V, Orpana H. Symptoms of postpartum anxiety and depression among women in Canada: findings from a national cross-sectional survey. Canadian Journal of Public Health 2020; 112:244-252. [PMID: 33079328 PMCID: PMC7910326 DOI: 10.17269/s41997-020-00420-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study presents national estimates on symptoms consistent with postpartum anxiety (PPA) and postpartum depression (PPD) and the association between these conditions and possible risk and protective factors in women who gave birth in Canada. METHODS Data were collected through the Survey on Maternal Health, a cross-sectional survey administered in Canada's ten provinces between November 2018 and February 2019 among women who gave birth between January 1 and June 30, 2018. A total of 6558 respondents were included. Weighted prevalence estimates were calculated, and logistic regression was used to model the relationship between symptoms consistent with PPA, PPD, and potential risk factors. RESULTS Overall, 13.8% of women had symptoms consistent with PPA, while the prevalence of having symptoms consistent with PPD was 17.9%. Results of the logistic regression models indicated that women who had a history of depression were 3.4 times (95% CI 2.7-4.2) more likely to experience symptoms consistent with PPA and 2.6 times more likely to experience symptoms consistent with PPD (95% CI 2.2-3.2) compared with those who did not. Women who reported good, fair, or poor physical health were 2.4 times more likely to experience symptoms consistent with PPD (95% CI 2.0-2.9) and 2.0 times more likely to experience symptoms consistent with PPA (95% CI 1.7-2.4) compared with those who reported very good or excellent health. Maternal marital status, other postpartum maternal support, and sense of community belonging were also significant. CONCLUSION This study highlights that a history of depression and good, fair, or poor physical health are associated with an increased odds of symptoms consistent with PPA and PPD, while other maternal support and sense of community belonging are associated with a decreased odds of these conditions.
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Affiliation(s)
- Mihaela Gheorghe
- Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1S 5H4, Canada.
| | - Mélanie Varin
- Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1S 5H4, Canada
| | - Suzy L Wong
- Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1S 5H4, Canada
| | - Melissa Baker
- Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1S 5H4, Canada
| | - Vera Grywacheski
- Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1S 5H4, Canada
| | - Heather Orpana
- Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1S 5H4, Canada.,School of Epidemiology and Public Health, University of Ottawa, Alta Vista Campus, Room 101, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.,Royal Ottawa Institute for Mental Health Research, 1145 Carling Ave, Ottawa, ON, K1Z 7K4, Canada
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16
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Gökşin İ, Ayaz-Alkaya S. The effect of progressive muscle relaxation on the postpartum depression risk and general comfort levels in primiparas. Stress Health 2020; 36:322-329. [PMID: 31919940 DOI: 10.1002/smi.2921] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/11/2019] [Accepted: 12/20/2019] [Indexed: 11/10/2022]
Abstract
In the postpartum period, mode of delivery, planned pregnancy, rapid changes in estrogen and progesterone hormone concentrations, quality of care, and environmental conditions affect the postpartum depression and comfort of the women. This study was conducted to evaluate the effect of progressive muscle relaxation (PMR) on the postpartum depression risk and general comfort levels in primiparas. A quasi-experimental design was used with pretest, post-test, and control group. The intervention and control groups consisted of 35 women each. PMR was applied to intervention group for 8 weeks. There was a statistically significant difference between Edinburgh Postnatal Depression Scale pretest and third follow-up scores of the intervention group (p < .05). There was a statistically significant difference between the intervention and control groups in the mean General Comfort Questionnaire scores at the first, second, and third follow-ups (p < .05). PMR may be effective on decreasing the postpartum depression risk and increasing general comfort. PMR could be administered through home visits to help women in postpartum period cope with their mental health problems after discharge.
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Affiliation(s)
- İlknur Gökşin
- Faculty of Health Sciences, Nursing Department, Aksaray University, Aksaray, Turkey
| | - Sultan Ayaz-Alkaya
- Faculty of Health Sciences, Nursing Department, Gazi University, Ankara, Turkey
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17
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Tryphonopoulos PD, Letourneau N. Promising Results From a Video-Feedback Interaction Guidance Intervention for Improving Maternal-Infant Interaction Quality of Depressed Mothers: A Feasibility Pilot Study. Can J Nurs Res 2020; 52:74-87. [PMID: 31910674 DOI: 10.1177/0844562119892769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mothers and infants affected by postpartum depression are known to have (1) reduced quality interactions and (2) elevated cortisol levels, both of which are linked to negative developmental outcomes in children. Parent training promoting sensitive and responsive maternal-infant interactions may help optimize development in children of mothers with postpartum depression. OBJECTIVES This pilot study tested a video-feedback interaction guidance intervention designed to improve maternal-infant interaction, depressive symptoms, and cortisol patterns of depressed mothers and their infants. METHOD An experimental, pre-test, post-test design was employed to randomly assign mothers with postpartum depression to intervention (n = 6) and control (n = 6) conditions. Intervention mothers received three video-feedback sessions during home visits, provided at three-week intervals. Control participants received three home visits on the same schedule. RESULTS Significant differences favoring the intervention group were observed in maternal-infant interaction quality, especially maternal sensitivity and cognitive growth fostering activities, and in reduced infant diurnal cortisol. CONCLUSION Professionally guided video-feedback intervention appears to support improvements in interactions between depressed mothers and their infants and optimizes infants' diurnal cortisol patterns. The findings from this feasibility pilot study have been used to support a large-scale follow-up exploration.
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Affiliation(s)
- Panagiota D Tryphonopoulos
- Arthur Labatt Family School of Nursing, Western University, FIMS and Nursing Building, London, Ontario, Canada
| | - Nicole Letourneau
- Faculty of Nursing, Cumming School of Medicine (Pediatrics, Psychiatry & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
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18
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Kołomańska-Bogucka D, Mazur-Bialy AI. Physical Activity and the Occurrence of Postnatal Depression-A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E560. [PMID: 31480778 PMCID: PMC6780177 DOI: 10.3390/medicina55090560] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/12/2019] [Accepted: 08/29/2019] [Indexed: 12/20/2022]
Abstract
Background and Objectives: During pregnancy and the postnatal period many changes occur in a woman's body, both in mental and physical spheres. The birth of a child and a new role-of a mother-can sometimes be associated with numerous negative emotions, uncertainty, fear, anxiety, disgust, depression, or sadness. In the puerperium period, the development of baby blues or postpartum depression may occur. Postpartum depression develops within one month of childbirth and may last up to one year. Depressive disorders that may develop in a young mother affect both her and the newborn's health. That is why it is so important to try to search for factors that could significantly reduce the likelihood of developing depression in this period. The study aims at assessing the relationship between physical activity during pregnancy and puerperium or in the postpartum and the development of postnatal depression. Materials and Methods: A review of the literature was carried out in the Medline-PubMed database. The search terms were "pregnancy" AND "physical activity AND postpartum depression". The study included only English-language publications published in the period 2000-2018. Results: A total of 216 references were found. After establishing the inclusion and exclusion criteria based on the analysis of titles and abstracts, 173 articles were excluded from the review. A total of 43 publications were read in full. Finally, 16 articles were included in the review. It was shown that regular physical activity during pregnancy, pregnancy, and puerperium, or in the postnatal period itself as compared to inactivity, reduces the risk of developing depression in pregnant women and after the birth of a child. Conclusions: Physical activity can be an essential factor in the prevention of depressive disorders of women in the postnatal period.
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Affiliation(s)
- Daria Kołomańska-Bogucka
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland
| | - Agnieszka Irena Mazur-Bialy
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland.
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Miller LJ, Ghadiali NY. Mental Health Across the Reproductive Cycle in Women Veterans. Mil Med 2019; 183:e140-e146. [PMID: 29415146 DOI: 10.1093/milmed/usx094] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/08/2017] [Indexed: 11/12/2022] Open
Abstract
Introduction Premenstrual, perinatal, and/or perimenopausal psychiatric problems require specific screening, assessment, and treatment strategies. The scope of these reproductive-linked psychiatric symptoms among women veterans is unknown. Due to high rates of sexual trauma among women veterans, it is also important to ascertain relationships between sexual trauma experiences and reproductive cycle mood problems. This pilot study investigates the prevalence of self-reported premenstrual, perinatal, and perimenopausal emotional problems and whether these correlate with pre-military sexual abuse, military sexual harassment, and/or military sexual assault, among veterans receiving psychiatric evaluations within a Veterans Administration Women's Health Clinic. Materials and Methods Participants included all women veterans (N = 186) who received psychiatric evaluations within a Veterans Administration Women's Health Clinic over a 13-mo period. Evaluations included a clinical questionnaire, a psychiatric interview, and medical record review. De-identified data were extracted from a clinical data repository for this descriptive study. Results High proportions of study participants reported emotional problems premenstrually (43.3%), during pregnancy (35.1%), postpartum (30.4%), or during perimenopause (31.2%). Unintended pregnancy (73.3% of pregnancies) and pregnancy loss (56.6% of women who had been pregnant) were prominent perinatal stressors. Military sexual harassment was significantly associated with emotional problems during pregnancy and postpartum. Conclusion These pilot data suggest the need for further study of the reproductive mental health needs of women veterans and their relationship with sexual trauma. The findings underscore the need for Veterans Administration facilities and other providers of veterans' health care to be prepared to detect, diagnose, and treat premenstrual, perinatal, and perimenopausal mental health problems.
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Affiliation(s)
- Laura J Miller
- Professor of Psychiatry; Loyola University Stritch School of Medicine; Medical Director of Women's Mental Health; Edward Hines Jr. VA Hospital; 5000 S. 5th Ave., Bldg. 228, Rm. 1016; Hines IL 60141
| | - Nafisa Y Ghadiali
- Assistant Professor of Psychiatry; Loyola University Stritch School of Medicine; Women's Mental Health Psychiatrist; Edward Hines Jr. VA Hospital; 5000 S. 5th Ave., Bldg. 228, Rm. 1016; Hines IL 60141
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Clavenna A, Seletti E, Cartabia M, Didoni A, Fortinguerra F, Sciascia T, Brivio L, Malnis D, Bonati M. Postnatal depression screening in a paediatric primary care setting in Italy. BMC Psychiatry 2017; 17:42. [PMID: 28122520 PMCID: PMC5264282 DOI: 10.1186/s12888-017-1205-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 01/11/2017] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Postnatal depression is a non-psychotic depressive disorder that begins within 4 weeks of childbirth and occurs in 13% of mothers and 10% of fathers. A prospective study with the aim to evaluate the prevalence of postnatal depression by screening parents with the Edinburgh Postnatal Depression Scale (EPDS) in the Italian paediatric primary care setting was performed. METHODS Mothers and fathers of infants born between 1 February and 31 July 2012, living in Italy's Milan-1 local health unit area, represented the target population of this pilot study. Parents attending well-child visits at any of the family paediatricians' offices between 60 to 90 days postpartum were asked to participate in the screening and to fill out the EPDS questionnaire. A cut-off score of 12 was used to identify parents with postnatal depression symptoms. Maternal and paternal socio-demographic variables and information concerning pregnancy and delivery were also collected. To investigate the association between screening positivity (dependent variable) and socio-demographic variables and factors related to pregnancy and delivery, a Pearson's χ2 test was used. Moreover, a stepwise multivariate logistic regression was carried out to evaluate the risk factors that most influence the probability of suffering from postnatal depression. RESULTS In all, 126 out of 2706 (4.7%, 95% CI 3.9-5.5%) mothers and 24 out of 1420 (1.7%, 95% CI 1.0-2.4%) fathers were found to be positive for depressive symptoms. Women with mood disorders and anxiety during pregnancy were at increased risk of postpartum depression (OR 22.9, 95% CI 12.1-43.4). Only 11 mothers (8.7%) positive to EPDS screening attended a psychiatric service, and for 8 of them the diagnosis of postnatal depression was confirmed. CONCLUSIONS The prevalence of postnatal depression was lower than previously reported. Routine screening resulted ineffective, since few mothers found positive for depression symptoms decided to attend psychiatric services.
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Affiliation(s)
- Antonio Clavenna
- Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, Milan, 20156, Italy.
| | - Elena Seletti
- 0000000106678902grid.4527.4Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche “Mario Negri”, via Giuseppe La Masa 19, Milan, 20156 Italy
| | - Massimo Cartabia
- 0000000106678902grid.4527.4Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche “Mario Negri”, via Giuseppe La Masa 19, Milan, 20156 Italy
| | - Anna Didoni
- 0000 0004 1757 8749grid.414818.0Child and Adolescent Neuropsychiatry Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Filomena Fortinguerra
- 0000000106678902grid.4527.4Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche “Mario Negri”, via Giuseppe La Masa 19, Milan, 20156 Italy
| | | | - Luca Brivio
- ATS Città Metropolitana di Milano, Milan, Italy
| | - Daniela Malnis
- Direzione Socio Sanitaria, ASST Santi Paolo e Carlo, Milan, Italy
| | - Maurizio Bonati
- 0000000106678902grid.4527.4Laboratory for Mother and Child Health, Department of Public Health, IRCCS- Istituto di Ricerche Farmacologiche “Mario Negri”, via Giuseppe La Masa 19, Milan, 20156 Italy
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Kingston D, McDonald S, Tough S, Austin MP, Hegadoren K, Lasiuk G. Public views of acceptability of perinatal mental health screening and treatment preference: a population based survey. BMC Pregnancy Childbirth 2014; 14:67. [PMID: 24521267 PMCID: PMC3925362 DOI: 10.1186/1471-2393-14-67] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 02/05/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND At a prevalence rate of 13-25%, mental health problems are among the most common morbidities of the prenatal and postnatal periods. They have been associated with increased risk of preterm birth and low birthweight, child developmental delay, and poor child mental health. However, very few pregnant and postpartum women proactively seek help or engage in treatment and less than 15% receive needed mental healthcare. While system-related barriers limit accessibility and availability of mental health services, personal barriers, such as views of mental health and its treatment, are also cited as significant deterrents of obtaining mental healthcare. The purposes of this population-based study were to identify the public's views regarding mental health screening and treatment in pregnant and postpartum women, and to determine factors associated with those views. METHODS A computer-assisted telephone survey was conducted by the Population Research Laboratory with a random sample of adults in Alberta, Canada. Questions were drawn from the Perinatal Depression Monitor, an Australian population-based survey on perinatal mental health; additional questions were developed and tested to reflect the Canadian context. Interviews were conducted in English and were less than 30 minutes in duration. Descriptive and multivariable regression analyses were conducted. RESULTS Among the 1207 respondents, 74.8% had post-secondary education, 16.3% were 18-34 years old, and two-thirds (66.1%) did not have children <18 years living at home. The majority of respondents strongly agreed/agreed that all women should be screened in the prenatal (63.0%) and postpartum periods (72.7%). Respondents reported that when seeking help and support their first choice would be a family doctor. Preferred treatments were talking to a doctor or midwife and counseling. Knowledge of perinatal mental health was the main factor associated with different treatment preferences. CONCLUSIONS The high acceptability of universal perinatal mental health screening among the public provides a strong message regarding the public value for routine screening during pregnancy and postpartum periods. Perinatal mental health literacy is the most prominent determinant of screening and treatment acceptability and preference. Efforts to enhance population literacy as part of a multifaceted perinatal mental health strategy may optimize pregnant and postpartum women's mental health.
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Affiliation(s)
- Dawn Kingston
- University of Alberta, 11405-87th Avenue, Edmonton, T6G 1C9 Alberta, Canada
| | | | | | | | - Kathy Hegadoren
- University of Alberta, 11405-87th Avenue, Edmonton, T6G 1C9 Alberta, Canada
| | - Gerri Lasiuk
- University of Alberta, 11405-87th Avenue, Edmonton, T6G 1C9 Alberta, Canada
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