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Gyimah L, Agyepong IA, Owiredu D, Awini E, Yevoo LL, Ashinyo ME, Aye SGEV, Abbas S, Cronin de Chavez A, Mirzoev T, Danso-Appiah A. Tools for screening maternal mental health conditions in primary care settings in sub-Saharan Africa: systematic review. Front Public Health 2024; 12:1321689. [PMID: 39391163 PMCID: PMC11466175 DOI: 10.3389/fpubh.2024.1321689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 08/27/2024] [Indexed: 10/12/2024] Open
Abstract
Introduction In sub-Saharan Africa, pregnant and postpartum women with mental health problems are often missed in healthcare systems. To address this, a practical and simple screening tool for maternal mental health should be available to primary healthcare workers. An important step toward having such a tool is to assess the existing tools and their effectiveness in primary care settings. Methods We systematically searched PubMed, LILAC, CINAHL, Google Scholar, African Index Medicus, HINARI, and African Journals Online from inception to 31 January 2023, without language restriction. Reference lists of retrieved articles were reviewed and experts in the field were contacted for studies not captured by our searches. All retrieved records were collated in Endnote, de-duplicated, and exported to Rayyan for screening. Study selection and data extraction were done by at least two reviewers using a pre-tested flow chart and data extraction form. Disagreements between reviewers were resolved through discussion. We contacted primary authors for missing or insufficient information and conducted a content analysis of the psychometric properties of the tools. Results In total, 1,181 studies were retrieved by our searches, of which 119 studies were included in this review. A total of 74 out of 119 studies (62%) were screened for depression during pregnancy and or the postpartum period. The Edinburg Postpartum Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) were the most commonly used tools. In total, 12 studies reported specificity and sensitivity for tools for measuring depression (EPDS, PHQ-9, and Whooley) and psychological distress [Self Report Questionnaire (SRQ) and Kessler Psychological Distress Scale (KPDS)]. The average sensitivity and specificity of the EPDS reported were 75.5 and 76.5%, respectively, at a cut-off of ≥13. The EPDS appears to be the most acceptable, adaptable, user-friendly, and effective in screening for maternal mental health conditions during pregnancy and postpartum. However, the methodological approach varied for a particular tool, and documentation on the attributes was scanty. Conclusion The EPDS was the most commonly used tool and considered as most acceptable, adaptable, user-friendly, and effective. Information on the performance and psychometric properties of the vast majority of screening tools was limited. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022323558, identifier CRD42022323558 (PROSPERO).
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Affiliation(s)
- Leveana Gyimah
- Pantang Hospital, Accra, Ghana
- Faculty of Psychiatry, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Irene Akua Agyepong
- Dodowa Health Research Centre, Research and Development Division, Ghana Health Service, Dodowa, Ghana
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - David Owiredu
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
- Centre for Evidence Synthesis and Policy, University of Ghana, Accra, Ghana
| | - Elizabeth Awini
- Dodowa Health Research Centre, Research and Development Division, Ghana Health Service, Dodowa, Ghana
| | - Linda Lucy Yevoo
- Dodowa Health Research Centre, Research and Development Division, Ghana Health Service, Dodowa, Ghana
| | | | - Sorre Grace Emmanuelle Victoire Aye
- Dodowa Health Research Centre, Research and Development Division, Ghana Health Service, Dodowa, Ghana
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Shazra Abbas
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Anna Cronin de Chavez
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tolib Mirzoev
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anthony Danso-Appiah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
- Centre for Evidence Synthesis and Policy, University of Ghana, Accra, Ghana
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Kidman R, Breton E, Behrman J, Rui YT, Kohler HP. Prevalence and early-life predictors of adverse childhood experiences: Longitudinal insights from a low-income country. CHILD ABUSE & NEGLECT 2024; 154:106895. [PMID: 38870710 PMCID: PMC11382283 DOI: 10.1016/j.chiabu.2024.106895] [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] [Indexed: 06/15/2024]
Abstract
BACKGROUND A sizeable literature shows that adverse childhood experiences (ACEs) are associated with poor health outcomes in later life. However, most studies on the prevalence and predictors of ACEs have been carried out in high-income countries using cross-sectional approaches. OBJECTIVE The present study explores the prevalence and predictors of ACEs in Malawi, a low-income country, using prospective longitudinal data collected on adolescents. PARTICIPANTS We use data on 1375 adolescents and their biological mothers from the Malawi Longitudinal Study of Families and Health (MLSFH). ACEs were reported by adolescents over two survey waves, in 2017-18 and 2021. Predictors were reported by mothers in 2008 and 2010. METHODS Multivariate ordinary least square and logistic regression analyses of ACEs exposure reported by adolescents on indicators of family arrangements and resources. RESULTS Adolescents report having been exposed to nearly seven ACEs on average. Among indicators of family arrangements and resources, the only significant predictors of cumulative ACEs exposure are polygyny (linked to parental absence) and mother's SF-12 mental health score (linked to physical abuse and witnessing domestic violence). CONCLUSIONS ACEs are much more prevalent in the low-income country under study than in middle- and high-income countries surveyed in prior research. Despite adversity being widespread, most indicators of family arrangements and resources highlighted in prior studies are not associated with adolescents' cumulative ACEs exposure in this context. Mothers' mental health in childhood nevertheless emerges as a significant predictor of adolescents' self-reported ACEs. These findings inform efforts aimed at preventing ACEs in high-adversity contexts.
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Affiliation(s)
- Rachel Kidman
- Program in Public Health and Department of Family, Population and Preventive Medicine, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States of America.
| | - Etienne Breton
- Population Aging Research Center, University of Pennsylvania, Philadelphia, PA 19104-6298, United States of America.
| | - Jere Behrman
- Population Aging Research Center, University of Pennsylvania, Philadelphia, PA 19104-6298, United States of America; Department of Economics, University of Pennsylvania, Philadelphia, PA 19104-6298, United States of America; Department of Sociology, University of Pennsylvania, Philadelphia, PA 19104-6298, United States of America.
| | - Yang Tingting Rui
- Population Aging Research Center, University of Pennsylvania, Philadelphia, PA 19104-6298, United States of America
| | - Hans-Peter Kohler
- Population Aging Research Center, University of Pennsylvania, Philadelphia, PA 19104-6298, United States of America; Department of Sociology, University of Pennsylvania, Philadelphia, PA 19104-6298, United States of America.
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Orton O, Bilgin A. Maternal Depression and Sleep Problems in Early Childhood: A Meta-Analysis. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01717-y. [PMID: 38836978 DOI: 10.1007/s10578-024-01717-y] [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] [Accepted: 05/16/2024] [Indexed: 06/06/2024]
Abstract
Both prenatal and postnatal maternal depression have been associated with increased sleep problems in early childhood. However, this association is less consistent for postnatal depression, and the strength of the association remains unclear. The aim of the current study was to provide a quantitative synthesis of the literature to estimate the magnitude of the association between maternal depression and sleep problems in early childhood. Medline, PsycINFO, PsycARTICLES, Web of Science, and Scopus were searched for prospective longitudinal studies from 1970 to December 2022. Of 117 articles screened, 22 studies met the inclusion criteria. Both prenatal depression (OR = 1.82; 95% CI = 1.28-2.61) and postnatal depression (OR = 1.65; 95% CI = 1.50-1.82) were associated with increased likelihood of sleep problems in early childhood. The heterogeneity between the studies was significant and high both for prenatal (Q = 432.323; I2 = 97.456, P < .001) and postnatal depression (Q = 44.902, I2 = 65.594, P < .001), which mean that conclusions are tentative and need to be considered within the possible influence of unmeasured confounding. However, mitigating depression symptoms in mothers both during pregnancy and in the postnatal period would be an effective strategy for reducing sleep problems in children.
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Affiliation(s)
| | - Ayten Bilgin
- Department of Psychology, University of Essex, Colchester, UK.
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Aljhani SA, Almeshal RA, Almeshal EA, Alofea AM, Alenizi AS. Predictors of postpartum depression and its association with sleep quality among mothers in Qassim, Saudi Arabia: A descriptive cross-sectional study. Int J Psychiatry Med 2024; 59:325-340. [PMID: 37767714 DOI: 10.1177/00912174231202932] [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] [Indexed: 09/29/2023]
Abstract
OBJECTIVE This cross-sectional study aims to examine the prevalence of postpartum depression (PPD) and sleep problems, their relationship, and the characteristics associated with depression/insomnia in Qassim, Saudi Arabia. METHODS An online survey was administered to a convenience sample of 395 mothers who had given birth within the preceding year. The survey comprised demographic characteristics, pregnancy and childbirth characteristics, depression (via the Edinburgh Postnatal Depression Scale; EPDS), and sleep quality (via the Pittsburgh Sleep Quality Index; PSQI). RESULTS Nearly two-thirds of respondents (62.3%) had PPD, while 92.2% experienced poor sleep quality. Both scales demonstrated a statistically significant positive correlation. Participants with previous PPD, peripartum depression, a personal or family history of other depression, those bottle-feeding their infants, or who had a change in sleep pattern scored significantly higher on the EPDS and had poorer PSQI scores. Respondents with a history of mental illness, pregnancy or delivery complications, those who lacked support, or gave birth to unhealthy newborns also had significantly higher EPDS scores. CONCLUSIONS PPD and poor sleep quality were highly prevalent among mothers living in the Qassim region of Saudi Arabia. Not surprisingly, PPD was strongly correlated with poor sleep quality. Postpartum counseling for mothers during the first year after delivery is necessary to decrease the risk of developing depressive symptoms and poor sleep quality. Screening for sleep-related difficulties and depression in prenatal and postnatal programs may help prevent the development of depressive disorder among postpartum women in this region of Saudi Arabia (or other areas of the Middle East).
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Affiliation(s)
- Sumayah A Aljhani
- Department of Psychiatry, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Razan A Almeshal
- Medical intern, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Emtenan A Almeshal
- Medical intern, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Alhanuf M Alofea
- Medical intern, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Adim S Alenizi
- Medical intern, College of Medicine, Qassim University, Qassim, Saudi Arabia
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Liow Y, Lazarus M, Loh V, Shorey S, Chee C, Young D, Valderas JM. Primary care physicians' perspectives on the identification and management of postnatal mental health problems. Fam Pract 2024; 41:185-193. [PMID: 38279950 DOI: 10.1093/fampra/cmae003] [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] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND Postnatal mental health problems (PMHPs) are prevalent and negatively affect mothers, children, and society. International and local guidelines recommend that Singapore primary care physicians (PCP) screen, assess, and manage mothers with PMHPs. However, little is known about their experiences and views. METHODS We conducted semi-structured interviews with 14 PCPs in Singapore. Interview questions elicited perspectives on the identification and management of mothers with PMHPs. The interview guide was developed from a conceptual framework incorporating the knowledge-attitudes-practices, self-efficacy, and socio-ecological models. Interviews were audio-recorded and transcribed. Thematic analysis was used to identify emergent themes. RESULTS Singapore PCPs viewed themselves as key providers of first-contact care to mothers with PMHPs. They believed mothers preferred them to alternative providers because of greater accessibility and trust. In detection, they were vigilant in identifying at-risk mothers and favoured clinical intuition over screening tools. PCPs were confident in diagnosing common PMHPs and believed that mothers not meeting diagnostic criteria must be readily recognized and supported. In managing PMHPs, PCPs expressed varying confidence in prescribing antidepressants, which were viewed as second-line to supportive counselling and psychoeducation. Impeding physician factors, constraining practice characteristics and health system limitations were barriers. Looking forward, PCPs aspired to leverage technology and multidisciplinary teams to provide comprehensive, team-based care for the mother-child dyad. CONCLUSION Singapore PCPs are key in identifying and managing mothers with PMHPs. To fully harness their potential in providing comprehensive care, PCPs need greater multidisciplinary support and technological solutions that promote remote disclosure and enhanced preparation for their role.
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Affiliation(s)
- Yiyang Liow
- National University Polyclinics, National University Health System, Singapore
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Monica Lazarus
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Victor Loh
- National University Polyclinics, National University Health System, Singapore
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cornelia Chee
- Department of Psychological Medicine, National University Hospital, National University Health System, Singapore
| | - Doris Young
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jose M Valderas
- Department of Family Medicine, National University Health System, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Asarnow LD, Norwood PP, Christodoulou J, Tomlinson M, Rotheram-Borus MJ. The Concurrent and Longitudinal Relationship between Perinatal Sleep Difficulties and Depression in a Large Sample of High-Risk Women in South Africa. Matern Child Health J 2024; 28:700-707. [PMID: 38110851 DOI: 10.1007/s10995-023-03850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION Perinatal depression and sleep difficulties are common among studies conducted in high income countries (HIC). This study examines the relationship between sleep difficulties and depression during the perinatal period and over an eight-year follow-up period in South Africa, a middle income country. METHOD A population cohort of 1238 pregnant women (mean age = 26.33) in 24 township neighborhoods in South Africa were recruited and reassessed six times over the next 8 years post birth with follow-up rates of 96-83%. The relationship between maternal depressed mood and sleep difficulties was examined over time, as well as the relationship of sleep with other socioeconomic, environmental, and psychiatric risk factors. RESULTS Thirty-five percent of the women reported sleep difficulties during the perinatal period; whereas only 8% reported sleep difficulties at 8-year follow-up. Perinatal sleep difficulties were associated with lower income, lower educational attainment, less access to electricity, more food insecurity, higher rates of interpersonal violence and HIV, alcohol consumption, and depressed mood at 8 years. However, the severity of depressed mood was the strongest predictor of sleep problems longitudinally and cross-sectionally, after accounting for all other risk factors. CONCLUSIONS We found that the severity of depressed mood is highly associated with sleep difficulties from pregnancy to 8 years post-birth and in a linear relationship, so that higher depressed mood is associated with more sleep problems. TRIAL REGISTRATION ClinicalTrials.gov registration: # NCT00996528.
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Affiliation(s)
- L D Asarnow
- Department of Psychiatry & Behavioral Science, University of California, San Francisco, USA.
| | - P P Norwood
- Semel Institute Center for Community Health, University of California, Los Angeles, USA
| | - J Christodoulou
- Department of Psychology, Palo Alto University, Palo Alto, USA
| | - M Tomlinson
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, UK
| | - M J Rotheram-Borus
- Semel Institute Center for Community Health, University of California, Los Angeles, USA
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Esposito G, Cantarutti A, Lupattelli A, Franchi M, Corrao G, Parazzini F. Does preterm birth increase the initiation of antidepressant use during the postpartum? A population-based investigation. Front Pharmacol 2024; 15:1325381. [PMID: 38601467 PMCID: PMC11004433 DOI: 10.3389/fphar.2024.1325381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Background Preterm birth may affect maternal mental health. We explored the relationship between preterm birth and the risk of initiating antidepressant use during the year after birth. Methods We conducted a population-based investigation using regional healthcare utilization databases. The exposure considered was preterm birth. The outcome was having at least one prescription for antidepressant medications during the year after birth. We used a log-binomial regression model including terms for maternal age at birth, nationality, educational level, parity, modality of conception, modality of delivery, use of other psychotropic drugs, and diabetes to estimate relative risk (RR) and 95% confidence intervals (CI) for the association between preterm birth and the initiation of antidepressant use. In addition, the absolute risk differences (ARD) were also computed according to the timing of birth. Results The cohort included 727,701 deliveries between 2010 and 2020 in Lombardy, Northern Italy. Out of these, 6,522 (0.9%) women had at least one prescription for antidepressant drugs during the year after birth. Preterm births were related to a 38% increased risk of initiation of antidepressant use during the year after birth (adjusted RR = 1.38; 95% CI: 1.25-1.52) for moderate to late preterm and to 83% (adjusted RR = 1.83; 95% CI: 1.46-2.28) for extremely and very preterm. Excluding women with only one antidepressant prescription, the association was consistent (adjusted RR = 1.41, 95%CI: 1.23-1.61 for moderate to late preterm and adjusted RR = 1.81, 95% CI: 1.31-2.49 for extremely and very preterm). Also, excluding women who used other psychotropics, the association remained consistent (adjusted RR = 1.39, 95%CI: 1.26-1.54 and adjusted RR = 1.91, 95% CI: 1.53-2.38, respectively for moderate to late and extremely and very preterm). Conclusion Women who delivered preterm may have an excess risk of initiation of antidepressant consumption during the first year after birth.
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Affiliation(s)
- Giovanna Esposito
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Anna Cantarutti
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, University of Oslo, Oslo, Norway
| | - Matteo Franchi
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Giovanni Corrao
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Costin MR, Taut D, Baban A, Ionescu T, Murray A, Lindsay C, Secara E, Abbasi F, Sarfo Acheampong I, Katus L, Luong Thanh Bao Y, Hernandez SCLS, Randeny S, Du Toit S, Valdebenito S, Eisner MP. The Role of Maternal Depression Symptoms and Maternal Attachment in Predicting Exclusive Breastfeeding: A Multisite Prospective Study. J Womens Health (Larchmt) 2024; 33:187-197. [PMID: 38011004 DOI: 10.1089/jwh.2023.0076] [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] [Indexed: 11/29/2023] Open
Abstract
Background: Previous research shows that 61% of children younger than 6 months in low- and middle-income countries (LMICs) are not exclusively breastfed. Although data on the role of pre- and postnatal depression on breastfeeding exclusivity is mixed, fetomaternal attachment might foster breastfeeding exclusivity. Thus, we tested the potential mediating role of fetomaternal attachment and postnatal depression in the relationship between maternal prenatal depression and exclusive breastfeeding. Materials and Methods: Data were collected as part of a prospective, cross-cultural project, Evidence for Better Lives Study, which enrolled 1208 expectant mothers, in their third trimester of pregnancy across eight sites, from LMICs. Of the whole sample, 1185 women (mean age = 28.32, standard deviation [SD] = 5.77) completed Computer-Aided Personal Interviews on prenatal depressive symptoms, fetomaternal attachment, and socioeconomic status. A total of 1054 women provided follow-up data at 3-6 months after birth, about postnatal depressive symptoms, exclusive breastfeeding, and infant health indicators. Path analysis was used to assess parallel mediation. Results: In the whole sample, the effect of prenatal depression on breastfeeding exclusivity was completely mediated by postnatal depression, whereas fetomaternal attachment did not mediate the relationship. The full mediation effect was replicated individually in Pakistan and Sri Lanka. Conclusions: The study results indicate that prenatal depression symptoms contributed to the development of depressive symptoms after birth, negatively affecting the probability of exclusive breastfeeding. Future research should explore this in early prevention interventions, increasing the chances of healthy child development in LMICs. Considering the mixed results around the sites, it is important to better understand the relationship between maternal depression, fetomaternal attachment and breastfeeding behavior in each site's socio-cultural context.
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Affiliation(s)
| | - Diana Taut
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Thea Ionescu
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Aja Murray
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Carene Lindsay
- Department of Basic Medical Sciences, Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Eugen Secara
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Fahad Abbasi
- Department of Jhpiego-Gender and Research, Fazaia Medical College, Islamabad, Pakistan
| | - Isaac Sarfo Acheampong
- Department of Medical Laboratory Science, Koforidua Technical University, Koforidua, Ghana
| | - Laura Katus
- Institute for Lifecourse Development, School of Human Sciences, University of Greenwich, London, United Kingdom
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom
| | - Yen Luong Thanh Bao
- Department of Epidemiology-Biostatistics and Demography, Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | | | - Shobhavi Randeny
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Stefani Du Toit
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Manuel P Eisner
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
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Dielemans A, Mahat P, Dunn JA, Balcke E, Kumar Jha R, Ghimire S, Gaire H, Honikman S. Prevalence of maternal depression and anxiety symptoms and associations with child mental health outcomes in rural Nepal. Trop Med Int Health 2024; 29:128-136. [PMID: 38126274 DOI: 10.1111/tmi.13956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVES This study describes the prevalence, associated factors and child mental health outcomes related to symptoms of maternal depression and anxiety within 5 years after childbirth in a rural district in Nepal. This association is not well-understood in rural, community-based settings in low- and middle-income countries (LMIC). METHODS A sample of 347 women with children under 5 years was recruited in September 2019 for a cross-sectional study in the rural Saptari district in Nepal. Multivariable logistic regression was used to investigate the association between maternal depressive or anxiety symptoms and children's experience and impact of emotional and behavioural difficulties. RESULTS In total, 144 women (41.5%) had moderate or severe depression symptoms and 118 (34%) had anxiety symptoms. Mothers with a lower income were more likely to have anxiety symptoms than the highest income group (OR: 1.8, 95% CI: 1.1-3.0). An association existed between maternal depressive symptoms and the impact of emotional or behavioural difficulties in children (OR: 2.44, 95% CI: 1.02-5.84). In contrast, there was no association between maternal anxiety and child outcomes. CONCLUSIONS Our findings suggest that the prevalence of probable maternal anxiety and depression symptoms was relatively high in this rural, low-resourced and community-based setting in Nepal. Maternal depressive symptoms were associated with the degree of impact on children's mental health post-infancy, emphasising the importance of improving maternal mental health in the early years of a child's life.
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Affiliation(s)
| | - Pashupati Mahat
- Centre for Mental Health and Counselling Nepal, Kathmandu, Nepal
| | - Julia Alexandra Dunn
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| | - Emily Balcke
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Rajesh Kumar Jha
- Centre for Mental Health and Counselling Nepal, Kathmandu, Nepal
| | - Smriti Ghimire
- Centre for Mental Health and Counselling Nepal, Kathmandu, Nepal
| | - Himal Gaire
- Centre for Mental Health and Counselling Nepal, Kathmandu, Nepal
| | - Simone Honikman
- Perinatal Mental Health Project, Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Frost A, Scherer E, Chung EO, Gallis JA, Sanborn K, Zhou Y, Hagaman A, LeMasters K, Sikander S, Turner E, Maselko J. Longitudinal pathways between maternal depression, parenting behaviors, and early childhood development: a mediation analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.24.24301747. [PMID: 38343808 PMCID: PMC10854292 DOI: 10.1101/2024.01.24.24301747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Maternal depression is a global public health concern with far-reaching impacts on child development, yet our understanding of mechanisms remains incomplete. This study examined whether parenting mediates the association between maternal depression and child outcomes. Participants included 841 rural Pakistani mother-child dyads (50% female). Maternal depression was measured at 12 months postpartum, parenting behaviors (warmth, stimulation, and harsh parenting) were measured at 24 months, and child outcomes (mental health, socioemotional development, and cognitive skills) were measured at 36 months. Maternal depression predicted increased harsh parenting, child mental health difficulties, and child socioemotional concerns; however, there was little evidence for parenting as a mediator between maternal depression and child outcomes. Sex-stratified results are discussed, and findings are situated in context.
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Geary O, Grealish A, Bright AM. The effectiveness of mother-led infant massage on symptoms of maternal postnatal depression: A systematic review. PLoS One 2023; 18:e0294156. [PMID: 38091329 PMCID: PMC10718423 DOI: 10.1371/journal.pone.0294156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/25/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Postnatal depression is a significant public health issue which may escalate and lead to adverse outcomes for women, infants, their family and the wider society. The aim of this review was to examine the effectiveness and experiences of mother-led infant massage on symptoms of maternal postnatal depression and to synthesise these findings to inform policy, practice and further research. METHODS A systematic search of five academic databases was conducted: CINAHL, MEDLINE, EMBASE, PsycINFO and Allied and Complementary Medicine Database in February 2023 with no date or geographic limiters set owing to the paucity of research on this subject area. Quality appraisal was undertaken using the Joanna Briggs Institute quality appraisal tools and all included RCT's were assessed separately using the Cochrane Risk of Bias Tool. Narrative synthesis was used to analyse the data. FINDINGS A total of (n = 323) studies were returned of which (n = 8) met the inclusion criteria for the review. This review identified a total sampling of (n = 521) women with maternal postnatal depression. The results are presented under three themes: 1) the effectiveness of mother-led infant massage on symptoms of postnatal depression; 2) women's experiences of mother-led infant massage; and 3) the effects of mother-led infant massage on the mother-infant relationship. DISCUSSION The review highlights women who used infant massage displayed a reduction in symptoms of postnatal depression, improved mother-infant interactions and improved self-efficacy in addition to benefits for infants. Public Health Nurse/Community Midwife-led infant massage may help to relieve such symptoms and empower women.
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Affiliation(s)
- Orla Geary
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Annmarie Grealish
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Ann-Marie Bright
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
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Sun Y, Ferguson M, Reeves MM, Kelly JT. Maternal Dietary Patterns and Risk of Postpartum Depression: A Systematic Review. Matern Child Health J 2023; 27:2077-2090. [PMID: 37814068 PMCID: PMC10618401 DOI: 10.1007/s10995-023-03781-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE Postpartum depression (PPD) has deleterious effects on both maternal and child outcomes. Poor maternal nutrition during pregnancy has been implicated in the development of PPD. This review aimed to explore the association between the overall dietary intake patterns during pregnancy and the development of PPD. METHODS A literature search was performed in PubMed, Embase, Scopus, CINAHL, and PsycINFO databases for relevant randomized controlled trials, cohort and cross-sectional studies published up to 17th September 2020. Included studies assessed at least one dietary pattern during pregnancy and reported on PPD. The Newcastle Ottawa Scale and the Joanna Briggs Institute critical appraisal tools were used to assess the quality of methodology. A narrative analysis was conducted. RESULTS Ten studies (eight cohort and two cross-sectional) were included with substantial heterogeneity in measurements of dietary intake exposures and PPD. The studies identified several types of healthy dietary patterns, including a 'healthy', 'health conscious', 'Japanese', 'high-glycemic index/glycemic load', 'Vegetable', 'Nut-Fruit', 'Seafood', and 'compliance with the Australian Dietary Guidelines'. The 'Western', 'unhealthy', 'Beverage', 'Cereal-Meat', and 'Egg' were labelled as unhealthy dietary patterns. Four of the eight studies showed an inverse association between adherence to healthy diets and risk of PPD, whereas only one of the seven studies showed that adherence to unhealthy diets was associated with increased risk of PPD. Methodological quality of the studies varied across the sample. CONCLUSIONS Our findings indicate that adherence to a healthy diet may be beneficial for PPD. However, the relationship between unhealthy diets and PPD needs to be corroborated by more high-quality studies.
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Affiliation(s)
- Yuyue Sun
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Megan Ferguson
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Marina M Reeves
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Jaimon T Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
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Pacho M, Aymerich C, Pedruzo B, Salazar de Pablo G, Sesma E, Bordenave M, Dieguez R, Lopez-Zorroza I, Herrero J, Laborda M, Fernandez-Rivas A, Garcia-Rizo C, Gonzalez-Torres MA, Catalan A. Substance use during pregnancy and risk of postpartum depression: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1264998. [PMID: 38025481 PMCID: PMC10666188 DOI: 10.3389/fpsyt.2023.1264998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Postpartum depression (PPD) is a prevalent mental health condition affecting women globally within the first year following childbirth. Substance use during pregnancy has been associated with an increased risk of developing PPD, but the evidence remains inconclusive. This meta-analysis aims to comprehensively assess the effects of different substances on PPD risk, exploring potential modifiers and confounding factors. Objectives To examine the proportion of PPD among substance users during pregnancy, compared to non-users, and investigate the specific risk associated with different substances (tobacco, alcohol, and non-specified substance use/multiple substance use). Methods A systematic literature search was conducted from inception to November 2022 using the Web of Science database (Clarivate Analytics), incorporating Web of Science Core Collection, the BIOSIS Citation Index, the KCI-Korean Journal Database, MEDLINE®, the Russian Science Citation Index, the SciELO Citation Index, and the Cochrane Central Register of Reviews, and Ovid/PsycINFO databases. Inclusion criteria comprised original studies with pregnant women, using validated depression scales and substance use reporting. Results Among the 26 included studies, encompassing 514,441 women, the pooled prevalence of PPD among substance users during pregnancy was 29% (95% CI 25-33). Meta-analyzes revealed an overall odds ratio (OR) of 3.67 (95% CI 2.31-5.85, p < 0.01) indicating a significantly higher risk of PPD among substance users compared to non-users. Subgroup analyzes demonstrated a higher risk for women with non-specified or multiple substance use (OR 4.67, 95% CI 2.59-8.41; p < 0.01) and tobacco use (OR 4.01, 95% CI 2.23-7.20; p < 0.01). Alcohol use showed a trend toward higher risk that did not reach statistical significance (OR 1.88, 95% CI 1.00-3.55; p = 0.051). Conclusion This meta-analysis provides evidence of an increased risk of PPD among pregnant substance users, particularly those using multiple substances or tobacco. However, caution is needed in interpreting the association with alcohol use due to its non-significant result. Systematic review registration This study protocol was registered at PROSPERO (registration number: CCRD42022375500).
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Affiliation(s)
- Malein Pacho
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Eva Sesma
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Marta Bordenave
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Rodrigo Dieguez
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Itziar Lopez-Zorroza
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Jon Herrero
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Maria Laborda
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Aranzazu Fernandez-Rivas
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Medicine, Institut de Neurociències, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Miguel Angel Gonzalez-Torres
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- NIH Oxford Health Biomedical Research Centre, Oxford, United Kingdom
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
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Roy A, Rahaman M. Prevalence of Undernutrition and Change Detection among under five years Children of Empowered Action Group States in India: Scrutinizing from National Family Health Survey, 2016-2021. Ecol Food Nutr 2023; 62:223-242. [PMID: 37614031 DOI: 10.1080/03670244.2023.2247333] [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] [Indexed: 08/25/2023]
Abstract
Change detection and prevalence of child undernutrition among the Empowered Action Group (EAG) states of India were studied using National Family Health Survey-4 and 5 data. The results identified that the prevalence of undernutrition in most of the EAG states is still more than 30%. Although stunting and underweight have decreased in all EAG states, this pattern is higher than that of the national level but the prevalence of wasting has only increased in Bihar. Strengthening public health initiatives and collaborative endeavor between organizations, enhancing mother's education, increasing awareness, and raising the economic as well as sociopolitical empowerment of mothers are essential for addressing the undernutrition issue.
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Affiliation(s)
- Arabinda Roy
- Department of Geography, Dr. Meghnad Saha College (affiliated to University of Gour Banga), Itahar, Uttar Dinajpur, India
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15
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Kumar A, Bartoli B, Lichand G, Wolf S. Sociodemographic predictors of depression and anxiety symptomatology among parents in rural Côte d'Ivoire. J Affect Disord 2023; 338:1-9. [PMID: 37245553 DOI: 10.1016/j.jad.2023.05.060] [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: 01/19/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND In Côte d'Ivoire, cocoa farming is a widespread practice in rural households, an occupation with increased risks of depression and anxiety exacerbated by economic instability. We used the Goldberg-18 Depression and Anxiety diagnostic tool to identify predictors of depressive and anxiety symptomatology among a sample of parents in rural cocoa farming communities. METHODS In a cross-sectional survey, the Goldberg-18 was administered to Ivorian parents (N = 2471). Confirmatory factor analysis (CFA) was conducted to confirm the factor structure of the assessment tool, and Ordinary Least Squares (OLS) regression with clustered standard errors was used to identify sociodemographic predictors of symptomatology. RESULTS CFA showed adequate fit statistics for a two-factor model measuring depressive and anxiety symptoms. Among respondents, 87 % screened positive for requiring further referral for clinical diagnosis. Sociodemographic predictors of depressive and anxiety symptoms were similar for males and females. For the total sample, higher monthly income, more years of education, and belonging to the Mandinka ethnic group predicted fewer depressive and anxiety symptoms. In contrast, higher depressive and anxiety symptomatology were associated with age. Single marital status predicted increased anxiety but not depressive symptoms for the full sample model and the female only sample, but not the male sample. LIMITATIONS This is a cross-sectional study. CONCLUSIONS The Goldberg-18 measures distinct domains of depressive and anxiety symptoms in a rural Ivorian sample. Age and single marital status are predictors of increased symptoms. Higher monthly income, higher education, and certain ethnic affiliations are protective factors.
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Affiliation(s)
- Anahita Kumar
- University of Pennsylvania, Graduate School of Education, United States of America.
| | | | | | - Sharon Wolf
- University of Pennsylvania, Graduate School of Education, United States of America
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Daliri DB, Afaya A, Afaya RA, Abagye N. Postpartum depression: The prevalence and associated factors among women attending postnatal clinics in the Bawku municipality, Upper East Region of Ghana. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e143. [PMID: 38867815 PMCID: PMC11114418 DOI: 10.1002/pcn5.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 06/14/2024]
Abstract
Introduction This study examined postpartum depression (PPD) among mothers in the Bawku municipality of Ghana, aiming to assess its prevalence and associated risk factors. Methods A total of 242 women, 2-12 weeks postpartum, were randomly recruited for this cross-sectional analytical study. The Edinburgh Postnatal Depression Scale was used for depression screening, and multivariate logistic regression analysis was employed to assess the factors associated with PPD. Results The study showed that 34.7% of the postpartum mothers were within the age range of 25-29, with a mean age of 27.9 (standard deviation [SD] ± 6.33). The prevalence of PPD was 50.4% (95% confidence interval [CI] 43.9-56.9). Several significant risk factors were identified, including inadequate prenatal visits (adjusted odds ratio [aOR] = 13.44, 95% CI 3.66-49.37, P < 0.001), obstetric complications (aOR = 3.39, 95% CI 1.23-11.19, P = 0.019), less than 3 weeks postpartum (aOR = 8.14, 95% CI 1.95, 33.94, P = 0.004), 6-8 weeks postpartum (aOR = 7.72, 95% CI 1.71-34.80, P = 0.008), and stressful life events (aOR = 3.30, 95% CI 1.23-8.89, P = 0.018). Conclusion The study concluded that the prevalence of PPD in the Bawku municipality is higher than previously reported in Ghana, emphasizing the need for early identification of pregnant women at risk for PPD.
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Affiliation(s)
- Dennis Bomansang Daliri
- Department of Global and International Health, School of Public HealthUniversity for Development StudiesTamaleGhana
- Presbyterian Psychiatric HospitalBolgatangaGhana
| | - Agani Afaya
- Department of Nursing, School of Nursing and MidwiferyUniversity of Health and Allied SciencesHoGhana
- Mo‐Im Kim Nursing Research Institute, College of NursingYonsei UniversitySeoulSouth Korea
| | - Richard Adongo Afaya
- Department of Midwifery and Women's Health, School of Nursing and MidwiferyUniversity for Development StudiesTamaleGhana
| | - Nancy Abagye
- Department of Midwifery, School of Nursing and MidwiferyUniversity of GhanaAccraGhana
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Kaiyo-Utete M, Langhaug L, Chingono A, Dambi JM, Magwali T, Henderson C, Chirenje ZM. Antenatal depression: Associations with birth and neonatal outcomes among women attending maternity care in Harare, Zimbabwe. PLoS One 2023; 18:e0270873. [PMID: 37418441 PMCID: PMC10328234 DOI: 10.1371/journal.pone.0270873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/21/2022] [Indexed: 07/09/2023] Open
Abstract
INTRODUCTION Antenatal depression is highly prevalent and is associated with negative birth and neonatal outcomes. However, the mechanisms and causality behind these associations remain poorly understood as they are varied. Given the variability in whether associations are present, there is need to have context-specific data to understand the complex factors that go into these associations. This study aimed to assess the associations between antenatal depression and birth and neonatal outcomes among women attending maternity care in Harare, Zimbabwe. METHODS We followed 354 pregnant women in second or third trimester, attending antenatal care services in two randomly selected clinics in Harare, Zimbabwe. Antenatal depression was assessed using the Structured Clinical Interview for DSM-IV. Birth outcomes included birth weight, gestational age at delivery, mode of delivery, Apgar score, and initiation of breastfeeding within one-hour postdelivery. Neonatal outcomes at six weeks postdelivery included infant's weight, height, illness, feeding methods and maternal postnatal depressive symptoms. The association between antenatal depression and categorical and continuous outcomes were assessed by logistic regression and point-biserial correlation coefficient, respectively. Multivariable logistic regression determined the confounding effects on statistically significant outcomes. RESULTS Prevalence of antenatal depression was 23.7%. It was associated with low birthweight [AOR = 2.30 (95% CI: 1.08-4.90)], exclusive breastfeeding [AOR = 0.42 (95%CI: 0.25-0.73)] and postnatal depressive symptoms [AOR = 4.99 (95%CI: 2.81-8.85)], but not with any other birth or neonatal outcomes measured. CONCLUSIONS The prevalence of antenatal depression in this sample is high with significant associations demonstrated for birth weight, maternal postnatal depressive symptoms and infant feeding methods Effective management of antenatal depression is thus crucial to the promotion of maternal and child health.
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Affiliation(s)
- Malinda Kaiyo-Utete
- Department of Primary Health Care Sciences, Mental Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- African Mental Health Research Initiative (AMARI), Research Support Centre, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Lisa Langhaug
- African Mental Health Research Initiative (AMARI), Research Support Centre, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Alfred Chingono
- Department of Primary Health Care Sciences, Mental Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jermaine M. Dambi
- African Mental Health Research Initiative (AMARI), Research Support Centre, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- Department of Primary Health Care Sciences, Rehabilitation Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- The Friendship Bench, Harare, Zimbabwe
| | - Thulani Magwali
- Department of Primary Health Care Sciences, Obstetrics and Gynaecology Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Claire Henderson
- Department of Health Services and Population Research, King’s College London Institute of Psychiatry, Psychology and Neurosciences, London, United Kingdom
| | - Z. Mike Chirenje
- Department of Primary Health Care Sciences, Obstetrics and Gynaecology Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- Faculty of Medicine and Health Sciences, Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
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18
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Shriyan P, Khetrapal S, van Schayck OCP, Babu GR. Maternal depressiveness and infant growth outcomes: Findings from the MAASTHI cohort study in India. J Psychosom Res 2023; 170:111378. [PMID: 37244068 PMCID: PMC7614640 DOI: 10.1016/j.jpsychores.2023.111378] [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: 09/25/2021] [Revised: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The study aims to examine the association between depressiveness in mothers on infant obesity and stunting at one year of age. METHODS We enrolled 4829 pregnant women, followed them up at public health facilities in Bengaluru for one year after birth. We collected information on women's sociodemographic characteristics, obstetric history, depressive symptoms during pregnancy and delivery within 48 h. We took infant anthropometric measurements at birth and one year. We used chi-square tests, and calculated an unadjusted odds ratio using univariate logistic regression. We used multivariate logistic regression to examine the association between maternal depressiveness, childhood adiposity, and stunting. RESULTS We found that the prevalence of depressiveness was 31.8% in mothers who delivered in public health facilities in Bengaluru. Infants born to mothers with depressiveness at birth had 3.9 times higher odds of having larger waist circumference than infants born to mothers with no depressiveness (AOR: 3.96, 95% Confidence Interval: 1.24,12.58) and 1.9 times higher odds of having a larger sum of skinfold thickness (AOR: 1.99, 95% CI: 1.18,3.38). Additionally, we found that infants born to mothers with depressiveness at birth had 1.7 times higher odds of stunting than infants born to mothers with no depressiveness (AOR: 1.72; 95%CI: 1.22,2.43) after adjusting for confounders. CONCLUSION Our study highlights a high prevalence of depressiveness among mothers seeking antenatal care at a public hospital is associated with an increased risk of infant adiposity and stunting at one year. Further research is needed to understand the underlying mechanisms and identify effective interventions.
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Affiliation(s)
- Prafulla Shriyan
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka 560023, India
| | | | - Onno C P van Schayck
- Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Giridhara R Babu
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka 560023, India; The Wellcome Trust/DBT India Alliance, New Delhi 110025, India.
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Saharoy R, Potdukhe A, Wanjari M, Taksande AB. Postpartum Depression and Maternal Care: Exploring the Complex Effects on Mothers and Infants. Cureus 2023; 15:e41381. [PMID: 37546054 PMCID: PMC10400812 DOI: 10.7759/cureus.41381] [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: 06/21/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Postpartum depression (PPD) is a common and debilitating mental health condition affecting many mothers worldwide. This review article aims to explore the complex effects of PPD on mothers and infants, focusing on maternal care. The transition to motherhood is a critical period characterized by numerous physical, psychological, and social changes, making women vulnerable to the onset of PPD. Consequently, PPD can significantly impact a mother's ability to provide optimal care for her infant, leading to potential adverse consequences for both parties. The article synthesizes existing research literature on the topic, encompassing studies from various disciplines, including psychology, psychiatry, obstetrics, and pediatrics. It begins by providing an overview of the prevalence and risk factors associated with PPD, emphasizing the importance of early detection and intervention. The impact of PPD on maternal caregiving behaviors, such as bonding, sensitivity, and responsiveness, is then examined, highlighting the potential disruptions in the mother-infant relationship. Furthermore, the article delves into the potential consequences of impaired maternal care on infant development, including emotional, cognitive, and social domains. Several factors contributing to the complex interplay between PPD and maternal care are discussed, including hormonal changes, psychosocial stressors, and the influence of social support networks. The review also addresses the bidirectional nature of the mother-infant relationship, whereby infant characteristics and behaviors can exacerbate or mitigate the effects of PPD on maternal care. Moreover, the article explores the role of healthcare providers and the importance of implementing effective screening, assessment, and treatment strategies for PPD to promote optimal maternal-infant outcomes. By consolidating current knowledge on the topic, this review article provides valuable insights into the multifaceted effects of PPD on both mothers and infants. Recognizing the significance of maternal care and understanding the mechanisms through which PPD disrupts it can inform the development of targeted interventions to promote early detection, effective treatment, and supportive interventions for mothers experiencing PPD. Ultimately, improving maternal mental health and enhancing maternal-infant relationships can yield long-term positive effects on mothers' and infants' well-being and development.
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Affiliation(s)
- Rishika Saharoy
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ashwini Potdukhe
- Medical Surgical Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mayur Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Avinash B Taksande
- Physiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Awini E, Agyepong IA, Owiredu D, Gyimah L, Ashinyo ME, Yevoo LL, Aye SGEV, Abbas S, Cronin de Chavez A, Kane S, Mirzoev T, Danso-Appiah A. Burden of mental health problems among pregnant and postpartum women in sub-Saharan Africa: systematic review and meta-analysis protocol. BMJ Open 2023; 13:e069545. [PMID: 37286328 PMCID: PMC10254702 DOI: 10.1136/bmjopen-2022-069545] [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: 10/27/2022] [Accepted: 05/17/2023] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Pregnancy and postpartum-related mental health problems pose serious public health threat to the society, but worryingly, neglected in sub-Saharan Africa (SSA). This review will assess the burden and distribution of maternal mental health (MMH) problems in SSA, with the aim to inform the implementation of context sensitive interventions and policies. METHODS AND ANALYSIS All relevant databases, grey literature and non-database sources will be searched. PubMed, LILAC, CINAHL, SCOPUS and PsycINFO, Google Scholar, African Index Medicus, HINARI, African Journals Online and IMSEAR will be searched from inception to 31 May 2023, without language restriction. The reference lists of articles will be reviewed, and experts contacted for additional studies missed by our searches. Study selection, data extraction and risk of bias assessment will be done independently by at least two reviewers and any discrepancies will be resolved through discussion between the reviewers. Binary outcomes (prevalence and incidence) of MMH problems will be assessed using pooled proportions, OR or risk ratio and mean difference for continuous outcomes; all will be presented with their 95% CIs. Heterogeneity will be investigated graphically for overlapping CIs and statistically using the I2 statistic and where necessary subgroup analyses will be performed. Random-effects model meta-analysis will be conducted when heterogeneity is appreciable, otherwise fixed-effect model will be used. The overall level of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation. ETHICS AND DISSEMINATION Although no ethical clearance or exemption is needed for a systematic review, this review is part of a larger study on maternal mental health which has received ethical clearance from the Ethics Review Committee of the Ghana Health Service (GHS-ERC 012/03/20). Findings of this study will be disseminated through stakeholder forums, conferences and peer review publications. PROSPERO REGISTRATION NUMBER CRD42021269528.
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Affiliation(s)
- Elizabeth Awini
- Research and Development Division, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana
| | - Irene Akua Agyepong
- Research and Development Division, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - David Owiredu
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
| | - Leveana Gyimah
- Department of Psychiatry, Pantang Hospital, Accra, Ghana
- Faculty of Psychiatry, Ghana College of Physicians and Surgeons, Accra, Ghana
| | | | - Linda Lucy Yevoo
- Research and Development Division, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana
| | - Sorre Grace Emmanuelle Victoire Aye
- Research and Development Division, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Shazra Abbas
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Anna Cronin de Chavez
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Sumit Kane
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Tolib Mirzoev
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Anthony Danso-Appiah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
- Centre for Evidence Synthesis and Policy, University of Ghana, Legon, Accra, Ghana
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21
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Mutiso VN, Musyimi CW, Tele A, Alietsi R, Andeso P, Ndetei DM. Edinburgh Postnatal Depression Scale (EPDS) for screening for depression in the first year post delivery in a low-resourced rural setting in Kenya. Transcult Psychiatry 2023; 60:476-483. [PMID: 34986050 DOI: 10.1177/13634615211043764] [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] [Indexed: 11/17/2022]
Abstract
Postnatal depression is one of the most common mental disorders among postnatal mothers and may have severe consequences for mothers and their children. Locally validated screening tools that can be self- or lay interviewer-administered are required to identify at-risk women, especially in settings with no mental health specialists. This study aimed to assess the validity and reliability of a culturally adapted version of the Edinburgh Postnatal Depression Scale (EPDS) in a local dialect (Kamba) in a Kenyan setting. Trained research assistants administered the local-language version of self-report scales (EPDS) to a sample of 544 Kamba-speaking women. The same scale was re-administered to the same research participants two weeks later by the same research assistants. The test scores were compared with an external 'gold standard' according to the DSM-IV criteria Mini-International Neuropsychiatric Interview for adults (MINI-Plus). The EPDS had an area under the curve (AUC) of 0.867 with 95% C.I of 0.836 to 0.894, with a cut-off point of ≥11, sensitivity of 81.0% (95% C.I 70.6-89.0) and specificity of 82.6% (95% CI 78.8-85.9). The positive predictive value (PPV) and negative predictive value (NPV) were 44.1% and 96.2%, respectively. The internal reliability was 0.852 and the test-retest reliability was 0.496. The EPDS showed good utility in detecting depressive disorder in Kamba-speaking postnatal women. It does not have to be administered by mental health workers (who are few in low- and middle-income countries); rather, this can be done by a trained lay interviewer.
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Affiliation(s)
| | | | - Albert Tele
- Africa Mental Health Research and Training Foundation
| | - Rita Alietsi
- Africa Mental Health Research and Training Foundation
| | | | - David M Ndetei
- Africa Mental Health Research and Training Foundation
- University of Nairobi
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22
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Răchită AIC, Strete GE, Sălcudean A, Ghiga DV, Rădulescu F, Călinescu M, Nan AG, Sasu AB, Suciu LM, Mărginean C. Prevalence and Risk Factors of Depression and Anxiety among Women in the Last Trimester of Pregnancy: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1009. [PMID: 37374213 DOI: 10.3390/medicina59061009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
Pregnancy represents a psychologically and emotionally vulnerable period, and research indicates that pregnant women have a higher prevalence of symptoms of anxiety and depression, debunking the myth that hormonal changes associated with pregnancy protect the mother. In recent years, several researchers have focused on the study of prenatal anxiety/depression-emotional disorders manifested by mood lability and low interest in activities-with a high prevalence. The main objective of this research was to conduct an antenatal screening in a cohort of pregnant women hospitalized for delivery in order to assess the prevalence of anxiety and depression. The secondary objective was to identify the risk factors associated with depression and anxiety in women in the third trimester of pregnancy. We carried out a prospective study in which we evaluated 215 pregnant women in the third trimester of pregnancy hospitalized for childbirth at the Obstetrics and Gynecology Clinic of the Târgu-Mureș County Clinical Hospital. The research was carried out between December 2019 and December 2021. The results showed that age and the environment of origin are the strongest predictors of mental health during pregnancy (OR = 0.904, 95%CI: 0.826-0.991; p = 0.029). For women from urban areas, there is an increased probability of falling at a higher level on the dependent variable (moderate depression) (OR = 2.454, 95%CI: 1.086-5.545; p = 0.032). In terms of health behaviors, none of the variables were statistically significant predictors of the outcome variable. The study highlights the importance of monitoring mental health during pregnancy and identifying relevant risk factors to provide appropriate care to pregnant women and the need for interventions to support the mental health of pregnant women. Especially in Romania, where there is no antenatal or postnatal screening for depression or other mental health conditions, these results could be used to encourage the implementation of such screening programs and appropriate interventions.
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Affiliation(s)
- Anca Ioana Cristea Răchită
- Doctoral School, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540139 Târgu Mureș, Romania
| | - Gabriela Elena Strete
- Department of Psychiatry, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
- Mental Health Center, Mureș County Clinical Hospital, 540072 Târgu Mureș, Romania
| | - Andreea Sălcudean
- Department of Ethics and Social Sciences, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
| | - Dana Valentina Ghiga
- Department of Medical Scientific Research Methodology, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
| | - Flavia Rădulescu
- Department of Endocrinology, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
| | - Mihai Călinescu
- Graduate of Cluj School of Public Health, Babes-Bolyai University Cluj Napoca, 400347 Cluj-Napoca, Romania
| | - Andreea Georgiana Nan
- First Department of Psychiatry, Clinical County Hospital, 540139 Târgu Mureș, Romania
| | - Andreea Bianca Sasu
- First Department of Psychiatry, Clinical County Hospital, 540139 Târgu Mureș, Romania
| | - Laura Mihaela Suciu
- Department of Obstetrics and Gynecology Clinic II, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
| | - Claudiu Mărginean
- Department of Obstetrics and Gynecology Clinic II, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
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23
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Rotheram-Borus MJ, Tomlinson M, Worthman CM, Norwood P, le Roux I, O'Connor MJ. Maternal depression, alcohol use, and transient effects of perinatal paraprofessional home visiting in South Africa: Eight-year follow-up of a cluster randomized controlled trial. Soc Sci Med 2023; 324:115853. [PMID: 37001280 PMCID: PMC10121853 DOI: 10.1016/j.socscimed.2023.115853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/28/2023]
Abstract
BACKGROUND South African mothers confront synergistic challenges from depression, alcohol use, and HIV/AIDS. The importance of maternal functioning for child development motivates interventions, yet long-term outcomes seldom are tracked. Furthermore, little is known about trajectories and the role of social-cultural factors in maternal depression and alcohol use across parenthood in low- and middle-income countries. METHODS We examined maternal outcomes at 5- and 8-years' post-birth, from the Philani Intervention Program (PIP), a randomized controlled trial of a prenatally-initiated home visiting intervention lasting through 6 months' post-birth which yielded some benefits for children and mothers through 3 years. Longitudinal Bayesian mixed-effects models assessed intervention effects for maternal depression and alcohol use from pre-birth through 8 years post-birth. We plotted trajectories of depression and alcohol use and analyzed their relationship over time. RESULTS Maternal benefits appeared limited and intervention outcomes differed at 5 and 8 years. Reduced depression in PIP versus standard care (SC) mothers at 3 years disappeared by 5 and 8 years. Depression prevalence declined from 35.1% prenatally to 5.5% at 8 years, independent of intervention or alcohol use. Alcohol use in both groups rebounded from a post-birth nadir; fewer PIP than SC mothers drank alcohol and reported problematic use at 5 but not 8 years. HIV+ prevalence did not differ by condition and increased from 26% to 45% over the reported period. CONCLUSIONS Dissipation of early child benefits from home visiting by age 8 years likely reflects lack of durable change in maternal behaviors compounded by social-cultural factors and cumulative effects of community deprivation. High prenatal rates warrant screening and treatment for depression in standard antenatal care. Low-and-middle income countries may need sustained interventions, including alcohol use reduction, to capitalize on initial gains from targeted interventions and address community social-cultural factors. HIV/AIDS continues to spread in this population.
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Affiliation(s)
- Mary Jane Rotheram-Borus
- Semel Institute Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, 10920 Wilshire Blvd. Suite 350, Los Angeles, CA, 90024, USA.
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Education Building, Francie Van Zijl Drive, Stellenbosch University, Tygerberg 7505, South Africa.
| | - Carol M Worthman
- Department of Anthropology, Emory University, 1557 Dickey Dr., Atlanta, GA, 30307, USA.
| | - Peter Norwood
- Semel Institute Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, 10920 Wilshire Blvd. Suite 350, Los Angeles, CA, 90024, USA.
| | - Ingrid le Roux
- Philani Maternal, Child Health and Nutrition Trust, P.O. Box 40188, Elonwabeni 7791, Cape Town, South Africa.
| | - Mary J O'Connor
- Semel Institute Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA.
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24
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Xue W, Cheng KK, Liu L, Li Q, Jin X, Yi J, Gong W. Barriers and facilitators for referring women with positive perinatal depression screening results in China: a qualitative study. BMC Pregnancy Childbirth 2023; 23:230. [PMID: 37020285 PMCID: PMC10074342 DOI: 10.1186/s12884-023-05532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 03/20/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Timely screening and referral can improve the outcomes of perinatal depression (PND). However, uptake rates of referral after PND screening are low in China and the reasons are unclear. The aim of this article is to explore the barriers and facilitators for referring women with positive results of PND screening in the Chinese primary maternal health care system. METHODS Qualitative data were collected from four primary health centers located in four different provinces of China. Each of the four investigators conducted 30 days of participant observations in the primary health centers from May to August 2020. Data were collected via participant observations and semi-structured in-depth interviews with new mothers who had positive results of PND screening, their family members, and primary health providers. Two investigators analyzed qualitative data independently. A thematic analysis was conducted, and data were framed using the social ecological model. RESULTS A total of 870 hours of observation and 46 interviews were carried out. Five themes were identified: individual (new mothers' knowledge of PND, perceived need to seek help), interpersonal (new mothers' attitudes towards providers, family support), institutional (providers' perception of PND, lack of training, time constraints), community (accessibility to mental health services, practical factors), and public policy (policy requirements, stigma). CONCLUSIONS The likelihood of new mothers accepting PND referral is related to factors in five areas. Intervention strategies can be developed around these themes and may include educating new mothers and their families about PND, training primary health providers to improve their awareness of condition and indication for referral, building mental health support in routine postpartum home visits, and providing support through mobile technology.
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Affiliation(s)
- Wenqing Xue
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, B15 2TT, Birmingham, UK
| | - Lu Liu
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - Qiao Li
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - Xin Jin
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - Jingmin Yi
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China
| | - Wenjie Gong
- Xiangya School of Public Health, Central South University, 110 Xiangya Road, 410078, Changsha, Hunan, China.
- Institute of Applied Health Research, University of Birmingham, B15 2TT, Birmingham, UK.
- Department of Psychiatry, University of Rochester, 14642, Rochester, USA.
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25
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Loh AHY, Ong LL, Yong FSH, Chen HY. Improving mother-infant bonding in postnatal depression - The SURE MUMS study. Asian J Psychiatr 2023; 81:103457. [PMID: 36638754 DOI: 10.1016/j.ajp.2023.103457] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/05/2023] [Accepted: 01/07/2023] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To study the effectiveness of the Sure Mums intervention in improving mother-baby bonding in a group of new mothers in Singapore. METHODS Over a period of 2 years from 2017 to 2019, thirty-two mothers were identified from our clinic population seeking treatment for postnatal mental health difficulties - these included depressive or anxiety symptoms, together with bonding difficulties. They received home-based mother-infant therapy sessions, and scores for the Postpartum Bonding Questionnaire (PBQ), Global Assessment of Functioning (GAF), and Edinburgh Postnatal Depression Scale (EPDS) were taken pre- and post-intervention. RESULTS In all, twenty-five mothers completed measures for baseline characteristics, pretreatment scores and post-treatment scores. Paired sample t-tests were conducted for the 4 subscales of the PBQ, the GAF rating score, and the EPDS score. Postintervention scores noted a reduction in the mean of all of the 4 PBQ subscales, and 3 of the 4 scores had differences that were shown to be statistically significant improvement. The EPDS pre-intervention mean score was 17.72, while mean postintervention EPDS score was 9.2. Total GAF scores showed an mean uptrend by 12-14 points, likely indicating significant improvement in the mothers' functioning post intervention. CONCLUSIONS The results of this programme shows promising evidence of its effectiveness in improving the quality of bonding in mothers with postnatal mental health difficulties. For future direction, we hope to offer the SURE MUMS programme to more mothers who are struggling to bond with their baby amidst the challenges of becoming a parent.
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Affiliation(s)
- Abigail Hong Yan Loh
- Ministry of Health Holdings Pte Ltd, 1 Maritime Square, #11-25 Harbour Front Centre, 099253, Singapore.
| | - Li Lian Ong
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore.
| | - Flora Su Hui Yong
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore.
| | - Helen Yu Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore, Singapore.
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26
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Yang W, Jiang Y, Ma L, Xiao M, Liu M, Ren Z, Hu L, Zhang Y. Cortical and subcortical morphological alterations in postpartum depression. Behav Brain Res 2023; 447:114414. [PMID: 37001820 DOI: 10.1016/j.bbr.2023.114414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/16/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
Postpartum depression (PPD) is the most common postpartum psychiatric disorder, which can negatively affect both mothers and their offspring. Although the functional changes of PPD have been extensively studied, little is known about its structural abnormalities. This study aimed to examine the cortical and subcortical morphological abnormalities in PPD. High resolution T1 structural MRI data of 29 PPD women and 23 matched healthy postpartum women (HPW) were included in this study. Using surface-based morphometry, we examined the differences between the PPD and HPW group in the cortical thickness, local gyrification index and shape changes of deep gray matter nuclei. Compared with the HPW group, women with PPD showed significantly increased cortical thickness in the left superior frontal gyrus, cuneus and right lingual gyrus and fusiform gyrus, which correlated marginally with the EPDS scores of these subjects. In addition, women with PPD showed significant regional inflation in the right pallidum compared with the HPW group. These findings provided further evidence for the structural brain abnormalities in PPD.
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27
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Osuna E, Symington EA, Malan L, Ricci C, Zandberg L, Smuts CM, Baumgartner J. Higher n-3 polyunsaturated fatty acid status during early pregnancy is associated with lower risk for depression at 12 months postpartum: The NuPED study. Prostaglandins Leukot Essent Fatty Acids 2023; 190:102528. [PMID: 36716632 DOI: 10.1016/j.plefa.2022.102528] [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: 07/06/2022] [Revised: 11/30/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023]
Abstract
Perinatal depression can negatively affect the health of the mother and her offspring. N-3 polyunsaturated fatty acids (PUFA) may play a role in the aetiology of depression. Therefore, we investigated the association of n-3 PUFA status during early pregnancy with perinatal depression among women living in urban Johannesburg, South Africa. For this prospective analysis, we analysed red blood cell (RBC) total phospholipid fatty acid (FA) composition (% of total FA) of 242 pregnant women at <18 weeks' gestation. We used the Edinburgh Postnatal Depression Scale (EPDS) to identify women at risk for depression (EPDS score ≥9) at <18, 22 and 36 weeks' gestation, and at 6 and 12 months postpartum. RBC EPA status was negatively (β=-0.22, p<0.05), and the AA/EPA ratio positively (β=0.24, p<0.05) associated with EPDS scores at 12 months postpartum. Higher RBC DHA and n-3 index were further associated with lower odds (OR=0.56 [95% CI: 0.32-0.91]; OR=0.63 [95% CI: 0.39-0.94]), while higher n-6/n-3 PUFA and AA/EPA ratios early in pregnancy were associated with higher odds for depression at 12 months postpartum ((OR=2.34 [95% CI: 1.12-4.97]; OR=1.02 [95% CI: 1.00-1.05]). Our results suggest that women with a higher RBC n-3 PUFA status during early pregnancy may be at lower risk for depression at 12 months postpartum.
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Affiliation(s)
- Ester Osuna
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland
| | - Elizabeth A Symington
- Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHER), North-West University, Potchefstroom, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland; Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa; Department of Nutritional Sciences, King's College London, London, United Kingdom.
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28
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Weldu A, Belachew A, Yilma M. The relationship between postpartum depression and appropriate infant feeding practice in eastern zone of Tigray, Ethiopia: A comparative cross-sectional study. PLoS One 2023; 18:e0280141. [PMID: 36696424 PMCID: PMC9876352 DOI: 10.1371/journal.pone.0280141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 12/21/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Understanding the relationship between postpartum depression and infant feeding practice may help to reduce the indirect impact of postpartum depression on infant feeding practice. This will further have a positive impact on reducing infant morbidity and mortality attributed to improper feeding practices. Although studies in the country have assessed the prevalence of infant feeding practices, those assessing the association between postpartum depression and infant feeding practices are lacking. Therefore, this study aimed to compare appropriate infant feeding practices and their associated factors among postpartum depressed and non-depressed mothers in Eastern Tigray. METHODS A comparative cross-sectional study was conducted from March 2019 to April 2019. A multistage random sampling technique was used to select 171 mothers with postpartum depression and 342 mothers without postpartum depression. Data were collected using a structured questionnaire from the Monitoring and Evaluating for Breastfeeding Practices toolkit, then entered into Epi- info and exported into SPSS for further analysis. A binary logistic regression was applied to determine the association between postpartum depression and appropriate infant feeding practice. RESULTS The overall prevalence of appropriate infant feeding practice was 37.6% (95% CI: 33.5%-41.9%). The prevalence was higher among mothers without postpartum depression 42.7% (95% CI: 42.9%-53.2%) than among postpartum depressed mothers 27.5% (95% CI: 24.7%-32.5%). The odds of appropriate infant feeding practice among mothers with infant birth orders of three or above was 58% (AOR = 0.42; 95% CI: 0.26-0.97) less than those mothers with infant birth orders of three and below. Households with monthly income 1000-1999 ETB (AOR = 2.26; 95% CI: 1.01-5.08), 2000-2999 ETB (AOR = 1.96; 95% CI: 1.21-4.73) and 3000-3999 ETB (AOR = 5.13; 95% CI: 1.97-13.4) were more likely to practice appropriate infant feeding. CONCLUSION The overall prevalence of appropriate infant feeding practices in the study area was low. A significantly higher proportion of mothers without postpartum depression practice appropriate infant feeding compared to mothers with postpartum depression. In addition, households with higher monthly incomes and mothers with infant birth orders three or above were significant determinants of appropriate infant feeding practice. Therefore, strengthening the provisions of nutritional education, integrating maternal mental health with routine maternal health care services, providing economic support to mothers with low income, and health education for multiparous women is a critical interventions to improve appropriate infant feeding practice.
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Affiliation(s)
- Angesom Weldu
- Department of Epidemiology, School of Public Health, Mizan Tepi University, Tepi, Ethiopia
- * E-mail:
| | - Ayele Belachew
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mengistu Yilma
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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29
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Kulisewa K, Dussault JM, Gaynes BN, Hosseinipour MC, Go VF, Kutengule A, LeMasters K, Meltzer-Brody S, Midiani D, Mphonda SM, Udedi M, Pence BW, Bengtson AM. The feasibility and acceptability of a task-shifted intervention for perinatal depression among women living with HIV in Malawi: a qualitative analysis. BMC Psychiatry 2022; 22:833. [PMID: 36581849 PMCID: PMC9798611 DOI: 10.1186/s12888-022-04476-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 12/15/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Perinatal depression (PND) is prevalent and negatively impacts HIV care among women living with HIV (WLHIV), yet PND remains under-identified in Malawian WLHIV. Accordingly, this formative study explored perceptions of the feasibility and acceptability of an integrated, task-shifted approach to PND screening and treatment in maternity clinics. METHODS We completed consecutive PND screenings of HIV+ women attending pre- or post-natal appointments at 5 clinics in Lilongwe district, Malawi. We conducted in-depth interviews with the first 4-5 women presenting with PND per site (n = 24 total) from July to August 2018. PND classification was based on a score ≥ 10 on the Edinburgh Postnatal Depression Scale (EPDS). We conducted 10 additional in-depth interviews with HIV and mental health providers at the 5 clinics. RESULTS Most participants endorsed the feasibility of integrated PND screening, as they believed that PND had potential for significant morbidity. Among providers, identified barriers to screening were negative staff attitudes toward additional work, inadequate staffing numbers and time constraints. Suggested solutions to barriers were health worker training, supervision, and a brief screening tool. Patient-centered counselling strategies were favored over medication by WLHIV as the acceptable treatment of choice, with providers supporting the role of medication to be restricted to severe depression. Providers identified nurses as the most suitable health workers to deliver task-shifted interventions and emphasized further training as a requirement to ensure successful task shifting. CONCLUSION Improving PND in a simple, task-shifted intervention is essential for supporting mental health among women with PND and HIV. Our results suggest that an effective PND intervention for this population should include a brief, streamlined PND screening questionnaire and individualized counselling for those who have PND, with supplemental support groups and depression medication readily available. These study results support the development of a PND intervention to address the gap in treatment of PND and HIV among WLHIV in Malawi.
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Affiliation(s)
- Kazione Kulisewa
- Department of Psychiatry and Mental Health, Kamuzu University of Health Sciences, Faculty of Medicine, Private Bag 360, Blantyre, Malawi
| | - Josée M Dussault
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Bradley N Gaynes
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mina C Hosseinipour
- UNC-Project Malawi, Lilongwe, Malawi
- Department of Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Vivian F Go
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Samantha Meltzer-Brody
- Department of Psychiatry, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Angela M Bengtson
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, Rhode Island, USA
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30
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Yao Y, Cui Y, Zhang Y, Li H, Zeng W. Population mental health matters child health disparity: a national level analysis. BMC Public Health 2022; 22:2372. [PMID: 36528613 PMCID: PMC9759864 DOI: 10.1186/s12889-022-14530-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/02/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The association between social distress and child health is important and attracts research interest. This study aims to examine the trend of inequality in the mortality rate for children under five (U5MR) over time and decompose the population mental health (PMH)-gradient in U5MR into different drivers at the national level. METHODS Data from 1990 to 2019 on the U5MR, PMH, and potential risk factors, such as socioeconomic status, environmental exposures at the national level, health behavior, basic water and sanitation services, urbanization, healthcare level, and HIV prevalence, were collected from online databases. We described the trend of U5MR and broke down U5MR based on the countries' risk factor status and PMH. We constructed regression models and decomposed the drivers of change in U5MR disparity based on PMH-gradient. RESULTS The difference in U5MR between countries with different levels of air pollution and income status was narrowed since 1990 for the high PMH groups. Countries with a higher level of PMH had less significant differences in U5MR between low- and middle-income groups than those with a lower level of PMH. The development of PMH-related gradient in child health is not consistent thoroughly. Before 2000, boys experienced a sharper decline in PMH-related gradient in health than girls did. The decomposition shows that the changes in PMH-gradient in child health were mainly caused by changes in the return to risk factors. The mental health of female population matters more in child health outcomes. CONCLUSION Although the U5MR converges across countries, the reason varies. The PMH gradient in child mortality is mainly explained by the change in the return to risk factors. The PMH-gradient health disparity in boys is larger than that in girls in 2019, which indicates that boys' health may be more vulnerable to the development of PMH recently. The findings remind us that we need to pay attention to the hidden reasons for the growth of disparity. It also suggests that improving PMH has a great impact on reducing PMH-related health disparity, especially for boys. Our research contributes to the understanding of the transition of PMH-related health disparity in U5MR and provides policy implications for reducing gender disparity in child health.
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Affiliation(s)
- Yao Yao
- grid.16821.3c0000 0004 0368 8293Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, 200025 P.R. China ,grid.16821.3c0000 0004 0368 8293China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yujie Cui
- grid.16821.3c0000 0004 0368 8293Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, 200025 P.R. China ,grid.16821.3c0000 0004 0368 8293China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yanfeng Zhang
- grid.33764.350000 0001 0476 2430School of Economics and Management, Harbin Engineering University, 145, Nantong Street, Nangang District, Harbin, 150001 P.R. China
| | - Heng Li
- grid.443524.00000 0000 9001 9434Public Health Governance Research Center, East China University of Political Science and Law, 1575 Wandu Hang Road, Songjiang District, Shanghai, 200042 P.R. China
| | - Wu Zeng
- grid.213910.80000 0001 1955 1644Department of Global Health, School of Health, Georgetown University, 3700 Reservoir Rd NW, Washington, DC, USA
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Depression and anxiety in second and third trimesters among pregnant women in Kenya: a hospital-based prevalence study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Evans C, Kreppner J, Lawrence PJ. The association between maternal perinatal mental health and perfectionism: A systematic review and meta-analysis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:1052-1074. [PMID: 35762187 PMCID: PMC9796248 DOI: 10.1111/bjc.12378] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Perfectionism is an important feature of adult psychopathology. In the absence of a prior review of the role of perfectionism in perinatal psychopathology, we aimed to ascertain whether perfectionism was associated with symptoms of maternal perinatal depression and anxiety. METHOD We followed PRISMA guidance (PROSPERO: 42019143369), estimated weighted effect sizes and tested possible moderators: timing (pre or post- natal), scales used to measure constructs, infant gender, temperament and age; and rated study quality. RESULTS Fourteen studies met eligibility criteria. Perfectionism as a whole, and the perfectionistic concerns dimension, were moderately correlated with common maternal perinatal mental health difficulties r = .32 (95% Confidence Interval = 0.23 to 0.42). In sub-group analyses, perfectionistic concerns were associated with depression (r = .35, 95% CI = 0.26-0.43). We found no evidence of significant moderation of associations. LIMITATIONS Included studies had methodological and conceptual limitations. All studies examined depression and two examined anxieties; all examined perfectionistic concerns and four examined perfectionist strivings. CONCLUSIONS Perfectionism, namely perfectionistic concerns, is potentially associated with common maternal perinatal mental health problems. While further research is warranted, identification of perfectionism in the perinatal period may help focus resources for intervention, reducing the prevalence of perinatal mental health difficulties.
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Affiliation(s)
- Clare Evans
- Sussex Partnership NHS Foundation TrustWest SussexUK
| | - Jana Kreppner
- Centre for Innovation in Mental HealthSchool of PsychologyUniversity of SouthamptonSouthamptonUK
| | - Peter J. Lawrence
- Centre for Innovation in Mental HealthSchool of PsychologyUniversity of SouthamptonSouthamptonUK
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Burger M, Einspieler C, Niehaus DJH, Unger M, Jordaan ER. Maternal mental health and infant neurodevelopment at 6 months in a low-income South African cohort. Infant Ment Health J 2022; 43:849-863. [PMID: 36268625 PMCID: PMC9828192 DOI: 10.1002/imhj.22021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 06/13/2022] [Indexed: 01/12/2023]
Abstract
Maternal mental health disorders and the adverse consequences for infant neurodevelopment have received substantial research attention in high-income countries over the past five decades. In Africa, where relatively little work has been done on this topic, researchers have largely focused on infant physical health outcomes. This longitudinal study investigated the neurodevelopment of infants at 6 months post-term with exposure to mothers with a clinical diagnosis of persistent mental health disorders residing in low-income communities in Cape Town, South Africa. Adjusted models revealed no significant differences on the Bayley Scales of Infant and Toddler Development (BSID-III) domains (cognitive, motor, language, socio-emotional, and adaptive behavior) between infants exposed to maternal mental health disorders (n = 62) and the comparison group (n = 35) at 3 and 6 months. Subgroup analyses found no significant differences on the BSID-III domains between infants with exposure to mood disorders (n = 31), as well as infants with exposure to comorbid (i.e., a combination of two or three) mental health disorders (n = 14) and the comparison group. However, infants with exposure to psychotic disorders (n = 14) scored significantly lower on the cognitive and the motor domains and the fine motor subscale. These novel data provide an important contribution to the scientific literature especially in the field of maternal psychotic disorders in Africa.
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Affiliation(s)
- Marlette Burger
- Faculty of Medicine and Health SciencesPhysiotherapy Division, Department of Health and Rehabilitation SciencesStellenbosch UniversityStellenboschSouth Africa
| | - Christa Einspieler
- Research Unit iDN––Interdisciplinary Developmental Neuroscience, Division of PhoniatricsMedical University of GrazGrazAustria
| | - Dana J. H. Niehaus
- Faculty of Medicine and Health SciencesDepartment of Psychiatry, Stellenbosch UniversityStellenboschSouth Africa
| | - Marianne Unger
- Faculty of Medicine and Health SciencesPhysiotherapy Division, Department of Health and Rehabilitation SciencesStellenbosch UniversityStellenboschSouth Africa
| | - Esme R. Jordaan
- Biostatistics UnitSouth African Medical Research CouncilParowSouth Africa,Statistics and Population StudiesUniversity of the Western CapeCape TownSouth Africa
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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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Mokwena K, Modjadji P. A comparative study of postnatal depression and associated factors in Gauteng and Free State provinces, South Africa. Afr J Prim Health Care Fam Med 2022; 14:e1-e11. [PMID: 36226935 PMCID: PMC9575337 DOI: 10.4102/phcfm.v14i1.3031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The factors contributing to probable postnatal depression (PND), a type of clinical depression that can affect woman after childbirth, are socially derived. Therefore, variations among groups of women necessitate studies in different communities. AIM This study compared the prevalence of PND and associated factors among women attending postnatal services facilities. SETTING The study setting included Tshwane Municipal district in Gauteng province (GP) and Fezile Dabi District (FS) in Free State province (FSP), South Africa. METHODS A total of 477 mothers within 12 weeks of giving birth were recruited by convenient sampling in health facilities. A self-developed questionnaire was used to obtain information on socio-demographics, obstetric history, and children's characteristics. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data on depression symptoms, with a score of ≥ 13 used as a cut-off for probable PND. Data were analysed using STATA 14. Multivariate logistic regression was used to determine association between probable PND and various covariates. RESULTS The overall mean age of women was 28 ± 6 years. The overall prevalence rate of PND was 22%, slightly higher in FS (23%) than in GP (21%). Most participants living in GP were married, had tertiary education, were employed and from the households with income of more than R8000.00. A chi-square test showed that planned pregnancy was significantly higher in GP compared with FS (p ≤ 0.001). Multivariate logistic regression showed that support from a partner or husband decreased the odds of a probable PND in GP (adjusted odd ratio [AOR] 0.37; 95% confidence interval [CI] [95%CI: 0.14-0.96; p = 0.041] and in the FS [AOR = 0.14, 95%CI: 0.05-0.40; p ≤ 0.001]). Significant associations of probable PND with several factors - planned pregnancy, baby age, support in difficult times, partner or husband drinking alcohol and stressful events - were more common in the FSP than in the GP. CONCLUSION The prevalence of probable PND and its associated risk factors in the GP and the FS indicates the need for routine screening and targeted interventions in both urban and rural settings.Contribution: The results confirm that the prevalence of PND is similar in both rural and urban areas, and that pregnancy planning remains a challenge in the FS, which calls for increased efforts to revive family planning programmes in primary health care facilities.
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Affiliation(s)
- Kebogile Mokwena
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria.
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Postpartum Depression after Maternal Isolation during the COVID-19 Pandemic: The MUMI-19 Study (Mothers Undergoing Mental Impact of COVID-19 Pandemic). J Clin Med 2022; 11:jcm11195504. [PMID: 36233372 PMCID: PMC9573123 DOI: 10.3390/jcm11195504] [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: 07/11/2022] [Revised: 08/27/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The COVID-19 pandemic has shaken the world by imposing unprecedented health measures, including in the postpartum period. Objectives: We aim to assess the impact of maternal isolation in the immediate postpartum period on the rate of postpartum depression (PPD) in a tertiary center. Study Design: We conducted a prospective cohort study, between 22 April and 29 October 2020, using anonymous questionnaires on 265 participants (129 during lockdown and 135 outside). The Edinburgh Postnatal Depression Scale (EPDS) was used as screening for PPD. We used a univariate logistic regression model to analyze the association between risk factors and PPD. Results: There was no difference between the two groups for PPD assessed by an EPDS score >10.5 on day 30 and/or day 60 (23.1% vs. 29.3%, p = 0.661) but on day 3 it was higher (31% vs. 17.8%, p = 0.015) during the lockdown period and partners were more impacted psychologically (48.3% vs. 10.5%, p < 0.001). Parity ≥1 was a protective factor for PPD (OR = 0.2, 95% CI [0.1−0.6], p = 0.003). Risk factors of PPD were: history of psychological abuses (OR = 6.4, CI 95% [1.1−37.6], p = 0.04), stressful life event (OR = 4.5, CI 95% [1.6−12.6], p = 0.004), and bad birth experience (OR = 5.1, CI 95% [1.4−17.8], p = 0.012). Conclusion: Maternal isolation in the immediate postpartum period is associated with an increased rate of moderate to severe symptoms of postpartum blues. The well-known long-term consequences of PPD must be balanced against the expected benefits of partner’s restrictive access to maternity ward.
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Golds L, Gillespie‐Smith K, Nimbley E, MacBeth A. What factors influence dyadic synchrony? A systematic review of the literature on predictors of mother-infant dyadic processes of shared behavior and affect. Infant Ment Health J 2022; 43:808-830. [PMID: 35913364 PMCID: PMC9540815 DOI: 10.1002/imhj.22011] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 06/01/2022] [Indexed: 11/05/2022]
Abstract
Dyadic behavioral synchrony is a complex interactional process that takes place between the mother and her infant. In the first year of life, when the infant is prelinguistic, processes such as synchrony enable the dyad to communicate through shared behavior and affect. To date, no systematic review has been carried out to understand the risk and protective factors that influence behavioral synchrony in the mother-infant dyad. The aim of this review was to identify and evaluate the factors that influence behavioral synchrony in the mother-infant dyad, when the infant is between 3 and 9 months old. Key electronic databases were searched between 1970 and April 2021, and 28 eligible studies were identified for review. As the results were largely heterogeneous, four subgroups of factors were identified: (i) infant demographics, (ii) physiological factors, (iii) maternal mental health, and (iv) miscellaneous factors. Identified risk factors and covariates suggest that social determinants of health, underpinned by biological factors, play a large role in influencing behavioral synchrony within the dyad. Implications for the need to identify additional risk and protective factors, as well as design support for at-risk families are discussed.
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Affiliation(s)
- Lisa Golds
- School of Health in Social ScienceUniversity of EdinburghEdinburghUK
| | | | - Emy Nimbley
- School of Health in Social ScienceUniversity of EdinburghEdinburghUK
| | - Angus MacBeth
- School of Health in Social ScienceUniversity of EdinburghEdinburghUK
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Skoog M, Hallström IK, Vilhelmsson A. Health care professionals’ experiences of screening immigrant mothers for postpartum depression–a qualitative systematic review. PLoS One 2022; 17:e0271318. [PMID: 35834550 PMCID: PMC9282607 DOI: 10.1371/journal.pone.0271318] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/28/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Postpartum depression is considered a major public health problem, which immigrant mothers are at particular risk of being affected by, but it can also have long-lasting traumatic effects on the child’s health and development. The Edinburgh Postnatal Depression Scale is the world’s most commonly employed screening instrument for postpartum depression, used in connection with a clinical interview to screen for symptoms of postpartum depression. The aim of this study was to synthesize health care professionals (HCPs) experiences of identifying signs of postpartum depression and performing screening on immigrant mothers, since previous research suggested that this task might be challenging. Methods The databases CINAHL, PubMed, PsycINFO, SocINDEX, Embase and Cochrane were searched for papers published January 2000–December 2020, reporting qualitative data on immigrants, postpartum depression and the Edinburgh Postnatal Depression Scale. Eight papers representing eight studies from four countries were included and the Critical Appraisal Skills Program was used to assess their quality. The synthesis of studies was guided by Noblit & Hare’s seven-step method based on meta-ethnography. Findings The synthesis resulted in two final themes: “I do my best, but I doubt that it’s enough” and “I can find no way forward”. The themes convey the fear and frustration that health care professionals experienced; fear of missing mothers with signs of postpartum depression, related to feeling uncomfortable in the cross-cultural setting and frustration in handling difficulties associated with communication, translated versions of the Edinburgh Postnatal Depression Scale and cultural implications of postpartum depression. Conclusions and clinical implication By supporting HCPs’ self-efficacy in handling cultural implications of postpartum depression and by developing evidence-based clinical guidelines for the use of interpreters and translated versions of the Edinburgh Postnatal Depression Scale the screening of immigrant mothers may be facilitated.
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Affiliation(s)
- Malin Skoog
- Faculty of Medicine, Department of Health Sciences, Lund University, Sweden
- * E-mail:
| | | | - Andreas Vilhelmsson
- Faculty of Medicine, Department of Clinical Sciences, Lund University, Sweden
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Larsen A, Pintye J, Marwa MM, Watoyi S, Kinuthia J, Abuna F, Richardson BA, Gomez L, Dettinger JC, John-Stewart G. Trajectories and predictors of perinatal depressive symptoms among Kenyan women: a prospective cohort study. Lancet Psychiatry 2022; 9:555-564. [PMID: 35598606 PMCID: PMC9233088 DOI: 10.1016/s2215-0366(22)00110-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/18/2022] [Accepted: 03/24/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND There are gaps in understanding longitudinal patterns and predictors of perinatal depressive symptoms in sub-Saharan Africa. This study aimed to explore trajectories of depressive symptoms and associated factors from pregnancy to 9 months post partum among Kenyan women. METHODS In this prospective cohort study, we analysed data from the PrEP Implementation for Mothers in Antenatal Care (PrIMA) study in which HIV-negative women were enrolled in pregnancy and followed up to 9 months post partum in 20 public sector maternal-child health clinics in western Kenya. Pregnant women were eligible for enrolment if they were not infected with HIV, aged 15 years or older, and were able to provide consent. Eligible participants were screened and enrolled between Jan 15, 2018, and July 31, 2019, and followed up to 9 months post partum, with the last participant study visit conducted on Jan 15, 2021. Study nurses serially assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CESD-10), intimate partner violence with the Hurt, Insult, Threaten, Scream scale, and social support with the Medical Outcomes Study scale. Generalised estimating equations were used to identify correlates of moderate-to-severe depressive symptoms (CESD-10 score ≥10) and group-based trajectory modelling identified discrete trajectories of perinatal depressive symptoms. FINDINGS Among 4447 participants in the main PrIMA study, 3555 had complete depressive symptom data in pregnancy and depressive symptom data post partum and were included in the primary analysis. Median age was 24·0 years (IQR 21·0-28·7), 1330 (38%) participants had low social support, and 278 (8%) reported intimate partner violence in pregnancy. All participants (100%) were female and all (100%) were of African Kenyan ethnicity. Prevalence of moderate-to-severe depressive symptoms was higher in pregnancy than post partum (870 [24·5%; 95% CI 23·1-25·9] vs 597 [6·8%; 15·6-18·1]; p<0·0001). Five patterns of depressive symptoms were identified; persistent moderate-to-severe depressive symptoms in pregnancy and post partum (295 [8·3%]), moderate-to-severe depressive symptoms in pregnancy that resolved post partum (139 [3·9%]), moderate-to-severe depressive symptoms that emerged post partum (40 [1·1%]), chronically mild symptoms (2709 [76·2%]), and no depressive symptoms (372 [10·5%]). Emergent moderate-to-severe depressive symptoms were associated with older age. Emergent, persistent, and resolving moderate-to-severe depressive symptoms were associated with intimate partner violence during pregnancy; and persistent and resolving moderate-to-severe depressive symptoms were associated with low social support and high HIV risk (all p<0·05). Moderate-to-severe depressive symptom risk was significantly increased with intimate partner violence (adjusted odds ratio 2·07 [95% CI 1·81-2·31]; p<0·0001), low social support (1·74 [1·56-1·95]; p<0·0001), and partner HIV-positive status (1·48 [1·22-1·78]; p<0·0001). 23·34% (95% CI 18·77-27·65) of cases of perinatal moderate-to-severe depressive symptoms were attributable to low social support. INTERPRETATION One third of women had perinatal moderate-to-severe depressive symptoms; nearly half of these had higher severity phenotypes of resolving, persistent, and emerging moderate-to-severe depressive symptoms that might require tailored interventions. Perinatal women with comorbid psychosocial stressors such as intimate partner violence and previous pregnancy loss should be prioritised for mental health services that augment social support within routine maternal-child health care. FUNDING National Institutes of Health. TRANSLATION For the Kiswahili translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Anna Larsen
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | - Jillian Pintye
- Department of Global Health, University of Washington, Seattle, WA, USA; Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | - Mary M Marwa
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - Salphine Watoyi
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - John Kinuthia
- Department of Global Health, University of Washington, Seattle, WA, USA; Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya; Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Felix Abuna
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - Barbra A Richardson
- Department of Global Health, University of Washington, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Laurén Gomez
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Julia C Dettinger
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Grace John-Stewart
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA
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Wake GE, Fitie GW, Ashenafi B, Tadese M, Tessema SD. Magnitude and Determinant Factors of Postpartum Depression Among Mothers Attending Their Postnatal and Vaccination Services at Public Health Institutions of Addis Ababa, Ethiopia. Front Public Health 2022; 10:882205. [PMID: 35615031 PMCID: PMC9124855 DOI: 10.3389/fpubh.2022.882205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background The postpartum period is known as a high-risk period for the onset of different maternal mental health problems. Globally, 10–20% of postnatal mothers suffer from depressive symptoms. This study aimed to assess the magnitude and determinant factors of postpartum depression among mothers attending their postnatal and vaccination services at public health institutions in Addis Ababa, Ethiopia. Methodology Health institution-based cross-sectional study was conducted among 461 postnatal mothers attending public health institutions in Addis Ababa from 15 May 2021 to 15 July 2021. A multistage sampling technique was employed to select the public health institutions and a systematic random sampling method was used to get selected, postnatal mothers. Epidata version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. P-value ≤ 0.05 was used as a cut point of statistical significance in multivariable binary logistic regression. Results From total postnatal mothers 91(19.7%) of them had postpartum depression. Occupational status [AOR = 3.39, 95% CI: 1.04, 8.15], marital status [AOR = 2.69, 95% CI =1.33, 5.45], income management [AOR = 3.76, 95% CI: 1.53, 8.21], sex of baby [AOR = 5.07, 95% CI: 1.24, 20.69], history of child death [AOR = 6.93, 95% CI: 2.67, 15.79], unplanned pregnancy [AOR = 3.08, 95% CI: 1.65, 7.93], negative life event [AOR = 2.39, 95% CI: 1.03, 5.39], substance use during pregnancy [AOR = 6.23, 95% CI: 2.72, 20.05], history of depression [AOR = 5.08, 95% CI: 1.79, 14.39], and marriage satisfaction [AOR = 6.37, 95% CI: 2.63, 14.29] were determinant factors of postpartum depression. Conclusion The prevalence of postpartum depression in this study is high compared to national findings. Occupational status, marital status, income management, sex of baby, history of child death, unplanned pregnancy, negative life event, substance use during pregnancy, history of depression, and marital satisfaction were determinant factors of postpartum depression. The ministry of health should integrate mental health services with existing maternal health care services. It would be better if all healthcare professionals working in the maternal and child health unit will routinely screen postpartum depressive symptoms and link them to mental health services.
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Burger M, Einspieler C, Jordaan ER, Unger M, Niehaus DJH. Early motor behavior of infants exposed to maternal mental health disorders - A South African perspective. Early Hum Dev 2022; 168:105572. [PMID: 35461052 DOI: 10.1016/j.earlhumdev.2022.105572] [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: 07/21/2021] [Revised: 01/20/2022] [Accepted: 04/11/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Over the past five decades the bulk of research on exposure to maternal mental health disorders and infant neurodevelopment has been generated in high-income countries. The current study included infants, residing in low-income communities in South Africa, born to mothers with a history of psychiatric disorders. AIM To assess the motor behavior of 10- to 20-week-old infants exposed to maternal mental health disorders, and a subgroup of infants with prenatal psychotropic medication exposure. METHODS The present study is a cross-sectional descriptive study, with a longitudinal subgroup analysis. General Movement Assessment (GMA), including the Motor Optimality Score-Revised (MOS-R), was used at 10-20 weeks corrected age to assess infant motor behavior. RESULTS The study included 112 infants. No significant difference (p = 0.523) was found on the MOS-R between infants exposed to maternal mental health disorders (n = 70) and the comparison group (n = 42). Both the exposed and comparison groups scored within the mildly reduced range on the MOS-R. No significant differences were found in a subgroup of infants with prenatal exposure to multi-class psychotropic medication (n = 17), mono-class psychotropic medication (n = 35) or valproate exposure (n = 10) (p > 0.1). CONCLUSION No association was found between exposure to maternal mental health disorders or exposure to psychotropic medication and infant motor behavior at 10-20 weeks post-term age on the MOS-R. Future research should focus on the contribution of exposure to specific classes and types of psychotropic medication on neurodevelopmental outcome of infants in larger cohorts.
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Affiliation(s)
- Marlette Burger
- Physiotherapy Division, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
| | - Christa Einspieler
- Research Unit iDN - Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Esme R Jordaan
- Biostatistics Unit, South African Medical Research Council, Parow, South Africa; Statistics and Population Studies, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Marianne Unger
- Physiotherapy Division, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Dana J H Niehaus
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
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Determinants of adolescent sleep: Early family environment, obstetric factors, and emotion regulation. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1016/j.appdev.2022.101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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COVID-19-related anxieties in first-time mothers during the first wave of the COVID-19 pandemic and after 6 months: A descriptive study. J Pediatr Nurs 2022; 64:126-132. [PMID: 35184936 PMCID: PMC8851201 DOI: 10.1016/j.pedn.2022.02.002] [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: 08/07/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The changes accompanying the transition to motherhood, joined by the stress aroused by the COVID-19 pandemic, may lead to high levels of parental anxieties. This study, conducted in two phases-in the midst of the first wave of the pandemic and after six months-explores differences in the level of COVID-19-related anxieties of Israeli mothers in their first year of parenthood. DESIGN AND METHODS A cross-sectional study carried out with 198 first-time mothers aged 22-48 who completed self-report questionnaires on April 2020 and again on October 2020. The questionnaire was distributed through social networks and included a demographic scale and the COVID-19-related anxieties questionnaire. FINDINGS In the first phase, mothers reported higher anxieties concerning economic damage (M = 3.42; 3.11), being in public places (M = 4.34; M = 3.51), using public transportation (M = 4.80; M = 4.31), and going for infant checkups (M = 4.13; M = 3.06). In the second phase, mothers reported higher anxiety about being infected (M = 3.19; M = 3.48). DISCUSSION The results suggest the need to be attentive to the double stress of new mothers in a dynamic time of crisis, especially at the beginning of the crisis when anxiety levels may be highest. APPLICATION TO PRACTICE The findings may aid in developing interventions for new mothers in times of crisis. The finding that the COVID-19-related anxieties of new mothers may decrease over time points to the urgency of making interventions by health and medical professionals available to women in the first months after the birth of their first child.
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Alonzo D, Popescu M, Zubaroglu Ioannides P. Mental health impact of the Covid-19 pandemic on parents in high-risk, low income communities. Int J Soc Psychiatry 2022; 68:575-581. [PMID: 33517821 PMCID: PMC7862916 DOI: 10.1177/0020764021991896] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND COVID-19 has spread across the globe, resulting in significant changes in virtually every aspect of life. Mitigation efforts, like shelter-in-place orders, have taken a particular toll on parents who have had to navigate disruptions in work and/or school schedules. Research from high-income countries demonstrates increased parental anxiety, stress, depression, and burnout resulting from the pandemic. It is unclear if these outcomes are the same for parents in high-risk communities in low-income countries where pre-pandemic conditions were deleterious. This study addresses this gap and examines the mental health impact of the pandemic on parents in high-risk communities in Guatemala. METHODS A total of 330 individuals from 11 districts in Guatemala participated in the study and were assessed for sociodemographic characteristics and mental health impairment. Chi-squares were conducted for bivariate analysis. Multivariate analysis was conducted using binary logistic regression. RESULTS Bivariate analysis revealed differences between groups on burnout, with parents more often reporting feelings of burnout than nonparents (p < .001). Binary regression demonstrated that non-parents were 70% less likely to endorse feelings of stress as compared to parents (OR = .285; p = .014). CONCLUSION Our findings underscore the importance of identifying the unique mental health impact of the COVID 19 pandemic on parents in high-risk communities. In high-risk communities, parental stress is a pressing problem that, if unaddressed, has the potential to result in even greater psychological distress and child maltreatment. Training community healthcare providers to assess and address parental stress can lead to increased community capacity and the development of a community-based network to serve as a first line of support for parents and their children.
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Affiliation(s)
- Dana Alonzo
- Graduate School of Social Service, Fordham University, West Harrison, NY, USA
| | - Marciana Popescu
- Graduate School of Social Service, Fordham University, West Harrison, NY, USA
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Dang TAT, Vo TV, Dunne MP, Eisner M, Luong-Thanh BY, Hoang TD, Nguyen LH. Effect of intimate partner violence during pregnancy on maternal mental health: a cohort study in central Vietnam. Women Health 2022; 62:205-213. [DOI: 10.1080/03630242.2022.2043984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Thi Anh Thu Dang
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thang Van Vo
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Michael P. Dunne
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia
| | - Manuel Eisner
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Bao-Yen Luong-Thanh
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Tuyen Dinh Hoang
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Lan Hoang Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
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Elkashif MML. Prevalence of Postpartum Depression, Associated Factors, Social Support, and Professional Assistance: A Cross-Sectional Study in Port Said, Egypt. INTERNATIONAL JOURNAL OF CHILDBIRTH 2022. [DOI: 10.1891/ijc-2021-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTIONPostpartum depression is a mental illness that affects post-childbirth mothers. It is associated with psychological and social risk factors such as negative childhood experiences and pregnancy and childbirth problems. Postpartum depression has not been a focus of concern in Egypt. Therefore, this study aimed to identify the prevalence of postpartum depression, its associated factors, social support, and professional assistance in Port Said, Egypt.METHODOLOGYA random sampling strategy was used to select 540 women ten weeks postpartum. Data were collected using a questionnaire during an interview to identify potential risk factors for postpartum depression. The modified Arabic version of the Edinburgh Postpartum Depression Scale was used to assess symptoms of postpartum depression which is a multidimensional measure of social communication. Statistical analysis was completed using SPSS 25.0. software.RESULTSIt was found that 24.4% of women were at risk for postpartum depression. Social support from family and friends was significantly associated with mitigation of postpartum depression.CONCLUSIONThis study affirmed postpartum depression was a common health problem among 540 women who gave birth in Port Said, Egypt. Early detection and efficient screening methods to detect postpartum depression should be applied, especially in areas with a high risk for this condition. Early detection may prevent complications for mothers, babies, and families.
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Tomlinson M, Skeen S, Melendez-Torres GJ, Hunt X, Desmond C, Morgan B, Murray L, Cooper PJ, Rathod SD, Marlow M, Fearon P. First 1,000 days: enough for mothers but not for children? Long-term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow-up of a randomised controlled trial. J Child Psychol Psychiatry 2022; 63:261-272. [PMID: 34227113 DOI: 10.1111/jcpp.13482] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depression. One avenue of early intervention focuses on the quality of the early mother-infant relationship. The aim of this study was to examine the long-term impact of an early intervention to improve the mother-infant relationship quality on child cognitive outcomes at 13 years of age. We also estimated the current costs to replicate the intervention. METHOD We re-recruited 333 children from an early childhood maternal-infant attachment intervention, 'Thula Sana', when the children were 13 years old, to assess whether there were impacts of the intervention on child cognitive outcomes, and maternal mood. We used the Kaufman Assessment Battery to assess the child cognitive development and the Patient Health Questionnaire (PHQ-9) and the Self-Reporting Questionnaire (SRQ-20) to assess maternal mental health. RESULTS Effect estimates indicated a pattern of null findings for the impact of the intervention on child cognitive development. However, the intervention had an effect on caregiver psychological distress (PHQ-9, ES = -0.17 [CI: -1.95, 0.05] and SRQ-20, ES = -0.30 [CI: -2.41, -0.19]), but not anxiety. The annual cost per mother-child pair to replicate the Thula Sana intervention in 2019 was estimated at ZAR13,365 ($780). CONCLUSION In a socio-economically deprived peri-urban settlement in South Africa, a home visiting intervention, delivered by community workers to mothers in pregnancy and the first six postpartum months, had no overall effect on child cognitive development at 13 years of age. However, those caregivers who were part of the original intervention showed lasting improvements in depressed mood. Despite the fact that there was no intervention effect on long-term child outcomes, the improvements in maternal mood are important.
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Affiliation(s)
- Mark Tomlinson
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa.,School of Nursing and Midwifery, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Sarah Skeen
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group, University of Exeter Medical School, Exeter, UK
| | - Xanthe Hunt
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Chris Desmond
- Priceless, School of Public Health, Wits University, Johannesburg, South Africa
| | - Barak Morgan
- Global Risk Governance Programme, Institute for Safety Governance and Criminology, Law Faculty, University of Cape Town, Cape Town, South Africa
| | - Lynne Murray
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Peter J Cooper
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Sujit D Rathod
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Marguerite Marlow
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Pasco Fearon
- Developmental Neuroscience Unit, University College London, London, UK
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Gunduz‐Bruce H, Takahashi K, Huang M. Development of neuroactive steroids for the treatment of postpartum depression. J Neuroendocrinol 2022; 34:e13019. [PMID: 34462985 PMCID: PMC9285576 DOI: 10.1111/jne.13019] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/22/2021] [Accepted: 07/25/2021] [Indexed: 01/25/2023]
Abstract
Postpartum depression (PPD) is a common major depressive episode surrounding childbirth, with estimated rates ranging from 5.5% to 23.5% of all live births across Europe and the USA based on the presence of key symptoms. PPD has been associated with significant impairments in both maternal functioning and mother-infant attachment, and these impairments can have lasting effects on the emotional and cognitive development of children. Although the precise pathophysiology of PPD is unknown, preclinical findings suggest that large fluctuations in neurosteroid hormone levels can induce physiological plasticity in the expression of functional GABAA receptors during pregnancy and the postpartum period, and that deficits in this plasticity may underpin a biological mechanism that contributes to the manifestation of depressive symptoms. Here, we review the controlled clinical trials to date that have assessed the efficacy of pharmacological treatments for PPD, including oestradiol, selective serotonin reuptake inhibitors, brexanolone (an iv formulation of allopregnanolone) and an investigational neuroactive steroid and GABAA positive allosteric modulator, zuranolone. Coupled with the GABAergic deficits implicated in major depressive disorder, these findings highlight not only the potential role of GABAA receptor plasticity in the pathophysiology of PPD, but also the novel therapeutic approach of using positive allosteric modulators targeting GABAergic transmission to treat women affected by PPD.
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Kohrt BK, Saltiel MM, Rosen EL, Cholotio M. The use of formative research to culturally adapt a psychosocial support program for perinatal Mayan women in Guatemala. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Yang K, Wu J, Chen X. Risk factors of perinatal depression in women: a systematic review and meta-analysis. BMC Psychiatry 2022; 22:63. [PMID: 35086502 PMCID: PMC8793194 DOI: 10.1186/s12888-021-03684-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/29/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Perinatal depression in women is associated with high morbidity and mortality, and has attracted increasing attention. The investigation of risk factors of perinatal depression in women may contribute to the early identification of depressed or depression-prone women in clinical practice. MATERIAL AND METHODS A computerized systematic literature search was made in Cochrane Library, PubMed, Web of Science, and EMBASE from January 2009 to October 2021. All included articles were published in English, which evaluated factors influencing perinatal depression in women. Based on the recommendations of the Cochrane Collaboration protocols, Review Manager 5.3 was used as a statistical platform. RESULTS Thirty-one studies with an overall sample size of 79,043 women were included in the review. Educational level (P = 0.0001, odds ratio [OR]: 1.40, 95% CI: [1.18,1.67]), economic status of families (P = 0.0001, OR: 1.69, 95%CI: [1.29,2.22]), history of mental illness (P < 0.00001, OR: 0.29, 95% CI: [0.18, 0.47]), domestic violence (P < 0.00001, OR: 0.24, 95% CI: [0.17,0.34]), perinatal smoking or drinking (P = 0.005, OR: 0.63; 95% CI [0.45, 0.87]; P = 0.008, OR: 0.43, 95% CI, [0.23 to 0.80]; respectively), and multiparity(P = 0.0003, OR: 0.74, 95% CI: [0.63, 0.87]) were correlated with perinatal depression in women. The stability of our pooled results was verified by sensitivity analysis and publication bias was not observed based on funnel plot results. CONCLUSION Lower educational level, poor economic status of families, history of mental illness, domestic violence, perinatal smoking or drinking, and multiparity serve as risk factors of perinatal depression in women.
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Affiliation(s)
- Kai Yang
- grid.33199.310000 0004 0368 7223Department of Anesthesiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Jing Wu
- grid.33199.310000 0004 0368 7223Department of Anesthesiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Xiangdong Chen
- Department of Anesthesiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430022, China.
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