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Si S, Zhao G, Song G, Liu J. Assisted reproductive technologies and postpartum depressive symptoms: A meta-analysis. J Affect Disord 2024; 356:300-306. [PMID: 38583599 DOI: 10.1016/j.jad.2024.03.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/08/2024] [Accepted: 03/29/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Assisted reproductive technologies (ARTs) have become the main treatment for infertility. ART treatment can be a stressful life event for infertile females. Whether there is an association between ARTs and postpartum depressive symptoms (PDS) has not been established. METHODS PubMed, MEDLINE, EMBASE, PsycINFO, and CNKI were searched. The pooled outcome was the difference in incidence of PDS within 1 year postpartum between ARTs and the spontaneous pregnancy group. RESULTS A total of 12 cohort studies, which were conducted in eight developed countries and two developing countries, were involved. In total, 106,338 pregnant women, including 4990 infertile females with ARTs treatment and 101,348 women with spontaneous pregnancy, were enrolled in our final analysis. ARTs women had a lower incidence of PDS compared to the spontaneous pregnancy group according to a random effect model (OR = 0.83, 95 % CI: 0.71-0.97, p = 0.022, I2 = 62.0 %). Subgroup analyses indicated that studies on late PDS (follow-up: 3-12 months postpartum) were more heterogeneous than those on early PDS (follow-up: <3 months postpartum) (I2 = 24.3 % vs. I2 = 0 %, interaction p-value < 0.001). There was a strong relationship between ARTs and late PDS (OR = 0.65, 95 % CI: 0.55-0.77, p < 0.001). Therefore, the possible source of heterogeneity was the postpartum evaluation time, which was confirmed by post-hoc meta-regression. LIMITATIONS Some underlying confounders, such as previous psychiatric illness, the limited availability of ARTs, and ethnic disparities, cannot be ignored and may have biased interpretation of the results. CONCLUSION The available data suggested that ARTs were associated with lower incidence of PDS, especially when follow-up lasted over 3 months. However, these findings should be interpreted with caution. Better-designed trials are needed to confirm this association.
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Affiliation(s)
- Si Si
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, China
| | - Ge Zhao
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, China
| | - Guang Song
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Liu
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, China.
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Zargar M, Sayyah M, Nikbakht R, Abdipour Z. Comparison of psychological disorders during and after pregnancies caused by assisted reproductive treatments and spontaneous pregnancies. Cent Nerv Syst Agents Med Chem 2023; 23:CNSAMC-EPUB-133742. [PMID: 37592788 DOI: 10.2174/1871524923666230817102216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/24/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Mental disorders during pregnancy are one of the major public health problems because of its effect on both mother and child, but the prevalence of psychiatric disorders in infertile women is largely unknown to compare psychiatric disorders during and after pregnancies with assisted reproductive therapies (ART) and spontaneous pregnancies. METHODS This cross-sectional study was conducted on pregnant women referring to midwifery centers in Ahvaz City in 2022. Pregnant women were included in two groups of either pregnancy caused by ART (n= 84) or spontaneous pregnancy (n= 256). The Symptom Checklist-90-R (SCL90-R) was used to assess psychiatric disorders during and after pregnancies. RESULTS A high percentage of women with spontaneous pregnancy (74.6%) and ART (91.7%) had some degree of psychological disorders. The severity of psychological disorders in both groups was higher during pregnancy than after pregnancy (P<0.001). The intensity of various psychological disorders during and after pregnancy in the ART pregnancy group was significantly higher than the control group (P<0.001). An increased risk of psychiatric disorders during pregnancy was associated with the history of psychiatric disorders [odd ratio (OR): 12.393; P= 0.022], family history of psychiatric disorders (OR:26.168; P<0.001), history of infertility (OR: 19.00; P<0.001), primary infertility (OR: 12.714; P=0.004), infertility duration more than three years (OR: 43.424; P<0.001), and frequency of embryo transfer (OR: 18.939; P=0.045). CONCLUSION Psychiatric disorders were prevalent among pregnant women in the study area especially in pregnant women with ART. Regular screening programs for mental health problem should be included in an antenatal care service especially in this high-risk group.
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Affiliation(s)
- Mahvash Zargar
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center,
Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Sayyah
- Educational Development Center, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roshan Nikbakht
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Abdipour
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Li CC, Hwang JL, Ko YL, Chen HH, Chien LY. Factors associated with postpartum depressive symptoms among women who conceived with infertility treatment. Acta Psychol (Amst) 2023; 238:103987. [PMID: 37467654 DOI: 10.1016/j.actpsy.2023.103987] [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: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023] Open
Abstract
Infertility treatment experiences may accumulate and influence postpartum psychological well-being among women with infertility. However, the association between infertility treatment experiences and postpartum depressive symptoms remained unclear. This cross-sectional survey aimed to describe depressive symptom scores of 180 women, who conceived while undergoing infertility treatment, at 2-6 months after childbirth, and to explore factors, including infertility history and treatment experiences, associated with postpartum depressive symptoms. Data were collected via telephone interviews and patient record reviews. Postpartum depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, with a cutoff score of 10. The prevalence of postpartum depressive symptoms was 34.4 %. Higher perceived stress levels after childbirth than before undergoing infertility treatment, a duration of infertility diagnosis longer than three years, maternal age >35 years, pregnancy conceived through in vitro fertilization (IVF), and experiencing all three lines of infertility treatment, namely ovarian stimulation, intrauterine insemination, and IVF, were associated with a higher risk of postpartum depressive symptoms. Breastfeeding, social support, and baby sex in line with stated preference were negatively associated with postpartum depressive symptoms. There were no significant interactions between the variables. The women's infertility history and treatment experiences were found to have influenced their postpartum depressive symptoms, especially among women who had a long duration of infertility, conceived through IVF, and had received all lines of infertility treatment.
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Affiliation(s)
- Chuan-Chen Li
- Department of Nursing, Fu Jen Catholic University Hospital, New Taipei City, Taiwan; Department of Nursing, Fu Jen Catholic Univeristy, New Taipei City, Taiwan
| | - Jiann-Loung Hwang
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Taipei IVF Center for Reproduction and Genetics, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan
| | - Yi-Li Ko
- Department of Nursing, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - Hung-Hui Chen
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan Univeristy Hospital, Taipei, Taiwan.
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan.
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Arvanitidou O, Kalaitzopoulos DR, Samartzis N, Athanasiadis A, Ierodiakonou-Benou I, Daniilidis A. Is Conception by Means In Vitro Fertilization Associated With Increased Risk of Antenatal Anxiety and Depression? Cureus 2023; 15:e36659. [PMID: 37102038 PMCID: PMC10123385 DOI: 10.7759/cureus.36659] [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] [Accepted: 03/24/2023] [Indexed: 04/28/2023] Open
Abstract
Objectives Mental health during pregnancy is a very important public health issue with negative effects on both maternal and child outcomes. The aim of our study is to examine the possible association between conception via in vitro fertilization (IVF) and anxiety or depression during the third pregnancy trimester in the Greek population during the years of financial crisis. Materials and Methods This single-center prospective cohort study was conducted in a tertiary university hospital during the period 2017-2018. Pregnant women attending the Antenatal Care Program between 30th-32nd gestational week were asked to complete Hamilton Anxiety Rating Scale (HAM-A) and Beck Depression Inventory (BDI). A propensity score match for 10 variables was conducted in a 1:3 ratio. Results Of the 521 eligible patients, 446 women were included in our study. Four hundred fourteen of them conceived spontaneously, and 32 via IVF. After propensity score matching, 76 remained in the analysis, of whom 57 conceived spontaneously and 19 with IVF. The IVF group had a higher rate of anxiety (18.8%) and a lower rate of depression (9.4%) than the spontaneous conception group (13.5% and 13.5%, respectively), but the differences were not statistically significant before and after propensity score matching. Conclusion Our study showed that pregnancies after IVF had a higher incidence of antenatal anxiety and a lower incidence of antenatal depression in comparison to pregnancies that were conceived naturally, although the differences did not reach statistical significance.
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Affiliation(s)
- Olga Arvanitidou
- Third Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | - Nicolas Samartzis
- Department of Gynecology and Obstetrics, Cantonal Hospital Schaffhausen, Schaffhausen, CHE
| | - Apostolos Athanasiadis
- Second Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | - Angelos Daniilidis
- Second Department of Obstetrics and Gynecology, School of Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Barber GA, Steinberg JR. The association between pregnancy intention, fertility treatment use, and postpartum depression. Soc Sci Med 2022; 314:115439. [PMID: 36274452 DOI: 10.1016/j.socscimed.2022.115439] [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: 02/19/2022] [Revised: 07/07/2022] [Accepted: 10/07/2022] [Indexed: 11/18/2022]
Abstract
RATIONALE Understanding whether postpartum depressive (PPD) symptoms vary by pregnancy intention and use of fertility treatments has implications for reproductive health policies and practices. OBJECTIVE The first aim of this study was to determine whether PPD symptoms differ between women who had unintended pregnancies, women who conceived spontaneously and were unsure about their pregnancy intention, women who used fertility treatments to conceive, and women who conceived spontaneously and intentionally. The second aim was to determine whether PPD symptoms differed based on the fertility treatment used to conceive (fertility drugs only, medicated insemination, or assisted reproductive technology [ART]). METHODS Data from the Pregnancy Risk Assessment Monitoring System (2012-2019), a cross-sectional survey administered to women throughout the U.S. who have recently given birth, was used to carry out our aims. RESULTS For the first aim (unweighted N = 243,677), compared to women who had spontaneous, intended pregnancies, women who had unintended pregnancies (OR: 1.32, 95% CI: 1.26-1.39, p < 0.01) and those with spontaneous pregnancies who were unsure about their intention (OR: 1.30, 95% CI: 1.23-1.38, p < 0.01) had higher odds of elevated PPD symptoms, adjusting for a range of covariates. Women who conceived with fertility treatments did not have higher odds of elevated PPD symptoms (OR: 0.97, 95% CI: 0.84-1.10, p = 0.61). For the second aim (unweighted N = 2,210), compared to those in the ART group, those who conceived using only fertility enhancing drugs had greater odds of developing elevated PPD symptoms (OR: 2.00, 95% CI: 1.24-3.24, p < 0.01). CONCLUSIONS These findings suggest that giving birth to an unintended pregnancy in the U.S. increases risk of elevated PPD symptoms. While overall women who conceive with the use of fertility treatments are not at increased risk of experiencing elevated PPD symptoms, there may be variability in risk based on the specific fertility treatments used.
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Affiliation(s)
- Gabriela A Barber
- University of Maryland, College Park, Maternal and Child Health Program, Department of Family Science, USA.
| | - Julia R Steinberg
- University of Maryland, College Park, Maternal and Child Health Program, Department of Family Science, USA
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Gastaldon C, Solmi M, Correll CU, Barbui C, Schoretsanitis G. Risk factors of postpartum depression and depressive symptoms: umbrella review of current evidence from systematic reviews and meta-analyses of observational studies. Br J Psychiatry 2022; 221:591-602. [PMID: 35081993 DOI: 10.1192/bjp.2021.222] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Evidence on risk factors for postpartum depression (PPD) are fragmented and inconsistent. AIMS To assess the strength and credibility of evidence on risk factors of PPD, ranking them based on the umbrella review methodology. METHOD Databases were searched until 1 December 2020, for systematic reviews and meta-analyses of observational studies. Two reviewers assessed quality, credibility of associations according to umbrella review criteria (URC) and evidence certainty according to Grading of Recommendations-Assessment-Development-Evaluations criteria. RESULTS Including 185 observational studies (n = 3 272 093) from 11 systematic reviews, the association between premenstrual syndrome and PPD was the strongest (highly suggestive: odds ratio 2.20, 95%CI 1.81-2.68), followed by violent experiences (highly suggestive: odds ratio (OR) = 2.07, 95%CI 1.70-2.50) and unintended pregnancy (highly suggestive: OR=1.53, 95%CI 1.35-1.75). Following URC, the association was suggestive for Caesarean section (OR = 1.29, 95%CI 1.17-1.43), gestational diabetes (OR = 1.60, 95%CI 1.25-2.06) and 5-HTTPRL polymorphism (OR = 0.70, 95%CI 0.57-0.86); and weak for preterm delivery (OR = 2.12, 95%CI 1.43-3.14), anaemia during pregnancy (OR = 1.47, 95%CI 1.17-1.84), vitamin D deficiency (OR = 3.67, 95%CI 1.72-7.85) and postpartum anaemia (OR = 1.75, 95%CI 1.18-2.60). No significant associations were found for medically assisted conception and intra-labour epidural analgesia. No association was rated as 'convincing evidence'. According to GRADE, the certainty of the evidence was low for Caesarean section, preterm delivery, 5-HTTLPR polymorphism and anaemia during pregnancy, and 'very low' for remaining factors. CONCLUSIONS The most robust risk factors of PDD were premenstrual syndrome, violent experiences and unintended pregnancy. These results should be integrated in clinical algorithms to assess the risk of PPD.
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Affiliation(s)
- Chiara Gastaldon
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; and Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA
| | - Marco Solmi
- Department of Neuroscience, University of Padua, Italy; and Padua Neuroscience Center, University of Padua, Italy
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA; Department of Psychiatry and Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, New York, USA; and Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Germany
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Georgios Schoretsanitis
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA; and Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
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Ohsuga T, Egawa M, Kii M, Ikeda Y, Ueda A, Chigusa Y, Mogami H, Mandai M. Association between nonanemic iron deficiency in early pregnancy and perinatal mental health: A retrospective pilot study. J Obstet Gynaecol Res 2022; 48:2730-2737. [DOI: 10.1111/jog.15397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/07/2022] [Accepted: 08/01/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Takuma Ohsuga
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Miho Egawa
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Misato Kii
- Faculty of Medicine Kyoto University Kyoto Japan
| | - Yumie Ikeda
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
- Department of Health Informatics Kyoto University School of Public Health Kyoto Japan
| | - Akihiko Ueda
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yoshitsugu Chigusa
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Haruta Mogami
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Masaki Mandai
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
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The association between conception history and subsequent postpartum depression and/or anxiety: Evidence from the Clinical Practice Research Datalink 1991-2013. J Affect Disord 2022; 310:266-273. [PMID: 35508205 DOI: 10.1016/j.jad.2022.04.138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Infertility, and fertility treatment, are associated with psychological distress that may influence subsequent mental health including postpartum depression and anxiety. METHODS Data for women who had a livebirth between 1991 and 2013 were drawn from the Clinical Practice Research Datalink. Conception history prior to their first recorded birth was categorised as 'no fertility problems', 'untreated subfertility', ovulation induction (OI), and assisted reproductive technologies (ART). Depression and/or anxiety in the 12 months postpartum were identified using records of diagnoses, symptoms, and prescriptions. Prevalence was compared, and odds ratios estimated using multivariable logistic regression. RESULTS Of 235,127 mothers, 31,947 (13.6%) had evidence of postpartum depression and/or anxiety. Mothers in the ART group had 22% lower odds of postnatal depression and/or anxiety compared to mothers in the fertile group (OR 0.78; 95% CI [0.70-0.86]; p < 0.0001). Accounting for prior mental health, lifestyle, sociodemographic and pregnancy-related factors reduced the strength of the association (aOR 0.87; 95% CI [0.78-0.97]; p = 0.01). There were no significant associations observed in the untreated subfertility or OI groups. LIMITATIONS As in any analysis of routine data, the quality of recording is important and some information was unavailable (e.g. education, social support). CONCLUSIONS Women with a history of subfertility, OI or ART treatment were not at increased risk of postpartum depression and/or anxiety compared to those with no fertility problems. It is important to explore whether women who underwent ART are less likely to experience depression/anxiety or do not seek help when needed, with implications for their health and care.
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Pavlov C, Egan K, Limbers C. Reliability and Validity of the PHQ-8 in First-Time Mothers who Used Assisted Reproductive Technology. Hum Reprod Open 2022; 2022:hoac019. [PMID: 35591921 PMCID: PMC9113338 DOI: 10.1093/hropen/hoac019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/17/2022] [Indexed: 11/19/2022] Open
Abstract
STUDY QUESTION Is the Patient Health Questionnaire-8 (PHQ-8) a valid and reliable measure of depression in first-time mothers who conceived via ART? SUMMARY ANSWER The results from this study provide initial support for the reliability and validity of the PHQ-8 as a measure of depression in mothers who have conceived using ART. WHAT IS KNOWN ALREADY Women who achieved a clinical pregnancy using ART experience many stressors and may be at an increased risk of depression. The PHQ-8 is a brief measure designed to detect the presence and severity of depressive symptoms. It has been validated in many populations; however, it has not been validated for use in this population. STUDY DESIGN, SIZE, DURATION This is a cross-sectional study of 171 first-time mothers in the USA, recruited through Amazon’s Mechanical Turk (MTurk). PARTICIPANTS/MATERIALS, SETTING, METHODS The reliability of the PHQ-8 was measured through a Cronbach’s alpha, the convergent validity was measured through the correlation between the PHQ-8 and the Generalized Anxiety Disorder-7 (GAD-7) measure of anxiety symptoms, and the structural validity was measured through a Confirmatory Factor Analysis. MAIN RESULTS AND THE ROLE OF CHANCE The Cronbach’s alpha for the total PHQ-8 was acceptable (α = 0.922). The correlation between the PHQ-8 and the GAD-7 was large (r = 0.88) indicating good convergent validity. Ultimately, a bifactor model provided the best model fit (χ2(13) = 23.8, P = 0.033; Comparative Fit Index = 0.987; Root Mean Square Error of Approximation = 0.07, Tucker–Lewis Index = 0.972). LIMITATIONS, REASONS FOR CAUTION The results are limited by: the predominantly white and well-educated sample, a lack of causation between the use of artificial reproductive technology and depressive symptoms, including mothers with children up to 5 years old, convergent validity being based on associations with a related construct instead of the same construct, lack of test-retest reliability, divergent validity and criterion-related validity, data collected through MTurk, and the fact that the measures used were all self-report and therefore may be prone to bias. WIDER IMPLICATIONS OF THE FINDINGS Consistent with previous literature, a bifactor model for the PHQ-8 was supported. As such, when assessing depression in first-time mothers who conceived via ART, using both the PHQ-8 total score and subdomain scores may yield the most valuable information. The results from this study provide preliminary support for the reliability and validity of the PHQ-8 as a measure of depression in first-time mothers who conceived using ART. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was used for the completion of this study. Throughout the study period and manuscript preparation, the authors were supported by the department funds at Baylor University. The authors declare that they have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- C Pavlov
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - K Egan
- Peninsula Behavioral Health, Palo Alto, CA 94306, USA
| | - C Limbers
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
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Capuzzi E, Caldiroli A, Ciscato V, Zanvit FG, Bollati V, Barkin JL, Clerici M, Buoli M. Is in vitro fertilization (IVF) associated with perinatal affective disorders? J Affect Disord 2020; 277:271-278. [PMID: 32841828 DOI: 10.1016/j.jad.2020.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/15/2020] [Accepted: 08/08/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Since mothers who undergo in vitro fertilization (IVF) may experience more anxiety and depressive symptoms than mothers who conceive naturally, a review of the literature was conducted to investigate whether IVF may be considered a risk factor for the development of anxiety or depression during pregnancy and post-partum. METHODS A thorough search of articles in Pubmed, PsycINFO and Isi Web of Knowledge was performed in order to produce a comprehensive review regarding the potential association of in vitro fertilization and anxiety/depression. RESULTS The search resulted in a total of 10 articles. Contradictory results were reported in the articles about the possible association between IVF and the occurrence of anxiety and depressive symptoms both during pregnancy and postpartum period. Three studies found that women who resorted to IVF showed less anxiety and depressive symptoms than those who conceived naturally especially with the progression of pregnancy and in the postpartum. LIMITATIONS Vulnerability to affective disorders of women affected by infertility may be independent from the outcome of IVF. Other limits are the limited research in this area, the small sample sizes, the heterogeneity of the tools used to assess affective symptoms. CONCLUSIONS The available data indicate that IVF is not associated with perinatal affective symptoms. Women who resorted to IVF could have less perinatal depressive symptoms as the result of a positive outcome of the technique and the satisfaction of the desire to become mothers. Further studies are necessary in order to draw definitive conclusions about this topic.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Veronica Ciscato
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza (MB), Italy
| | - Francesco Giuseppe Zanvit
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza (MB), Italy
| | - Valentina Bollati
- EPIGET-Epidemiology, Epigenetics and Toxicology Lab-Department of Clinical Sciences and Community Health, University of Milan, 20122, Milan, Italy
| | - Jennifer L Barkin
- Department of Community Medicine, Mercer University School of Medicine, 1550 College Street, Macon, GA 31207, United States
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy; Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza (MB), Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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11
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Perinatal Mood and Anxiety Disorders in Women Undergoing Medically Assisted Reproduction. PSYCHIATRY INTERNATIONAL 2020. [DOI: 10.3390/psychiatryint1020011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Women taking advantage of medically assisted reproduction (MAR) techniques may differ from spontaneously conceiving women (nonMAR) in risk of depression and/or anxiety. We aimed to investigate possible differences between MAR and nonMAR through the use of the Edinburgh Postnatal Depression Scale in a sample of Italian-speaking women at their third trimester of pregnancy. Methods: We administered the Edinburgh Postnatal Depression Scale (EPDS) to two groups of pregnant women, MAR and nonMAR, at the third trimester of pregnancy (T0), one month after delivery (T1), and three months after delivery (T2) from February 2013 to December 2019. EPDS total scores cutoffs were ≥9 for risk of depression, 9–11 mild depression, ≥12 major depression, and the EPDS-3A cluster ≥4 was a proxy for anxiety. Results: Included were 1303 nonMAR women and 92 MAR, an expected disproportion. NonMAR and MAR women did not differ on depression or anxiety at any assessment timepoint. MAR women were older than nonMAR, consumed more alcohol and medical drugs, and displayed more complications during pregnancy. Scoring over the threshold on depression risk was associated with foreign nationality, unemployment, psychiatric history of the patient, family or partner, psychiatric problems in past pregnancies, hyperemesis, premenstrual syndrome (PMS), and stressful life events in the last year at baseline, and, for some of them, at other timepoints. In contrast, MAR past or current was associated with having suprathreshold depression at the first-month postpartum follow-up. Conclusions: Taken together, our data show that women opting for MAR do not differ from spontaneously conceiving women regarding psychiatric outcomes but do differ on some sociodemographic and clinical variables.
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Muruganandam P, Shanmugam D, Ramachandran N. Does the Mode of Conception Influence Early Postpartum Depression? A Prospective Comparative Study from South India. Indian J Psychol Med 2020; 42:525-529. [PMID: 33354077 PMCID: PMC7735233 DOI: 10.1177/0253717620928439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 04/06/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Besides infertility, the treatment associated with it is potentially related to psychological stress to mothers. This study was conducted to know whether the mode of conception has any association with early postpartum depression. METHOD A prospective cohort study was conducted on postnatal mothers at a tertiary care hospital from January to June 2019. The study participants were divided into two groups: postnatal mothers who delivered following spontaneous conception and assisted conception. Basic sociodemographic and obstetric details were collected. Postnatal depression assessment was done at the end of first and sixth week after delivery on all the mothers by using the Edinburgh Postnatal Depression Scale (EPDS). RESULTS In total, 110 subjects (55 in each group) were included in the study. The primary outcome measured was the presence of postpartum depression (EPDS score ≥10). The mean (±SD) age of the participants was 29 ± 6.4 years. The sociodemographic profiles of the two groups were comparable except for mean age, mode of delivery, socioeconomic status, prepregnancy body mass index -the group differences in these variables were statistically significant (P ≤ 0.05). There was no significant difference in the EPDS scores at one week or six weeks of postpartum among the two groups. Comparison of EPDS score among the two groups by Fisher's exact test showed that those mothers with a past history of depression were more likely to have postpartum depression immediately after delivery. CONCLUSION Mode of conception was not associated with an increase in postpartum depression among women who underwent infertility treatment.
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Affiliation(s)
| | - Deepa Shanmugam
- Dept. of Obstetrics & Gynecology, Aarupadai Veedu Medical College, Puducherry, India
| | - Niranjjan Ramachandran
- Dept. of Community Medicine, Aarupadai Veedu Medical College & Hospital, Puducherry, India
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Yoshimasu K, Miyauchi N, Sato A, Yaegashi N, Nakai K, Hattori H, Arima T. Assisted reproductive technologies are slightly associated with maternal lack of affection toward the newborn: The Japan Environment and Children's Study. J Obstet Gynaecol Res 2020; 46:434-444. [PMID: 31944470 DOI: 10.1111/jog.14189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/13/2019] [Indexed: 12/26/2022]
Abstract
AIM To evaluate the association between use of assisted reproductive technology (ART) and mother-to-infant bonding. METHODS Using nationwide birth cohort study with periodical follow-ups for mothers and children during pregnancy and at 1 year after delivery, mothers were classified following three groups; infertility group with ART: 2792 mothers; infertility group with non-ART treatment (ovulation induction and intrauterine insemination): 3835 mothers and unaided pregnancy group: 78 726 mothers. Data on maternal and child health as well as basic characteristics were collected via medical records and self-administered questionnaires. The Japanese version of Mother-to-Infant Bonding Scale was used to evaluate maternal bonding style. To evaluate the association between ART and maternal bonding toward babies, multivariate analysis was used with adjustment for potential confounders such as babies' sex, socio-economic status and history of maternal mental disorders. RESULTS Multivariate logistic regression analysis indicated that ART was slightly but significantly associated with an increased risk of maternal lack of affection toward their newborn (adjusted odds ratio 1.10, 95% confidence interval 1.02-1.20), while non-ART was significantly associated with both maternal lack of affection and anger/rejection toward the newborn. No substantial association was observed between ART and overall Mother-to-Infant Bonding Scale score (adjusted odds ratio 1.03, 95% confidence interval 0.94-1.12). Very slight negative correlations were observed between poor mother-to-infant bonding and good infant mental and physical development at both 6 months and 1 year. CONCLUSION ART may exert a negative influence on maternal emotion after delivery, but this does not have strong correlation with child development evaluated by mothers.
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Affiliation(s)
- Kouichi Yoshimasu
- Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Naoko Miyauchi
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akiko Sato
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kunihiko Nakai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiromitsu Hattori
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
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Tay CT, Teede HJ, Boyle JA, Kulkarni J, Loxton D, Joham AE. Perinatal Mental Health in Women with Polycystic Ovary Syndrome: A Cross-Sectional Analysis of an Australian Population-Based Cohort. J Clin Med 2019; 8:jcm8122070. [PMID: 31775244 PMCID: PMC6947322 DOI: 10.3390/jcm8122070] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/14/2019] [Accepted: 11/22/2019] [Indexed: 12/12/2022] Open
Abstract
Women with polycystic ovary syndrome (PCOS) have many risk factors associated with perinatal mental disorders, but research in this area is scarce. This study aims to compare the prevalence of common perinatal mental disorders in women with and without PCOS, and examine the relationship between PCOS and common perinatal mental disorders. We performed a cross-sectional study on self-reported data of 5239 women born between 1973 to 1978 in the Australian Longitudinal Study on Women’s Health. Compared with women not reporting PCOS, women reporting PCOS had higher prevalence of antenatal depression (8.9% vs. 4.4%, p < 0.001), antenatal anxiety (11.7% vs. 5.6%, p < 0.001), postnatal depression (26.8% vs. 18.6%, p < 0.001) and postnatal anxiety (18.4% vs. 12.0%, p < 0.001). PCOS was positively associated with antenatal depression and/or anxiety (adjusted odds ratio 1.8, 95% confidence interval 1.2–2.6) but not postnatal depression and/or anxiety after controlling for sociodemographic and lifestyle factors, reproductive history, obstetric complications and pre-existing depression and anxiety. General perinatal guidelines currently do not recognize PCOS as a risk factor and the international evidence based PCOS guideline noted inadequate evidence in this area. This paper addresses the gap in literature and highlights the need to screen for common perinatal mental disorders in women with PCOS.
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Affiliation(s)
- Chau Thien Tay
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton VIC 3168, Australia or (C.T.T.); (H.J.T.); (J.A.B.)
- Department of Diabetes and Vascular Medicine, Monash Health, Clayton VIC 3168, Australia
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton VIC 3168, Australia or (C.T.T.); (H.J.T.); (J.A.B.)
- Department of Diabetes and Vascular Medicine, Monash Health, Clayton VIC 3168, Australia
| | - Jacqueline A. Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton VIC 3168, Australia or (C.T.T.); (H.J.T.); (J.A.B.)
| | - Jayashri Kulkarni
- The Monash Alfred Psychiatry Research Centre, Monash University and the Alfred Hospital, Melbourne VIC 3004, Australia;
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Callaghan NSW 2308, Australia;
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton VIC 3168, Australia or (C.T.T.); (H.J.T.); (J.A.B.)
- Department of Diabetes and Vascular Medicine, Monash Health, Clayton VIC 3168, Australia
- Correspondence: ; Tel.: +613-8572-2661
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Amirchaghmaghi E, Malekzadeh F, Chehrazi M, Ezabadi Z, Sabeti SH. A Comparison of Postpartum Depression in Mothers Conceived by Assisted Reproductive Technology and Those Naturally Conceived. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2019; 13:277-281. [PMID: 31710187 PMCID: PMC6875850 DOI: 10.22074/ijfs.2020.5466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/24/2019] [Indexed: 11/23/2022]
Abstract
Background It is thought that mothers who conceive via assisted reproductive technology (ART) may be at greater
risk of postpartum depression (PPD) because of the problems and psychological stresses associated with ART treat-
ment. The aim of the present study is to determine the occurrence of PPD among mothers who conceive by ART in
comparison with mothers who naturally conceive. The Edinburgh Postnatal Depression Scale (EPDS) was used to
assess PPD. Materials and Methods This historical cohort study investigated 406 mothers with infants aged 3-9 months. Three
hundred and eight women with natural pregnancies were selected as the control group from mothers who referred to
Tehran healthcare centres for infant vaccinations. The ART group consisted of 98 women who conceived via ART at
Royan Institute. Participants completed a general questionnaire that asked about education, occupation, number of
children, delivery method, history of infant hospitalization, breastfeeding, mothers’ and infants’ ages, cause of infertil-
ity (ART group), and history of depression. A validated Persian version of the EPDS was used to measure depressive
symptoms. Results The mean EPDS score in mothers who naturally conceived was 8.38 ± 0.35 in comparison with mothers who
conceived via ART (7.59 ± 0.63). The proportions of women who reported PPD were 26.0% for the control group
and 20.4% for the ART group. There was no statistically significant difference in PPD between the control and ART
groups (P=0.26). Conclusion The occurrence of PPD in mothers who conceived via ART was similar to those who conceived naturally.
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Affiliation(s)
- Elham Amirchaghmaghi
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.,Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Farideh Malekzadeh
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.Electronic Address: .,Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Ezabadi
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Medical Education, School of Medicine and Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
| | - S Hokufeh Sabeti
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Association between infertility treatment and perinatal depressive symptoms: A meta-analysis of observational studies. J Psychosom Res 2019; 120:110-117. [PMID: 30929701 DOI: 10.1016/j.jpsychores.2019.03.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/15/2019] [Accepted: 03/16/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Recent reports have shown a considerable number of couples received infertility treatment, raising new concerns about the association between infertility treatment and perinatal depressive symptoms. However, the conclusions of existing studies were inconsistent. Therefore, we conducted a meta-analysis to determine whether infertility treatment increase the risk of developing perinatal depressive symptoms. METHODS A systematic literature search was performed in several databases up to July 2018 for relevant articles. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup and sensitivity analyses were performed to explore possible sources of heterogeneity. RESULTS Twenty-two studies with a total of 69,201 individuals were included in this study. The pooled OR of the association between infertility treatment and perinatal depressive symptoms was 1.01(95% CI: 0.83, 1.23), with substantial heterogeneity (I2 = 63%, P < .001). However, in subgroup analyses, a significantly positive association between infertility treatment and depressive symptoms was observed only in some Asian countries (six studies), and the pooled OR was 1.73 (95% CI:1.07, 2.81). An inverse association was found in 6-12 months after delivery (OR = 0.56, 95% CI:0.33, 0.96). Sensitivity analyses validated evidence of the robustness of the findings. CONCLUSION The results show that women who receive infertility treatment do not appear to be at increased risk of significant perinatal depressive symptoms compared with those after spontaneous conception.
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Somatic symptom disorder manifested as acute abdominal pain during pregnancy preceding perinatal depression: a case report. Arch Womens Ment Health 2019; 22:301-304. [PMID: 29804154 DOI: 10.1007/s00737-018-0863-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/17/2018] [Indexed: 10/16/2022]
Abstract
Somatic symptom disorder (SSD) occurring as abdominal pain during pregnancy can be very difficult to distinguish from physical diseases; prompt diagnosis and appropriate treatment are required. SSD can develop into perinatal depression, which may need intensive psychiatric intervention. Here, we present the first case report of SSD preceding perinatal depression. This case shows the clinical importance of SSD in obstetrics both as a cause of abdominal pain and as a precursor of depression.
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Yoshimasu K, Sato A, Miyauchi N, Tsuno K, Nishigori H, Nakai K, Arima T. Lack of association between receiving ART treatment and parental psychological distress during pregnancy: Preliminary findings of the Japan Environment and Children's Study. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2018; 5:5-16. [PMID: 29774270 PMCID: PMC5952739 DOI: 10.1016/j.rbms.2017.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/06/2017] [Accepted: 09/14/2017] [Indexed: 06/08/2023]
Abstract
In a nationwide population-based birth cohort study in Japan, pregnant women and their partners were evaluated for psychological distress as part of the first and second/third trimester health checks. Participants were divided into three groups: an infertility group receiving assisted reproductive technology (ART) treatment (239 mothers and 151 fathers); an infertility group receiving non-ART treatment (350 mothers and 215 fathers); and a spontaneous pregnancy group (8514 mothers and 5110 fathers). Data on maternal and child health as well as basic characteristics were collected via medical records and self-administered questionnaires. The Kessler Six-item Psychological Distress Scale was employed for eligible women and their partners. Multivariate logistic regression analysis was used to evaluate the association between psychological distress experienced during pregnancy and ART treatment, with adjustment for potential confounders such as basic health status and socio-economic status. The mothers who received ART treatment suffered less psychological distress than the mothers in the other two groups. In multivariate analysis adjusted for background characteristics, no significant association was observed between persistent maternal distress and ART treatment (adjusted odds ratio 0.79, 95% confidence interval 0.49-1.26). Higher socio-economic status among couples receiving ART treatment may explain, in part, the lack of association between ART treatment and parental distress during pregnancy.
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Affiliation(s)
- Kouichi Yoshimasu
- Department of Hygiene, School of Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan
| | - Akiko Sato
- Environment and Genome Research Centre, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Naoko Miyauchi
- Environment and Genome Research Centre, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kanami Tsuno
- Department of Hygiene, School of Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan
| | - Hidekazu Nishigori
- Environment and Genome Research Centre, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Obstetrics and Gynaecology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kunihiko Nakai
- Environment and Genome Research Centre, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Takahiro Arima
- Environment and Genome Research Centre, Tohoku University Graduate School of Medicine, Miyagi, Japan
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Purewal S, Chapman SCE, van den Akker OBA. Depression and state anxiety scores during assisted reproductive treatment are associated with outcome: a meta-analysis. Reprod Biomed Online 2018; 36:646-657. [PMID: 29622404 DOI: 10.1016/j.rbmo.2018.03.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 03/07/2018] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
Abstract
This meta-analysis investigated whether state anxiety and depression scores during assisted reproductive technology (ART) treatment and changes in state anxiety and depression scores between baseline and during ART treatment are associated with treatment outcome. PubMed, PsycInfo, Embase, ScienceDirect, Web of Science and Scopus were searched and meta-analytic data analysed using random effects models to estimate standardized mean differences. Eleven studies (2202 patients) were included. Women who achieved pregnancy had significantly lower depression scores during treatment than women who did not become pregnant (-0.302; 95% CI: -0.551 to -0.054, z = -2.387, P = 0.017; I2 = 77.142%, P = 0.001). State anxiety scores were also lower in women who became pregnant (-0.335; 95% CI: -0.582 to -0.087, z = -2.649, P = 0.008; I2 = 81.339%, P = 0.001). However, changes in state anxiety (d = -0.056; 95% CI: -0.195 to 0.082, z = -0.794; I2 = 0.00%) and depression scores (d = -0.106; 95% CI: -0.296 to 0.085, z = -1.088; I2 = 0.00%) from baseline to treatment were not associated with ART outcome. Clinics should aim to promote better psychosocial care to help patients manage the psychological and physical demands of ART treatment, giving realistic expectations.
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Affiliation(s)
- Satvinder Purewal
- Institute of Psychology, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1AD, UK.
| | - Sarah C E Chapman
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down Road, Bath, BA2 7AY, UK
| | - Olga B A van den Akker
- Department of Psychology, Faculty of Science and Technology, Middlesex University, London, NW4 4BT, UK
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Gambadauro P, Iliadis S, Bränn E, Skalkidou A. Conception by means of in vitro fertilization is not associated with maternal depressive symptoms during pregnancy or postpartum. Fertil Steril 2017; 108:325-332. [DOI: 10.1016/j.fertnstert.2017.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/04/2017] [Accepted: 06/06/2017] [Indexed: 12/16/2022]
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Tendais I, Figueiredo B. Parents’ anxiety and depression symptoms after successful infertility treatment and spontaneous conception: does singleton/twin pregnancy matter? Hum Reprod 2016; 31:2303-12. [DOI: 10.1093/humrep/dew212] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 08/01/2016] [Indexed: 12/25/2022] Open
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van den Akker O, Postavaru GI, Purewal S. Maternal psychosocial consequences of twins and multiple births following assisted and natural conception: a meta-analysis. Reprod Biomed Online 2016; 33:1-14. [PMID: 27156004 DOI: 10.1016/j.rbmo.2016.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/14/2016] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
Abstract
The aim of this meta-analysis is to provide new evidence on the effects on maternal health of multiple births due to assisted reproductive technology (ART). A bibliographic search was undertaken using PubMed, PsycINFO, CINAHL and Science Direct. Data extraction was completed using Cochrane Review recommendations, and the review was performed following PRISMA and MOOSE guidelines. Meta-analytic data were analysed using random effects models. Eight papers (2993 mothers) were included. Mothers of ART multiple births were significantly more likely to experience depression (standardized mean difference [SMD] d = 0.198, 95% CI 0.050 - 0.345, z = 2.623, P = 0.009; heterogeneity I(2) = 36.47%), and stress (SMD d = 0.177, 95% CI 0.049 - 0.305, P = 0.007; heterogeneity I(2) = 0.01%) than mothers of ART singletons. No difference in psychosocial distress (combined stress and depression) (SMD d = 0.371, 95% CI -0.153 - 0.895; I(2) = 86.962%, P = 0.001) or depression (d = 0.152, 95% CI -0.179 - 0.483: z = 0.901; I(2) = 36.918%) were found between mothers of ART and naturally conceived multiple births. In conclusion, mothers of ART multiple births were significantly more likely to have depression and stress than mothers of ART singletons, but were no different from mothers of naturally conceived multiples.
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Affiliation(s)
- Olga van den Akker
- Department of Psychology, School of Science and Technology, Middlesex University, Hendon, London, NW44BT, UK.
| | - Gianina-Ioana Postavaru
- Centre for Sustainable Working Life, Birkbeck, University of London, Malet Street, Bloomsbury, London, WC1E 7HX, UK
| | - Satvinder Purewal
- Institute of Psychology, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1AD, UK
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