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Nechaeva E, Kharkova O, Postoev V, Grjibovski AM, Darj E, Odland JØ. Awareness of postpartum depression among midwives and pregnant women in Arkhangelsk, Arctic Russia. Glob Health Action 2024; 17:2354008. [PMID: 38828500 PMCID: PMC11149570 DOI: 10.1080/16549716.2024.2354008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Postpartum depression (PPD) affects approximately 17% of the women worldwide with nearly half of all cases going undetected. More research on maternal mental health, particularly among healthcare professionals and pregnant mothers, could help identify PPD risks and reduce its prevalence. OBJECTIVE Given that awareness of PPD is a crucial preventive factor, we studied PPD awareness among midwives and pregnant women in Arkhangelsk, Arctic Russia. METHODS A qualitative study was conducted using in-depth semi-structured interviews. Midwives and pregnant women were recruited from the women's clinic of the Arkhangelsk municipal polyclinic. Seven midwives and 12 pregnant mothers were interviewed. RESULTS Midwives described limited time for psychological counselling of pregnant women; they reported that their primary focus was on the physiological well-being of women. Pregnant women have expressed a desire for their families to share responsibilities. The participants considered PPD as a mix of psychological and physiological symptoms, and they also highlighted a discrepancy between the expectations of pregnant women and the reality of motherhood. The present study underscored the limited understanding of PPD identification. CONCLUSIONS The findings suggest that there is a need for increased awareness among midwives and pregnant women regarding PPD. Prevention programs targeting PPD with a specific emphasis on enhancing maternal mental health knowledge are warranted.
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Affiliation(s)
- Elena Nechaeva
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Olga Kharkova
- Department of Pedagogy and Psychology, Northern State Medical University, Arkhangelsk, Russia
| | - Vitaly Postoev
- Department of Public Health, Health Care and Social Work, Northern State Medical University, Arkhangelsk, Russia
| | - Andrej M. Grjibovski
- Department of Health Policy and Management, Al-Farabi Kazakh National University, Almaty, Kazakhstan
- Department of Epidemiology and Modern Vaccination Technologies, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia
| | - Elisabeth Darj
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Jon Øyvind Odland
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of General Hygiene, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Roy SK, Majumdar S, Singh R, Paul A. Prevalence and risk factors of depressive symptoms in the postpartum period: An experience from urban West Bengal, India. J Family Med Prim Care 2024; 13:2880-2885. [PMID: 39228561 PMCID: PMC11368309 DOI: 10.4103/jfmpc.jfmpc_1050_23] [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: 06/24/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 09/05/2024] Open
Abstract
Introduction Postpartum depression (PPD) is a form of depression that affects new mothers within the first year after childbirth. PPD can negatively impact both the mother's quality of life and the child's development. Untreated PPD can lead to adverse outcomes, such as infant growth retardation, poor child survival, impaired development, and undernutrition. The burden of PPD is a significant public health concern, with a global prevalence increase of 18.4% from 2005 to 2015. Early detection and intervention of PPD can mitigate the severity and chronicity of symptoms. Aims This study aimed to determine the prevalence of PPD among mothers in an urban area of Kolkata and identify any influencing factors. Materials and Methods The study utilized a cross-sectional design, surveying 189 mothers within the postpartum period of 6 weeks to 1 year. Edinburg Postnatal Depression Scale was used to identify possible PPD. Results About 29% of the women had probable PPD, 19% had possible depression, and 15% had no depression. Factors associated with depression included low birth weight and primiparity, while financial independence served as a protective factor. Multinomial regression analysis revealed that low-birth-weight babies, marital conflict, lack of support at home, and primiparity had higher odds of depression, whereas financial independence was a protective factor. Age was not statistically significant. Conclusion A high prevalence of PPD and significant associations with factors emphasized the importance of screening all mothers for PPD, providing medical care and counselling, and ensuring acceptance and support from partners, family, and society.
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Affiliation(s)
- Sunetra K. Roy
- Department of Community Medicine, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Sukanta Majumdar
- Department of Community Medicine, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Rashmi Singh
- Department of Community Medicine, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Avijit Paul
- Department of Community Medicine, Calcutta National Medical College, Kolkata, West Bengal, India
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Ravaldi C, Mosconi L, Crescioli G, Lombardo G, Russo I, Morese A, Ricca V, Vannacci A. Are midwives trained to recognise perinatal depression symptoms? Results of MAMA (MAternal Mood Assessment) cross-sectional survey in Italy. Arch Womens Ment Health 2024; 27:567-576. [PMID: 38308142 PMCID: PMC11230996 DOI: 10.1007/s00737-024-01439-z] [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: 09/06/2023] [Accepted: 01/29/2024] [Indexed: 02/04/2024]
Abstract
PURPOSE To assess the knowledge, clinical experience, and attitudes of Italian midwives toward perinatal depression (PND) and to explore how these factors impact the quality of care. METHODS We conducted a cross-sectional online survey among 152 midwives employed in public hospitals across Italy. The questionnaire covered a range of topics, including demographic data, professional experience, knowledge of PND symptoms, risk factors, and clinical management, as well as communication skills and personal experiences with PND cases. RESULTS A concerning 76.3% of midwives displayed inadequate knowledge of PND based on current scientific literature. Those with a more comprehensive understanding were notably more confident in their practice, expressing significantly fewer apprehensions about communicating with mothers (25.8% vs 74.2%) and lesser concerns about the mothers' future well-being (38.9% vs 62.95%). The survey results also emphasised the midwives' call for specialised guidelines and formal training in PND management and underscored the value of communication skills, continuity of care, and family engagement in supporting affected mothers. CONCLUSION This inaugural study sheds light on the current state of knowledge and attitudes among Italian midwives regarding PND. It pinpoints crucial areas for educational enhancement and practice improvement, suggesting that elevated levels of midwife expertise in PND could significantly elevate the standard of care and expedite early diagnosis and treatment.
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Affiliation(s)
- Claudia Ravaldi
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Laura Mosconi
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Giada Crescioli
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - Giulia Lombardo
- Unit of Obstetrics and Gynecology, Parma University Hospital, Parma, Italy
| | - Ilenia Russo
- Unit of Obstetrics and Gynecology, "S. Marta E S. Verera" Hospital, ASP Catania, Acireale, Italy
| | - Angelo Morese
- Section of Pediatrics, Obstetrics and Gynecology and Nursing, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Section of Psychiatry, Department of Health Sciences, University of Florence, Florence, Italy
| | - Alfredo Vannacci
- PEARL Perinatal Research Laboratory, CiaoLapo Foundation, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy.
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Hong L, Yang A, Liang Q, He Y, Wang Y, Tao S, Chen L. Wife-Mother Role Conflict at the Critical Child-Rearing Stage: A Machine-Learning Approach to Identify What and How Matters in Maternal Depression Symptoms in China. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:699-710. [PMID: 37897552 DOI: 10.1007/s11121-023-01610-5] [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: 10/17/2023] [Indexed: 10/30/2023]
Abstract
Maternal depression (MD) was one of the most prevalent psychiatric problems worldwide. However, it easily remains untreated and misses the best time to prevent the emergence or worsening of major depressive symptoms due to under-observed stigma and the lack of effective screening tools. Thus, this study aims to develop and validate a machine learning-based MD symptoms prediction model integrating more observable and objective factors to early detect and monitor MD risk. A cross-sectional study was conducted in 10 community vaccination centers in Wenzhou, China, and a total of 1099 mothers were surveyed by using purposive sampling. A questionnaire containing questions regarding socio-demographic variables, psychophysiological variables, wife role-related variables, and mother role-related variables was used to collect data. A framework of data preprocessing, feature selection, and model evaluation was implemented to develop an optimal risk prediction model. Results demonstrated that the XG-Boost algorithm provided robust performance with the highest AUC and well-balanced sensitivity and specificity (AUC = 0.90, sensitivity = 0.74, specificity = 0.90). Furthermore, the causal mediation analysis indicated that wife-mother role conflict positively predicted MD symptoms, and it also exerted influence on mothers suffering through the mediation of anxiety and insomnia. Findings from the present study may help guide the development of MD screening tools to early detect and provide the modifiable risk factor information for timely tailored prevention.
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Affiliation(s)
- Liuzhi Hong
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Ai Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Qi Liang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yuhan He
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yulin Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Shuhan Tao
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Li Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, 325035, China.
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Younis AS, Julaidan GS, Alsuwaylimi RA, Almajed BM, AlShammari RT, AlFirm RB, Alfarra LA. Prevalence of Paternal Prenatal Depression and Its Associated Factors in Saudi Arabia. Risk Manag Healthc Policy 2024; 17:1083-1092. [PMID: 38707520 PMCID: PMC11067918 DOI: 10.2147/rmhp.s454926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/20/2024] [Indexed: 05/07/2024] Open
Abstract
Background Paternal prenatal depression affects not only the fathers but also their spouses and children's future lives. Many socioeconomic and cultural factors affect the probability of paternal depression. Little is known about the prevalence of and factors associated with paternal prenatal depression in the Middle East. Aim To estimate the prevalence of paternal prenatal depression among fathers visiting a tertiary university hospital, as well as to determine the factors associated with paternal prenatal depression within study participants. Methods This analytical cross-sectional study included 442 fathers whose wives were pregnant and were undergoing regular assessments at antenatal clinics in a tertiary university hospital in Riyadh, Saudi Arabia. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess paternal depression. Bivariate and multivariate analyses were performed. Results The prevalence of paternal prenatal depression was 26.9%. It was correlated with smoking (odds ratio (OR)=1.8, p=0.006), maternal depression (OR=4.59, p<0.001), and experiencing isolation (OR=5.34, p<0.001). The odds of paternal prenatal depression decreased with social support from friends and family (OR=0.227 and 0.133, respectively) and p<0.001. Discussion and Conclusion Paternal prenatal depression was prevalent within the study participants. Notably, experiences of isolation and maternal depression emerged as prominent factors that were significantly associated with the manifestation of paternal depression. Consequently, it becomes imperative to implement systematic depression screenings for expectant fathers and to meticulously consider the array of the factors associated with paternal depression.
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Affiliation(s)
- Afnan S Younis
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | - Renad B AlFirm
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Lena A Alfarra
- Department of Obstetrics and Gynecology, King Saud University Medical City, Riyadh, Saudi Arabia
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Landman A, Ngameni EG, Dubreucq M, Dubreucq J, Tebeka S, Dubertret C. Postpartum blues: a predictor of postpartum depression, from the IGEDEPP Cohort. Eur Psychiatry 2024; 67:e30. [PMID: 38555958 PMCID: PMC11059245 DOI: 10.1192/j.eurpsy.2024.1741] [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: 01/28/2024] [Revised: 03/16/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND To identify the different factors associated with postpartum blues and its association with postpartum depression, from a large French cohort. METHODS We conducted an analysis of the Interaction Gene Environment in Postpartum Depression cohort, which is a prospective, multicenter cohort including 3310 women. Their personal (according to the Diagnostic and Statistical Manual, fifth edition [DSM-5]) and family psychiatric history, stressful life events during childhood, pregnancy, and delivery were collected. Likewise, the French version of the Maternity Blues Scale questionnaire was administered at the maternity department. Finally, these women were assessed at 8 weeks and 1 year postpartum by a clinician for postpartum depression according to DSM-5 criteria. RESULTS The prevalence of postpartum blues in this population was 33%, and significant factors associated with postpartum blues were found as personal (aOR = 1.2) and family psychiatric history (aOR = 1.2), childhood trauma (aOR = 1.3), obstetrical factors, or events related to the newborn, as well as an experience of stressful life events during pregnancy (aOR = 1.5). These factors had a cumulative effect, with each additional factor increasing the risk of postpartum blues by 31%. Furthermore, adjustment for sociodemographic measures and history of major depressive episode revealed a significant association between postpartum blues and postpartum depression, mainly at early onset, within 8 weeks after delivery (aOR = 2.1; 95% CI = 1.6-2.7), but also at late onset (aOR = 1.4; 95% CI = 1.1-1.9), and mainly if the postpartum blues is severe. CONCLUSION These results justify raising awareness among women with postpartum blues, including reassurance and information about postpartum depression, its symptomatology, and the need for management in case of worsening or prolongation of postpartum blues.
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Affiliation(s)
- Alexandra Landman
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, Colombes, France
| | | | - Marine Dubreucq
- Centre Referent de Rehabilitation Psychosociale, GCSMS REHACOOR 42, Saint-Étienne, France
- INSERM U1290 (Research on Healthcare Performance (RESHAPE)), University Lyon 1, Lyon, France
| | - Julien Dubreucq
- Department of Child and Adolescent Psychiatry, University Hospital of Saint-Étienne, Saint-Priest-en-Jarez, France
- CNRS 5229 (Institute of Cognitive Neuroscience), University Lyon 1, Lyon, France
| | | | - Sarah Tebeka
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, Colombes, France
- Institute of Psychiatry and Neuroscience of Paris (IPNP), Université Paris Cité, INSERM U1266, Team 1, Paris75014, France
| | - Caroline Dubertret
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, Colombes, France
- Institute of Psychiatry and Neuroscience of Paris (IPNP), Université Paris Cité, INSERM U1266, Team 1, Paris75014, France
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Tan DJA, Sultana R, Chow SYX, Tan CW, Tan HS, Chen HY, Chua TE, Sng BL. Investigating Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Validation Cohort Study. Neuropsychiatr Dis Treat 2024; 20:439-447. [PMID: 38439945 PMCID: PMC10910974 DOI: 10.2147/ndt.s448853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/16/2024] [Indexed: 03/06/2024] Open
Abstract
Purpose This study aimed to validate a proposed association model previously published to determine the clinical relevance of pre-operative determinants in the development of PND after Cesarean delivery (CD). Patients and Methods Parturients undergoing elective CD under neuraxial anesthesia were recruited for a prospective cohort study between Oct 2021 and Oct 2022 at KK Women's and Children's Hospital, Singapore. Predelivery pain, psychological and mechanical temporal summation, and demographic data were recorded. A follow-up survey was conducted at 6 to 10 weeks after CD. The primary outcome was the incidence of PND, defined as an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10. Results A total of 180 patients were recruited for validation. PND 6 to 10 weeks post-delivery occurred in 18.9% of recruited parturients. Multivariate regression analyses showed that higher pre-operative CSI scores (p=0.0156), higher anxiety levels about upcoming surgery (p=0.0429), increased pre-operative pain scores on movement (p=0.0110), and higher pre-operative HADS subscale scores on anxiety (p=0.0041) were independently associated with the development of PND weeks post-CD. Lower anticipation of pain medication needs (p=0.0038) was independently associated with the development of PND post-CD. The area under curve (AUC) of this multivariable model (training cohort), internal cross validation (training cohort) and external cross validation (validation cohort) were 0.818 (95% CI, 0.746 to 0.889), 0.785 (95% CI, 0.707 to 0.864) and 0.604 (95% CI, 0.497 to 0.710) respectively. Conclusion The proposed model performed well in a local population. Further refinement is necessary to test the proposed model in populations with social and cultural differences.
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Affiliation(s)
- Daryl Jian An Tan
- Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | | | - Chin Wen Tan
- Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore, Singapore
- Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Hon Sen Tan
- Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore, Singapore
- Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Helen Yu Chen
- Department of Psychological Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
- Paediatrics Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Tze-Ern Chua
- Department of Psychological Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
- Paediatrics Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Ban Leong Sng
- Department of Women’s Anesthesia, KK Women’s and Children’s Hospital, Singapore, Singapore
- Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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Castro J, Gigase FAJ, Molenaar NM, Ibroçi E, Perez-Rodriguez MM, Lieb W, Janevic T, de Witte LD, Bergink V, Rommel AS. Increased postpartum anxiety symptoms after perinatal SARS-CoV-2 infection in a large, prospective pregnancy cohort in New York City. J Psychiatr Res 2024; 170:130-137. [PMID: 38134722 PMCID: PMC10905645 DOI: 10.1016/j.jpsychires.2023.12.020] [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: 06/23/2023] [Revised: 11/15/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
Numerous studies reported an increase of postpartum mood symptoms during the COVID-19 pandemic. Yet, the link between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and perinatal mental health is less well understood. We investigated the associations between prenatal SARS-CoV-2 infection and postpartum depressive and anxiety symptoms, including examinations of infection timing and pandemic timeline. We included 595 participants from Generation C, a prospective pregnancy cohort in New York City (2020-2022). Prenatal SARS-CoV-2 infection was determined via laboratory or medical diagnosis. Depression and anxiety symptoms were measured 4-12 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder questionnaire (GAD), respectively. Quantile regressions were conducted with prenatal SARS-CoV-2 infection as exposure and continuously measured EPDS and GAD scores as outcomes. We reran the analyses in those with COVID-19-like symptoms in the trimester during which infection occurred. 120 (20.1%) participants had prenatal SARS-CoV-2 infection. After adjusting for socio-demographic, obstetric and other maternal health factors, prenatal SARS-CoV-2 infection was associated with higher median postpartum anxiety scores (b = 0.55, 95% CI = 0.15; 0.96). Late gestation infection (b = 1.15, 95% CI = 0.22; 2.09) and symptomatic infection (b = 1.15, 95% CI = 0.12; 2.18) were also associated with higher median postpartum anxiety scores. No associations were found with depressive symptoms. The associations were not moderated by time since the start of the pandemic. This study suggests that prenatal SARS-CoV-2 infection increases the risk of postpartum anxiety symptoms among participants reporting median anxiety symptoms. Given that this association was not affected by pandemic timing and that SARS-CoV-2 transmission continues, individuals infected with SARS-CoV-2 during pregnancy should be monitored for postpartum anxiety symptoms.
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Affiliation(s)
- Juliana Castro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Frederieke A J Gigase
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Nina M Molenaar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Erona Ibroçi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | | | - Whitney Lieb
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Teresa Janevic
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Lot D de Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Anna-Sophie Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
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Shebelsky R, Sadi W, Heesen P, Aber RN, Fein S, Iluz-Freundlich D, Shmueli A, Azem K, Radyan Tamayev I, Binyamin Y, Orbach-Zinger S. The relationship between postpartum pain and mother-infant bonding: A prospective observational study. Anaesth Crit Care Pain Med 2024; 43:101315. [PMID: 37865216 DOI: 10.1016/j.accpm.2023.101315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023]
Abstract
INTRODUCTION Postpartum pain is associated with impaired maternal recovery and may influence mother-infant bonding. METHODS Participants who underwent a vaginal or cesarean delivery were assessed 24 h postpartum. Postpartum pain intensity was measured using the Verbal Numeric Score (VNS) (0-10) and classified as non-severe (<8) or severe pain (≥8). Maternal-infant bonding was evaluated using the Post-Partum Bonding Questionnaire (PBQ; 0-125), with a score > 5 defining impaired bonding. Demographic data included age, BMI, parity, education level, economic status, partnership, prior history of depression, familial history of depression, desire to breastfeed, epidural analgesia during labor, rooming in, and Edinburgh Postnatal Depression Scale (EPDS). Data were analyzed using 2 separate multivariable logistic regression models for vaginal and cesarean deliveries, where maximum postpartum pain was the independent variable and impaired postpartum bonding was the dependent variable and controlled for the other factors collected. RESULTS Severe postpartum pain (VNS ≥ 8) showed no significant relationship with impaired bonding when controlling for confounding variables. In vaginal deliveries, there was an association between a history of depression and impaired bonding (Odds Ratio 2.2 [1.07-4.65], p = 0.04) and EPDS > 10 and impaired bonding (OR 11.5 [3.2-73.6], p < 0.001). For cesarean deliveries, rooming in with the baby had a protective effect (OR 11.5 [3.2-73.6], p < 0.001). CONCLUSIONS Contrary to expectations, severe postpartum pain did not influence maternal-infant binding in the cohort of patients with vaginal and cesarean deliveries. Instead, factors such as maternal mental health and rooming-in practices appeared to exert more significant influence. CLINICAL TRIAL REGISTRATION NCT05206552.
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Affiliation(s)
- Rostislav Shebelsky
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Wadeea Sadi
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | | | - Rachel N Aber
- Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Shai Fein
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Iluz-Freundlich
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Anat Shmueli
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Karam Azem
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Inbar Radyan Tamayev
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Yair Binyamin
- Department of Anesthesiology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Sharon Orbach-Zinger
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
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Piper JA, Musumeci G, Castorina A. The Neuroanatomy of the Habenular Complex and Its Role in the Regulation of Affective Behaviors. J Funct Morphol Kinesiol 2024; 9:14. [PMID: 38249091 PMCID: PMC10801627 DOI: 10.3390/jfmk9010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/13/2023] [Accepted: 12/31/2023] [Indexed: 01/23/2024] Open
Abstract
The habenular complex is a diencephalic structure divided into the medial and lateral divisions that lie within the epithalamus of most vertebrates. This brain structure, whose activities are mainly regulated via inputs/outputs from and to the stria medullaris and the fasciculus retroflexus, plays a significant role in the modulation of anti-reward behaviors in both the rodent and human brain. Such anti-reward circuits are regulated by dopaminergic and serotonergic projections with several other subcortical and cortical regions; therefore, it is plausible that impairment to this key subcortical structure or its connections contributes to the pathogenesis of affective disorders. Current literature reveals the existence of structural changes in the habenula complex in individuals afflicted by such disorders; however, there is a need for more comprehensive investigations to elucidate the underlying neuroanatomical connections that underpin disease development. In this review article, we aim to provide a comprehensive view of the neuroanatomical differences between the rodent and human habenular complex, the main circuitries, and provide an update on the emerging roles of this understudied subcortical structure in the control of affective behaviors, with special emphasis to morbid conditions of the affective sphere.
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Affiliation(s)
- Jordan Allan Piper
- School of Health Sciences, College of Health and Medicine, University of Tasmania (Sydney), Sydney, NSW 2040, Australia;
- Laboratory of Cellular & Molecular Neuroscience (LCMN), School of Life Sciences, Faculty of Science, University of Technology Sydney, P.O. Box 123, Sydney, NSW 2007, Australia
| | - Giuseppe Musumeci
- Department of Biomedical & Biotechnological Sciences, Anatomy, Histology & Movement Sciences, University of Catania, 95123 Catania, Italy;
| | - Alessandro Castorina
- Laboratory of Cellular & Molecular Neuroscience (LCMN), School of Life Sciences, Faculty of Science, University of Technology Sydney, P.O. Box 123, Sydney, NSW 2007, Australia
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11
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Mulugeta Y, Mohammed AA, Ibrahim IM, Getachew G, Ahmed KY. Postpartum depression and associated factors in Afar Region, northeast Ethiopia. Heliyon 2023; 9:e19914. [PMID: 37809513 PMCID: PMC10559328 DOI: 10.1016/j.heliyon.2023.e19914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/11/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Background To effectively address the burden of postpartum depression (PPD), it is crucial to gain a comprehensive understanding of its magnitude and the factors associated with it in the pastoral and hot region of the Afar Region. This will help identify the progress made thus far and highlight areas that require further attention to accelerate efforts toward reducing the impact of PPD. Notably, no previous study has examined the prevalence and associated factors of PPD specifically in pastoral communities within Ethiopia, including the Afar Region. Accordingly, we investigated the prevalence and associated factors of PPD among postpartum women in the Afar Region, Northeast Ethiopia. Methods An institution-based cross-sectional study was conducted in the Awsi Rasu Zone of Afar Regional State from June to July 2021. The study employed a systematic random sampling method to select a total of 302 postpartum mothers who had visited the Expanded Program of Immunisation (EPI) clinics in public health facilities within the Awsi Rasu Zone of the Afar Region. The measurement of PPD was performed using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable binary logistic regression modelling was used to investigate associations between sociodemographic, obstetric and health service, and psychosocial factors with PPD. Results The overall prevalence of PPD was 37.4% with a 95% confidence interval (CI) from 32.0% to 43.0%. Postpartum women who attained high school education were associated with a lower odds of PPD compared to those who did not attain formal schooling (adjusted odds ratio [AOR] = 0.31; 95% CI: 0.12, 0.82). Postpartum women with a family history of mental illness (AOR = 2.34; 95% CI: 1.24, 4.41), those who had trouble in infant feeding (AOR = 4.26; 95% CI: 2.32, 7.83), and those who experienced intimate partner violence (AOR = 3.09; 95% CI: 1.58, 6.04) were positively associated with PPD. Conclusion The results of our study revealed that the prevalence of PPD in the Awsi Rasu Zone of the Afar Region is higher than both the national and global averages. The findings also highlighted the need for targeted interventions addressing the needs of pastoral postpartum women who experience various stressors, such as feeding difficulties and intimate partner violence.
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Affiliation(s)
| | - Ahmed Adem Mohammed
- Department of Nursing, College of Medicine and Health Science, Samara University, PO Box: 132, Samara, Ethiopia
| | - Ibrahim Mohammed Ibrahim
- Department of Midwifery, College of Medicine and Health Science, Samara University, PO Box: 132, Samara, Ethiopia
| | | | - Kedir Y. Ahmed
- Department of Public Health, College of Medicine and Health Science, Samara University, PO Box: 132, Samara, Ethiopia
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
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12
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Scala M, Fanelli G, De Ronchi D, Serretti A, Fabbri C. Clinical specificity profile for novel rapid acting antidepressant drugs. Int Clin Psychopharmacol 2023; 38:297-328. [PMID: 37381161 PMCID: PMC10373854 DOI: 10.1097/yic.0000000000000488] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Abstract
Mood disorders are recurrent/chronic diseases with variable clinical remission rates. Available antidepressants are not effective in all patients and often show a relevant response latency, with a range of adverse events, including weight gain and sexual dysfunction. Novel rapid agents were developed with the aim of overcoming at least in part these issues. Novel drugs target glutamate, gamma-aminobutyric acid, orexin, and other receptors, providing a broader range of pharmacodynamic mechanisms, that is, expected to increase the possibility of personalizing treatments on the individual clinical profile. These new drugs were developed with the aim of combining a rapid action, a tolerable profile, and higher effectiveness on specific symptoms, which were relatively poorly targeted by standard antidepressants, such as anhedonia and response to reward, suicidal ideation/behaviours, insomnia, cognitive deficits, and irritability. This review discusses the clinical specificity profile of new antidepressants, namely 4-chlorokynurenine (AV-101), dextromethorphan-bupropion, pregn-4-en-20-yn-3-one (PH-10), pimavanserin, PRAX-114, psilocybin, esmethadone (REL-1017/dextromethadone), seltorexant (JNJ-42847922/MIN-202), and zuranolone (SAGE-217). The main aim is to provide an overview of the efficacy/tolerability of these compounds in patients with mood disorders having different symptom/comorbidity patterns, to help clinicians in the optimization of the risk/benefit ratio when prescribing these drugs.
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Affiliation(s)
- Mauro Scala
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
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13
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Henry LM, Manian N, Esposito G, Bornstein MH. The Home Environments of Infants of Mothers with Early, Remitted Clinical Depression and No Depression during the First Two Years Postpartum. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1471. [PMID: 37761432 PMCID: PMC10528664 DOI: 10.3390/children10091471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 09/29/2023]
Abstract
The current study examines stability, continuity, and group and gender differences in the home environments of infants of mothers with early, remitted clinical depression and no postpartum depression, overcoming methodological variations in the extant literature. Fifty-five mothers diagnosed with clinical depression (major or minor depression, dysthymia, or depressive disorder not otherwise specified) at 5 months and fully remitted by 15 and 24 months, and 132 mothers with no postpartum depression (Mage = 32.47; 69.7% European American) completed the Home Observation for Measurement of the Environment (HOME) Inventory Infant/Toddler version when their infants were 15 and 24 months old. No differences in stability estimates of the HOME scales were found between the groups. In terms of continuity, controlling for maternal education and infant birth order, HOME responsivity, involvement, and total score decreased, while HOME acceptance increased between 15 and 24 months in the full sample. There were no effects of group or gender. Results may point to the home environment as a key protective factor for infants of mothers with early, remitted clinical depression, or findings may suggest improved maternal parenting cognitions and practices following remission.
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Affiliation(s)
- Lauren M. Henry
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA;
| | - Nanmathi Manian
- Westat, Rockville, MD 20850, USA;
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy;
| | - Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA;
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Nguyen HTH, Hoang PA, Do TKL, Taylor-Robinson AW, Nguyen TTH. Postpartum depression in Vietnam: a scoping review of symptoms, consequences, and management. BMC Womens Health 2023; 23:391. [PMID: 37496038 PMCID: PMC10369808 DOI: 10.1186/s12905-023-02519-5] [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: 11/01/2022] [Accepted: 06/30/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a major health issue that can affect both mothers and their newborn children. In Vietnam, approximately 20% of mothers suffer from PPD. However, there is a lack of synthesized evidence regarding the case management of PPD in the Vietnamese context. A review of early symptoms, consequences, and management strategies of PPD will help to inform best practices to reduce complications and shorten the recovery time after parturition. METHODS This scoping review aims to analyze and synthesize the findings of studies on PPD examining the symptoms, consequences, and management strategies among Vietnamese women. MEDLINE, CINAHL, PubMed, ScienceDirect, EBSCOHost, Google Scholar, and a networked digital library of projects, theses, and dissertations published between 2010 and 2022 in Vietnam were accessed following search terms including "Vietnam", "depression", "postpartum", "symptom/experience", "consequence", and "management". FINDINGS The most-reported symptoms were sadness, tiredness, the feeling of being ignored, lack of interest in the baby, reduced appetite, and sleep disturbance. The recognized consequences were child stunting and slow growth, without mentioning its long-term effects on mothers. Our findings indicated that PPD in Vietnam has not been sufficiently managed; mothers tend to seek help from 'fortune-tellers' or 'word-of-mouth' practices rather than from evidence-based modern medicine. CONCLUSION This scoping review provides an initial stage of PPD symptoms, consequences, and management along with facilitating an interventional program to support this vulnerable group of women. A large survey of Vietnamese mothers' symptoms, effects, and management strategies is needed.
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Affiliation(s)
- Huyen Thi Hoa Nguyen
- College of Health Sciences, VinUniversity, Vinhomes Ocean Park, Hanoi, Da Ton, Gia Lam, 100000, Vietnam.
- Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.
| | - Phuong Anh Hoang
- College of Health Sciences, VinUniversity, Vinhomes Ocean Park, Hanoi, Da Ton, Gia Lam, 100000, Vietnam
- Faculty of Nursing and Midwifery, Hanoi Medical University, No 1 Ton That Tung, Dong Da, 100000, Hanoi, Vietnam
| | - Thi Kim Ly Do
- University Medical Center Schleswig-Holstein, Lübeck campus, Ratzeburger Allee 96, Lübeck, 23562, Germany
| | - Andrew W Taylor-Robinson
- College of Health Sciences, VinUniversity, Vinhomes Ocean Park, Hanoi, Da Ton, Gia Lam, 100000, Vietnam
| | - Thi Thanh Huong Nguyen
- College of Health Sciences, VinUniversity, Vinhomes Ocean Park, Hanoi, Da Ton, Gia Lam, 100000, Vietnam
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15
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Romanenko A, Bielka K. LABOUR ANALGESIA AND THE RISK OF POSTPARTUM DEPRESSION. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 75:2948-2952. [PMID: 36723308 DOI: 10.36740/wlek202212109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim: To find association between postpostpartum depression incidence and mode of labour analgesia. PATIENTS AND METHODS Materials and methods: This is a prospective observational study conducted at the Kyiv City Maternity Hospital №5 (from March 2020 to May 2021). Using google-form and face-to-face interviews, 321 women completed Childbirth Experience Questionnaire on the 2- 3-rd day in the postpartum period. After the first survey, only 35% of women agreed to screen for postpartum depression (PPD) by Edinburgh Postnatal Depression Scale. Univariate logistic regression method was used to assess the risk relation between PPD and factors. RESULTS Results: Women who used nitrous oxide (50:50) and non-pharmacological methods of labour analgesia were associated with the decreased risk of PPD (p = 0,044), OR = 2.83 (95% CI 1,03-7,79), compared to women with patient-control epidural analgesia. On the other hand, there are factors which do not have impact on the risk of depressive symptoms, such as age (p = 0,266); parity (p = 0,713); mode of delivery (p=0,959); pain intensity (p=0,931). CONCLUSION Conclusions: Our findings confirmed the association between nitrous oxide and the alternative methods of labour analgesia usage and decreased risk of development PPD.
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16
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Daehn D, Rudolf S, Pawils S, Renneberg B. Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public - a systematic review. BMC Pregnancy Childbirth 2022; 22:574. [PMID: 35854232 PMCID: PMC9295513 DOI: 10.1186/s12884-022-04865-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background The perinatal period is a time of increased vulnerability to mental health problems, however, only a small proportion of women seek help. Poor mental health literacy (MHL) is a major barrier to seeking help for mental health problems. This study aimed to collect the existing evidence of MHL associated with perinatal mental health problems (PMHP) among perinatal women and the public. This review analysed which tools were used to assess perinatal MHL as well as the findings concerning individual components of perinatal MHL. Methods Four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) were analysed from their inception until September 1, 2020. Not only quantitative studies reporting on components of MHL (knowledge, attitudes, and help-seeking), but also studies reporting overall levels of MHL relating to PMHP were taken into account. Two independent reviewers were involved in the screening and extraction process and data were analysed descriptively. Results Thirty-eight of the 13,676 retrieved articles satisfied the inclusion criteria. The majority of selected studies examined MHL related to PMHP in perinatal women (N = 28). The most frequently examined component of MHL in the selected data set was help-seeking. A lack of uniformity in assessing MHL components was found. The most common focus of these studies was postpartum depression. It was found that the ability to recognize PMHP and to identify relevant symptoms was lacking among both perinatal women and the public. Perinatal women had low intentions of seeking help for PMHP and preferred seeking help from informal sources while reporting a variety of structural and personal barriers to seeking help. Stigmatizing attitudes associated with PMHP were found among the public. Conclusions There is a need for educational campaigns and interventions to improve perinatal MHL in perinatal women and the public as a whole. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04865-y.
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Affiliation(s)
- Daria Daehn
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.
| | - Sophie Rudolf
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Silke Pawils
- Department of Medical Psychology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Babette Renneberg
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
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17
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Nisa' F, Damayanti NA, Suhariadi F, Herisanty W, Afiyah RK. Internal factors affecting the mother's psychological capital in exclusive breastfeeding during the COVID-19 pandemic. J Public Health Res 2022; 11:22799036221106619. [PMID: 35911426 PMCID: PMC9335479 DOI: 10.1177/22799036221106619] [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: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/15/2022] Open
Abstract
Background: During the pandemic, in terms of breastfeeding, most mothers experience anxiety and discomfort. The impact of this condition will decrease the production of breast milk. The purpose of this study was to determine the internal factors that affect the psychological capital of mothers when breastfeeding during the COVID-19 pandemic in Petiken Village, Gresik. Design and methods: This study was an analytical study with a cross-sectional approach. The population of this study was all breastfeeding mothers who had babies aged 6–12 months. The sampling technique used was simple random sampling involving 102 respondents. The independent variables were motivation, perception, and attitude. The dependent variable was psychological capital. Data were collected from June to July 2021. The data analysis was conducted using the logistic regression test to determine the variable with a significance level of p < 0.05. Results: The results of the multivariate analysis showed that the motivation variable was p = 0.036. Motivation had effect on psychological capital. While the perception variable was p = 0.056 (p > 0.05), the perception had no effect on psychological capital. The attitude variable p = 0.055 (p > 0.05), the attitude had no effect on psychological capital. The factor that affects the mother’s psychological capital in relation to exclusive breastfeeding during the COVID-19 pandemic was motivation. Conclusion: It is expected that mothers have a high motivation which can affect the mother’s psychological capital. It is needed to increase and succeed at providing exclusive breastfeeding.
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Affiliation(s)
- Fauziyatun Nisa'
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.,Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama, Surabaya, Indonesia
| | | | - Fendy Suhariadi
- Faculty of Psychology, Universitas Airlangga, Surabaya, Indonesia
| | - Wesiana Herisanty
- Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama, Surabaya, Indonesia
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18
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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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Kahalon R, Yanushevsky Cnaani G, Preis H, Benyamini Y. The complex effects of maternal expectations on postpartum depressive symptoms: when does a protective factor become a risk factor? J Psychosom Obstet Gynaecol 2022; 43:74-82. [PMID: 32701018 DOI: 10.1080/0167482x.2020.1795826] [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] [Indexed: 10/23/2022] Open
Abstract
PURPOSE The present study assessed the effects of several prenatal maternal expectations on postpartum depression (PPD), while considering two relevant factors - incongruence between planned and actual birth and the rigidity of the birth plan - that can affect whether maternal expectations act as protective factors or risk factors for PPD. METHODS Primiparous women (N = 527) were recruited to a longitudinal study about women's birth choices and experiences. At time 1, during pregnancy, women completed a questionnaire assessing prenatal depression, preferred birth plan, birth plan flexibility-rigidity and maternal expectations (i.e. Natural-Fulfillment, Infant-Reflects-Mothering, Sacrifice). At time 2, two-months post-partum, they reported their actual birth mode and answered a questionnaire assessing their PPD symptoms. RESULTS Natural-fulfillment maternal expectations were negatively related to PPD symptoms. Yet, the interaction of high natural-fulfillment expectations with an unfulfilled birth plan and the rigidity of the birth plan, served as a risk factor for PPD symptomatology. CONCLUSIONS Understanding the conditions under which specific prenatal maternal expectations serve as a risk factor for PPD, can help healthcare providers identify women who are at high risk for developing PPD symptoms and plan preemptive interventions.
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Affiliation(s)
- Rotem Kahalon
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,The School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | | | - Heidi Preis
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,Department of Psychology, Stoney Brook University, Stoney Brook, NY, USA
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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20
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Mohamuud SA, Abukar MI, Ahmed MY, Ali MA, Abdurahman IA, Mohamed MH, Ali MA. Postpartum Depression and Associated Factors among Mothers Who Gave Birth in the Last 12 Months in Mogadishu Somalia, Community Based Cross-Sectional Study. Health (London) 2022. [DOI: 10.4236/health.2022.1410076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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21
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Cimino S, Tambelli R, Di Vito P, D'Angeli G, Cerniglia L. The quality of father-child feeding interactions mediates the effect of maternal depression on children's psychopathological symptoms. Front Psychiatry 2022; 13:968171. [PMID: 36072463 PMCID: PMC9444047 DOI: 10.3389/fpsyt.2022.968171] [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: 06/13/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Research has shown that Postnatal maternal depression (PND) is associated with children's emotional and behavioral problems during infancy, but the possible effect of father-child relationship quality on this association is yet to be thoroughly investigated. We recruited 401 families (802 parents; 401 children) via mental health clinics in Central Italy. We divided families into two groups: Group 1 included families with mothers with PND; Group 2 included families with mothers without PND (control group). The assessment took place at T1 (18 months of age of children) and T2 (36 months of age of children): postnatal maternal depression was measured through the Edinburgh Postnatal Depression Scale (EPDS); parent-child relationship quality was assessed through the Scale for the Assessment of Feeding Interactions (SVIA); and the child emotional-behavioral functioning was evaluated with the Child-Behavior-Checklist (CBCL). Compared to the control group, the children of the groups where mothers had PND, showed overall higher scores (i.e., more maladaptive) on the CBCL. A direct effect of postnatal maternal depression on children's emotional-behavioral functioning was found, both at T1 and at T2. A mediation effect of father-child relationship quality between postnatal maternal depression and child outcomes was also found. These results could inform prevention and intervention programs in families with mothers with PND.
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Renata Tambelli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Paola Di Vito
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Gessica D'Angeli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Luca Cerniglia
- International Telematic University Uninettuno, Rome, Italy
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22
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Fischbein R, Cook HL, Baughman K, Díaz SR. Using machine learning to predict help-seeking among 2016–2018 Pregnancy Risk Assessment Monitoring System participants with postpartum depression symptoms. WOMEN'S HEALTH 2022. [DOI: 10.1177/17455057221139664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Despite the importance of early identification and treatment, postpartum depression often remains largely undiagnosed with unreported symptoms. While research has identified several factors as prompting help-seeking for postpartum depression symptoms, no research has examined help-seeking for postpartum depression using data from a multi-state/jurisdictional survey analyzed with machine learning techniques. Objectives: This study examines help-seeking among people with postpartum depression symptoms using and demonstrating the utility of machine learning techniques. Methods: Data from the 2016–2018 Pregnancy Risk Assessment Monitoring System, a cross-sectional survey matched with birth certificate data, were used. Six US states/jurisdictions included the outcome help-seeking for postpartum depression symptoms and were used in the analysis. An ensemble method, “Super Learner,” was used to identify the best combination of algorithms and most important variables that predict help-seeking among 1920 recently pregnant people who screen positive for postpartum depression symptoms. Results: The Super Learner predicted well and had an area under the receiver operating curve of 87.95%. It outperformed the highest weighted algorithms which were conditional random forest and stochastic gradient boosting. The following variables were consistently among the top 10 most important variables across the algorithms for predicting increased help-seeking: participants who reported having been diagnosed with postpartum depression, having depression during pregnancy, living in particular US states, being a White compared to Black or Asian American individual, and having a higher maternal body mass index at the time of the survey. Conclusion: These results show the utility of using ensemble machine learning techniques to examine complex topics like help-seeking. Healthcare providers should consider the factors identified in this study when screening and conducting outreach and follow-up for postpartum depression symptoms.
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Affiliation(s)
- Rebecca Fischbein
- Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Heather L Cook
- Department of Mathematical Sciences, University of Southern Indiana, Evansville, IN, USA
| | - Kristin Baughman
- Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Sebastián R Díaz
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
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Haßdenteufel K, Lingenfelder K, Schwarze CE, Feisst M, Brusniak K, Matthies LM, Goetz M, Wallwiener M, Wallwiener S. Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study. JMIR Ment Health 2021; 8:e26665. [PMID: 34890349 PMCID: PMC8709910 DOI: 10.2196/26665] [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: 12/20/2020] [Revised: 02/11/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a severe mental disorder that often results in poor maternal-infant attachment and negatively impacts infant development. Universal screening has recently been recommended to identify women at risk, but the optimal screening time during pregnancy has not been defined so far. Thus, web-based technologies with widespread use among women of childbearing age create new opportunities to detect pregnancies with a high risk for adverse mental health outcomes at an early stage. OBJECTIVE The aim of this study was to stratify the risk for PPD and to determine the optimal screening time during pregnancy by using a web-based screening tool collecting electronic patient-reported outcomes (ePROs) as the basis for a screening algorithm. METHODS In total, 214 women were repeatedly tested for depressive symptoms 5 times during and 3 times after pregnancy by using the Edinburgh Postnatal Depression Scale (EPDS), accessible on a web-based pregnancy platform, developed by the authors of this study. For each prenatal assessment, the area under the curve (AUC), sensitivity, specificity, and predictive values for PPD were calculated. Multivariate logistic regression analyses were applied to identify further potential predictors, such as age, education, parity, relationship quality, and anxiety, to increase predictive accuracy. RESULTS Digitally collected data from 214 pregnant women were analyzed. The predictive accuracy of depressive symptoms 3 and 6 months postpartum was reasonable to good regarding the screening in the second (AUC=0.85) and third (AUC=0.75) trimester. The multivariate logistic regression analyses resulted in an excellent AUC of 0.93 at 3 months and a good AUC of 0.87 at 6 months postpartum. CONCLUSIONS The best predictive accuracy for PPD has been shown for screening between the 24th and the 28th gestational week (GW) and seems to be beneficial for identifying women at risk. In combination with the aforementioned predictive factors, the discriminatory power improved, particularly at 3 months postpartum. Screening for depression during pregnancy, combined with the women's personal risk profile, can be used as a starting point for developing a digital screening algorithm. Thereby, web-based assessment tools constitute feasible, efficient, and cost-effective approaches. Thus, they seem to be beneficial in detecting high-risk pregnancies in order to improve maternal and infant birth outcomes in the long term.
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Affiliation(s)
- Kathrin Haßdenteufel
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany
| | - Katrin Lingenfelder
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany
| | | | - Manuel Feisst
- Institute of Medical Biometry, Heidelberg University, Heidelberg, Germany
| | - Katharina Brusniak
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany
| | - Lina Maria Matthies
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany
| | - Maren Goetz
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany
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Morgan JK, Santosa H, Fridley RM, Conner KK, Hipwell AE, Forbes EE, Huppert TJ. Postpartum Depression Is Associated With Altered Neural Connectivity Between Affective and Mentalizing Regions During Mother-Infant Interactions. Front Glob Womens Health 2021; 2:744649. [PMID: 34816247 PMCID: PMC8593996 DOI: 10.3389/fgwh.2021.744649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/24/2021] [Indexed: 11/28/2022] Open
Abstract
Although there has been growing interest in mood-related neural alterations in women in the initial weeks postpartum, recent work has demonstrated that postpartum depression often lingers for months or years following birth. However, research evaluating the impact of depression on maternal brain function during mother-infant interactions in the late postpartum period is lacking. The current study tested the hypothesis that depressive symptoms at 12-months postpartum are associated with neural alterations in affective and social neural regions, using near-infrared spectroscopy during in vivo mother-infant interactions. Participants were 23 birth mothers of 12-month-old infants (60% boys). While undergoing near-infrared spectroscopy, mothers engaged in an ecologically valid interactive task in which they looked at an age-appropriate book with their infants. Mothers also reported on their depressive symptoms in the past week and were rated on their observed levels of maternal sensitivity during mother-infant play. Greater depressive severity at 12-months postpartum was related to lower connectivity between the right temporoparietal junction and the lateral prefrontal cortex, but greater connectivity between the right temporoparietal junction and anterior medial prefrontal cortex during mother-infant interaction. Given the putative functions of these neural regions within the maternal brain network, our findings suggest that in the context of depression, postpartum mothers' mentalizing about her infants' thoughts and feelings may be related to lower ability to express and regulate her own emotions, but greater ability to engage in emotional bonding with her infant. Future work should explore how connectivity among these regions is associated with longitudinal changes in maternal behavior, especially in the context of changes in mothers' depressive symptoms (e.g., with treatment) over time.
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Affiliation(s)
- Judith K. Morgan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Hendrik Santosa
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rachel M. Fridley
- University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Kaetlyn K. Conner
- University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Erika E. Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Theodore J. Huppert
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, United States
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Bornstein MH, Manian N, Henry LM. Clinically depressed and typically developing mother-infant dyads: Domain base rates and correspondences, relationship contingencies and attunement. INFANCY 2021; 26:877-900. [PMID: 34343395 DOI: 10.1111/infa.12427] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 07/11/2021] [Accepted: 07/15/2021] [Indexed: 11/28/2022]
Abstract
Maternal depression is associated with adverse outcomes in infants. Unfavorable parenting practices likely constitute one pathway of risk transmission from mother to infant, but definitional and methodological variation in the extant literature precludes a comprehensive or conclusive understanding of potential underlying mechanisms. This study aimed to illuminate the role of maternal clinical depression in mother-infant interaction by turning a microanalytic lens on four substantive relationship issues: base rates, correspondences, contingencies, and attunement. Several maternal parenting practices (aggregated into social, didactic, and language domains) and several infant behaviors (aggregated into social, exploration, and non-distress vocalization domains) were microcoded to 0.10 s from naturalistic hour long interactions of clinically depressed mothers (n = 60) and matched non-depressed controls (n = 60) with their 5-month-olds. Clinically depressed mothers spontaneously engaged their infants less didactically, were less contingent to their infants in social, didactic, and language domains, and were less attuned with their infants than were non-depressed mothers. Infants of clinically depressed mothers vocalized non-distress less than infants of non-depressed mothers. These differences unveil key disadvantages in the everyday lived experiences of infants of clinically depressed mothers. The findings advance understanding of maternal depression and its effects and have implications for identifying infants at risk on account of their mothers' clinical depression.
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Affiliation(s)
- Marc H Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.,Institute for Fiscal Studies, London, UK.,UNICEF, New York City, New York, USA
| | - Nanmathi Manian
- University of Maryland, Baltimore County, Baltimore, Maryland, USA
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Abstract
ABSTRACT Despite extensive research, the etiology behind postpartum depression (PPD) remains a mystery. Experts have theorized about various potential risk factors, including hormonal fluctuations, genetics, prior history of depression, low socioeconomic status, adolescent pregnancy, and certain personality traits. This article provides foundational information about PPD, reviewing the risk factors for and the consequences of this mood disorder. Postpartum blues and postpartum psychosis are briefly discussed for context, although they differ from PPD. Screening and treatment options are explained, and nursing implications for practice are presented.
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Affiliation(s)
- Barbara Marie Alba
- Barbara Marie Alba is the director of nursing for maternal-child health services at New York-Presbyterian Hospital, New York City. Contact author: . The author and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the author is available at www.ajnonline.com
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Schrey-Petersen S, Tauscher A, Dathan-Stumpf A, Stepan H. Diseases and complications of the puerperium. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:arztebl.m2021.0168. [PMID: 33972015 PMCID: PMC8381608 DOI: 10.3238/arztebl.m2021.0168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 02/28/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND In terms of maternal morbidity and mortality, the puerperium is just as significant as pregnancy and childbirth. Nearly half of all maternal deaths occur in the time after delivery. METHODS This review is based on pertinent articles in English and German from the years 2000- 2020 that were retrieved by a selective search in MEDLINE and EMBASE, as well as on the available guidelines in English and German and on German-language textbooks of obstetrics. RESULTS The most common and severe complications are, in the post-placental phase, bleeding and disturbances of uterine involution; in the first seven days after delivery, infection (e.g., endomyometritis, which occurs after 1.6% [0.9; 2.5] of all births) and hypertension-related conditions. Thromboembolism, incontinence and disorders of the pelvic floor, mental disease, and endocrine disturbances can arise at any time during the puerperium. In an Australian study, the incidence of embolism was 0.45 per 1000 births, with 61.3% arising exclusively after delivery. CONCLUSION Basic familiarity with the most common and severe diseases in the puerperium is important for non-gynecologists as well, among other things because highly acute, lifethreatening complications can arise that demand urgent intervention.
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Affiliation(s)
| | - Anne Tauscher
- Division of Obstretics, University of Leipzig Medical Center
| | | | - Holger Stepan
- Division of Obstretics, University of Leipzig Medical Center
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Effects of mother–child interaction on school adaptation of children according to maternal depression. FRONTIERS OF NURSING 2021. [DOI: 10.2478/fon-2021-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
Factors influencing school adaptation of school-aged children include both executive function (EF) and parent–child interaction. This study aims to investigate the developmental trajectory of mother–child interaction longitudinally using latent growth model analysis.
Methods
A longitudinal descriptive survey study was conducted. The participants comprised of 1,614 mothers and school-aged children, who participated in the Panel Study on Korean Children (6th–8th panel surveys). A model was designed and analyzed using latent growth modeling to estimate the pattern of change over time.
Results
In the group where the maternal depression was within the normal range, only the path by which the change rate of mother–child interaction affected school adaptation of children was statistically nonsignificant (t = 1.007, p = 0.314). In the group where maternal depression was mild or higher, only the paths by which the initial value of mother–child interaction affected EF difficulty (t = −2.75, p = 0.032) and EF difficulty affected school adaptation (t = −7.876, p < 0.001) were statistically significant.
Conclusions
This study confirms the research models developed by dividing mother–child interaction into two groups according to depression levels (i.e., normal range and mild or higher-level depression). The findings provide a basis for construction of individualized interventions.
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Premji S, McDonald SW, McNeil DA, Spackman E. Maximizing maternal health and value for money in postpartum depression screening: a cost-effectiveness analysis using the All Our Families cohort and administrative data in Alberta, Canada. J Affect Disord 2021; 281:839-846. [PMID: 33239243 DOI: 10.1016/j.jad.2020.11.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/08/2020] [Accepted: 11/08/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Postpartum depression (PPD) affects 10-15% of women, is costly and debilitating, yet often remains undiagnosed. Within Alberta, Canada, screening is conducted at public health well child clinics using the Edinburgh Postnatal Depression Scale. If screened high-risk, women are offered referral to their family physicians for follow up diagnosis and treatment. METHODS We developed a decision tree to estimate the cost-effectiveness of PPD screening versus not screening in Alberta over a two-year time horizon using a public healthcare payer perspective. Both the current practice (51% attending referral) and a scenario analysis (100% attending referral) are presented. RESULTS Current practice results suggest screening leads to an incremental cost-effectiveness ratio (ICER) of $17,644 USD per quality adjusted life year (QALY). At a population-level, this resulted in an annual 813 (11%) additional cases diagnosed, 120 additional QALYs gained, and an additional cost of $2.1 million relative to not screening. With 100% attending referral, the ICER fell to $13,908 per QALY, resulting in an annual 1997 (27%) additional cases diagnosed, 249 additional QALYs gained, and an additional cost of $3.5 million relative to not screening. LIMITATIONS We were unable to explore the cost-effectiveness of PPD screening versus not screening for secondary populations, including children. CONCLUSIONS The results suggest screening may be most valuable when participation and compliance are maximized, where all women screened high-risk attend referral. This leads to greater value for money and increased maternal health gains across the population. Collaboration among public health and primary care services is encouraged to improve outcomes.
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Affiliation(s)
- Shainur Premji
- Population, Public and Indigenous Health, Alberta Health Services; Community Health Sciences, Cumming School of Medicine, University of Calgary.
| | - Sheila W McDonald
- Population, Public and Indigenous Health, Alberta Health Services; Community Health Sciences, Cumming School of Medicine, University of Calgary; Paediatrics, Cumming School of Medicine, University of Calgary
| | - Deborah A McNeil
- Population, Public and Indigenous Health, Alberta Health Services; Community Health Sciences, Cumming School of Medicine, University of Calgary; Faculty of Nursing, University of Calgary
| | - Eldon Spackman
- Community Health Sciences, Cumming School of Medicine, University of Calgary
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30
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Zanardo V, Giliberti L, Giliberti E, Grassi A, Perin V, Parotto M, Soldera G, Straface G. The role of gestational weight gain disorders in symptoms of maternal postpartum depression. Int J Gynaecol Obstet 2020; 153:234-238. [PMID: 33113162 DOI: 10.1002/ijgo.13445] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/03/2019] [Accepted: 10/26/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To examine the association of gestational weight gain (GWG), categorized according to 2009 IOM guidelines as adequate, inadequate, and excessive, with symptoms of mental disorders perceived by mothers after childbearing as anhedonia, anxiety, and depression, defined by the Edinburgh Postnatal Depression Scale (EPDS). Previous studies indicated that disorders related to GWG are associated with an increased risk of postpartum psychological distress. METHODS A prospective cohort study took place at the Policlinico Abano Terme, Italy, from May 2016 to November 2018. RESULTS The sample included 1268 healthy at term puerperae, 557 (43.9%) with adequate, 388 (30.6%) with inadequate, and 323 (25.5%) with excessive GWG. Mean EPDS scores were comparable among inadequate, adequate, and excessive GWG groups. However, mean factor scores for anhedonia and anxiety were significantly higher (P = 0.041 and P = 0.001, ANOVA) in mothers with excessive GWG. Conversely, factor scores for depression were significantly higher (P = 0.008, ANOVA) in mothers with inadequate GWG. CONCLUSION It was found that excessive GWG across an uncomplicated pregnancy is a warning sign of symptoms of anhedonia and anxiety, whereas inadequate GWG is a significant indicator of symptoms of depression. These relationships highlight the potential for interventions directed toward psychosocial support to have beneficial effects upon GWG.
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Affiliation(s)
- Vincenzo Zanardo
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Lara Giliberti
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Elia Giliberti
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Agostino Grassi
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Veronica Perin
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Matteo Parotto
- Department of Anesthesia, University of Toronto, Toronto, ON, Canada
| | - Gino Soldera
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Gianluca Straface
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
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Mutua J, Kigamwa P, Ng'ang'a P, Tele A, Kumar M. A comparative study of postpartum anxiety and depression in mothers with pre-term births in Kenya. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Adeyemo EO, Oluwole EO, Kanma-Okafor OJ, Izuka OM, Odeyemi KA. Prevalence and predictors of postpartum depression among postnatal women in Lagos, Nigeria. Afr Health Sci 2020; 20:1943-1954. [PMID: 34394261 PMCID: PMC8351853 DOI: 10.4314/ahs.v20i4.53] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Globally, postpartum depression is one of the most common but often unrecognized complications of childbirth, yearly affecting about 10–15% of postnatal women. This study aimed to determine the prevalence of postpartum depression and its predictors among postnatal women in Lagos. Methods A descriptive cross-sectional study was conducted among 250 mothers in Eti-Osa Local Government Area of Lagos State, Nigeria, attending six Primary Health Care centers for infant immunization at six weeks post-delivery. Data was collected using a pretested semi-structured interviewer administered questionnaire which included the Edinburgh Postnatal Depression Scale. Analysis was carried out using SPSS version 23TM. Chi-square and logistic regression analyses were used to determine associations and predictive relationships between various factors and the presence of postpartum depression. The level of significance was set at <0.05. Results The prevalence of postpartum depression was 35.6%. Multiparity, delivery by cesarean section, mother being unwell after delivery, and not exclusively breastfeeding the baby were the factors linked with postpartum depression. Following multiple logistic regression, having postpartum blues (p=0.000; OR=32.77; 95%CI=7.23–148.58)., not getting help with caring for the baby (p=0.008; OR=2.64; 95%CI=1.29–5.42), experiencing intimate partner violence (p=0.000; OR=5.2; 95%CI=2.23–11.91) and having an unsupportive partner (p=0.018; OR=2.6; 95%CI=1.17–5.78) were identified as predictors of postpartum depression. Conclusion This study revealed a high prevalence of postpartum depression, identifying both the obstetric and psychosocial predictors. Social support for women both in the pre- and postnatal periods and routine screening of women for postpartum depression should be encouraged for early detection and immediate intervention.
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Affiliation(s)
- E O Adeyemo
- Department of Community Health and Primary Care, College of Medicine University of Lagos. Lagos State, Nigeria
| | - E O Oluwole
- Department of Community Health and Primary Care, College of Medicine University of Lagos. Lagos State, Nigeria
| | - O J Kanma-Okafor
- Department of Community Health and Primary Care, College of Medicine University of Lagos. Lagos State, Nigeria
| | - O M Izuka
- Federal Medical Centre Umuahia, Abia State, Nigeria
| | - K A Odeyemi
- Department of Community Health and Primary Care, College of Medicine University of Lagos. Lagos State, Nigeria
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Dadi AF, Miller ER, Mwanri L. Postnatal depression and its association with adverse infant health outcomes in low- and middle-income countries: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:416. [PMID: 32698779 PMCID: PMC7374875 DOI: 10.1186/s12884-020-03092-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 07/03/2020] [Indexed: 02/08/2023] Open
Abstract
Background Postnatal Depression (PND) is a mood disorder that steals motherhood and affects the health and development of a newborn. While the impact of PND on motherhood and newborn in developed countries are well described, its epidemiology and health consequences in infant is not well known in middle-and low-income countries. The objective of this review was to determine the burden and association of PND with adverse infant health outcomes in low-and middle- income countries. Methods We searched observational studies written in the English language and conducted in middle-and low-income countries between December 1st, 2007, and December 31st, 2017. The CINHAL, MEDLINE, Emcare, PubMed, Psych Info, and Scopus databases were searched for the following search terms: PND, acute respiratory infection, pneumonia, diarrhea, exclusive breastfeeding, common infant illnesses, and malnutrition. We excluded studies in which the primary outcomes were not measured following a standardized approach. We have meta-analyzed the estimates from primary studies by adjusting for possible publication bias and heterogeneity. The analysis was conducted in Stata 14. The study was registered in PROSPERO protocol number CRD42017082624. Result Fifty-eight studies on PND prevalence (among 63,293 women) and 17 studies (among 32,454 infants) on infant health outcomes were included. PND prevalence was higher in the low-income countries (Pooled prevalence (PP) = 25.8%; 95%CI: 17.9–33.8%) than in the middle-income countries (PP = 20.8%; 95%CI: 18.4–23.1%) and reached its peak in five to ten weeks after birth. Poor obstetric history and social support, low economic and educational status, and history of exposure to violence were associated with an increased risk of PND. The risk of having adverse infant health outcomes was 31% higher among depressed compared to non-depressed postnatal mothers (Pooled relative risk (PRR) = 1.31; 95%CI: 1.17–1.48). Malnutrition (1.39; 1.21–1.61), non-exclusive breastfeeding (1.55; 1.39–1.74), and common infant illnesses (2.55; 1.41–4.61) were the main adverse health outcomes identified. Conclusions One in four and one in five postnatal mothers were depressed in low and middle-income countries, respectively. Causes of depression could be explained by social, maternal, and psychological constructs. High risk of adverse infant health outcomes was associated with PND. Timely screening of PND and evidence-based interventions were a pressing need in low and middle-income countries.
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Affiliation(s)
- Abel Fekadu Dadi
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. .,College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia.
| | - Emma R Miller
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
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Cacciola E, Psouni E. Insecure Attachment and Other Help-Seeking Barriers among Women Depressed Postpartum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3887. [PMID: 32486285 PMCID: PMC7313466 DOI: 10.3390/ijerph17113887] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/23/2020] [Accepted: 05/27/2020] [Indexed: 11/16/2022]
Abstract
When untreated, postpartum depression (PPD) can severely, negatively affect maternal health, child development, and the wellbeing and functioning of the entire family. Yet, despite screening and treatment programs for PPD, many women who experience depression with onset in the postpartum year do not communicate their symptoms. Negative relational experiences early in life, such as not receiving sensitive help and support when needed, often result in so-called insecure attachment styles, and there is evidence that these may contribute to the development and maintenance of PPD. However, the role of insecure attachment styles in non-help-seeking is unknown for this group. Using mixed quantitative and qualitative methodology, we identified help-seeking barriers of women who experienced depression with onset in the postpartum year but who had not sought help for their depression (N = 37), and explored links to their attachment orientations as assessed through both self-reported attachment style and narrative based attachment script assessment. The sample was non-normative regarding attachment, with an over-representation of avoidant attachment styles. Help-seeking barriers varied systematically with the mother's adult attachment style. Specifically, convictions of a strong self and lack of trust in healthcare professionals constituted a common barrier among women with avoidant attachment styles, while unrealistic expectations about motherhood constituted a barrier for women with secure attachment styles. This new knowledge on how barriers to communicating symptoms and seeking help when suffering from PPD vary systematically with attachment orientation can help formulate individualized, and therefore more efficient, approaches to addressing non-help-seeking behavior in women who suffer in silence.
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Affiliation(s)
- Emily Cacciola
- Department of Psychology, Lund University, PO Box 213, SE221-00 Lund, Sweden
| | - Elia Psouni
- Department of Psychology, Lund University, PO Box 213, SE221-00 Lund, Sweden
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Dadi AF, Mwanri L, Woodman RJ, Azale T, Miller ER. Causal mechanisms of postnatal depression among women in Gondar town, Ethiopia: application of a stress-process model with generalized structural equation modeling. Reprod Health 2020; 17:63. [PMID: 32381087 PMCID: PMC7206662 DOI: 10.1186/s12978-020-00912-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/24/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Postnatal depression (PND) is the second most common cause of disability and the most common complication after childbirth. Understanding the potential mechanisms by which the stress process can lead to PND is an important step for planning preventive interventions for PND. This study employed a stress process model to explore the possible pathways leading to PND in Gondar Town, Ethiopia. METHODS A community-based cohort study was conducted in 916 pregnant women, who were assessed for depression in their second or third trimester of pregnancy and re-assessed two to eight weeks after birth. Women with an Edinburgh Postnatal Depression Scale (EPDS) ≥6 were considered to be depressed. Modified Poisson regression was used to identify the independent predictors of PND. A Generalized Structural Equation Modeling (GSEM) was then used to explore the direct and indirect effects of stressors and their mediators on PND. RESULTS The prevalence and incidence proportion of PND were 9.27% (95%CI: 7.45, 11.36) and 7.77% (95%CI: 6.04, 9.79), respectively and 2.1% of the women demonstrated symptoms of depression within the study period. PND was independently predicted by having limited postnatal care services, Antenatal Depression (AND) and a Common Mental Disorders (CMD) before pregnancy, (IRR = 1.8; 95%CI: 1.0, 3.2), 1.6(95%CI: 1.4, 1.7), and 2.4 (95%CI: 1.4, 4.3) respectively). In SEM, AND (standardized total effect = 0.36) and a CMD before pregnancy (standardized total effect = 0.11) had both a direct and an indirect positive effect on PND scores. Low birth weight (standardized β = 0.32) and self-reported labor complications (standardized β = 0.09) had direct effects only on PND scores. CONCLUSION The observed incidence and prevalence of PND in Ethiopia were lower than in previous studies. A CMD before pregnancy and low birth weight (LBW) increased PND scores, and these effects were in part mediated via antenatal depression and labor complications. Early detection and treatment of depression before or during pregnancy could either directly or indirectly reduce the risk of labor complications and PND. Interventions that reduce LBW or improve the uptake of postnatal care might reduce PND incidence.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
- Flinders University, College of Medicine and Public Health, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, 5001, SA, Australia.
| | - Lillian Mwanri
- Flinders University, College of Medicine and Public Health, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, 5001, SA, Australia
| | - Richard J Woodman
- Flinders University, College of Medicine and Public health, Center for Epidemiology and Biostatistics, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, 5001, SA, Australia
| | - Telake Azale
- Department of Health Promotion and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Emma R Miller
- Flinders University, College of Medicine and Public Health, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, 5001, SA, Australia
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Dadi AF, Akalu TY, Baraki AG, Wolde HF. Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis. PLoS One 2020; 15:e0231940. [PMID: 32343736 PMCID: PMC7188237 DOI: 10.1371/journal.pone.0231940] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 04/05/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Postnatal depression (PND) is a major cause of negative health-related behaviors and outcomes during infancy, childhood and adolescent period. In Africa, the burden of postnatal depression is high. However, it is under-investigated hence under-treated. To fill this information gap and to advise further interventions, we aimed at analyzing its epidemiology in Africa. Methods We searched observational studies conducted in Africa and published in between 01/01/2007 and 30/06/2018 in CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases. We assessed the quality of the studies using the Newcastle Ottawa Scale (NOS) and included studies with good quality. We evaluated the heterogeneity using the Higgins I2 statistics. We used a random-effects model to pool estimates. We assessed publication bias using the funnel plot and Egger's test statistics and adjusted using Tweedie’s and Duval Trim and Fill analysis. The protocol has been registered in the PROSPERO (Protocol No. CRD42018100461). Results Nineteen studies involving 40,953 postnatal mothers were part of this systematic review and meta-analysis. The overall pooled prevalence of PND was 16.84% (95% CI: 14.49% –19.19%). The odds of having PND was higher among women with a poor obstetric condition (POR = 2.11; 95% CI: 1.11–4.01) and history of adverse birth and infant health outcomes (POR = 2.85; 95% CI: 1.29–6.25). Having a history of common mental health disorders (POR = 2.47; 95% CI: 1.51–4.04), poor social support (POR = 2.06; 95% CI: 1.05–4.05), lower economic status (POR = 2.38; 95% CI: 1.75–3.23), and those who had exposure to a different form of intimate partner violence (POR = 2.87; 95% CI: 1.60–5.16) had higher odds of PND. Conclusion While robust prevalence studies are scarce, our review indicated a high prevalence rate of postnatal depression. The analysis also identified postpartum women at increased risk of PND. Therefore, there is a need to design and escalate comprehensive strategies to decrease its burden, focusing on those women at risk of PND.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, Discipline of Public Health, Flinders University, Adelaide, Australia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
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Lim G, LaSorda KR, Farrell LM, McCarthy AM, Facco F, Wasan AD. Obstetric pain correlates with postpartum depression symptoms: a pilot prospective observational study. BMC Pregnancy Childbirth 2020; 20:240. [PMID: 32321455 PMCID: PMC7178606 DOI: 10.1186/s12884-020-02943-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Data linking labor pain and postpartum depression are emerging. Robust, prospective evaluations of this relationship while factoring other important variables are lacking. We assessed perinatal pain and other factors predicting postpartum depression (PPD) symptoms. METHODS Third trimester women, stratified by a priori plan to receive or avoid labor epidural analgesia, were longitudinally followed from the prenatal period through labor and delivery, until 6 weeks and 3 months postpartum. Electronic pain data was collected hourly during labor in real time, capturing pain unpleasantness, intensity, pain management satisfaction, and expectations. Prenatal and postpartum data included anxiety, depression, the Brief Pain Inventory (BPI), pain catastrophizing, resiliency, and perceived social support and stress. The primary outcome was Edinburgh Postnatal Depression Score (EPDS) as a marker of PPD symptoms. The primary pain variable of interest was labor pain emotional valence (unpleasantness burden, area under the curve for entire labor duration). Single and multivariable linear regressions examined perinatal pain variables in relation to EPDS. RESULTS Of 72 subjects included, 55 planned/received labor epidural analgesia and 17 planned avoidance/avoided it. In the planned epidural group, the emotional valence of labor pain independently predicted six-week EPDS (labor pain unpleasantness burden, R2 = 0.42, P = 0.002). In addition to labor pain, prenatal and postpartum pain variables from the BPI independently predicted six-week EPDS. Three-month depression scores were linked to labor and acute pain (6 weeks postpartum), but not to chronic (3 months postpartum) pain variables. Intrapartum pain management satisfaction and expectations were largely met or exceeded and did not differ between analgesia groups. CONCLUSION For susceptible women, pain at all perinatal time points-prenatal, labor, and postpartum-appear to be independently linked to depression scores at 6 weeks postpartum. The relationships are true, even though satisfaction and expectations regarding labor pain management were met or exceeded. These data support the concept that labor and acute postpartum pain influences both acute and long-term PPD symptoms, although additional data are needed to assess how analgesia preference interacts with these relationships.
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Affiliation(s)
- Grace Lim
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. .,Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. .,Magee-Womens Research Institute, Pittsburgh, PA, USA. .,UPMC Magee-Womens Hospital, 300 Halket Street, Suite 3510, Pittsburgh, PA, 15213, USA.
| | - Kelsea R LaSorda
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lia M Farrell
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ann M McCarthy
- The Midwife Center for Birth and Womens Health, Pittsburgh, PA, USA
| | - Francesca Facco
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - Ajay D Wasan
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Pittsburgh Center for Pain Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Labrague LJ, McEnroe-Petitte D, Tsaras K, Yboa BC, Rosales RA, Tizon MM, D'souza MS. Predictors of postpartum depression and the utilization of postpartum depression services in rural areas in the Philippines. Perspect Psychiatr Care 2020; 56:308-315. [PMID: 31355473 DOI: 10.1111/ppc.12428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/07/2019] [Accepted: 07/14/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study explored the prevalence and predictors of postpartum depression (PPD) as well as the utilization and evaluation of PPD services among postpartum women in rural areas of the Philippines. DESIGN AND METHODS A cross-sectional study was conducted. One hundred sixty-five women who visited maternal facilities in the rural areas of the Central Philippines completed the Edinburgh Postnatal Depression Scale (EPDS). FINDINGS The prevalence of PPD was 16.4% at the sixth postpartum week. Occupation and marital status had significant direct influences on PPD. PPD services were not routinely provided by doctors and nurses. PRACTICE IMPLICATIONS Our results highlight a greater need to intensify government programs relative to PPD services, specifically related to the early detection and screening of PPD among high-risk pregnancies.
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Affiliation(s)
- Leodoro J Labrague
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | | | - Konstantinos Tsaras
- Department of Nursing, Technological Educational Institute of Thessaly, Larissa, Greece
| | - Begonia C Yboa
- College of Nursing and Health Sciences, Catbalogan, Philippines
| | | | - Maricel M Tizon
- College of Nursing and Health Sciences, Catbalogan, Philippines
| | - Melba S D'souza
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
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Tryphonopoulos PD, Letourneau N. Promising Results From a Video-Feedback Interaction Guidance Intervention for Improving Maternal-Infant Interaction Quality of Depressed Mothers: A Feasibility Pilot Study. Can J Nurs Res 2020; 52:74-87. [PMID: 31910674 DOI: 10.1177/0844562119892769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mothers and infants affected by postpartum depression are known to have (1) reduced quality interactions and (2) elevated cortisol levels, both of which are linked to negative developmental outcomes in children. Parent training promoting sensitive and responsive maternal-infant interactions may help optimize development in children of mothers with postpartum depression. OBJECTIVES This pilot study tested a video-feedback interaction guidance intervention designed to improve maternal-infant interaction, depressive symptoms, and cortisol patterns of depressed mothers and their infants. METHOD An experimental, pre-test, post-test design was employed to randomly assign mothers with postpartum depression to intervention (n = 6) and control (n = 6) conditions. Intervention mothers received three video-feedback sessions during home visits, provided at three-week intervals. Control participants received three home visits on the same schedule. RESULTS Significant differences favoring the intervention group were observed in maternal-infant interaction quality, especially maternal sensitivity and cognitive growth fostering activities, and in reduced infant diurnal cortisol. CONCLUSION Professionally guided video-feedback intervention appears to support improvements in interactions between depressed mothers and their infants and optimizes infants' diurnal cortisol patterns. The findings from this feasibility pilot study have been used to support a large-scale follow-up exploration.
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Affiliation(s)
- Panagiota D Tryphonopoulos
- Arthur Labatt Family School of Nursing, Western University, FIMS and Nursing Building, London, Ontario, Canada
| | - Nicole Letourneau
- Faculty of Nursing, Cumming School of Medicine (Pediatrics, Psychiatry & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
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Agarwala A, Arathi Rao P, Narayanan P. Prevalence and predictors of postpartum depression among mothers in the rural areas of Udupi Taluk, Karnataka, India: A cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2018.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Elwood J, Murray E, Bell A, Sinclair M, Kernohan WG, Stockdale J. A systematic review investigating if genetic or epigenetic markers are associated with postnatal depression. J Affect Disord 2019; 253:51-62. [PMID: 31029013 DOI: 10.1016/j.jad.2019.04.059] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 03/08/2019] [Accepted: 04/08/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Postnatal depression (PND) is common, affects the health of the mother, the development of the infant and places a large financial burden on services. Genetic and epigenetic biomarkers for PND could potentially improve the accuracy of current antenatal screening approaches. The aim of this systematic review is to report on the evidence for an association between genetic or epigenetic factors and postnatal depression. METHOD A systematic search of five databases (Medline, EMBASE, PILOT, PsychINFO and SCOPUS) was carried out using the following (MeSh) terms and keywords: postpartum, depression, postnatal depression, genetics, genetic polymorphisms and epigenetics. Inclusion criteria were applied and quality of studies was assessed using guidelines from the HuGE Review Handbook (Little and Higgins, 2006). RESULTS Following removal of duplicate articles, 543 remained; of these 37 met the inclusion criteria. Positive associations have been reported between PND and polymorphisms in the HMNC1, COMT, MAOT, PRKCB, ESR1, SLC6A4 genes in the presence of stressful life events, the BDNF gene when the postnatal period occurs during autumn and winter months and the OXT and OXTR genes in the presence of childhood adversity experienced by the mother. Epigenetic interactions with genotype, estrogen, and childhood adversity were identified that are predictive of PND. LIMITATIONS The number of studies investigating some of the markers was small and grey literature was not included. CONCLUSION This review highlights the importance of examining the interaction between epigenetic, genetic, hormonal and environmental factors in order to fully understand the risk factors for PND and to improve the accuracy of current antenatal and early postnatal screening procedures. Women susceptible to PND appear to have heightened epigenetic sensitivity to the physiological changes of childbirth or to environmental factors conferred by genotype.
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Affiliation(s)
- Judith Elwood
- Centre for Maternal, Fetal and Infant Research Ulster University, Shore Road, Co. Antrim, N. Ireland BT370Q, United Kingdom.
| | - Elaine Murray
- Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute, Ulster University, United Kingdom
| | - Aleeca Bell
- Department of Women, Children and Family Health Science, University of Illinois at Chicago College of Nursing, United States
| | - Marlene Sinclair
- Centre for Maternal, Fetal and Infant Research Ulster University, Shore Road, Co. Antrim, N. Ireland BT370Q, United Kingdom
| | - W George Kernohan
- Managing Chronic Illness Research Centre, Institute of Nursing and Health Research, Ulster University, United Kingdom
| | - Janine Stockdale
- School of Nursing and Midwifery, Queen's University Belfast, United Kingdom
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Using Matching-Adjusted Indirect Comparisons and Network Meta-analyses to Compare Efficacy of Brexanolone Injection with Selective Serotonin Reuptake Inhibitors for Treating Postpartum Depression. CNS Drugs 2019; 33:1039-1052. [PMID: 31642037 PMCID: PMC6825025 DOI: 10.1007/s40263-019-00672-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Brexanolone injection, the first therapy approved by the US FDA for the treatment of postpartum depression (PPD) in adults, has been shown to produce a significantly greater decrease in the Hamilton Rating Scale for Depression (HAM-D) total score than placebo in randomised controlled trials (RCTs) of women with PPD. OBJECTIVES Given the rapid effect of brexanolone injection (within 60 h) sustained throughout the length of the trials (30 days), we sought to compare its efficacy data against selective serotonin reuptake inhibitors (SSRIs), the class of antidepressants most commonly prescribed for PPD, using HAM-D and Edinburgh Postnatal Depression Scale (EPDS) outcomes from currently available RCTs. METHODS We extracted data from 26 studies identified in a systematic literature review of pharmacological and pharmacological/nonpharmacological combination therapies in PPD. Six studies were suitable to form evidence networks through which to perform indirect treatment comparisons (ITCs) of HAM-D and EPDS outcomes between brexanolone and SSRIs. Having assessed the comparability and suitability of the available evidence for analysis, we discovered significant heterogeneity in the study designs, most notably in the placebo arms of the trials. We therefore conducted matching-adjusted indirect comparisons (MAICs) between brexanolone and the placebo arms of comparator studies, subsequently using the MAIC results of brexanolone versus placebo, and results for SSRIs versus placebo, to form ITCs of brexanolone versus SSRIs at three separate time points-day 3, week 4 and last observation. ITCs were calculated as the differences in change from baseline (CFB) in HAM-D and, separately, CFB in EPDS, between treatments, and reported with 95% confidence intervals (CIs). RESULTS For all time points, MAICs showed larger differences in CFB for brexanolone compared with SSRIs. Differences (95% CIs) between brexanolone and SSRIs were 12.79 (8.04-17.53) [day 3], 5.87 (- 1.62 to 13.37) [week 4] and 0.97 (- 6.35 to 8.30) [last observation] for the HAM-D. For the EPDS, the differences in CFB were 7.98 (5.32-10.64) [day 3], 6.35 (3.13-9.57) [week 4] and 4.05 (0.79-7.31) [last observation]. Other analytical approaches are also presented to demonstrate the similarity of results, using a network meta-analysis approach, and the importance of using the MAIC method to control for the important heterogeneity between placebo arms. CONCLUSIONS Acknowledging the limitations of ITCs and this evidence base, when compared with SSRIs, these analyses suggest that brexanolone demonstrated larger differences in CFB for both patient- and clinician-reported PPD outcomes and at all investigated time points after adjusting for differences between placebos in the included studies.
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Stajić M, Maksimović Ž. Aripiprazole as a mood stabiliser in postpartum depression with premorbid passive-dependent personality structure: A case report. SCRIPTA MEDICA 2019. [DOI: 10.5937/scriptamed50-22410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Riazanova OV, Alexandrovich YS, Ioscovich AM. The relationship between labor pain management, cortisol level and risk of postpartum depression development: a prospective nonrandomized observational monocentric trial. Rom J Anaesth Intensive Care 2018; 25:123-130. [PMID: 30393769 DOI: 10.21454/rjaic.7518.252.rzn] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Postpartum depression (PPD) is the main psychological status disorder and women suffering from postpartum depression often need long-term psychological and socio-economic rehabilitation. The study is dedicated to the evaluation of the role of labor pain management using epidural analgesia in natural delivery on stress level in labor and frequency of postnatal depression. Materials and methods 210 women were investigated and divided into two groups. In the first group for labor pain management in natural delivery, patient-controlled epidural analgesia was used (bolus - 10.0 - 0.08% ropivacaine hydrochloride, lockout - 30 min, limit - 120 ml/6 h) with a background of continuous-flow infusion of local anesthetic 0.08% ropivacaine hydrocluoride solution. Patients in the second group had no pain relief in delivery. The stress level was evaluated using blood plasma cortisol level in the early stages of labor, 6 hours and 3 days after delivery. The assessment of depression development was carried out step-by-step: Before the delivery, 6 hours after, 3 days and 6 weeks after the delivery. Results The baby blues frequency 6 hours after the delivery in the group where the pain relief was conducted was 29.91%, with cortisol level below and equal to 2310.91 nmol/l. In the group with no pain relief 6 hours after delivery, baby blues was found in 15.53% of puerperas (p < 0.05) and the cortisol level was 2673.82 nmol/l (p < 0.05). Six weeks after the birth, postpartum depression was diagnosed in 4.67% of women who received epidural analgesia during delivery, in comparison to 6.79% with no pain relief during delivery. However, the difference was not statistically significant (p < 0.05). Conclusions The use of epidural analgesia leads to a significant reduction of pain syndrome and stress response during natural delivery, increases the risk of baby blues in the early postnatal period, but slightly influences the frequency of postpartum depression.
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Affiliation(s)
- Oksana V Riazanova
- Department of Anesthesiology and Intensive Care, Saint-Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - Yurii S Alexandrovich
- Department of Anesthesiology and Intensive Care, Saint-Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - Alexander M Ioscovich
- Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
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Farré-Sender B, Torres A, Gelabert E, Andrés S, Roca A, Lasheras G, Valdés M, Garcia-Esteve L. Mother-infant bonding in the postpartum period: assessment of the impact of pre-delivery factors in a clinical sample. Arch Womens Ment Health 2018; 21:287-297. [PMID: 29046965 DOI: 10.1007/s00737-017-0785-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 10/03/2017] [Indexed: 11/30/2022]
Abstract
This study aims to examine the extent to which a variety of pre-delivery factors (demographic, reproductive, psychological, psychiatric, and psychopathological) predict disturbances in mother-infant bonding (MIB) in the postpartum period. Two hundred fifty-one pregnant women enrolled at a public perinatal psychiatric service were assessed between the first and second trimester of pregnancy and at 6-7 weeks after delivery. During pregnancy, the psychological risk factors were assessed with the Vulnerable Personality Style Questionnaire, the Marital Adjustment Scale, the Early Trauma Inventory, and the General Health Questionnaire. To detect psychopathology, the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory were used. At the postpartum evaluation, MIB was measured by the Postpartum Bonding Questionnaire. The results of the final regression model showed that emotional abuse in childhood, family psychiatric history, previous psychiatric hospitalization, and anxiety during pregnancy were significant predictors of MIB disturbances in postpartum, explaining 10.7% of the variance. The evaluation of women's risk factors in pregnancy is important in order to prevent MIB disturbances and thus to ensure the welfare of mothers and their babies.
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Affiliation(s)
- Borja Farré-Sender
- Perinatal Psychiatry Program, Department of Psychiatry and Clinical Psychology, Hospital Clinic, C/ Sabino de Arana 1, 08028, Barcelona, Spain. .,Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain.
| | - Anna Torres
- Perinatal Psychiatry Program, Department of Psychiatry and Clinical Psychology, Hospital Clinic, C/ Sabino de Arana 1, 08028, Barcelona, Spain.,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Vulnerability, Psychopathology and Gender research group (SGR2014/1411), Generalitat de Catalunya, Catalonia, Spain.,Department of Psychiatry and Clinical Psychology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Estel Gelabert
- Neuropsychopharmacology Programme, IMIM-Hospital del Mar, Barcelona, Spain
| | - Susana Andrés
- Perinatal Psychiatry Program, Department of Psychiatry and Clinical Psychology, Hospital Clinic, C/ Sabino de Arana 1, 08028, Barcelona, Spain
| | - Alba Roca
- Perinatal Psychiatry Program, Department of Psychiatry and Clinical Psychology, Hospital Clinic, C/ Sabino de Arana 1, 08028, Barcelona, Spain
| | - Gracia Lasheras
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain
| | - Manuel Valdés
- Vulnerability, Psychopathology and Gender research group (SGR2014/1411), Generalitat de Catalunya, Catalonia, Spain.,Department of Psychiatry and Clinical Psychology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lluïsa Garcia-Esteve
- Perinatal Psychiatry Program, Department of Psychiatry and Clinical Psychology, Hospital Clinic, C/ Sabino de Arana 1, 08028, Barcelona, Spain.,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Vulnerability, Psychopathology and Gender research group (SGR2014/1411), Generalitat de Catalunya, Catalonia, Spain
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Abdul Raheem R, Chih HJ, Binns CW. Factors Associated With Maternal Depression in the Maldives: A Prospective Cohort Study. Asia Pac J Public Health 2018; 30:244-251. [DOI: 10.1177/1010539518756380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the study was to document perinatal depression in mothers in the Maldives and associated factors. A cohort of 458 mothers was recruited at the 2 major hospitals in Malé, the Maldives, and followed from 36 weeks of pregnancy to 3 months after birth. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure maternal depression. Maternal sociodemographic factors and infant’s health were also recorded. The prevalence of depressive symptoms (EPDS score ≥13) at 36 weeks of pregnancy and at 1 and 3 months postpartum were 24%, 27%, and 12%, respectively. Having experienced stressful life events is an established risk factor for maternal depression across these time points. Having depressive symptoms during the postpartum period is significantly associated with presence of antenatal depressive symptoms. Future studies may look into effectiveness of strategies that cope with stressors in the management of maternal depression.
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Affiliation(s)
| | - Hui J. Chih
- Curtin University, Western Australia, Australia
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Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S, Ragonesi M, Barkham M, Churchill D, Henshaw C, Newstead J, Slade P, Spiby H, Stewart-Brown S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technol Assess 2018; 20:1-414. [PMID: 27184772 DOI: 10.3310/hta20370] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Postnatal depression (PND) is a major depressive disorder in the year following childbirth, which impacts on women, their infants and their families. A range of interventions has been developed to prevent PND. OBJECTIVES To (1) evaluate the clinical effectiveness, cost-effectiveness, acceptability and safety of antenatal and postnatal interventions for pregnant and postnatal women to prevent PND; (2) apply rigorous methods of systematic reviewing of quantitative and qualitative studies, evidence synthesis and decision-analytic modelling to evaluate the preventive impact on women, their infants and their families; and (3) estimate cost-effectiveness. DATA SOURCES We searched MEDLINE, EMBASE, Science Citation Index and other databases (from inception to July 2013) in December 2012, and we were updated by electronic alerts until July 2013. REVIEW METHODS Two reviewers independently screened titles and abstracts with consensus agreement. We undertook quality assessment. All universal, selective and indicated preventive interventions for pregnant women and women in the first 6 postnatal weeks were included. All outcomes were included, focusing on the Edinburgh Postnatal Depression Scale (EPDS), diagnostic instruments and infant outcomes. The quantitative evidence was synthesised using network meta-analyses (NMAs). A mathematical model was constructed to explore the cost-effectiveness of interventions contained within the NMA for EPDS values. RESULTS From 3072 records identified, 122 papers (86 trials) were included in the quantitative review. From 2152 records, 56 papers (44 studies) were included in the qualitative review. The results were inconclusive. The most beneficial interventions appeared to be midwifery redesigned postnatal care [as shown by the mean 12-month EPDS score difference of -1.43 (95% credible interval -4.00 to 1.36)], person-centred approach (PCA)-based and cognitive-behavioural therapy (CBT)-based intervention (universal), interpersonal psychotherapy (IPT)-based intervention and education on preparing for parenting (selective), promoting parent-infant interaction, peer support, IPT-based intervention and PCA-based and CBT-based intervention (indicated). Women valued seeing the same health worker, the involvement of partners and access to several visits from a midwife or health visitor trained in person-centred or cognitive-behavioural approaches. The most cost-effective interventions were estimated to be midwifery redesigned postnatal care (universal), PCA-based intervention (indicated) and IPT-based intervention in the sensitivity analysis (indicated), although there was considerable uncertainty. Expected value of partial perfect information (EVPPI) for efficacy data was in excess of £150M for each population. Given the EVPPI values, future trials assessing the relative efficacies of promising interventions appears to represent value for money. LIMITATIONS In the NMAs, some trials were omitted because they could not be connected to the main network of evidence or did not provide EPDS scores. This may have introduced reporting or selection bias. No adjustment was made for the lack of quality of some trials. Although we appraised a very large number of studies, much of the evidence was inconclusive. CONCLUSIONS Interventions warrant replication within randomised controlled trials (RCTs). Several interventions appear to be cost-effective relative to usual care, but this is subject to considerable uncertainty. FUTURE WORK RECOMMENDATIONS Several interventions appear to be cost-effective relative to usual care, but this is subject to considerable uncertainty. Future research conducting RCTs to establish which interventions are most clinically effective and cost-effective should be considered. STUDY REGISTRATION This study is registered as PROSPERO CRD42012003273. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- C Jane Morrell
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Paul Sutcliffe
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Stevens
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alison Scope
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Matt Stevenson
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Rebecca Harvey
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alice Bessey
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Anna Cantrell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Cindy-Lee Dennis
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Shijie Ren
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Margherita Ragonesi
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Michael Barkham
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Dick Churchill
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Carol Henshaw
- Division of Psychiatry, Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - Jo Newstead
- Nottingham Experts Patients Group, Clinical Reference Group for Perinatal Mental Health, Nottingham, UK
| | - Pauline Slade
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Sarah Stewart-Brown
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Ahmadpanah M, Nazaribadie M, Aghaei E, Ghaleiha A, Bakhtiari A, Haghighi M, Bahmani DS, Akhondi A, Bajoghli H, Jahangard L, Holsboer-Trachsler E, Brand S. Influence of adjuvant detached mindfulness and stress management training compared to pharmacologic treatment in primiparae with postpartum depression. Arch Womens Ment Health 2018; 21:65-73. [PMID: 28721461 DOI: 10.1007/s00737-017-0753-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 06/19/2017] [Indexed: 12/30/2022]
Abstract
Ten to 15% of mothers experience postpartum depression (PPD). If untreated, PPD may negatively affect mothers' and infants' mental health in the long term. Accordingly, effective treatments are required. In the present study, we investigated the effect of detached mindfulness (DM) and stress management training (SMT) as adjuvants, compared to pharmacologic treatment only, on symptoms of depression in women with PPD. Forty-five primiparae (mean age: M = 24.5 years) with diagnosed PPD and treated with an SSRI (citalopram; CIT) took part in the study. At baseline, they completed questionnaires covering socio-demographic data and symptoms of depression. Experts rated also symptoms of depression. Next, participants were randomly assigned to one of the following study conditions: adjuvant detached mindfulness (CIT+DM); adjuvant stress management training (CIT+SMT); control condition (CIT). Self- and experts' ratings were completed at the end of the study 8 weeks later, and again at 8 weeks follow-up. Symptoms of depression decreased significantly over time, but more so in the CIT+DM and CIT+SMT group, compared to the control condition. The pattern of results remained stable at follow-up. In primiparae with PPD and treated with a standard SSRI, adjuvant psychotherapeutic interventions led to significant and longer-lasting improvements.
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Affiliation(s)
- Mohammad Ahmadpanah
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran
| | - Marzieh Nazaribadie
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran
| | - Elham Aghaei
- Department of Psychology, School of Human Sciences, Shahed University, Tehran, Iran
| | - Ali Ghaleiha
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran
| | - Azade Bakhtiari
- Department of Psychology and Educational Sciences, University of Isfahan, Isfahan, Iran
| | - Mohammad Haghighi
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran
| | - Dena Sadeghi Bahmani
- University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland
| | - Amineh Akhondi
- Hamadan Educational Organization, Ministry of Education, Hamadan, Iran
| | - Hafez Bajoghli
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Jahangard
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran
| | - Edith Holsboer-Trachsler
- University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland
| | - Serge Brand
- University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland. .,University of Basel, Department of Sport, Exercise, and Health; Division of Sport and Psychosocial Health, Basel, Switzerland. .,Kermanshah University of Medical Sciences (KUMS), Psychiatry Department, Kermanshah, Iran.
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49
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Fletcher R, Kay-Lambkin F, May C, Oldmeadow C, Attia J, Leigh L. Supporting men through their transition to fatherhood with messages delivered to their smartphones: a feasibility study of SMS4dads. BMC Public Health 2017; 17:953. [PMID: 29237439 PMCID: PMC5729488 DOI: 10.1186/s12889-017-4978-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 12/05/2017] [Indexed: 11/12/2022] Open
Abstract
Background The transition to parenthood can be a challenging time, in which both mothers and fathers experience increased risk of distress and depression. Mothers are more likely than fathers to engage with services and have their mental health monitored and attended to during the perinatal period. The present study aimed to explore whether smartphone technology could be used to address fathers’ needs across their transition to fatherhood. Methods A corpus of messages, including linked information and mood tracking software, was designed to support and enhance paternal relationships with their babies, their partners and themselves across the perinatal period. Messages were sent to project participants (N = 520) from 12-weeks’ gestation to 24-weeks after birth. Results Of those fathers enrolled (N = 520), 21.5% scored >13 on K6 and completion rate (85%) was similar between these and other fathers. Most fathers (63.1%) clicked at least one link and responses were received for 20.5% of mood tracker questions. The probability of reporting worse mood scores decreased over time. Fathers completing post study surveys (N = 101) reported that messages helped them in their experience of becoming a new dad (92.8%), as well as helping them develop a strong relationship with their new child (54.9%), and in their relationship with their partner (79%). Conclusions The present study has demonstrated that it is both feasible and acceptable to support new fathers with SMS4dads, a relationship-focused messaging system designed to be delivered to smartphones across fathers’ transition to parenthood.
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Affiliation(s)
- Richard Fletcher
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Francis Kay-Lambkin
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Chris May
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, LOT 1 kookaburra circuit, New Lambton Heights, NSW, 2305, Australia
| | - John Attia
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, LOT 1 kookaburra circuit, New Lambton Heights, NSW, 2305, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, LOT 1 kookaburra circuit, New Lambton Heights, NSW, 2305, Australia
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50
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Li M, Chou SY. Modeling postpartum depression in rats: theoretic and methodological issues. DONG WU XUE YAN JIU = ZOOLOGICAL RESEARCH 2017; 37:229-36. [PMID: 27469254 DOI: 10.13918/j.issn.2095-8137.2016.4.229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions.
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Affiliation(s)
- Ming Li
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, 68588-0308 USA.
| | - Shinn-Yi Chou
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, 68588-0308 USA
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