Perinatal depression

Efficacy of bright light therapy improves outcomes of perinatal depression: A systematic review and meta-analysis of randomized controlled trials

The efficacy of bright light therapy (BLT) in the context of perinatal depression remains underexplored. This meta-analysis aimed to systematically assess the effectiveness of BLT among perinatal depression. A comprehensive literature search was performed across several databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, CNKI and the clinical trials registry platform, covering the period from the inception of each database up to January 2024. The Cochrane Collaboration's bias assessment tool was employed to evaluate the quality of the included studies. Review Manager 5.3 Software was utilized to conduct the meta-analysis. Six trials, encompassed a total of 167 participants diagnosed with perinatal depression were incorporated quantitative analysis, all of those have been published in English, with no restriction on publication year, and used BLT and dim light therapy (DLT) as intervention. The relative risk (RR) of BLT compared to DLT for perinatal depression is 1.46 (fixed effects model, p = 0.04, 95 % CI = [1.02, 2.10]), indicating a significant improvement in depression outcomes compared to DLT groups. The heterogeneity test yielded an I2 value of 41 % (p = 0.13), indicated a low degree of heterogeneity. Considering the small sample size, we conducted a sensitivity analysis, found RR increased to 2.33 (fixed effects model, p = 0.001, CI = 1.39-3.92). Cochrane Risk of Bias Tool showed only a single study was deemed high quality. This study indicates a beneficial impact of BLT on perinatal depression, subgroup analysis finds no significant mediation effects of different parameters after sensitivity analyses. It is recommended that future studies with larger samples be conducted to explore the effects of BLT on perinatal depression.

The Effect of Health Education Based on the PRECEDE-PROCEED Model on the Psychological State of the Spouses of Primiparous Women During the Puerperium and on Maternal Breastfeeding

Background

Based on the PRECEDE-PROCEED (Predisposing, Reinforcing, and Enabling Causes in Educational Diagnosis and Evaluation-Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development) model (PPM), we investigated the psychological status of the spouses of primiparous women to implement a health education program.

Methods

The study retrospectively analyzed 310 spouses of primigravid women who gave birth from March 2022 to March 2024. 154 spouses received regular education, and 156 spouses aslo received health education of PPM. Binary logistic regression analysis was performed to analyze the independent risk factors for negative emotions of the spouses of primigravid women during puerperium. Analysis of variance was performed to determine the differences in the effect of maternal breastfeeding on the growth and development of infants between the two models of health education.

Results

The health education group based on the PPM was defined as Group A, while the regular health education group was defined as Group B. The SAS (Anxiety self-assessment scale) and SDS (Depression self-assessment scale) of the spouses in Group A were significantly lower than those of the spouses in Group B three days postpartum. Health education intervention (OR = 0.239, P = 0.001), maternal psychological state (OR = 0.458, P = 0.004), and the education level of the spouses (OR = 0.480, P = 0.006) independently influenced the emergence of negative emotions in spouses. The SCL-90 (symptom checklist 90) scores of Group A were significantly lower than those of Group B but significantly higher than the national norm (P < 0.05).

Conclusion

The content of the program not only helps increase the adaptability and participation of the spouses in their role as fathers but also helps increase the effect of maternal breastfeeding on the growth and development of infants.

Incidence of postpartum depression among women with postpartum haemorrhage in Kano, northern Nigeria

The burden of postpartum depression (PPD), an important but largely neglected cause of maternal morbidity, is often increased by the presence of common co-morbidities, such as postpartum haemorrhage (PPH). Additionally, stress and the absence of social support can amplify PPD risk. Understanding the relationship between these conditions will help identify at-risk women and allow prompt intervention. Using a prospective cohort design, we recruited 72 women who had experienced PPH and another 72 women who had not within 24 h of delivery to assess the risk of PPD among them. The cumulative incidence of PPD among all participants was 15.3% (19/124). There was insufficient evidence to suggest that women with PPH have a higher risk of PPH than women without PPH (OR: 1.32; 95% CI: 0.55-3.13). Poor social support and high perceived stress increased the risk of PPD. We recommend screening for PPD among women with high perceived stress and low social support.

Are midwives trained to recognise perinatal depression symptoms? Results of MAMA (MAternal Mood Assessment) cross-sectional survey in Italy

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.

Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions

Pregnancy and childbirth are major life events for women and their families, characterized by physical, psychological, and emotional changes that can trigger anxiety, depression, and mental disorders in susceptible individuals. Acute labor pain is an independent risk factor for persistent pain in the postpartum period and is associated with depressive disorders. Epidural analgesia is a well-established technique that has commonly been regarded as the gold standard in pain management during labor. Although the relationships between labor pain, labor epidural analgesia, and postpartum depression have been studied by many investigators, the results of these studies are conflicting. Some literature suggest that labor epidural analgesia is associated with a reduction in the incidence of postpartum depression; however, other studies have failed to demonstrate this association. Unmet analgesic needs expectations, unmet birth expectations, and/or the quality of social support during labor may contribute to postpartum depression. The limitations of the published studies included differential misclassification of study variables and residual confounding, variations in the diagnosis of depression, and incomplete history data. Thus, future studies should include information on sociodemographic and patient-level variables and assessments of pain during labor or in the postpartum period. Better management of labor pain should be provided to prevent long-term morbidity and improve maternal and neonatal outcomes. Anesthesiologists could collaboratively work with obstetricians and perinatal psychiatrists to ensure that hospitals prioritize screening and treatment for postpartum depression.

Association between gestational depression and weight management behaviors during pregnancy: A cross-sectional study in Eastern China

An undesirable psychological state may deteriorate individual's weight management-related behaviors. This study aims to see if ineffective weight control measures were linked to depressive symptoms during pregnancy. We conducted a cross-sectional questionnaire survey of 784 pregnant women and collected information on sociodemographic factors, maternal characteristics, depression, and weight management activities throughout pregnancy (exercise management, dietary management, self-monitoring regulation, and management objectives). About 17.5% of pregnant women exhibited depressive symptoms. The mean score on dietary management was upper-middle, exercise management and self-monitoring regulation were medium, and management objectives were lower-middle. Multivariable linear regression analysis revealed that pregnant women with depressive symptoms had lower levels of exercise management (β = -1.585, p = 0.005), dietary management (adjusted β = -0.984, p = 0.002), and management objectives (adjusted β = -0.726, p = 0.009). However, there was no significant relationship between depressive symptoms and pregnant women's self-monitoring regulating behavior (p > 0.05). The findings indicated the inverse association between depressive symptoms and gestational weight management behaviors. These results offer important indications for pregnancy weight management professionals by highlighting the need for mental health interventions for pregnant women experiencing depressive symptoms.