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Wang Y, Yan P, Wang G, Liu Y, Xiang J, Song Y, Wei L, Chen P, Ren J. Trajectory on postpartum depression of Chinese women and the risk prediction models: A machine-learning based three-wave follow-up research. J Affect Disord 2024; 365:185-192. [PMID: 39154983 DOI: 10.1016/j.jad.2024.08.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 07/06/2024] [Accepted: 08/12/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Our study delves into postpartum depression (PPD) extending observation up to six months postpartum, addressing the gap in long-term follow-ups and uncover critical intervention points. METHOD Through a continuous three-wave cohort study involving 3174 of 10,730 invited postpartum women, we utilized machine learning to predict PPD risk, incorporating self-reported surveys and health records from October 2021 to Jan 2023. RESULTS PPD prevalence slightly decreased from 30.9 % to 29.1 % over six months. The Random Forest model emerged as the most effective, identifying key predictors of PPD at different stages. The top three factors at first month were newborn's birth weight, maternal weight before delivery and before pregnancy. The EPDS scores of last time, newborn's birth weight and maternal weight before pregnancy and before delivery were main predictors for EPDS scores at third and sixth months postpartum. LIMITATION The study faces limitations such as potential selection bias due to the convenience sampling method and the reliance on self-reported measures, which may introduce reporting bias. Furthermore, the high attrition rate could affect the representativeness of the sample and the generalizability of the findings. CONCLUSION There is a slight decrease in PPD rates over six months, yet the prevalence remains high. This underscores the need for early and ongoing mental health support for new mothers. Our study highlights the efficacy of machine learning in enhancing PPD risk assessment and tailoring intervention strategies, paving the way for more personalized healthcare approaches in postpartum care.
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Affiliation(s)
- Yu Wang
- Department of Obstetric Nursing, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Ping Yan
- Department of Obstetric Nursing, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Guan Wang
- West China School of Nursing, Sichuan University, China
| | - Yi Liu
- Department of Obstetric Nursing, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Jie Xiang
- Department of Obstetric Nursing, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Yujia Song
- School of Computer and Software Engineering, Xihua University, China
| | - Lin Wei
- Department of Obstetric Nursing, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Peng Chen
- School of Computer and Software Engineering, Xihua University, China
| | - Jianhua Ren
- Department of Obstetric Nursing, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China; West China School of Nursing, Sichuan University, China.
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Fu C, Li C, Wan X, Yang Y, Zhang S, Hu J. The Relationship Between Adverse Childhood Experiences and Postpartum Depression: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:3066-3081. [PMID: 38516894 DOI: 10.1177/15248380241235639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Although numerous factors have been found to influence postpartum depression (PPD), no previous meta-analysis have systematically explored whether it is affected by adverse childhood experiences (ACEs). This study aimed to explore the influence of ACEs and their subtypes on PPD. A systematic literature search was conducted using Web of Science, PubMed, Embase, Wan Fang, China Science and Technology Journal Database, Chinese Biomedical Database, and China National Knowledge Infrastructure, and literature was screened according to inclusion and exclusion criteria. Methodological quality assessment and data extraction were performed on the included studies. A random-effects model was used to pool the effects. In total, 24 studies were included, and 73 independent effects were extracted from them. The meta-analysis revealed that ACE was a risk factor for PPD (odds ratio [OR] = 2.31, 95% confidence interval [CI] [2.04, 2.63]). The subgroup analysis results showed that emotional abuse was the ACE subtype most strongly related to the occurrence of PPD (OR = 2.95, 95% CI [2.08, 4.20]), followed by emotional neglect (OR = 2.87, 95% CI [1.89, 4.36]) and sexual abuse (OR = 2.81, 95% CI [1.93, 4.09]). In addition, family member incarceration (OR = 2.62, 95% CI [1.51, 4.54]), physical abuse (OR = 2.31, 95% CI [1.67, 3.19]), and physical neglect (OR = 2.15, 95% CI [1.36, 3.39]) also have strong effects on PPD. ACE is a risk factor for PPD. Early screening of ACE plays an important role in the prevention and intervention of PPD.
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Affiliation(s)
- Congrui Fu
- Hebei Medical University, Shijiazhuang, China
| | - Cong Li
- Hebei Medical University, Shijiazhuang, China
| | - Xin Wan
- Clinical College of Hebei Medical University, Shijiazhuang, China
| | - Yu Yang
- Hebei Medical University, Shijiazhuang, China
| | | | - Jie Hu
- Hebei Medical University, Shijiazhuang, China
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3
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Si S, Zhao G, Song G, Liu J. Assisted reproductive technologies and postpartum depressive symptoms: A meta-analysis. J Affect Disord 2024; 356:300-306. [PMID: 38583599 DOI: 10.1016/j.jad.2024.03.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/08/2024] [Accepted: 03/29/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Assisted reproductive technologies (ARTs) have become the main treatment for infertility. ART treatment can be a stressful life event for infertile females. Whether there is an association between ARTs and postpartum depressive symptoms (PDS) has not been established. METHODS PubMed, MEDLINE, EMBASE, PsycINFO, and CNKI were searched. The pooled outcome was the difference in incidence of PDS within 1 year postpartum between ARTs and the spontaneous pregnancy group. RESULTS A total of 12 cohort studies, which were conducted in eight developed countries and two developing countries, were involved. In total, 106,338 pregnant women, including 4990 infertile females with ARTs treatment and 101,348 women with spontaneous pregnancy, were enrolled in our final analysis. ARTs women had a lower incidence of PDS compared to the spontaneous pregnancy group according to a random effect model (OR = 0.83, 95 % CI: 0.71-0.97, p = 0.022, I2 = 62.0 %). Subgroup analyses indicated that studies on late PDS (follow-up: 3-12 months postpartum) were more heterogeneous than those on early PDS (follow-up: <3 months postpartum) (I2 = 24.3 % vs. I2 = 0 %, interaction p-value < 0.001). There was a strong relationship between ARTs and late PDS (OR = 0.65, 95 % CI: 0.55-0.77, p < 0.001). Therefore, the possible source of heterogeneity was the postpartum evaluation time, which was confirmed by post-hoc meta-regression. LIMITATIONS Some underlying confounders, such as previous psychiatric illness, the limited availability of ARTs, and ethnic disparities, cannot be ignored and may have biased interpretation of the results. CONCLUSION The available data suggested that ARTs were associated with lower incidence of PDS, especially when follow-up lasted over 3 months. However, these findings should be interpreted with caution. Better-designed trials are needed to confirm this association.
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Affiliation(s)
- Si Si
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, China
| | - Ge Zhao
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, China
| | - Guang Song
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Liu
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, China.
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Nashwan AJ, Rehan ST, Imran L, Abbas SG, Khan SF. Exploring the clinical potentials of zuranolone in managing postpartum depression: A new therapeutic horizon. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132:110983. [PMID: 38412941 DOI: 10.1016/j.pnpbp.2024.110983] [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: 10/20/2023] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 02/29/2024]
Abstract
Postpartum depression (PPD) poses a major threat to maternal mental health and wellbeing while also adversely affecting the mother's relationship with her baby, leading to significant repercussions that may hinder the growth and cognitive development of the child. For decades, antidepressants have been the mainstay of treating PPD; however, recent evidence suggests that antidepressants are not as effective as they are believed to be and there is a dire need to explore new treatment options. In 2023, a breakthrough in treating PPD emerged with the recent FDA approval of zuranolone, a gamma-aminobutyric acid (GABAA) receptor selective positive allosteric modulator. The implementation of zuranolone in treating PPD can prove to be revolutionary, considering it is the first oral medication available for PPD. Our review aims to discuss the various clinical trials that have been conducted to validate the efficacy of zuranolone in mitigating the symptoms of PPD, hence, leading to better outcomes for mothers.
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Affiliation(s)
- Abdulqadir J Nashwan
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; Hamad Medical Corporation, Doha 3050, Qatar.
| | | | - Laiba Imran
- Dow University of Health Sciences, Karachi 74200, Pakistan
| | | | - Sara Fahim Khan
- Institute of Professional Psychology, Bahria University, Karachi 75260, Pakistan
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Brunton R. Childhood abuse and perinatal outcomes for mother and child: A systematic review of the literature. PLoS One 2024; 19:e0302354. [PMID: 38787894 PMCID: PMC11125509 DOI: 10.1371/journal.pone.0302354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 04/02/2024] [Indexed: 05/26/2024] Open
Abstract
Childhood abuse can have long-term adverse outcomes in adulthood. These outcomes may pose a particular threat to the health and well-being of perinatal women; however, to date, this body of knowledge has not been systematically collated and synthesized. This systematic review examined the child abuse literature and a broad range of perinatal outcomes using a comprehensive search strategy. The aim of this review was to provide a clearer understanding of the distinct effect of different abuse types and areas where there may be gaps in our knowledge. Following PRISMA guidelines, EBSCO, PsychInfo, Scopus, Medline, CINAHL, PubMed, and Google Scholar databases and gray literature including preprints, dissertations and theses were searched for literature where childhood abuse was associated with any adverse perinatal outcome between 1969 and 2022. Exclusion criteria included adolescent samples, abuse examined as a composite variable, editorials, letters to the editor, qualitative studies, reviews, meta-analyses, or book chapters. Using an assessment tool, two reviewers extracted and assessed the methodological quality and risk of bias of each study. From an initial 12,384 articles, 95 studies were selected, and the outcomes were categorized as pregnancy, childbirth, postnatal for the mother, and perinatal for mother and child. The prevalence of childhood abuse ranged from 5-25% with wide variability (physical 2-78%, sexual 2-47%, and emotional/psychological 2-69%). Despite some consistent findings relating to psychological outcomes (i.e., depression and PTSD), most evidence was inconclusive, effect sizes were small, or the findings based on a limited number of studies. Inconsistencies in findings stem from small sample sizes and differing methodologies, and their diversity meant studies were not suitable for a meta-analysis. Research implication include the need for more rigorous methodology and research in countries where the prevalence of abuse may be high. Policy implications include the need for trauma-informed care with the Multi-level Determinants of Perinatal Wellbeing for Child Abuse Survivors model a useful framework. This review highlights the possible impacts of childhood abuse on perinatal women and their offspring and areas of further investigation. This review was registered with PROSPERO in 2021 and funded by an internal grant from Charles Sturt University.
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Affiliation(s)
- Robyn Brunton
- School of Psychology, Charles Sturt University, Bathurst Campus, Bathurst, NSW, Australia
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Basile-Ibrahim B, Combellick J, Mead TL, Sorensen A, Batten J, Schafer R. The Social Context of Pregnancy, Respectful Maternity Care, Biomarkers of Weathering, and Postpartum Mental Health Inequities: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:480. [PMID: 38673391 PMCID: PMC11049830 DOI: 10.3390/ijerph21040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Background: Mental health disorders are the number one cause of maternal mortality and a significant maternal morbidity. This scoping review sought to understand the associations between social context and experiences during pregnancy and birth, biological indicators of stress and weathering, and perinatal mood and anxiety disorders (PMADs). Methods: A scoping review was performed using PRISMA-ScR guidance and JBI scoping review methodology. The search was conducted in OVID Medline and Embase. Results: This review identified 74 eligible English-language peer-reviewed original research articles. A majority of studies reported significant associations between social context, negative and stressful experiences in the prenatal period, and a higher incidence of diagnosis and symptoms of PMADs. Included studies reported significant associations between postpartum depression and prenatal stressors (n = 17), socioeconomic disadvantage (n = 14), negative birth experiences (n = 9), obstetric violence (n = 3), and mistreatment by maternity care providers (n = 3). Birth-related post-traumatic stress disorder (PTSD) was positively associated with negative birth experiences (n = 11), obstetric violence (n = 1), mistreatment by the maternity care team (n = 1), socioeconomic disadvantage (n = 2), and prenatal stress (n = 1); and inverse association with supportiveness of the maternity care team (n = 5) and presence of a birth companion or doula (n = 4). Postpartum anxiety was significantly associated with negative birth experiences (n = 2) and prenatal stress (n = 3). Findings related to associations between biomarkers of stress and weathering, perinatal exposures, and PMADs (n = 14) had mixed significance. Conclusions: Postpartum mental health outcomes are linked with the prenatal social context and interactions with the maternity care team during pregnancy and birth. Respectful maternity care has the potential to reduce adverse postpartum mental health outcomes, especially for persons affected by systemic oppression.
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Affiliation(s)
| | - Joan Combellick
- School of Nursing, Yale University, Orange, CT 06477, USA; (J.C.)
| | - Thomas L. Mead
- Biomedical Libraries, Dartmouth College, Hanover, NH 03755, USA;
| | - Alee Sorensen
- School of Nursing, Yale University, Orange, CT 06477, USA; (J.C.)
| | - Janene Batten
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT 06510, USA;
| | - Robyn Schafer
- Division of Advanced Nursing Practice, School of Nursing, Rutgers University, Newark, NJ 07107, USA;
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
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7
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Konjevod M, Gredicak M, Vuic B, Tudor L, Nikolac Perkovic M, Milos T, Svob Strac D, Pivac N, Nedic Erjavec G. Overview of metabolomic aspects in postpartum depression. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110836. [PMID: 37541332 DOI: 10.1016/j.pnpbp.2023.110836] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/06/2023]
Abstract
Along with the typical biochemical alterations that occur during pregnancy, certain metabolic changes might be associated with the development of several psychiatric disorders, including postpartum depression (PPD), which is the most common type of psychiatric disorder during pregnancy or first postpartum year, and it develops in about 15% of women. Metabolomics is a rapidly developing discipline that deals with the metabolites as the final products of all genetically controlled biochemical pathways, highly influenced by external and internal changes. The aim of this paper was to review the published studies whose results suggest or deny a possible association between the fine regulation of the metabolome and PPD, enabling conclusions about whether metabolomics could be a useful tool in defining the biochemical pathways directly involved in the etiology, diagnosis and course of PPD. Beside numerous hormonal changes, a lot of different metabolic pathways have been discovered to be affected in women with PPD or associated with its development, including alterations in the energy metabolism, tryptophan and amino acid metabolism, steroid metabolism, purine cycle, as well as neurotransmitter metabolism. Additionally, metabolomics helped in defining the association between PPD and the exposure to various endocrine disrupting metabolites during pregnancy. Finally, metabolome reflects different PPD therapies and exposure of fetus or breastfed infants to pharmacotherapy prescribed to a mother suffering from PPD. This review can help in creating the picture about metabolomics' broad application in PPD studies, but it also implies that its potential is still not completely used.
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Affiliation(s)
| | - Martin Gredicak
- General Hospital Zabok and Hospital for the Croatian Veterans, Bracak 8, p.p. 36, 49210 Zabok, Croatia
| | - Barbara Vuic
- Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia.
| | - Lucija Tudor
- Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia.
| | | | - Tina Milos
- Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia.
| | | | - Nela Pivac
- Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia; University of Applied Sciences Hrvatsko Zagorje Krapina, Setaliste hrvatskog narodnog preporoda 6, 49000 Krapina, Croatia.
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Waqas A, Nadeem M, Rahman A. Exploring Heterogeneity in perinatal depression: a comprehensive review. BMC Psychiatry 2023; 23:643. [PMID: 37667216 PMCID: PMC10478465 DOI: 10.1186/s12888-023-05121-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 08/18/2023] [Indexed: 09/06/2023] Open
Abstract
Perinatal depression (PND) is a significant contributor to maternal morbidity globally. Recognized as a major cause of poor infant development, epidemiological and interventional research on it has increased over the last decade. Recently, studies have pointed out that PND is a heterogeneous condition, with variability in its phenotypes, rather than a homogenous latent entity and a concrete diagnosis, as previously conceptualized in psychometric literature and diagnostic systems. Therefore, it is pertinent that researchers recognize this to progress in elucidating its aetiology and developing efficacious interventions.This systematic review is conducted in accordance with the Meta-analysis of observational studies in epidemiology (MOOSE). It aims to provide an updated and comprehensive account of research on heterogeneity in phenotypes of PND and its implications in research, public health, and clinical practice. It provides a synthesis and quality assessment of studies reporting heterogeneity in PND using cutting-edge statistical techniques and machine learning algorithms. After reporting the phenotypes of PND, based on heterogeneous trajectories and symptom profiles, it also elucidates the risk factors associated with severe forms of PND, followed by robust evidence for adverse child outcomes. Furthermore, recommendations are made to improve public health and clinical practice in screening, diagnosis, and treatment of PND.
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Affiliation(s)
- Ahmed Waqas
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK.
| | | | - Atif Rahman
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
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9
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Wedajo LF, Alemu SS, Jarso MH, Golge AM, Dirirsa DE. Late postpartum depression and associated factors: community-based cross-sectional study. BMC Womens Health 2023; 23:280. [PMID: 37221573 DOI: 10.1186/s12905-023-02444-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Late postpartum depression is the presence of depressive symptoms beyond the early postpartum period and is a significant mental health problem that has a devastating impact on mothers, infants, partners, family members, the healthcare system, and the world's economy. However, there is limited information regarding this problem in Ethiopia. OBJECTIVE To assess the prevalence of late postpartum depression and associated factors. METHOD the community-based cross-sectional study was employed among 479 postpartum mothers in Arba Minch town from May 21 to June 21, 2022. The pre-tested face-to-face interviewer administered a structured questionnaire used to collect the data. A bivariate and multivariable analysis was done using a binary logistic regression model to identify factors associated with late postpartum depression. Both crude and adjusted odds ratios with 95% CI were calculated, and a p-value of < 0.05 was used to declare statistically significant factors. RESULT The prevalence of late postpartum depression was 22.98% (95% CI: 19.16, 26.80). Husband Khat use (AOR = 2.64; 95% CI: 1.18, 5.91), partner dissatisfaction with the gender of the baby (AOR = 2.53; 95% CI: 1.22, 5.24), short inter-delivery interval (AOR = 6.80; 95% CI: 3.34, 13.84), difficulty to meet husband sexual need (AOR = 3.21; 95% CI: 1.62, 6.37), postpartum intimate partner violence (AOR = 4.08; 95% CI: 1.95, 8.54), and low social support (AOR = 2.50; 95% CI: 1.25, 4.50) were significantly associated factors at p-value < 0.05. CONCLUSION Overall, 22.98% of mothers suffered from late postpartum depression. Therefore, based on the identified factors, the Ministry of Health, Zonal Health Departments, and other responsible agencies should establish effective strategies to overcome this problem.
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Affiliation(s)
- Lema Fikadu Wedajo
- Department of Midwifery, Mattu University College of medical and Health Sciences, Mattu, Ethiopia.
| | - Solomon Seyife Alemu
- Department of Midwifery, Mattu University College of medical and Health Sciences, Mattu, Ethiopia
- Department of Midwifery, Madda Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Mohammedamin Hajure Jarso
- Department of Psychiatry, Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Aman Mamo Golge
- Department of Nursing, Madda Walabu University College of Medicine and Health Sciences, Sheshemene, Ethiopia
| | - Dejene Edosa Dirirsa
- College of Medicine and Health Sciences, Department of Midwifery, Salale University, Salale, Ethiopia
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Ding X, Liang M, Wang H, Song Q, Guo X, Su W, Li N, Liu H, Ma S, Zhou X, Sun Y. Prenatal stressful life events increase the prevalence of postpartum depression: Evidence from prospective cohort studies. J Psychiatr Res 2023; 160:263-271. [PMID: 36889197 DOI: 10.1016/j.jpsychires.2023.02.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 03/10/2023]
Abstract
Postpartum depression (PPD) occurs frequently among postpartum women. Stressful life events (SLE) have gradually been recognized as risk factors for PPD. However, research on this topic has produced equivocal results. The purpose of this study was to explore whether women who experienced prenatal SLE had a higher prevalence of PPD. Electronic databases were systematically searched until October 2021. Only prospective cohort studies were included. Pooled prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using random effects models. This meta-analysis included 17 studies involving 9822 individuals. Women who experienced prenatal SLE had a higher prevalence for PPD (PR = 1.82, 95%CI = 1.52-2.17). In subgroup analyses, a 112% and 78% higher prevalence of depressive disorders (PR = 2.12, 95%CI = 1.34-3.38) and depressive symptoms (PR = 1.78, 95%CI = 1.47-2.17) were detected in women who experienced prenatal SLE. The effect of SLE on PPD at postpartum different time points differed: PR = 3.25 (95%CI = 2.01-5.25) for ≤6 weeks, PR = 2.01 (95%CI = 1.53-2.65) for 7-12 weeks, PR = 1.17 (95%CI = 0.49-2.31) for >12 weeks. No obvious publication bias was detected. The findings support that prenatal SLE increase the prevalence of PPD. The effect of SLE on PPD tends to slightly decrease during the postpartum period. Furthermore, these findings highlight the importance of screening for PPD as early as possible, particularly among postpartum women who have experienced SLE.
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Affiliation(s)
- Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiaoqin Zhou
- Department of Psychiatry, Chaohu Hospital/Anhui Psychiatric Center, Anhui Medical University, Hefei, 238000, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Chaohu Hospital, Anhui Medical University, Hefei, 238000, China; Centre for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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11
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Gauld C, Pignon B, Fourneret P, Dubertret C, Tebeka S. Comparison of relative areas of interest between major depression disorder and postpartum depression. Prog Neuropsychopharmacol Biol Psychiatry 2023; 121:110671. [PMID: 36341842 DOI: 10.1016/j.pnpbp.2022.110671] [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: 04/20/2022] [Revised: 10/11/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Postpartum depression (PPD) is defined as a major depressive disorder (MDD) beginning after childbirth. Wide debates aim to better understand PPD's specificities compared with MDD. One of the keys in differentiating PPD from MDD is to systematically study scientific "Areas Of Interest" (AOIs) of these disorders. METHODS In November 2021, we performed an extraction and textual computational analysis of associated terms for PPD and MDD, using the biomedical database PubMed. We performed an undirected lexical network analysis to map the 150 first terms in space. Then, we used an unsupervised machine learning technique to detect word patterns and automatically cluster AOIs with a topic-modeling analysis. RESULTS We identified 30,000 articles of the 554,724 articles for MDD and 15,642 articles for PPD. Four AOIs were detected in the MDD network: mood disorders and their treatments, risk factors, consequences and quality of life, and mental health and comorbidities. Five AOIs were detected in the PPD network: mood disorders and treatments, risk factors, consequences and child health, patient's background, and the challenges of screening. DISCUSSION AND CONCLUSION Limitations are both methodological, in particular due to the qualitative interpretation of AOIs, and are also related to the difficult transferability of these research results to the clinical practice. The partial overlap between AOIs for MDD and for PPD suggest that the latter is a particular form of the former.
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Affiliation(s)
- Christophe Gauld
- Department of Psychopathology of Child and Adolescent Development, Hospices Civils de Lyon, Lyon 1, France; UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France.
| | - Baptiste Pignon
- Univ Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », France; DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Pierre Fourneret
- Department of Psychopathology of Child and Adolescent Development, Hospices Civils de Lyon, Lyon 1, France; Marc Jeannerod Institute of Cognitive Sciences UMR 5229, CNRS & Claude Bernard University, Lyon 1, France
| | - Caroline Dubertret
- Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neurosciences, Team 1, Paris, France; Department of Psychiatry, AP-HP, Louis Mourier Hospital, F-92700 Colombes, France
| | - Sarah Tebeka
- Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neurosciences, Team 1, Paris, France; Department of Psychiatry, AP-HP, Louis Mourier Hospital, F-92700 Colombes, France
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Kjeldsen MMZ, Bricca A, Liu X, Frokjaer VG, Madsen KB, Munk-Olsen T. Family history of psychiatric disorders as a risk factor for maternal postpartum depression: a systematic review protocol. Syst Rev 2022; 11:68. [PMID: 35422027 PMCID: PMC9011941 DOI: 10.1186/s13643-022-01952-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 04/06/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is the most common postpartum psychiatric disorder, affecting 11-15% of new mothers, and initiatives towards early identification and treatment are essential due to detrimental consequences. Family history of psychiatric disorders is a risk factor for developing psychiatric episodes outside the postpartum period, but evidence of the association between familial risk and PPD is not clear. Hence, the objective of this systematic review is to summarize the current literature on the association between family history of psychiatric disorders and PPD. METHODS This protocol has been developed and reported according to the PRISMA-P guidelines for systematic reviews. A comprehensive literature search will be conducted in PubMed, Embase, and PsycINFO from inception of the databases, supplemented with citation tracking and reference screening of the included studies. Two independent authors will examine all retrieved articles for inclusion in two steps: title/abstract screening and full-text screening. Eligible studies are case-control and cohort studies reporting a risk estimate for the association between family history of psychiatric disorders and PPD. Studies will be assessed for risk of bias using the Newcastle-Ottawa Scale. The association between family psychiatry and PPD will be combined in a meta-analysis using a restricted maximum likelihood method (REML). Heterogeneity will be quantified using I2 and investigated through meta-regression, subgroup and sensitivity analyses, and publication bias will be evaluated via visual inspection of a funnel plot. The overall strength and quality of the findings will be evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. If meta-analysis is not possible, data will be synthesized narratively in text and tables. DISCUSSION This systematic review will be the first to summarize current knowledge and present an overall estimate for the association between family history of psychiatric disorders and PPD. Evaluation of psychiatric family history as a PPD risk factor is essential to assist early identification of women at high risk of PPD in routine perinatal care. SYSTEMATIC REVIEW REGISTRATION PROSPERO ID: 277998 (registered 10th of September 2021).
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Affiliation(s)
- Mette-Marie Zacher Kjeldsen
- National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 26, 8210 Aarhus V, Aarhus, Denmark. .,Department of Public Health, Aarhus University, Aarhus, Denmark.
| | - Alessio Bricca
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Xiaoqin Liu
- National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 26, 8210 Aarhus V, Aarhus, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kathrine Bang Madsen
- National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 26, 8210 Aarhus V, Aarhus, Denmark
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 26, 8210 Aarhus V, Aarhus, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Kariuki EW, Kuria MW, Were FN, Ndetei DM. Predictors of postnatal depression in the slums Nairobi, Kenya: a cross-sectional study. BMC Psychiatry 2022; 22:242. [PMID: 35382788 PMCID: PMC8981836 DOI: 10.1186/s12888-022-03885-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postnatal depression (PND) is a universal mental health problem that prevents mothers' optimal existence and mothering. Although research has shown high PND prevalence rates in Africa, including Kenya, little research has been conducted to determine the contributing factors, especially in low-resource communities. OBJECTIVE This study aimed to investigate the PND risk factors among mothers attending Lang'ata and Riruta Maternal and Child Health Clinics (MCH) in the slums, Nairobi. METHODS This study was cross-sectional. It is part of a large study that investigated the effectiveness of a brief psychoeducational intervention on PND. Postnatal mothers (567) of 6-10 weeks postanatal formed the study population. Depression rate was measured using the original 1961 Beck's Depression Inventory (BDI). In addition, a sociodemographic questionnaire (SDQ) was used to collect hypothesized risk variables. Multivariable logistic regression analysis was used to explore predictors of PND. RESULTS The overall prevalence of PND in the sample of women was 27.1%. Women aged 18-24 (β = 2.04 95% C.I.[0.02; 4.05], p = 0.047), dissatisfied with body image (β = 4.33 95% C.I.[2.26; 6.41], p < 0.001), had an unplanned pregnancy (β = 2.31 95% C.I.[0.81; 3.80], p = 0.003 and felt fatigued (β = - 1.85 95% C.I.[- 3.50; 0.20], p = 0.028) had higher odds of developing PND. Participants who had no stressful life events had significantly lower depression scores as compared to those who had stressful life events (β = - 1.71 95% C.I.[- 3.30; - 0.11], p = 0.036) when depression was treated as a continuous outcome. Sensitivity analysis showed that mothers who had secondary and tertiary level of education had 51 and 73% had lower likelihood of having depression as compared to those with a primary level of education (A.O.R = 0.49 95% C.I.[0.31-0.78], p = 0.002) and (A.O.R = 0.27 95% C.I.[0.09-0.75], p = 0.013) respectively. CONCLUSION This study reveals key predictors/risk factors for PND in low-income settings building upon the scanty data. Identifying risk factors for PND may help in devising focused preventive and treatment strategies.
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Affiliation(s)
- Esther W. Kariuki
- grid.10604.330000 0001 2019 0495Department of Psychiatry, School of Medicine, The University of Nairobi, P.O. Box 30197, GPO, Nairobi, Kenya
| | - Mary W. Kuria
- grid.10604.330000 0001 2019 0495Department of Psychiatry, School of Medicine, The University of Nairobi, P.O. Box 30197, GPO, Nairobi, Kenya
| | - Fredrick N. Were
- grid.10604.330000 0001 2019 0495Department of Psychiatry, School of Medicine, The University of Nairobi, P.O. Box 30197, GPO, Nairobi, Kenya
| | - David M. Ndetei
- grid.10604.330000 0001 2019 0495Department of Psychiatry, School of Medicine, The University of Nairobi, P.O. Box 30197, GPO, Nairobi, Kenya
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