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Amer SA, Zaitoun NA, Abdelsalam HA, Abbas A, Ramadan MS, Ayal HM, Ba-Gais SEA, Basha NM, Allahham A, Agyenim EB, Al-Shroby WA. Exploring predictors and prevalence of postpartum depression among mothers: Multinational study. BMC Public Health 2024; 24:1308. [PMID: 38745303 PMCID: PMC11092128 DOI: 10.1186/s12889-024-18502-0] [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: 02/06/2024] [Accepted: 04/02/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Postpartum depression (PPD) affects around 10% of women, or 1 in 7 women, after giving birth. Undiagnosed PPD was observed among 50% of mothers. PPD has an unfavorable relationship with women's functioning, marital and personal relationships, the quality of the mother-infant connection, and the social, behavioral, and cognitive development of children. We aim to determine the frequency of PPD and explore associated determinants or predictors (demographic, obstetric, infant-related, and psychosocial factors) and coping strategies from June to August 2023 in six countries. METHODS An analytical cross-sectional study included a total of 674 mothers who visited primary health care centers (PHCs) in Egypt, Yemen, Iraq, India, Ghana, and Syria. They were asked to complete self-administered assessments using the Edinburgh Postnatal Depression Scale (EPDS). The data underwent logistic regression analysis using SPSS-IBM 27 to list potential factors that could predict PPD. RESULTS The overall frequency of PPD in the total sample was 92(13.6%). It ranged from 2.3% in Syria to 26% in Ghana. Only 42 (6.2%) were diagnosed. Multiple logistic regression analysis revealed there were significant predictors of PPD. These factors included having unhealthy baby adjusted odds ratio (aOR) of 11.685, 95% CI: 1.405-97.139, p = 0.023), having a precious baby (aOR 7.717, 95% CI: 1.822-32.689, p = 0.006), who don't receive support (aOR 9.784, 95% CI: 5.373-17.816, p = 0.001), and those who are suffering from PPD. However, being married and comfortable discussing mental health with family relatives are significant protective factors (aOR = 0.141 (95% CI: 0.04-0.494; p = 0.002) and (aOR = 0.369, 95% CI: 0.146-0.933, p = 0.035), respectively. CONCLUSION The frequency of PPD among the mothers varied significantly across different countries. PPD has many protective and potential factors. We recommend further research and screenings of PPD for all mothers to promote the well-being of the mothers and create a favorable environment for the newborn and all family members.
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Affiliation(s)
- Samar A Amer
- Department of Public Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Nahla A Zaitoun
- Department of Family Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Heba A Abdelsalam
- Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Abdallah Abbas
- Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Mohamed Sh Ramadan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hassan M Ayal
- Hammurabi Medical College, University of Babylon, Al-Diwaniyah, Iraq
| | | | - Nawal Mahboob Basha
- Department of General Medicine, Shadan Institute of Medical Science, Hyderabad, India
| | - Abdulrahman Allahham
- College of Medicine, Sulaiman Alrajhi University, Albukayriah, Al-Qassim, Saudi Arabia
| | - Emmanuael Boateng Agyenim
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana Legon, Accra, Ghana
| | - Walid Amin Al-Shroby
- Department of Public Health and Community Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Huang C, Fan Y, Hu S. The Prevalence and Influencing Factors of Postpartum Depression Between Primiparous and Secundiparous. J Nerv Ment Dis 2023; 211:190-194. [PMID: 36108287 DOI: 10.1097/nmd.0000000000001591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Since the implementation of "two-child policy" in China, the prevalence and influencing factors of postpartum depression (PPD) between women at first childbirth and second childbirth remains unclear. We aimed to compare the prevalence and the influencing factors of PPD between the two groups. Postpartum women were recruited at their 6-week postpartum checkups and invited to complete questionnaires. The prevalence rate of PPD was 42.1%. There was no statistical difference found regarding the prevalence of PPD and the total score on the Edinburgh Postnatal Depression Scale between the two groups. The median of the item "self-injury" was significantly higher among women at first childbirth. Women with gestational diabetes in pregnancy, antenatal anxiety and depression, abortion, having babies getting sick occasionally, and deteriorated relationships with partner in pregnancy had much higher risks for PPD. Both primiparous and secundiparous had a high prevalence of PPD. It provides scientific evidence for clinical preventive and nursing care for PPD.
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Affiliation(s)
| | | | - Sanlian Hu
- Nursing Department, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Cristóbal-Cañadas D, Parrón-Carreño T, Nievas-Soriano BJ. Effect of the Kangaroo Mother Method after Preterm Delivery on Maternal Stress and Anxiety in the Context of the COVID-19 Pandemic-A Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16432. [PMID: 36554312 PMCID: PMC9778417 DOI: 10.3390/ijerph192416432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The kangaroo mother method (KMM) may benefit infants and mothers in many ways. However, few studies focused on its efficacy on maternal anxiety and stress, especially in the context of the COVID-19 pandemic. OBJECTIVE To examine the effect of the kangaroo mother method (KMM) on postnatal stress and anxiety in mothers of preterm infants in neonatal intensive care, in the context of the COVID-19 pandemic. METHODS A cohort study of two groups of 56 mother-infant dyads recruited from a neonatal intensive care unit was conducted. Two groups were compared in terms of the mean duration of KMM during the twelve days of the study: the intervention group (mean duration of more than ninety minutes per day) and the control group (less than ninety minutes). Maternal stress was measured using the Parental Stressor: Neonatal Intensive Care Unit (PSS: NICU) scale and STAI E/R questionnaire before and after intervention (KMM). Demographic and other maternal covariates were extracted from medical records. Daily NICU records were used to track the frequency and duration of KMM sessions. RESULTS Mothers of the intervention group scored lower on the PSS: NICU and STAI E/R, although no statistically significant differences were found (p > 0.05). CONCLUSIONS Contrary to research based on biological and physiological parameters in newborns or performed before the COVID-19 pandemic, the differences found in applying subjective scales in mothers in the context of the COVID-19 pandemic were not significant. Therefore, mothers' perception of physical contact with their preterm infants may not have been as positive due to their fear of transmitting COVID.
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Affiliation(s)
- Delia Cristóbal-Cañadas
- Neonatal and Pediatric Intensive Care Unit, Torrecárdenas University Hospital, 04009 Almeria, Spain
| | - Tesifón Parrón-Carreño
- Nursing, Physiotherapy and Medicine Department, University of Almeria, 04120 Almeria, Spain
- Andalusian Council of Health at Almeria Province, 04005 Almeria, Spain
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Hamed SA, Elwasify M, Abdelhafez M, Fawzy M. Peripartum depression and its predictors: A longitudinal observational hospital-based study. World J Psychiatry 2022; 12:1061-1075. [PMID: 36158302 PMCID: PMC9476840 DOI: 10.5498/wjp.v12.i8.1061] [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: 10/04/2021] [Revised: 01/08/2022] [Accepted: 07/18/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Depression is a common problem in women in childbearing years due to burdens of motherhood and building a family. Few studies estimate the prevalence of antepartum depression compared to those in the postpartum period.
AIM To estimate the prevalence and the severities of peripartum depression and major depressive disorder and their predictors.
METHODS This is a longitudinal observation study. It included 200 women scoring ≥ 13 with the Edinburgh Postpartum Depression Scale, indicating presence of symptoms of depression. They had a gestational age of ≥ 6 wk and did follow-ups until the 10th week to 12th weeks postpartum. Information of women's reactions to life circumstances and stressors during the current pregnancy were gathered from answers to questions of the designed unstructured clinical questionnaire. Severities of depression, anxiety, and parenting stress were determined by the Beck Depre-ssion Inventory, State-Trait Anxiety Inventory for Adults, and Parenting Stress Index-Short Form, respectively. Psychiatric interviewing was done to confirm the diagnosis of major depression. Measuring the levels of triiodothronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) was done in both antepartum and postpartum periods.
RESULTS Out of 968 (mean age = 27.35 ± 6.42 years), 20.66% (n = 200) of the patients had clinically significant symptoms of depression and 7.44% had major depression. Previous premenstrual dysphoria, post-abortive depression, and depression unrelated to pregnancy and were reported in 43%, 8%, and 4.5% of the patients, respectively. Psychosocial stressors were reported in 15.5% of the patients. Antepartum anxiety and parenting stress were reported in 90.5% and 65% of the patients, respectively. Postpartum T3, T4, and TSH levels did not significantly differ from reference values. Regression analysis showed that anxiety trait was a predictor for antepartum (standardized regression coefficients = 0.514, t = 8.507, P = 0.001) and postpartum (standardized regression coefficients = 0.573, t = 0.040, P = 0.041) depression. Antepartum depression (standardized regression coefficients = -0.086, t = -2.750, P = 0.007), and parenting stress (standardized regression coefficients = 0.080, t = 14.34, P = 0.0001) were also predictors for postpartum depression.
CONCLUSION Results showed that 20.66% of the patients had clinically significant symptoms of depression and 7.44% had major depression. Anxiety was a predictor for antepartum and postpartum depression. Antepartum depression and parenting stress were also predictors for postpartum depression.
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Affiliation(s)
- Sherifa Ahmed Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut 71516, Egypt
| | - Mohamed Elwasify
- Department of Psychiatry, Mansoura University, Mansoura 11001, Egypt
| | - Mohamed Abdelhafez
- Department of Obstetrics and Gynecology, Mansoura University, Mansoura 11001, Egypt
| | - Mohamed Fawzy
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut 71516, Egypt
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Huang C, Han W, Hu S. The Effects of the Solution-Focused Model on Anxiety and Postpartum Depression in Nulliparous Pregnant Women. Front Psychol 2022; 13:814892. [PMID: 35444587 PMCID: PMC9013840 DOI: 10.3389/fpsyg.2022.814892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/14/2022] [Indexed: 12/01/2022] Open
Abstract
Background Solution-focused model (SFM) is an intervention method that fully mobilizes patients’ initiative through their potential. We aimed to investigate the effects of SFM on anxiety and postpartum depression (PPD) in nulliparous pregnant women compared with routine care services. Methods We chose the mothers diagnosed as depressed or with depressive tendency by Edinburgh Postpartum Depression Scale (EPDS) at 28 weeks of gestation and divided them into the intervention and control groups. The control group only took the routine pregnancy healthy nursing, while the SFM group took the regular nursing and SFM counselling. Different assessments were conducted at 28 weeks of gestation, post-delivery, and post-intervention to evaluate the anxiety and depression levels of the patients. Finally, nursing satisfaction was evaluated by the nursing satisfaction questionnaire. Results Compared with the control group, SFM could decrease the scores of anxiety and depression more effectively and influence sleep quality more positively. We also found that SFM resulted in significantly higher nursing satisfaction than that in the control group (p = 0.0046). Conclusion In conclusion, SFM could effectively alleviate anxiety and PPD in nulliparous pregnant women.
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Affiliation(s)
- Cuiqin Huang
- Department of Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Wei Han
- Department of Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Sanlian Hu
- Nursing Department, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Sanlian Hu,
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Erten Ö, Biyik İ, Soysal C, Ince O, Keskin N, Tascı Y. Effect of the Covid 19 pandemic on depression and mother-infant bonding in uninfected postpartum women in a rural region. BMC Pregnancy Childbirth 2022; 22:227. [PMID: 35305584 PMCID: PMC8934050 DOI: 10.1186/s12884-022-04580-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Postpartum depression and maternal-infant attachment scores were examined in uninfected women during the COVID 19 pandemic in Kutahya, a rural province in Turkey's North Aegean region. Methods This cohort study was conducted in the Kutahya Health Sciences University Hospital obstetrics unit between April 2021 and August 2021. 178 low-risk term pregnant women who gave birth were given the surveys Edinburgh Postpartum Depression Scale and Mother-to-Infant Bonding Scale (MIBQ) 6 weeks after birth. The Edinburgh Postpartum Depression Scale was used to determine postpartum depression and the Mother-to-Infant Bonding Scale was used to determine maternal attachment. Results In this study, the postpartum depression rate was calculated as 17.4%. When depressed and non-depressed patients were compared, education level, maternal age, BMI, MIBQ score, history of previous pregnancies, route of delivery, previous operation history, economic status, employment status and pregnancy follow-up information were found to be similar (p > 0.05). The ratings on the Mother-to-Infant Bonding Scale were found to be similar in depressed and non-depressed patients (p > 0.05). The odds of maternal depression for patients who received guests at home was 3.068 (95%CI [1.149–8.191]) times the odds of patients who did not receive guests at home. Conclusions Although a relationship has been found between accepting guests in the postpartum period and postpartum depression, it is necessary to investigate in further studies whether there is a causal relationship.
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Unintended pregnancy and postpartum depression: A meta-analysis of cohort and case-control studies. J Psychosom Res 2020; 138:110259. [PMID: 33002811 DOI: 10.1016/j.jpsychores.2020.110259] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The majority of original studies showed that unintended pregnancy is related to adverse obstetric outcomes, however, up to now, the influence of unintended pregnancy on the risk of developing postpartum depression (PPD) remains unclear. This study aimed to assess the association between unintended pregnancy and the risk of developing PPD by conducting a meta-analysis of cohort and case-control studies. METHODS PubMed, Web of Science, Embase, and Cochrane Library were searched up to December 31, 2019 to identify relevant studies evaluating the association between unintended pregnancy and PPD. Meta-analysis was performed using RevMan software and Stata software. Potential heterogeneity source was explored by subgroup and sensitivity analyses, and potential publication bias was tested using Begg's funnel plots and Begg's linear regression test. RESULTS A total of thirty studies involving 65,454 participants were included in our meta-analysis. Overall, women who get pregnant unintendedly compared with those who are intending to be pregnant were at a significantly higher risk of developing PPD (odds ratio [OR] = 1.53; 95% confidence interval [CI]: 1.35-1.74; P < 0.00001). CONCLUSIONS Unintended pregnancy is significantly associated with the risk of developing PPD. These findings highlight the necessity of screening for pregnancy intention and integrating family planning and personalized mental health services into primary healthcare to promote maternal mental health.
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Aydemir S, Onan N. The Relationship Between Maternal Self-confidence and Postpartum Depression in Primipara Mothers: A Follow-Up Study. Community Ment Health J 2020; 56:1449-1456. [PMID: 32067199 DOI: 10.1007/s10597-020-00588-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 02/13/2020] [Indexed: 11/27/2022]
Abstract
This follow-up study was performed in order to determine the relationship between maternal self-confidence and postpartum depression in primipara mothers over time. It was conducted between February and December 2017 with 82 primipara mothers. Data was collected using Participant information forms, The Pharis Self-confidence Scale (PSCS), and The Edinburgh Postpartum Depression Scale (EPPDS) in three phases in the 6th postpartum week (1st follow up), 10th week (2nd follow up), and 14th week (3rd follow up) and was evaluated using independent t test, Pearson correlation analysis, the Cochran's Q test, and Repeated Measures ANOVA. The mean PSCS scores were found to be 42.6 ± 6.27 in the 1st follow up, 50.3 ± 5.12 in the 2nd follow up, and 55.9 ± 4.05 in the 3rd follow up. EPPDS mean scores were found to be 8.98 ± 5.04 in the 1st follow up, 5.18 ± 3.63 in the 2nd follow up, and 2.09 ± 2.12 in the 3rd follow up. A negative and strong relationship between maternal self-confidence and postpartum depression continuing across follow up phases was found.
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Affiliation(s)
- Sibel Aydemir
- Vocational School of Health Services, Karabuk University, Karabük, Turkey
| | - Nevin Onan
- Department of Psychiatric Nursing, Faculty of Health Sciences, Karabuk University, Demir-Çelik Kampüsü, 78050, Karabük, Turkey.
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Ye Z, Wang L, Yang T, Chen LZ, Wang T, Chen L, Zhao L, Zhang S, Luo L, Qin J. Gender of infant and risk of postpartum depression: a meta-analysis based on cohort and case-control studies. J Matern Fetal Neonatal Med 2020; 35:2581-2590. [PMID: 32635787 DOI: 10.1080/14767058.2020.1786809] [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: 12/24/2022]
Abstract
BACKGROUND It is inconclusive nowadays for the association between infant's gender and their mothers' risk of developing postpartum depression (PPD). In addition, a complete overview is missing. A meta-analysis of cohort and case-control studies was performed to address the question of whether women who gave birth to a female infant were at an increased risk of developing PPD, compared with those giving birth to a male infant. METHODS Unrestricted searches were conducted, with an end date parameter of 31 January 2018, of PubMed, Embase, Google Scholar, Cochrane Libraries, and Chinese databases, to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. RESULTS Twenty-three studies involving 119,736 women were included for analysis. Overall, mothers who gave birth to a female infant experienced a significantly increased risk of developing PPD compared with the reference group (OR = 1.15, 95%CI: 1.01-1.31; p = .03). However, substantial heterogeneity (p < .00001; I2 = 75%) was observed across studies. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed. CONCLUSIONS Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, the present study suggests women giving birth to a girl are associated with a higher risk of developing PPD when compared with those giving birth to a boy. Improving family and social communication and reducing gender preference should be important components of any such interventions.Statement of significanceProblem or issue Interestingly, the known risk factors leading to PPD are basically the same in different regions and cultures, but the gender of the infant seems to be an exception.What is already known Some studies conducted in traditional western countries indicated that there is a weak or null association between infant's gender and risk of PPD, while others suggested a positive association. In contrast, studies conducted in Nigeria, India, Turkey and China showed that mothers giving birth to a female infant were at a higher risk of developing PPD.What this paper adds Today, the association between infant's gender and risk of developing postpartum depression (PPD) is still uncertain; additionally, a complete overview is missing. Our study represents the first meta-analysis of risk of PPD associated with infant's gender.
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Affiliation(s)
- Ziwei Ye
- Central South University, Changsha, China
| | - Lesan Wang
- Central South University, Changsha, China
| | - Tubao Yang
- Central South University, Changsha, China
| | | | | | - Letao Chen
- Central South University, Changsha, China
| | | | | | - Liu Luo
- Central South University, Changsha, China
| | - Jiabi Qin
- Central South University, Changsha, China
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Çankaya S. The effect of psychosocial risk factors on postpartum depression in antenatal period: A prospective study. Arch Psychiatr Nurs 2020; 34:176-183. [PMID: 32513469 DOI: 10.1016/j.apnu.2020.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/29/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study was to determine the psychosocial risk factors that may increase the risk of developing postpartum depression (PPD) symptoms in the antenatal period at postpartum 6-8 weeks. METHODS This study was a prospective longitudinal design, in which women completed questionnaire measures both at the third trimester of pregnancy and 6-8 weeks after birth. The present study was conducted in the women's clinic of a Medical Faculty Hospital in the Central Anatolia region of Turkey between March 15 and August 15, 2019. A total of 245 pregnant women in the third trimester were included in the study. Data were collected using a sociodemographic and obstetric data collection form, Pregnancy Psychosocial Health Assessment Scale, Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Edinburgh Postnatal Depression Scale. RESULTS Forty-four (18%) of the 245 women had scores above the cut-off point (>13) in EPDS. Being subjected to violence from husband or another male member of the family during pregnancy, having problems in marriage, depression, anxiety, and high levels of perceived stress affect the risk of developing PPD by 55% (χ2 = 101.034, P < 0.001). It was observed that those who scored low on the psychosocial health scale, those who experienced unplanned pregnancy, those with pregnancy that was not wanted by the husband, those who were emotionally abused, and those who experienced a sad event in their families were more sensitive to PPD symptoms. CONCLUSIONS Psychosocial health, perceived stress, and psychosocial risk factors, such as depression and anxiety, during pregnancy are important determinants of postpartum depressive symptoms.
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Affiliation(s)
- Seyhan Çankaya
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey.
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Guo YJ, Shan YM, Wang ZJ, Shen ZF. Efficacy of transcranial magnetic stimulation and fluoxetine in the treatment of postpartum depression: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20170. [PMID: 32481286 PMCID: PMC7249935 DOI: 10.1097/md.0000000000020170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/07/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Numerous studies have reported that transcranial magnetic stimulation (TMS) and fluoxetine is used in the treatment of postpartum depression (PPD). Currently, no study has systematically investigated the efficacy and safety of TMS and fluoxetine for the treatment of patients with PPD. Thus, this study will assess the efficacy and safety of TMS and fluoxetine for treating PPD. METHODS Relevant studies involving TMS and fluoxetine for the treatment of patients with PPD will be comprehensively searched from the electronic databases from inception to the February 1, 2020: Cochrane Library, EMBASE, MEDILINE, CINAHL, AMED, WANGFANG, VIP, and CNKI databases. No language and publication time restrictions will be applied. RevMan 5.3 software will be utilized for data pooling, data analysis, and risk of bias evaluation. If necessary, we will also assess reporting bias using funnel plot and Egger test. RESULTS This study will comprehensively summarize the existing evidence to assess the efficacy and safety of TMS and fluoxetine for treating PPD. CONCLUSION The findings of this study may help to establish a better approach to treat PPD using TMS and fluoxetine. DISSEMINATION AND ETHICS This study will be disseminated through a peer-reviewed journal. This study does not need ethical approval as no primary patient data will be used. SYSTEMATIC REVIEW REGISTRATION INPLASY202040017.
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Affiliation(s)
| | - Yong-Ming Shan
- School of Mathematics and Information Engineering, Jiaxing University, Jiaxing, China
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Phoosuwan N, Manwong M, Eriksson L, Lundberg PC. Perinatal depressive symptoms among Thai women: A hospital-based longitudinal study. Nurs Health Sci 2019; 22:309-317. [PMID: 31821706 DOI: 10.1111/nhs.12669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 10/10/2019] [Accepted: 11/02/2019] [Indexed: 11/29/2022]
Abstract
The authors of this longitudinal study investigated risk factors for postpartum depressive symptoms and differences in depressive symptoms at late pregnancy and at 1 and 3 months postpartum. In Sakhonnakhon Province, in northeastern Thailand, 449 women were recruited during late pregnancy and followed at 1 and 3 months postpartum with the use of psychosocial factors. Depressive symptom scores were measured using the Edinburgh Postnatal Depression Scale (EPDS). The scores were compared using dependent-samples t-tests, and multiple linear regression analyses were used to identify risk factors for depressive symptoms at 1 and 3 months postpartum. EPDS scores decreased from late pregnancy to 1 month postpartum and remained on the same level until 3 months postpartum. Low psychological well-being scores and low personal monthly income were risk factors for increased EPDS scores at 1 and 3 months postpartum. Pregnant women in Thailand who have a low income, have limited social support, and report low psychological well-being are at increased risk for postpartum depression. Results of this study suggest they should be screened for depressive symptoms during pregnancy, referred for diagnosis, and provided treatment to reduce the risk of ongoing depressive symptoms during the postpartum period.
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Affiliation(s)
- Nitikorn Phoosuwan
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden.,Faculty of Public Health, Kasetsart University Chalermphrakiat Sakonnakhon Province Campus, Chiang Khruea, Thailand
| | - Mereerat Manwong
- College of Medicine and Public Health, Ubonratchathani University, Ubon Ratchathani, Thailand
| | - Leif Eriksson
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
| | - Pranee C Lundberg
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
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Afshari P, Tadayon M, Abedi P, Yazdizadeh S. Prevalence and related factors of postpartum depression among reproductive aged women in Ahvaz, Iran. Health Care Women Int 2019; 41:255-265. [PMID: 30924721 DOI: 10.1080/07399332.2019.1578779] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In this study authors aimed to identify the prevalence and related factors of postpartum depression in Ahvaz, Iran. A total of 505 women enrolled in this study from six public health centers in Ahvaz city, Republic of Iran. This study started in February and completed in September 2014. Data was gathered using a socio-demographic and Edinburgh Postnatal Depression Scale Persian version. Authors screened women from 14 days to 6 months postpartum. Mothers with a score of >12 were classified as a postpartum depression (PPD). Our results revealed that 196 individuals (38.8%) had PPD. Women with PPD had significantly more of the following characteristics: undesired pregnancy, neonatal hospitalization, congenital abnormalities, history of postpartum depression, history of lifetime episode of depression, stressful events during pregnancy and an experience of domestic violence during pregnancy (p < 0.05). Our results showed that congenital abnormalities (OR = 2.99, 95% CI: 1.44-5.90), history of PPD (OR = 2.61, 95% CI:1.53-4.44), a lifetime episode of depression (OR = 3.26, 95% CI: 1.63-6.49) and having stressful events in the last year (OR = 4.1, CI: 2.19-7.80) were significantly contributed to the PPD. PPD is a common health problem among mothers and screening should be performed after childbearing to identify mothers at the risk.
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Affiliation(s)
- Poorandokht Afshari
- Midwifery Department, Menopause Andropause Research Centre, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mitra Tadayon
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Centre, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shiva Yazdizadeh
- Midwifery Department, Menopause Andropause Research Centre, Jundishapur University of Medical Sciences, Ahvaz, Iran
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Ayhan Başer D. The Evaluation of the Relationship Between Postpartum Depression and Breastfeeding. ANKARA MEDICAL JOURNAL 2018. [DOI: 10.17098/amj.461652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Arifin SRM, Cheyne H, Maxwell M. Review of the prevalence of postnatal depression across cultures. AIMS Public Health 2018; 5:260-295. [PMID: 30280116 PMCID: PMC6141558 DOI: 10.3934/publichealth.2018.3.260] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 07/12/2018] [Indexed: 12/15/2022] Open
Abstract
The purpose of this review was to examine articles related to recent epidemiological evidence of the prevalence of maternal postnatal depression (PND) across different countries and cultures and to identify specific epidemiological studies that have been carried out exclusively in Malaysia on the prevalence of maternal PND. The review was undertaken in two stages, an initial review and an updated review. At both stages systematic literature searches of online databases were performed to identify articles on the prevalence of maternal PND. A total of 124 articles concerning research conducted in more than 50 countries were included in the final analysis. There were wide variations in the screening instruments and diagnostic tools used although the Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument applied to identify PND. The prevalence of maternal PND ranged from 4.0% to 63.9%, with Japan and America recording the lowest and highest rates, respectively. Within continents, a wide variation in reported prevalence was also found. The reported rates of maternal PND in Malaysia were much higher than that previously documented with a range of 6.8–27.3%. This review indicated that the widely cited prevalence of maternal PND of 10–15% underestimates rates of PND worldwide. The reasons for this variability may not be fully explained by review methods. Future studies should evaluate the nature of women's PND experiences across cultures to explain these wide variations.
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Affiliation(s)
- Siti Roshaidai Mohd Arifin
- Department of Special Care Nursing, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling Scotland, United Kingdom
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling Scotland, United Kingdom
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Karaçam Z, Çoban A, Akbaş B, Karabulut E. Status of postpartum depression in Turkey: A meta-analysis. Health Care Women Int 2018; 39:821-841. [DOI: 10.1080/07399332.2018.1466144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Zekiye Karaçam
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Ayden Çoban
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Burcu Akbaş
- Department of Midwifery, Institute of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Erdem Karabulut
- Medical Faculty Department of Biostatistics, Hacettepe University, Ankara, Turkey
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Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries. Front Psychiatry 2018; 8:248. [PMID: 29449816 PMCID: PMC5799244 DOI: 10.3389/fpsyt.2017.00248] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/07/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD and a meta-regression to identify economic, health, social, or policy factors associated with national PPD prevalence. METHODS We conducted a systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To test for country level predictors, we drew on data from UNICEF, WHO, and the World Bank. Random effects meta-regression was used to test national predictors of PPD prevalence. FINDINGS 291 studies of 296284 women from 56 countries were identified. The global pooled prevalence of PPD was 17.7% (95% confidence interval: 16.6-18.8%), with significant heterogeneity across nations (Q = 16,823, p = 0.000, I2 = 98%), ranging from 3% (2-5%) in Singapore to 38% (35-41%) in Chile. Nations with significantly higher rates of income inequality (R2 = 41%), maternal mortality (R2 = 19%), infant mortality (R2 = 16%), or women of childbearing age working ≥40 h a week (R2 = 31%) have higher rates of PPD. Together, these factors explain 73% of the national variation in PPD prevalence. INTERPRETATION The global prevalence of PPD is greater than previously thought and varies dramatically by nation. Disparities in wealth inequality and maternal-child-health factors explain much of the national variation in PPD prevalence.
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Affiliation(s)
- Jennifer Hahn-Holbrook
- Department of Psychology, University of California, Merced, Merced, CA, United States
- Center for Excellence in Biopsychosocial Approaches to Health, Chapman University, Orange, CA, United States
| | | | - Itzel Anaya
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
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Kim Y, Dee V. Sociodemographic and Obstetric Factors Related to Symptoms of Postpartum Depression in Hispanic Women in Rural California. J Obstet Gynecol Neonatal Nurs 2017; 47:23-31. [PMID: 29221670 DOI: 10.1016/j.jogn.2017.11.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To investigate the relationships among sociodemographic and obstetric factors and symptoms of postpartum depression (PPD) in Hispanic women living in rural California. DESIGN Quantitative, cross-sectional, descriptive design. SETTING Rural southern California communities. PARTICIPANTS A convenience sample of 223 Hispanic women, ages 18 to 42 years old, with one living infant younger than 12 months old. METHODS Interviewer-administered Edinburgh Postnatal Depression Scale and sociodemographic and obstetric history survey (maternal age, marital status, education, annual household income, employment, sex of infant, birth type, and number of children). Chi-square and logistic regression analyses were used to determine associations and predictive relationships among sociodemographic and obstetric factors and symptoms of PPD. RESULTS Low education levels, unemployment, cesarean birth, and more than one young child were significantly related to PPD risk (Edinburgh Postnatal Depression Scale scores ≥ 10). Many of the factors associated with PPD symptoms in this sample of Hispanic women were similar to those previously reported in the literature. CONCLUSION Our findings highlighted the need for PPD care among Hispanic women in rural areas. Early assessment and intervention for symptoms of PPD are needed to enhance health equity and promote better health for women who live in rural communities.
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Lin WC, Chang SY, Chen YT, Lee HC, Chen YH. Postnatal paternal involvement and maternal emotional disturbances: The effect of maternal employment status. J Affect Disord 2017; 219:9-16. [PMID: 28501681 DOI: 10.1016/j.jad.2017.05.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/04/2017] [Accepted: 05/06/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Recently, studies have begun emphasizing paternal involvement during the perinatal period and its impact on maternal health. However, most studies have assessed maternal perception and focused on adolescents or minority groups in Western countries. Therefore, the current study investigated the association between paternal involvement and maternal postnatal depression and anxiety, along with the effects of maternal job status in the Asian society of Taiwan. METHODS This study recruited pregnant women in the first trimester of pregnancy as well as their partners on prenatal visits from July 2011 to September 2013 at four selected hospitals in metropolitan areas of Taipei, Taiwan. In total, 593 parental pairs completed the first interview and responded to the follow-up questionnaires until 6 months postpartum. Self-reported data were collected, and multiple logistic regression models were used for analyses. RESULTS Lower paternal childcare and nursing frequency was independently associated with an increased risk of maternal postpartum depression (adjusted odds ratio (OR) =4.33, 95% confidence interval (CI)=1.34-13.98), particularly among unemployed mothers. Furthermore, among unemployed mothers, the risk of postnatal anxiety was 3.14 times higher in couples with fathers spending less time with the child, compared with couples with fathers spending more time (95% CI=1.10-8.98). However, no significant findings were obtained for employed mothers. CONCLUSIONS The high prevalence of maternal postnatal emotional disturbances warrants continual consideration. Higher paternal involvement in childcare arrangements should be emphasized to aid in ameliorating these maternal emotional disturbances, particularly among unemployed mothers.
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Affiliation(s)
- Wan-Chien Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Shin-Yow Chang
- Department of Living Science, National Open University, Taipei, Taiwan
| | - Yi-Ting Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University (Doctoral Student), Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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20
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Gender preference and perinatal depression in Turkey: A cohort study. PLoS One 2017; 12:e0174558. [PMID: 28355286 PMCID: PMC5371330 DOI: 10.1371/journal.pone.0174558] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 03/11/2017] [Indexed: 01/08/2023] Open
Abstract
Background Child gender preference is important in some cultures and has been found to modify risk for antenatal and postnatal depression. We investigated discrepancies in the child gender preference between participating women and other key family members and the extent to which these predicted perinatal depression. Methods In a large cohort study of perinatal depression in urban and rural Turkey, participants had been asked about child gender preferences: their own, and those of their husband, parents, and parents in-law. Of 730 participants recruited in their third trimester (94.6% participation), 578 (79.2%) were reassessed at a mean (SD) 4.1 (3.3) months after childbirth, and 488 (66.8%) were reassessed at 13.7 (2.9) months. Results No associations were found between any gender preference reported in the antenatal period and depression at any examination. On the other hand, we found associations of antenatal depression with differences in participant-reported gender preference and that reported for their mother-in-law (OR 1.81, 1.08–3.04). This non-agreement also predicted depression at the 4 month (OR 2.24, 1.24–4.03) and 14 month (OR 2.07, 1.05–4.04) post-natal examinations. These associations with postnatal depression persisted after adjustment for a range of covariates (ORs 3.19 (1.54–6.59) and 3.30 (1.49–7.33) respectively). Conclusions Reported disagreement in child gender preferences between a woman and her mother-in-law was a predictor of post-natal depression and may reflect wider family disharmony as an underlying factor.
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Kaya V, Uguz F, Sahingoz M, Gezginc K. Pregnancy-Onset Obsessive-Compulsive Disorder: Clinical Features, Comorbidity, and Associated Factors. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20130713091314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Veli Kaya
- Beyhekim State Hospital, Psychiatry Clinic, Konya - Turkey
| | - Faruk Uguz
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Psychiatry, Konya - Turkey
| | - Mine Sahingoz
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Psychiatry, Konya - Turkey
| | - Kazim Gezginc
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Obstetrics and Gynecology, Konya - Turkey
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Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry 2016; 3:973-982. [PMID: 27650773 PMCID: PMC5155709 DOI: 10.1016/s2215-0366(16)30284-x] [Citation(s) in RCA: 596] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/19/2016] [Accepted: 08/22/2016] [Indexed: 12/11/2022]
Abstract
Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries.
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Affiliation(s)
- Bizu Gelaye
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Marta B Rondon
- Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru
| | - Ricardo Araya
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Michelle A Williams
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
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Abdollahi F, Zarghami M, Sazlina SG, Zain AM, Mohammad AJ, Lye MS. Prediction of incidence and bio-psycho-socio-cultural risk factors of post-partum depression immediately after birth in an Iranian population. Arch Med Sci 2016; 12:1043-1051. [PMID: 27695496 PMCID: PMC5016576 DOI: 10.5114/aoms.2016.58642] [Citation(s) in RCA: 4] [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: 11/27/2012] [Accepted: 02/25/2013] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. The purpose of the present study was to determine the incidence of early PPD and possible relevant risk factors among women attending primary health centers in Mazandaran province, Iran for the first time. MATERIAL AND METHODS A longitudinal cohort study was conducted among 2279 eligible women during weeks 32-42 of pregnancy to determine bio-psycho-socio-cultural risk factors of depression at 2 weeks post-partum using the Iranian version of the Edinburgh Postnatal Depression Scale (EPDS). Univariate and hierarchical multiple logistic regression models were used for data analysis. RESULTS Among 1,739 mothers whose EPDS scores were ≤ 12 during weeks 32-42 of gestation and at the follow-up study, the cumulative incidence rate of depression was 6.9% (120/1,739) at 2 weeks post-partum. In the multivariate model the factor that predicted depression symptomatology at 2 weeks post-partum was having psychiatric distress in pregnancy based on the General Health Questionnaire (GHQ) (OR = 1.06, (95% CI: 1.04-1.09), p = 0.001). The risk of PPD also lower in those with sufficient parenting skills (OR = 0.78 (95% CI: 0.69-0.88), p = 0.001), increased marital satisfaction (OR = 0.94 (95% CI: 0.9-0.99), p = 0.03), increased frequency of practicing rituals (OR = 0.94 (95% CI: 0.89-0.99), p = 0.004) and in those whose husbands had better education (OR = 0.03 (95% CI: 0.88-0.99), p = 0.04). CONCLUSIONS The findings indicated that a combination of demographic, sociological, psychological and cultural risk factors can make mothers vulnerable to PPD.
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Affiliation(s)
- Fatemeh Abdollahi
- Department of Public Health, Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehran Zarghami
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shariff-Ghazali Sazlina
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Azhar Md Zain
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Asghari Jafarabadi Mohammad
- Injury Epidemiology and Prevention Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Munn-Sann Lye
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Top ED, Karaçam Z. Effectiveness of Structured Education in Reduction of Postpartum Depression Scores: A Quasi-Experimental Study. Arch Psychiatr Nurs 2016; 30:356-62. [PMID: 27256941 DOI: 10.1016/j.apnu.2015.12.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 09/16/2015] [Accepted: 12/17/2015] [Indexed: 12/21/2022]
Abstract
The aim of this study was to evaluate effectiveness of structured education in reduction of postpartum depression scores among women. This was a quasi-experimental study with a pre-post tests and a control group. Non-random sampling was used and the study included a total of 103 Turkish women, 52 of whom were in the intervention group and 51 were in the control group. The women in the intervention group were offered structured education for postpartum depression and given structured education material. Effectiveness of the education given was evaluated by comparing scores for Edinburg Postpartum Depression Scale obtained before and after delivery between the intervention and the control groups. Before education, median score (8.0±4.8) for Edinburg Postpartum Depression Scale of the intervention group were significantly higher the than the control group (6.0±6.0, p=0.010), but the groups were statistically similar in terms of having depression (intervention: 17.3%, control: 11.8%, p=0.425). After education, the median score for Edinburg Postpartum Depression Scale and the ratio of the women having depression in the intervention group were significantly lower than in the control group (respectively intervention: 4.0±3.0, control: 10.0±4.0, p=0.000; intervention: 7.7%, control: 25.5%, p=0.015). Besides, the median score (8.0±4.8) of the intervention group before education were significantly higher than the score (4.0±3.0) obtained after education (p=0.000), while the median score (6.0±6.0) of the control group before education were lower than the score (10.0±4.0) obtained after education (p=0.000). This study revealed that structured education offered to women by nurses was effective in reducing the postpartum depression scores and the numbers of women having depression.
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Affiliation(s)
- Ekin Dila Top
- İzmir Katip Çelebi University Faculty of Health Sciences, Division of Nursing, İzmir, Turkey
| | - Zekiye Karaçam
- Adnan Menderes University Aydın School of Health, Division of Midwifery, Aydın, Turkey.
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Differentiating between Transient and Enduring distress on the Edinburgh Depression Scale within screening contexts. J Affect Disord 2016; 196:252-8. [PMID: 26943942 DOI: 10.1016/j.jad.2016.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 12/24/2015] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Research has shown that women screened as being 'possibly depressed' on the Edinburgh Depression Scale consist of two distinct duration types: those with Transient distress, and those with Enduring distress. This paper reports on the exploration of antenatal data to ascertain if information from the initial EDS screening can help determine which women may have Transient, and which Enduring, distress after just a few weeks. METHODS Data from three antenatal studies were explored, where the EDS had been given twice within a psychosocial screening setting. Repeat testing of the EDS, together with a diagnostic interview, was conducted 2-5 weeks later. RESULTS Women with Enduring distress (those scoring high on both occasions) were significantly more likely to meet criteria for a depressive disorder than those with Transient distress. They also scored significantly and clinically meaningfully higher on their initial EDS, though no cut-off score was optimal in discriminating between the two duration categories. Differentiation could also not be made from the endorsement of the self-harm question, but was best when women were asked to predict how they would be feeling, and why. LIMITATIONS The data come from three studies just with English-speaking women with slightly different methodologies, producing information on a fairly small number of women with Transient (n=12-29) and Enduring (n=14-25) distress. In addition the EDS re-test interval of between 2 and 5 weeks was quite wide. CONCLUSIONS Clinical implications are that women who score high initially on the EDS are most likely to continue to score high (have Enduring distress) if they themselves think this will be the case, or if they only give wishful thinking as the reason as to why they think they will feel better. Research studies should also therefore analyse their data taking into account this duration category.
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Abdollahi F, Agajani-Delavar M, Zarghami M, Lye MS. Postpartum Mental Health in First-Time Mothers: A Cohort Study. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e426. [PMID: 31168307 PMCID: PMC6549244 DOI: 10.17795/ijpbs-426] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 11/30/2015] [Accepted: 01/13/2016] [Indexed: 11/25/2022]
Abstract
Background Post-partum depression (PPD) can produce adverse symptoms that make motherhood one of the most tumultuous events in a female’s life. First-time mothers who have problems adapting themselves to the mother’s role are more vulnerable to PPD. Objectives The current study aimed to explore the extent of social support and parental self-efficacy on PPD, this study was conducted among the first-time pregnant women. Patients and Methods A prospective cohort study assessed the depressive symptoms and related factors among 838 first-time not depressed pregnant women from third trimester of pregnancy to 12 weeks postpartum who attended primary health centers (Jan to July 2009). The study employed Edinburgh postnatal depression scale, social support appraisals scale, network orientation scale, marital inventory, parental expectation survey and socio-demographic questionnaires. Logistic regression was used for data analysis. Results The incidence of depression was 10.7% at three months post-partum. The adjusted odds ratio showed the PPD was associated with perceived social isolation (OR = 1.06; 95% CI = 1.01 - 1.12), lack of marital satisfaction (OR = 0.91; 95% CI = 0.86 - 0.97) and low parental self-efficacy (OR = 0.74; 95% CI = 0.65 - 0.85). Conclusions A high incidence of PPD was identified among the first-time mothers which makes PPD one of the major health problems in females. The important effects of perceived social isolation, maternal parental self-efficacy, and marital satisfaction on reducing the risk of PPD should be considered.
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Affiliation(s)
- Fatemeh Abdollahi
- Public Health Department, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Mazandaran, IR Iran
| | - Mouloud Agajani-Delavar
- Department of Midwifery, Faculty of Nursing, Fatemezahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Mazandaran, IR Iran
| | - Mehran Zarghami
- Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, IR Iran.,Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Mazandaran, IR Iran
| | - Munn-Sann Lye
- Department of Community Health, Faculty of Medicine and Health Sciences, University of Putra Malaysia, Serdang, Malaysia
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Topuzoğlu A, Binbay T, Ulaş H, Elbi H, Tanık FA, Zağlı N, Alptekin K. The epidemiology of major depressive disorder and subthreshold depression in Izmir, Turkey: Prevalence, socioeconomic differences, impairment and help-seeking. J Affect Disord 2015; 181:78-86. [PMID: 25933098 DOI: 10.1016/j.jad.2015.04.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 04/08/2015] [Accepted: 04/08/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Subclinical and clinical depression is common, widely distributed in the general population, and usually associated with role impairment and help-seeking. Reliable information at the population level is needed to estimate the disease burden of depression and associated care needs in Turkey. METHOD The cross-sectional study aimed to assess the prevalence of subthreshold (SubD) and clinical major depressive disorder (MDD) in Izmir, Turkey. In the 5242 eligible households, a total of 4011 individuals were successfully interviewed, yielding a response rate of 76.5%. Prevalence estimates of MDD and SubD depression were formed by using the responses to the questions of the CIDI section E. Short Form 36 (SF-36) to assess health status and functional impairments in eight scaled scores during the last four weeks. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, as well as prescribed medicines and any hospitalization. RESULTS The one year prevalence estimate for CIDI/DSM IV MDD was 8.2% (95% CI, 7.4-9.1). Less educated, low income, uninsured, low SES, unemployed/disabled and housewives, slum area residents had higher one year MDD prevalence. Determined prevalence of help seeking from mental health services of SubD and MDD cases were 23.6%, 30.6% respectively. Only 24.8% of clinically depressive patients received minimally adequate treatment. LIMITATIONS Cross sectional design. CONCLUSION Higher MDD prevalence correlates with younger ages, female gender, unemployment, less education, lower monthly income, lower SES and uninsurance. Help seeking from mental health services were low. There are treatment gap and impairment in depressive group.
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Affiliation(s)
- Ahmet Topuzoğlu
- Dokuz Eylul University, Department of Psychiatry, Izmir, Turkey.
| | - Tolga Binbay
- Dokuz Eylul University, Department of Psychiatry, Izmir, Turkey
| | - Halis Ulaş
- Dokuz Eylul University, School of Medicine, Department of Psychiatry, Izmir, Turkey
| | - Hayriye Elbi
- Ege University, School of Medicine, Department of Psychiatry, Izmir, Turkey
| | - Feride Aksu Tanık
- Ege University, School of Medicine, Department of Public Health, Izmir, Turkey
| | - Nesli Zağlı
- Ege University, Department of Psychiatry, Izmir, Turkey
| | - Köksal Alptekin
- Dokuz Eylul University, Department of Psychiatry, Izmir, Turkey
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Kirkan TS, Aydin N, Yazici E, Aslan PA, Acemoglu H, Daloglu AG. The depression in women in pregnancy and postpartum period: A follow-up study. Int J Soc Psychiatry 2015; 61:343-9. [PMID: 25069455 DOI: 10.1177/0020764014543713] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM This was a follow-up study to determine postpartum depression (PPD) and its causes in a population previously evaluated in the first trimester of pregnancy. METHODS The study sample consisted of pregnant women who were evaluated in the first trimester and 360 women who were re-evaluated in the postpartum period. Detailed sociodemographic data were obtained from the women, and depression was assessed with the Edinburgh Postpartum Depression scale (EPDS) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I Disorders (SCID-I). RESULTS In this follow-up study, the prevalence of PPD was 35% (n = 126). A depressive disorder in the first trimester of pregnancy, previous mental disorder, somatic disorder, exposure to domestic violence during pregnancy, baby's staying in the incubator and not breastfeeding were predictors of PPD. Exposure to violence and a history of previous depression predicted depression both in pregnancy and in the postpartum period. CONCLUSION Depression rates are high in Eastern Turkey. Exposure to violence during pregnancy and the existence of a previous mental disorder were risk factors for perinatal depression in this study. Performing screening tests can identify women at risk of pregnancy-related depression. Prevention programs should be established in areas where the prevalence of depression is high.
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Affiliation(s)
- Tulay Sati Kirkan
- Department of Psychiatry, Bolge Treatment and Research Hospital, Erzurum, Turkey
| | - Nazan Aydin
- Department of Psychiatry, Bakırköy Mental and Neurologic Disease,Treatment and Research Hospital, İstanbul, Turkey
| | - Esra Yazici
- Department of Psychiatry, Sakarya Training and Research Hospital, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Puren Akcali Aslan
- Department of Psychiatry, Adana Mental and Neurologic Disease Treatment and Research Hospital, Adana, Turkey
| | - Hamit Acemoglu
- Department of Medical Education, Atatürk University, Erzurum, Turkey
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Turkcapar AF, Kadıoğlu N, Aslan E, Tunc S, Zayıfoğlu M, Mollamahmutoğlu L. Sociodemographic and clinical features of postpartum depression among Turkish women: a prospective study. BMC Pregnancy Childbirth 2015; 15:108. [PMID: 25935726 PMCID: PMC4491203 DOI: 10.1186/s12884-015-0532-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 04/16/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is moderate to severe depression in a woman after she has given birth. Findings from several well-designed studies reflect great variability in rates, from 10 to 22%, and also in risk factors for PPD. This variability may reflect geographical location. The incidence and risk factors for PPD among Turkish women are not well documented. It is, however, important to understand the risk factors to develop preventive intervention strategies. This study aims to examine the prevalence of PPD and associated risk factors among a sample of women receiving services at a tertiary obstetrics hospital in Ankara, Turkey. METHODS A sample of 671 women, between 36 and 40 gestational weeks, were enrolled and screened for depressive symptomatology using the Hospital Depression Inventory. Sociodemographic and clinical data were also collected. At a subsequent postpartum evaluation, 6-8 weeks post-delivery, 540 of the 671 were screened using the Edinburgh Postnatal Depression Scale (EPDS) for PPD. RESULTS Eighty-three (15.4%) of the 540 women had scores above the cutoff point (>13) on the EPDS. Statistically significant correlations were found between antenatal, prenatal and postpartum depression scores (r = 0.24). Women reporting suicidal thoughts during pregnancy (OR: 6.99), history of past PPD (OR: 6.64), physical violence during pregnancy (OR: 6.20) or during the postpartum period (OR: 5.87), previous psychiatric history (OR: 4.16), depressive symptoms during pregnancy (OR: 1.70), subjectively lower level of satisfaction with the pregnancy (OR:0. 69), a history of premenstrual syndrome (PMS) (OR: 2.05), and unplanned pregnancy (OR: 1.69) had higher odds for developing PPD. CONCLUSION One in six mothers screened as positive for PPD. Women who had previously been diagnosed with PPD, reported suicidal thoughts during pregnancy, or had been exposed to physical violence were at especially high risk for postpartum depression. To prevent and treat postpartum depression, special attention should be paid to women reporting these characteristics.
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Affiliation(s)
| | - Nezaket Kadıoğlu
- Zekai Tahir Burak (ZTB) Women's Health Research and Education Hospital, Ankara, Turkey
| | - Ebru Aslan
- Zekai Tahir Burak (ZTB) Women's Health Research and Education Hospital, Ankara, Turkey.
| | - Suphi Tunc
- Zekai Tahir Burak (ZTB) Women's Health Research and Education Hospital, Ankara, Turkey.
| | - Müjdegül Zayıfoğlu
- Zekai Tahir Burak (ZTB) Women's Health Research and Education Hospital, Ankara, Turkey.
| | - Leyla Mollamahmutoğlu
- Zekai Tahir Burak (ZTB) Women's Health Research and Education Hospital, Ankara, Turkey.
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Brunton RJ, Dryer R, Saliba A, Kohlhoff J. Pregnancy anxiety: A systematic review of current scales. J Affect Disord 2015; 176:24-34. [PMID: 25687280 DOI: 10.1016/j.jad.2015.01.039] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 01/14/2015] [Accepted: 01/15/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Depression in pregnancy is a serious health issue; however, anxiety in pregnancy, with a reported higher prevalence, may also be a serious issue. Anxiety symptoms in pregnancy can relate to several anxiety types, such as general anxiety, anxiety disorders, and pregnancy-related anxiety (PrA), anxiety characterised by pregnancy specific fears and worries. Awareness of these distinctions however, is not always widespread. Both general anxiety and PrA are associated with maternal negative outcomes (e.g. increased nausea) however; PrA is more often associated with negative outcomes for the child (e.g. preterm birth). Furthermore, PrA is potentially a risk factor for postnatal depression with assessment of PrA potentially affording important intervention opportunities. Currently several different instruments are used for PrA however their psychometric properties are unclear. To our knowledge a review of current instruments and their psychometric properties is lacking, this paper aims to fill that gap. METHODS Studies, which assessed PrA, published between 1983 and 2013 in peer-reviewed journals, were identified. RESULTS Sixty studies were identified after applying inclusion/exclusion criteria, and classified as: pregnancy-related anxiety specific, scales for other constructs, sub scales of another instrument and general anxiety scales. Each scale's strengths and limitations were discussed. LIMITATIONS Our findings may be limited by restricting our review to peer-reviewed journals. This was done however as we sought to identify scales with good psychometric properties. CONCLUSIONS Currently no scales are available for pregnancy-related anxiety with sound theoretical and psychometric properties. Clinically the need for such a scale is highlighted by the potential intervention opportunities this may afford. Future research should be directed towards the development of such a scale.
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Affiliation(s)
- Robyn J Brunton
- School of Psychology, Charles Sturt University, Bathurst, NSW 2795, Australia.
| | - Rachel Dryer
- School of Psychology, Charles Sturt University, Bathurst, NSW 2795, Australia
| | - Anthony Saliba
- School of Psychology, Charles Sturt University, Bathurst, NSW 2795, Australia
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Norhayati MN, Hazlina NHN, Asrenee AR, Emilin WMAW. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord 2015; 175:34-52. [PMID: 25590764 DOI: 10.1016/j.jad.2014.12.041] [Citation(s) in RCA: 444] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 12/15/2014] [Accepted: 12/15/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND The prevalence of postpartum depression worldwide varies from 0.5% to 60.8% in the first 12 months postpartum using self-reported questionnaire. This review aims to update the current magnitude of postpartum depression based on self-reported questionnaire and clinical interview and explore its associated factors in developed and developing countries. METHODS A literature search conducted between 2005 and 2014 identified 203 studies, of which 191 used self-reported questionnaire in 42 countries and 21 used structured clinical interview in 15 countries. Nine studies used a combination of self-reported questionnaire and clinical interview. RESULT The prevalence of postpartum depression varies from 1.9% to 82.1% in developing countries and from 5.2% to 74.0% in developed countries using self-reported questionnaire. Structured clinical interview shows a much lower prevalence range from 0.1% in Finland to 26.3% in India. Antenatal depression and anxiety, previous psychiatric illness, poor marital relationship, stressful life events, negative attitude towards pregnancy, and lack of social support are significant contributors to postpartum depression. LIMITATION All studies are included irrespective of the methodological quality, such as small sample size and their inclusion could affect the generalizability of the results. CONCLUSION The current prevalence of postpartum depression is much higher than that previously reported, and similar risk factors are documented. A culturally sensitive cut-off score with adequate psychometric properties of the screening instruments should be available. In future studies, examining the physical, biological, and cultural factors in qualitative studies and in those with adequate methodological qualities is recommended.
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Affiliation(s)
- M N Norhayati
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
| | - N H Nik Hazlina
- Women Health Development Unit, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - A R Asrenee
- Department of Psychiatry, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - W M A Wan Emilin
- Perpustakaan Hamdan Tahir, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
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Alfayumi-Zeadna S, Kaufman-Shriqui V, Zeadna A, Lauden A, Shoham-Vardi I. The association between sociodemographic characteristics and postpartum depression symptoms among Arab-Bedouin women in Southern Israel. Depress Anxiety 2015; 32:120-8. [PMID: 25044129 DOI: 10.1002/da.22290] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 06/01/2014] [Accepted: 06/04/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Prevalence rates of postpartum depression (PPD) are 10 to 20% among various populations. Little is known about the characteristics of PPD among populations experiencing cultural transition. This study aimed to assess PPD symptoms (PPDS) prevalence and to identify risk factors unique to Arab-Bedouin women in southern Israel. METHODS The sample included 564 women who visited maternal and child health clinics. Sociodemographic characteristics were obtained using in-person interviews. PPDS were assessed using a validated Arabic translation of the Edinburgh Postnatal Depression Scale (EPDS). Prevalence of PPDS was estimated using the cut-off score of EPDS ≥10; a more stringent cut-off score of EPDS ≥13 was used to define women with moderate to severe PPDS. RESULTS The prevalence of PPDS among women was 31%, of which 19.1% were assessed as having moderate to severe symptoms (EPDS ≥ 13). In a multivariate logistic regression, the variables associated with EPDS ≥10 were having an ill-infant odds ratio (OR) = 3.9, lack of husband's support (OR = 2.6), history of emotional problems (OR = 3.2), low income (OR = 1.6), low level of education (OR = 1.6), high marital conflicts (OR = 1.5), and an unplanned pregnancy (OR = 1.5). CONCLUSION In the generally understudied population of Arab-Bedouin women living in southern Israel, we found a high prevalence of PPDS. The unique risk factors described in our research can inform health care professionals in designing interventions for early detection and prevention of PPD.
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Affiliation(s)
- Samira Alfayumi-Zeadna
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Maccabi Healthcare Services, Beer-Sheva, Israel
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Nakić Radoš S, Herman R, Tadinac M. Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women. Health Care Women Int 2015; 37:23-44. [DOI: 10.1080/07399332.2014.992522] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Abdollahi F, Sazlina SG, Zain AM, Zarghami M, Asghari Jafarabadi M, Lye MS. Postpartum depression and psycho-socio-demographic predictors. Asia Pac Psychiatry 2014; 6:425-34. [PMID: 25262614 DOI: 10.1111/appy.12152] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 08/06/2014] [Indexed: 12/11/2022]
Abstract
INTRODUCTION There appears to be a growing international recognition of postpartum depression as a significant public health concern. This paper determined the prevalence and psycho-socio-demographic predictors of postpartum depression symptomatology and its constancy over 12-week postpartum in Mazandaran province Iranian women. METHODS Edinburgh Postnatal Depression Scale and General Health Questionnaire were used to identify possible health and depression status in a cohort of 1,950 eligible pregnant women who attended primary health centers from January to June 2010, at 2 and 12 weeks postpartum. Logistic regression analysis was used to determine the predictors of postpartum depression among women. RESULTS Prevalence of continued depression was found to be 9.9% on all three assessments. A mother's psychological distress, experience of depression, and anxiety in the first and second trimester of pregnancy and a family history of depression were the characteristics that had the strongest significant association with the development of postpartum depression. Women who married at a younger age also were more prone to postpartum depression development. CONCLUSIONS One in ten depressed women in this study continued to be depressed over the 12-week postpartum period. Interventions should target women with the greatest risk, especially those with psychological distress during pregnancy.
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Affiliation(s)
- Fatemeh Abdollahi
- Department of Public Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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Abdollahi F, Zarghami M, Azhar MZ, Sazlina SG, Lye MS. Predictors and incidence of post-partum depression: a longitudinal cohort study. J Obstet Gynaecol Res 2014; 40:2191-200. [PMID: 25132641 DOI: 10.1111/jog.12471] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 04/13/2014] [Indexed: 01/09/2023]
Abstract
AIM This study was designed to identify the incidence and the related factors contributing to post-partum depression (PPD) in women in Iran for the first time. MATERIAL AND METHODS A total of 2279 eligible pregnant women from 32-42 weeks of pregnancy to 12 weeks post-partum (2009) who attended primary health centers in Mazandaran province were screened for depression using the Iranian version of the Edinburgh Postnatal Depression Scale. Pregnant women free from depression were assessed using validated questionnaires, including the Premenstrual Syndrome Questionnaire, Social Support Appraisal Scale, Network Orientation Scale, General Health Questionnaire, Marital Inventory, Life Events Rating Scale and Parental Expectation Survey. Logistic regression analysis was used to determine the risk factors of PPD. RESULTS Of 1801 women who screened negative for depression at 32-42 weeks' gestation, cumulative incidence proportions were 6.7%, 4.3% and 4.5% during 0-2, >2-8 and >8-12 weeks post-partum, respectively. The factors predictive of PPD were: history of depression during the first two trimesters of pregnancy (odds ratio [OR] = 2.55, 95% confidence interval [CI] = 1.59-4.1); psychiatric disorder during pregnancy (OR = 1.08, 95%CI = 1.06-1.11); gestational diabetes (OR = 2.93, 95%CI = 1.46-5.88); recurrent urinary infection (OR = 2.25, 95%CI = 1.44-3.52); unwanted pregnancy (OR = 2.5, 95%CI = 1.69-3.7) and low household income (OR = 3.57, 95%CI = 1.49-8.5). The risk was decreased with increasing age (OR = 0.88, 95%CI = 0.84-0.92) and those with high self-efficacy for mothering (OR = 0.7, 95%CI = 0.62-0.78). CONCLUSION A high rate of new cases of PPD was identified in Iranian women. A combination of psychological, sociological, obstetric and sociodemographic factors can render mothers vulnerable to post-partum depression.
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Affiliation(s)
- Fatemeh Abdollahi
- Public Health Department, Faculty of Health, Addiction Institute, Sari, Iran
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Goker A, Yanikkerem E, Demet MM, Dikayak S, Yildirim Y, Koyuncu FM. Postpartum depression: is mode of delivery a risk factor? ISRN OBSTETRICS AND GYNECOLOGY 2012; 2012:616759. [PMID: 23304542 PMCID: PMC3530850 DOI: 10.5402/2012/616759] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 12/03/2012] [Indexed: 11/23/2022]
Abstract
There are various factors related to postpartum depression. In this study we have aimed to determine the effect of mode of delivery on the risk of postpartum depression. A total of 318 women who applied for delivery were included in the study. Previously diagnosed fetal anomalies, preterm deliveries, stillbirths, and patients with need of intensive care unit were excluded from the study. Data about the patients were obtained during hospital stay. During the postpartum sixth week visit Edinburgh postnatal depression scale (EPDS) was applied. There was no significant difference between EPDS scores when compared according to age, education, gravidity, wanting the pregnancy, fear about birth, gender, family type, and income level (P > 0.05). Those who had experienced emesis during their pregnancy, had a history of depression, and were housewives had significantly higher EPDS scores (P < 0.05). Delivering by spontaneous vaginal birth, elective Cesarean section, or emergency Cesarean section had no effect on EPDS scores. In conclusion healthcare providers should be aware of postpartum depression risk in nonworking women with a history of emesis and depression and apply the EPDS to them for early detection of postpartum depression.
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Affiliation(s)
- Asli Goker
- Department of Obstetrics and Gynecology, University of Celal Bayar, 45030 Manisa, Turkey
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Serhan N, Ege E, Ayrancı U, Kosgeroglu N. Prevalence of postpartum depression in mothers and fathers and its correlates. J Clin Nurs 2012; 22:279-84. [DOI: 10.1111/j.1365-2702.2012.04281.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2012] [Indexed: 01/29/2023]
Affiliation(s)
- Nilüfer Serhan
- Department of Nursing; The Institute of Health Sciences; Selcuk University; Konya; Turkey
| | - Emel Ege
- Department of Nursing; The Institute of Health Sciences; Selcuk University; Konya; Turkey
| | - Unal Ayrancı
- Medico Social Center; Eskisehir Osmangazi University; Meselik-Eskisehir; Turkey
| | - Nedime Kosgeroglu
- Health College; Eskişehir Osmangazi University; Meselik-Eskisehir; Turkey
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Parsons CE, Young KS, Rochat TJ, Kringelbach ML, Stein A. Postnatal depression and its effects on child development: a review of evidence from low- and middle-income countries. Br Med Bull 2012; 101:57-79. [PMID: 22130907 DOI: 10.1093/bmb/ldr047] [Citation(s) in RCA: 226] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION OR BACKGROUND It is well established that postnatal depression (PND) is prevalent in high-income countries and is associated with negative personal, family and child developmental outcomes. SOURCES OF DATA Here, studies on the prevalence of maternal PND in low- and middle-income countries are reviewed and a geographical prevalence map is presented. The impact of PND upon child outcomes is also reviewed. AREAS OF AGREEMENT The available evidence suggests that rates of PND are substantial, and in many regions, are higher than those reported for high-income countries. An association between PND and adverse child developmental outcomes was identified in many of the countries examined. AREAS OF CONTROVERSY Significant heterogeneity in prevalence rates and impact on child outcomes across studies means that the true extent of the disease burden is still unclear. AREAS TIMELY FOR DEVELOPING RESEARCH Nonetheless, there is a compelling case for the implementation of interventions to reduce the impact of PND on the quality of the mother-infant relationship and improve child outcomes.
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Screening for postpartum depression using Kurdish version of Edinburgh postnatal depression scale. Arch Gynecol Obstet 2011; 285:1249-55. [PMID: 22159747 DOI: 10.1007/s00404-011-2165-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 11/23/2011] [Indexed: 12/27/2022]
Abstract
BACKGROUND One of the important public health problems affecting maternal and child health is postpartum depression (PPD). It generally occurs within 6-8 weeks after childbirth. OBJECTIVES To determine the prevalence of postpartum depression (PPD) using a Kurdish version of Edinburgh postpartum depression scale (EPDS) and to analyze the risk factors for postpartum depression in a population of puerperal Kurdish women in Erbil city. PATIENTS AND METHODS A cross-sectional study was conducted between 20th of June and 30th of November 2010, in 14 antenatal care units of primary health centers, in Erbil city, Kurdistan region, Iraq. The sample of the study included 1,000 puerperal women (6-8 weeks postpartum), ranging in age from 14 to 48 years. Data were collected after interviewing the women using a questionnaire designed by the researchers, and the Kurdish version of the EPDS. Chi square test of association and the logistic regression tests were used in the analysis. RESULTS The prevalence of postpartum depression was 28.4%. Logistic regression analysis showed that the factors found to be associated with PPD were: physical or sexual abuse, delivery by cesarean section, history of past psychiatric illness, and family history of past psychiatric illness; while marriage with no previous agreement, and high socio-economic level were associated with lower levels of PPD. CONCLUSION The Kurdish version of the EPDS can be successfully used to screen depression in a Kurdish population of puerperal women.
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Le Strat Y, Dubertret C, Le Foll B. Prevalence and correlates of major depressive episode in pregnant and postpartum women in the United States. J Affect Disord 2011; 135:128-38. [PMID: 21802737 DOI: 10.1016/j.jad.2011.07.004] [Citation(s) in RCA: 173] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 05/24/2011] [Accepted: 07/07/2011] [Indexed: 12/24/2022]
Abstract
BACKGROUND Little is known about the prevalence and comorbidity of Major Depressive Episode (MDE) during pregnancy in the general population. This study presents nationally representative data on the prevalence, correlates, and psychiatric comorbidities of depression in women during pregnancy and postpartum in the United States. METHOD Data were drawn from the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC). The NESARC is a survey of 43,093 adults aged 18 years and older residing in households in the United States of whom 14,549 were women 18 to 50 years old with known past-year pregnancy status. Diagnoses of depression and other mood, anxiety, and drug disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV version. RESULTS The overall prevalence of MDE during pregnancy was 12.4%. Among pregnant and postpartum women, depression was associated with younger age, ethnicity other than Latino, being widowed, divorced, separated or never married, traumatic events within the past 12 months and pregnancy complication. Strong associations were found between MDE during pregnancy and postpartum and nearly all 12-month psychiatric disorders. Past-year depressed pregnant and postpartum women were more likely than nondepressed pregnant women to use substances (including alcohol, illicit drugs and cigarettes). Past-year pregnant and postpartum women were significantly less likely to receive past-year treatment for depression than nonpregnant women although not after adjusting for background sociodemographic characteristics. CONCLUSIONS These results indicate that depression during pregnancy and postpartum is associated with a large range of psychiatric disorders. The high frequency of psychiatric comorbidities, the elevated use of any substances and the high rate of unmet needs should be kept in mind when considering the management of depression during pregnancy and postpartum.
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Affiliation(s)
- Yann Le Strat
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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Sword W, Kurtz Landy C, Thabane L, Watt S, Krueger P, Farine D, Foster G. Is mode of delivery associated with postpartum depression at 6 weeks: a prospective cohort study. BJOG 2011; 118:966-77. [DOI: 10.1111/j.1471-0528.2011.02950.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Witt WP, Wisk LE, Cheng ER, Hampton JM, Creswell PD, Hagen EW, Spear HA, Maddox T, Deleire T. Poor prepregnancy and antepartum mental health predicts postpartum mental health problems among US women: a nationally representative population-based study. Womens Health Issues 2011; 21:304-13. [PMID: 21349740 DOI: 10.1016/j.whi.2011.01.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 12/08/2010] [Accepted: 01/07/2011] [Indexed: 11/12/2022]
Abstract
PURPOSE Mental health problems disproportionately affect women, particularly during the childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. METHODS We examined data on 1,863 mothers from 11 panels of the 1996-2006 Medical Expenditure Panel Survey. Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of "fair" or "poor." RESULTS Of the women included, 9.5% reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor prepregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between prepregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. CONCLUSION Although poor antepartum mental health is the strongest predictor of postpartum mental health problems, prepregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health because they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond.
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Affiliation(s)
- Whitney P Witt
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, USA.
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