Multidimensional influencing factors of postpartum depression based on the perspective of the entire reproductive cycle: evidence from western province of China

OBJECTIVE

China has a serious burden of Postpartum depression (PPD). In order to improve the current situation of high burden of PPD, this study explores the factors affecting PPD from the multidimensional perspectives with physiology, family support and social support covering the full-time chain of pre-pregnancy-pregnancy-postpartum.

METHODS

A follow-up survey was conducted in the Qujing First People's Hospital of Yunnan Province from 2020 to 2022, and a total of 4838 pregnant women who underwent antenatal checkups in the hospital were enrolled as study subjects. Mothers were assessed for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and logistic regression was used to analyse the level of mothers' postnatal depression and identify vulnerability characteristics.

RESULTS

The prevalence of mothers' PPD was 46.05%, with a higher prevalence among those who had poor pre-pregnancy health, had sleep problems during pregnancy, and only had a single female fetus. In the family support dimension, only family care (OR = 0.52, 95% CI 0.42-0.64) and only other people care(OR = 0.78, 95% CI 0.64-0.96) were the protective factors of PPD. The experience risk of PPD was higher among mothers who did not work or use internet.

CONCLUSION

The PPD level in Yunnan Province was significantly higher than the global and Chinese average levels. Factors affecting mothers' PPD exist in all time stages throughout pregnancy, and the influence of family support and social support on PPD shouldn't be ignored. There is an urgent need to extend the time chain of PPD, move its prevention and treatment forward and broaden the dimensions of its intervention.

The impact of prenatal depression and diabetes management self-efficacy on postpartum stress and depression in women with gestational diabetes mellitus

AIMS

The study aimed to examine the impact of prenatal depression and diabetes management self-efficacy on postpartum stress and postpartum depression in women with gestational diabetes mellitus.

BACKGROUND

Poor perinatal mental health is linked to various adverse pregnancy outcomes in women with gestational diabetes mellitus.

DESIGNS

A predictive study design and the guidelines for the STROBE checklist were used for the study.

METHODS

A total of 119 pregnant women with a positive 75 g-glucose challenge test were recruited at a medical centre. The Taiwanese depression questionnaire (TDQ), the diabetes management self-efficacy scale (DMSES) and the Hung postpartum stress scale (Hung PSS) were used for data collection at the 24th week of pregnancy and the first week after childbirth.

RESULTS

Diabetes management self-efficacy was correlated with postpartum stress in women with gestational diabetes mellitus. Moreover, prenatal depression was a predictor of postpartum stress and postpartum depression, respectively, in women with gestational diabetes mellitus.

CONCLUSIONS

Healthcare providers should assess those women's diabetes management self-efficacy and mood status during prenatal visits and offer the needed intervention to reduce the levels of postpartum stress and postpartum depression of those women after childbirth.

RELEVANCE TO CLINICAL PRACTICE

A holistic care approach integrated diabetic care and mental health for women with gestational diabetes mellitus in a timely manner is warranted to promote perinatal mental health in women with gestational diabetes mellitus.

A Practice-Based Research Database to Study Perinatal Nurse Home Visiting to Pregnant Women With Diabetes

BACKGROUND AND AIMS

Accumulation of real-world evidence from practice-based perinatal nurse home visits to pregnant women with diabetes prompted this translational perinatal health disparities research. Given the global diabetes epidemic, this academic-community partnered research team is studying the utilization, processes, and outcomes of this understudied model of perinatal nurse home visiting that provide home-based enhanced diabetes care to pregnant women. Because the nursing records provide the rich source of data for the study, our aim is to provide an in-depth description of the Philadelphia Pregnancy and Diabetes Home Visiting (PPD-HV) research database developed from data in the longitudinal nursing records.

METHODS

This descriptive study uses retrospective data abstracted from paper-based perinatal nurse home visiting clinical records to create the PPD-HV, a HIPAA compliant, secure REDCap electronic research database. The sample includes 248 urban, pregnant women with diabetes who received a total of 1,644 home visits during the year 2012. The setting was Philadelphia, a large metropolitan city in the northeastern part of the United States. The PPD-HV database followed the information fields of the paper-based clinical nursing forms, which were originally designed by following the Omaha System to guide documenting the nursing process used in caring for patients in their homes.

RESULTS

Using REDCap, the PPD-HV research database is robust with 239 variables and captures longitudinal clinical nursing data. Among the pregnant women with diabetes receiving nurse home visits, the mean age was 30.7 years, most were single, and had given birth to other children.

LINKING EVIDENCE TO ACTION

Real-world clinical nursing practice data provide a rich source of research data to advance understandings about this model of enhanced diabetes care and the pregnant women with diabetes receiving the care. Considering the global epidemic of diabetes, this is a perinatal nurse home visiting model to replicate and evaluate.

The Perinatal Biopsychosocial Consequences of Various Levels of Gestational Hyperglycemia

This study was to compare biopsychosocial consequences among three groups of women with gestational hyperglycemia. We conducted a repeated-measures study at five time points among 132 women with gestational hyperglycemia. Women's physiological indicators and their psychosocial indicators were measured. There were 22.7% of participants had gestational diabetes mellitus (GDM), 11.4% had gestational impaired glucose tolerance (G-IGT), and 65.9% had mild gestational hyperglycemia (MGH). Women with GDM had higher fasting blood glucose and systolic/diastolic blood pressure than women with MGH. Women with GDM had higher diastolic blood pressure compared to women with G-IGT. Significant differences were found between the five time points regarding women's fasting blood glucose, diastolic blood pressure, depression, and health status. Health care providers should conduct early screening for predictors of metabolic syndrome in women with any degree of gestational hyperglycemia. Nursing interventions could be offered as early as the perinatal period to promote women's health.

First-time fathers' health status during the perinatal period

BACKGROUND

For first-time fathers, the perinatal period is a critical period of stress and imbalance. Marital intimacy and social support may affect their stress and health status while they change their roles.

AIM

This study was to explore the changes of and correlations among marital intimacy, social support, and health status and predictors of first-time fathers' health status during the perinatal period.

METHODS

With a repeated measures study design, a total of 217 first-time fathers whose spouses were in the third trimester of pregnancy were recruited for the study. The Chinese Health Questionnaire, Marital Intimacy Scale, and Social Support Scale were employed to collect data at a medical center in the 36th week of pregnancy and the 1st and 4th weeks after childbirth.

RESULTS

The levels of marital intimacy and social support of first-time fathers during the perinatal period increased significantly with time. Meanwhile, the period of the first week after childbirth was a predictor of first-time father's health status.

CONCLUSIONS

This study only tracked the first-time fathers' health status in the 36th week of pregnancy and the 1st and 4th weeks after childbirth. Future studies could track them until one year after childbirth in order to explore the impact of the perinatal period on the couples and their babies. During the perinatal period, health care providers shall assess and provide needed interventions to first-time fathers as soon as possible to facilitate the first-time fathers to get ready for the role transition and to promote their health status.