1
|
Lupattelli A, Branquinho M, Cardoso C, Tauqeer F, Bjørndal LD, Fonseca A. Psychometric properties of the Decisional Conflict Scale in a sample of perinatal women with depressive symptoms: A study in Portugal and Norway. PATIENT EDUCATION AND COUNSELING 2024; 127:108337. [PMID: 38820986 DOI: 10.1016/j.pec.2024.108337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/10/2024] [Accepted: 05/20/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVE To assess the psychometric properties, i.e., reliability and construct validity of the 16-item Decisional Conflict Scale (DCS) and sub-scales in women with perinatal depressive symptoms in Norway and Portugal. METHODS We included 415 women in Portugal and 163 in Norway (≥18 years) who were pregnant or had given birth in the last 12 months and presenting with active depressive symptoms. Women replied to the original DCS items. We conducted confirmatory factor analysis, estimated internal consistency reliability, and examined factorial invariance across country, perinatal status, and treatment uptake. RESULTS The DCS factor model had good fit to the data, with all items loading significantly on their respective factor (.585 to .958). There was configural invariance of the DCS across countries, treatment, and perinatal status. The internal consistency of the total DCS (Cronbach's alpha) was .958, and for the subscales it ranged from .798 to .947. CONCLUSIONS The DCS is a valid and reliable measure of the decisional conflict in women with perinatal depressive symptoms in Portugal and Norway. PRACTICE IMPLICATIONS Measuring the extent of decisional conflict regarding treatment and the effect of multiple interventions towards its reduction, is critical to facilitate the decision-making process of women with perinatal mental illness.
Collapse
Affiliation(s)
- Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
| | - Mariana Branquinho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Catarina Cardoso
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Fatima Tauqeer
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Ludvig D Bjørndal
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ana Fonseca
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| |
Collapse
|
2
|
Den Besten-Bertholee D, Touw DJ, Damer EA, Mian P, Ter Horst PGJ. Sertraline, citalopram and paroxetine in lactation: passage into breastmilk and infant exposure. Front Pharmacol 2024; 15:1414677. [PMID: 38841362 PMCID: PMC11150716 DOI: 10.3389/fphar.2024.1414677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/30/2024] [Indexed: 06/07/2024] Open
Abstract
Objectives This study aimed to investigate the plasma and breastmilk concentrations for sertraline, citalopram and paroxetine for assessment of the Milk/Plasma (M/P) ratio and Absolute Infant Dose (AID), and to determine actual infant drug exposure through breastfeeding. Subsequently, informed recommendations will be formulated regarding the advisability of breastfeeding in women undergoing treatment with the three most widely used antidepressants. Methods A pharmacokinetic study in lactating women and their infants using sertraline, citalopram or paroxetine was performed. Paired breastmilk and plasma samples and single point infant plasma samples were collected to determine antidepressant concentrations. An Area Under the Curve (AUC) based approach with the trapezoidal rule was used to calculate M/P ratios and AID for all three antidepressants by combining all measured concentrations for the same dose. Results Thirty-seven lactating women and their infants participated in this study. 111 paired breastmilk and plasma samples and 37 single point infant plasma samples were collected. Detectable concentrations of sertraline, citalopram and paroxetine were present in all breastmilk samples. For sertraline and citalopram M/P ratio is above one, indicating higher breastmilk than plasma concentrations, however, drug exposure by breastmilk did not lead to detectable plasma drug levels in any of the 15 infants for sertraline, for nine (out of 13) infants for citalopram and for eight (out of nine) infants for paroxetine. Conclusion Given the well-known benefits of breastfeeding, our findings support breastfeeding of infants by mothers who are taking sertraline, citalopram or paroxetine is safe. Sertraline and paroxetine are the preferred antidepressants during breastfeeding, reaching mostly undetectable infant drug levels.
Collapse
Affiliation(s)
| | - Daan J. Touw
- Groningen Research Institute of Pharmacy, Section Pharmaceutical Analysis, University of Groningen, Groningen, Netherlands
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | | | - Paola Mian
- Groningen Research Institute of Pharmacy, Section Pharmaceutical Analysis, University of Groningen, Groningen, Netherlands
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | | |
Collapse
|
3
|
Silva RD, Teixeira AC, Pinho JA, Marcos P, Santos JC. Sleep, anxiety, depression, and stress in critically ill patients: a descriptive study in a Portuguese intensive care unit. Acute Crit Care 2024; 39:312-320. [PMID: 38863362 PMCID: PMC11167415 DOI: 10.4266/acc.2023.01256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/02/2024] [Accepted: 04/05/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Sleep disorders are common among patients admitted to intensive care units (ICUs). This study aimed to assess the perceptions of sleep quality, anxiety, depression, and stress reported by ICU patients and the relationships between these perceptions and patient variables. METHODS This cross-sectional study used consecutive non-probabilistic sampling to select participants. All patients admitted for more than 72 hours of ICU hospitalization at a Portuguese hospital between March and June 2020 were asked to complete the "Richard Campbell Sleep Questionnaire" and "Anxiety, depression, and Stress Assessment Questionnaire." The resulting data were analyzed using descriptive statistics, Pearson's correlation coefficient, Student t-tests for independent samples, and analysis of variance. The significance level for rejecting the null hypothesis was set to α ≤0.05. RESULTS A total of 52 patients admitted to the ICU for at least 72 hours was recruited. The mean age of the participants was 64 years (standard deviation, 14.6); 32 (61.5%) of the participants were male. Approximately 19% had psychiatric disorders. The prevalence of self-reported poor sleep was higher in women (t[50]=2,147, P=0.037) and in participants with psychiatric problems, although this difference was not statistically significant (t[50]=-0.777, P=0.441). Those who reported having sleep disorders before hospitalization had a worse perception of their sleep. CONCLUSIONS Sleep quality perception was worse in female ICU patients, those with psychiatric disorders, and those with sleep alterations before hospitalization. Implementing early interventions and designing nonpharmacological techniques to improve sleep quality of ICU patients is essential.
Collapse
Affiliation(s)
- Rui Domingues Silva
- Departamento de Anestesiologia, Cuidados Intensivos e Emergência,Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Abílio Cardoso Teixeira
- Escola Superior de Saúde de Santa Maria, Porto, Portugal
- CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal
| | - José António Pinho
- Departamento de Anestesiologia, Cuidados Intensivos e Emergência,Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Escola Superior de Saúde de Santa Maria, Porto, Portugal
| | - Pedro Marcos
- Departamento de Anestesiologia, Cuidados Intensivos e Emergência,Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - José Carlos Santos
- Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal
- CIDNUR - Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Lisboa, Portugal
| |
Collapse
|
4
|
Bennetter KE, Waage CW, Jenum AK, Vøllestad NK, Robinson HS, Richardsen KR. Cross-Cultural Contact and Norwegian Language Skills Among Ethnic Minority Women in Norway, and Relationship with Physical Activity in Pregnancy and Postpartum: The STORK-Groruddalen Cohort Study. J Immigr Minor Health 2024; 26:63-71. [PMID: 37639042 PMCID: PMC10771598 DOI: 10.1007/s10903-023-01535-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 08/29/2023]
Abstract
There are few studies of the migration context factors and physical activity (PA) level among minority ethnic women in Europe. We investigated the association between migration context factors and moderate to vigorous physical activity (MVPA) among minority ethnic women. Objectively recorded MVPA were obtained from 487 minority ethnic women included in the STORK-Groruddalen Cohort Study at three time points in pregnancy/postpartum. We investigated the associations between (a) contact with ethnic Norwegians and (b) Norwegian language skills and. No associations were observed in pregnancy. Postpartum, women who reported contact with ethnic Norwegians accumulated 17 MVPA min/day (95% CI: -.60, 34.54) more than women with no contact. In complete case analyses, this difference was significant (27 MVPA min/day (95% CI: 8.60, 44.54)). In early postpartum women with contact with ethnic Norwegians seems to be more physically active than women without contact. No associations were observed in pregnancy.
Collapse
Affiliation(s)
- Karin Elisabeth Bennetter
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway.
| | - Christin Wiegels Waage
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway
- Institute of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Anne Karen Jenum
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nina Køpke Vøllestad
- Institute of Health and Society, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Hilde Stendal Robinson
- Institute of Health and Society, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Kåre Rønn Richardsen
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway
- Institute of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
5
|
Xiao W, Yang Y, Xiao H, Huang P, Wei D, Wu Y, Yu J, He JR, Qiu X. Impact of closed-off management due to COVID-19 rebound on maternal depression during pregnancy. BMC Pregnancy Childbirth 2024; 24:88. [PMID: 38287284 PMCID: PMC10823603 DOI: 10.1186/s12884-024-06285-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/21/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND This study aimed to assess the impacts of closed-off measures with different strictness levels (lockdown, partial lockdown and non-lockdown) and geographic proximity to patients with coronavirus disease 2019 (COVID-19) on prenatal depression during an epidemic rebound of COVID-19. METHODS This was a cross-sectional web-based survey including 880 pregnant women. Depressive symptoms were measured by Self-Rating Depression Scale (SDS) and geographic proximity was calculated using Geographic Information Systems. Linear and logistic regression were used to assess the associations of closed-off measures and geographic proximity with SDS scores and depressive symptoms. Restricted cubic splines were used to model non-linear associations between geographic proximity and depression symptoms. RESULTS Compared with those living in non-lockdown areas, women in lockdown areas had higher SDS scores (adjusted β: 3.51, 95% CI: 1.80, 5.21) and greater risk of depressive symptoms (adjusted OR: 4.00, 95% CI: 2.18, 7.35), but evidence for partial lockdown was not obvious. A progressive increase in the risk of depressive symptoms was found with decreasing distance to COVID-19 patients when geographic proximity was <8 kilometers. Compared to those in the 5th quintile of geographic proximity, women in the first, second and third quintiles had at least 6 times higher risk of depressive symptoms. CONCLUSIONS Pregnant women under strict closed-off management during COVID-19 epidemic have high risk of depression. A specific range around the residences of reported COVID-19 patients should be underlined as potential clustering of high prenatal depression levels. Our findings highlight the importance of enhancing mental health management during the COVID-19 epidemic for pregnant women.
Collapse
Affiliation(s)
- Wanqing Xiao
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Yuting Yang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
| | - Huiyun Xiao
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Peiyuan Huang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
| | - Dongmei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Yingfang Wu
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jia Yu
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China.
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China.
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
- Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
- Provincial Key Laboratory of Research in Structure Birth Defect Disease and Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China.
| |
Collapse
|
6
|
Robinson HS, Vøllestad NK, Bennetter KE, Waage CW, Jenum AK, Richardsen KR. Pelvic girdle pain in pregnancy and early postpartum - prevalence and risk factors in a multi-ethnic cohort. BMC Musculoskelet Disord 2024; 25:21. [PMID: 38166902 PMCID: PMC10759664 DOI: 10.1186/s12891-023-07135-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Pelvic girdle pain (PGP) is common during and after pregnancy. It has been assumed that Scandinavian women report more PGP than women of other ethnicities. However, there are few population-based studies on ethnic differences and few with ethnicity as risk factor for PGP. The purposes of the present study were: To examine the prevalence of self-reported PGP through pregnancy and early postpartum in a multi-ethnic cohort. To investigate how ethnicity and patient characteristics were associated with risk of PGP during pregnancy and early postpartum. To investigate if clinical and personal factors obtained in gestation week (GW) 15 were associated with PGP in GW28 and postpartum week (PPW) 14. METHODS This study analyzed questionnaire data from 823 women from the Stork - Groruddalen mult-iethnic cohort study in Norway. Chi-square tests were used to investigate ethnic differences in prevalence of self-reported PGP, and logistic regression analyses to identify factors associated with self-reported PGP. RESULTS Women from South-Asia and Middle East reported 10-20% higher prevalence of self-reported PGP at all time points compared with Western women. Ethnicity was associated with PGP in GW15 and PPW14, adjusted for parity. Pain locations in pelvic area (PGP locations) in GW15, especially combined symphysis and posterior PGP, gave the highest risk (OR=7.4) for PGP in GW28 and in PPW14 (OR = 3.9). Being multiparous was a risk for PGP in PPW14 (OR=1.9). CONCLUSIONS Women of South Asian and Middle Eastern background had higher risk of self-reported PGP than Western women. Ethnicity was associated with PGP in GW15 and PPW14, after adjustments for parity. PGP locations in GW15 was the most prominent risk factor for PGP in GW28 and PPW14, whilst ethnicity was not significant in multivariable analyses.
Collapse
Affiliation(s)
- Hilde Stendal Robinson
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway.
| | - Nina K Vøllestad
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
| | | | - Christin W Waage
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Institute of Health and Society, Department of General Practice, University of Oslo, Oslo, Norway
| | - Kåre Rønn Richardsen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
7
|
Sayahi M, Nikbina M, Jahangirimehr A, Barati B. Mental health status of pregnant women during COVID-19 in healthcare centers of Iran: A cross-sectional study. PLoS One 2023; 18:e0294850. [PMID: 38015922 PMCID: PMC10683986 DOI: 10.1371/journal.pone.0294850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The COVID-19 pandemic impacted every single aspect of life. In addition to being a public health emergency, the COVID-19 outbreak impacted the mental health of individuals, especially pregnant women. This study aimed to examine the mental health status of pregnant women and also the effect of sociodemographic factors on their mental health status during COVID-19 in healthcare centers of Iran. METHODS This cross-sectional, analytical-descriptive study was conducted among pregnant women referring to healthcare centers in Shoushtar, Iran, in 2021. Multistage cluster sampling was used to select participants. Data were collected using the General Health Questionnaire-28 (GHQ-28). Data were analyzed using SPSS software version 22. The Pearson correlation coefficient was used to examine the association between quantitative variables. A generalized linear model (GLM) was applied to estimate the effect of independent variables on the dependent variable (mental health). RESULTS A total of 197 participants with a mean ± SD age of 27.85 ± 6.37 years took part in this study. The total mean score of mental health was estimated at 17.47±8.20. The highest mean ± SD score was, respectively, related to social dysfunction (6.63 ± 2.86), anxiety and insomnia (5.28 ± 3.53), and somatic symptoms (4.17 ± 3.27). Mental health disorder was significantly correlated with participants' age (R = .223, P = .00), number of pregnancy (gravida) (R = .272, P = .00), number of births (para) (R = 0.272, P = .00), and number of abortions (R = .172, P = .015). About 80% of pregnant women did not reveal impaired mental health conditions or psychological distress, while 19.3% showed scores that indicate probable mental health conditions. CONCLUSION Social dysfunction was the most common mental health problem among pregnant women. It is necessary to pay more attention to the mental health status of pregnant women during a pandemic. Interventions such as practical strategies to promote social support and improve pregnant women's mental health during pregnancy are highly important.
Collapse
Affiliation(s)
- Masoumeh Sayahi
- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Maryam Nikbina
- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Azam Jahangirimehr
- Department of Public Health, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Barat Barati
- Department of Radiologic Technology, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| |
Collapse
|
8
|
Akinsolu FT, Abodunrin OR, Lawale AA, Bankole SA, Adegbite ZO, Adewole IE, Olagunju MT, Ola OM, Dabar AM, Sanni-Adeniyi RA, Gambari AO, Njuguna DW, Salako AO, Ezechi OC. Depression and perceived stress among perinatal women living with HIV in Nigeria. Front Public Health 2023; 11:1259830. [PMID: 38054071 PMCID: PMC10694505 DOI: 10.3389/fpubh.2023.1259830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/18/2023] [Indexed: 12/07/2023] Open
Abstract
Background Pregnancy and postpartum periods are crucial stages for women's mental health, and women living with HIV are particularly susceptible to depression and psychological stress due to various factors. This study investigated the prevalence and associated factors of depression and perceived stress among women living with HIV during their perinatal period in Ibadan, Nigeria. Methods A cross-sectional survey was conducted in three HIV treatment centers in Ibadan, Nigeria, among women living with HIV between the ages of 19 and 49 who were either pregnant or had given birth within the last 2 years. The study was conducted from September 2022 to December 2022. An interviewer-administered questionnaire was used to collect the data from the participants. Ethical approval and informed consent were obtained, and data were analyzed using the Statistical Package for Social Science version 26. Results The study included 402 participants, of whom 69.0 and 78.0% reported symptoms of depression and perceived stress, respectively. However, 15.2% of the participants have comorbid depression and stress. Positive partner status was significantly associated with lower perceived depression, while gestational age between 29 and 40 weeks was significantly associated with lower perceived stress. The co-occurrence of depression and perceived stress was associated with partner status, income level, family support, gestational age, and years on antiretroviral therapy. Conclusion The high prevalence of depression, perceived stress, and their co-occurrence among women living with HIV during the perinatal period call for incorporating mental health care into routine maternal healthcare for all women, particularly those living with HIV. This finding emphasizes the need for public health efforts to prioritize perinatal mental health and improve access to care and support for women and their partners.
Collapse
Affiliation(s)
- Folahanmi T. Akinsolu
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Olunike R. Abodunrin
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Lagos State Health Management Agency, Ministry of Health, Lagos, Nigeria
- Department of Epidemiology and Health Statistics, School of Public Health, Nanjing Medical University, Jiangning, Jiangsu, China
| | | | | | | | | | - Mobolaji T. Olagunju
- Department of Epidemiology and Health Statistics, School of Public Health, Nanjing Medical University, Jiangning, Jiangsu, China
| | | | - Anita M. Dabar
- Department of Public Health, Lead City University, Ibadan, Nigeria
| | | | - Aisha O. Gambari
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Diana Wangeshi Njuguna
- School of Nursing, Department of Medical-Surgical Nursing, Dedan Kimathi University of Technology, Nairobi, Kenya
| | - Abideen O. Salako
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Oliver C. Ezechi
- Department of Public Health, Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
| |
Collapse
|
9
|
Waage CW, Toftemo I, Brænd AM, Sletner L, Sommer C, Birkeland KI, Richardsen KR, Shakeel N, Vøllestad NK, Jenum AK. Cohort profile update: the Norwegian STORK Groruddalen (STORK G) pregnancy and birth cohort-the role of ethnicity and causal pathways for obesity, type 2 diabetes, cardiovascular disease and other health issues. BMJ Open 2023; 13:e076251. [PMID: 37899145 PMCID: PMC10619061 DOI: 10.1136/bmjopen-2023-076251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023] Open
Abstract
PURPOSE The STORK Groruddalen cohort was set up in 2008 to explore ethnic differences in: (1) maternal health, primarily gestational diabetes (GDM) and related health issues during pregnancy and post partum, and effects of exposures on risk for type 2 diabetes, cardiovascular disease and other health issues, and (2) offspring's growth and body composition, overweight/obesity and effects of early life exposures. PARTICIPANTS 823 women (74% of invited) were followed from gestational week (GW) 15. Data were collected from 618 fathers. In total, 59% of women and 53% of fathers had origin from non-Western countries. Maternal mean age was 29.9 years (SD 4.9), and body mass index (BMI) 25.3 kg/m2 (4.9). Data were obtained from 772 women (94%) at GW 28, and 662 women (80%) 14 weeks post partum. Eleven years post partum, 385 women (53% of eligible/47% of original cohort) attended, age was 42.0 years (4.8) and BMI 27.1 kg/m2 (5.1). We have data for 783 children at birth, and for 586 at last time point, mean age 8.6 (0.5) years, weight 30.7 (6.8) kg and length 133.9 (6.3) cm. FINDINGS TO DATE We collected questionnaire data from parents, clinical measurements and blood samples from mothers, and data on children's growth (mid-pregnancy to 8 years). Our biobank includes maternal blood and urine samples, biopsy material from placentas and umbilical venous cord blood. We found several clinically important differences in maternal health, with higher risk in ethnic minority groups for GDM, insulin resistance, vitamin D and iron deficiency, depressive symptoms and physical inactivity. Contrasting patterns of fetal growth and risk of overweight/thinness at preschool age were observed across ethnic groups. Maternal GDM, obesity and high gestational weight gain were associated with children's BMI trajectories. FUTURE PLANS We will examine the impact of maternal and fetal health and development during pregnancy on long-term outcomes for mothers and offspring. TRIAL REGISTRATION NUMBER Project title STORK G-2: Women and Risk of Type 2 Diabetes NCT03870724 (ClinicalTrials.gov).
Collapse
Affiliation(s)
- Christin W Waage
- Department of General Practice, University of Oslo, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Akershus, Norway
| | - Ingun Toftemo
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Anja Maria Brænd
- Department of General Practice, University of Oslo, Oslo, Norway
- General Practice Research Unit (AFE), University of Oslo, Oslo, Norway
- The Antibiotic Centre for Primary Care, Department of General Practice, University of Oslo, Oslo, Norway
| | - Line Sletner
- Department of Child and Adolescents Medicine, Akershus University Hospital, Lorenskog, Norway
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Kåre Inge Birkeland
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Department of Transplantation, University of Oslo, Oslo, Norway
| | - Kåre Rønn Richardsen
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Akershus, Norway
| | - Nilam Shakeel
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Nina Køpke Vøllestad
- Department of Interdisciplinary Health Science, University of Oslo, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), University of Oslo, Oslo, Norway
| |
Collapse
|
10
|
Kulshreshtha S, Siwatch S, Aggarwal N, Rohilla M, Grover S. Mental health issues in antenatal women with prior adverse pregnancy outcomes: Unmasking the mental anguish of rainbow pregnancy. Indian J Med Res 2023; 158:190-196. [PMID: 37787261 PMCID: PMC10645033 DOI: 10.4103/ijmr.ijmr_1241_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Indexed: 10/04/2023] Open
Abstract
Background & objectives Mental health issues in pregnancy have adverse implications on the quality of life, however still they go unevaluated and underreported. Women with previous history of abortions or stillbirth may have a higher risk of experiencing mental health problems. The present investigation was aimed to study the prevalence of depression, anxiety, stress and domestic violence in antenatal women with prior pregnancy losses and the need for interventions to treat the same. Methods One hundred pregnant women with a history of prior pregnancy losses (group 1) and 100 women without obstetrical losses (group 2) were enrolled in this cross-sectional study carried out in a tertiary care hospital in India. Women were screened for depression, anxiety, stress and domestic violence using various questionnaires: EPDS (Edinburgh postnatal depression scale), PRAQ-2 (pregnancy-related anxiety questionnaire-revised 2), GAD 7 (generalized anxiety disorder-7) and PSS (perceived stress scale). Results The prevalence of depression (EPDS scale) and pregnancy specific anxiety (PRAQ-2 scale) was significantly higher in group 1 than in group 2 (27 vs. 10%, P=0.008; and 15 vs. 6%, P=0.03). The prevalence of general anxiety (GAD 7 scale) and stress (PSS), however, was high and comparable in both the groups (33 vs. 29%, P=0.44; and 33 vs. 27%; P=0.35 respectively). Recurrent abortions was found to be an independent risk factor for depression [adjusted odds ratio=26.45; OR=28]. In group 1, 31 per cent required counselling in the psychiatry department and nine per cent required medication. Interpretation & conclusion Mental health issues, especially depression, are prevalent in antenatal women with previous losses. Unrecognised and untreated, there is a need for counselling and developing screening protocols at India's societal and institutional levels.
Collapse
Affiliation(s)
- Shatakshi Kulshreshtha
- Department of Obstetrics & Gynaecology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sujata Siwatch
- Department of Obstetrics & Gynaecology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Neelam Aggarwal
- Department of Obstetrics & Gynaecology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Minakshi Rohilla
- Department of Obstetrics & Gynaecology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| |
Collapse
|
11
|
Asim S, Nichini E, Goggins WB, Dong D, Yeoh EK. Maternity care experience of Pakistani ethnic minority women in Hong Kong. Front Public Health 2023; 11:1009214. [PMID: 36935720 PMCID: PMC10014597 DOI: 10.3389/fpubh.2023.1009214] [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: 08/01/2022] [Accepted: 02/07/2023] [Indexed: 03/06/2023] Open
Abstract
Background Persistent inequalities in maternity care experience and outcomes exist globally for ethnic minority (EM) and migrant women. Despite the fact that this is an important research area, no prior study has been done in Hong Kong (HK) to examine maternity care experience of EM women. Objectives To investigate maternity care experience of Pakistani EM women (both local born and immigrants) during pregnancy, birth and after birth in hospital in HK. An evaluation of their satisfaction and factors predicting satisfaction with care during the three phases of maternity care was included in the study. Methods A cross sectional survey was conducted among Pakistani EM women who had given birth in HK in last 3 years, using a structured questionnaire by a bilingual interviewer, from April to May 2020. Counts and percentages were used to describe all categorical variables. Association between predictor variables and overall satisfaction was assessed by bivariate analysis and multiple logistic regression. Results One hundred and twenty questionnaires were completed. Almost 60 percent of the women were very satisfied with the overall care. More than half of the women described the care they received as kind, respectful and well communicated. After adjusting for age and parity, HK born Pakistani women expressed relatively less satisfaction with care, especially during pregnancy and labor and birth, as compared with Pakistan born women. Women with conversational or fluent English-speaking ability also felt comparatively less satisfied particularly from intrapartum and postnatal care in hospital. Education level had a negative association with satisfaction with care during pregnancy. Conclusions Maternity care providers should take into account the diversity of EM women population in HK. Our findings suggest that effective communication and care that can meet individual needs, expectations, and values is imperative to improve experience and quality of maternity care for EM women in HK.
Collapse
Affiliation(s)
- Saba Asim
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Elena Nichini
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - William Bernard Goggins
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Dong Dong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Hong Kong, Hong Kong SAR, China
- *Correspondence: Dong Dong
| | - Eng-King Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
12
|
Community-based bilingual doula support during labour and birth to improve migrant women's intrapartum care experiences and emotional well-being-Findings from a randomised controlled trial in Stockholm, Sweden [NCT03461640]. PLoS One 2022; 17:e0277533. [PMID: 36399476 PMCID: PMC9674173 DOI: 10.1371/journal.pone.0277533] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 10/11/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the effectiveness of community-based bilingual doula (CBD) support for improving the intrapartum care experiences and postnatal wellbeing of migrant women giving birth in Sweden. DESIGN Randomised controlled trial. SETTING Six antenatal care clinics and five hospitals in Stockholm, Sweden. PARTICIPANTS 164 pregnant Somali-, Arabic-, Polish-, Russian- and Tigrinya-speaking women who could not communicate fluently in Swedish, were ≥18 years and had no contra-indications for vaginal birth. INTERVENTION In addition to standard labour support, women were randomised to CBD support (n = 88) or no such support during labour (n = 76). Trained CBDs met with women prior to labour, provided support by telephone after labour had started, then provided emotional, physical and communication support to women throughout labour and birth in hospital, and then met again with women after the birth. PRIMARY OUTCOMES Women's overall ratings of the intrapartum care experiences (key question from the Migrant Friendly Maternity Care Questionnaire) and postnatal wellbeing (mean value of Edinburgh Postnatal Depression Scale) at 6-8 weeks after birth. RESULTS In total, 150 women remained to follow-up; 82 women (93.2%) randomised to receive CBD support and 68 women (89.5%) randomised to standard care (SC). Of women allocated CBD support, 60 (73.2%) received support during labour. There were no differences between the groups regarding women's intrapartum care experiences (very happy with care: CBD 80.2% (n = 65) vs SC 79.1% (n = 53); OR 1.07 CI 95% 0.48-2.40) or emotional wellbeing (EPDS mean value: CBD 4.71 (SD 4.96) vs SC 3.38 (SD 3.58); mean difference 1.33; CI 95% - 0.10-2.75). CONCLUSIONS Community-based doula support during labour and birth for migrant women neither increased women's ratings of their care for labour and birth nor their emotional well-being 2 months postpartum compared with receiving standard care only. Further studies on the effectiveness of CBD powered to evaluate obstetric outcomes are needed. TRIAL REGISTRATION Trial registration at ClinicalTrial.gov NCT03461640 https://www.google.com/search?client=firefox-b-d&q=NCT03461640.
Collapse
|
13
|
Massae AF, Larsson M, Pembe AB, Mbekenga C, Svanberg AS. Patterns and predictors of fear of childbirth and depressive symptoms over time in a cohort of women in the Pwani region, Tanzania. PLoS One 2022; 17:e0277004. [PMID: 36327253 PMCID: PMC9632885 DOI: 10.1371/journal.pone.0277004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Fear of childbirth (FoB) and depressive symptoms (DS) are experienced by many women and can negatively affect women during and after pregnancy. This study assessed patterns of FoB and DS over time and associations of postpartum FoB and DS with sociodemographic and obstetric characteristics. METHODS We conducted a longitudinal study at six health facilities in Tanzania in 2018-2019. Pregnant women were consecutively assessed for FoB and DS before and after childbirth using the Wijma Delivery Expectancy/Experience Questionnaire versions A & B and the Edinburgh antenatal and postnatal depressive scale. This paper is based on 625 women who completed participation. RESULTS The prevalence rates of FoB and DS during pregnancy were 16% and 18.2%, respectively, and after childbirth, 13.9% and 8.5%. Some had FoB (6.4%) and DS (4.3%) at both timepoints. FoB was strongly associated with DS at both timepoints (p < 0.001). Both FoB (p = 0.246) and DS (p < 0.001) decreased after childbirth. Never having experienced obstetric complications decreased the odds of postpartum and persisting FoB (adjusted odds ratio (aOR) 0.44, 95% confidence interval (CI) 0.23-0.83). Giving birth by caesarean section (aOR 2.01, 95% CI 1.11-3.65) and having more than 12 hours pass between admission and childbirth increased the odds of postpartum FoB (aOR 2.07, 95% CI 1.03-4.16). Postpartum DS was more common in women with an ill child/stillbirth/early neonatal death (aOR 4.78, 95% CI 2.29-9.95). Persisting DS was more common in single (aOR 2.59, 95% CI 1.02-6.59) and women without social support from parents (aOR 0.28, 95% 0.11-0.69). CONCLUSIONS FoB and DS coexist and decrease over time. Identifying predictors of both conditions will aid in recognising women at risk and planning for prevention and treatment. Screening for FoB and DS before and after childbirth and offering psychological support should be considered part of routine antenatal and postnatal care. Furthermore, supporting women with previous obstetric complications is crucial. Using interviews instead of a self-administered approach might have contributed to social desirability. Also, excluding women with previous caesarean sections could underestimate FoB and DS prevalence rates.
Collapse
Affiliation(s)
- Agnes Fredrick Massae
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Margareta Larsson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Andrea Barnabas Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Columba Mbekenga
- School of Nursing, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | | |
Collapse
|
14
|
Brito APA, Silva CM, Riesco ML, McArthur A. Experiences of health professionals in screening for postpartum depressive symptoms: a qualitative systematic review protocol. JBI Evid Synth 2022; 20:2329-2335. [DOI: 10.11124/jbies-21-00329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
15
|
Melby TC, Sørensen NB, Henriksen L, Lukasse M, Flaathen EME. Antenatal depression and the association of intimate partner violence among a culturally diverse population in southeastern Norway: A cross-sectional study. Eur J Midwifery 2022; 6:44. [PMID: 35935753 PMCID: PMC9289962 DOI: 10.18332/ejm/150009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Antenatal depression and intimate partner violence (IPV) are independently associated with adverse short- and long-term health effects for women and their children. The main aim of the study was to investigate the prevalence of antenatal depression and the association between symptoms of antenatal depression and physical, emotional and sexual abuse in a culturally diverse population attending antenatal care. METHODS A cross-sectional study was conducted with 1812 culturally diverse pregnant women from Safe Pregnancy, a randomized controlled trial to test the effect of an intimate partner violence intervention for abused women in southeastern Norway. RESULTS More than one in ten women (14%) reported symptoms of antenatal depression. Women with symptoms of antenatal depression were significantly younger and single, had lower educational level, more limited economic resources and were more likely to use tobacco and to report negative experiences regarding alcohol consumption, including that of her partner, compared to women with no symptoms of depression. A total of 15.4% of the women reported experiences of some form of IPV during their lifetime. Most women reported previous experiences of IPV rather than recent experiences. Women with a history of IPV were significantly more likely to report symptoms of antenatal depression, after adjusting for confounding factors (AOR=1.96; 95% CI: 1.35–2.83). CONCLUSIONS Women who reported symptoms of antenatal depression were significantly more likely to have experienced physical, emotional and sexual IPV than women with no history of IPV. It is important to identify women at risk of antenatal depression in order to offer appropriate services during pregnancy.
Collapse
Affiliation(s)
- Thea Cathrine Melby
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Nina Benedicte Sørensen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Division of General Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Eva Marie E Flaathen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
16
|
Finnbogadóttir HR, Persson EK. Risk for partners’ depression and anxiety during pregnancy and up to one year postpartum: A longitudinal cohort study. Eur J Midwifery 2022; 6:40. [PMID: 35814527 PMCID: PMC9214657 DOI: 10.18332/ejm/148162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Families may benefit from increased focus on partner emotional well-being during pregnancy and the perinatal period. Our aim was to explore the risk for depression and anxiety during pregnancy and one year postpartum in relation to partners’ self-reported health, sense of coherence, social support, and lifestyle factors. METHODS This is a longitudinal cohort study using three questionnaires that were answered twice during pregnancy and at one year postpartum. Participants (n=532) were recruited between April 2012 and September 2013, and follow-up was between April 2012 and March 2015, in Sweden. RESULTS In late pregnancy, 8.9% of the prospective partners were at high risk for depression and 8.3% one year postpartum. An increased risk for depression was found amongst those reporting ‘fair or very poor’ sexual satisfaction and those reporting ‘fair or very poor’ health during pregnancy and postpartum. High anxiety was reported by 10.8% during late pregnancy and 12.4% one year postpartum. Partners who were unemployed, had financial difficulties, and who scored low on a Sense of Coherence scale, showed significantly higher anxiety in late pregnancy and postpartum. Social support has a significant and positive impact concerning signs of depression and anxiety, both during pregnancy and postpartum. CONCLUSIONS More than 10% of partners in this study showed depressive symptoms and anxiety, indicating a problem in need of attention by stakeholders. Strengthening social support is of greatest importance. It is time for the introduction of family-focused care aimed at prevention of depression and anxiety, and maintenance of family well-being.
Collapse
Affiliation(s)
- Hafrún R Finnbogadóttir
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Eva K Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| |
Collapse
|
17
|
Oliveira TA, Luzetti GGCM, Rosalém MMA, Mariani Neto C. Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:452-457. [PMID: 35253138 PMCID: PMC9948039 DOI: 10.1055/s-0042-1743095] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To detect depression during pregnancy and in the immediate postpartum period using the Edinburgh postpartum depression scale (EPDS). METHODS Cross sectional study of 315 women, aged between 14 and 44 years, who received perinatal care at the Leonor Mendes de Barros Hospital, in São Paulo, between July 1st, 2019 and October 30th, 2020. The cutoff point suggesting depression was ≥ 12. RESULTS The screening indicated 62 (19.7%) patients experiencing depression. Low family income, multiparity, fewer prenatal appointments, antecedents of emotional disorders, dissatisfaction with the pregnancy, poor relationship with the partner, and psychological aggression were all risk factors associated with depression in pregnancy or in the immediate postpartum period. Antecedents of depression and psychology aggression during pregnancy were significant variables for predicting perinatal depression in the multivariate analysis. CONCLUSION There is a significant association between the occurrence of perinatal depression and the aforementioned psychosocial factors. Screening patients with the EPDS during perinatal and postpartum care could facilitate establishing a line of care to improve the wellbeing of mother and infant.
Collapse
Affiliation(s)
- Tenilson Amaral Oliveira
- Hospital Maternidade Leonor Mendes de Barros, São Paulo, SP, Brazil.,Universidade Cidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil
| | | | - Márcia Maria Auxiliadora Rosalém
- Hospital Maternidade Leonor Mendes de Barros, São Paulo, SP, Brazil.,Universidade Cidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil
| | - Corintio Mariani Neto
- Hospital Maternidade Leonor Mendes de Barros, São Paulo, SP, Brazil.,Universidade Cidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil
| |
Collapse
|
18
|
Hlongwane R, Phoswa WN. Effect of antidepressants in pregnancy outcomes: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27885. [PMID: 34918638 PMCID: PMC8677962 DOI: 10.1097/md.0000000000027885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/03/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Depression is much more common in women pre their pregnancies with antidepressants use less common which is caused by when many patients opt to discontinue with the use due to its side effects it causes. But whether depression is treated by antidepressants or not this has the same negative pregnancy outcomes on both the mother and the unborn and even born child from these mothers. METHODS Information will be retrieved for this systematic review and meta-analysis study on antidepressants use pregnancy outcomes from PubMed and Google scholar search engines using search medical subjects headings on PubMed and the PICOS framework as the determinant of the research question. All returned articles searched will be stored to Zotero.org and the software RevMan will be used to analyze data. ETHICS AND DISSEMINATION The review and meta-analysis will not require ethical approval and the findings will be published in peer-reviewed journals and presented at local and international conferences. In addition, findings from this study will assist in assessing health related risk outcomes of antidepressants during- and postpregnancy on both the fetal and mother either when used pre- and during-pregnancy. SYSTEMATIC REVIEW REGISTRATION International prospective Register of Systematic Reviews (PROSERO) number: CRD42021232111.
Collapse
|
19
|
Li P, Wang H, Feng J, Chen G, Zhou Z, Gou X, Ye S, Fan D, Liu Z, Guo X. Association Between Perceived Stress and Prenatal Depressive Symptoms: Moderating Effect of Social Support. J Multidiscip Healthc 2021; 14:3195-3204. [PMID: 34819730 PMCID: PMC8606966 DOI: 10.2147/jmdh.s341090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/04/2021] [Indexed: 12/19/2022] Open
Abstract
Purpose Prenatal depressive symptoms are an important mental health problem during pregnancy. We aimed to explore the moderating role of social support on the association between perceived stress and prenatal depressive symptoms. Materials and Methods A cross-sectional study was conducted at an obstetrics clinic. A total of 1846 women completed a self-administered questionnaire, with a response rate of 91.8%. Results Of the 1846 participants, 28.2% reported prenatal depressive symptoms (Edinburgh postnatal depression scale score ≥ 9). After adjusting for demographic characteristics, gestational age, exercise, and passive smoking, both perceived stress (adjusted odds ratio (AOR): 1.210, 95% confidence interval (CI): 1.178–1.242) and social support (AOR: 0.950, 95% CI: 0.932–0.968) were associated with prenatal depressive symptoms. Moreover, social support had a moderating effect on the association between perceived stress and prenatal depressive symptoms (p < 0.001), and pregnant women with low social support were more likely to be affected by stress and experience prenatal depressive symptoms. Conclusion Our study suggests that higher social support reduces the impact of stress on pregnant women, which in turn, decreases the risk of prenatal depressive symptoms. Therefore, interventions aimed at improving social support should be considered for the prevention and treatment of prenatal depressive symptoms.
Collapse
Affiliation(s)
- Pengsheng Li
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Haiyan Wang
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Biobank, Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Jinping Feng
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Gengdong Chen
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Zixing Zhou
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Xiaoyan Gou
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Biobank, Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Shaoxin Ye
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Dazhi Fan
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Zhengping Liu
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Xiaoling Guo
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| |
Collapse
|
20
|
Santos DF, Silva RDP, Tavares FL, Primo CC, Maciel PMA, Souza RSD, Leite FMC. Prevalence of postpartum depression symptoms and their association with violence: a cross-sectional study, Cariacica, Espírito Santo, Brazil, 2017. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e20201064. [PMID: 34816887 DOI: 10.1590/s1679-49742021000400002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/20/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the prevalence of postpartum depression symptoms among puerperal women and their association with violence. METHODS This was a cross-sectional study with puerperal women cared for at a public maternity hospital in Cariacica, ES, Brazil, in 2017. A questionnaire prepared by the authors and validated instruments were used. Pearson's chi-square test was performed in the analysis and association was expressed in prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS Postpartum depression symptom prevalence was 36.7% (95%CI 31.6;42.0). Total family income was inversely associated with this prevalence (p<0.05). Mothers who were single (PR=1.75 - 95%CI 1.17;2.64), wished to abort (PR=1.96 - 95%CI 1.50;2.56), drank alcohol during pregnancy (PR=1.37 - 95%CI 1.00;1.86), experienced intimate partner violence in their lifetime (PR=1.94 - 95%CI 1.38;2.73), and during pregnancy (PR=1.41 - 95%CI 1.07;1.85), had higher prevalence of depression symptoms. CONCLUSION Postpartum depression symptoms are associated with marital status, wanting to abort, alcohol consumption during pregnancy and intimate partner violence.
Collapse
Affiliation(s)
- Dherik Fraga Santos
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
| | | | - Fábio Lúcio Tavares
- Universidade Federal do Espírito Santo, Departamento de Enfermagem, Vitória, ES, Brasil
| | - Cândida Caniçali Primo
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
| | | | - Renata Santos de Souza
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Enfermagem, Vitória, ES, Brasil
| | | |
Collapse
|
21
|
Pedraza DF, Lins ACDL. [Clinical complications during pregnancy: a systematic review of studies with pregnant Brazilian women]. CIENCIA & SAUDE COLETIVA 2021; 26:5329-5350. [PMID: 34787223 DOI: 10.1590/1413-812320212611.3.33202019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 11/21/2019] [Indexed: 11/22/2022] Open
Abstract
The scope of this paper was to describe the main clinical complications among pregnant Brazilian women reported in the literature, identifying the most relevant exposure factors and their outcomes in maternal and child health. This is a systematic review of articles published between 2010 and 2018. Three reviews and 36 empirical articles were included; mental disorders (n=9), infectious diseases (n=9) and severe maternal morbidity (n=8) were the main clinical complications during pregnancy. In addition, four articles focused on determining the main conditions or causes of hospitalization, with a higher frequency of Urinary Tract Infection, anemia and hypertensive diseases. Maternal age at reproductive extremes, lower schooling, socioeconomic vulnerability, racial characteristics and the use of public health services were the most relevant exposure factors. Unfavorable health outcomes associated with clinical complications in pregnancy were verified in the eight articles with this profile. The frequency of pregnant women with potential life-threatening clinical complications is high in the country, highlighting the importance of primary care coverage and the implementation of interventions to reduce and prevent adverse maternal and child outcomes.
Collapse
Affiliation(s)
- Dixis Figueroa Pedraza
- Universidade Estadual da Paraíba. Av. das Baraúnas 351, Campus Universitário, Bodocongó. 58109-753 Campina Grande PB Brasil.
| | - Anahi Cézar de Lima Lins
- Universidade Estadual da Paraíba. Av. das Baraúnas 351, Campus Universitário, Bodocongó. 58109-753 Campina Grande PB Brasil.
| |
Collapse
|
22
|
Massae AF, Larsson M, Leshabari S, Mbekenga C, Pembe AB, Svanberg AS. Predictors of fear of childbirth and depressive symptoms among pregnant women: a cross-sectional survey in Pwani region, Tanzania. BMC Pregnancy Childbirth 2021; 21:704. [PMID: 34666696 PMCID: PMC8524824 DOI: 10.1186/s12884-021-04169-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 09/24/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Many women experience fear of childbirth (FoB) and depressive symptoms (DS) during pregnancy, but little is known about FoB among Tanzanian women. The current study aimed to assess the prevalence of FoB and DS among pregnant women and determine predictors of each and both, focusing on sociodemographic and obstetric predictors. METHODS A cross-sectional study was conducted at six health facilities in two districts in Tanzania between 2018 and 2019. In total, 694 pregnant women with gestational age between 32 and 40 weeks and expecting vaginal delivery were consecutively recruited and assessed for FoB and DS. We collected data through interviews using 6 and 4-points Likert Scale of the Wijma Delivery Expectancy Questionnaire Version A and Edinburgh Postnatal Depression Scale, respectively. Women who scored ≥66 and ≥ 10 were categorised as having FoB and DS, respectively. We performed multivariable logistic regression to investigate the predictors of FoB and DS. RESULTS The prevalence rates of FoB and DS among pregnant women were 15.1 and 17.7%, respectively. FoB and DS were more likely in women aged above 30 years [Adjusted Odds Ratio (AOR) 6.29, 95%CI 1.43-27.84] and in single mothers (AOR 2.57, 95%CI 1.14-5.78). Women with secondary education and above (AOR 0.22, 95%CI 0.05-0.99) and those who had given birth previously (AOR 0.27, 95% CI 0.09-0.87) were less likely to have FoB in combination with DS Women who had previous obstetric complications, and those who did not receive any social support from male partners in previous childbirth were more likely to have FoB and DS. FoB was strongly associated with DS (AOR 3.42, 95%CI 2.12-5.53). DS only was more common in women who had inadequate income (AOR 2.35, 95%CI 1.38-3.99) or had previously experienced a perineal tear (AOR 2.32, 95%CI 1.31-4.08). CONCLUSIONS Not having a formal education, having only primary education, being aged above 30 years, being single, being nulliparous, having experienced obstetric complications, and having a lack of social support from a male partner during previous pregnancy and childbirth were predictors of FoB and DS during pregnancy. FoB and DS were strongly associated with each other. It is vital to identify at-risk women early, to offer support during pregnancy and childbirth.
Collapse
Affiliation(s)
- Agnes Fredrick Massae
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
- Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Margareta Larsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Sebalda Leshabari
- Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Columba Mbekenga
- School of Nursing and Midwifery, The Aga Khan University, Dar es Salaam, Tanzania
| | - Andrea Barnabas Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | |
Collapse
|
23
|
Kassa GM, Arowojolu AO, Odukogbe ATA, Yalew AW. Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia: A prospective cohort study. PLoS One 2021; 16:e0257485. [PMID: 34550977 PMCID: PMC8457495 DOI: 10.1371/journal.pone.0257485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adolescent pregnancy is considered a major contributor to maternal and child morbidity and mortality, the greatest concern of developing countries and an important public health issue globally. Adolescents are responsible for eleven percent of births worldwide and they face several pregnancy and childbirth related complications. However, in low-income countries like Ethiopia, there are limited researches conducted to investigate outcomes of adolescent pregnancy. Therefore, this study was conducted to assess the adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia. METHODS A prospective cohort study was conducted in 12 health facilities from seven districts in East Gojjam zone, Northwest Ethiopia. A total of 418 adolescents (15-19 years old) and 836 adult women (20-34 years old) who attended randomly selected health facilities in East Gojjam zone were included. Data were collected starting from admission to the maternity ward for labor and delivery, and postnatal depression was measured at six weeks' postpartum period using the Edinburgh Postnatal Depression Scale. Generalized estimating equations (GEE) was used to account for the within subject correlation and assess the effect of different known factors that could influence the outcome of this study. RESULTS A lower percentage of adolescent (58.4%) than adult (71.2%) women had their first antenatal care booking before 16 weeks of gestation. After adjusting for different confounding factors, the adverse outcome that was significantly associated with adolescent pregnancy was postpartum depression (AOR: 2.29; 95% CI, 1.42, 3.7, p-value = 0.001). Assisted vaginal delivery (AOR: 0.44; 95% CI, 0.23, 0.86, p-value 0.016) and cesarean section (AOR: 0.43; 95% CI, 0.19, 0.97, p-value = 0.042) were significantly lower among adolescent women. CONCLUSIONS Adolescent pregnancy is associated with higher odds of postpartum depression, and lower odds to undergo cesarean section and assisted vaginal delivery than adult women. Perinatal care services should be more adolescent-friendly to ensure early diagnosis and treatment of postpartum depression. School and community-based awareness programs regarding use of contraception to prevent unwanted adolescent pregnancy, early antenatal care booking and adverse pregnancy outcomes of adolescent pregnancy and provision of psychosocial support are recommended.
Collapse
Affiliation(s)
- Getachew Mullu Kassa
- Department of Obstetrics and Gynaecology, Pan African University Life and Earth Sciences Institutes, College of Medicine, University of Ibadan, Ibadan, Nigeria
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Ayodele O. Arowojolu
- Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Akin Tunde A. Odukogbe
- Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Alemayehu Worku Yalew
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
24
|
Xu K, Zhang Y, Zhang Y, Xu Q, Lv L, Zhang J. Mental health among pregnant women under public health interventions during COVID-19 outbreak in Wuhan, China. Psychiatry Res 2021; 301:113977. [PMID: 34020217 PMCID: PMC8088032 DOI: 10.1016/j.psychres.2021.113977] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 04/25/2021] [Indexed: 12/21/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has become a pandemic. As the first city struck by the COVID-19 outbreak, Wuhan had implemented unprecedented public health interventions. The mental health of pregnant women during these anti-epidemic controls remains unknown. A total of 274 pregnant women living in Wuhan during the COVID-19 outbreak took part in our investigation online. The data on mental health conditions were evaluated using Edinburgh Postnatal Depression Scale (EPDS), Self-Rating Anxiety Scale (SAS), Chinese Perceived Stress Scale (CPSS), and Pittsburgh Sleep Quality Index (PSQI). We also collected the information on physical health status and precautionary measures against COVID-19. The prevalence of depression, anxiety, stress, and poor sleep quality was 16.1%, 13.9%, 42.7%, 37.6%, respectively. Comparing to SAS, PSQI score in pregnant women who participated in the survey after April 8 (date of Wuhan reopening), those data collected before April 8 were significantly higher. High levels of stress, severe health concerns over the fetus, and poor hygienic practices were negatively associated with mental health conditions. In conclusion, a large proportion of pregnant women reported psychological symptoms during the epidemic, which negatively related to the severe health concerns over fetus and poor hygienic practices. More psychological support during the epidemic would promote maternal mental well-being.
Collapse
Affiliation(s)
- Ke Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Ya Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Qiao Xu
- Maternal and Child Health Hospital of Jianghan District, 50 Machangjiao Rd, Wuhan, Hubei, China
| | - Lan Lv
- Maternal and Child Health Hospital of Jianghan District, 50 Machangjiao Rd, Wuhan, Hubei, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China.
| |
Collapse
|
25
|
Shorey SY, Ng ED, Chee CYI. Anxiety and depressive symptoms of women in the perinatal period during the COVID-19 pandemic: A systematic review and meta-analysis. Scand J Public Health 2021; 49:730-740. [PMID: 33966511 DOI: 10.1177/14034948211011793] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS The prevalence of perinatal anxiety and depressive symptoms have been speculated to increase during an infectious disease outbreak but remains unknown in the context of the COVID-19 situation. Therefore, this review aimed to examine the prevalence of antenatal and postnatal anxiety and depressive symptoms among pregnant women and postpartum mothers during the COVID-19 period. METHODS Six electronic databases were systematically searched for articles from November 2019 to December 2020. Twenty-six observational studies and brief reports were included in the meta-analysis. RESULTS Overall, the prevalence of anxiety was greater than depression in both antenatal and postnatal periods, and the prevalence of depression was higher in the antenatal period than the postnatal period. The pooled prevalence for antenatal anxiety symptoms, antenatal depressive symptoms and postnatal depressive symptoms were 40% (95% confidence intervals (CI): 0.27-0.52), 27% (95% CI: 0.20-0.33) and 17% (95% CI: 0.10-0.24), respectively. Europe (56%, 95% CI: 0.28-0.85) had significantly higher prevalence of antenatal anxiety than Asia (16%, 95% CI: 0.09-0.23). CONCLUSIONS The heightened prevalence of perinatal psychological disorders served as an impetus for healthcare professionals and policy makers to ramp up their support and mitigation strategies for pregnant women and mothers in times of health crisis.
Collapse
Affiliation(s)
- Shefal Y Shorey
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Esperanza D Ng
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cornelia Y I Chee
- Department of Psychological Medicine, National University Hospital, Singapore
| |
Collapse
|
26
|
Pampaka D, Papatheodorou SI, AlSeaidan M, Al Wotayan R, Wright RJ, Buring JE, Dockery DW, Christophi CA. Antenatal depressive symptoms and adverse perinatal outcomes. BMC Pregnancy Childbirth 2021; 21:313. [PMID: 33879069 PMCID: PMC8059279 DOI: 10.1186/s12884-021-03783-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 04/08/2021] [Indexed: 11/22/2022] Open
Abstract
Background The association of antenatal depression with adverse pregnancy, birth, and postnatal outcomes has been an item of scientific interest over the last decades. However, the evidence that exists is controversial or limited. We previously found that one in five women in Kuwait experience antenatal depressive symptoms. Therefore, the aim of this study was to examine whether antenatal depressive symptoms are associated with preterm birth (PTB), small for gestational age (SGA), or large for gestational age (LGA) babies in this population. Methods This was a secondary analysis based on data collected in the Transgenerational Assessment of Children’s Environmental Risk (TRACER) Study that was conducted in Kuwait. Logistic regression analysis was used to examine whether antenatal depressive symptoms assessed using the Edinburgh Depression Scale (EDS) were associated with preterm birth, small for gestational age, and large for gestational age babies. Results A total of 1694 women had complete information about the outcomes of interest. Women with depressive symptoms in pregnancy had increased, albeit non-significant, odds of having PTB (OR = 1.41; 95%CI: 0.81, 2.45), SGA babies (OR = 1.26; 0.80, 1.98), or LGA babies (OR = 1.27; 0.90, 1.79). Antenatal depressive symptoms had similar increased odds for the three outcomes even after adjusting for several covariates though none of these reached statistical significance. Conclusions In the present study, the depressive symptoms in pregnancy did not predict adverse birth outcomes, such as PTB, SGA, and LGA, which adds to the currently non-conclusive literature. However, further research is needed to examine these associations, as the available evidence is quite limited.
Collapse
Affiliation(s)
- Despina Pampaka
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus
| | | | | | | | - Rosalind J Wright
- Department of Pediatrics & Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie E Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Douglas W Dockery
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus. .,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| |
Collapse
|
27
|
Perzow SED, Hennessey EMP, Hoffman MC, Grote NK, Davis EP, Hankin BL. Mental health of pregnant and postpartum women in response to the COVID-19 pandemic. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 4:100123. [PMID: 33649750 PMCID: PMC7904453 DOI: 10.1016/j.jadr.2021.100123] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/19/2021] [Accepted: 02/20/2021] [Indexed: 12/21/2022] Open
Abstract
Background The COVID-19 pandemic has been uniquely challenging for pregnant and postpartum women. Uncontrollable stress amplifies risk for maternal depression and anxiety, which are linked to adverse mother and child outcomes. This study examined change in internalizing symptoms from before to during the COVID-19 pandemic among pregnant and postpartum women longitudinally, and investigated moderation by loneliness and other contextual risk factors. Methods 135 women (Mage = 31.81; 26% Latina, 55% non-Hispanic White, 11% Black; 39% low-income) enrolled in an existing prospective study completed self-report questionnaires including the EPDS and STAI-short form during early pregnancy, prior to COVID-19, and during COVID-19. Results Depressive symptoms were higher during COVID-19 compared to pre-COVID-19 and just as high as during early pregnancy. Anxiety symptoms were higher during COVID-19 compared to both pre-COVID-19 and early pregnancy. Higher loneliness was associated with increased depressive symptoms during COVID-19. Greater COVID-19 specific adversity was linked to greater increases in internalizing symptoms during COVID-19. Lower income-to-needs-ratio most strongly predicted symptoms during early pregnancy. Limitations The present study is longitudinal, but the correlational nature of the data precludes causal conclusions regarding the effect of the pandemic on mental health. Conclusion Longitudinal analyses suggest the COVID-19 pandemic resulted in increased internalizing symptoms among diverse pregnant and postpartum women. Interpersonal and contextual factors exacerbate risk and the impact of the pandemic on women's mental health. Identifying mothers at-risk for depression and anxiety may increase treatment utilization, mitigate fetal and infant exposure to maternal depression and anxiety, and help prevent adverse child outcomes.
Collapse
Affiliation(s)
| | | | - M Camille Hoffman
- University of Colorado School of Medicine, Department of Obstetrics and Gynecology, USA
| | - Nancy K Grote
- University of Washington, School of Social Work, USA
| | - Elysia Poggi Davis
- University of Denver, Department of Psychology, USA.,University of California, Irvine Department of Psychiatry and Human Behavior, USA
| | - Benjamin L Hankin
- The University of Illinois at Urbana-Champaign, Department of Psychology, USA
| |
Collapse
|
28
|
Voltas N, Arija V, Hernández-Martínez C, Nappi L, Cibelli G, Basora J, Canals J. Perinatal emotional states: a comparative study between two cohorts recruited in a Mediterranean environment. Women Health 2020; 61:221-234. [PMID: 33213300 DOI: 10.1080/03630242.2020.1847749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Experiencing negative emotional states during pregnancy has been linked to adverse outcomes for mother and offspring. Our study aims were to compare the perinatal emotional states and obstetrical variables between pregnant women recruited in Spain (n = 202) and Italy (n = 103), and to investigate prenatal anxiety related factors. The study had two phases. In the 1st phase (3rd trimester of pregnancy), prenatal anxiety was assessed using the State-Trait Anxiety Inventory (STAI); other prenatal and sociodemographic variables were also collected. In the 2nd phase (40 days postpartum), the STAI and the Edinburgh Postnatal Depression Scale were administered. Compared to the Spanish sample, the Italian sample presented higher STAI state and STAI factor 1 mean scores (22.5 vs. 18.6 and 10.0 vs. 7.2), shorter gestations (mean gestation weeks: 39.1 vs. 39.8), more unplanned pregnancies (31.1% vs. 16.4%), and more cesareans deliveries (42.5% vs. 16.0%). Low socioeconomic levels, younger ages, previous miscarriages and unplanned pregnancies were related to prenatal anxiety. Postpartum depression rates was 31.3% and there were no differences between countries. Our results suggested that it may be interesting in both countries to create a prenatal monitoring protocol that attaches more importance to emotional wellbeing both during pregnancy and in the long term.
Collapse
Affiliation(s)
- Núria Voltas
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira I Virgili, Tarragona, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira I Virgili, Spain
| | - Victoria Arija
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira I Virgili, Spain.,Nutrition and Public Health Unit, Universitat Rovira I Virgili, Reus, Spain
| | - Carmen Hernández-Martínez
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira I Virgili, Tarragona, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira I Virgili, Spain
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Josep Basora
- Institut d'Investigació en Atenció Primària Jordi Gol, Tarragona, Spain
| | - Josefa Canals
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira I Virgili, Tarragona, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira I Virgili, Spain
| |
Collapse
|
29
|
Akinbode TD, Pedersen C, Lara-Cinisomo S. The Price of Pre-adolescent Abuse: Effects of Sexual Abuse on Perinatal Depression and Anxiety. Matern Child Health J 2020; 25:1083-1093. [PMID: 33206305 DOI: 10.1007/s10995-020-03088-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Childhood abuse is a major public health concern and a risk factor for subsequent poor maternal mental health. This study of 176 racially diverse women explored the associations between the histories of childhood sexual abuse and depression and anxiety during pregnancy, at six weeks postpartum, and 12 weeks postpartum. METHODS Data on depressive and anxiety symptoms were gathered during pregnancy, at six weeks postpartum, and 12 weeks postpartum. Sociodemographic data were collected during pregnancy, while data on childhood sexual abuse were gathered during the 12-week postpartum period. Bivariate analyses and repeated mixed-effects linear regression with bootstrapping were used to assess the association between childhood sexual abuse and perinatal depressive and anxiety symptoms. RESULTS Childhood sexual abuse was significantly associated with depressive symptoms (β = 2.52, 95% CI 1.72, 3.32, p < .001) and anxiety symptoms (β = 4.44, 95% CI 3.70, 5.81, p < .001) over time, while controlling for demographic characteristics and lifetime major depression and anxiety. Depressive and anxiety symptoms decreased over the perinatal period and were highest during pregnancy. Black women were more likely to report higher depressive symptoms (β = 1.35, 95% CI 0.51, 2.19, p = .002) and anxiety symptoms (β = 3.29 95% CI 1.72, 4.87, p < .001) over time compared to White women. DISCUSSION The results highlight the importance of assessing the long-term effects of childhood sexual abuse on perinatal depressive and anxiety symptoms to help inform the development of interventions for women, particularly Black women.
Collapse
Affiliation(s)
- Tanitoluwa Demilade Akinbode
- College of Agricultural, Consumer & Environmental Sciences, Department of Human Development & Family Studies, University of Illinois at Urbana-Champaign, 222 Bevier Hall, 905 S. Goodwin Avenue, Urbana, 61801, IL, USA.
| | - Cort Pedersen
- Department of Psychiatry, The University of North Carolina at Chapel Hill, CB #7160, Chapel Hill, 27599, NC, USA
| | - Sandraluz Lara-Cinisomo
- College of Applied Health Sciences, Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 1206 S. Fourth St, Champaign, 61820, IL, USA
| |
Collapse
|
30
|
Bangma M, Kazemier BM, Papatsonis DNM, Van der Zaag-Loonen HJ, Paarlberg KM. The association between depressive symptoms during pregnancy and post-delivery fear of childbirth; a prospective study. J Reprod Infant Psychol 2020; 38:367-377. [PMID: 32393062 DOI: 10.1080/02646838.2020.1753031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Fear of childbirth is an important reason for a caesarean section on request. OBJECTIVE To assess the association between depressive symptoms during pregnancy and post-delivery fear of childbirth (PFOC). METHODS We prospectively studied pregnant women from two hospitals in the Netherlands. Women completed the Edinburgh Depression Scale (EPDS), the Wijma Delivery Experience Questionnaire (W-DEQ B) and questions concerning risk factors. Depressive symptoms were assessed at baseline and six weeks post-delivery. PFOC was assessed six weeks post-delivery. Baseline characteristics and pregnancy outcomes were compared between women with and without a depression at baseline. The association between depression and PFOC was assessed with multivariable logistic regression analysis. RESULTS 245 women participated in this study. At baseline 11% suffered from depressive symptoms. There were no differences in pregnancy outcomes. Women with depressive symptoms more often suffered from depressive symptoms six weeks post-delivery (adjusted OR 4.9, 95% CI 1.4-17). PFOC six weeks post-delivery was present in 11%. Women with depression were at increased risk of PFOC six weeks post-delivery (adjusted OR 9.2, 95% CI 2.6-32). CONCLUSION This study shows that women with depression at baseline are at increased risk for depression and PFOC six weeks post-delivery.
Collapse
Affiliation(s)
- Meike Bangma
- Department of Obstetrics and Gynaecology, Amphia Teaching Hospital Breda , Breda, The Netherlands
| | - Brenda M Kazemier
- Department of Obstetrics and Gynaecology, Gelre Hospitals Apeldoorn Location , Apeldoorn, The Netherlands.,Department of Obstetrics and Gynaecology, Academic Medical Centre Amsterdam , Amsterdam, The Netherlands
| | - Dimitri N M Papatsonis
- Department of Obstetrics and Gynaecology, Amphia Teaching Hospital Breda , Breda, The Netherlands
| | | | - K Marieke Paarlberg
- Department of Obstetrics and Gynaecology, Gelre Hospitals Apeldoorn Location , Apeldoorn, The Netherlands
| |
Collapse
|
31
|
Reduction in physical activity significantly increases depression and anxiety in the perinatal period: a longitudinal study based on a self-report digital assessment tool. Arch Gynecol Obstet 2020; 302:53-64. [PMID: 32372342 DOI: 10.1007/s00404-020-05570-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/25/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Physical activity can reduce pregnancy-related complications and contributes substantially to improving maternal mental health. A reduction in activity encompassing exercise and daily household tasks throughout the course of pregnancy increases the risk of depression and anxiety. The following research examines the longitudinal interaction between exercise, general physical activity, and mental health outcomes in pregnant women. METHODS This prospective longitudinal study was conducted at the maternity departments of two major university hospitals in Germany. Self-reported data of 597 women were digitally assessed every 4 weeks from the second trimester until birth as well as 3 and 6 months postnatally. Depressive and anxiety symptoms were assessed using the EPDS, PRAQ, and STAI and physical activity levels were measured using the PPAQ questionnaire. Cross-sectional and longitudinal analyses using Pearson's correlation coefficient and multiple regression models were conducted. RESULTS We found a significant reduction in general physical activity in the period from the 20th to 32nd gestational week. Women who reported a greater decline during pregnancy showed significantly higher depression and anxiety scores. In stratified analyses, only baseline mental health scores proved to be variables with stronger impact on postnatal depression and anxiety outcomes. CONCLUSION General physical activity and maternal mental health significantly influence each other during and after pregnancy. Both physical activity and the prevention of perinatal mental disorders should be systematically encouraged during perinatal care to prevent adverse maternal and fetal birth outcomes.
Collapse
|
32
|
Jani R, Knight-Agarwal CR, Bloom M, Takito MY. The Association Between Pre-Pregnancy Body Mass Index, Perinatal Depression and Maternal Vitamin D Status: Findings from an Australian Cohort Study. Int J Womens Health 2020; 12:213-219. [PMID: 32273777 PMCID: PMC7105885 DOI: 10.2147/ijwh.s239267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/07/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to assess the relationship between early-pregnancy Body Mass Index (BMI), perinatal depression risk and maternal vitamin D status. Patients and Methods A retrospective cohort study from 2013 to 2017 was undertaken involving 16,528 birth events in the Australian Capital Territory. Multivariate binary logistic regression was conducted using the forced entry method. Mediation of the association between maternal early-pregnancy BMI and perinatal depression risk by vitamin D status was also tested. Results Adjusted logistic regression models found that high maternal early-pregnancy BMI was associated with increased risk of developing perinatal depression (AOR 1.421; 95% CI, 1.191, 1.696) as well as increased odds of being vitamin D deficient (AOR 1.950; 95% CI; 1.735, 2.191). In comparison to women with low perinatal depression risk, women with high perinatal depression risk had increased odds of being vitamin D deficient (AOR 1.321; 95% CI, 1.105, 1.579). Maternal early-pregnancy BMI was a weak significant predictor of perinatal depression risk after including vitamin D as a mediator, consistent with partial mediation, Path C: B=0.016 (95% CI 1.003, 1.030), p= 0.02. Path C´: B=0.014 (95% CI 1.001, 1.028), p= 0.04. Conclusion In line with current Australian recommendations, women with high early-pregnancy BMI should be screened for both perinatal depression risk and vitamin D deficiency, with referral to relevant support services when indicated.
Collapse
Affiliation(s)
- Rati Jani
- The University of Canberra, School of Clinical Sciences, Faculty of Health, Canberra, ACT, Australia
| | | | - Michael Bloom
- Northern Sydney Local Area Health District, Sydney, NSW, Australia
| | - Monica Yuri Takito
- School of Physical Education and Sport, The University of Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
33
|
Hue MT, Nguyet Van NH, Nha PP, Vu NT, Duc PM, Van Trang NT, Thinh PTN, Anh LN, Huyen LT, Tu NH. Factors associated with antenatal depression among pregnant women in Vietnam: A multisite cross-sectional survey. Health Psychol Open 2020; 7:2055102920914076. [PMID: 32215215 PMCID: PMC7081472 DOI: 10.1177/2055102920914076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This study aimed to describe the status of antenatal depression and its associated factors among pregnant women in Vietnam. A cross-sectional study was conducted in four obstetric hospitals in Vietnam from January to September 2019. A total of 1260 pregnant women were interviewed using a structured questionnaire. A Tobit regression model was used to determine factors associated with antenatal depression. Results showed that pregnant women were at high risk of antenatal depression (24.5%). Women with fetus abnormalities and higher education were at higher risk of antenatal depression. We highlighted the need for implementing formal screening programs to early detect antenatal depression.
Collapse
|
34
|
Silverman ME, Medeiros C, Burgos L. Early pregnancy mood before and during COVID-19 community restrictions among women of low socioeconomic status in New York City: a preliminary study. Arch Womens Ment Health 2020; 23:779-782. [PMID: 32844329 PMCID: PMC7447087 DOI: 10.1007/s00737-020-01061-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/18/2020] [Indexed: 11/03/2022]
Abstract
To explore the mental health consequences of COVID-19-related social restrictions on pregnant women living in low socioeconomic status. Prenatal women appearing at the Mount Sinai Hospital Ambulatory Practice were screened for mood symptomatology from February 2, 2020, through June 12, 2020. An improvement in prenatal mood was observed following social restrictions compared to before the pandemic. The impact of COVID-19 remains largely unknown and may be useful towards understanding the needs of pregnant women living in poverty.
Collapse
Affiliation(s)
- Michael E. Silverman
- grid.416167.3Department of Psychiatry, Icahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, NY USA
| | - Cathryn Medeiros
- grid.416167.3Department of Social Work Services, The Mount Sinai Hospital, New York, NY USA
| | - Laudy Burgos
- grid.416167.3Department of Social Work Services, Icahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, NY USA
| |
Collapse
|
35
|
Harding KA, Pushpanathan ME, Whitworth SR, Nanthakumar S, Bucks RS, Skinner TC. Depression prevalence in Type 2 diabetes is not related to diabetes-depression symptom overlap but is related to symptom dimensions within patient self-report measures: a meta-analysis. Diabet Med 2019; 36:1600-1611. [PMID: 31532013 DOI: 10.1111/dme.14139] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2019] [Indexed: 01/24/2023]
Abstract
AIM Depression is common in Type 2 diabetes, yet rates vary. Overlap between symptoms of depression and diabetes may account for this variability in depression prevalence rates. We examined to what extent depression prevalence was a function of the proportion of depression-diabetes symptom overlap (items within symptom dimensions) and sample characteristics. METHODS Electronic and hand searching of published and unpublished works identified 147 eligible papers. Of 3656 screened, 147 studies (149 samples, N = 17-229 047, mean sample age 25.4-82.8 years, with 152 prevalence estimates), using 24 validated depression questionnaires were selected. Sample size, publication type, sample type, gender, age, BMI, HbA1c , depression questionnaire and prevalence rates were extracted. RESULTS Prevalence rates ranged from 1.8% to 88% (mean = 28.30%) and were higher in younger samples, samples with higher mean HbA1c and clinic samples. Diabetes-depression symptom overlap did not affect prevalence. A higher proportion of anhedonia, cognition, cognitive, negative affect and sleep disturbance symptoms, and a lower proportion of somatic symptoms were consistently associated with higher depression prevalence. CONCLUSIONS The lack of an overall effect of diabetes-depression symptom overlap might suggest that assessment of depression in Type 2 diabetes is generally not confounded by co-occuring symptoms. However, questionnaires with proportionally more or fewer items measuring other symptom categories were associated with higher estimates of depression prevalence. Depression measures that focus on the cardinal symptoms of depression (e.g. negative affect and cognition), limiting symptoms associated with increasing diabetes symptomatology (e.g. sleep disturbance, cognitive) may most accurately diagnose depression.
Collapse
Affiliation(s)
- K A Harding
- VA Puget Sound Healthcare System, Seattle, WA, USA
| | - M E Pushpanathan
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - S R Whitworth
- Australian Government Department of Health, Canberra, Australia
| | - S Nanthakumar
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - R S Bucks
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - T C Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
36
|
Habtamu Belete A, Alemayehu Assega M, Alemu Abajobir A, Abebe Belay Y, Kassahun Tariku M. Prevalence of antenatal depression and associated factors among pregnant women in Aneded woreda, North West Ethiopia: a community based cross-sectional study. BMC Res Notes 2019; 12:713. [PMID: 31666120 PMCID: PMC6822359 DOI: 10.1186/s13104-019-4717-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/10/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To assess the prevalence of antenatal depression and factors associated with antenatal depression among pregnant women in Aneded woreda, Northwest Ethiopia, 2019. A community based- cross sectional study was conducted in Aneded woreda among 7 kebles' of North-West, Ethiopia from March 16 to April 23, 2019. A total of 342 pregnant women were recruited using simple random sampling. RESULT The prevalence of antenatal depression was 15.20%. Urban residence [AOR = 6.8; 95% CI (1.97, 23.32)], marital status of being unmarried [AOR = 5.1; 95% CI (1.79, 14.63)], occupation of being government employee [AOR = 8.8; 95% CI (2.06, 37.12)] and merchant [AOR = 3.7; 95% CI (1.27, 10.91)], prim gravid [AOR = 5.3; 95% CI (2.03, 13.82)], not attend ANC follow up [AOR = 8.7; 95% CI (3.46, 21.79)], intimate partner violence [AOR = 4.5; 95% CI (1.28, 15.52)], unplanned pregnancy [AOR = 6.2; 95% CI (2.37, 16.06)], and substance use [AOR = 5.6; 95% CI (2.12, 14.92)] were significantly factors. Strengthen the risk prevention activities so important to tackle the problem of antenatal depression.
Collapse
Affiliation(s)
- Abebe Habtamu Belete
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Mulunesh Alemayehu Assega
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Amanuel Alemu Abajobir
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.,Maternal and Child Wellbeing Unit, African Population and Health Research Centre, Nairobi, Kenya
| | - Yihalem Abebe Belay
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mengistie Kassahun Tariku
- Department of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
37
|
Abstract
OBJECTIVES The aim of this study was to explore the prevalence of exposure to occupational hazards and depressive mood with associated underlying risk factors among pregnant workers. METHODS Women at 12 weeks of gestation (n = 172) were recruited during regular prenatal screening. Data were obtained via questionnaires that explored job details and Edinburgh Postnatal Depression Scale. RESULTS The most commonly encountered hazard was prolonged standing. The majority of women reported that the workplace provided no information on the safety or rights of pregnant women, but those exposed to at least four hazards had more access to such services (P < 0.05). Thirteen percent may have suffered from depressive symptomatology. Higher-level work-related burnout, lower job control, and reduced workplace support were significantly associated with possible antenatal depressive symptoms. CONCLUSION Pregnant workers are exposed to substantial levels of occupational hazards and may experience depressive symptoms; thus, their work conditions require monitoring and improvement.
Collapse
|
38
|
Leirbakk MJ, Magnus JH, Torper J, Zeanah P. Look to Norway: Serving new families and infants in a multiethnic population. Infant Ment Health J 2019; 40:659-672. [PMID: 31318444 PMCID: PMC6973293 DOI: 10.1002/imhj.21804] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Despite recognition that immigrant women face significant health challenges, addressing the healthcare needs of immigrants is a source of debate in the United States. Lack of adequate healthcare for immigrants is recognized as a social justice issue, and other countries have incorporated immigrants into their healthcare services. Oslo, the fastest growing capital in Europe, is rapidly shifting to a heterogeneous society prompting organizational action and change. The New Families Program serves first-time mothers and their infants in an Oslo district serving 53% minorities from 142 countries. Anchored in salutogenic theory, the program aims to support the parent-child relationship, children's development and social adaptation, and to prevent stress-related outcomes. Formative research has informed the successful program development and implementation within the existing maternal and child healthcare service. Implications for addressing maternal and child health needs of an immigrant population are presented.
Collapse
Affiliation(s)
- Maria J Leirbakk
- Department of Health Sciences, University of Oslo, Norway and City of Oslo, Agency for Health
| | - Jeanette H Magnus
- Section for Leadership, University of Oslo, Oslo, Norway and Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Johan Torper
- Department for Health and Social Services, City of Oslo, Norway
| | - Paula Zeanah
- Picard Center, College of Nursing, University of Louisiana, Lafayette, Louisiana, USA
| |
Collapse
|
39
|
Kassa GM, Arowojolu AO, Odukogbe AA, Yalew AW. Adverse neonatal outcomes of adolescent pregnancy in Northwest Ethiopia. PLoS One 2019; 14:e0218259. [PMID: 31194833 PMCID: PMC6564016 DOI: 10.1371/journal.pone.0218259] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 05/29/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Adolescents have physical, social and psychological characteristics that are different from adults. Adolescent pregnancy results in pregnancy and childbirth complications- an area neglected in developing countries like Ethiopia. This study, therefore, was conducted to assess the adverse neonatal outcomes of adolescent pregnancy in Northwest Ethiopia. METHODS Institutional-based study was conducted in East Gojjam zone, Northwest Ethiopia. A total of 374 adolescent (15-19 years) and 760 adult (20-34 years) women were included in this study. Data were collected among women who came to randomly selected health facilities in East Gojjam zone. Data were collected by trained research assistants using a structured data collection questionnaire. Descriptive statistics, chi-square test, and Student's t-tests were utilized. Bivariate and multivariable logistic regression analysis were employed to adjust for confounding factors of adverse neonatal outcomes. Statistical significance was declared when the p-value was less than 0.05. RESULTS Higher proportion of adolescent than adult women were from rural area (57.2% vs 44.7%), were not married (5.1% vs 1.7%), were pregnant for the first time (91.7% vs 34.1%), didn't attend antenatal care (ANC) follow-up (12% vs 4.5%), and had late initiation of ANC follow-up. After adjusting for known confounding factors, the odds of low birth weight (LBW) was higher among adolescents than adult women (AOR 2.14; 95% CI, 1.36, 3.36, p-value = 0.001). Similarly, the odds of preterm birth was higher among adolescents than adult women (AOR 1.65; 95% CI, 1.09, 2.49, p-value = 0.017). There was no statistically significant difference in the rate of low Apgar score at first and five minutes after birth and neonatal Intensive Care Unit (ICU) admission between babies born from adolescent and adult women. CONCLUSIONS Adolescent women were less likely to receive ANC service. Babies born from adolescent women are at higher odds of adverse neonatal outcomes like LBW and preterm birth than babies born from adult women. Use of community- and health facility-based intervention programs that can prevent adolescent pregnancy and reduce adverse neonatal outcomes among adolescent girls is recommended.
Collapse
Affiliation(s)
- Getachew Mullu Kassa
- Pan African University Life and Earth Sciences Institutes, Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - A. O. Arowojolu
- Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - A. A. Odukogbe
- Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Alemayehu Worku Yalew
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
40
|
Sheeba B, Nath A, Metgud CS, Krishna M, Venkatesh S, Vindhya J, Murthy GVS. Prenatal Depression and Its Associated Risk Factors Among Pregnant Women in Bangalore: A Hospital Based Prevalence Study. Front Public Health 2019; 7:108. [PMID: 31131270 PMCID: PMC6509237 DOI: 10.3389/fpubh.2019.00108] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/11/2019] [Indexed: 01/17/2023] Open
Abstract
Background: Depression is the commonest psychological problem that affects a woman during her perinatal period worldwide. The risk of prenatal depression increases as the pregnancy progresses and clinically significant depressive symptoms are common in the mid and late trimester. There is a paucity of research on depression during the prenatal period in India. Given this background, the present study aimed to assess the prevalence of prenatal depression and its associated risk factors among pregnant women in Bangalore, Southern India. Methods: The study was nested within an on-going cohort study. The study participants included 280 pregnant women who were attending the antenatal clinic at Jaya Nagar General Hospital (Sanjay Gandhi Hospital) in Bangalore. The data was collected by using a structured questionnaire which included. Edinburgh Postnatal Depression Scale (EPDS) to screen for prenatal depression. Results: The proportion of respondents who screened positive for prenatal depression was 35.7%. Presence of domestic violence was found to impose a five times higher and highly significant risk of developing prenatal depression among the respondents. Pregnancy related anxiety and a recent history of catastrophic events were also found to be a positive predictors of prenatal depression. Conclusion: The high prevalence of prenatal depression in the present study is suggestive of its significance as a public health problem. Health care plans therefore can include screening and diagnosis of prenatal depression in the antenatal care along with other health care facilities provided.
Collapse
Affiliation(s)
- B. Sheeba
- Research Assistant, Indian Institute of Public Health Hyderabad, Public Health of Foundation of India, Bangalore, India
| | - Anita Nath
- Wellcome Trust DBT India Alliance, Intermediate Fellow in Clinical and Public Health, Indian Institute of Public Health Hyderabad, Public Health Foundation of India, Hyderabad, India
| | - Chandra S. Metgud
- Professor, Department of Community Medicine, Pt. Jawahar Lal Nehru Memorial Medical College, Belgavi, India
| | | | - Shubhashree Venkatesh
- Research Assistant, Indian Institute of Public Health Hyderabad, Public Health of Foundation of India, Bangalore, India
| | - J. Vindhya
- Research Assistant, Indian Institute of Public Health Hyderabad, Public Health of Foundation of India, Bangalore, India
| | | |
Collapse
|
41
|
Pottinger AM, Carroll K. Reproductive needs of PLHIV in Jamaica: relationship between fertility desire, motives and depression. J Reprod Infant Psychol 2019; 38:38-48. [PMID: 30939927 DOI: 10.1080/02646838.2019.1599334] [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] [Indexed: 01/19/2023]
Abstract
Background/objective: Advances in antiretroviral therapy and assisted reproduction technology which allow for longer and healthier lives and safer conception options necessitate a new understanding of the sexual and reproductive needs of persons living with HIV (PLHIV). This study examines fertility desire and motives for having children among PLHIV in Jamaica and explores the association with depressive symptoms.Methods: In a cross-sectional study, 251 PLHIV in their reproductive years voluntarily completed an interviewer-administered questionnaire. SPSS analyses involved bivariate and logistic regression models significant at p < .05.Results: A desire to have children was expressed by 66% (n = 166), mostly males and persons younger than 40 years. Of those in a current relationship (n = 126), not having previous children best predicted fertility desire (p = .001; CI 0.04-0.44) as well as motives to conceive (p = .02; CI 0.01-0.66). PLHIVs in their reproductive years who are at depression risk are those in a sero-discordant relationship (p = .01; CI 1.48-30.22) and who have been diagnosed between 1 and 4 years (p = .05; CI 0.01-1.04).Conclusions: HIV status does not dampen the desire to have future children. There is need to evaluate the sexual, reproductive and mental health needs of PLHIV.
Collapse
Affiliation(s)
- Audrey M Pottinger
- Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
| | - Kamali Carroll
- The Hugh Wynter Fertility Management Unit, The University of the West Indies, Kingston, Jamaica
| |
Collapse
|
42
|
Al-Hashimi FJG, Kareem Alalaf S, Al Tawil NG. Screening for depression during pregnancy using the Kurdish version of the Edinburgh Postnatal Depression Scale in Erbil city. Health Care Women Int 2019; 41:240-254. [PMID: 30865576 DOI: 10.1080/07399332.2019.1571592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We aimed to determine any difference in the prevalence rate of depression during the three trimesters of pregnancy and its association with certain obstetric risk factors. In total, 1000 pregnant women attending primary health centers in the city of Erbil, Kurdistan, Iraq were assessed for depression using the Edinburgh Postnatal Depression Scale. Women in the first and second trimesters had a significantly higher probability of depression than those in the third trimester. Screening early in pregnancy and following pregnant women in each trimester may help to identify those who are susceptible to depression and enable appropriate intervention.
Collapse
Affiliation(s)
| | - Shahla Kareem Alalaf
- Department of Obstetrics and Gynecology, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq
| | - Namir G Al Tawil
- Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq
| |
Collapse
|
43
|
van der Voorn B, Hollanders JJ, Kieviet N, Dolman KM, de Rijke YB, van Rossum EF, Rotteveel J, Honig A, Finken MJ. Maternal Stress During Pregnancy Is Associated with Decreased Cortisol and Cortisone Levels in Neonatal Hair. Horm Res Paediatr 2019; 90:299-307. [PMID: 30541006 PMCID: PMC6492510 DOI: 10.1159/000495007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 10/30/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Hair glucocorticoids (GCs) offer a retrospective view on chronic GC exposure. We assessed whether maternal pre- and postnatal stress was associated with neonatal and maternal hair GCs postpartum (pp). METHODS On the first day pp 172 mother-infant pairs donated hair, of whom 67 had consulted a centre of expertise for psychiatric disorders during pregnancy. Maternal stress was scored on the Hospital Anxiety and Depression Scale during the first/second (n = 46), third trimester (n = 57), and pp (n = 172). Hair cortisol and cortisone levels were determined by liquid chromatography-tandem mass spectrometry, and associations with maternal hospital anxiety subscale (HAS) and hospital depression subscale (HDS) scores, and antidepressant use were analyzed with linear regression. RESULTS Neonatal hair GCs were negatively associated with elevated HAS-scores during the first/second trimester, log 10 (β [95% CI]) cortisol -0.19 (-0.39 to 0.02) p = 0.07, cortisone -0.10 (-0.25 to 0.05) p = 0.17; third trimester, cortisol -0.17 (-0.33 to 0.00) p = 0.05, cortisone -0.17 (-0.28 to -0.05) p = 0.01; and pp, cortisol -0.14 (-0.25 to -0.02) p = 0.02, cortisone -0.07 (-0.16 to 0.02) p = 0.10. A similar pattern was observed for elevated HDS-scores. Maternal hair GCs were positively associated with elevated HAS-scores pp (cortisol 0.17 [0.01 to 0.32] p = 0.04, cortisone 0.18 [0.06 to 0.31] p = 0.01), but not prenatally or with elevated HDS-scores. Antidepressant use was associated with elevated maternal hair GCs (p ≤ 0.05), but not with neonatal hair GCs. CONCLUSION Exposure to excessive pre- and perinatal maternal stress was associated with a decrease in neonatal hair GCs, while elevated stress-scores around birth were associated with increased maternal hair GCs and elevated stress-scores earlier in gestation were not associated with maternal hair GCs pp. Further studies are needed to test associations with infant neurodevelopment.
Collapse
Affiliation(s)
- Bibian van der Voorn
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands,
| | - Jonneke J. Hollanders
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - Noera Kieviet
- Department of Pediatrics, Psychiatry Obstetrics Pediatrics Expert Center, OLVG West, Amsterdam, The Netherlands
| | - Koert M. Dolman
- Department of Pediatrics, Psychiatry Obstetrics Pediatrics Expert Center, OLVG West, Amsterdam, The Netherlands
| | - Yolanda B. de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Elisabeth F.C. van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Joost Rotteveel
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan Honig
- Department of Pediatrics, Psychiatry Obstetrics Pediatrics Expert Center, OLVG West, Amsterdam, The Netherlands,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn J.J. Finken
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
44
|
Pampaka D, Papatheodorou SI, AlSeaidan M, Al Wotayan R, Wright RJ, Buring JE, Dockery DW, Christophi CA. Postnatal depressive symptoms in women with and without antenatal depressive symptoms: results from a prospective cohort study. Arch Womens Ment Health 2019; 22:93-103. [PMID: 29971553 DOI: 10.1007/s00737-018-0880-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 06/22/2018] [Indexed: 01/01/2023]
Abstract
Evidence exists that the risk factors for depression in the antenatal and postnatal period may differ, but only a handful of studies looked at depression longitudinally. The aims of this study were (1) to estimate the prevalence of postnatal depressive symptoms in Kuwait where data about postnatal depression are scarce and identify its determinants and (2) to compare these risk factors between women who had experienced antenatal depressive symptoms and those that did not. Data collected in the TRansgenerational Assessment of Children's Environmental Risk (TRACER) Study in Kuwait were used in this analysis. The sample was restricted to the 1348 women who answered the Edinburgh Postnatal Depression Scale (EPDS) both antenatally and postnatally. The prevalence of postnatal depressive symptoms, defined by an EPDS score ≥ 10, was 11.7%. Overall, antenatal depressive symptoms were the strongest determinant of postnatal depressive symptoms. Multivariable logistic regression analysis showed that in women with depressive symptoms in pregnancy, having a lower household income was the most significant risk factor for postnatal depressive symptoms. Among women without antenatal depressive symptoms, those who had lower income, were Kuwaitis, experienced other problems in pregnancy such as perceived stress, PTSD symptoms and social isolation, and those who delivered a boy had higher odds of postnatal depressive symptoms. Antenatal depressive symptoms and other psychosocial characteristics can predict postnatal depressive symptoms. Therefore, maternal mental health issues should be detected during the antenatal period and support should be provided in order to lower the risk of postnatal depression and its sequelae.
Collapse
Affiliation(s)
- Despina Pampaka
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.
| | - Stefania I Papatheodorou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus
| | | | | | - Rosalind J Wright
- Department of Pediatrics and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Douglas W Dockery
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
45
|
den Besten-Bertholee D, van der Meer DH, Ter Horst PGJ. Quality of Lactation Studies Investigating Antidepressants. Breastfeed Med 2019; 14:359-365. [PMID: 31013435 DOI: 10.1089/bfm.2019.0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: The aim of this study was to determine the quality of lactation studies investigating antidepressants in breast milk according to the Food and Drug Administration (FDA) draft guidelines and the article by Begg et al., 2002, published in the official journal of the International Lactation Consultant Association (ILCA). Materials and Methods: We used PubMed and LactMed® for the literature search. Furthermore, cross references were searched for additional studies. Results: A total number of 60 articles were included for review. For selective serotonin reuptake inhibitors and venlafaxine, only two studies correctly assessed the absolute infant dose and milk to plasma ratio; one sertraline and one fluoxetine study. Of all tricyclic antidepressants, one study for amitriptyline and one for nortriptyline assessed these endpoints correctly. We found a lack of information on breast milk sampling methods in many studies. Concentrations needed for the calculations were based on single measurements instead of at least five measurements during one dose interval, and the relative infant dose was not normalized by maternal weight, or an average maternal weight of 70 kg was used as a standard. Discussion: We conclude that the quality of the current literature on this topic does not meet the standards of the FDA. Studies of higher quality are needed to determine the extent of drug transfer to breast milk for antidepressants, so an adequate recommendation about use of these drugs during lactation can be given.
Collapse
|
46
|
Vitamin D deficiency and depressive symptoms in the perinatal period. Arch Womens Ment Health 2018; 21:745-755. [PMID: 29845325 DOI: 10.1007/s00737-018-0852-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 05/09/2018] [Indexed: 01/13/2023]
Abstract
Depression affects 1 in 7 women during the perinatal period. Women with vitamin D deficiency may be at an increased risk for depression. This study investigated the relationship between maternal and cord blood 25-hydroxyvitamin D (25OHD) and maternal depressive symptoms over the perinatal period. Study objectives were to examine variations and relationships between maternal and cord blood vitamin D levels and maternal depressive symptoms over the perinatal period. At a large medical center in southern California, pregnant women (N = 126) were recruited for this longitudinal cohort study. Depressive symptoms (Edinburgh Postnatal Depression Screen, EPDS) and vitamin D status (25OHD) were measured at three time points in the perinatal period: time 1 (T1; N = 125) EPDS and 25OHD were collected in early pregnancy; time 2 (T2; N = 96) EPDS was conducted in the third trimester with blood collected at time of delivery; and time 3 (T3; N = 88) was collected postpartum. A significant inverse relationship between vitamin D status and depressive symptoms was observed between 25OHD and EPDS scores at all time points in this sample (T1 = - 0.18, P = 0.024; T2 = - 0.27, P = 0.009; T3 = - 0.22, P = 0.019). This association remained after controlling for confounders. Low cord blood 25OHD levels were inversely associated with higher EPDS scores in the third trimester (r = - 0.22, P = 0.02). Clinicians may want to consider screening women diagnosed with vitamin D deficiency for depression and vice versa. Vitamin D may represent an important biomarker for pregnant and postpartum women diagnosed with depression. Further studies examining underlying mechanisms and supplementation are needed.
Collapse
|
47
|
Shakeel N, Sletner L, Falk RS, Slinning K, Martinsen EW, Jenum AK, Eberhard-Gran M. Prevalence of postpartum depressive symptoms in a multiethnic population and the role of ethnicity and integration. J Affect Disord 2018; 241:49-58. [PMID: 30096592 DOI: 10.1016/j.jad.2018.07.056] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 06/11/2018] [Accepted: 07/22/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Postpartum depression (PPD) may have adverse effects on both mother and child. The aims were to determine the prevalence of postpartum depressive symptoms, PPDS, identify associations with ethnicity and with the level of social integration. METHOD Population-based, prospective cohort study of 643 pregnant women (58% ethnic minorities) attending primary antenatal care in Oslo. Questionnaires regarding demographics and health issues were collected through interviews. PPDS was defined as a sum score ≥ 10 by the Edinburgh Postnatal Depression Scale, used as the main outcome in logistic regression analyses, first with ethnicity, second with level of integration as main explanatory factors. RESULTS The prevalence of PPDS was higher in ethnic minorities 12.7% (95% CI: 9.31-16.09) than in Western Europeans 4.8% (2.26-7.34). Adverse life events, lack of social support and depressive symptoms during the index pregnancy were other significant risk factors. Western European with PPDS were more likely to have had depressive symptoms also during pregnancy than women from ethnic minorities (72.2% versus 33.3%, p = 0.041). When replacing ethnicity with integration, a low level of integration was independently associated with PPDS (2.1 (1.11-3.95)). LIMITATIONS Cases with PPDS were limited. Heterogeneity in the ethnic groups is a concern. CONCLUSION Both point prevalence and new onset of PPDS was higher among ethnic minorities than among Western Europeans. Low level of integration was associated with PPDS. Our findings suggest that clinicians should be aware of the increased risk of new cases of PPDS among ethnic minorities compared to Western European women and offer evidence-based care accordingly.
Collapse
Affiliation(s)
- Nilam Shakeel
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway.
| | - Line Sletner
- Department of Pediatrics and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway.
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Norway.
| | - Kari Slinning
- Center for Child and Adolescent Mental Health Eastern and Southern Norway (R.BUP Oslo), Norway.
| | - Egil W Martinsen
- Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Norway.
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway.
| | - Malin Eberhard-Gran
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway; Health Services Research Centre, Akershus University Hospital, Lørenskog; Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway.
| |
Collapse
|
48
|
Wei DM, Au Yeung SL, He JR, Xiao WQ, Lu JH, Tu S, Chen NN, Lam KBH, Cheng KK, Leung GM, Xia HM, Schooling CM, Qiu X. The role of social support in family socio-economic disparities in depressive symptoms during early pregnancy: Evidence from a Chinese birth cohort. J Affect Disord 2018; 238:418-423. [PMID: 29913379 DOI: 10.1016/j.jad.2018.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/22/2018] [Accepted: 06/04/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few studies have examined the association between a composite measure of family socio-economic position (SEP)2 and depressive symptoms among Chinese pregnant women, nor any potential underlying mechanisms which may be amenable to preventative interventions. METHODS We investigated the association between a composite SEP measure and depressive symptoms during early pregnancy, and tested for mediation by social support and moderation by parity in the Born in Guangzhou Cohort Study (n = 12,382) using adjusted logistic regression and causal mediation analysis. RESULTS In this population, 18.4% of women experienced depressive symptoms before the 20th gestational week. Compared with the highest quartile, the lowest SEP score quartile was associated with a higher risk of depressive symptoms (OR 1.50, 95% CI 1.31-1.71), which was more pronounced among multiparous women than nulliparous women (P for interaction <0.001). Social support mediated the association between SEP and depressive symptoms, with greater proportion mediated in nulliparous women (73.4% for the lowest SEP score quartile) than multiparous women (30.5%). LIMITATIONS Depressive symptoms were measured by Self-rated Depression Scale, which is not designed as a clinical diagnosis tool for depression. We only had information on perceived social support but not actual social support, although these two parameters were modestly correlated. CONCLUSION Lower SEP was associated with higher risk of depressive symptoms in pregnant women, driven by social support. And the association between SEP and depressive symptoms and mediation by social support were modified by parity. Whether this association extends to the post pregnancy period or is amenable to cost-effective interventions should be investigated in further studies.
Collapse
Affiliation(s)
- Dong-Mei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China
| | - Shiu Lun Au Yeung
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China
| | - Wan-Qing Xiao
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China
| | - Jin-Hua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China
| | - Si Tu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China
| | - Nian-Nian Chen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China
| | | | - Kar-Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Hui-Min Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China; Department of Neonatal Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China.
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, China.
| |
Collapse
|
49
|
Pampaka D, Papatheodorou SI, AlSeaidan M, Al Wotayan R, Wright RJ, Buring JE, Dockery DW, Christophi CA. Depressive symptoms and comorbid problems in pregnancy - results from a population based study. J Psychosom Res 2018; 112:53-58. [PMID: 30097136 DOI: 10.1016/j.jpsychores.2018.06.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 06/12/2018] [Accepted: 06/21/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To estimate the prevalence of antenatal depressive symptoms, identify relevant risk factors, and assess comorbid mental health problems, among pregnant women enrolled in a population based study. METHODS This was a secondary analysis of data collected from 1916 pregnant women who participated in the TRansgenerational Assessment of Children's Environmental Risk (TRACER) study in Kuwait, and had answered the Baseline Questionnaire and completed the Edinburgh Depression Scale (EDS). Logistic regression models were used to examine the association of depressive symptoms with baseline socio-demographic characteristics and psychosocial indicators. RESULTS The prevalence of antenatal depressive symptoms, using a cut-off of EDS score ≥ 10, was 20.1%. Depressive symptoms were reported more by women of lower family income and had self-reported history of depression prior to pregnancy, with women in the third trimester having higher odds of antenatal depressive symptoms compared to those in the second trimester. Pregnancy-related anxiety, higher perceived stress levels, and post-traumatic stress disorder symptoms were comorbid with the presence of depressive symptoms. CONCLUSION The findings showed that one in five pregnant women in Kuwait experiences antenatal depressive symptoms and that these symptoms are comorbid with other mental health problems. Screening for antenatal depression and providing support to pregnant women should be considered.
Collapse
Affiliation(s)
- Despina Pampaka
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
| | - Stefania I Papatheodorou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | | | | | - Rosalind J Wright
- Department of Pediatrics, Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Douglas W Dockery
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
50
|
Shakeel N, Richardsen KR, Martinsen EW, Eberhard-Gran M, Slinning K, Jenum AK. Physical activity in pregnancy and postpartum depressive symptoms in a multiethnic cohort. J Affect Disord 2018; 236:93-100. [PMID: 29723768 DOI: 10.1016/j.jad.2018.04.081] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/06/2018] [Accepted: 04/14/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There is strong evidence that postpartum depression is associated with adverse health effects in the mother and infant. Few studies have explored associations between physical activity in pregnancy and postpartum depression. We aimed to investigate whether physical activity during pregnancy was inversely associated with postpartum depressive symptoms, PPDS in a multiethnic sample. METHOD Population-based, prospective cohort of 643 pregnant women (58% ethnic minorities) attending primary antenatal care from early pregnancy to postpartum in Oslo between 2008 and 2010. Data on demographics and health outcomes were collected during standardized interviews. PPDS was defined by a sum score ≥10 from the Edinburgh Postnatal Depression Scale (EPDS), 3 months after birth. Physical activity was recorded with Sense Wear™ Pro3 Armband (SWA) in gestational week 28 and defined as moderate-to-vigorous intensity physical activity (MVPA) accumulated in bouts ≥10 min. RESULTS Women who accumulated ≥150 MVPA minutes/week had significantly lower risk (OR = 0.2, 95% CI: 0.06-0.90), for PPDS compared to those who did not accumulate any minutes/week of MVPA, adjusted for ethnic minority background, depressive symptoms in the index pregnancy and self-reported pelvic girdle syndrome. The results for MVPA persisted in the sub-sample of ethnic minority women. LIMITATIONS Numbers of cases with PPDS were limited. The SWA does not measure water activities. Due to missing data for SWA we used multiple imputations. CONCLUSION Women meeting the physical activity recommendation (>150 MVPA min/week) during pregnancy have a lower risk of PPDS compared to women who are not active during pregnancy.
Collapse
Affiliation(s)
- Nilam Shakeel
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway.
| | - Kåre Rønn Richardsen
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Norway.
| | - Egil W Martinsen
- Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Norway.
| | - Malin Eberhard-Gran
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway; Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway.
| | - Kari Slinning
- Center for Child and Adolescent Mental Health Eastern and Southern Norway (R.BUP Oslo), Norway.
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway.
| |
Collapse
|