1
|
Vaziri-harami R, Kazemi SN, Vaziri-harami S, Najafiarab H. Prevalence of depression among pregnant women and its correlation with the choice of delivery method. Ann Med Surg (Lond) 2024; 86:2538-2542. [PMID: 38694325 PMCID: PMC11060296 DOI: 10.1097/ms9.0000000000001849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/04/2024] [Indexed: 05/04/2024] Open
Abstract
Background Caesarean section is usually limited to cases where natural vaginal delivery is not possible or poses a serious risk to the foetus and mother. Psychological health of mothers is likely to play an important role in the method of delivery. This study aims to investigate the prevalence of depression in pregnant women and its relationship with the choice of delivery method and other demographic parameters. Methods In this descriptive cross-sectional study, 250 mothers referring to the hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran, were selected, and their demographic information and level of depression was collected using a questionnaire. Statistical analysis was conducted to evaluate the correlation between depression, method of delivery and other associated parameters. Results Among 250 pregnant women, 225 (90%) had no depression, 25 (10%) had mild depression and no moderate or severe depression was reported in any pregnant mother. Also, 146 (58.4%) were willing to have a caesarean section and 104 (41.6%) wanted to have a normal delivery. The choice of delivery method was not significantly associated with depression. Analyzes showed that increasing maternal age is associated with a greater tendency to caesarean delivery. The incidence and higher depression scores of mothers showed a significant association with the history of previous abortions. Conclusion Although in this study no significant association was observed between depression in pregnant mothers and the choice delivery, due to the high prevalence of caesarean section in the country and its progression to higher percentages, it seems that the design and implementation of effective programs and interventions is required.
Collapse
Affiliation(s)
- Roya Vaziri-harami
- Department of Psychiatry, School of Medicine, Behavioral Sciences Research Center, Imam Hossein Hospital Shahid Beheshti University of Medical Sciences
| | - Seyyedeh Neda Kazemi
- Preventative Gynecology Research Center
- Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Tehran University of Medical Sciences, Tehran, Iran
| | - Saharnaz Vaziri-harami
- Department of Psychiatry, School of Medicine, Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences
| | | |
Collapse
|
2
|
Koerner R, Rechenberg K, Rinaldi K, Duffy A. Are Providers Adequately Screening for Anxiety Symptoms During Pregnancy? Nurs Womens Health 2024; 28:109-116. [PMID: 38278513 DOI: 10.1016/j.nwh.2023.09.007] [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: 07/21/2023] [Revised: 09/19/2023] [Accepted: 12/06/2023] [Indexed: 01/28/2024]
Abstract
OBJECTIVE To examine the difference in prevalence of self-reported anxiety symptoms throughout pregnancy compared to clinical diagnosis of an anxiety disorder by a provider. DESIGN Secondary data analysis of a prospective cohort study of 50 pregnant individuals. SETTING/LOCAL PROBLEM Pregnant individuals commonly experience heightened anxiety symptoms, which are associated with adverse perinatal outcomes. However, a diagnosis of an anxiety disorder by a health care provider is less common, which may result in insufficient mental health intervention. PARTICIPANTS Pregnant individuals were recruited at their first prenatal appointment and followed until birth. INTERVENTION/MEASUREMENTS We examined anxiety symptoms using the Edinburgh Postnatal Depression Scale Anxiety subscale. We conducted a medical record review to examine if pregnant individuals were clinically diagnosed with an anxiety disorder. RESULTS Based on an Edinburgh Postnatal Depression Scale Anxiety subscale cutoff score of ≥5, 40% (n = 20) of individuals experienced anxiety symptoms during pregnancy. However, only 16% (n = 8) of participants were diagnosed with an anxiety disorder by a health care provider. CONCLUSION Anxiety symptoms are prevalent throughout pregnancy and may be underdiagnosed by health care providers. An intervention to increase clinical diagnosis of an anxiety disorder and subsequent referral to a mental health specialist may be indicated.
Collapse
|
3
|
Nawab T, Akram A, Rafat D, Khan T. Antepartum Depression and Its Clinico-Social Correlates: A Cross Sectional Study in a Tertiary Hospital of North India. J Obstet Gynaecol India 2023; 73:247-254. [PMID: 38143973 PMCID: PMC10746677 DOI: 10.1007/s13224-023-01878-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/04/2023] [Indexed: 12/26/2023] Open
Abstract
Background Maternal depression, the second leading cause of disease burden in women worldwide is often under-diagnosed and untreated. It can have consequences for pregnancy outcomes and child health. Objectives (1) To estimate the prevalence of antepartum depression among females attending antenatal clinic of a tertiary hospital. (2) To determine its obstetric and clinico-social correlates. Methods A cross-sectional study was conducted in antenatal clinic by consecutive sampling of 300 pregnant women. We included those in third trimester, aged 18-40 years and giving informed consent and excluded those with pre-diagnosed mental disorders. Pre-tested structured questionnaire and Edinburgh postnatal depression scale used. Score ≥ 10 indicated possible antepartum depression (APD). Chi-square test and logistic regression analysis applied using IBM SPSS version 22.0. P < 0.05 was considered statistically significant. Results Prevalence of possible APD was 23.3%. It was higher among urban females (25.3%) than rural (17.7%) but the difference was not statistically significant. APD increased with increasing maternal age. Other socio-demographic and obstetric factors were not associated significantly with APD. History of recent stressful life event, domestic violence, marital conflict, lack of support from husband, and preference of male child were found to be the significant correlates. Conclusions More than one out of five antenatal females had possible antepartum depression, but none had sought treatment for the same. Antenatal women of higher age and those afflicted with social pathologies are more at risk. Screening for APD should be included in the maternal and child health care programme to address this hidden 'iceberg' disease.
Collapse
Affiliation(s)
- Tabassum Nawab
- Department of Community Medicine, J. N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
| | - Atia Akram
- Department of Community Medicine, J. N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
- Department of Obstetrics and Gynaecology, J. N. Medical College, Aligarh Muslim University, Aligarh, India
| | - Dalia Rafat
- Department of Obstetrics and Gynaecology, J. N. Medical College, Aligarh Muslim University, Aligarh, India
| | - Tamkin Khan
- Department of Obstetrics and Gynaecology, J. N. Medical College, Aligarh Muslim University, Aligarh, India
| |
Collapse
|
4
|
Yang J, Qu Y, Zhan Y, Ma H, Li X, Man D, Wu H, Huang P, Ma L, Jiang Y. Trajectories of antepartum depressive symptoms and birthweight: a multicenter and prospective cohort study. Psychiatry Clin Neurosci 2023; 77:631-637. [PMID: 37632723 DOI: 10.1111/pcn.13590] [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: 03/28/2023] [Revised: 08/01/2023] [Accepted: 08/10/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Antepartum depression is a prevalent unhealthy mental health problem worldwide, particularly in low-income countries. It is a major contributor to adverse birth outcomes. Previous studies linking antepartum depression to birthweight have yielded conflicting results, which may be the reason that the depressive symptoms were only measured once during pregnancy. This study aimed to explore the associations between trajectories of antepartum depressive symptoms and birthweight. METHODS Depressive symptoms were assessed prospectively at each trimester in 3699 pregnant women from 24 hospitals across 15 provinces in China, using the Edinburgh Postpartum Depression Scale (EPDS). Higher scores of EPDS indicated higher levels of depressive symptoms. Associations between trajectories of depressive symptoms and birthweight were examined using group-based trajectory modeling (GBTM), propensity score-based inverse probability of treatment weighting (IPTW), and logistic regression. RESULTS GBTM identified five trajectories. Compared with the low-stable trajectory of depressive symptoms, only high-stable (OR = 1.35, 95% CI: 1.15-2.52) and moderate-rising (OR = 1.18, 95% CI: 1.12-1.85) had an increased risk of low birthweight (LBW) in the adjusted longitudinal analysis of IPTW. There was no significant increase in the risk of LBW in moderate-stable and high-falling trajectories. However, trajectories of depressive symptoms were not associated with the risk of macrosomia. CONCLUSION Antepartum depressive symptoms were not constant. Trajectories of depressive symptoms were associated with the risk of LBW. It is important to optimize and implement screening, tracking, and intervention protocols for antepartum depression, especially for high-risk pregnant women, to prevent LBW.
Collapse
Affiliation(s)
- Jichun Yang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yimin Qu
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yongle Zhan
- School of Public Health, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Haihui Ma
- Department of Obstetrics, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Xiaoxiu Li
- Department of Pediatric Gastroenterology, Dongguan Maternal and Child Health Care Hospital, Dongguan, China
| | - Dongmei Man
- Department of Obstetrics, Affiliated Hospital of Jining Medical University, Jining, China
| | - Hongguo Wu
- Department of Perinatal Health, Jiaxian Maternal and Child Health Care Hospital, Jiaxian, China
| | - Ping Huang
- Department of Nutrition, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Liangkun Ma
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
5
|
Kristbergsdottir H, Valdimarsdottir HB, Steingrimsdottir T, Sigurvinsdottir R, Skulason S, Lydsdottir LB, Jonsdottir SS, Olafsdottir H, Sigurdsson JF. The role of childhood adversity and prenatal mental health as psychosocial risk factors for adverse delivery and neonatal outcomes. Gen Hosp Psychiatry 2023; 85:229-235. [PMID: 37995481 DOI: 10.1016/j.genhosppsych.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/13/2023] [Accepted: 10/13/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE Exposure to adverse childhood experiences (ACEs) is a significant predictor for physical and mental health problems later in life, especially during the perinatal period. Prenatal common mental disorders (PCMDs) are well-established as a risk for obstetric interventions but knowledge on combined effects of multiple psychosocial risk factors is sparse. We aim to examine a comprehensive model of ACEs and PCMDs as risk factors for poor delivery and neonatal outcomes. METHOD With structural equation modeling, we examined direct and indirect pathways between psychosocial risk and delivery and neonatal outcomes in a prospective cohort from pregnancy to birth in Iceland. RESULTS Exposure to ACEs increased risk of PCMDs [β = 0.538, p < .001, CI: 0.195-1.154] and preterm delivery [β = 0.768, p < .05, CI: 0.279-1.007)]. An indirect association was found between ACEs and increased risk of non-spontaneous delivery [β = 0.054, p < .05, CI: 0.004-0.152], mediated by PCMDs. Identical findings were observed for ACEs subcategories. CONCLUSION ACEs are strong predictors for mental health problems during pregnancy. Both ACEs and PCMDs diagnosis are associated with operative delivery interventions and neonatal outcomes. Findings underscore the importance of identifying high-risk women and interventions aimed at decreasing psychosocial risk during the prenatal period.
Collapse
Affiliation(s)
| | - Heiddis Bjork Valdimarsdottir
- Department of Psychology Reykjavik University, Iceland; Department of Population Health Science and Policy, Mount Sinai, School of Medicine, New York, USA.
| | - Thora Steingrimsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Obstetrics and Gynecology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
| | | | - Sigurgrimur Skulason
- Directorate of Education, Kopavogur, Iceland; Faculty of Psychology, University of Iceland, Reykjavik, Iceland.
| | | | | | - Halldora Olafsdottir
- Mental Health Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
| | - Jon Fridrik Sigurdsson
- Department of Psychology Reykjavik University, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| |
Collapse
|
6
|
Ng CM, Kaur S, Kok EY, Chew WL, Takahashi M, Shibata S. Sleep, light exposure at night, and psychological wellbeing during pregnancy. BMC Public Health 2023; 23:1803. [PMID: 37716989 PMCID: PMC10504708 DOI: 10.1186/s12889-023-16655-y] [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: 01/30/2023] [Accepted: 08/30/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Psychological wellbeing during pregnancy is imperative for optimal maternal outcomes. The present study aimed to determine the association between sleep quality, light exposure at night, and psychological wellbeing in the 2nd and 3rd trimesters of pregnancy. METHODS This prospective study was conducted in 9 randomly selected government maternity clinics in Kuala Lumpur, Malaysia. Healthy women aged 20-48 years old with single pregnancy were recruited using convenience sampling (n = 169). Sleep quality, light exposure at night, and psychological wellbeing were self-reported using the Pittsburgh Sleep Quality Index (PSQI), Harvard Light Exposure Assessment (H-LEA), and Depression, Anxiety, and Stress Scale (DASS-21) in the 2nd trimester and followed-up at the 3rd trimester. RESULTS During the 2nd and 3rd trimesters of pregnancy, mild to severe symptoms of stress (10.7 and 11.3%), anxiety (42 and 44.3%), and depression (9.6 and 16.6%) were observed among the participants. Adjusted multiple linear regression revealed that poor sleep quality and higher light exposure at night were attributed to greater stress and depression symptoms in the 3rd trimester. Higher lux level exposed from 10 pm to < 1 am was associated with increased stress (β = 0.212, p = 0.037) and depression (β = 0.228, p = 0.024). Only poor sleep quality was observed to adversely affect anxiety (β = 0.243, p = 0.002) and depression levels (β = 0.259, p = 0.001) in the 2nd trimester. CONCLUSIONS Present study provided preliminary findings on the association between sleep quality, light at night, and psychological wellbeing of pregnant women. As a recommendation, future research could investigate whether public health interventions aimed at decreasing artificial light at night can benefit sleep quality and the psychological health of pregnant women.
Collapse
Affiliation(s)
- Choon Ming Ng
- School of Pharmacy, Monash University Malaysia, South Lagoon Road, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - Satvinder Kaur
- Faculty of Applied Sciences, UCSI University, 1, Jalan Puncak Menara Gading, Taman Connaught, 56000, Kuala Lumpur, Malaysia.
| | - Ee Yin Kok
- Faculty of Applied Sciences, UCSI University, 1, Jalan Puncak Menara Gading, Taman Connaught, 56000, Kuala Lumpur, Malaysia
| | - Wan Ling Chew
- Faculty of Applied Sciences, UCSI University, 1, Jalan Puncak Menara Gading, Taman Connaught, 56000, Kuala Lumpur, Malaysia
| | - Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo, 152-8550, Japan
| | - Shigenobu Shibata
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| |
Collapse
|
7
|
Abulseoud OA, Chan B, Rivera-Chiauzzi EY, Egol CJ, Nettey VN, Van Ligten MJ, Griffin TN, Aly M, Sinha S, Schneekloth TD. Psychiatric disorders during pregnancy in asymptomatic and mildly symptomatic SARS-CoV-2 positive women: Prevalence and effect on outcome. Psychiatry Res 2023; 326:115313. [PMID: 37336168 PMCID: PMC10273774 DOI: 10.1016/j.psychres.2023.115313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/21/2023]
Abstract
The effect of psychiatric comorbidity on pregnancy outcome among SARS-CoV-2 positive women with asymptomatic and mildly symptomatic infections remains largely unknown. We reviewed the electronic medical records of all pregnant women who received care at Mayo Health System and tested positive for SARS-CoV-2 (RT-PCR) from March 2020 through October 2021. Among 789 patients, 34.2% (n = 270) had psychiatric comorbidity. Of those with psychiatric comrobidity, 62.2% (n = 168) had depression prior to pregnancy, and 5.2% (n = 14) reported new-onset depression during pregnancy. Before pregnancy, 65.6% (n = 177) had anxiety, and 4.4% (n = 12) developed anxiety during pregnancy Thirteen percent of SARS-CoV-2 positive pregnant women (n = 108) received psychotropic medication during pregnancy. In addition, 6.7% (n = 18) and 10.7% (n = 29) of pregnant women with psychiatric comorbidity had documented nicotine, cannabis and/ or illicit substance use during and prior to pregnancy, respectively. We depicted a significantly higher risk for cesarean delivery [35.6% vs. 24.9%) in asymptomatic and mildly symptomatic SARS-CoV-2 positive pregnant women with psychiatric comorbidity. In conclusion, the prevalence rates of depression, anxiety, and prescribed antidepressant medications during pregnancy among asymptomatic and mildly symptomatic SARS-CoV-2 infected women were substantially higher than average, which negatively impacted pregnancy and neonatal outcomes.
Collapse
Affiliation(s)
- Osama A Abulseoud
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ 58054; Department of Neuroscience, Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Phoenix, Arizona 58054.
| | - Belinda Chan
- Department of Pediatrics, Neonatology, University of Utah, Salt Lake City, Utah 84108
| | | | - Claudine J Egol
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ 58054
| | - Victor N Nettey
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ 58054
| | | | | | - Mohamed Aly
- Department of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, Arizona 85054
| | - Shirshendu Sinha
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ 58054
| | - Terry D Schneekloth
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ 58054
| |
Collapse
|
8
|
Jones L, Mariapun J, Tan AXQ, Kassim Z, Su TT. Maternal wellbeing of Malaysian mothers after the birth of a preterm infant. BMC Pregnancy Childbirth 2023; 23:510. [PMID: 37442958 DOI: 10.1186/s12884-023-05823-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND In Malaysia approximately 7% of births result in a preterm birth (< 37 weeks). Research in many other countries has found that mothers of preterm infants experience poorer psychological wellbeing. However, there has been limited research in Malaysia. We examined wellbeing, using the WHO Quality of Life brief version questionnaire (WHOQOL-BREF), in mothers who have preterm and full-term infants. METHODS Data was collected as part of the South East Asian Community Observatory MISS-P project. A total of 3221 mothers (7.9% with a preterm and 92.1 with a full-term birth) completed a survey, with a range of measures, including the WHOQoL-BREF and sociodemographic questions. RESULTS For the physical health, psychological wellbeing and quality of their environment WHOQOL-BREF domains, a lower gestational age, a lower education level, and having had an emergency caesarean delivery were significantly associated (p < 0.05) with a lower quality of life, and there was a weak effect for ethnicity for some domains. The effects were strongest for mothers' education level. CONCLUSIONS There is a weak but significant relationship between the gestational age of an infant and the mother's quality of life. Mothers in Malaysia with a preterm infant or a lower level of education may benefit from additional support.
Collapse
Affiliation(s)
- Liz Jones
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia.
| | - Jeevitha Mariapun
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Abbey Xiao Qian Tan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Zaid Kassim
- 2Segamat District Public Health Office, Ministry of Health, 85000, Segamat, Johor, Malaysia
| | - Tin Tin Su
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University (Malaysia), Jalan Lagoon, Selatan, Bandar Sunway, Selangor State, Malaysia
| |
Collapse
|
9
|
Hong SA, Buntup D. Maternal Depression during Pregnancy and Postpartum Period among the Association of Southeast Asian Nations (ASEAN) Countries: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5023. [PMID: 36981932 PMCID: PMC10049420 DOI: 10.3390/ijerph20065023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Identification of mothers with depression is important because untreated perinatal depression can have both short- and long-term consequences for the mother, the child, and the family. This review attempts to identify the prevalence of antenatal and postnatal depression (AD and PD, respectively) of mothers among the ASEAN member countries. A literature review was conducted using PubMed, Scopus, and the Asian Citation Index. The reviews covered publications in peer-reviewed journals written in the English language between January 2010 and December 2020. Of the 280 articles identified, a total of 37 peer-reviewed articles conducted in 8 out of 11 ASEAN member countries were included. The Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument used to identify depression. This study showed the number of studies reporting the prevalence of AD was 18 in five countries. For PD, 24 studies in eight countries were included. The prevalence of AD ranged from 4.9% to 46.8%, and that of PD ranged from 4.4% to 57.7%. This first review among ASEAN countries showed very few studies conducted in lower-middle-income and substantial heterogeneity in prevalence among studies reviewed. Further research should be conducted to estimate the prevalence using a large representative sample with a validated assessment tool among the ASEAN countries.
Collapse
|
10
|
Priyadarshanie MN, Waas DA, Goonewardena S, Senaratna CV, Fernando S. Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri Lanka. Heliyon 2023; 9:e13900. [PMID: 36915536 PMCID: PMC10006716 DOI: 10.1016/j.heliyon.2023.e13900] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
Purpose Evidence on the association between antenatal anxiety disorders (AADs) and adverse pregnancy outcomes with detection of AADs using the gold-standard is scarce despite being vital to make decisions on interventions. We aimed to determine this association in women attending tertiary-care antenatal clinics in Sri Lanka. Material and methods Presence/absence of AADs in a systematic random sample of 221 antenatal women attending routine antenatal clinics of a teaching hospital who participated in a questionnaire-validation study were confirmed by a psychiatrist. These women were followed up until the end of pregnancy. Information on antenatal comorbidities, adverse pregnancy outcomes was extracted from health records. The association between AADs with antenatal comorbidities and adverse pregnancy outcomes were reported using adjusted odds ratios (ORs) and 95%confidence intervals (CIs) generated from logistic regression models. Results Mean (±SD) age of the women was 30 (±5.8) years. AADs were diagnosed in 81 (37%) women. Compared to women without AADs, those who had AADs were more at risk of pregnancy-induced hypertension (OR 6.1; 95% CI 1.2-31.9), gestational diabetes mellitus (OR 12.6; 95% CI 1.5-107.2), preterm labour (OR 4.3; 95% CI 1.4-13.0), prolonged labour (OR 19.0; 95% CI 7.1-51.1), lower segment caesarean section (OR 4.7; 95% CI 2.5-8.7) and low birthweight (OR 11.2; 95% CI 4.8-26.3). All miscarriages, stillbirths and assisted labour occurred exclusively in those with AADs. Conclusions AADs are strongly associated with several adverse pregnancy outcomes. Causal pathways and effect of interventions for AADs must be explored in future research.
Collapse
Affiliation(s)
- M Nirmala Priyadarshanie
- Department of Nursing & Midwifery, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Rathmalana, Sri Lanka
| | - Dulshika A Waas
- Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Sampatha Goonewardena
- Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Chamara V Senaratna
- Non-Communicable Diseases Research Centre, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Sharaine Fernando
- Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| |
Collapse
|
11
|
Zhang F, Zhou J, Zhang S, Qin X, Li P, Tao F, Huang K. Impact of pregnancy-related anxiety on preschoolers' emotional and behavioral development: Gender specificity, critical time windows and cumulative effect. J Affect Disord 2023; 323:176-184. [PMID: 36471547 DOI: 10.1016/j.jad.2022.11.085] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies on the gender-specific effect of PrA on children's emotional and behavioral development are limited. Lack of PrA data on the entire pregnancy had caused difficulties in identifying the key time window and cumulative effects. METHODS Based on Ma'anshan Birth Cohort in China, mothers at pregnancy and children followed up to 4 years of age were tested using the PrA questionnaire and the Achenbach Child Behavior Checklist (CBCL) 1.5-5. Finally, 1699 mother-child pairs were included in the study and regression models were developed for analysis. RESULTS Children of mothers with PrA are at significantly elevated risk for abnormal mood/behavior at preschool age. Girls seemed to be more sensitive to maternal PrA than boys, mainly manifested in internalizing problems; The third trimester of pregnancy might be a critical time window when maternal PrA affected children's internalizing problems; Longer the duration women had PrA during pregnancy, more possibilities their children would have to develop internalizing and externalizing problems. LIMITATIONS The PrA questionnaire may be different from PrA questionnaires in other countries such as due to different cultural contexts. Findings need to be interpreted with more caution. Factors such as maternal postpartum depression and care practices of nursing staff were not considered. No data were collected on disease as well as caregiver emotional status, which also impacts the reporting and identification of emotional/behavioral problems in children. CONCLUSIONS Gender-specific and cumulative effect of PrA on preschoolers' emotional/behavioral development is observed. The third trimester of pregnancy might be the critical time window.
Collapse
Affiliation(s)
- Fu Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; Key Laboratory of Population Health Across Life Cycle(AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Jixing Zhou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; Key Laboratory of Population Health Across Life Cycle(AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Shanshan Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; Key Laboratory of Population Health Across Life Cycle(AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Xiaoyun Qin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; Key Laboratory of Population Health Across Life Cycle(AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Peixuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; Key Laboratory of Population Health Across Life Cycle(AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; Key Laboratory of Population Health Across Life Cycle(AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; Key Laboratory of Population Health Across Life Cycle(AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, China..
| |
Collapse
|
12
|
Bied A, Njuguna S, Mohd Shukri NH, Zainudin Z. Psychometric Features of the Edinburgh Postnatal Depression Scale Among Malaysian Women: A Cross-Sectional Study. Cureus 2023; 15:e34822. [PMID: 36923176 PMCID: PMC10008783 DOI: 10.7759/cureus.34822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 02/11/2023] Open
Abstract
Background The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item questionnaire developed to identify women at risk for postpartum depression (PD). EPDS symptom patterns appear to vary by nation. The EPDS items and their correlation with affirmative EPDS screens have thus far been minimally studied among Malaysians. Using positive predictive value (PPV) and negative predictive value (NPV), this study aims to evaluate the EPDS-based psychometric features of individual answer items. Methodology A cross-section of postpartum women receiving care at two tertiary care facilities in Malaysia underwent screening assessments in the course of receiving treatment. EPDS was employed with an aggregate cutoff score (≥12). EPDS items were assessed as predictors of abnormal EPDS screens. Results A total of 219 participants were screened, among which 66 were positive on the EPDS. EPDS item responses were collected (item responses 0-3: PPV = 0.07-0.78 and NPV = 0.93-0.22). A negative response to any item strongly predicted a negative EPDS screen (item entry = 0 and NPV = 0.93). Affirmative responses on items 8, 9, and 10 were particularly strong predictors of abnormal EPDS scores, while negative responses to items 3, 5, and 7 were strong predictors of negative EPDS scores. A substantial NPV for any item (response 0 and NPV items 1-10 = 0.93) and a moderate PPV for any affirmative response (responses 1-3, PPV items 1-10 = 0.60) were observed. Conclusions This is one of the few studies to examine the EPDS item responses among Malaysian women. The results suggest that depression remains prevalent in this postpartum population. Our findings reveal a robust NPV for any negative response to the individual items of the scale, a moderate PPV for any affirmative response, and a particularly robust validity for specific EPDS items. Physical complaints, rather than feelings of sadness, figure prominently in this population, suggesting a tendency among Malaysian women toward somatization.
Collapse
Affiliation(s)
- Adam Bied
- Department of Psychiatry and Behavioral Sciences, ABC Medical, Reading, USA
| | - Susan Njuguna
- Department of Psychiatry and Behavioral Sciences, ABC Medical, Reading, USA
| | - Nurul Husna Mohd Shukri
- Laboratory of Youth and Community Well, Institute for Social Science Studies, Universiti Putra Malaysia, Serdang, MYS.,Faculty of Medicine and Health Sciences, Department of Nutrition, Universiti Putra Malaysia, Serdang, MYS
| | - Zurina Zainudin
- Faculty of Medicine and Health Sciences, Department of Pediatrics, Universiti Putra Malaysia, Serdang, MYS
| |
Collapse
|
13
|
Deutsch AR, Vargas MC, Lucchini M, Brink LT, Odendaal HJ, Elliott AJ. Effect of individual or comorbid antenatal depression and anxiety on birth outcomes and moderation by maternal traumatic experiences and resilience. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 9:100365. [PMID: 35966253 PMCID: PMC9373828 DOI: 10.1016/j.jadr.2022.100365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Although antenatal depression and anxiety (e.g., negative antenatal mental health; NAMH) are individually associated with preterm birth (PTB) and infant neurological impairment, few studies account for comorbidity. Understanding how NAMH impacts PTB and infant neurological functioning by either singular (depression or anxiety) or comorbid status, as well as the way in which these effects can be moderated by additional risk or protective factors (traumatic experiences and trait resiliency) can contribute further understanding of NAMH effects on birth outcomes. Methods The sample included 3042 mother-infant dyads from U.S. and South Africa cohorts of the Safe Passage Study (N = 3042). A four-category NAMH variable was created to categorize depression-only, anxiety-only, comorbid, or no NAMH statuses. Results There were no NAMH main effects on PTB, however, anxiety-only and comorbid NAMH increased odds of PTB for mothers with higher rates of traumatic life experiences. Anxiety-only and comorbid NAMH were associated with increased odds of newborn neurological impairment, and the effect of comorbid NAMH was stronger for mothers with higher rates of traumatic experiences. Resiliency decreased odds of neurological impairment for mothers who reported depression-only or anxiety-only NAMH. Limitations Limitations included potential artefacts of two cohorts that differed in rates of almost all variables, a single time point for measuring NAMH, and lack of pregnancy-specific NAMH measures. Conclusions Especially when compared to mothers with no NAMH, comorbidity or singular-condition NAMH statuses associate with negative birth outcomes in nuanced ways, especially when considering additional contexts that may foster or protect against NAMH.
Collapse
Affiliation(s)
- Arielle R. Deutsch
- Avera Research Institute
- University of South Dakota School of Medicine, Department of Pediatrics
| | | | - Maristella Lucchini
- Columbia University Irving Medical Center, Department of Psychiatry
- New York State Psychiatric Institute, Division of Developmental Neuroscience
| | - Lucy T. Brink
- Stellenbosch University, School of Medicine and Health Science, Department of Obstetrics and Gynaecology
| | - Hein J. Odendaal
- Stellenbosch University, School of Medicine and Health Science, Department of Obstetrics and Gynaecology
| | - Amy J. Elliott
- Avera Research Institute
- University of South Dakota School of Medicine, Department of Pediatrics
| |
Collapse
|
14
|
Determinants of Pregnancy-Related Anxiety among Women Attending Antenatal Checkup at Public Health Institutions in Debre Markos Town, Ethiopia. DEPRESSION RESEARCH AND TREATMENT 2022; 2022:6935609. [PMID: 35968260 PMCID: PMC9363933 DOI: 10.1155/2022/6935609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/25/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Pregnancy-related anxiety has been associated with many pregnancy adverse outcomes including preterm birth, low birth weight, postpartum depression, and resulting in long-term sequels on the child's emotional, cognitive, and behavioral development. This study is aimed at assessing the magnitude of pregnancy-related anxiety and associated factors among pregnant women attending antenatal checkup at Debre Markos town public health institutions, Northwest Ethiopia. METHODS An institution-based cross-sectional study was conducted among 423 pregnant women at Debre Markos town, Northwest Ethiopia, from February 1st to March 30th, 2021. A systematic random sampling technique was used to select the study participants. Data were collected sing a structured, pretested, and interviewer-administered questionnaire. The collected data were entered with Epi-data version 4.6 and then exported to SPSS version 23. Both bivariable and multivariable logistic regression analyses were undertaken to identify significantly associated variables with pregnancy-related anxiety. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p value of ≤0.05 was used to claim statistical association. RESULT In this study, a total of 408 pregnant women participated, giving a 96.4% response rate. The prevalence of pregnancy-related anxiety was found to be 43.9% (95% CI: 39.5, 49.2). Having no formal education (AOR = 3.37; 95% CI: 1.32, 8.58), primigravida (AOR = 1.94; 95% CI: 1.17, 3.24), intimate partner violence (AOR = 2.88; 95% CI: 1.47, 5.64), and poor social support (AOR = 2.05; 95% CI: 1.18, 3.56) was significantly associated with pregnancy-related anxiety. CONCLUSION In this study, the prevalence of pregnancy-related anxiety was found to be high when compared to other study findings. The regional educational department should give emphasis for gender pedagogies which pay attention to the specific learning needs of girls. In addition, interventions on violence against women and social support for the women may reduce the problem.
Collapse
|
15
|
Ali MH, Seif SA, Kibusi SM. The Influence of Fear During Pregnancy, Labour and Delivery on Birth Outcome Among Post-Delivery Women: A Case Control Study in Zanzibar. East Afr Health Res J 2022; 6:147-154. [PMID: 36751688 PMCID: PMC9887506 DOI: 10.24248/eahrj.v6i2.693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 11/25/2022] [Indexed: 01/02/2023] Open
Abstract
Background Assessing the influence of fear during pregnancy, labour, and delivery on birth outcomes among women is very important. Normally, women experience happiness during pregnancy, but some may develop fear which may cause maternal and neonatal complications. The aim of this study was to determine the influence of fear during pregnancy, labour and delivery on birth outcome among post-delivery women in Zanzibar. Methodology This was a matched case-control study involving 204 post-delivery women who were randomly selected from 4 hospitals in Zanzibar. Cases (n=68) were those who experienced a negative birth outcome, whether maternal, fetal, or both. The control group (n=136) had normal birth outcomes. A self-administered questionnaire was used to collect data and was analyzed using SPSS whereby percentages, chi-square test, and odds ratio results were reported. Results Among cases, 27(39.7%) had high level of fear during pregnancy compared to the control group, 75(40.4%). During labour, 29(42.6%) of cases had high level of fear, and in control, 55(42.4%). And during delivery 35(51.4%) of cases had highest level of fear, while only 47(34.5%) of control had high level of fear. The chi-square test showed only fear during delivery was significantly associated with undesirable birth outcomes. Women who experienced a high level of fear during delivery were 2 times more likely to have undesirable birth outcomes (AOR=1.941, p=.051) after adjusting for other variables. Conclusion This study established that most women experience high level of fear during pregnancy, labour and delivery. A high level of fear during delivery is associated with having negative birth outcomes, but not during pregnancy and labour. The findings are of clinical importance as they highlight the need to integrate a universal screening intervention into antenatal care services for early management.
Collapse
Affiliation(s)
- Mwanaali H. Ali
- Department of Clinical Nursing, The University of Dodoma-Tanzania
| | - Saada A. Seif
- Department of Nursing Management and Education, The University of Dodoma-Tanzania,Correspondence to Saada A. Seif ()
| | | |
Collapse
|
16
|
Chandra PS, Bajaj A, Desai G, Satyanarayana VA, Sharp HM, Ganjekar S, Supraja TA, Jangam KV, Venkatram L, Kandavel T. Anxiety and depressive symptoms in pregnancy predict low birth weight differentially in male and female infants-findings from an urban pregnancy cohort in India. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2263-2274. [PMID: 34114109 DOI: 10.1007/s00127-021-02106-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 05/10/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study examined the contributions of antenatal anxiety, depression, and partner violence to low birth weight (LBW) in infants and to sex-specific birth weight outcomes among mothers from a cohort in urban India. METHODS Data from 700 mothers from the PRAMMS cohort (Prospective Assessment of Maternal Mental Health Study) were used. Pregnant women were assessed in each trimester-T1, T2 and T3, for symptoms of anxiety, and depression as well as partner violence. Multivariate analyses were performed for the whole sample and then for male and female infants separately. The final multivariable logistic regression models were each built using a backward selection procedure and controlling for confounders. To accommodate longitudinally measured data, change in scores (T2-T1 and T3-T2) of anxiety and depression were included in the model. RESULTS Of the 583 women with a singleton live birth, birth weight was available for 514 infants and LBW was recorded in 80 infants (15.6%). Of these, 23 infants were preterm. Overall, higher T1 Depression scores (OR: 1.11; 95% CI 1.040, 1.187) and an increase in both Depression scores (OR: 1.12; 95% CI 1.047, 1.195) from T1 to T2 and Anxiety scores (OR: 1.32; 95% CI 1.079, 1.603) between T2 and T3 were predictors of LBW. Female infants had a higher chance of LBW with increase in maternal anxiety between T1-T2 (OR: 1.69; 95% CI 1.053, 2.708) and T2-T3 (OR: 1.49; 95% CI 1.058, 2.086); partner violence during pregnancy just failed to reach conventional statistical significance (OR: 2.48; 95% CI 0.810, 7.581) in girls. Male infants had a higher chance of LBW with higher baseline depression scores at T1 (OR: 1.23; 95% CI 1.042, 1.452) and an increase in depression scores (OR: 1.25; 95% CI 1.060, 1.472) from T1 to T2. CONCLUSION Increasing prenatal anxiety and depressive symptoms in different trimesters of pregnancy were associated with LBW with sex-specific patterns of association in this sample from a Low and Middle Income Country.
Collapse
Affiliation(s)
- Prabha S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
| | - Aakash Bajaj
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Geetha Desai
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Veena A Satyanarayana
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Helen M Sharp
- Department of Psychological Science, University of Liverpool, Liverpool, UK
| | - Sundarnag Ganjekar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - T A Supraja
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Kavita V Jangam
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Latha Venkatram
- Department of Obstetrics, Rangadore Memorial Hospital, Bangalore, India
| | - Thennarasu Kandavel
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India
| |
Collapse
|
17
|
Gordon S, Rotheram-Fuller E, Rezvan P, Stewart J, Christodoulou J, Tomlinson M. Maternal depressed mood and child development over the first five years of life in South Africa. J Affect Disord 2021; 294:346-356. [PMID: 34315096 DOI: 10.1016/j.jad.2021.07.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND While the negative impact of peri-natal depression is well-documented in high-income countries, the long-term effects across the life course in low and middle-income countries is less clear. Children's adjustment over the first five years is examined as a function of patterns of maternal depressed mood. METHODS Pregnant women in 24 peri-urban townships (N = 1,238) were randomized to a home-visiting intervention or standard care and reassessed five times, with high retention. There were no intervention effects on children past 18 months. Multilevel regression models examined the impact of depressed mood on child outcomes. Using the Edinburgh Postnatal Depression Scale, four patterns of maternal depressed mood were identified: never (40.6%); antenatal (13.0%); early childhood (26.1%); and recurrent episodes of depressed mood (20.3 %). FINDINGS Mothers' patterns of depressive symptoms and child outcomes were similar, regardless of intervention. Never depressed mothers were significantly younger, had higher income, less food insecurity, were more likely to have electricity, be living with HIV or have an HIV positive partner, and had fewer problems with alcohol than depressed mothers. Children of mothers who experienced depressed mood weighed less, were more aggressive, and were hospitalized more often than children of never depressed mothers, but were similar in cognitive and social development. INTERPRETATIONS Depressed mood, has significant negative impacts on South African children's growth and aggressive behavior. The timing of maternal depressed mood was less important than never having a depressed mood or a recurrent depressed mood. FUNDING There were no funding conflicts in executing this trial.
Collapse
Affiliation(s)
- Sarah Gordon
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | | | | | - Jackie Stewart
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | | | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa; School of Nursing and Midwifery, Queens University, Belfast, United Kingdom.
| |
Collapse
|
18
|
Zochowski MK, Kolenic GE, Zivin K, Tilea A, Admon LK, Hall SV, Advincula A, Dalton VK. Trends In Primary Cesarean Section Rates Among Women With And Without Perinatal Mood And Anxiety Disorders. Health Aff (Millwood) 2021; 40:1585-1591. [PMID: 34606349 DOI: 10.1377/hlthaff.2021.00780] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Reducing the rate of cesarean sections among women considered at low risk for delivery by that method is a goal of Healthy People 2030. Prior research suggests that perinatal mood and anxiety disorders increase the risk for cesarean section, but data are limited. This cross-sectional study of commercially insured women examined the relationship between perinatal depression and anxiety disorders and primary (first-time) cesarean section rates, using administrative claims data for US in-hospital deliveries from the period 2008-17. Of the 360,225 delivery hospitalizations among 317,802 unique women, 24.0 percent included a delivery by primary cesarean section, and 3.1 percent carried a diagnosis of depression, anxiety, or both made during the index pregnancy. Using an adjusted generalized estimating equation, we found that the predicted probability of primary cesarean section was 3.5 percentage points higher, on average, among women with these disorders compared with those without them. Our findings confirm the importance of pursuing research to identify mechanisms by which perinatal depression and anxiety disorders increase the risk for primary caesarean section among women otherwise considered at low risk for delivery by that method, as well as effective interventions.
Collapse
Affiliation(s)
- Melissa K Zochowski
- Melissa K. Zochowski is a research specialist in the Department of Psychiatry, University of Michigan, in Ann Arbor, Michigan
| | - Giselle E Kolenic
- Giselle E. Kolenic is a statistician in the Department of Obstetrics and Gynecology, University of Michigan
| | - Kara Zivin
- Kara Zivin is a professor in the Department of Psychiatry, University of Michigan, a research career scientist at the Veterans Affairs Ann Arbor Healthcare System, and a senior health researcher at Mathematica, all in Ann Arbor, Michigan
| | - Anca Tilea
- Anca Tilea is a data and analytics manager in the Department of Obstetrics and Gynecology, University of Michigan
| | - Lindsay K Admon
- Lindsay K. Admon is an assistant professor in the Department of Obstetrics and Gynecology, University of Michigan
| | - Stephanie V Hall
- Stephanie V. Hall is a doctoral student in the Department of Psychiatry, University of Michigan
| | - Agatha Advincula
- Agatha Advincula is a student intern, Benjamin Franklin Scholars, University of Pennsylvania, in Philadelphia, Pennsylvania
| | - Vanessa K Dalton
- Vanessa K. Dalton is a professor in the Department of Obstetrics and Gynecology, University of Michigan
| |
Collapse
|
19
|
Beyene GM, Azale T, Gelaye KA, Ayele TA. The effect of antenatal depression on birth weight among newborns in South Gondar zone, Northwest Ethiopia: a population-based prospective cohort study. Arch Public Health 2021; 79:121. [PMID: 34225799 PMCID: PMC8256480 DOI: 10.1186/s13690-021-00643-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/17/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND There is a high prevalence of antenatal depression and low birth weight (LBW) (< 2.5 kg) in Ethiopia. Prior evidence revealed that the association between antenatal depression and LBW in high- and low-income countries is conflicting. The effect of antenatal depression on birth weight is under-researched in Ethiopia. We aimed to examine the independent effect of antenatal depression on newborn birth weight in an urban community in Northwest Ethiopia. METHODS A total of 970 pregnant women were screened for antenatal depression in their second and third trimester of pregnancy through the use of the Edinburgh Postnatal Depression Scale (EPDS). A logistic regression model was used to adjust confounders and determine associations between antenatal depression and low birth weight. Information was collected on the birth weight of newborns and mother's socio-demographic, anthropometric, obstetric, clinical, psychosocial, and behavioral factors. RESULTS The cumulative incidence of LBW was found to be 27.76%. The cumulative incidence of LBW in those born from depressed pregnant women was 40% as compared to 21% in none depressed. While considering all other variables constant, mothers who had antenatal depression were 2.51 (COR = 2.51 (95 CI: 1.87, 3.37)) more likely to have a child with low birth weight. After adjusting for potential confounders, antenatal depression in the second and third trimester of pregnancy (AOR = 1.92 (95% CI: 1.31, 2.81)) remained significantly associated with LBW. Mid-Upper Arm Circumference (MUAC) ≤21, lack of ANC follow up, and preterm births were also associated with LBW. CONCLUSION This study showed that antenatal depression during the second and third trimester of pregnancy is associated with LBW of newborns and replicates results found in high-income countries. Linking early screening, detection, and treatment of antenatal depression into routine antenatal care could be essential to improve pregnancy outcomes.
Collapse
Affiliation(s)
- Getnet Mihretie Beyene
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
20
|
Acheampong K, Pan X, Kaminga AC, Wen SW, Liu A. Risk of adverse maternal outcomes associated with prenatal exposure to moderate-severe depression compared with mild depression: A fellow-up study. J Psychiatr Res 2021; 136:32-38. [PMID: 33548828 DOI: 10.1016/j.jpsychires.2021.01.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pregnancy is a time of increased vulnerability for the development of anxiety and depression. The purpose of this study was to compare the risk of developing adverse maternal and perinatal outcomes between pregnant women with moderate-severe depression and those who had mild depression. METHODS Our study was performed in a prospective cohort of 360 depressed pregnant women, recruited and followed up to delivery at the Adventist Hospital in Bekwai Municipality, Ghana. The research began in February 2020 and the follow-up was completed in August 2020. The pregnant women who had depression were classified into two groups: those who had moderate-severe depression (Patient Health Questionnaires-9 (PHQ-9) score ≥15) and those who had mild depression (PHQ-9 score <15). Crude and adjusted relative risk (RR) with their corresponding 95% confidence intervals (95% CIs) for women with moderate-severe depression as compared with women with mild depression were then estimated. RESULT Out of a total of 360 pregnant women, 43 (11.9%) screened positive for moderate-severe depression. After adjusting for potential confounders, women with moderate-severe depression during pregnancy, as compared with women who had mild depression had an increased risk of pre-eclampsia (RR adjusted = 2.01; 95% CI:1.21-3.33); Caesarean section (RR adjusted = 1.78; 95% CI:1.18-2.70); and episiotomy (RR adjusted = 1.66; 95% CI: 1.06-2.60). On the other hand, no statistically significant association of severity of depression and perinatal outcomes was observed. CONCLUSION Compared with mild depression, symptoms of moderate-severe depression in pregnancy significantly increased risks of adverse maternal outcomes such as pre-eclampsia, caesarean section delivery, and episiotomy.
Collapse
Affiliation(s)
- Kwabena Acheampong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, 410078, China; Department of Public Health, Adventist University of Africa, Kenya; Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiongfeng Pan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, 410078, China
| | - Atipatsa Chiwanda Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, 410078, China
| | - Shi Wu Wen
- OMNI Research Group, Ottawa Hospital Research Institute, Canada; Department of Obstetrics and Gynaecology and School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, 410078, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China.
| |
Collapse
|
21
|
Ghimire U, Papabathini SS, Kawuki J, Obore N, Musa TH. Depression during pregnancy and the risk of low birth weight, preterm birth and intrauterine growth restriction- an updated meta-analysis. Early Hum Dev 2021; 152:105243. [PMID: 33190020 DOI: 10.1016/j.earlhumdev.2020.105243] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/14/2020] [Accepted: 10/18/2020] [Indexed: 12/21/2022]
Abstract
AIM Depression during pregnancy is a significant cause of adverse birth outcomes, and its prevalence has increased in recent years. This study aimed to give an updated quantification of the risk of preterm birth (PTB), low birth weight (LBW) and intrauterine growth restriction (IUGR) that is associated with antenatal depression. METHOD The search was done in different databases, including Web of Science, Scopus and PubMed, from January 2010 to March 2020, and only English-language articles were considered. We only included studies that assessed depression during pregnancy and those that reported data on antenatal depression with at least one adverse birth outcome (PTB, LBW, or IUGR). The quality of studies was assessed using an adaptation of the Newcastle-Ottawa scale assessment tool. The analysis was conducted using STATA (version 12), pooled effect sizes were calculated using the random-effects model and heterogeneity was tested for using the I2 statistic. RESULTS The analysis included 23 studies of PTB, LBW and IUGR. There was a significant risk of PTB (RR = 1.35, 95% CI 1.19-1.52), LBW (RR = 1.86, 95% CI 1.32-2.62) and IUGR (RR = 4.39, 95% CI 2.45-7.86). Control for confounders, time of assessing depression, among others altered the risk of LBW due to depression. In addition, depressed women in developing countries had a higher risk of PTB (RR = 2.07, 95% CI 1.13-3.81). CONCLUSION This study identifies a significant risk of PTB, LBW and IUGR due to antennal depression and recognises a need for targeted preventive interventions such as prompt screening to improve and promote maternal mental health care.
Collapse
Affiliation(s)
- Upama Ghimire
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Global Health School of Public Health, Southeast University, Nanjing 210009, Jiangsu Province, China.
| | - Shireen Salome Papabathini
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Global Health School of Public Health, Southeast University, Nanjing 210009, Jiangsu Province, China
| | - Joseph Kawuki
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Global Health School of Public Health, Southeast University, Nanjing 210009, Jiangsu Province, China; Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Nathan Obore
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Global Health School of Public Health, Southeast University, Nanjing 210009, Jiangsu Province, China
| | - Taha Hussein Musa
- Key Laboratory of Environmental Medicine Engineering, Department Epidemiology and Health Statistics, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu Province, China; Biomedical Research Institute, Darfur College, Nyala, Sudan
| |
Collapse
|
22
|
Validation of the patient health Questionnaire-9 (PHQ-9) for detecting depression among pregnant women in Lima, Peru. CURRENT PSYCHOLOGY 2020; 41:3797-3805. [DOI: 10.1007/s12144-020-00882-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|