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Wu D, Chen S, Zhong X, Zhang J, Zhao G, Jiang L. Prevalence and factors associated with antenatal depressive symptoms across trimesters: a study of 110,584 pregnant women covered by a mobile app-based screening programme in Shenzhen, China. BMC Pregnancy Childbirth 2024; 24:480. [PMID: 39014317 PMCID: PMC11251361 DOI: 10.1186/s12884-024-06680-z] [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: 03/11/2024] [Accepted: 07/04/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Antenatal depression is a significant public health issue affecting pregnant women both globally and in China. Using data from a mobile app-based screening programme, this study explored the prevalence and factors associated with antenatal depressive symptoms across different trimesters in Shenzhen. METHODS A retrospective cross-sectional study was conducted on pregnant women who gave birth in any hospital in Shenzhen between July 2021 and May 2022 and underwent depression screening using an official maternal and infant health mobile app at least once during pregnancy. Depressive symptoms were evaluated using the 9-item Patient Health Questionnaire (PHQ-9), with cut-off scores of 5 and 10 for mild and high level of symptoms, respectively. The prevalence for each trimester was determined by calculating the proportion of women scoring 5 or higher. A variety of sociodemographic, obstetric, psychological, and lifestyle factors were assessed for their association with depressive symptoms. Chi-square test and multivariate logistic regression were performed to identify significant predictors. RESULTS A total of 110,584 pregnant women were included in the study, with an overall prevalence of depressive symptoms of 18.0% and a prevalence of high-level symptoms of 4.2%. Depressive symptoms were most prevalent in the first trimester (10.9%) and decreased in the second (6.2%) and third trimesters (6.3%). Only a small proportion (0.4%) of women showed persistent depressive symptoms across all trimesters. Anxiety symptoms in early pregnancy emerged as the most significant predictor of depressive symptoms. Other factors linked to an increased risk throughout pregnancy include lower marital satisfaction, living with parents-in-law, experience of negative life events, as well as drinking before and during pregnancy. Factors associated with a reduced risk throughout pregnancy include multiparity and daily physical activity. CONCLUSIONS This large-scale study provides valuable insights into the prevalence and factors associated with antenatal depressive symptoms in Shenzhen. The findings underscore the need for targeted interventions for high-risk groups and the integration of mental health care into routine antenatal services. Continuous, dynamic monitoring of depressive symptoms for pregnant women and ensuring at-risk women receive comprehensive follow-up and appropriate psychological or psychiatric care are crucial for effectively addressing antenatal depression and improving maternal and infant health outcomes.
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Affiliation(s)
- Dadong Wu
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518000, Guangdong Province, China
- Shenzhen Key Laboratory of Maternal and Child Health and Diseases, Shenzhen, 518000, Guangdong Province, China
| | - Siqi Chen
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Xiaoqi Zhong
- The Second School of Clinical Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong Province, China
| | - Jiayi Zhang
- School of Health Management, Southern Medical University, Guangzhou, 510515, Guangdong Province, China
| | - Guanglin Zhao
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Lei Jiang
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518000, Guangdong Province, China.
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Kiyak S. The relationship of depression, anxiety, and stress with pregnancy symptoms and coping styles in pregnant women: A multi-group structural equation modeling analysis. Midwifery 2024; 136:104103. [PMID: 38986391 DOI: 10.1016/j.midw.2024.104103] [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: 01/27/2024] [Revised: 05/11/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND The changes during pregnancy can increase susceptibility to mental health problems such as depression, anxiety and stress, which is why coping strategies are so important. The aim of this study is to investigate the relationships between depression, anxiety, stress, pregnancy symptoms and coping styles in pregnant women across trimesters, using a multigroup structural equation model. METHODS This cross-sectional and correlational study was conducted with 301 pregnant women who applied to the prenatal clinic of a state university's medical faculty. A hypothetical model was created based on transactional stress and coping theory and literature reviews. Data were collected using a participant information form, the Depression Anxiety Stress Scale, the Pregnancy Symptom Inventory and the Stress Coping Styles Scale. RESULTS Among pregnant women, 40.9 % had symptoms of stress, 52.8 % of anxiety and 37.2 % of depression. Pregnancy symptoms and emotion-focused coping are positively associated with depression, anxiety, and stress (β = 0.468-0.590; β = 0.222-0.373 respectively). Problem-focused coping is negatively associated with depression, anxiety, and stress. (β = -0.255:-0.389). Problem-focused coping is negatively associated with pregnancy symptoms in the whole sample (β = -0.121) and in the third trimester (β = -0.124). The model explained 51 % of the variance in the 1st, 42 % in the 2nd, and 64 % in the 3rd trimesters. CONCLUSION This study showed that problem-focused coping strategies are negatively associated with depression, anxiety and stress and play an important protective role in this context. These findings contribute to understanding the factors affecting mental health during pregnancy and emphasize the importance of developing problem-focused coping skills for pregnant women.
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Affiliation(s)
- Sibel Kiyak
- Necmettin Erbakan University, Seydişehir Kamil Akkanat Faculty of Health Sciences, Department of Obstetrics and Gynecology Nursing, Anabağlar District, Prof. Dr. Necmettin Erbakan Street No:19 /3 postal code: 42370, Seydişehir Konya Turkey
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Roddy Mitchell A, Gordon H, Atkinson J, Lindquist A, Walker SP, Middleton A, Tong S, Hastie R. Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2343711. [PMID: 37976063 PMCID: PMC10656650 DOI: 10.1001/jamanetworkopen.2023.43711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023] Open
Abstract
Importance Anxiety disorders are associated with poor maternal and neonatal outcomes. Women in low- and middle-income countries (LMICs) are thought to be disproportionally burdened by these disorders, yet their prevalence is unclear. Objective To conduct a systematic review and meta-analysis to determine the prevalence of 6 anxiety and related disorders among perinatal women in LMICs. Data Sources Embase, MEDLINE, PsycINFO, Cochrane Library, CINAHL, and Web of Science databases were searched from inception until September 7, 2023. Study Selection Studies conducted in World Bank-defined LMICs and reporting prevalence of generalized anxiety disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder, panic disorder, or adjustment disorder during the perinatal period (conception to 12 months post partum) using a validated method were included. Data Extraction and Synthesis This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Study eligibility, extracted data, and risk of bias of included studies were assessed by 2 independent reviewers. Random-effects meta-analysis was used to estimate pooled point prevalence. Subgroup analyses were performed by specific anxiety disorder. Main Outcomes and Measures Main outcomes were prevalence estimates of each anxiety disorder, measured as percentage point estimates and corresponding 95% CIs. Results At total of 10 617 studies were identified, 203 of which met the inclusion criteria and reported the outcomes of 212 318 women from 33 LMICs. Generalized anxiety disorder was the most reported (184 studies [90.6%]) and most prevalent disorder at 22.2% (95% CI, 19.4%-25.0%; n = 173 553). Posttraumatic stress disorder was the second most prevalent (8.3%; 95% CI, 5.0%-12.2%; 33 studies; n = 22 452). Adjustment disorder was least prevalent (2.9%; 95% CI, 0.0%-14.1%; 2 studies; n = 475). The prevalence of generalized anxiety varied by country income status, with the highest prevalence among lower-middle-income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109), followed by low-income (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961) and upper-middle-income (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496) countries. Conclusions and Relevance These findings suggest that 1 in 5 women living in LMICs experience anxiety disorders during pregnancy and post partum. Targeted action is needed to reduce this high burden.
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Affiliation(s)
- Alexandra Roddy Mitchell
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Hannah Gordon
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Jessica Atkinson
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Anthea Lindquist
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Susan P. Walker
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Anna Middleton
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Stephen Tong
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Roxanne Hastie
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
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Takelle GM, Nakie G, Rtbey G, Melkam M. Depressive symptoms and associated factors among pregnant women attending antenatal care at Comprehensive Specialized Hospitals in Northwest Ethiopia, 2022: an institution-based cross-sectional study. Front Psychiatry 2023; 14:1148638. [PMID: 37415690 PMCID: PMC10322208 DOI: 10.3389/fpsyt.2023.1148638] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Background Depression during pregnancy has a significant impact on public health as it can adversely affect both the mother's and the child's health. These can have devastating effects on the mother, the unborn child, and the entire family. Objective This study aimed to determine the prevalence of depressive symptoms and associated factors among pregnant women in Ethiopia. Method An institutional-based cross-sectional study was conducted among pregnant women attending antenatal care services at comprehensive specialized hospitals in Northwest Ethiopia from May to June 2022. Measurement The desired data were collected through face-to-face interview techniques by using validated questionnaires such as the Edinburgh Postnatal Depression Scale, the Oslo-3 social support scale, and the Abuse Assessment Screen tools. The data were analyzed by using SPSS Version 25. Logistic regression analysis was used to identify factors associated with antenatal depressive symptoms. Variables having a p-value of <0.2 in the bivariate analysis were entered into the multivariable logistic regression. A p-value of <0.05 was considered statistically significant, at 95% CI. Results This study revealed that 91 (19.2%) pregnant women screened positive for depressive symptoms. According to multivariable logistic regression, living in rural areas (adjusted odds ratio (AOR) = 2.58, 95% CI: 1.267, 5.256), being in the second or third trimesters of gestational phase (AOR = 4.40, 95% CI: 1.949, 9.966 and AOR = 5.42, 95% CI: 2.438, 12.028, respectively), having a history of alcohol use (AOR = 2.41, 95% CI: 1.099, 5.260), having moderate or poor social support (AOR = 2.55, 95% CI: 1.220, 5.338 and AOR = 2.41, 95% CI: 1.106, 5.268), and having a history of intimate partner violence (AOR = 2.67, 95% CI: 1.416, 5.016) were the factors significantly associated with depressive symptoms at a p-value of ≤ 0.05. Conclusion and recommendation The prevalence of depressive symptoms among pregnant women was high. Living in rural areas, second and third trimesters, use of alcohol, having moderate to poor social support, and having a history of intimate partner violence were variables significantly associated with depressive symptoms during pregnancy.
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Lowe LA, Betts D. Midwifery Acupuncturists' Management of Antenatal Anxiety and Depression: Data from a Survey in Aotearoa (New Zealand). Med Acupunct 2023; 35:63-72. [PMID: 37095785 PMCID: PMC10122233 DOI: 10.1089/acu.2022.0062] [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: 02/19/2023] Open
Abstract
Objective The goal of this research was to explore how New Zealand midwifery acupuncturists manage mild-to-moderate antenatal anxiety and depression (AAD). Materials and Methods A survey (Surveymonkey®) on midwives' perceptions of acupuncture for treating AAD was distributed late in 2019 to midwives who completed a Certificate in Midwifery Acupuncture. Data were collected on referrals and on acupuncture and complementary and alternative medicine use for AAD and associated symptoms of concern (SoC), such as low-back and pelvic pain (LBPP), sleep issues, stress, other pain, and pregnancy issues. Descriptive analysis was used to report data. Results Of 119 midwives, 66 responded (55.5%). For AAD and SoC, midwives mostly referred patients to general practitioners and counselors, and administered acupuncture themselves. Acupuncture was most accessed for LBPP (n = 38; 70.4%), sleep (n = 31; 57.4%), anxiety (n = 27; 50.0%); stress (n = 26; 48.1%), and other pain (n = 20, 37.0%). Massage was second most-accessed for LBPP (n = 36; 66.7%), sleep (n = 25; 46.3%), and stress (n = 24; 44.4%). For depression, treatments were herbs (n = 16; 29.6%), homeopathy (n = 14; 25.9%), and acupuncture and massage (both n = 13; 24.1%). Acupuncture was most used for other pregnancy issues: birth preparation (n = 44, 88.0%); assisted labor induction (n = 43; 86.0%): nausea and vomiting (n = 43; 86.0%); breech (n = 37; 74.0%); and headaches/migraines (n = 29; 58.0%). Conclusion Acupuncture is commonly used by midwife acupuncturists in New Zealand to treat a range of pregnancy issues, including anxiety, SoC for AAD, and other pregnancy issues. Further research would be beneficial.
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Affiliation(s)
- Lee-Ana Lowe
- Dunedin, Aotearoa (New Zealand)
- New Zealand School of acupuncture and Traditional Chinese Medicine, Auckland, Aotearoa (New Zealand)
| | - Debra Betts
- New Zealand School of acupuncture and Traditional Chinese Medicine, Auckland, Aotearoa (New Zealand)
- University Western Sydney, Sydney, Australia
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He J, Yang W, He Q, Tang Y, Wang Y, Wang G, Jiang X, Ren J. Chinese pregnant women's knowledge, attitude, and practice of self-protection against coronavirus disease 2019 during the post-pandemic period: A structural equation modeling-based survey. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 87:103559. [PMID: 36714184 PMCID: PMC9869621 DOI: 10.1016/j.ijdrr.2023.103559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 01/03/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to investigate the Chinese pregnant women's levels of knowledge, attitude, and practice (KAP) of self-protection against coronavirus disease 2019 (COVID-19) during the post-pandemic period, to aid the development of targeted health education. An online questionnaire was conducted for 2156 Chinese pregnant women from October 1, 2021, to December 31, 2021, to collect socio-demographic and KAP information. Structural equation modeling (SEM) was used to determine self-protection-related factors. The mean age of the participants was 30 ± 4.1 years. SEM indicated that pregnant women's level of knowledge can directly and indirectly affect the practice of self-protection (r = 0.23) through their belief, with a correlation coefficient of 0.56 and 0.46 between knowledge and belief and belief and practice, respectively. The "basic protection" and "hospital visits after infection" exerted the greatest impact on knowledge formation, with correlation coefficients of 0.85 and 0.89, respectively. Attitude had a direct effect on practice with a correlation coefficient of 0.46. "Awareness of prevention and control" and "family and social support" had the greatest impact on belief formation, with correlation coefficients of 0.77 and 0.73, respectively. Pregnant Chinese women were generally familiar with COVID-19 knowledge, and their levels of knowledge and beliefs particularly affect the practice of self-protection. Health education aimed at improving pregnant women's knowledge and belief toward self-protection against COVID-19 may be an effective way to guide them toward positive practices and promote their health and that of their babies.
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Key Words
- AGFI, adjusted goodness of fit index
- BMI, body mass index
- CFI, comparative fix index
- CMIN/DF, Chi-square fit statistics/degree of freedom
- COVID-19
- COVID-19, coronavirus disease 2019
- GFI, goodness-of-fit index
- I-CVI, individual-item content validity index
- IFI, incremental fix index
- KAP theory
- KAP, knowledge attitude and practice
- MERS, Middle eastern respiratory syndrome
- Post-pandemic period
- Pregnant women
- RMSEA, root mean square error of approximation
- S-CVI, scale-content validity index
- SARS, severe acute respiratory syndrome
- SEM, structural equation modeling
- Self-protection
- TLI, Tucker-Lewis index
- UA, universal agreement
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Affiliation(s)
- Jingjing He
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Wenqian Yang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Qiuyang He
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Yuxin Tang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Yonghong Wang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Guoyu Wang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Xiaolian Jiang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, SC 28/610000, China
| | - Jianhua Ren
- Department of nursing, West China Second University Hospital / West China School of Nursing, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan, SC 28/610000, China
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Guo J, Li X, He J, Ai M, Gan Y, Zhang Q, Zheng A, Chen W, Chen L, Liang S, Yu X, Kuang L. A propensity score matching study: The prevalence of mental health problems among pregnant women at first antenatal care increased in Chongqing during the first wave of the COVID-19 pandemic. Front Public Health 2023; 11:1142461. [PMID: 37124799 PMCID: PMC10140498 DOI: 10.3389/fpubh.2023.1142461] [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: 01/11/2023] [Accepted: 03/13/2023] [Indexed: 05/02/2023] Open
Abstract
Background The 2019 coronavirus disease (COVID-19) pandemic increased the risks of mental health challenges, especially anxiety and depression. However, the impact of COVID-19 on mental health during pregnancy has not been fully established. Therefore, we investigated the impact of the COVID-19 pandemic on maternal mental health. Methods Two cohorts of pregnant women at their first antenatal care in the First Affiliated Hospital of Chongqing Medical University were enrolled in this study. One cohort was enrolled before the COVID-19 outbreak, from 1 June to 31 December 2019 (n = 5,728, pre-COVID-19 group), while the other was enrolled during the COVID-19 pandemic, from 24 January to 23 March 2020 (n = 739, COVID-19 pandemic group). Symptoms of depression, anxiety, and somatization disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15), with a cutoff point of 10 for moderate-to-severe depression, anxiety, and somatoform symptoms. The propensity score matching method (1:1) was used to balance differences in demographic characteristics between groups. A chi-square analysis was performed to compare differences in demographic characteristics between the groups. Results Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms among pregnant women at their first antenatal care visit during the COVID-19 pandemic (9.5, 2.2, and 20.8%, respectively) was significantly lower than those before the pandemic (16.3, 4.4, and 25.7%, respectively) (p < 0.05). Compared with the same period before the pandemic, during the pandemic, the number of women newly registered for antenatal care decreased by nearly 50%. There were significant differences in the distributions of demographic characteristics between the groups (p < 0.05). After matching the demographic characteristics, differences in the prevalence of maternal mental health disorders between the groups reversed dramatically. Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms during the COVID-19 pandemic in this population (2.3, 9.6, and 20.8%, respectively) was significantly higher than those before the pandemic (0.3, 3.9, and 10%, respectively) (p < 0.05). Conclusion The COVID-19 pandemic increased mental health risks among pregnant women. As a large proportion of pregnant women with mental health challenges delay their prenatal care or change healthcare facilities after the outbreak of public health emergencies, there is a need to establish a balanced healthcare system in medical institutions at all levels.
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Affiliation(s)
- Jiamei Guo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinglan He
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yao Gan
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qi Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Anhai Zheng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wanjun Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lulu Chen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Sisi Liang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoyu Yu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Li Kuang,
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Zhang J, Yuan H, Xu L, Yi C, Tang W. The impact of COVID-19 on the mental health of pregnant women in Shanghai, China. Front Public Health 2022; 10:938156. [PMID: 36276386 PMCID: PMC9583156 DOI: 10.3389/fpubh.2022.938156] [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: 05/07/2022] [Accepted: 09/14/2022] [Indexed: 01/25/2023] Open
Abstract
Background COVID-19 has dramatically impacted people's health, especially mental health. This study aimed to compare the psychological status of pregnant women before and after the COVID-19 outbreak. Methods Participants were recruited (from September 29, 2019, to November 5, 2020) and screened by the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7). The study participants were categorized into three groups based on two turning-points: January 23, 2020, when China initiated a locked-down strategy, and May 11, 2020, when Shanghai started to ease the COVID-19 measures. Multivariable logistic regression was used to determine the factors associated with depression and anxiety in pregnant women. We used enter method for variable selection; only variables with P <0.10 were included in the final model. Results We recruited 478 pregnant women. After the outbreak, the depression rate (PHQ-9 ≥ 5) increased by 12.3% (from 35.4 to 47.7%), and the anxiety rate (GAD-7 ≥ 5) was stable (13.3 vs. 16.2%). The multivariable logistic regression results further confirmed that the odds of depression in pregnant women increased 81% after the outbreak (aOR = 1.81, 95%CI: 1.16-2.84). However, the median depression scale score was still statistically higher after the pandemic situation was stable (5.0 vs. 4.0) compared to the outbreak period. Conclusion The depression rate increased among pregnant women after the outbreak and was not recovered after the ease of COVID-19 measures in Shanghai. Health institutes should pay attention to the long-term influence of the pandemic.
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Affiliation(s)
- Jiali Zhang
- Fenglin Community Health Service Center, Shanghai, China
| | - Hualong Yuan
- Fenglin Community Health Service Center, Shanghai, China
| | - Liping Xu
- Fenglin Community Health Service Center, Shanghai, China
| | - Chuntao Yi
- Fenglin Community Health Service Center, Shanghai, China
| | - Weiming Tang
- Guangdong No. 2 Provincial People's Hospital, Guangzhou, China,The University of North Carolina at Chapel Hill Project-China, Guangzhou, China,*Correspondence: Weiming Tang
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Hulsbosch LP, Boekhorst MG, Endendijk J, Nyklíček I, Potharst ES, Pop VJ. Trait mindfulness scores are related to trajectories of depressive symptoms during pregnancy. J Psychiatr Res 2022; 151:166-172. [PMID: 35489176 DOI: 10.1016/j.jpsychires.2022.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/31/2022] [Accepted: 04/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Exploring possible protective factors against antenatal depression is important since antenatal depression is common and affects both mother and child. The person characteristic trait mindfulness may be such a protective factor. Because of the high variability in depressive symptoms over time, we aimed to assess the association between trait mindfulness and trajectories of depressive symptoms during pregnancy. METHODS A subsample of 762 women participating in the HAPPY study completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy. Possible different trajectories of Edinburgh Postnatal Depression Scale (EPDS) scores, assessed at each pregnancy trimester, were explored with growth mixture modeling. RESULTS Three EPDS trajectories (classes) were identified: low stable symptom scores (N = 607, 79.7%), decreasing symptom scores (N = 74, 9.7%) and increasing symptom scores (N = 81, 10.6%). Compared to belonging to the low stable class (reference), women with higher scores on the trait mindfulness facets 'acting with awareness' and 'non-judging' were less likely to belong to the decreasing class (OR = 0.81, 95% CI [0.73, 0.90] and OR = 0.77, 95% CI [0.70, 0.84]) and increasing class (OR = 0.88, 95% CI [0.80, 0.97] and OR = 0.72, 95% CI [0.65, 0.79]). Women with higher scores on 'non-reacting' were less likely to belong to the increasing class (OR = 0.89, 95% CI [0.82, 0.97]), but not the decreasing class (OR = 0.96, 95% CI [0.87, 1.04]). All analyses were adjusted for confounders. CONCLUSIONS Characteristics of trait mindfulness predicted low stable levels of depressive symptoms throughout pregnancy. Mindfulness-based programs may be beneficial for pregnant women as a strategy to alleviate depression risks.
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Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Myrthe Gbm Boekhorst
- Center of Research in Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Joyce Endendijk
- Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands.
| | - Ivan Nyklíček
- Center of Research in Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Eva S Potharst
- UvA Minds, Academic Outpatient (child and Adolescent) Treatment Center of the University of Amsterdam, Amsterdam, the Netherlands; Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands.
| | - Victor Jm Pop
- Center of Research in Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
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Luciano M, Di Vincenzo M, Brandi C, Tretola L, Toricco R, Perris F, Volpicelli A, Torella M, La Verde M, Fiorillo A, Sampogna G. Does antenatal depression predict post-partum depression and obstetric complications? Results from a longitudinal, long-term, real-world study. Front Psychiatry 2022; 13:1082762. [PMID: 36590632 PMCID: PMC9795022 DOI: 10.3389/fpsyt.2022.1082762] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Main aims of the present paper are to: (1) assess the prevalence of antenatal depression (AD) and identify its predictors; (2) analyse the impact of AD on obstetric outcomes and on the incidence of post-partum depression. METHODS All pregnant women referring to the Gynecology and Obstetrics inpatients unit of the University of Campania "Luigi Vanvitelli" were invited to participate. Upon acceptance, women completed the Italian version of the Edinburgh Postnatal Depression Scale and an ad-hoc questionnaire on the women's sociodemographic, gynecological and peripartum characteristics as well as their psychiatric history. Women were assessed at each trimester of pregnancy, immediately after the childbirth and after one, three, 6 and 11 months. RESULTS 268 pregnant women were recruited, with a mean of 32.2 (±5.81) years. Ninety-seven women (36.2%) reported the presence of depressive symptoms during pregnancy. Predictors of AD were personal history of depression, a family history for depressive disorders and problematic relationships with the partner. The presence of AD was associated to a reduced gestational age at the time of delivery, a lower APGAR score at 1 and 5 min, labor induction and admission of the new-born into neonatal intensive care unit. Mothers with antenatal depression are less likely to natural breastfeed. Lastly, antenatal depression was a risk factor for higher EPDS scores at follow-ups. CONCLUSIONS Our results support the idea that women should be screened during pregnancy and post-partum for the presence of depressive and anxiety symptoms. Health professionals should be adequately trained to detect psychiatric symptoms during pregnancy.
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Affiliation(s)
- Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Carlotta Brandi
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Lucia Tretola
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Rita Toricco
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Francesco Perris
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Antonio Volpicelli
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Marco Torella
- Obstetrics and Gynaecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco La Verde
- Obstetrics and Gynaecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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