The association of intimate partner violence with postpartum depression in women during their first month period of giving delivery in health centers at Dessie town, 2019

Effect of male partners' involvement and support on reproductive, maternal and child health and well-being in East Africa: A scoping review

Background and Aims

East African countries have high rates of maternal and child mortality and morbidity. Studies have shown that the involvement of male partners in reproductive health can benefit maternal and child health (MCH). This scoping review aims to provide an overview of the evidence across East Africa that describes male partner involvement and its effect on maternal, reproductive, and child well-being.

Methods

Ten databases were searched to identify quantitative data on male's involvement in East Africa. Studies reporting qualitative data, "intention to use" data or only reporting on male partner's education or economic status were excluded. Studies were organized into five a priori categories: antenatal care (ANC), human immunodeficiency virus, breastfeeding, family planning, and intimate partner violence with further categories developed based on studies included.

Results

A total of 2787 records were identified; 644 full texts were reviewed, and 96 studies were included in this review. Data were reported on 118,967 mothers/pregnant women and 15,361 male partners. Most of the studies (n = 83) were reported from four countries Ethiopia (n = 49), Kenya (n = 14), Tanzania (n = 12) and Uganda (n = 10). The evidence indicates that male partner involvement and support is associated with improved reproductive, MCH across a wide range of outcomes. However, the studies were heterogeneous, using diverse exposure and outcome measures. Also, male partners' lack of practical and emotional support, and engagement in violent behaviors towards partners, were associated with profound negative impacts on MCH and well-being.

Conclusions

The body of evidence, although heterogeneous, provides compelling support for male involvement in reproductive health programs designed to support MCH. To advance research in this field, an agreement is needed on a measure of male partner "involvement." To optimize benefits of male partners' involvement, developing core outcome sets and regional coordination are recommended.

Substance use during pregnancy and risk of postpartum depression: a systematic review and meta-analysis

Introduction

Postpartum depression (PPD) is a prevalent mental health condition affecting women globally within the first year following childbirth. Substance use during pregnancy has been associated with an increased risk of developing PPD, but the evidence remains inconclusive. This meta-analysis aims to comprehensively assess the effects of different substances on PPD risk, exploring potential modifiers and confounding factors.

Objectives

To examine the proportion of PPD among substance users during pregnancy, compared to non-users, and investigate the specific risk associated with different substances (tobacco, alcohol, and non-specified substance use/multiple substance use).

Methods

A systematic literature search was conducted from inception to November 2022 using the Web of Science database (Clarivate Analytics), incorporating Web of Science Core Collection, the BIOSIS Citation Index, the KCI-Korean Journal Database, MEDLINE®, the Russian Science Citation Index, the SciELO Citation Index, and the Cochrane Central Register of Reviews, and Ovid/PsycINFO databases. Inclusion criteria comprised original studies with pregnant women, using validated depression scales and substance use reporting.

Results

Among the 26 included studies, encompassing 514,441 women, the pooled prevalence of PPD among substance users during pregnancy was 29% (95% CI 25-33). Meta-analyzes revealed an overall odds ratio (OR) of 3.67 (95% CI 2.31-5.85, p < 0.01) indicating a significantly higher risk of PPD among substance users compared to non-users. Subgroup analyzes demonstrated a higher risk for women with non-specified or multiple substance use (OR 4.67, 95% CI 2.59-8.41; p < 0.01) and tobacco use (OR 4.01, 95% CI 2.23-7.20; p < 0.01). Alcohol use showed a trend toward higher risk that did not reach statistical significance (OR 1.88, 95% CI 1.00-3.55; p = 0.051).

Conclusion

This meta-analysis provides evidence of an increased risk of PPD among pregnant substance users, particularly those using multiple substances or tobacco. However, caution is needed in interpreting the association with alcohol use due to its non-significant result.

Systematic review registration

This study protocol was registered at PROSPERO (registration number: CCRD42022375500).

The effect of emotional support on postpartum depression among postpartum mothers in Asia: A systematic review

INTRODUCTION

Postpartum depression (PPD) is a chronic mood illness that typically develops in the first few months after giving birth. It affects 17.2% of women worldwide, and its deleterious consequences on infants, children, and mothers have elicited global public concern. Therefore, this paper aims to present an overview of the relationship between emotional support and PPD among postpartum mothers in the Asia region.

METHODS

An extensive search using various keywords was conducted in Science Direct, PsycINFO, PubMed, Scopus, Cochrane Library, JSTOR, Springer Link, and Taylor Francis. The screening process was compliant with the PRISMA guideline, while the quality of the selected studies was assessed using the QuADS tool.

RESULTS

The analysis included 15 research from 12 different countries with 6031 postpartum mothers. A decreased risk of PPD for postpartum mothers is shown to be significantly correlated with greater emotional support, and vice versa.

DISCUSSION

Asian women are less likely to seek emotional assistance than other mothers, which is influenced by culture. There needs to be more research on the impact of culture on postpartum mothers' emotional support. Additionally, this review hopes to raise awareness among the mothers' friends and family as well as the medical community to be more attentive to postpartum mothers' emotional needs and offer specialized assistance.

Obstetric violence in southwestern Turkey: Risk factors and its relationship to postpartum depression

This study was conducted to determine the relationship between violence, risk factors, and depression at the end of pregnancy. The sample of this descriptive and cross-sectional study consisted of 426 women for normal postpartum monitoring during the six-month period and living in southwestern Turkey of the study. About 5.6% of the women who participated in the study were exposed to obstetric violence. 5.2% of them were intimate partner violence before pregnancy. 79.1% (n = 24), 29.1%, and 25% of them were subjected to physical, sexual, and economic violence, respectively. In addition, 7.5% of women were exposed to verbal obstetric violence. It was found that the postpartum depression scores of the women who had been subjected to violence from their husbands before pregnancy were high.

Landscaping the evidence of intimate partner violence and postpartum depression: a systematic review

OBJECTIVE

To assess the evidence of the association between exposure to intimate partner violence (IPV) and postpartum depression. IPV during pregnancy can have immediate and long-term physical and mental health consequences for the family. Therefore, it has been hypothesised that IPV may affect the risk of developing postpartum depression.

METHODS

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Global Health Library, Scopus and Google scholar were searched for published studies without restrictions on language, time or study design (up to May 2020). Studies were included if they assessed postpartum depression using the Edinburg Postnatal Depression Scale (cut-off≥10), among women who had been exposed to IPV (emotional, physical and/or sexual abuse). The quality of studies was judged according to the Newcastle-Ottawa scale.

RESULTS

A total of 33 studies were included in the review (participants n=131 131). The majority of studies found an association between exposure to IPV and the development of signs of postpartum depression. Overall, studies measured both exposure and outcome in various ways and controlled for a vast number of different confounders. Thirty percent of the studies were set in low-income and lower-middle-income countries while the rest were set in upper-middle-income and high-income countries and the association did not differ across settings. Among the studies reporting adjusted OR (aOR) (n=26), the significant aOR ranged between 1.18 and 6.87 (95% CI 1.12 to 11.78). The majority of the studies were judged as 'good quality' (n=20/33).

CONCLUSION

We found evidence of an association between exposure to IPV and the development of signs of postpartum depression. Meta-analysis or individual patient data meta-analysis is required to quantify the magnitude of the association between IPV and postpartum depression.

PROSPERO REGISTRATION NUMBER

CRD42020209435.

The Important Role of Partner Support in Women's Mental Disorders During the Perinatal Period. A Literature Review

The arrival of a newborn is often a happy event in a woman's life. However, many women experience perinatal distress such as anxiety disorders and depression during pregnancy or postpartum period. Although the positive interpersonal relationships of women with their wider environment seem to be a support network, research shows that support provided by partners is a very important protective factor in reducing mental health disorders in both prenatal and postnatal period in a woman's life. for this reason, more research needs to be done in the field of perinatal distress in order to clarify the causes that lead to mental disorders and to strengthen the partner's role in the management of perinatal mental disorders of women.

Characterization and stratification of the correlates of postpartum depression in sub-Saharan Africa: A systematic review with meta-analysis

Postpartum depression (PPD) is a common mental health challenge in resource-constrained sub-Saharan Africa (SSA). Characterizing its correlates will aid prediction, early detection, and pre-emptive interventions. This review aimed to systematically synthesize and stratify PPD correlates in sub-Saharan Africa. The review was structured as per the Preferred Reporting Item for Systematic Reviews and Meta-Analyses. We included studies that reported the correlates of PPD in SSA. We searched PubMed, Medline, CINAHL, Academic Search Complete, and PsycINFO for relevant peer-reviewed literature. The correlates of PPD constituted the primary outcome. A random effect model was fitted to estimate the pooled correlation coefficient per correlate. The clinical relevance of correlates was stratified based on strength of correlation (r) and recurrence (f). The mean age of the participants was 27.0 ± 6.0 years, and 68.6% of participants had completed at least secondary education. The correlates of PPD in SSA were intimate partner violence (IPV) ((risk weight (rw) = 2.8; r = 0.212 (confidence interval (CI): 0.11–0.31), poor social support (PSS) (rw = 1.9; r = 0.250 (0.133–0.361)), unwanted pregnancy (UP) (rw = 1.6; r = 0.279 (CI: 0.14–0.41); I² = 95.89), and maternal age (MA) (rw = 0.96; r = 0.27 (CI: 0.154–0.37)), among others. A cumulative risk weight of ⩾0.95 was predictive of PPD and marks the critical point at which preemptive interventions should be instituted. The stratification of risk PPD factors and computation of risk stability index are useful in identifying the clinical significant risk factors. The provision of critical risk point will simplify early detection thus facilitating cost-effectiveness. Of the correlates of PPD in SSA, IPV, PSS, UP, and MA are the most important. Targeted screening and pre-emptive interventions for women with high risk weight may be a reasonable strategy both in the short and long term.

Lived experiences of Ugandan women who had recovered from a clinical diagnosis of postpartum depression: a phenomenological study

BACKGROUND

Postpartum depression affects a significant proportion of women of childbearing age. The birth of a newborn baby is normally considered a joyful event, inhibiting mothers from expressing their depressive feelings. If the condition is not well understood and managed, mothers with postpartum depression are likely to experience suicidal ideation or even commit suicide. This study explored lived experiences of women who had recovered from a clinical diagnosis of postpartum depression in southwestern Uganda.

METHODS

This phenomenological study adopted the explorative approach through in-depth interviews as guided by the biopsychosocial model of depression. It was conducted in Mbarara Regional Referral Hospital, Bwizibwera Health Centre IV and Kinoni Health Centre IV located in Mbarara and Rwampara districts, southwestern Uganda. Data were collected from 30 postpartum mothers who were purposively selected, between 9th December 2019 and 25th September 2020. We analyzed this work using thematic data analysis and this was steered by the Colaizzi's six-step phenomenological approach of inquiry.

RESULTS

The findings were summarized into five major themes: 1) somatic experiences including insomnia and headache, breast pain, poor breast milk production, weight loss and lack of energy; 2) difficulties in home and family life including overwhelming domestic chores, lack of social support from other family members, fighting at home and financial constraints due to COVID-19 pandemic; 3) negative emotions including anger, self-blame, despondency and feelings of loneliness and regrets of conceiving or marriage; 4) feelings of suicide, homicide and self-harm including suicidal ideation and attempt, homicidal ideations and attempt and feelings of self-harm and 5) coping with postpartum depression including spirituality, termination of or attempt to leave their marital relationships, acceptance, counselling and seeking medical treatment, perseverance.

CONCLUSION AND RECOMMENDATIONS

Suicidal and homicidal thoughts are important parts of the postpartum depression experience, and these may put the lives of the mothers, their spouses and their babies at a great risk. Poor relationship quality, intimate partner violence and lack of financial resources contribute significantly to the negative emotional experiences of mothers with PPD.