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Shinohara S, Horiuchi S, Shinohara R, Otawa S, Kushima M, Miyake K, Yui H, Kojima R, Ooka T, Akiyama Y, Yokomichi H, Yamagata Z. Multiple pregnancy as a potential risk factor for postpartum depression: The Japan Environment and Children's Study. J Affect Disord 2023; 329:218-224. [PMID: 36849005 DOI: 10.1016/j.jad.2023.02.088] [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: 11/05/2022] [Revised: 02/10/2023] [Accepted: 02/19/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Postpartum depression (PPD) results in adverse consequences for both mother and infant. However, the association between multiple pregnancy and PPD is unknown because of the difference in the estimated prevalence rate of PPD based on country, ethnicity, and study type. Thus, this study aimed to determine whether Japanese women with multiple pregnancy were at a high risk of developing PPD at 1 and 6 months postpartum. METHODS In this nationwide prospective cohort study (the Japan Environment and Children's Study), conducted between January 2011 and March 2014, 77,419 pregnant women were enrolled. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) 1 and 6 months postpartum. A score of ≥13 points implied "positive" for PPD. Multiple logistic regression analyses estimated the association between multiple pregnancy and PPD risk. RESULTS Overall, 77,419 pregnancies (singleton, n = 76,738; twins, n = 676; triplets, n = 5) were included; 3.6 % and 2.9 % of pregnant women had PPD at 1 and 6 months postpartum, respectively. Compared with singleton pregnancy, multiple pregnancy was not associated with PPD at 1 month, but at 6 months postpartum (adjusted odd ratios: 0.968 [95 % confidence interval {CI}, 0.633-1.481] and 1.554 [95 % CI, 1.046-2.308], respectively). LIMITATIONS 1) Some potential PPD risk factors could not be evaluated, 2) PPD was not diagnosed by psychiatrists, and 3) depressive symptoms at 6 months postpartum were considered PPD; however, definitions may vary. CONCLUSIONS Japanese women with multiple pregnancy may be regarded as a target group for follow-up and postpartum depression screening for at least 6 months during the initial postpartum period.
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Affiliation(s)
- Satoshi Shinohara
- Department of Obstetrics and Gynecology, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi 400-8506, Japan.
| | - Sayaka Horiuchi
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Ryoji Shinohara
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Sanae Otawa
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Kunio Miyake
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Hideki Yui
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Reiji Kojima
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Tadao Ooka
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Yuka Akiyama
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Hiroshi Yokomichi
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Zentaro Yamagata
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan; Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
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2
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Kasaven LS, Raynaud I, Jalmbrant M, Joash K, Jones BP. The impact of the COVID-19 pandemic on perinatal services and maternal mental health in the UK. BJPsych Open 2023; 9:e13. [PMID: 36636816 PMCID: PMC9874036 DOI: 10.1192/bjo.2022.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND COVID-19 has created many challenges for women in the perinatal phase. This stems from prolonged periods of lockdowns, restricted support networks and media panic, alongside altered healthcare provision. AIMS We aimed to review the evidence regarding the psychological impact on new and expecting mothers following changes to antenatal and postnatal service provision within the UK throughout the pandemic. METHOD We conducted a narrative literature search of major databases (PubMed, Medline, Google Scholar). The literature was critically reviewed by experts within the field of antenatal and perinatal mental health. RESULTS Changes to service provision, including the introduction of telemedicine services, attendance of antenatal appointments without partners or loved ones, and lack of support during the intrapartum period, are associated with increased stress, depression and anxiety. Encouraging women and their partners to engage with aspects of positive psychology through newly introduced digital platforms and virtual service provision has the potential to improve access to holistic care and increase mental well-being. An online course, designed by Imperial College Healthcare NHS Trust in response to changes to service provision, focuses on postnatal recovery inspiration and support for motherhood (PRISM) through a 5-week programme. So far, the course has received positive feedback. CONCLUSIONS The pandemic has contributed to increased rates of mental illness among pregnant and new mothers in the UK. Although the long-term implications are largely unpredictable, it is important to anticipate increased prevalence and complexity of symptoms, which could be hugely detrimental to an already overburdened National Health Service.
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Affiliation(s)
- Lorraine S Kasaven
- Department of Surgery and Cancer, Imperial College London, UK; Cutrale Perioperative and Ageing Group, Imperial College London, UK; and Department of Obstetrics and Gynaecology, Queen Charlottes and Chelsea Hospital, Imperial College NHS Trust, UK
| | - Isabel Raynaud
- West Middlesex University Hospital, Chelsea and Westminster Hospitals NHS Trust, UK
| | | | - Karen Joash
- Department of Obstetrics and Gynaecology, Queen Charlottes and Chelsea Hospital, Imperial College NHS Trust, UK
| | - Benjamin P Jones
- Department of Surgery and Cancer, Imperial College London, UK; and Department of Obstetrics and Gynaecology, Queen Charlottes and Chelsea Hospital, Imperial College NHS Trust, UK
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3
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Camoni L, Mirabella F, Gigantesco A, Brescianini S, Ferri M, Palumbo G, Calamandrei G. The Impact of the COVID-19 Pandemic on Women's Perinatal Mental Health: Preliminary Data on the Risk of Perinatal Depression/Anxiety from a National Survey in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192214822. [PMID: 36429541 PMCID: PMC9690658 DOI: 10.3390/ijerph192214822] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 05/05/2023]
Abstract
Increasing evidence suggests that during the COVID-19 pandemic, anxiety and depression during the perinatal period increased. The aim of the study is to estimate the prevalence of risk for both maternal depression and anxiety among women attending 18 healthcare centres in Italy during the SARS-COV-2 pandemic and to investigate the psychosocial risks and protective factors associated. It was divided into a retrospective phase (2019, 2020, and the first nine months of 2021) and a prospective phase (which began in November 2021 and it is still ongoing), which screened 12,479 and 2349 women, respectively, for a total of 14,828 women in the perinatal period. To evaluate the risk of anxiety and depression, the General Anxiety Disorder-7 (GAD-7), the Edinburgh Postnatal Depression Scale (EPDS), and an ad hoc form were used to collect sociodemographic variables. In the prospective study, the average age of the women is 31 (range 18-52) years. Results showed that the percentage of women who had EPDS score ≥9 increased from 11.6% in 2019 to 25.5% in the period ranging from November 2021 to April 2022. In logistic regression models, the variables associated with the risk of depression at a level ≤0.01 include having economic problems (OR 2.16) and not being able to rely on support from relatives or friends (OR 2.36). Having the professional status of the housewife is a lower risk (OR 0.52). Those associated with the risk of anxiety include being Italian (OR 2.97), having an education below secondary school level (OR 0.47), having some or many economic problems (OR 2.87), being unable to rely on support from relatives or friends (OR 2.48), and not having attended an antenatal course (OR 1.41). The data from this survey could be useful to determine the impact of the SARS-COV-2 pandemic on women and to establish a screening program with common and uniformly applied criteria which are consistent with national and international women's mental health programs.
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4
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Perceived social support on postpartum mental health: An instrumental variable analysis. PLoS One 2022; 17:e0265941. [PMID: 35511885 PMCID: PMC9070871 DOI: 10.1371/journal.pone.0265941] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
The postpartum period is a challenging transition period with almost one in ten mothers experiencing depression after childbirth. Perceived social support is associated with mental health. Yet empirical evidence regarding the causal effects of social support on postpartum mental health remains scarce. In this paper, we used a nationally representative panel data of women to examine causality between perceived social support and postpartum mental health. We used fixed-effect method and included dependent variable lags to account for past mental health condition before birth (i.e., the pre-pregnancy and prenatal periods). The study also used an instrumental variable approach to address endogeneity. We find a declining trend in postpartum mental health between 2002 to 2018. Our study also showed that past mental health (i.e., before childbirth) is positively correlated with postpartum mental health. A universal routine mental health screening for expectant and new mothers should remain a key priority to ensure mental wellbeing for the mothers and their infants.
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5
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Xayyabouapha A, Sychareun V, Quyen BTT, Thikeo M, Durham J. Prevalence and Risk Factors Associated With Postpartum Depressive Symptoms Among Women in Vientiane Capital, Lao PDR. Front Public Health 2022; 10:791385. [PMID: 35592080 PMCID: PMC9110677 DOI: 10.3389/fpubh.2022.791385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
Postpartum depression (PPD), the onset of depressive episodes after childbirth, is the most common psychological condition following childbirth, and a global public health concern. If undiagnosed and/or untreated, postpartum depression can have negative effects on maternal and child health, however, there are few studies on the prevalence of postpartum depression in low- and middle-income countries. To contribute to filling this gap, this study examined the prevalence and risk factors associated with postpartum depressive symptoms among women after delivery in Vientiane Capital, Lao PDR. The study was a cross-sectional design, with multistage sampling used to identify women between 4 and 24 weeks after giving birth (N = 521). The Edinburgh Postnatal Depression Scale was used to identify women with postpartum depressive symptoms. Univariate and multivariate logistic regressions identified risk factors associated with postpartum depressive symptoms. The prevalence of postpartum depressive symptoms among participants was 21.3%. Associated factors were having at least 2-3 living children (AOR: 1.9, 95% CI: 1.1-3.0), experiencing mental health problems during pregnancy (AOR: 3.3, 95% CI: 1.4-7.6), experiencing conflicts with family members (AOR: 2.5, 95% CI: 1.5-4.0), the experience of intimate partner violence (AOR: 2.6, 95% CI: 1.3-5.5), and receiving moderate social support (AOR: 5.6, 95% CI: 3.2-10.0). In contexts where access to mental health specialists has severely constrained maternal and child healthcare providers at primary health care must be supported to develop the necessary skills to identify risk factors and symptoms and offer basic essential services for postpartum depressive symptom (PDS). The study identified a high proportion of mothers with postnatal depressive symptoms, highlighting the need to screen and treat mothers who present with PDS, as not doing so exposes mother and their children to a range of negative health and social outcomes. Addressing the stigma associated with mental health illness and mental health illness and domestic violence that prevents women from seeking healthcare, must also be developed, implemented, and evaluated.
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Affiliation(s)
- Amkha Xayyabouapha
- Faculty of Public Health, University of Health Sciences and Hanoi University of Public Health, Vientiane, Laos
| | | | - Bui Thi Tu Quyen
- Biostatistics Department, Faculty of Fundamental Sciences, Hanoi University of Public Health, Vietnam, Laos
| | - Manivone Thikeo
- Faculty of Public Health, University of Health Sciences, Vientiane, Laos
| | - Jo Durham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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6
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Yuen M, Hall OJ, Masters GA, Nephew BC, Carr C, Leung K, Griffen A, McIntyre L, Byatt N, Moore Simas TA. The Effects of Breastfeeding on Maternal Mental Health: A Systematic Review. J Womens Health (Larchmt) 2022; 31:787-807. [PMID: 35442804 DOI: 10.1089/jwh.2021.0504] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Breastfeeding has many positive effects on the health of infants and mothers, however, the effect of breastfeeding on maternal mental health is largely unknown. The goal of this systematic review was to (1) synthesize the existing literature on the effects of breastfeeding on maternal mental health, and (2) inform breastfeeding recommendations. Materials and Methods: A literature search was conducted in electronic databases using search terms related to breastfeeding (e.g., breastfeeding, infant feeding practices) and mental health conditions (e.g., mental illness, anxiety, depression), resulting in 1,110 records. After reviewing article titles and abstracts, 339 articles were advanced to full-text review. Fifty-five articles were included in the final analysis. Results: Thirty-six studies reported significant relationships between breastfeeding and maternal mental health outcomes, namely symptoms of postpartum depression and anxiety: 29 found that breastfeeding is associated with fewer mental health symptoms, one found it was associated with more, and six reported a mixed association between breastfeeding and mental health. Five studies found that breastfeeding challenges were associated with a higher risk of negative mental health symptoms. Conclusions: Overall, breastfeeding was associated with improved maternal mental health outcomes. However, with challenges or a discordance between breastfeeding expectations and actual experience, breastfeeding was associated with negative mental health outcomes. Breastfeeding recommendations should be individualized to take this into account. Further research, specifically examining the breastfeeding experiences of women who experienced mental health conditions, is warranted to help clinicians better personalize breastfeeding and mental health counseling.
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Affiliation(s)
- Megan Yuen
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Olivia J Hall
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Grace A Masters
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | - Catherine Carr
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine Leung
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Adrienne Griffen
- Maternal Mental Health Leadership Alliance, Arlington, Virginia, USA
| | | | - Nancy Byatt
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.,UMass Memorial Health, Worcester, Massachusetts, USA
| | - Tiffany A Moore Simas
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.,UMass Memorial Health, Worcester, Massachusetts, USA
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7
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Filippetti ML, Clarke ADF, Rigato S. The mental health crisis of expectant women in the UK: effects of the COVID-19 pandemic on prenatal mental health, antenatal attachment and social support. BMC Pregnancy Childbirth 2022; 22:68. [PMID: 35081906 PMCID: PMC8790719 DOI: 10.1186/s12884-022-04387-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/04/2022] [Indexed: 12/14/2022] Open
Abstract
Background Pregnancy has been shown to be times in a woman’s life particularly prone to mental health issues, however a substantial percentage of mothers report subclinical perinatal mental health symptoms that go undetected. Experiences of prenatal trauma, such as the COVID-19 pandemic, may exacerbate vulnerability to negative health outcomes for pregnant women and their infants. We aimed to examine the role of: 1) anxiety, depression, and stress related to COVID-19 in predicting the quality of antenatal attachment; 2) perceived social support and COVID-19 appraisal in predicting maternal anxiety and depression. Methods A sample of 150 UK expectant women were surveyed during the COVID-19 pandemic. Questions included demographics, pregnancy details, and COVID-19 appraisal. Validated measures were used to collect self-reported maternal antenatal attachment (MAAS), symptoms of anxiety (STAI), depression (BDI-II), and stress related to the psychological impact of COVID-19 (IES-r). Results We found that the pandemic has affected UK expectant mothers’ mental health by increasing prevalence of depression (47%), anxiety (60%) and stress related to the psychological impact of COVID-19 (40%). Women for whom COVID-19 had a higher psychological impact were more likely to suffer from depressive (95% HDPI = [0.04, 0.39]) and anxiety symptoms (95% HPDI = [0.40, 0.69]). High depressive symptoms were associated with reduced attachment to the unborn baby (95% HPDI [-0.46, -0.1]). Whilst women who appraised the impact of COVID-19 to be more negative showed higher levels of anxiety (HPDI = [0.15, 0.46]), higher social support acted as a protective factor and was associated with lower anxiety (95% HPDI = [-0.52, -0.21]). Conclusions The current findings demonstrate that direct experience of prenatal trauma, such as the one experienced during the COVID-19 pandemic, significantly amplifies mothers’ vulnerability to mental health symptoms and impairs the formation of a positive relationship with their unborn baby. Health services should prioritise interventions strategies aimed at fostering support for pregnant women. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04387-7.
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Affiliation(s)
- Maria Laura Filippetti
- Centre for Brain Science, Department of Psychology, University of Essex, Colchester, UK.
| | - Alasdair D F Clarke
- Centre for Brain Science, Department of Psychology, University of Essex, Colchester, UK
| | - Silvia Rigato
- Centre for Brain Science, Department of Psychology, University of Essex, Colchester, UK
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8
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Bull E, Al-Janabi S, Gittens CB. Are women with traits of perfectionism more likely to develop perinatal depression? A systematic review and meta-analysis. J Affect Disord 2022; 296:67-78. [PMID: 34592658 DOI: 10.1016/j.jad.2021.09.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/14/2021] [Accepted: 09/12/2021] [Indexed: 11/25/2022]
Abstract
Women who present with a maladaptive form of the perfectionism trait may be vulnerable to perinatal depression (PND). The studies examining this association, though, differ in the specific time-points at which PND is measured, the tool/s used to assess PND and/or perfectionism, and the sample of women used; consequently, extant results reflecting this association can be difficult to integrate and interpret. This systematic review and meta-analysis seeks to clarify the association between PND and perfectionism by surveying literature on the relationship. Literature search strategies were developed using medical subject headings (MeSH) and text words related to PND and perfectionism. Nine electronic databases of published and unpublished literature were searched for relevant studies, which were selected for inclusion in this systematic review and meta-analysis if they contained data on female participants aged 18 or over and pregnant or who were within 12 months post-birth; additionally, studies were included if they contained quantitative reporting of depressive symptoms and trait perfectionism symptoms within the perinatal period (between pregnancy and up to 12 months post-birth). Ten publications were selected for inclusion based on independent review against the selection criteria by the authors. Eight of the 10 publications provided substantial correlational data and were analysed using meta-analytic techniques. All studies showed a significant positive relationship between measures of perfectionism and depression at various time points within the perinatal period (3rd trimester to 12-months postpartum), including concurrently in pregnancy, concurrently in postpartum, and longitudinally between pregnancy and postpartum. Interestingly, however, moderation analyses identified that the relationship between perfectionism and PND in the 3rd trimester may emerge only when a perinatal-specific, but not when a general, depression screening tool is used. These analyses also revealed that the strength of the relationship between perfectionism and PND may increase with length of time postpartum. The findings of this systematic review and meta-analysis, thus, suggest that medical professionals should consider perfectionism when formulating PND prevention strategies and assessing for PND using perinatal-specific screening tools.
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Affiliation(s)
- Emilie Bull
- College of Health and Human Sciences, Charles Darwin University, Darwin, Australia
| | - Shahd Al-Janabi
- College of Health and Human Sciences, Charles Darwin University, Darwin, Australia.
| | - Catherine B Gittens
- College of Health and Human Sciences, Charles Darwin University, Darwin, Australia
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9
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Harris ML, Egan N, Forder PM, Loxton D. Increased chronic disease prevalence among the younger generation: Findings from a population-based data linkage study to inform chronic disease ascertainment among reproductive-aged Australian women. PLoS One 2021; 16:e0254668. [PMID: 34407075 PMCID: PMC8372972 DOI: 10.1371/journal.pone.0254668] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/30/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Chronic disease represents an ongoing public health challenge in Australia with women disproportionately affected and at younger ages compared to men. Accurate prevalence and ascertainment of chronic disease among women of reproductive age at the population level is essential for meeting the family planning and reproductive health challenges that chronic diseases pose. This study estimated the prevalence of chronic disease among younger Australian women of reproductive age, in order to ascertain key conditions that would benefit from targeted family planning support strategies. METHODS AND FINDINGS Population-level survey data from the 1973-78 and 1989-95 cohorts of the Australian Longitudinal Study on Women's Health were linked to health service use, pharmaceutical, cancer and cause of death data to ascertain the prevalence and chronic disease trends for ten chronic health conditions associated with poor maternal and foetal outcomes. Individual chronic disease algorithms were developed for each chronic disease of interest using the available linked datasets. Lifetime prevalence of chronic disease varied substantially based on each individual data source for each of the conditions of interest. When all data sources were considered, all conditions with the exception of mental health conditions were higher among women in the 1973-78 cohort. However, when focused on point prevalence at similar ages (approximately 25-30 years), the chronic disease trend for women in the 1989-95 cohort was substantially higher, particularly for mental health conditions (70.4% vs 23.6%), diabetes (4.5% vs 1.3%) and multimorbidity (17.9% vs 9.1%). CONCLUSIONS Given the low concordance between individual data sources, the use of multiple data sources are recommended for chronic disease research focused on women of reproductive age. In order to reduce the increasing chronic disease and multimorbidity trend among women, strategic chronic disease interventions are required to be implemented in childhood and adolescence to ensure the long-term health of not only current but also future generations.
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Affiliation(s)
- Melissa L. Harris
- Centre for Women’s Health Research, University of Newcastle, Newcastle, Australia
| | - Nicholas Egan
- Centre for Women’s Health Research, University of Newcastle, Newcastle, Australia
| | - Peta M. Forder
- Centre for Women’s Health Research, University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- Centre for Women’s Health Research, University of Newcastle, Newcastle, Australia
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10
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Zipursky JS, Thiruchelvam D, Redelmeier DA. Prenatal electrocardiogram testing and postpartum depression: A population-based cohort study. Obstet Med 2021; 15:31-39. [PMID: 35444726 PMCID: PMC9014547 DOI: 10.1177/1753495x211012502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/12/2021] [Accepted: 03/30/2021] [Indexed: 11/22/2022] Open
Abstract
Background Cardiovascular symptoms in pregnancy may be a clue to psychological distress.
We examined whether electrocardiogram testing in pregnant women is
associated with an increased risk of subsequent postpartum depression. Methods We conducted a population-based cohort study of pregnant women who delivered
in Ontario, Canada comparing women who received a prenatal ECG to women who
did not. Results In total, 3,238,218 women gave birth during the 25-year study period of whom
157,352 (5%) received an electrocardiogram during prenatal care. Receiving
an electrocardiogram test was associated with a one-third relative increase
in the odds of postpartum depression (odds ratio 1.34; 95% confidence
interval 1.29–1.39, p < 0.001). Conclusion The association between prenatal electrocardiogram testing and postpartum
depression suggests a possible link of organic disease with mental illness,
and emphasizes that cardiovascular symptoms may be a clinical clue to the
presence of an underlying mood disorder.
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Affiliation(s)
| | - Deva Thiruchelvam
- Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Donald A Redelmeier
- Department of Medicine, University of Toronto, Toronto, Canada
- Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
- Center for Leading Injury Prevention Practice Education & Research, Toronto, Canada
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11
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Jakaitė V, Peštenytė A, Zakarevičienė J, Sniečkuvienė V, Žitkutė V, Ramašauskaitė D, Domža G. Predictors of exclusive breastfeeding in the first six months: four consecutive surveys in a tertiary hospital in Lithuania. Int Breastfeed J 2021; 16:22. [PMID: 33627150 PMCID: PMC7903648 DOI: 10.1186/s13006-021-00364-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/08/2021] [Indexed: 11/26/2022] Open
Abstract
Background There are little up-to-date data available on the duration of exclusive breastfeeding in Lithuania. The aim of our study was to examine the factors that could influence exclusive breastfeeding during the first 6 months of life. Methods In 2016, a survey was conducted at the Obstetrics and Gynecology Clinic of Vilnius University Hospital, Santaros Klinikos. Women in postnatal wards were opportunistically offered questionnaires and later followed up by telephone interviews at 6 weeks, 3 months, and 6 months postpartum. We used binary logistic regression to determine the factors that impacted exclusive breastfeeding during the first 6 months following childbirth. Results Of 475 eligible women that were approached, a total of 447 women were recruited, with response rates of 76.1, 71.4 and 67.0% at 6 weeks, 3 months, and 6 months postpartum, respectively. The prevalence of exclusive breastfeeding through the 6 month postpartum period was 39.8%. Exclusive breastfeeding during days 2 to 4 postpartum was positively influenced by factors such as a natural childbirth, the practice of breastfeeding on demand and maternal self-confidence in breastfeeding. Subsequently, exclusive breastfeeding on demand in the immediate postpartum period and exclusive breastfeeding for up to 3 months were associated with successful exclusive breastfeeding up to 6 months. However, the adverse factors that limited the success and duration of exclusive breastfeeding included free samples of human milk substitutes or advertising at primary healthcare centers 6 weeks after childbirth, pacifier use 6 months after childbirth, as well as amniotomy for labor induction. Conclusions Our research demonstrated that exclusive breastfeeding is impacted in both directions by a range of factors during particular periods after delivery. One of the novel findings was the adverse influence of amniotomy for labor induction on exclusive breastfeeding rates. Taking into account diverse factors influencing exclusive breastfeeding and the absence of a single way to promote it, there is a crucial need to increase the incidence of exclusive breastfeeding until infants reach the age of 6 months. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-021-00364-6.
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Affiliation(s)
- Vaidilė Jakaitė
- Centre of Obstetrics and Gynecology, Vilnius University Hospital Santaros Klinikos, 2 Santariškių St, LT-08661, Vilnius, Lithuania. .,Clinic of Obstetrics and Gynecology of the Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania.
| | - Aurelija Peštenytė
- Clinic of Obstetrics and Gynecology of the Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania.,Clinic of Obstetrics and Gynecology, Vilnius City Clinical Hospital, Vilnius, Lithuania
| | - Jolita Zakarevičienė
- Centre of Obstetrics and Gynecology, Vilnius University Hospital Santaros Klinikos, 2 Santariškių St, LT-08661, Vilnius, Lithuania.,Clinic of Obstetrics and Gynecology of the Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania
| | - Vilija Sniečkuvienė
- Centre of Obstetrics and Gynecology, Vilnius University Hospital Santaros Klinikos, 2 Santariškių St, LT-08661, Vilnius, Lithuania.,Clinic of Obstetrics and Gynecology of the Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania
| | - Viktorija Žitkutė
- Centre of Obstetrics and Gynecology, Vilnius University Hospital Santaros Klinikos, 2 Santariškių St, LT-08661, Vilnius, Lithuania.,Clinic of Obstetrics and Gynecology of the Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania
| | - Diana Ramašauskaitė
- Centre of Obstetrics and Gynecology, Vilnius University Hospital Santaros Klinikos, 2 Santariškių St, LT-08661, Vilnius, Lithuania.,Clinic of Obstetrics and Gynecology of the Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania
| | - Gintautas Domža
- Centre of Obstetrics and Gynecology, Vilnius University Hospital Santaros Klinikos, 2 Santariškių St, LT-08661, Vilnius, Lithuania.,Clinic of Obstetrics and Gynecology of the Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania
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12
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Öksüz EE. Postpartum Depression Among Women With Disabilities: A Multicultural Counseling Perspective. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jmcd.12205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Elif Emir Öksüz
- School of Human Services University of Cincinnati
- Now at Department of Psychology Ankara Yıldırım Beyazıt University
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13
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Moss KM, Dobson AJ, Mishra GD. Testing the role of the timing and chronicity of maternal depressive symptoms in the associations with child behaviour and development. Paediatr Perinat Epidemiol 2020; 34:678-686. [PMID: 32535995 DOI: 10.1111/ppe.12681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/04/2020] [Accepted: 03/08/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is debate regarding whether the association between maternal depressive symptoms (MDS) and child outcomes is due to the timing or chronicity of symptoms. OBJECTIVES To investigate whether critical periods, sensitive periods, or accumulation models provided the best explanation for the association between MDS and children's behaviour and development. METHODS Data on mothers (N = 892) were collected from 1996 to 2015 as part of the Australian Longitudinal Study on Women's Health, a prospective longitudinal epidemiological study. Data on children (N = 978, 2-12 years) were collected in 2016/17 as part of the Mothers and their Children's Health study. Mothers were categorised according to whether they reported MDS (scored ≥ 10 on the CESD-10) before pregnancy, during pregnancy, or in early childhood. Child outcomes were maternal-rated behaviour problems (Strengths and Difficulties Questionnaire; SDQ) and teacher-rated development (Australian Early Development Census; AEDC). We used a structured life course approach to rigorously test critical period, sensitive period, and accumulation (ie chronicity) theories by comparing the fit of a series of models. RESULTS Most mothers did not report MDS at any time (69.2%), 16.9% reported MDS before pregnancy, 13.2% during pregnancy, and 16.5% in early childhood. High/very high total behaviour problems were reported for 7.0% of children, and developmental vulnerability/risk was reported for 15.9% for social competence and 15.7% for emotional maturity. An accumulation model was the best fit, with each period of MDS associated with an increase of 1.71 points (95% CI 1.26, 2.17) on the SDQ and decreases of 0.31 (95% CI -0.50, -0.12) and 0.29 points (95% CI -0.49, -0.08) on AEDC social competence and emotional maturity, respectively. CONCLUSIONS Chronic MDS were associated with poorer child outcomes than MDS at any single time. Sensitive and critical period models were not supported. This suggests chronicity of symptoms may be more important than timing.
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Affiliation(s)
- Katrina M Moss
- School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, QLD, Australia
| | - Annette J Dobson
- School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, QLD, Australia
| | - Gita D Mishra
- School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, QLD, Australia
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14
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Goren G, Sarid O, Philippou P, Taylor A. Sense of Coherence Mediates the Links between Job Status Prior to Birth and Postpartum Depression: A Structured Equation Modeling Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6189. [PMID: 32858960 PMCID: PMC7504177 DOI: 10.3390/ijerph17176189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/20/2020] [Accepted: 08/23/2020] [Indexed: 11/17/2022]
Abstract
Postpartum depression (PPD) has detrimental effects on the health of the mother, child and family. Socio-demographic variables can influence PPD. Sense of coherence (SOC) is a personal resource that mitigates the experience of stressful events. We hypothesized that SOC would have a protective effect against PPD over time. The aim was to investigate the effects of socio-demographic factors and SOC on PPD at birth (T1) and nine months postpartum (T2). A longitudinal study of primiparous women (n = 114; age range 18-47 years) measured PPD, SOC and socio-demographics at T1 and T2. The majority were married, had no economic difficulties and were employed before birth. Results showed that PPD at T1 (15.8%) declined to 6.2% (T2). Job status was positively associated with SOC at T1. The structured equation model accounted for 27% of the variance in PPD (T2). In the first pathway, job status was linked to PPD (T2) via SOC at T1 and T2. In the second, SOC and PPD (T1) and SOC (T2) mediated the link between job status and PPD (T2). Results and clinical implications are discussed in the context of the theory of conservation of resources. An intervention for enhancing SOC is recommended for woman at risk of PPD.
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Affiliation(s)
- Ganit Goren
- The Spitzer Department of Social Work, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (G.G.); (O.S.); (P.P.)
| | - Orly Sarid
- The Spitzer Department of Social Work, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (G.G.); (O.S.); (P.P.)
| | - Philippos Philippou
- The Spitzer Department of Social Work, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (G.G.); (O.S.); (P.P.)
| | - Alyx Taylor
- School of Psychology, Sport and Physical Activity, AECC University College, Bournemouth BH5 2DF, UK
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15
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Palumbo G, Mirabella F, Gigantesco A. Positive screening and risk factors for postpartum depression. Eur Psychiatry 2020; 42:77-85. [DOI: 10.1016/j.eurpsy.2016.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 11/15/2016] [Accepted: 11/19/2016] [Indexed: 11/29/2022] Open
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16
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Moss KM, Loxton D, Dobson AJ, Slaughter V, Mishra GD. Testing competing mediators of the association between pre-conception maternal depression and child health-related quality of life: the MatCH study. Arch Womens Ment Health 2020; 23:53-62. [PMID: 30656489 DOI: 10.1007/s00737-019-0941-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/07/2019] [Indexed: 10/27/2022]
Abstract
Maternal depression is a potent risk factor for poor child development across a number of domains but the mechanisms of transmission are poorly understood. This study aimed to test competing mediators of the association between pre-conception maternal depression and child psychosocial functioning. In 2016, mothers in the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health were asked to be part of the Mothers and their Children's Health study and to complete surveys on the health of their three youngest children under 13 years. The current study includes children aged 0-12 years (N = 5532, M = 6.99 years, SD = 3.22 years) and their mothers (N = 2917). We used the CESD-10 to measure depression and the PedsQL to measure psychosocial functioning, and used multilevel structural equation modeling to test hypotheses. Pre-conception maternal depression was associated with poorer maternal mental health and parenting after birth. The effect of pre-conception maternal depression was mediated by post-birth maternal depression in children aged 0-4 years (unstandardized regression coefficient (B) = - 0.26, 95%CI - 0.38, - 0.13) and children aged 5-12 years (B = - 0.25, 95%CI - 0.34, - 0.16), and by post-birth maternal stress (B = - 0.04, 95%CI - 0.08, - 0.01), and parenting (B = - 0.03, 95%CI - 0.04, - 0.02) in children aged 5-12 years. Post-birth maternal depression was the strongest mediator. Pre-conception is the optimal time for depression intervention. Post-birth interventions should include a focus on reducing depression and improving negative parenting aspects such as hostility and discipline.
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Affiliation(s)
- Katrina M Moss
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia.
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, The University of Newcastle, New Lambton Heights, New South Wales, 2305, Australia
| | - Annette J Dobson
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia
| | - Virginia Slaughter
- School of Psychology, The University of Queensland, St Lucia, Queensland, 4067, Australia
| | - Gita D Mishra
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia
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17
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Badakhsh M, Hastings-Tolsma M, Firouzkohi M, Amirshahi M, Hashemi ZS. The lived experience of women with a high-risk pregnancy: A phenomenology investigation. Midwifery 2020; 82:102625. [PMID: 31923707 DOI: 10.1016/j.midw.2019.102625] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Pregnancy is a time of transformation, hope, expectation, and worry for women and their families - none more so than when the pregnancy is at-risk. The objective of this study was to describe the lived experience of women during high-risk pregnancy. METHODS This qualitative investigation utilized a hermeneutic phenomenology study. The study was conducted in a public health center in a large urban area in southeast Iran. Purposive sampling of 20 women with a high-risk pregnancy. Participants included both nulligravid and multigravid women in the second and third trimesters of pregnancy with varied medical conditions. Data collection used face-to-face interview with transcribed data analyzed using Braun and Clarke's six stage thematic analysis approach. RESULTS Four themes were extracted and included challenge of family in high-risk pregnancy, challenge of anticipation for motherhood, and challenges for future pregnancies, and challenge of adaptation. CONCLUSIONS Findings demonstrate that women with a high-risk pregnancy struggle to adapt with burdens related to successful maternal role attainment and family functioning. Fears about pregnancy outcome and future pregnancies are dominant.
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Affiliation(s)
- Mahin Badakhsh
- Midwifery Department, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Iran.
| | - Marie Hastings-Tolsma
- Nurse Midwifery, Louise Herrington School of Nursing, Baylor University, Dallas, TX 75246, USA; University of Johannesburg, South Africa
| | - Mohammadreza Firouzkohi
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Iran
| | - Mehrbanoo Amirshahi
- Midwifery Department, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Iran
| | - Zohreh Sadat Hashemi
- Midwifery Department, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Iran
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18
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Maternal perinatal mental health: Associations with bonding, mindfulness, and self‐criticism at 18 months’ postpartum. Infant Ment Health J 2019; 41:69-81. [DOI: 10.1002/imhj.21827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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19
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Chojenta C, William J, Martin MA, Byles J, Loxton D. The impact of a history of poor mental health on health care costs in the perinatal period. Arch Womens Ment Health 2019; 22:467-473. [PMID: 30251209 DOI: 10.1007/s00737-018-0912-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 09/17/2018] [Indexed: 11/29/2022]
Abstract
The perinatal period is a critical time for mental health and is also associated with high health care expenditure. Our previous work has identified a history of poor mental health as the strongest predictor of poor perinatal mental health. This study aims to examine the impact of a history of poor mental health on health care costs during the perinatal period. Data from the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) were linked with a number of administrative datasets including the NSW Admitted Patient Data Collection and Perinatal Data Collection, the Medicare Benefits Scheme and the Pharmaceuticals Benefits Scheme between 2002 and 2011. Even when taking birth type and private health insurance status into account, a history of poor mental health resulted in an average increase of over 11% per birth across the perinatal period. These findings indicate that an investment in prevention and early treatment of poor mental health prior to child bearing may result in a cost saving in the perinatal period and a reduction of the incidence of women experiencing poor perinatal mental health.
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Affiliation(s)
- Catherine Chojenta
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Jananie William
- Research School of Finance, Actuarial Studies and Statistics, Australian National University, Canberra, ACT, 2601, Australia
| | - Michael A Martin
- Research School of Finance, Actuarial Studies and Statistics, Australian National University, Canberra, ACT, 2601, Australia
| | - Julie Byles
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
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20
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Pampaka D, Papatheodorou SI, AlSeaidan M, Al Wotayan R, Wright RJ, Buring JE, Dockery DW, Christophi CA. Postnatal depressive symptoms in women with and without antenatal depressive symptoms: results from a prospective cohort study. Arch Womens Ment Health 2019; 22:93-103. [PMID: 29971553 DOI: 10.1007/s00737-018-0880-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 06/22/2018] [Indexed: 01/01/2023]
Abstract
Evidence exists that the risk factors for depression in the antenatal and postnatal period may differ, but only a handful of studies looked at depression longitudinally. The aims of this study were (1) to estimate the prevalence of postnatal depressive symptoms in Kuwait where data about postnatal depression are scarce and identify its determinants and (2) to compare these risk factors between women who had experienced antenatal depressive symptoms and those that did not. Data collected in the TRansgenerational Assessment of Children's Environmental Risk (TRACER) Study in Kuwait were used in this analysis. The sample was restricted to the 1348 women who answered the Edinburgh Postnatal Depression Scale (EPDS) both antenatally and postnatally. The prevalence of postnatal depressive symptoms, defined by an EPDS score ≥ 10, was 11.7%. Overall, antenatal depressive symptoms were the strongest determinant of postnatal depressive symptoms. Multivariable logistic regression analysis showed that in women with depressive symptoms in pregnancy, having a lower household income was the most significant risk factor for postnatal depressive symptoms. Among women without antenatal depressive symptoms, those who had lower income, were Kuwaitis, experienced other problems in pregnancy such as perceived stress, PTSD symptoms and social isolation, and those who delivered a boy had higher odds of postnatal depressive symptoms. Antenatal depressive symptoms and other psychosocial characteristics can predict postnatal depressive symptoms. Therefore, maternal mental health issues should be detected during the antenatal period and support should be provided in order to lower the risk of postnatal depression and its sequelae.
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Affiliation(s)
- Despina Pampaka
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.
| | - Stefania I Papatheodorou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus
| | | | | | - Rosalind J Wright
- Department of Pediatrics and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Douglas W Dockery
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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21
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Basrowi RW, Sastroasmoro S, Sulistomo AW, Bardosono S, Hendarto A, Soemarko DS, Sungkar A, Khoe LC, Vandenplas Y. Challenges and Supports of Breastfeeding at Workplace in Indonesia. Pediatr Gastroenterol Hepatol Nutr 2018; 21:248-256. [PMID: 30345237 PMCID: PMC6182487 DOI: 10.5223/pghn.2018.21.4.248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 06/18/2018] [Accepted: 07/09/2018] [Indexed: 01/20/2023] Open
Abstract
Due to increased number of women workers in Indonesia in the last decade, numbers of women living as a worker and a housewife have increased. This also increases the potential risk of breastfeeding discontinuation. Three months of maternal leave policy and inadequate lactation promotion support in workplace have been identified as factors that hinder lactating practices. The World Health Organization recommendation of 6 months of exclusive breastfeeding and joined regulation of three Indonesia ministers (Ministry of Health, Ministry of Labour, and Ministry of Women Empower) have failed to improve the exclusive breastfeeding rate among female workers in Indonesia due to the lack of a standardized guideline on lactation promotion at workplace. In addition, very limited or no studies have been conducted to evaluate the impact of workplace-based lactation intervention programs on exclusive breastfeeding rate among female workers. This is because the relationship of lactation with working performance and productivity could not motivate employer to invest in workplace-based lactation promotion facility or program.
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Affiliation(s)
- Ray Wagiu Basrowi
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Sudigdo Sastroasmoro
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Astrid W Sulistomo
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Saptawati Bardosono
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Aryono Hendarto
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Dewi S Soemarko
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Ali Sungkar
- Department of Obstetric Gynaecology, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Levina Chandra Khoe
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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22
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The association between social support and postpartum depression in women: A cross sectional study. Women Birth 2018; 32:e238-e242. [PMID: 30274879 DOI: 10.1016/j.wombi.2018.07.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 07/19/2018] [Accepted: 07/21/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Prevalence of postpartum depression is estimated to be about 10-15% worldwide. Many risk factors are supposed to play a role leading a new mother to maternal postpartum depression which can considerably affect the baby, mother, family and also the society. OBJECTIVE To investigate the prevalence of maternal postpartum depression and its association with social support. METHODS Using a cross-sectional study, 200 new mothers who attended three teaching hospitals in Tehran, Iran were selected with a convenience sampling. Postpartum depression was assessed using the Iranian version of Edinburgh Postpartum Depression Scale and women's levels of social support were measured using the Iranian version of Social Support Questionnaire. RESULTS Prevalence of postpartum depression was 43.5% in new mothers. The mean (±Standard Deviation) score of social support network was 2.09±0.99; which is lower in depressed mothers in comparison to non-depressed mothers (1.78±0.87 vs. 2.33±1.00 respectively, P<0.001). A reverse significant association was found between social support and postpartum depression after adjusting for confounding variables such as past history of depression, illness of baby and medication consumption during pregnancy (Odds Ratio=0.47, 95% Confidence Interval=0.33-0.67). CONCLUSION The bigger the social network of a mother, the less postpartum depression occurs. It is suggested to educate the family about the very important role of social support and improve it in every aspect of health care in order to prevent postpartum depression.
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23
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Lowndes TA, Egan SJ, McEvoy PM. Efficacy of brief guided self-help cognitive behavioral treatment for perfectionism in reducing perinatal depression and anxiety: a randomized controlled trial. Cogn Behav Ther 2018; 48:106-120. [DOI: 10.1080/16506073.2018.1490810] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Sarah J. Egan
- School of Psychology, Curtin University, Perth, Australia
| | - Peter M. McEvoy
- School of Psychology, Curtin University, Perth, Australia
- Centre for Clinical Interventions, Perth, Australia
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24
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Lupattelli A, Twigg MJ, Zagorodnikova K, Moretti ME, Drozd M, Panchaud A, Rieutord A, Juraski RG, Odalovic M, Kennedy D, Rudolf G, Juch H, Nordeng H. Self-reported perinatal depressive symptoms and postnatal symptom severity after treatment with antidepressants in pregnancy: a cross-sectional study across 12 European countries using the Edinburgh Postnatal Depression Scale. Clin Epidemiol 2018; 10:655-669. [PMID: 29922092 PMCID: PMC5997125 DOI: 10.2147/clep.s156210] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE This study aimed at exploring the prevalence of self-reported antenatal and postnatal depressive symptoms by severity across multiple countries and the association between antidepressant treatment in pregnancy and postnatal symptom severity. MATERIALS AND METHODS This was a multinational web-based study conducted across 12 European countries (n=8069). Uniform data collection was ensured via an electronic questionnaire. Pregnant women at any gestational week and mothers of children with <1 year of age could participate. We used the Edinburgh Postnatal Depression Scale (EPDS) to measure the prevalence of antenatal and postnatal depressive symptoms according to severity, which were corrected by survey weight adjustment (descriptive analysis). Within mothers with a psychiatric disorder (n=173), we estimated the association between antidepressant treatment in pregnancy and postnatal depressive symptom severity, as standardized EPDS mean scores, via the inverse probability of treatment weight (association analysis). RESULTS In the descriptive analysis (n=8069), the period prevalence of moderate-to-very severe depressive symptoms was higher in the western and eastern regions relative to the northern region, both in the antenatal period (6.8%-7.5% vs 4.3%) and in the postnatal period (7.6% vs 4.7%). One in two mothers with psychiatric disorders used an antidepressant in pregnancy (86 of 173). In the association analysis, women medicated at any time during pregnancy (adjusted β=-0.34, 95% confidence interval [CI] =-0.66, -0.02) had a significant postnatal symptom severity reduction compared with the nonmedicated counterpart. This effect was larger (β=-0.74, 95% CI =-1.24, -0.24) when the analysis was restricted to mothers within 6 months after childbirth. CONCLUSION The prevalence of self-reported antenatal and postnatal depressive symptoms differs across European countries. Among women with psychiatric disorders, those who had been on treatment with antidepressants during pregnancy were less likely to report postnatal depressive symptoms, particularly within the 6-month period after childbirth, compared with the nonmedicated counterpart.
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Affiliation(s)
- Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy and PharmaTox Strategic Research Initiative, University of Oslo, Oslo, Norway
| | - Michael J Twigg
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, UK
| | - Ksenia Zagorodnikova
- Northwest Medical Center for Drug Safety in Pregnancy and Lactation, Northwest State Medical University named after I. I. Mechnikov, St. Petersburg, Russia
| | - Myla E Moretti
- Clinical Trials Unit, Ontario Child Health Support Unit, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mariola Drozd
- Department of Applied Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Alice Panchaud
- School of Pharmaceutical Sciences, University of Geneva and Lausanne, Geneva, Switzerland
- Division of Clinical Pharmacology and Swiss Teratogen Information Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Andre Rieutord
- Pharmacy Service, Hospital Antoine-Béclère, GH HUPS, APHP, Clamart France and Européenne de Formation pour les Pharmaciens, Clamart, France
| | - Romana Gjergja Juraski
- Children’s Hospital Srebrnjak, Medical School of Osijek, Josip Juraj Strossmayer University, Osijek, Croatia
| | - Marina Odalovic
- Faculty of Pharmacy, University of Belgrade, Beograd, Serbia
| | - Debra Kennedy
- MotherSafe, Royal Hospital for Women, Sydney, NSW, Australia
- School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
| | - Gorazd Rudolf
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Herbert Juch
- Cell Biology, Histology and Embryology, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University Graz, Graz, Austria
| | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy and PharmaTox Strategic Research Initiative, University of Oslo, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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25
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Perinatal Depression and Associated Factors among Mothers in Southern Ethiopia: Evidence from Arba Minch Zuria Health and Demographic Surveillance Site. PSYCHIATRY JOURNAL 2018; 2018:7930684. [PMID: 29854717 PMCID: PMC5954952 DOI: 10.1155/2018/7930684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/21/2018] [Accepted: 03/15/2018] [Indexed: 11/18/2022]
Abstract
Background. Perinatal depression is a serious mental health problem that can negatively affect the lives of women and children. The adverse consequences of perinatal depression in high-income countries also occur in low-income countries. Objective. To assess the perinatal depression and associated factors among mothers in Southern Ethiopia. Methods. A community based cross-sectional study was conducted among selected 728 study participants in Arba Minch Zuria HDSS. A pretested questionnaire was used to collect the data. Data were analyzed using STATA version 12 software. Descriptive statistical methods were used to summarize the characteristics of the mothers. Bivariate and multivariable logistic regression was used for analysis. Results. The prevalence of perinatal depression among the study period was 26.7%. In the final multivariable logistic regression, monthly income AOR (95% C.I): 4.2 (1.9, 9.3), parity [AOR (95% C.I): 0.14 (0.03, 0.65)], pregnancy complications AOR (95% C.I): 5 (2.5, 10.4), husband smoking status [AOR (95% C.I): 4.12 (1.6, 10.6)], history of previous depression AOR (95% C.I): 2.7 (1.54, 4.8), and family history of psychiatric disorders were the independent factors associated with perinatal depression. Conclusion. The study showed a high prevalence of perinatal depression among pregnant mothers and mothers who have less than a one-year-old child.
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A longitudinal investigation of perfectionism and repetitive negative thinking in perinatal depression. Behav Res Ther 2017; 97:26-32. [DOI: 10.1016/j.brat.2017.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 05/31/2017] [Accepted: 06/26/2017] [Indexed: 11/17/2022]
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Ugarte AU, López-Peña P, Vangeneberg CS, Royo JGT, Ugarte MAA, Compains MTZ, Medrano MPR, Toyos NM, Lamo EA, Dueñas MBB, González-Pinto A. Psychoeducational preventive treatment for women at risk of postpartum depression: study protocol for a randomized controlled trial, PROGEA. BMC Psychiatry 2017; 17:13. [PMID: 28086766 PMCID: PMC5237273 DOI: 10.1186/s12888-016-1162-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 12/07/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Postpartum depression is a disease with a prevalence of 20% that has deleterious consequences not only for the mother but also for the baby and can cause delays in physical, social and cognitive development. In this context, the European Union Committee on Public Health has declared it essential that preventative measures are taken by centres providing care for women with a multidisciplinary approach. PROGEA is a multicentre, single-blind randomized, 3-year, longitudinal clinical trial aiming to evaluate the efficacy of a psychoeducational programme in preventing postpartum depression in at-risk women, based on a range of clinical variables, and explore prognostic factors. This paper describes the methods and rationale behind the study. METHODS We will study women receiving treatment as usual plus a psychoeducation cognitive behavioural therapy (CBT)-based intervention and a control group receiving only treatment as usual. The sample will be recruited from an incidental sampling of pregnant women in two health regions. We will recruit 600 women in the third trimester of pregnancy who consent to take part in the study. Almost half of the women, about 280, would be expected to have some risk factors for postpartum depression. All those found to have risk factors will be evaluated, and we estimate that a quarter will be classified as at-risk of developing postpartum depression as measured with the Edinburgh Postnatal Depression Scale. This subset will be randomly allocated to receive treatment as usual with or without the CBT intervention. Six sessions of CBT (1 individual and 5 group) will be offered by a psychologist. DISCUSSION Findings from this study will be used to design a definitive study that will examine the clinical and cost-effectiveness of the CBT-based intervention in improving the mood of women in the postpartum period. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02323152 ; Date: December 2014.
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Affiliation(s)
- Amaia Ugarte Ugarte
- Department of Psychiatry, University Hospital of Alava-Santiago, Vitoria, Spain. .,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Madrid, Spain.
| | - Purificación López-Peña
- Department of Psychiatry, University Hospital of Alava-Santiago, Vitoria, Spain ,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Madrid, Spain
| | | | | | | | | | | | - Nerea Muñoz Toyos
- Obstetrics and Gynecology Service, OSAKIDETZA, Basque Country, Spain
| | | | | | - Ana González-Pinto
- Department of Psychiatry, University Hospital of Alava-Santiago, Vitoria, Spain ,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Madrid, Spain ,School of Medicine, University of the Basque Country, Vitoria, Spain
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