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Lubis PN, Saputra M, Rabbani MW. A systematic review of the benefits of breastfeeding against postpartum depression in low-middle-income countries. J Ment Health 2024:1-13. [PMID: 38869015 DOI: 10.1080/09638237.2024.2361232] [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: 02/16/2023] [Accepted: 03/16/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND The positive impact of breastfeeding against postpartum depression has been increasingly reported. However, no studies have systematically and critically examined current evidence on breastfeeding practices' influences on postpartum depression in LMICs. AIM To review the influence of breastfeeding on postpartum depression in LMICs. METHODS We searched original research in English published over the last ten years (2012 - 2022) within 8 databases: EBSCOhost, EMBASE, Pubmed, Sage Journals, Science Direct, APA PsycArticles, Taylor & Francis, Google Scholar, and citation tracking. The risk of bias assessment used The Newcastle Ottawa Scale and The Modified Jadad Scale. We followed the PRISMA statement after the protocol had been registered on the PROSPERO. The review included 21 of 11015 articles. RESULTS Of 21 articles, 16 examined breastfeeding practices, 2 each investigated breastfeeding self-efficacy and breastfeeding education, and 1 each assessed breastfeeding attitude and breastfeeding support. 3 randomized control trials and 5 cohorts revealed that breastfeeding decreased the EPDS scores. However, 4 cross-sectional studies indicated that breastfeeding is nonsignificantly associated with postpartum depression. CONCLUSION This review indicated that breastfeeding may alleviate or prevent postpartum depression. Our findings indicated that integrating breastfeeding-related programs and policies into postpartum depression prevention may benefit public health. REGISTRATION PROSPERO (CRD42022315143).
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Affiliation(s)
| | - Maman Saputra
- Tulodo Organizations and Universitas Terbuka, Indonesia
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Zhao Y, Lin Q, Zhu X, Wang J. Randomized Clinical Trial of a Prenatal Breastfeeding and Mental Health Mixed Management Intervention. J Hum Lact 2021; 37:761-774. [PMID: 33571031 DOI: 10.1177/0890334421991058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The continuity of maternal depressive symptoms throughout the perinatal period and breastfeeding problems have adverse influences on breastfeeding. RESEARCH AIM To compare the feeding patterns and breastfeeding experiences, maternal health and mental health, and breastfeeding self-efficacy between women with depressive symptoms who participated in a prenatal individualized mixed management intervention and those who received usual care. METHODS Chinese primigravida (N = 182) with an Edinburgh Postnatal Depression Scale score ≥ 9 in late pregnancy (≥ 28 weeks and < 35 weeks) were randomly assigned to the intervention group (n = 84) or the control group (n = 84). Intervention group participants received four sessions of individualized mixed management combining psycho-education and breastfeeding education. Breastfeeding self-efficacy, feeding patterns, maternal depression, and health status were evaluated in both groups. RESULTS Significant differences were noted between the groups in breastfeeding self-efficacy at 42 days postpartum (p < .05) and feeding patterns at 3 months and 6 months postpartum (p < .05). Repeated measures analysis of variance showed significant differences in the EPDS scores between groups at three postpartum time points (p < .05). The intervention group had significantly lower postpartum depression as diagnosed by the MINI (p < .05). CONCLUSIONS A prenatal individualized mixed management intervention holds promise as an effective prevention and health promotion program addressing breastfeeding outcomes and maternal mental health.This RCT was registered (ChiCTR-IOR-17013761) with Chinese Clinical Trial Registry, http://www.chictr.org.cn/enIndex.aspx on 12/7/2017.
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Affiliation(s)
- Ying Zhao
- 12478 School of Nursing, Fudan University, Shanghai, PR China
| | - Qiping Lin
- 92276 Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Xinli Zhu
- 92276 Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Jing Wang
- 92276 Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
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Butler MS, Young SL, Tuthill EL. Perinatal depressive symptoms and breastfeeding behaviors: A systematic literature review and biosocial research agenda. J Affect Disord 2021; 283:441-471. [PMID: 33272686 PMCID: PMC7954873 DOI: 10.1016/j.jad.2020.11.080] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/08/2020] [Accepted: 11/08/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Breastfeeding is recommended to improve maternal and infant health globally. Depression has been posited to negatively impact breastfeeding, although potential causal and bidirectional pathways between these two phenomena have not been sufficiently characterized. We therefore conducted a systematic review to critically evaluate available evidence on the relationship between perinatal depressive symptoms and breastfeeding behaviors; to identify knowledge gaps and propose a biosocial research agenda to advance our understanding of this topic. METHODS A systematic search strategy was applied across seven databases. Data were extracted and aggregated using the matrix method to provide a narrative synthesis of findings. RESULTS Thirty-eight studies from 20 countries spanning 1988 through 2018 fit the inclusion criteria. In general, methods across studies were heterogeneous. Fourteen different tools were used to measure perinatal depressive symptoms. Nearly half the studies did not provide breastfeeding definitions. No studies from low-income countries met inclusion criteria. More than half (63%) of studies demonstrated a negative association between depressive symptoms across the perinatal period and less exclusive breastfeeding and/or shorter breastfeeding durations. LIMITATIONS Heterogeneity in study design, definitions, assessment tools, and measurement time points limited the comparability of study findings. Causality cannot be assessed. CONCLUSIONS Available evidence suggests perinatal depressive symptoms negatively associated with breastfeeding exclusivity and duration, which can lead to suboptimal infant nutrition and detrimental impacts on maternal mental and physical health. To better understand this relationship, we propose including consistent operationalization and assessment of depression and breastfeeding globally and concurrent repeated measures of key biological and social factors.
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Affiliation(s)
| | - Sera L Young
- Department of Anthropology, Northwestern University; Institute for Policy Research, Northwestern University
| | - Emily L Tuthill
- Department of Community Health Systems, University of California, San Francisco
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Sun J, Zhu Y, Li Y, Li N, Liu T, Su X, Dai Z, Zhang Y, Pan L, Jiang W, Zhu W. Maternal postpartum feeding anxiety was associated with infant feeding practices: results from the mother-infant cohort study of China. BMC Pregnancy Childbirth 2020; 20:780. [PMID: 33317471 PMCID: PMC7737271 DOI: 10.1186/s12884-020-03483-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 12/08/2020] [Indexed: 11/20/2022] Open
Abstract
Background Maternal feeding anxiety (FA) was prevalent during puerperium and might affect infant feeding practices. This study was aimed to investigate the FA status in Chinese postpartum women and its relationship with infant feeding practices (FPs). Methods Participants were from the Mother-Infant Cohort Study of China, in which the dietary and feeding practices, physical and psychiatric health for both mothers and infants were followed up from childbirth to next 2 years. In this study the maternal feeding anxiety (FA) status at 0–3 months postpartum was assessed by Li’s Self-rating Feeding Anxiety Scale (SFAS). Infant feeding practices (FPs) at 0–3 months, including breastfeeding-related behaviors, responsive feeding and infant food refusal were investigated by self-designed questionnaire. Results In total 456 mothers the average feeding anxiety scores (FAS) was 41.02 ± 8.02 (mean ± SD), and maternal FA prevalence were 61.4% (FAS>38) with severe FA being 8.6% (FAS>52) at 0–3 months postpartum. The FAS was related with infant FPs, and lower maternal FAS was significantly related with infant colostrum feeding (40.86 ± 8.02 vs 44.74 ± 11.33, P < 0.05), but higher FAS was related with bottle feeding (41.95 ± 8.28 vs 39.69 ± 7.92, P < 0.05). The mothers with severe feeding anxiety (FAS > 53) were more likely to feed infants with bottle (ORs, 95%CI: 2.41, 1.11 ~ 5.19). There were not significant association between FAS and exclusive breastfeeding and responsive feeding practices (P > 0.05). The higher FAS was associated with infant food refusal behaviors, the maternal scores whose infant “never”, “rarely”, “sometimes” and “often” spat out food when feeding were 39.86 ± 8.02, 41.47 ± 8.18, 41.36 ± 7.44 and 42.14 ± 12.03 increasingly (P > 0.05), and the FA prevalence was significantly different among groups (P < 0.05). The infants whose mother was identified as feeding anxiety were more likely to refuse opening the mouth when feeding (P < 0.05). Multivariate analysis indicated maternal FAS was positively related to infant bottle feeding (βi = 2.487, P < 0.05) and outdoor sunshine exposure practice (βi = 1.787, P < 0.05), and negatively related to household income level (βi = − 0.118, P < 0.05). Conclusions Maternal postpartum feeding anxiety was associated with some infant feeding practices, including bottle feeding and infant food refusal behaviors. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03483-w.
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Affiliation(s)
- Jing Sun
- Department of Nutrition and Food Hygiene, Peking University School of Public Health; National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Yimin Zhu
- Shijingshan District Center for Diseases Prevention and Control, Beijing, 100043, China
| | - Yongjin Li
- Shunyi District Center for Diseases Prevention and Control, Beijing, 101300, China
| | - Niuniu Li
- Department of Nutrition and Food Hygiene, Peking University School of Public Health; National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Tan Liu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health; National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Xiao Su
- Department of Nutrition and Food Hygiene, Peking University School of Public Health; National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Zhiyong Dai
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Beijing, 100191, China
| | - Yanchun Zhang
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Beijing, 100191, China
| | - Lina Pan
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Beijing, 100191, China
| | - Wei Jiang
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Beijing, 100191, China
| | - Wenli Zhu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health; National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China.
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Association between maternal satisfaction with breastfeeding and postpartum depression symptoms. PLoS One 2020; 15:e0242333. [PMID: 33201903 PMCID: PMC7671548 DOI: 10.1371/journal.pone.0242333] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 10/31/2020] [Indexed: 01/28/2023] Open
Abstract
Background Due to the multiple health benefits of breastfeeding, it is essential to identify factors that may negatively interfere with this healthy practice. Among such factors are postpartum depression (PPD) and maternal satisfaction with breastfeeding. The objective of this study was to evaluate the association between maternal satisfaction with breastfeeding and symptoms of PPD in the first month after childbirth. Methods This cross-sectional study nested in a cohort study was conducted in Porto Alegre, Brazil, with 287 puerperal women selected at two maternity hospitals, one public and one private. Women were interviewed at their homes the week after the infant completed 30 days of life. A structured questionnaire was applied, as well as instruments to evaluate maternal satisfaction with breastfeeding (Maternal Breastfeeding Evaluation Scale) and to screen for PPD (Edinburgh Postnatal Depression Scale). The association between higher satisfaction with breastfeeding (outcome) and negative PPD screening test was assessed using Poisson regression with robust variance, adjusting for specific covariables. Adjusted prevalence ratios (aPR) and respective 95% confidence intervals (95%CI) were estimated. Results The prevalence of increased satisfaction with breastfeeding (defined as women with scores above the median) was 47% higher among women who screened negative for PPD when compared to those with a positive result (aPR 1.47; 95%CI 1.01–2.16). This result was adjusted for maternal age and skin color, cohabitation with the infant’s father, planned pregnancy, type of delivery, exclusive breastfeeding, and occurrence of breastfeeding problems. Conclusions The findings of this study showed an association between higher maternal satisfaction with breastfeeding and absence of PPD symptoms, reinforcing the importance of caring for the mental health of pregnant and puerperal women and paying attention to their satisfaction with breastfeeding.
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Dadi AF, Akalu TY, Baraki AG, Wolde HF. Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis. PLoS One 2020; 15:e0231940. [PMID: 32343736 PMCID: PMC7188237 DOI: 10.1371/journal.pone.0231940] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 04/05/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Postnatal depression (PND) is a major cause of negative health-related behaviors and outcomes during infancy, childhood and adolescent period. In Africa, the burden of postnatal depression is high. However, it is under-investigated hence under-treated. To fill this information gap and to advise further interventions, we aimed at analyzing its epidemiology in Africa. Methods We searched observational studies conducted in Africa and published in between 01/01/2007 and 30/06/2018 in CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases. We assessed the quality of the studies using the Newcastle Ottawa Scale (NOS) and included studies with good quality. We evaluated the heterogeneity using the Higgins I2 statistics. We used a random-effects model to pool estimates. We assessed publication bias using the funnel plot and Egger's test statistics and adjusted using Tweedie’s and Duval Trim and Fill analysis. The protocol has been registered in the PROSPERO (Protocol No. CRD42018100461). Results Nineteen studies involving 40,953 postnatal mothers were part of this systematic review and meta-analysis. The overall pooled prevalence of PND was 16.84% (95% CI: 14.49% –19.19%). The odds of having PND was higher among women with a poor obstetric condition (POR = 2.11; 95% CI: 1.11–4.01) and history of adverse birth and infant health outcomes (POR = 2.85; 95% CI: 1.29–6.25). Having a history of common mental health disorders (POR = 2.47; 95% CI: 1.51–4.04), poor social support (POR = 2.06; 95% CI: 1.05–4.05), lower economic status (POR = 2.38; 95% CI: 1.75–3.23), and those who had exposure to a different form of intimate partner violence (POR = 2.87; 95% CI: 1.60–5.16) had higher odds of PND. Conclusion While robust prevalence studies are scarce, our review indicated a high prevalence rate of postnatal depression. The analysis also identified postpartum women at increased risk of PND. Therefore, there is a need to design and escalate comprehensive strategies to decrease its burden, focusing on those women at risk of PND.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, Discipline of Public Health, Flinders University, Adelaide, Australia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
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Ghaedrahmati M, Kazemi A, Kheirabadi G, Bahrami M, Ebrahimi A. Examining the relationship between mothers' prenatal mental health and demographic factors with postpartum depression. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:146. [PMID: 30596118 PMCID: PMC6282477 DOI: 10.4103/jehp.jehp_6_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 08/16/2018] [Indexed: 06/01/2023]
Abstract
BACKGROUND AND AIM Prenatal mental health has been shown to be related with postpartum depression. However, the role of mental and psychological factors in postpartum depression requires especial attention. Furthermore, the relationship between demographic factors and postpartum depression is contradictory. The study was aimed to identify role of prenatal anxiety and depression and demographic factors with postpartum depression. MATERIALS AND METHODS A prospective cohort study was conducted with 303 pregnant women who have gestational age from 28 to 36 weeks and referred to health-care centers in Isfahan city and follow-up for 6-12 weeks after postpartum. Data were collected using the demographic form, Edinburgh depression, and anxiety Spielberger questionnaire during pregnancy and Edinburgh depression inventory in the 6th and 12th weeks after childbirth. Descriptive statistics and linear logistic regression were used to analyze the data. In demographic factors, data were analyzed using the Student's t-test, Chi-square, Pearson and Spearman test and after the meaningfulness of regression was used. RESULTS Results showed that the 6 and 12 weeks after childbirth, 61 patients (20/1%) and 33 patients (10/9%) had postpartum depression. The most important risk factors for depression in the first 6 weeks were history of infertility (confidence interval [CI]: 0.56-0.767) (P = 0.018) and history of depression (CI: 1.155-1.369) (P = 0.000) and in 12 weeks, postpartum were history of depression (CI: 0.072-1.305) (P = 0.001). CONCLUSION Infertility and history of depression during pregnancy were two risk factors of postpartum depression which should be taken into consideration during prenatal care.
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Affiliation(s)
- Maryam Ghaedrahmati
- Student Research Committee, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Women Health Research Centre, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Kheirabadi
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masood Bahrami
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amrollah Ebrahimi
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Garcia-Leal C, De Rezende MG, Corsi-Zuelli FMDG, De Castro M, Del-Ben CM. The functioning of the hypothalamic-pituitary-adrenal (HPA) axis in postpartum depressive states: a systematic review. Expert Rev Endocrinol Metab 2017; 12:341-353. [PMID: 30058891 DOI: 10.1080/17446651.2017.1347500] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A large body of literature suggests the role of the hypothalamic-pituitary-adrenal (HPA) axis in postpartum depression (PPD). Nonetheless, these studies present discrepant methodology and results; thus, this hypothesis deserves further exploration. Areas covered: This review included studies investigating the HPA axis in PPD or postpartum blues published until November 2016. In total, 48 studies met the inclusion criteria. The HPA axis was mostly investigated in the immediate postpartum period (62.5%), and the majority of studies collected samples in the morning (43.8%), with one measure in a single day (43.8%), and blood was the fluid more often collected (58.4%). Seven out of 21 studies evaluating postpartum blues, and 15 out of 28 studies evaluating PPD detected abnormalities in the HPA axis functioning. Expert commentary: We found a significant heterogeneity in the methodology adopted by studies and consequently, in the results. Despite that, the majority of studies reported HPA changes in women with PPD during the remote period. Notably, reactivity tests pointed to attenuated HPA axis response. Ideally, future investigations should use validated reactivity tests, include larger sample sizes, consider many measures of cortisol throughout the day, and more than one day of collection. We also recommend that studies continue to use validated scales for mood assessment.
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Affiliation(s)
- Cybele Garcia-Leal
- a Division of Psychiatry, Department of Neuroscience and Behavior, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - Marcos Gonçalves De Rezende
- a Division of Psychiatry, Department of Neuroscience and Behavior, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - Fabiana Maria das Graças Corsi-Zuelli
- a Division of Psychiatry, Department of Neuroscience and Behavior, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - Margaret De Castro
- b Division of Endocrinology, Department of Internal Medicine, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
| | - Cristina Marta Del-Ben
- a Division of Psychiatry, Department of Neuroscience and Behavior, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil
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