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Hanach N, Radwan H, Fakhry R, Dennis CL, issa WB, Faris ME, Obaid RS, Al Marzooqi S, Tabet C, De Vries N. Prevalence and risk factors of postpartum depression among women living in the United Arab Emirates. Soc Psychiatry Psychiatr Epidemiol 2023; 58:395-407. [PMID: 36239744 PMCID: PMC9971080 DOI: 10.1007/s00127-022-02372-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 10/02/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Postpartum depression received almost no attention in the United Arab Emirates (UAE). The aim was to examine the prevalence of depressive symptomatology and the associated risk factors among women in the UAE. METHODS A prospective cohort study recruited women from postpartum wards in hospitals across four emirates in the UAE. Women completed questionnaires immediately after childbirth and at 3 and 6 months postpartum. Depressive symptomatology was measured using the Edinburgh Postnatal Depression Scale (EPDS > 12). Risk factors were identified using the generalized estimating equation. A stratified analysis of the postpartum period was performed. RESULTS Among the 457 women recruited, 35% exhibited depressive symptomatology within the first 6 months postpartum. Younger women (< 25 years), part-time employment, the receipt of financial support from the family, and difficulty in managing monthly income were associated with a higher risk of postpartum depression. Husband's employment, husband's support, and living in own house were associated with a lower risk of postpartum depression. Maternity leave of more than 3 months increased the risk of depression during the first 3 months postpartum. From 3 to 6 months postpartum, Muslim women had a higher risk of depression whereas women who breastfed other children and in the past 7 days, and perceived their infant as healthy had a lower risk of depression. CONCLUSIONS The prevalence of maternal depressive symptomatology is considerable in the UAE. Risk factors change over the 6-month postpartum period suggesting the need for an innovative multidisciplinary approach to the management of postpartum depression, including follow-up screening.
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Affiliation(s)
- Nivine Hanach
- Faculty of Health, Medicine, and Life Sciences, CAPHRI, Maastricht University, P.O. Box 616, Maastricht, Netherlands.
| | - Hadia Radwan
- grid.412789.10000 0004 4686 5317Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Randa Fakhry
- grid.412789.10000 0004 4686 5317Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Cindy-Lee Dennis
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Wegdan Bani issa
- grid.412789.10000 0004 4686 5317Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E. Faris
- grid.412789.10000 0004 4686 5317Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- grid.412789.10000 0004 4686 5317Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Suad Al Marzooqi
- grid.43519.3a0000 0001 2193 6666Department of Psychology, Al Ain, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Charbel Tabet
- grid.450307.50000 0001 0944 2786CREG, Grenoble Alpes University, Paris, France
| | - Nanne De Vries
- grid.5012.60000 0001 0481 6099Faculty of Health, Medicine, and Life Sciences, CAPHRI, Maastricht University, P.O. Box 616, Maastricht, Netherlands
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Faisal-Cury A, Tabb K, Matijasevich A. Partner relationship quality predicts later postpartum depression independently of the chronicity of depressive symptoms. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2021; 43:12-21. [PMID: 32725101 PMCID: PMC7861178 DOI: 10.1590/1516-4446-2019-0764] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/19/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Given the lifelong implications of extended postpartum depression (PPD), research is needed to examine the social factors implicated in its development (such as relationship quality) and associated predictors. This study sought to examine the association of partner relationship quality (PRQ) and decline of sexual life (DSL) with maternal PPD at 12-15 months after childbirth. METHODS Prospective study of 294 low-income postpartum women. A structured questionnaire and the Patient Health Questionnaire-9 (PHQ-9) captured responses for the main outcome variable and covariates. RESULTS The prevalence of the main outcome (PPD at 12-15 months) was 19.1%. Using logistic regression models, low PRQ (risk ratio [RR] = 1.58, 95%CI 1.01-2.49) and DSL (RR = 1.97, 95%CI 1.23-3.15) were associated with PPD at 12-15 months even after controlling for perinatal depression. CONCLUSIONS Late PPD (12 to 15 months after giving birth) is very common among low-income women, and is independently associated with different aspects of the couple's relationship. Improving PRQ may prevent late PPD. Future investigations are warranted.
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Affiliation(s)
- Alexandre Faisal-Cury
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Karen Tabb
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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Chen SL, Chang SM, Kuo PL, Chen CH. Stress, anxiety and depression perceived by couples with recurrent miscarriage. Int J Nurs Pract 2019; 26:e12796. [PMID: 31713284 DOI: 10.1111/ijn.12796] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/25/2019] [Accepted: 09/22/2019] [Indexed: 11/29/2022]
Abstract
AIM Recurrent miscarriage is considered a major life event. The main purposes of this study were to compare the differences in stress, anxiety, social support, sleep quality and depressive symptoms in couples experiencing recurrent miscarriage compared to peers who experience full-term normal childbirth in southern Taiwan. METHODS Convenience sampling and snowball sampling were used respectively to recruit 78 couples with and 80 couples without recurrent miscarriage from October 2014 to July 2015. Five structured questionnaires including Perceived Stress Scale, State- Anxiety Inventory, Interpersonal Support Evaluation List, Pittsburgh Sleep Quality Index and Edinburgh Depression Scale were administered. RESULTS Women who experienced recurrent miscarriage perceived significantly higher levels of stress, anxiety and depressive symptoms than their husbands. Women in the recurrent miscarriage group reported significantly greater depressive symptoms than women of the other group. A stepwise multiple regression analysis indicated key predictors of depressive symptoms among women of childbearing age, accounting for 62.9% of the variance, were anxiety, stress, social support and history of recurrent miscarriage. CONCLUSION Women with recurrent miscarriage suffer mild to moderate depressive symptoms and a greater incidence of depression than their peers who experienced normal childbirth. Health professionals can use the knowledge gained from these findings to evaluate women with recurrent miscarriage for stress, anxiety and depressive symptoms and develop supportive interventions.
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Affiliation(s)
- Shu-Lan Chen
- Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Shao-Min Chang
- Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Pao-Lin Kuo
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
| | - Chung-Hey Chen
- Department of Nursing, HungKuang University, Taichung, Taiwan.,Department of Nursing & Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
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Lin YH, Chen CM, Su HM, Mu SC, Chang ML, Chu PY, Li SC. Association between Postpartum Nutritional Status and Postpartum Depression Symptoms. Nutrients 2019; 11:E1204. [PMID: 31141947 PMCID: PMC6628029 DOI: 10.3390/nu11061204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 01/04/2023] Open
Abstract
Taiwanese women may practice traditional confinement after childbirth, and no study has investigated the nutritional status and the effects of postpartum depression on such women. The aim of this study was to investigate the association between nutritional status and postpartum depression at 6-8 weeks postpartum. A cross-sectional study was conducted on postpartum women who returned to the obstetrics and gynecology clinic for routine examination from January 2016 to September 2017. A total of 344 women received assessments based on the Edinburgh Postnatal Depression Scale (EPDS). An EPDS score of ≥10 indicated the presence of postpartum depressive symptoms (PPDS). A total of 97 women without such symptoms and 23 with PPDS completed nutritional parameter analyses and questionnaires. The results showed that the prevalence of postpartum depression (PPD) was 8.4%. The proportion was 70% for those who practiced confinement at home, significantly higher than for those in the non-PPDS group (45%). The overall psychological stress score was significantly higher and the postpartum care satisfaction score was significantly lower in those with PPDS compared to those without. In terms of nutritional biomarkers, the plasma riboflavin levels in the PPDS group were significantly lower than those in their symptomless counterparts (13.9%). The vitamin D insufficiency and deficiency rates in the non-PPD and PPDS groups were 35%, 41%, 48%, 26%, respectively. However, compared with those in the non-PPDS group, those with PPDS had significantly higher ratios of Σn-6/Σn-3, C20:3n-6/C18:3n-6, and C20:4n-6/(C20:5n-3 + C22:6n-3) (by 8.2%, 79.7%, and 8.8%, respectively), whereas they had lower ratios of C22:6n-3/C22:5n-6 (by 15.5%). Higher plasma riboflavin and erythrocyte C16:1n-9, C24:1n-9, C18:3n-6, and C20:5n-3 levels and lower Σn-6 fatty acid and C22:5n-6 levels decreased the risk of PPD after type of confinement, overall mental stress scores, and postpartum care satisfaction scores were adjusted for the logistic regression analysis. In conclusion, the plasma riboflavin level and erythrocyte fatty acid composition are potentially major contributors to PPD development.
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Affiliation(s)
- Yu-Hung Lin
- Department of Obstetrics and Gynecology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan.
- School of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan.
- Department of Obstetrics and Gynecology, Taipei Medical University, Taipei 11031, Taiwan.
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei 10041, Taiwan.
| | - Chiao-Ming Chen
- Department of food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei 10462, Taiwan.
| | - Hui-Min Su
- Physiology, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
| | - Shu-Ci Mu
- School of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan.
- Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan.
| | - Mei-Ling Chang
- Department of food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei 10462, Taiwan.
| | - Pei-Yin Chu
- Department of food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei 10462, Taiwan.
| | - Sing-Chung Li
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan.
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Lin PY, Chiu TH, Ho M, Pei-Chen Chang J, Hui-Chih Chang C, Su KP. Major depressive episodes during pregnancy and after childbirth: A prospective longitudinal study in Taiwan. J Formos Med Assoc 2019; 118:1551-1559. [PMID: 30928189 DOI: 10.1016/j.jfma.2019.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/31/2018] [Accepted: 03/07/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Major depressive episodes (MDEs) are common during pregnancy and postpartum periods, and the consequences can be severe to mother and offspring. Few studies have investigated the clinical factors associated with the onset and remission of perinatal depression in different time points. METHODS A cohort of 234 pregnant women was recruited and assessed with structured Mini-International Neuropsychiatric Interview (MINI) for diagnoses of MDEs. The severity of mood status was measured with Taiwanese version of the Edinburgh Postnatal Depression Scale (EPDS-T) and the second edition of Beck Depression Inventory (BDI-II) at 16 weeks' gestation, 28 weeks' gestation and 4 weeks postpartum. Statistical analysis was conducted by independent t-tests, chi-squared, and Fisher's exact tests. RESULTS Thirty-one pregnant women (13.2%) developed MDEs; 11 (4.7%) at the 16th week, 8 (3.4%) at the 28th week of gestation, and 12 (5.1%) at the 4th week of postpartum. Among the 19 women with prenatal MDEs, 9 (47%) experienced remission by the end of pregnancy, and 10 sustained, resulting in the cumulative prevalence of 9.4% (22 out of 234) for postpartum MDEs. Women with lower levels of education, family history of psychiatric disorders, lack of postpartum recuperation, and family-bond stress were more likely to experience MDEs. More preterm birth and lower birth weights were reported in postpartum-onset than pregnancy-onset MDEs. Psychiatric interventions were associated with a higher percentage of remission of MDE during the perinatal period. CONCLUSION The findings of this study provide clinical implications for early detection and intervention of MDEs throughout the pregnancy.
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Affiliation(s)
- Pan-Yen Lin
- College of Medicine, China Medical University, Taichung, Taiwan; Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Department of Psychiatry, Wei Gong Memorial Hospital, Miao-Li, Taiwan
| | - Tsan-Hung Chiu
- Department of Obstetrics, China Medical University Hospital, Taichung, Taiwan
| | - Ming Ho
- Department of Obstetrics, China Medical University Hospital, Taichung, Taiwan
| | - Jane Pei-Chen Chang
- College of Medicine, China Medical University, Taichung, Taiwan; Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
| | - Cherry Hui-Chih Chang
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Pin Su
- College of Medicine, China Medical University, Taichung, Taiwan; Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan.
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Chang SR, Lin WA, Lin HH, Shyu MK, Lin MI. Sexual dysfunction predicts depressive symptoms during the first 2 years postpartum. Women Birth 2018; 31:e403-e411. [DOI: 10.1016/j.wombi.2018.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/12/2017] [Accepted: 01/03/2018] [Indexed: 11/16/2022]
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Lin WC, Chang SY, Chen YT, Lee HC, Chen YH. Postnatal paternal involvement and maternal emotional disturbances: The effect of maternal employment status. J Affect Disord 2017; 219:9-16. [PMID: 28501681 DOI: 10.1016/j.jad.2017.05.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/04/2017] [Accepted: 05/06/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Recently, studies have begun emphasizing paternal involvement during the perinatal period and its impact on maternal health. However, most studies have assessed maternal perception and focused on adolescents or minority groups in Western countries. Therefore, the current study investigated the association between paternal involvement and maternal postnatal depression and anxiety, along with the effects of maternal job status in the Asian society of Taiwan. METHODS This study recruited pregnant women in the first trimester of pregnancy as well as their partners on prenatal visits from July 2011 to September 2013 at four selected hospitals in metropolitan areas of Taipei, Taiwan. In total, 593 parental pairs completed the first interview and responded to the follow-up questionnaires until 6 months postpartum. Self-reported data were collected, and multiple logistic regression models were used for analyses. RESULTS Lower paternal childcare and nursing frequency was independently associated with an increased risk of maternal postpartum depression (adjusted odds ratio (OR) =4.33, 95% confidence interval (CI)=1.34-13.98), particularly among unemployed mothers. Furthermore, among unemployed mothers, the risk of postnatal anxiety was 3.14 times higher in couples with fathers spending less time with the child, compared with couples with fathers spending more time (95% CI=1.10-8.98). However, no significant findings were obtained for employed mothers. CONCLUSIONS The high prevalence of maternal postnatal emotional disturbances warrants continual consideration. Higher paternal involvement in childcare arrangements should be emphasized to aid in ameliorating these maternal emotional disturbances, particularly among unemployed mothers.
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Affiliation(s)
- Wan-Chien Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Shin-Yow Chang
- Department of Living Science, National Open University, Taipei, Taiwan
| | - Yi-Ting Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University (Doctoral Student), Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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Yim IS, Tanner Stapleton LR, Guardino CM, Hahn-Holbrook J, Dunkel Schetter C. Biological and psychosocial predictors of postpartum depression: systematic review and call for integration. Annu Rev Clin Psychol 2015; 11:99-137. [PMID: 25822344 PMCID: PMC5659274 DOI: 10.1146/annurev-clinpsy-101414-020426] [Citation(s) in RCA: 377] [Impact Index Per Article: 41.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Postpartum depression (PPD) adversely affects the health and well being of many new mothers, their infants, and their families. A comprehensive understanding of biopsychosocial precursors to PPD is needed to solidify the current evidence base for best practices in translation. We conducted a systematic review of research published from 2000 through 2013 on biological and psychosocial factors associated with PPD and postpartum depressive symptoms. Two hundred fourteen publications based on 199 investigations of 151,651 women in the first postpartum year met inclusion criteria. The biological and psychosocial literatures are largely distinct, and few studies provide integrative analyses. The strongest PPD risk predictors among biological processes are hypothalamic-pituitary-adrenal dysregulation, inflammatory processes, and genetic vulnerabilities. Among psychosocial factors, the strongest predictors are severe life events, some forms of chronic strain, relationship quality, and support from partner and mother. Fully integrated biopsychosocial investigations with large samples are needed to advance our knowledge of PPD etiology.
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Affiliation(s)
- Ilona S Yim
- Department of Psychology and Social Behavior, University of California, Irvine, California 92697;
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Deng AW, Xiong RB, Jiang TT, Luo YP, Chen WZ. Prevalence and risk factors of postpartum depression in a population-based sample of women in Tangxia Community, Guangzhou. ASIAN PAC J TROP MED 2014; 7:244-9. [DOI: 10.1016/s1995-7645(14)60030-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 01/15/2014] [Accepted: 02/15/2014] [Indexed: 11/29/2022] Open
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