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Carvalho Hilje C, Bauer NH, Reis D, Kapp C, Ostermann T, Vöhler F, Längler A. The role of breastfeeding and formula feeding regarding depressive symptoms and an impaired mother child bonding. Sci Rep 2024; 14:11417. [PMID: 38763963 PMCID: PMC11102907 DOI: 10.1038/s41598-024-62168-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024] Open
Abstract
Associations between depressive symptoms and breastfeeding are well documented. However, evidence is lacking for subdivisions of feeding styles, namely exclusive breastfeeding, exclusive formula feeding and a mixed feeding style (breastfeeding and formula feeding). In addition, studies examining associations between mother-child-bonding and breastfeeding have yielded mixed results. The aim of this study is to provide a more profound understanding of the different feeding styles and their associations with maternal mental health and mother-child-bonding. Data from 307 women were collected longitudinally in person (prenatally) and by telephone (3 months postnatally) using validated self-report measures, and analyzed using correlational analyses, unpaired group comparisons and regression analyses. Our results from a multinomial regression analysis revealed that impaired mother-child-bonding was positively associated with mixed feeding style (p = .003) and depressive symptoms prenatal were positively associated with exclusive formula feeding (p = .013). Further studies could investigate whether information about the underlying reasons we found for mixed feeding, such as insufficient weight gain of the child or the feeling that the child is unsatiated, could help prevent impaired mother-child-bonding. Overall, the results of this study have promising new implications for research and practice, regarding at-risk populations and implications for preventive measures regarding postpartum depression and an impaired mother-child-bonding.
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Affiliation(s)
- Clara Carvalho Hilje
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany
| | - Nicola H Bauer
- Institute of Midwifery Science, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Daniela Reis
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany.
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany.
| | - Claudia Kapp
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Thomas Ostermann
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Franziska Vöhler
- Department of Obstetrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
| | - Alfred Längler
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany
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Abreu GR, Zaccarelli-Magalhães J, Féba LS, Penna EY, Silva JP, Teixeira MV, Manes M, Vergara GA, Rodrigues LMA, Fukushima AR, Ricci EL, Spinosa HS. Fluoxetine alters rat's milk properties causing impact on offspring's development. Toxicol Appl Pharmacol 2024; 483:116805. [PMID: 38191078 DOI: 10.1016/j.taap.2024.116805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
Fluoxetine is an antidepressant used to treat several conditions including postpartum depression. This disease causes cognitive, emotional, behavioral and physical changes, negatively affecting the mother, child and family life. However, fluoxetine is excreted in breast milk, causing short and long-term effects on children who were exposed to the drug during lactation, so studies that seek to uncover the consequences of these effects are needed. Thus, the aim of this study was to evaluate the effects of fluoxetine on the nutritional characteristics of milk and on growth and neurobehavioral development of the offspring on a rat model. Lactating rats were divided into 4 groups: control group and three experimental groups, which were treated with different doses of fluoxetine (1, 10 and 20 mg/kg) during the lactation. Dams body weight and milk properties were measured, as well as offspring's growth and physical and neurobehavioral development. Results showed that the use of fluoxetine during lactation decreased dam's body weight and alters milk's properties, leading to a decrease in offspring's growth until adulthood. Therefore, the use of fluoxetine during lactation needs to be cautiously evaluated, with the benefits to the mothers and the associated risk to the offspring carefully balance.
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Affiliation(s)
- Gabriel R Abreu
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil.
| | - Julia Zaccarelli-Magalhães
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - Laís S Féba
- Health Science Institute, Mackenzie Presbyterian University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Emily Y Penna
- Health Science Institute, Mackenzie Presbyterian University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Julia P Silva
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - Mariana V Teixeira
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - Marianna Manes
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - Guilherme A Vergara
- Hospital Israelita Albert Einstein, Avenida Albert Einstein, 627, 05652-000 São Paulo, Brazil
| | | | - André R Fukushima
- Centro Universitário das Américas FAM, Rua Augusta, 1508, 01304-001 São Paulo, Brazil; School of Health Sciences IGESP, Rua da Consolação, 1025, 01301-000 São Paulo, Brazil
| | - Esther L Ricci
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil; Health Science Institute, Mackenzie Presbyterian University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil; School of Health Sciences IGESP, Rua da Consolação, 1025, 01301-000 São Paulo, Brazil
| | - Helenice S Spinosa
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
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Shoib S, Saleem T, Menon V, Ali SAEZ, Arafat SMY. Filicide in South Asia: Demography, risk factors, psychiatric, and legal aspects. MEDICINE, SCIENCE, AND THE LAW 2023; 63:159-167. [PMID: 36046949 DOI: 10.1177/00258024221122248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background & Objective: Filicide is an act of killing a child up to the age of 18 years committed by his or her parent(s) or parental figure(s), including guardians and stepparents. There is absence of data and research regarding filicide in South Asia. The present study aimed to address the empirical lacuna in South Asia and to expand the literature in order to broaden the understanding of filicide. Method: The search was conducted in the databases of PubMed, PubMed Central, Scopus, and Google Scholar. The original articles, quantitative studies, case studies, and full-length articles were included for the present review. Publications in only the English language, which clarified that the child was killed by parent(s) in eight South Asian countries from 2000 to 2020 were included. Results: A total of 13 reports of filicide were found in the eight South Asian countries; 12 from India and 1 from Pakistan. The most common method of filicide was by administering poisonous substances and burning by parents, depression was responsible for 7 cases of filicide, schizophrenia was responsible for one case. Conclusion: The review identified that there is a scarcity of research on filicide in South Asia. Rigorous research and investment for the compilation of data on filicide are needed to reduce it in South Asia. This may further help in the protection of lives of children as well as for taking steps for rehabilitation of parents and society.
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Affiliation(s)
- Sheikh Shoib
- Department of Psychiatry, Jawaharlal Nehru Memorial Hospital (JLNMH), India
| | - Tamkeen Saleem
- Department of Clinical Psychology, Shifa Tameer-e-millat University, Islamabad, Pakistan
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), India
| | | | - S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Bangladesh
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Zaccarelli-Magalhães J, Abreu GR, Fukushima AR, Pantaleon LP, Ribeiro BB, Munhoz C, Manes M, de Lima MA, Miglioli J, Flório JC, Lebrun I, Waziry PAF, Fonseca TL, Bocco BMLC, Bianco AC, Ricci EL, Spinosa HS. Postpartum depression in rats causes poor maternal care and neurochemical alterations on dams and long-lasting impairment in sociability on the offspring. Behav Brain Res 2023; 436:114082. [PMID: 36041571 PMCID: PMC10823501 DOI: 10.1016/j.bbr.2022.114082] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/22/2022]
Abstract
Postpartum depression is a mentally disabling disease with multifactorial etiology that affects women worldwide. It can also influence child development and lead to behavioral and cognitive alterations. Despite the high prevalence, the disease is underdiagnosed and poorly studied. To study the postpartum depression caused by maternal separation model in rats, dams were separated from their litter for 3 h daily starting from lactating day (LD) 2 through LD12. Maternal studies were conducted from LD5 to LD21 and the offspring studies from postnatal day (PND) 2 through PND90. The stress caused by the dam-offspring separation led to poor maternal care and a transient increase in anxiety in the offspring detected during infancy. The female offspring also exhibited a permanent impairment in sociability during adult life. These changes were associated with neurochemical alterations in the prefrontal cortex and hippocampus, and low TSH concentrations in the dams, and in the hypothalamus, hippocampus and striatum of the offspring. These results indicate that the postpartum depression resulted in a depressive phenotype, changes in the brain neurochemistry and in thyroid economy that remained until the end of lactation. Changes observed in the offspring were long-lasting and resemble what is observed in children of depressant mothers.
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Affiliation(s)
- Julia Zaccarelli-Magalhães
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil.
| | - Gabriel R Abreu
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - André R Fukushima
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil; School of Health Sciences IGESP, Rua da Consolação, 1025, 01301-000 São Paulo, Brazil; Centro Universitário das Américas, Rua Augusta, 1508, 01304-001 São Paulo, Brazil
| | - Lorena P Pantaleon
- Health Science Institute, Presbyterian Mackenzie University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Beatriz B Ribeiro
- Health Science Institute, Presbyterian Mackenzie University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Camila Munhoz
- Health Science Institute, Presbyterian Mackenzie University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Marianna Manes
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - Mayara A de Lima
- Centro Universitário das Américas, Rua Augusta, 1508, 01304-001 São Paulo, Brazil
| | - Júlia Miglioli
- Centro Universitário das Américas, Rua Augusta, 1508, 01304-001 São Paulo, Brazil
| | - Jorge C Flório
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - Ivo Lebrun
- Laboratory of Biochemistry and Biophysics, Butantan Institute, Avenida Vital Brazil, 1500, 05503-900 São Paulo, Brazil
| | - Paula A F Waziry
- Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, United States
| | - Tatiana L Fonseca
- Section of Endocrinology, Diabetes, and Metabolism, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, United States
| | - Bárbara M L C Bocco
- Section of Endocrinology, Diabetes, and Metabolism, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, United States
| | - Antônio C Bianco
- Section of Endocrinology, Diabetes, and Metabolism, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, United States
| | - Esther L Ricci
- School of Health Sciences IGESP, Rua da Consolação, 1025, 01301-000 São Paulo, Brazil; Health Science Institute, Presbyterian Mackenzie University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Helenice S Spinosa
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
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Wang XH, Zhou Y, Wang Q, Yan X, Huang YH. Effects of goal-oriented nursing intervention on postpartum depression. Medicine (Baltimore) 2022; 101:e30651. [PMID: 36123863 PMCID: PMC9478242 DOI: 10.1097/md.0000000000030651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This retrospective study aimed to explore the effects of goal-oriented nursing intervention (GONI) on postpartum depression (PPD). We retrospectively analyzed the medical records of 72 women with PPD. They were allocated to a treatment group (n = 36, exercise plus GONI) or a control group (n = 36, exercise). Patients in both groups received a total of 3 months of treatment. Outcomes included the 17-item Hamilton Rating Scale for Depression (HAMD-17) total score, HAMD-17 response rate (≥50% score reduction), HAMD-17 remission rate (score ≤ 7), and adverse events. Outcomes were analyzed before and after 3-month of treatment. After treatment, patients in the treatment group achieved more effective outcomes in the HADM-17 total score (P < .01), HADM-17 response rate (P < .01), HADM-17 remission rate (P < .01) than those in the control group. Regarding safety, the medical records of both the groups did not report any adverse events. The results of this study showed that GONI and exercise had more effects in patients with PPD. Further prospective studies are required to validate our findings.
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Affiliation(s)
- Xin-Hui Wang
- Department of Obstetrics, Bao Ji People’s Hospital, Bao Ji, China
| | - Yu Zhou
- Department of Nursing Care, Bao Ji People’s Hospital, Bao Ji, China
| | - Qing Wang
- Department of Obstetrics, Bao Ji People’s Hospital, Bao Ji, China
| | - Xuan Yan
- Department of Psychiatry, Bao Ji People’s Hospital, Bao Ji, China
| | - Yan-Hong Huang
- Department of Obstetrics, Bao Ji People’s Hospital, Bao Ji, China
- *Correspondence: Yan-Hong Huang, Department of Obstetrics, Bao Ji People’s Hospital, No. 24 Xinhua Lane, Jing-er Road, Bao Ji 721000, China (e-mail: )
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Shelke A, Chakole S. A Review on Risk Factors of Postpartum Depression in India and Its Management. Cureus 2022; 14:e29150. [PMID: 36258936 PMCID: PMC9573019 DOI: 10.7759/cureus.29150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 11/05/2022] Open
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Pebryatie E, Paek SC, Sherer P, Meemon N. Associations Between Spousal Relationship, Husband Involvement, and Postpartum Depression Among Postpartum Mothers in West Java, Indonesia. J Prim Care Community Health 2022; 13:21501319221088355. [PMID: 35343810 PMCID: PMC8966113 DOI: 10.1177/21501319221088355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Indonesia is actively promoting husband involvement in maternal health care, since it has been claimed to impact the wellbeing of mothers. This study aims to investigate the extent to which spousal relationship, husband involvement, and maternal health behavior affect postpartum depression among Indonesian mothers. METHOD A survey was carried out among 336 postpartum mothers who received maternal care in 27 independent midwifery clinics in 7 regions of West Java Province, Indonesia. The measurement model of husband involvement comprising 4 dimensions, namely maternity care engagement, instrumental support, emotional support, and informational support were developed and validated using confirmatory factor analysis. The Quality of Marriage Index (QMI) and the Edinburgh Postnatal Depression Scale (EPDS) were also validated and used to measure spousal relationship and postpartum depressive symptoms. A structural equation model was specified to examine the association between spousal relationship, husband involvement, maternal healthy behavior, and postpartum depression. RESULTS The study confirms the assumption that the quality of the spousal relationship could determine husband's involvement during pregnancy, childbirth, and postpartum (γ = .60, P < .001), eventually leading to better maternal healthy behavior (γ = .015, P < .001) and a decrease in postpartum depressive symptoms among mothers (γ = -.21, P < .001). CONCLUSIONS The study results suggest the needs to promote comprehensive husband involvement to enhance the wellbeing of mothers. This can be achieved through couple interventions at the community level and the inclusion of a supportive role for husbands in the maternal and childcare guidebook offered during ANC visits.
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Affiliation(s)
- Elit Pebryatie
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.,Poltekkes Kemenkes Tasikmalaya, Indonesia
| | - Seung Chun Paek
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Penchan Sherer
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Natthani Meemon
- Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
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Cozzolino M, Troiano G, Coccia ME. Spontaneous pregnancy versus assisted reproductive technologies: implications on maternal mental health. Women Health 2021; 61:303-312. [PMID: 33593227 DOI: 10.1080/03630242.2021.1881025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Postpartum depression (PPD) is a major depressive disorder that affects women during the perinatal period. Our study aimed to evaluate the onset of psychological effects in spontaneous pregnancies in contrast with pregnancies resulting from in vitro fertilization (IVF). We carried out a prospective cohort study using the Edinburgh Postnatal Depression Scale to evaluate postpartum depression. Patients were divided into 3 different groups based on their conception method: group A included spontaneous pregnancies, group B included pregnancies after homologous IVF, and group C pregnancies after heterologous IVF. The study included 245 patients. In the first year postpartum the incidence of psychological disorders was different exclusively at discharge from hospital (24.8% A vs. 38.7 B vs. 19% C) [P < .05] and one year after childbirth (13.3% A vs. 3.4% B vs. 4.8% C) [P < .05]. The multifactorial analysis showed a significant positive association between psychological distress and advanced maternal age, low parental education, nulliparity, preterm delivery and low fetal weight at birth, multiple pregnancies and multiple births, low pain threshold, and high rate of requesting analgesia intrapartum [P < .05]. Our results suggest a high correlation between PPD and pregnancies resulting from homologous IVF at the time of discharge, whereas there is a higher chance that spontaneous pregnancies develop postpartum depression one year after delivery.
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Affiliation(s)
- Mauro Cozzolino
- IVIRMA, IVI Foundation, Avenida Fernando Abril Martorell, Valencia, Spain.,Department of Obstetrics, Gynaecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA.,Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Maria Elisabetta Coccia
- Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Florence, Italy
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Factors Associated with Postnatal Depression among Mothers Attending at Bharatpur Hospital, Chitwan. DEPRESSION RESEARCH AND TREATMENT 2020; 2020:9127672. [PMID: 33029398 PMCID: PMC7528020 DOI: 10.1155/2020/9127672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/03/2020] [Accepted: 09/11/2020] [Indexed: 11/17/2022]
Abstract
Postnatal depression is linked with adverse outcomes for mothers, offspring, and her entire family, which stands as a significant public health problem and is often taken as a neglected issue of maternal and child health in the developing world. Postnatal depression is often falsely interpreted as common consequences related to the recent delivery. The main objective of this study is to find out the status of postnatal depression and the factors associated with it among the postnatal mothers attending at Bharatpur Hospital. Methodology. A total of 242 postnatal women were included in a hospital-based cross-sectional descriptive study. A systematic random sampling technique was done to get the sampling interval. Face to face interview technique was used for data collection, and depressive symptoms were measured by the Edinburgh Postnatal Depression Scale. Data was entered in Epi-Data and imported to SPSS for analysis. The data were summarized in terms of frequency (percentage), mean (SD), or median (IQR) as per necessity for descriptive analysis. The chi-square test and binary logistic regression were performed to find out the association between the covariates and depression status, assuming significance at p value <0.05. Results. The study revealed that the prevalence of postnatal depression was 16.9% by EPDS at cutoff point ≥12. It was found that postnatal depression was associated with current age, smoking, pressure to conceive a child, intent of pregnancy, and delivery-related complications. Conclusion. Postnatal depression within six months of delivery was found among nearly one-fifth of women, where 13.6% also had suicidal thoughts. More than half of the postnatal women had an early marriage. It is recommended that mothers with high risk should be routinely screened for postnatal depression followed by necessary interventions as well as safe motherhood counseling.
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Ergen AM, Yalçın SS. Unexpected drug residuals in human milk in Ankara, capital of Turkey. BMC Pregnancy Childbirth 2019; 19:348. [PMID: 31604458 PMCID: PMC6788077 DOI: 10.1186/s12884-019-2506-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 09/12/2019] [Indexed: 12/20/2022] Open
Abstract
Background Breast milk is a natural and unique nutrient for optimum growth and development of the newborn. The aim of this study was to investigate the presence of unpredictable drug residues in mothers’ milk and the relationship between drug residues and maternal-infant characteristics. Methods In a descriptive study, breastfed infants under 3 months of age and their mothers who applied for child health monitoring were enrolled for the study. Information forms were completed for maternal-infant characteristics, breastfeeding problems, crying and sleep characteristics of infants. Maternal and infant anthropometric measurements and maternal milk sample were taken. Edinburgh Postpartum Depression Scale was applied to mothers. RANDOX Infiniplex kit for milk was used for residual analysis. Results Overall, 90 volunteer mothers and their breastfed infants were taken into the study and the mean age of the mothers and their infants was 31.5 ± 4.2 years and 57.8 ± 18.1 days, respectively. Anti-inflammatory drug residues in breast milk were detected in 30.0% of mothers and all had tolfenamic acid. Overall, 94.4% had quinolone, 93.3% beta-lactam, 31.1% aminoglycoside and 13.3% polymycin residues. Drugs used during pregnancy or lactation period were not affected by the presence of residues. Edinburgh postpartum depression scores of mothers and crying and sleeping problems of infants were similar in cases with and without drug residues in breast milk. When controlling confounding factors, maternal body mass index alterations were detected to be significantly lower in mothers with anti-inflammatory drug residues in breast milk than in their counterparts (p = 0.017). Conclusions Our study suggests that there are unpredictable drug residues in the milk of many mothers. Anti-inflammatory drug exposure might affect maternal weight change during the postpartum period. Further studies are required to evaluate the impact of drug residues on maternal and infant health.
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Affiliation(s)
- Ayşe Meltem Ergen
- Department of Family Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sıddıka Songül Yalçın
- Unit of Social Pediatrics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Klampfl SM, Bosch OJ. Mom doesn't care: When increased brain CRF system activity leads to maternal neglect in rodents. Front Neuroendocrinol 2019; 53:100735. [PMID: 30684507 DOI: 10.1016/j.yfrne.2019.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/22/2018] [Accepted: 01/18/2019] [Indexed: 12/18/2022]
Abstract
Mothers are the primary caregivers in mammals, ensuring their offspring's survival. This strongly depends on the adequate expression of maternal behavior, which is the result of a concerted action of "pro-maternal" versus "anti-maternal" neuromodulators such as the oxytocin and corticotropin-releasing factor (CRF) systems, respectively. When essential peripartum adaptations fail, the CRF system has negative physiological, emotional and behavioral consequences for both mother and offspring often resulting in maternal neglect. Here, we provide an elaborate and unprecedented review on the implications of the CRF system in the maternal brain. Studies in rodents have advanced our understanding of the specific roles of brain regions such as the limbic bed nucleus of the stria terminalis, medial preoptic area and lateral septum even in a CRF receptor subtype-specific manner. Furthermore, we discuss potential interactions of the CRF system with other neurotransmitters like oxytocin and noradrenaline, and present valuable translational aspects of the recent research.
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Affiliation(s)
- Stefanie M Klampfl
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany
| | - Oliver J Bosch
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Regensburg, Germany.
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Wang L, Fu K, Li X, Kong B, Zhang B. Exposure to third-hand smoke during pregnancy may increase the risk of postpartum depression in China. Tob Induc Dis 2018; 16:17. [PMID: 31516417 PMCID: PMC6659510 DOI: 10.18332/tid/87141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Our aim was to investigate the association between third-hand smoke exposure (THS) during pregnancy and postpartum depression (PPD) among Chinese women. METHODS A total of 973 participants that completed the questionnaire and reviews were included in this cross-sectional study. The THS exposure was assessed based on a questionnaire with key questions from the Global Adult Tobacco Survey (2nd edition) while postpartum depression status was assessed using the Edinburgh Postnatal Depression Scale. Logistic regression models were used to estimate the association between THS exposure during pregnancy and risk of PPD, after adjustment for potential confounders. RESULTS The prevalence of postpartum depression among all participants was 17.8%. Of the 973 participants, 725 (74.5%) were exposed to THS during pregnancy while 248 (25.5%) were not. Compared with those who were never exposed to passive smoking, puerperal women who were exposed to THS were at higher risk of PPD (OR=1.71, 95% CI: 1.12-2.60) in the logistic regression model. CONCLUSIONS Our study suggests that exposure to third-hand smoke may be a risk factor for postpartum depression among Chinese women. Future preventive interventions should include strategies that target the puerperal women who are exposed to THS during pregnancy. Tobacco control measures that are effective in reducing the prevalence of smoking may have little effect in reducing women's exposure to THS during pregnancy, especially in private places that urgently need other public health strategies.
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Affiliation(s)
- Li Wang
- Liaocheng People's Hospital, Medical College of Liaocheng University, Liaocheng, China
| | - Ke Fu
- Department of Gynecology and Obstetrics, Liaocheng NO.4 People's Hospital, Liaocheng, China
| | - Xuri Li
- Department of Gynecology and Obstetrics, Qingdao Hiser Medical Group, Qingdao, China
| | - Beihua Kong
- Shandong University, Qilu Hospital, Jinan, China
| | - Bin Zhang
- Liaocheng People's Hospital, Liaocheng, China
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Landess J, Friedman SH. A 28-Year-Old New Mother with Insomnia and Anxiety. Psychiatr Ann 2018. [DOI: 10.3928/00485713-20180103-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Obstetric risk factors for depression during the postpartum period in South Korea: a nationwide study. J Psychosom Res 2017; 102:15-20. [PMID: 28992892 DOI: 10.1016/j.jpsychores.2017.09.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/28/2017] [Accepted: 09/01/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Postpartum depression is related to many adverse effects in both mothers and their children; therefore, proper screening and early interventions are needed. This study aims to identify the risk factors of postpartum depression. Our primary focus is on obstetric risk factors. METHODS This study is a cross-sectional study which we extracted the data of women who gave birth between January 1st, 2010 and December 31st, 2012 from the Health Insurance Review and Assessment service (HIRA) database. We analyzed the data using multivariable logistic regression models. RESULTS A total of 17,483 (1.4%) women suffered from depression during the postpartum period. Younger (<20years) and advanced maternal age (≥35years), primiparity, previous depression, peripartum hysterectomy, uterine artery embolization, preterm delivery, placental abruption, cesarean delivery, induced labor, and preeclampsia were found to increase the likelihood of having depression after delivery. CONCLUSIONS Our findings suggest that there are several risk factors that lead women to postpartum depression. Therefore, early detection and well-management of the symptoms and risk factors for postpartum depression along with social support can help both physical and psychological conditions of women after childbirth.
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Torres R, Goyal D, Burke-Aaronson AC, Gay CL, Lee KA. Patterns of Symptoms of Perinatal Depression and Stress in Late Adolescent and Young Adult Mothers. J Obstet Gynecol Neonatal Nurs 2017; 46:814-823. [PMID: 28888919 DOI: 10.1016/j.jogn.2017.08.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To compare symptoms of depression, maternal adjustment, and perceived stress in late adolescent and young adult mothers and to examine the patterns of these symptoms during the first 3 months after birth. DESIGN Secondary analysis of existing longitudinal data. SETTING San Francisco Bay Area, with participants in their home environments. PARTICIPANTS Ethnically diverse women expecting their first infants recruited during the third trimester from childbirth education classes and antenatal clinics. The final sample included 34 participants in the late adolescent group (18-20 years) and 48 participants in the young adult group (21-24 years). METHODS The Center for Epidemiologic Studies Depression Scale was used to assess depression symptoms, the Maternal Adjustment and Maternal Attitudes Scale was used to assess maternal adjustment, and the 10-item Perceived Stress Scale was used to assess perceived stress. Repeated-measures analyses of variance were used to examine changes over time in depression, maternal adjustment, and perceived stress scores. RESULTS Compared with young adult participants, late adolescent participants had greater mean depression scores (F(1, 61) = 8.02, p = .006) and perceived stress scores (F(1, 62) = 9.45, p = .003) at all time points. Scores for maternal adjustment could not be compared because of the low internal validity of the instrument. CONCLUSION Our results indicated that late adolescent mothers may have more symptoms of depression and stress in late pregnancy and the early postpartum period than young adult mothers. Clinicians in maternity and pediatric settings should be vigilant in screening for depression and stress in this vulnerable population during their transitions to motherhood.
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Xu H, Ding Y, Ma Y, Xin X, Zhang D. Cesarean section and risk of postpartum depression: A meta-analysis. J Psychosom Res 2017; 97:118-126. [PMID: 28606491 DOI: 10.1016/j.jpsychores.2017.04.016] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/22/2017] [Accepted: 04/22/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The association of cesarean section (CS) with the risk of postpartum depression (PPD) remains controversial. Therefore, we conducted a meta-analysis to explore the association between CS and the risk of PPD. METHODS A systematic literature search was performed in PubMed, Web of Science and Embase databases for relevant articles up to November 2016. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with fixed-effects model or random-effects model. RESULTS A total of 28 studies from 27 articles involving 532,630 participants were included in this meta-analysis. The pooled OR of the association between CS and PPD risk was 1.26 (95% CI: 1.16-1.36). In subgroup analyses stratified by study design [cohort studies: (1.25, 95% CI: 1.10-1.41); case-control studies: (1.25, 95% CI: 1.00-1.56); cross-sectional studies: (1.44, 95% CI: 1.14-1.82)] and adjustment status of complications during pregnancy [adjusted for: (1.29, 95% CI: 1.12-1.48); not-adjusted for: (1.24, 95% CI: 1.13-1.36)], the above-mentioned associations remained consistent. The pooled ORs of PPD were 1.15 (95% CI: 0.92-1.43) for elective cesarean section (ElCS) and 1.47 (95% CI: 1.33-1.62) for emergency cesarean section (EmCS). CONCLUSION This meta-analysis suggests that CS and EmCS increase the risk of PPD. Further evidence is needed to explore the associations between the specific types of CS and the risk of PPD.
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Affiliation(s)
- Hui Xu
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Yu Ding
- Department of Reproduction, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Yue Ma
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Xueling Xin
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
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Chronic stress prior to pregnancy potentiated long-lasting postpartum depressive-like behavior, regulated by Akt-mTOR signaling in the hippocampus. Sci Rep 2016; 6:35042. [PMID: 27756905 PMCID: PMC5069466 DOI: 10.1038/srep35042] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 09/19/2016] [Indexed: 12/14/2022] Open
Abstract
Postpartum depression (PPD) affects over 10% of new mothers and adversely impacts the health of offspring. One of the greatest risk factors for PPD is prepregnancy stress but the underlying biological mechanism is unknown. Here we constructed an animal model which recapitulated prepregnancy stress induced PPD and tested the role of Akt-mTOR signaling in the hippocampus. Female virgin Balb/c mice received chronic restraint stress, followed by co-housing with a normal male mouse. We found that the chronic stress led to a transient depressive-like condition that disappeared within two weeks. However, prepregnantly stressed females developed long-term postpartum depressive-like (PPD-like) symptoms as indicated by deficient performance in tests of sucrose preference, forced swim, and novelty-suppressed feeding. Chronic stress induced transient decrease in Akt-mTOR signaling and altered expressions of glutamate receptor subunits NR1 and GluR1, in contrast to long-term deficits in Akt-mTOR signaling, GluR1/NR1 ratio, and hippocampal neurogenesis in PPD-like mice. Acute ketamine improved the molecular signaling abnormality, and reversed the behavioral deficits in PPD-like mice in a rapid and persistent manner, in contrast to ineffectiveness by chronic fluoxetine treatment. Taken together, we find that chronic prepregnancy stress potentiates a long-term PPD, in which Akt-mTOR signaling may play a crucial role.
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Klampfl SM, Brunton PJ, Bayerl DS, Bosch OJ. CRF-R1 activation in the anterior-dorsal BNST induces maternal neglect in lactating rats via an HPA axis-independent central mechanism. Psychoneuroendocrinology 2016; 64:89-98. [PMID: 26630389 PMCID: PMC4712652 DOI: 10.1016/j.psyneuen.2015.11.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 11/15/2015] [Accepted: 11/16/2015] [Indexed: 01/09/2023]
Abstract
Adequate maternal behavior in rats requires minimal corticotropin-releasing factor receptor (CRF-R) activation in the medial-posterior bed nucleus of the stria terminalis (mpBNST). Based on the architectural heterogeneity of the BNST and its distinct inter-neural connectivity, we tested whether CRF-R manipulation in another functional part, the anterior-dorsal BNST (adBNST), differentially modulates maternal behavior. We demonstrate that in the adBNST, activation of CRF-R1 reduced arched back nursing (ABN) and nursing, whereas activation of CRF-R2 resulted in an initial reduction in nursing but significantly increased the incidence of ABN 5h after the treatment. Following stressor exposure, which is detrimental to maternal care, ABN tended to be protected by CRF-R1 blockade. Maternal motivation, maternal aggression, and anxiety were unaffected by any manipulation. Furthermore, under basal and stress conditions, activation of adBNST CRF-R1 increased plasma ACTH and corticosterone concentrations, whereas stimulation of adBNST CRF-R2 increased basal plasma ACTH and corticosterone concentrations, but blocked the stress-induced increase in plasma corticosterone secretion. Moreover, both the CRF-R1 and -R2 antagonists prevented the stress-induced increase in plasma corticosterone secretion. Importantly, elevated levels of circulating corticosterone induced by intra-adBNST administration of CRF-R1 or -R2 agonist did not impact maternal care. Finally, Crf mRNA expression in the adBNST was increased during lactation; however, Crfr1 mRNA expression was similar between lactating and virgin rats. In conclusion, maternal care is impaired by adBNST CRF-R1 activation, and this appears to be the result of a central action, rather than an effect of elevated circulating levels of CORT. These data provide new insights into potential causes of disturbed maternal behavior postpartum.
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Affiliation(s)
- Stefanie M. Klampfl
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, 93053 Regensburg, Germany
| | - Paula J. Brunton
- Division of Neurobiology, The Roslin Institute and R(D)SVS, University of Edinburgh, Midlothian EH25 9RG, UK
| | - Doris S. Bayerl
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, 93053 Regensburg, Germany
| | - Oliver J. Bosch
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, 93053 Regensburg, Germany,Corresponding author. Fax: +49 941 9433052.
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Gressier F, Letranchant A, Cazas O, Sutter-Dallay A, Falissard B, Hardy P. Post-partum depressive symptoms and medically assisted conception: a systematic review and meta-analysis. Hum Reprod 2015; 30:2575-86. [DOI: 10.1093/humrep/dev207] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 07/31/2015] [Indexed: 11/13/2022] Open
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Lonstein JS, Lévy F, Fleming AS. Common and divergent psychobiological mechanisms underlying maternal behaviors in non-human and human mammals. Horm Behav 2015; 73:156-85. [PMID: 26122301 PMCID: PMC4546863 DOI: 10.1016/j.yhbeh.2015.06.011] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
Abstract
Maternal interactions with young occupy most of the reproductive period for female mammals and are absolutely essential for offspring survival and development. The hormonal, sensory, reward-related, emotional, cognitive and neurobiological regulators of maternal caregiving behaviors have been well studied in numerous subprimate mammalian species, and some of the importance of this body of work is thought to be its relevance for understanding similar controls in humans. We here review many of the important biopsychological influences on maternal behaviors in the two best studied non-human animals, laboratory rats and sheep, and directly examine how the conceptual framework established by some of the major discoveries in these animal "models" do or do not hold for our understanding of human mothering. We also explore some of the limits for extrapolating from non-human animals to humans. We conclude that there are many similarities between non-human and human mothers in the biological and psychological factors influencing their early maternal behavior and that many of the differences are due to species-characteristic features related to the role of hormones, the relative importance of each sensory system, flexibility in what behaviors are exhibited, the presence or absence of language, and the complexity of cortical function influencing caregiving behaviors.
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Affiliation(s)
- Joseph S Lonstein
- Neuroscience Program, 108 Giltner Hall, Michigan State University, East Lansing, MI 48824, USA; Department of Psychology, 108 Giltner Hall, Michigan State University, East Lansing, MI 48824, USA.
| | - Frédéric Lévy
- Physiologie de la Reproduction et des Comportements, INRA-CNRS-Université de Tours IFCE, Nouzilly 37380, France.
| | - Alison S Fleming
- Fraser Mustard Institute for Human Development, University of Toronto, Toronto, Ontario, Canada; Department of Psychology, University of Toronto at Mississauga, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada.
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22
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The Trajectories and Predictors of Maternal Post Natal Depressive Symptoms in a High Risk Group, Based on Latent Growth Modeling. ADONGHAKOEJI 2015. [DOI: 10.5723/kjcs.2015.36.3.77] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Chu XX, Dominic Rizak J, Yang SC, Wang JH, Ma YY, Hu XT. A natural model of behavioral depression in postpartum adult female cynomolgus monkeys (Macaca fascicularis). DONG WU XUE YAN JIU = ZOOLOGICAL RESEARCH 2014; 35:174-81. [PMID: 24866487 DOI: 10.11813/j.issn.0254-5853.2014.3.174] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Postpartum depression (PPD) is a modified form of major depressive disorders (MDD) that can exert profound negative effects on both mothers and infants than MDD. Within the postpartum period, both mothers and infants are susceptible; but because PPD typically occurs for short durations and has moderate symptoms, there exists challenges in exploring and addressing the underlying cause of the depression. This fact highlights the need for relevant animal models. In the present study, postpartum adult female cynomolgus monkeys (Macaca fascicularis) living in breeding groups were observed for typical depressive behavior. The huddle posture behavior was utilized as an indicator of behavioral depression postpartum (BDP) as it has been established as the core depressive-like behavior in primates. Monkeys were divided into two groups: A BDP group (n=6), which were found to spend more time huddling over the first two weeks postpartum than other individuals that formed a non-depression control group (n=4). The two groups were then further analyzed for locomotive activity, stressful events, hair cortisol levels and for maternal interactive behaviors. No differences were found between the BDP and control groups in locomotive activity, in the frequencies of stressful events experienced and in hair cortisol levels. These findings suggested that the postpartum depression witnessed in the monkeys was not related to external factors other than puerperium period. Interestingly, the BDP monkeys displayed an abnormal maternal relationship consisting of increased infant grooming. Taken together, these findings suggest that the adult female cynomolgus monkeys provide a natural model of behavioral postpartum depression that holds a number of advantages over commonly used rodent systems in PPD modeling. The cynomolgus monkeys have a highly-organized social hierarchy and reproductive characteristics without seasonal restriction-similar to humans-as well as much greater homology to humans than rodents. As such, this model may provide a greater translational efficiency and research platform for systematically investigating the etiology, treatment, prevention of PPD.
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Affiliation(s)
- Xun-Xun Chu
- Laboratory of Primate Neuroscience Research and Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming 650223, China;University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Joshua Dominic Rizak
- Laboratory of Primate Neuroscience Research and Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming 650223, China; University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Shang-Chuan Yang
- Laboratory of Primate Neuroscience Research and Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming 650223, China
| | - Jian-Hong Wang
- Laboratory of Primate Neuroscience Research and Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming 650223, China; Kunming Primate Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China
| | - Yuan-Ye Ma
- Laboratory of Primate Neuroscience Research and Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming 650223, China; Kunming Primate Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China.
| | - Xin-Tian Hu
- Laboratory of Primate Neuroscience Research and Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming 650223, China; Kunming Primate Research Center, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China.
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Bobo WV, Wollan P, Lewis G, Bertram S, Kurland MJ, Vore K, Yawn BP. Depressive symptoms and access to mental health care in women screened for postpartum depression who lose health insurance coverage after delivery: findings from the Translating Research into Practice for Postpartum Depression (TRIPPD) effectiveness study. Mayo Clin Proc 2014; 89:1220-8. [PMID: 25091871 DOI: 10.1016/j.mayocp.2014.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 04/16/2014] [Accepted: 05/08/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the impact of losing health insurance coverage on perceived need for and access to mental health care in women screened for postpartum depression (PPD) in primary care settings. PATIENTS AND METHODS The study sample included 2343 women enrolled in a 12-month, multisite, randomized trial that compared clinical outcomes of a comprehensive PPD screening and management program with usual care (March 1, 2006, through August 31, 2010). Screening for PPD occurred at the first postpartum visit (5-12 weeks) using the Edinburgh Postnatal Depression Scale followed by the 9-item Patient Health Questionnaire. Insurance status during the prenatal period, at delivery, and during the first postpartum year and perceived need for and access to mental health care during the first postpartum year were assessed via questionnaires completed by individual patients and participating practices. RESULTS Rates of uninsured increased from 3.8% during pregnancy and delivery (n=87 of 2317) to 10.8% at the first postpartum visit (n=253 of 2343) and 13.7% at any subsequent visit to the practice after 2 months post partum (n=226 of 1646) (P<.001, both comparisons vs baseline). For patients with data on insurance type during follow-up, insurance loss occurred primarily in Medicaid beneficiaries. Nine-item Patient Health Questionnaire scores and self-reported need for mental health care did not differ significantly between patients who remained insured and those who lost insurance during the first postpartum year. However, of patients who reported the need for mental health care, 61.1% of the uninsured (n=66 of 108) vs 27.1% of the insured (n=49 of 181) reported an inability to obtain mental health care (P<.001). CONCLUSION Loss of insurance during the first postpartum year did not significantly affect depressive symptoms or perceived need for mental health care but did adversely affect self-reported ability to obtain mental health care.
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Affiliation(s)
- William V Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Peter Wollan
- Department of Research, Olmsted Medical Center, Rochester, MN
| | - Greg Lewis
- Family Medicine Residency, St Joseph's Hospital, Maricopa County Clinic, Phoenix, AZ
| | - Susan Bertram
- Department of Research, Olmsted Medical Center, Rochester, MN
| | | | | | - Barbara P Yawn
- Department of Research, Olmsted Medical Center, Rochester, MN.
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Perani CV, Slattery DA. Using animal models to study post-partum psychiatric disorders. Br J Pharmacol 2014; 171:4539-55. [PMID: 24527704 DOI: 10.1111/bph.12640] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 01/09/2014] [Accepted: 01/31/2014] [Indexed: 12/24/2022] Open
Abstract
The post-partum period represents a time during which all maternal organisms undergo substantial plasticity in a wide variety of systems in order to ensure the well-being of the offspring. Although this time is generally associated with increased calmness and decreased stress responses, for a substantial subset of mothers, this period represents a time of particular risk for the onset of psychiatric disorders. Thus, post-partum anxiety, depression and, to a lesser extent, psychosis may develop, and not only affect the well-being of the mother but also place at risk the long-term health of the infant. Although the risk factors for these disorders, as well as normal peripartum-associated adaptations, are well known, the underlying aetiology of post-partum psychiatric disorders remains poorly understood. However, there have been a number of attempts to model these disorders in basic research, which aim to reveal their underlying mechanisms. In the following review, we first discuss known peripartum adaptations and then describe post-partum mood and anxiety disorders, including their risk factors, prevalence and symptoms. Thereafter, we discuss the animal models that have been designed in order to study them and what they have revealed about their aetiology to date. Overall, these studies show that it is feasible to study such complex disorders in animal models, but that more needs to be done in order to increase our knowledge of these severe and debilitating mood and anxiety disorders.
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Affiliation(s)
- C V Perani
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, Regensburg, Germany
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Avni-Barron O, Hoagland K, Ford C, Miller LJ. Preconception planning to reduce the risk of perinatal depression and anxiety disorders. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/eog.10.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hatters Friedman S, Kessler A, Nagle Yang S, Parsons S, Friedman H, Martin RJ. Delivering perinatal psychiatric services in the neonatal intensive care unit. Acta Paediatr 2013; 102:e392-7. [PMID: 23772977 DOI: 10.1111/apa.12323] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 06/10/2013] [Accepted: 06/12/2013] [Indexed: 11/27/2022]
Abstract
AIM To describe characteristics of mothers who would likely benefit from on-site short-term psychiatric services while their infant is in the neonatal intensive care unit (NICU). METHODS For 150 consecutive mothers who were referred for psychiatric evaluation and psychotherapeutic intervention in an innovative NICU mental health programme, baseline information was collected. Data regarding their referrals, diagnosis, treatments and infants were analysed. RESULTS Most mothers were referred because of depression (43%), anxiety (44%) and/or difficulty coping with their infant's medical problems and hospitalization (60%). Mothers of VLBW infants were disproportionately more likely to be referred. A majority of mothers accepted the referral and were treated; most only required short-term psychotherapy. A minority resisted or refused psychiatric assessment; a quarter of these had more difficult interactions with staff or inappropriate behaviours. In these cases, the role of the psychiatrist was to work with staff to promote healthy interactions and to foster maternal-infant bonding. CONCLUSION Overall, on-site psychiatric services have been accepted by a majority of referred NICU mothers, and most did not require long-term treatment. A considerable need exists for psychiatric services in the NICU to promote optimal parenting and interactions.
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Affiliation(s)
- Susan Hatters Friedman
- Departments of Psychiatry and Pediatrics; Case Western Reserve University/University Hospitals of Cleveland; Cleveland OH USA
| | - Ann Kessler
- Departments of Pediatrics; Case Western Reserve University/University Hospitals of Cleveland; Cleveland OH USA
| | - Sarah Nagle Yang
- Departments of Psychiatry; Case Western Reserve University/University Hospitals of Cleveland; Cleveland OH USA
| | - Sarah Parsons
- Departments of Psychiatry; Case Western Reserve University/University Hospitals of Cleveland; Cleveland OH USA
| | - Harriet Friedman
- Departments of Pediatrics; Case Western Reserve University/University Hospitals of Cleveland; Cleveland OH USA
| | - Richard J. Martin
- Departments of Pediatrics; Case Western Reserve University/University Hospitals of Cleveland; Cleveland OH USA
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Friedman SH, Cavney J, Resnick PJ. Mothers who kill: evolutionary underpinnings and infanticide law. BEHAVIORAL SCIENCES & THE LAW 2012; 30:585-597. [PMID: 22961624 DOI: 10.1002/bsl.2034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 07/07/2012] [Accepted: 07/26/2012] [Indexed: 06/01/2023]
Abstract
Women who kill their children present a profound challenge to accepted notions of motherhood and the protection offered by mothers to their children. Historically, societies have varied in the sanctions applied to perpetrators of such acts, across both time and place. Where penalties were once severe and punitive for mothers, in modern times some two dozen nations now have infanticide acts that reduce the penalties for mothers who kill their infants. Embedded within these acts are key criteria that relate (a) only to women who are (b) suffering the hormonal or mood effects of pregnancy/lactation at the time of the offence which is (c) usually restricted to within the first year after delivery. Criticisms of infanticide legislation have largely centered on inherent gender bias, misconceptions about the hormonal basis of postpartum psychiatric disorders, and the nexus and contribution of these disorders to the offending in relation to issues of culpability and sentencing. Important differences between female perpetrators relative to the age of the child victim have also highlighted problems in the implementation of infanticide legislation. For example, women who commit neonaticide (murder during the first day of life) differ substantially from mentally ill mothers who kill older children. However, despite these shortcomings, many nations have in recent years chosen to retain their infanticide acts. This article reviews the central controversies of infanticide legislation in relation to current research and fundamental fairness. Using evolutionary psychology as a theoretical framework to organize this discussion, it is argued that infanticide legislation is at best unnecessary and at worst misapplied, in that it exculpates criminal intent and fails to serve those for whom an infanticide defense might otherwise have been intended.
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Affiliation(s)
- Susan Hatters Friedman
- Case Western Reserve University School of Medicine, Connections, Beachwood, OH 44122, USA.
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Barrett J, Wonch KE, Gonzalez A, Ali N, Steiner M, Hall GB, Fleming AS. Maternal affect and quality of parenting experiences are related to amygdala response to infant faces. Soc Neurosci 2012; 7:252-68. [DOI: 10.1080/17470919.2011.609907] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Kuo SY, Yang YL, Kuo PC, Tseng CM, Tzeng YL. Trajectories of depressive symptoms and fatigue among postpartum women. J Obstet Gynecol Neonatal Nurs 2012; 41:216-226. [PMID: 22375929 DOI: 10.1111/j.1552-6909.2011.01331.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To identify and characterize the trajectories of depressive and fatigue symptoms and determine the relationship between these two trajectories and associated predictors. DESIGN A prospective, follow-up study. SETTING A teaching medical center in central Taiwan. PARTICIPANTS A convenience sample of 121 low-risk, childbearing women. METHODS Depressive and fatigue symptoms were assessed using the Edinburgh Postnatal Depression Scale and Fatigue Continuum Form respectively during the third trimester (time 1), one day postpartum (time 2), three days postpartum (time 3), and one week postpartum (time 4). Participants also completed structured questionnaires on demographic features, health status, and sleep quality. RESULTS The mean age of participants was 31.2 years. We observed four distinctive trajectories of depressive symptoms and three trajectories of fatigue using group-based trajectory modeling. A frequent conoccurrence of similar levels of these symptoms was found; that is, mothers in the high-risk depressive symptoms group were most likely to fall into the high-risk group for fatigue. Joint trajectories were predicted by poor sleep score (odds ratio = 2.96, 95% confidence interval = 1.2, 7.3) using multinomial logistic regression analysis. CONCLUSION Overlapping but distinct trajectories of depressive symptoms and fatigue were found. These results suggest that differentiation between depressive symptoms and fatigue is possible and important for improving care during the early postpartum period.
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Affiliation(s)
- Shu-Yu Kuo
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan, R.O.C
| | - Ya-Ling Yang
- School of Nursing, College of Medicine, National Taiwan University and an adjunct supervisor in the Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan, R.O.C
| | - Pi-Chao Kuo
- College of Nursing, Chung Shan Medical University and a research advisor in the Nursing Department, Chung Shan Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chi-Meng Tseng
- Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Ya-Ling Tzeng
- School of Nursing, China Medical University and an adjunct supervisor in the Department of Nursing, China Medical University Hospital, Taichung, Taiwan, R.O.C..
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Hillerer KM, Neumann ID, Slattery DA. From stress to postpartum mood and anxiety disorders: how chronic peripartum stress can impair maternal adaptations. Neuroendocrinology 2012; 95:22-38. [PMID: 22042058 DOI: 10.1159/000330445] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 06/25/2011] [Indexed: 12/16/2022]
Abstract
The peripartum period, in all mammalian species, is characterised by numerous adaptations at neuroendocrine, molecular and behavioural levels that prepare the female for the challenges of motherhood. These changes have been well characterised and, while they are necessary to ensure the survival and nurturance of the offspring, there is growing belief that they are also required for maternal mental health. Thus, while increased calmness and attenuated stress responsivity are common characteristics of the peripartum period, it also represents a time of increased susceptibility to mood disorders. While a number of risk factors for these disorders are known, their underlying aetiology remains poorly understood, due at least in part to a lack of appropriate animal models. One translatable risk factor is stress exposure during the peripartum period. In the following review we first describe common peripartum adaptations and the impact postpartum mood disorders have on these. We then discuss the known consequences of peripartum stress exposure on such maternal adaptations that have been described in basic research.
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Affiliation(s)
- Katharina M Hillerer
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, Regensburg, Germany
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Hillerer KM, Reber SO, Neumann ID, Slattery DA. Exposure to chronic pregnancy stress reverses peripartum-associated adaptations: implications for postpartum anxiety and mood disorders. Endocrinology 2011; 152:3930-40. [PMID: 21846798 DOI: 10.1210/en.2011-1091] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Maternal adaptations, such as decreased anxiety and attenuated stress responsiveness, are necessary to enable successful postnatal development of the offspring. However, there is growing evidence that they are also required to protect the mental health of the mother and that exposure to chronic stress during pregnancy may prevent such adaptations. Overcrowding stress (24 h) and restraint stress (2 × 1 h) were employed on alternate days between pregnancy d 4-16 to examine the impact of chronic pregnancy stress on relevant behavioral, neuroendocrine, and neuronal peripartum adaptations. To determine whether the chronic stress-induced alterations were specific to the peripartum period, we included virgins as controls. Validating the stress procedure, we demonstrated decreased body-weight gain and increased adrenal weight in stressed dams, relative to their nonstressed controls. Chronic stress prevented a number of peripartum adaptations, including basal plasma hypercorticosterone levels, increased oxytocin mRNA expression in the hypothalamic paraventricular nucleus, and anxiolysis. However, chronic stress did not prevent the peripartum-associated decrease in CRH mRNA expression or attenuate corticosterone response to an acute stressor, nor did it affect hypothalamic vasopressin mRNA expression. Illustrating the specificity of these stress-induced changes to the peripartum period, none of these parameters were affected in stressed virgins. Although chronic stress did not alter depression-related behavior, it reversed the response to acute imipramine treatment and increased active maternal behavior in lactation. Thus, prevention of the peripartum-associated increases in basal corticosterone and oxytocin system activity by pregnancy stress reveal two alterations that may increase the risk of postpartum psychiatric disorders, particularly anxiety.
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Affiliation(s)
- Katharina M Hillerer
- Dept. of Behavioral and Molecular Neurobiology, University of Regensburg, 93053 Regensburg, Germany
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The Survivor Moms’ Companion: Feasibility, Safety, and Acceptability of a Posttraumatic Stress Specific Psychoeducation Program for Pregnant Survivors of Childhood Maltreatment and Sexual Trauma. INTERNATIONAL JOURNAL OF CHILDBIRTH 2011. [DOI: 10.1891/2156-5287.1.2.122] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pregnant women with history of abuse and posttraumatic stress disorder (PTSD) have increased risk of adverse mental health and childbearing outcomes. The Survivor Moms’ Companion (SMC) is a psychoeducation program designed to meet the needs of women abuse survivors affected by PTSD during the childbearing year. This article reports on the feasibility, safety, and acceptability findings of an open pilot. Participants completed 10 self-study modules and structured tutoring sessions, and completed self-report measures, including reports of tutor fidelity to the manual, repeated assessment of PTSD symptoms, Subjective Units of Disturbance (SUD) scores, and evaluation interviews. Results indicate that the intervention can be implemented within low-resource settings with high level of fidelity to the manual. Monitoring of PTSD symptom level and distress indicate that the intervention is safe. Participants report satisfaction with the format and content and appreciation for the tutoring component. The SMC appears to be feasible, safe, and acceptable.
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Gossler SM. Use of complementary and alternative therapies during pregnancy, postpartum, and lactation. J Psychosoc Nurs Ment Health Serv 2010; 48:30-6. [PMID: 21053788 DOI: 10.3928/02793695-20100930-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 08/30/2010] [Indexed: 01/24/2023]
Abstract
The use of complementary and alternative therapies for depression is an issue of growing interest for practitioners who care for women. Postpartum depression is a serious and debilitating illness that affects many women, their infants, and families. Often, women do not report feelings of sadness or depression to their health care providers due to stigma. Some women have multiple concerns in using prescription drugs, especially if they are breastfeeding their infants. In addition, more women are educating themselves about the potential side and adverse effects of prescriptions drugs and are exploring complementary and alternative therapies. With the availability of information from multiple sources, whether accurate or not, women may be using these therapies inappropriately. Two major concerns in using complementary and alternative therapies are the purity and safety of the herbs and herbal formulations and the potential lack of communication between the client and health care provider.
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Affiliation(s)
- Sandra M Gossler
- University of Tennessee, College of Nursing, Knoxville, Tennessee 37996-4180, USA.
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Pires GN, Andersen ML, Giovenardi M, Tufik S. Sleep impairment during pregnancy: possible implications on mother-infant relationship. Med Hypotheses 2010; 75:578-82. [PMID: 20800370 DOI: 10.1016/j.mehy.2010.07.036] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 07/19/2010] [Indexed: 11/25/2022]
Abstract
The modern living standard has imposed upon society a situation of chronic sleep deprivation. This chronic loss of sleep affects women more than it does men. As a result, the postponement of pregnancy has become a common choice due to the priority given to social and domestic activities. For women, pregnancy represents a condition of intense physical and physiological changes that subject the pregnant woman to a number of potentially stressful situations, ultimately interfering with their quality of sleep. Chronic sleep deprivation, along with the changes imposed on women through pregnancy, can lead to several harmful consequences for the pregnant woman and the child, and can potentially undermine the mother-infant relationship. This article discusses circumstances under which sleep deprivation and poor sleep quality during pregnancy could result in damage to the mother-infant relationship, specifically through maternal fatigue, postpartum depression and changes in pregnancy-related hormonal secretions and activity.
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Affiliation(s)
- Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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Ross LE, McQueen K, Vigod S, Dennis CL. Risk for postpartum depression associated with assisted reproductive technologies and multiple births: a systematic review. Hum Reprod Update 2010; 17:96-106. [DOI: 10.1093/humupd/dmq025] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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