Maternal age and number of children are risk factors for depressive disorders in non-perinatal women of reproductive age

Mental Health in Obstetric Patients and Providers During the COVID-19 Pandemic

Psychiatric morbidity is the most common childbirth complication with 1 in 5 women experiencing a perinatal mood or anxiety disorder. The cost of this psychiatric morbidity is pervasive, contributing to devastating maternal health, child developmental, and economic consequences. The coronavirus disease 2019 (COVID-19) pandemic, and associated changes to perinatal experiences, resulted in profound psychological reactions including increased anxiety, depression, stress disorders, and sleep disturbance, further impacting obstetric patients. Providers' mental health has been challenged by moral injury and shared trauma. This article reviews mental health outcomes in regard to the COVID-19 pandemic for obstetric patients and their providers.

Fertility history and use of antidepressant medication in late mid-life: a register-based analysis of Norwegian women and men

OBJECTIVES

Life course influences on later life depression may include parenting trajectories. We investigate associations between number and timing of births and use of antidepressant medication in late mid-life using data on the whole Norwegian population.

METHODS

We estimated logistic regression models to analyse variations in the purchase of antidepressants between 2004 and 2008 by timing of births and number of children among women and men aged 45-73, using Norwegian population register data. We controlled for age, education, marital and partnership status, and (in some models) family background shared among siblings.

RESULTS

Mothers and fathers of two or more children were generally less likely to purchase antidepressants than the childless. Mothers who started childbearing before age 22 were an exception, although according to sibling models they were not more likely to purchase antidepressants. All models showed that women who became mothers before age 26 and had only one child had higher odds of medication purchase than the childless. Older age at first birth was generally associated with lower risks of antidepressant purchase.

CONCLUSION

This analysis of high-quality data for a national population indicates that early motherhood, childlessness and low parity are associated with higher usage of antidepressants in late mid-life. Our data did not allow identification of mediating pathways, and we lacked information on early mental and physical health and some other potentially important confounders not shared between siblings. Furthermore purchase of antidepressants is not a perfect indicator of depression. Those concerns aside, the results suggest complex effects of fertility on depression that merit further investigation.

Mental disorders in pregnancy and 5-8 years after delivery

BACKGROUND

Even though mental disorders represent a major public health problem for women and respective children, there remains a lack of epidemiological longitudinal studies to assess the psychological status of women throughout pregnancy and later in life. This epidemiological cohort study assessed the relationship between mental disorders of 409 Brazilian women in pregnancy and 5-8 years after delivery.

METHODS

The women were followed from 1997 to 2000 at 17 health services, and subsequently from 2004 to 2006 at their homes. Mental disorders were investigated by the Perceived Stress Scale-PSS, General Health Questionnaire-GHQ and State-Trait Anxiety Inventories-STAI. The relationship between scores of the PSS, GHQ and STAI 5-8 years after delivery and in pregnancy was assessed by multivariate linear regression analysis, controlling for the following confounders: maternal age, education, per capita income, family size, work, marital status and body mass index.

RESULTS

Scores of the PSS, GHQ and STAI 5-8 years after delivery were positively associated with scores of the PSS, GHQ and STAI in the three trimesters of pregnancy, and inversely associated with maternal age and per capita income (adj. R2 varied from 0.15 to 0.37). PSS, GHQ and STAI scores in the 3rd trimester of pregnancy were positively associated with scores of the PSS, GHQ and STAI in the 1st and 2nd trimesters of pregnancy (adj. R2 varied from 0.31 to 0.65).

CONCLUSIONS

The results of this study reinforce the urgency to integrate mental health screening into routine primary care for pregnant and postpartum women.

Effects of tobacco exposure on perinatal suicidal ideation, depression, and anxiety

Background

Previous studies have stressed the importance of tobacco exposure for the mood disorders of depression and anxiety. Although a few studies have focused on perinatal women, none have specifically considered the effects of smoking and secondhand smoke exposure on perinatal suicidal ideation. Thus, this study aimed to investigate the relationships of smoking/secondhand smoke exposure status with suicidal ideation, depression, and anxiety from the first trimester to the first month post partum.

Methods

This cross-sectional study based on self-reported data was conducted at five hospitals in Taipei, Taiwan from July 2011 to June 2014. The questionnaire inquired about women’s pregnancy history, sociodemographic information, and pre-pregnancy smoking and secondhand smoke exposure status, and assessed their suicidal ideation, depression, and anxiety symptoms. Logistic regression models were used for analysis.

Results

In the 3867 women in the study, secondhand smoke exposure was positively associated with perinatal depression and suicidal ideation. Compared with women without perinatal secondhand smoke exposure, women exposed to secondhand smoke independently exhibited higher risks for suicidal ideation during the second trimester (odds ratio (OR) = 7.63; 95 % confidence interval (CI) = 3.25–17.93) and third trimester (OR = 4.03; 95 % CI = 1.76–9.23). Women exposed to secondhand smoke had an increased risk of depression, especially those aged 26–35 years (OR = 1.71; 95 % CI = 1.27–2.29).

Conclusions

Secondhand smoke exposure also considerably contributes to adverse mental health for women in perinatal periods, especially for the severe outcome of suicidal ideation. Our results strongly support the importance of propagating smoke-free environments to protect the health of perinatal women.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3254-z) contains supplementary material, which is available to authorized users.

Prevalence and related factors of common mental disorders during pregnancy in Japan: a cross-sectional study

Background

Common mental disorders (CMD) during pregnancy can have a clearly harmful influence on both mothers and children. Some studies have reported related factors for mental disorders, such as region-specific background. This study examined the prevalence of CMD and its related factors in mid-pregnancy in Japan.

Methods

Pregnant women between 12 and 24 weeks gestation and aged ≥20 years were consecutively recruited at a maternity hospital in Japan between May 2014 and September 2014. CMD were diagnosed using the Mini-International Neuropsychiatric Interview (MINI), self-rated depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale, and interpersonal traumatic experience was measured using the Life Events Checklist.

Results

Among 297 eligible pregnant women, 177 participated in the study. Two participants (1.1 %) met the criteria for major depressive disorder. The most frequent diagnosis was agoraphobia (n = 7; 3.9 %). Eleven participants (6.2 %) met the criteria for one or more diagnoses, with 2 participants having two mental disorders and 3 having three mental disorders. Six participants developed CMD after gestation. Logistic regression analysis revealed history of psychiatric disorder, past interpersonal traumatic experience, and feeling pressure to have a child were associated with CMD.

Conclusion

These findings indicate a lower prevalence of CMD in mid-pregnancy in Japan than reported in most other countries. Besides the related factors reported previously, feeling pressure to have a child might increase risk for CMD among pregnant women in Japan. Asian cultural background might be related to the lower CMD prevalence and risk factors identified in this study.