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Wu Q, Radey M, Han SJ, Jalapa K, Tawfiq D, McWey L. Profiles of perceived resources among low-income, rural mothers: Prospective associations with maternal and child outcomes. FAMILY PROCESS 2024; 63:331-347. [PMID: 36720209 PMCID: PMC10387500 DOI: 10.1111/famp.12862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 12/01/2022] [Accepted: 01/09/2023] [Indexed: 06/18/2023]
Abstract
Low-income, rural families face significant mental health risks. However, the understanding of resources associated with mental health risks is limited. The present study investigated the associations between perceived resources of low-income, rural mothers, and longitudinal maternal and child outcomes. This study utilized longitudinal data from the Family Life Project (N = 1203), from US rural areas with high poverty rates. Mothers reported their resources at 6-month postpartum, and their levels of depression, anxiety, and role overload were assessed at 2-year postpartum. Mothers reported their children's behavioral problems at 3 years old. Using a person-centered approach, we identified four maternal profiles: lower resources (7.1%); higher intra-family support (11.1%); higher inter-family support (20.8%); and higher resources (60.9%). In general, the higher resource profile was associated with lower mental health concerns of mothers and lower levels of behavior problems of children. Mothers in the higher intra-family support profile had disproportionately higher role overload. Children of mothers in the higher inter-family support profile showed disproportionately higher behavioral problems. Maternal partner status and education were significant predictors of resource profiles. Findings support the heterogeneity in perceived resources among low-income, rural families and different risk levels. Identifying these subgroups has significant implications for policy and interventions aimed toward this vulnerable population.
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Affiliation(s)
- Qiong Wu
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | | | - Soo Jin Han
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | - Karina Jalapa
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | - Dania Tawfiq
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | - Lenore McWey
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
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Watkins V, Kavanagh SA, Macdonald JA, Rasmussen B, Maindal HT, Hosking S, Wynter K. "I always felt like I wasn't supposed to be there". An international qualitative study of fathers' engagement in family healthcare during transition to fatherhood. Midwifery 2024; 130:103928. [PMID: 38290320 DOI: 10.1016/j.midw.2024.103928] [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: 02/19/2023] [Revised: 12/20/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Engagement of fathers in family health services confers benefits for the health and wellbeing of the whole family. The childbirth continuum is traditionally considered a feminine event, however, commensurate with the changing paradigm of gender equity in family healthcare worldwide, the role of fathers is in transformation. The aim of the study is to explore father's perceptions and experiences of healthcare engagement during pregnancy and early infant care. DESIGN Qualitative free-text questions were embedded in a large multi-country, cross-sectional survey, to explored fathers' attendance, participation, and experience of health care during appointments with their pregnant partner and/or baby. SETTING AND PARTICIPANTS Expectant and new fathers were recruited through Prolific®, an international paid online survey platform. FINDINGS Qualitative responses (n=889) were provided by fathers from 28 countries, with experiences of a range of contexts and models of care; 46.8% of whose partners were pregnant and 53.2% had given birth since 2020. The findings suggest that although most fathers wanted to attend and participate in maternity and early parenting-related healthcare, multiple barriers were identified at the individual father, organisational context, and societal levels. Fathers reported negative social factors such as gender bias and restrictive gender norms as barriers to their healthcare engagement. In contrast, factors that enabled fathers to overcome barriers included the fathers' feelings of confidence in their partner's autonomy and decision-making skills, trusted professional relationships with clinicians, and clinicians with good interpersonal skills. KEY CONCLUSIONS Multiple barriers restrict the participation of fathers in healthcare for childbearing and early parenting. Knowledge of these barriers can inform healthcare redesign to include more successful engagement strategies for fathers, to benefit fathers, mothers, and infants alike. IMPLICATIONS FOR PRACTICE Health professionals consulting with the mother, father and infant triad are ideally placed to address the healthcare needs of both parents. Early engagement of fathers in family health care by use of inclusive interpersonal skills and the development of a trusted relationship has potential to improve paternal mental health, and may be associated with benefits for the health, wellbeing and safety of the whole family.
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Affiliation(s)
- Vanessa Watkins
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia.
| | - Shane A Kavanagh
- Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health; Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia; University of Melbourne, Department of Paediatrics, Melbourne, Australia
| | - Bodil Rasmussen
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Victoria, Australia; University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark.; University of Southern Denmark, Faculty of Health Sciences and Steno Diabetes Center, Odense, Denmark; Aarhus University, Department of Public Health, Aarhus, Denmark
| | - Helle Terkildsen Maindal
- Deakin University, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia; Aarhus University, Department of Public Health, Aarhus, Denmark; Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Sarah Hosking
- Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia
| | - Karen Wynter
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Victoria, Australia; Monash University, Department of Psychiatry, School of Clinical Sciences, Clayton, Victoria, Australia
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Keles E, Bilge Y, Kumru P, Celik Z, Cokeliler I. Association between perceived social support, marital satisfaction, differentiation of self and perinatal depression. North Clin Istanb 2023; 10:181-188. [PMID: 37181054 PMCID: PMC10170377 DOI: 10.14744/nci.2023.79923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 01/29/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE The aim of the study was to investigate the relationship between peripartum depression and social support, marital satisfaction, and self-differentiation. METHODS This cross-sectional study was conducted on postpartum women from December 28, 2021, and March 31, 2022. Postpartum women were evaluated using a questionnaire consisting of sections assessing sociodemographic characteristics, obstetric history, and psychometric instruments: Edinburgh Postpartum Depression Scale (EPDS), Marital Disaffection Scale (MDS), Multidimensional Scale of Perceived Social Support (MSPSS), and Differentiation of Self Inventory (DSI). RESULTS A total of 425 mothers were included in the study. Of those, 140 (32.9%) mothers scored ≥13 points on EPDS, and 285 (67.1%) mothers scored ≤12 points. Mothers who scored ≥13 on the EPDS were found to have significantly higher scores for marital dissatisfaction. Total scores of family support, friend support, emotional cutoff, fusion with others, and differentiation of self were higher in mothers who scored ≤12 points on the EPDS. There was no significant difference between the two groups in terms of significance with others, emotional reactivity and I position. CONCLUSION This study found that marital satisfaction is important in the development of perinatal depression both directly and through family support and emotional cuttoff. In addition, mothers with family support, friend support, and self-differentiation had comparatively lower EPDS scores, while mothers with marital dissatisfaction had higher EPDS scores.
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Affiliation(s)
- Esra Keles
- Department of Gynecologic Oncology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkiye
| | - Yildiz Bilge
- Department of Psychology, University of Health Sciences, Hamidiye Faculty of Life Sciences, Istanbul, Turkiye
| | - Pinar Kumru
- Department of Obstetrics and Gynecology, University of Health Sciences, Zeynep Kamil Women and Children’s Disease Training and Research Hospital, Istanbul, Turkiye
| | - Zeynep Celik
- Department of Obstetrics and Gynecology, University of Health Sciences, Zeynep Kamil Women and Children’s Disease Training and Research Hospital, Istanbul, Turkiye
| | - Irem Cokeliler
- Department of Obstetrics and Gynecology, University of Health Sciences, Zeynep Kamil Women and Children’s Disease Training and Research Hospital, Istanbul, Turkiye
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COVID-19-related anxieties in first-time mothers during the first wave of the COVID-19 pandemic and after 6 months: A descriptive study. J Pediatr Nurs 2022; 64:126-132. [PMID: 35184936 PMCID: PMC8851201 DOI: 10.1016/j.pedn.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The changes accompanying the transition to motherhood, joined by the stress aroused by the COVID-19 pandemic, may lead to high levels of parental anxieties. This study, conducted in two phases-in the midst of the first wave of the pandemic and after six months-explores differences in the level of COVID-19-related anxieties of Israeli mothers in their first year of parenthood. DESIGN AND METHODS A cross-sectional study carried out with 198 first-time mothers aged 22-48 who completed self-report questionnaires on April 2020 and again on October 2020. The questionnaire was distributed through social networks and included a demographic scale and the COVID-19-related anxieties questionnaire. FINDINGS In the first phase, mothers reported higher anxieties concerning economic damage (M = 3.42; 3.11), being in public places (M = 4.34; M = 3.51), using public transportation (M = 4.80; M = 4.31), and going for infant checkups (M = 4.13; M = 3.06). In the second phase, mothers reported higher anxiety about being infected (M = 3.19; M = 3.48). DISCUSSION The results suggest the need to be attentive to the double stress of new mothers in a dynamic time of crisis, especially at the beginning of the crisis when anxiety levels may be highest. APPLICATION TO PRACTICE The findings may aid in developing interventions for new mothers in times of crisis. The finding that the COVID-19-related anxieties of new mothers may decrease over time points to the urgency of making interventions by health and medical professionals available to women in the first months after the birth of their first child.
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Kariuki EW, Kuria MW, Were FN, Ndetei DM. Predictors of postnatal depression in the slums Nairobi, Kenya: a cross-sectional study. BMC Psychiatry 2022; 22:242. [PMID: 35382788 PMCID: PMC8981836 DOI: 10.1186/s12888-022-03885-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postnatal depression (PND) is a universal mental health problem that prevents mothers' optimal existence and mothering. Although research has shown high PND prevalence rates in Africa, including Kenya, little research has been conducted to determine the contributing factors, especially in low-resource communities. OBJECTIVE This study aimed to investigate the PND risk factors among mothers attending Lang'ata and Riruta Maternal and Child Health Clinics (MCH) in the slums, Nairobi. METHODS This study was cross-sectional. It is part of a large study that investigated the effectiveness of a brief psychoeducational intervention on PND. Postnatal mothers (567) of 6-10 weeks postanatal formed the study population. Depression rate was measured using the original 1961 Beck's Depression Inventory (BDI). In addition, a sociodemographic questionnaire (SDQ) was used to collect hypothesized risk variables. Multivariable logistic regression analysis was used to explore predictors of PND. RESULTS The overall prevalence of PND in the sample of women was 27.1%. Women aged 18-24 (β = 2.04 95% C.I.[0.02; 4.05], p = 0.047), dissatisfied with body image (β = 4.33 95% C.I.[2.26; 6.41], p < 0.001), had an unplanned pregnancy (β = 2.31 95% C.I.[0.81; 3.80], p = 0.003 and felt fatigued (β = - 1.85 95% C.I.[- 3.50; 0.20], p = 0.028) had higher odds of developing PND. Participants who had no stressful life events had significantly lower depression scores as compared to those who had stressful life events (β = - 1.71 95% C.I.[- 3.30; - 0.11], p = 0.036) when depression was treated as a continuous outcome. Sensitivity analysis showed that mothers who had secondary and tertiary level of education had 51 and 73% had lower likelihood of having depression as compared to those with a primary level of education (A.O.R = 0.49 95% C.I.[0.31-0.78], p = 0.002) and (A.O.R = 0.27 95% C.I.[0.09-0.75], p = 0.013) respectively. CONCLUSION This study reveals key predictors/risk factors for PND in low-income settings building upon the scanty data. Identifying risk factors for PND may help in devising focused preventive and treatment strategies.
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Affiliation(s)
- Esther W. Kariuki
- grid.10604.330000 0001 2019 0495Department of Psychiatry, School of Medicine, The University of Nairobi, P.O. Box 30197, GPO, Nairobi, Kenya
| | - Mary W. Kuria
- grid.10604.330000 0001 2019 0495Department of Psychiatry, School of Medicine, The University of Nairobi, P.O. Box 30197, GPO, Nairobi, Kenya
| | - Fredrick N. Were
- grid.10604.330000 0001 2019 0495Department of Psychiatry, School of Medicine, The University of Nairobi, P.O. Box 30197, GPO, Nairobi, Kenya
| | - David M. Ndetei
- grid.10604.330000 0001 2019 0495Department of Psychiatry, School of Medicine, The University of Nairobi, P.O. Box 30197, GPO, Nairobi, Kenya
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Ana Y, Lewis MG, van Schayck OCP, Babu GR. Is physical activity in pregnancy associated with prenatal and postnatal depressive symptoms?: Results from MAASTHI cohort study in South India. J Psychosom Res 2021; 144:110390. [PMID: 33740554 PMCID: PMC7611353 DOI: 10.1016/j.jpsychores.2021.110390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Physical inactivity leads to depression and other adverse health consequences. Pregnant women are an important subgroup to study the health consequences due to physical inactivity since it can lead to adverse outcomes in pregnancy and even after delivery. Therefore, we aimed at understanding the level of physical activity among pregnant women, prevalence of prenatal and postnatal depressive symptoms and whether level of physical activity is associated with prenatal and postnatal depressive symptoms. METHODS In an ongoing cohort study, we measured the physical activity using a validated Physical Activity Level (PAL) questionnaire. We administered the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy and within seven days of delivery to assess depressive symptoms in 1406 women. Associations were adjusted for potential confounders such as maternal age, education, socioeconomic status, gravida, EPDS score during pregnancy, social support, skinfold thickness, blood pressure, blood sugar level. RESULTS We found that 7.2% of pregnant women had low levels of physical activity. The prevalence of prenatal and postnatal depressive symptoms was 9.0% and 31.9% respectively. Pregnant women with a low level of physical activity had significantly higher odds of developing postpartum depressive symptoms (OR = 3.15, CI: 1.98-5.02, p < 0.001) when adjusted for potential confounders. CONCLUSIONS Moderate level of physical activity among pregnant mothers is essential and has its association with postnatal depressive symptoms. Health care professionals need to counsel pregnant women to assess depressive symptoms at both the prenatal and postpartum period and inform them about the importance of the optimal level of physical activity.
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Affiliation(s)
- Yamuna Ana
- Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bangalore, India.
| | - Melissa Glenda Lewis
- Indian Institute of Public Health-Hyderabad, Public Health Foundation of India (PHFI), Hyderabad, India.
| | - Onno C P van Schayck
- Care, and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands.
| | - Giridhara R Babu
- Lifecourse Epidemiology, Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bangalore, India; Public health and clinical medicine, Wellcome Trust/DBT India Alliance, New Delhi, India.
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Susukida R, Usuda K, Hamazaki K, Tsuchida A, Matsumura K, Nishi D, Inadera H. Association of prenatal psychological distress and postpartum depression with varying physical activity intensity: Japan Environment and Children's Study (JECS). Sci Rep 2020; 10:6390. [PMID: 32286432 PMCID: PMC7156653 DOI: 10.1038/s41598-020-63268-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 03/18/2020] [Indexed: 01/24/2023] Open
Abstract
Evidence is mixed on the associations between physical activity during pregnancy and perinatal depression, and it is limited for different physical activity intensities. Data for 92,743 pregnant women from the Japan Environment and Children’s Study were analyzed in this study. Psychological distress during pregnancy was assessed as moderate or severe using the Kessler Psychological Distress Scale (K6 5–12 and ≥13, respectively). Postpartum depression was assessed using the Edinburgh Postpartum Depression Scale (EPDS; cut-off score 9). Women with only light physical activity had significantly lower odds of psychological distress during pregnancy than those with no physical activity (K6 5–12: adjusted odds ratio [AOR] 0.86, 95% confidence interval [95%CI] 0.82, 0.90; K6 ≥ 13: AOR 0.64, 95%CI 0.58, 0.72). Women with a combination of light, moderate and vigorous physical activity had significantly higher odds of psychological distress during pregnancy (K6 5–12: AOR 1.32, 95%CI 1.18, 1.48; K6 ≥ 13: AOR 1.45, 95%CI 1.16, 1.81) and depression after childbirth (EPDS ≥ 9: AOR 1.42, 95%CI 1.24, 1.61). Physical activity intensity should be considered when assessing psychological distress risk during pregnancy and depression risk after delivery. Future research should evaluate specific physical activity programs with optimal intensity for pregnant women to prevent and treat their psychological distress and depression.
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Affiliation(s)
- Ryoko Susukida
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.,Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Kentaro Usuda
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.,Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan. .,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Kenta Matsumura
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Daisuke Nishi
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.,Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.,Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
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Dinkel DM, Hein N, Snyder K, Siahpush M, Maloney S, Smith L, Farazi PA, Hanson C. The impact of body mass index and sociodemographic factors on moderate-to-vigorous physical activity and sedentary behaviors of women with young children: A cross-sectional examination. ACTA ACUST UNITED AC 2020; 16:1745506519897826. [PMID: 31971094 PMCID: PMC6984422 DOI: 10.1177/1745506519897826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives: Moderate-to-vigorous physical activity provides multiple benefits to women after childbirth. To achieve these benefits, the recommendation that adults obtain, 150 min of moderate-to-vigorous physical activity per week and reduce sedentary behaviors, also applies to women in the post-partum phase of the life span. However, research examining the moderate-to-vigorous physical activity and sedentary behaviors of women with young children (0–2 years) is limited. A greater understanding of these behaviors from a nationally representative sample is needed. Therefore, the primary objective of this study was to determine the levels of moderate-to-vigorous physical activity and sedentary behaviors of a nationally representative sample of women with young children within the United States. A secondary objective was to examine the influence of body mass index and sociodemographic factors on these behaviors. Methods: Cross-sectional data from four cycles of the National Health and Nutrition Examination Survey (2007–2008, 2009–2010, 2011–2012, and 2013–2014) were used for analysis. Descriptive statistics were calculated and a generalized linear model was used to investigate associations between mean minutes of moderate-to-vigorous physical activity, sedentary activity, body mass index, and sociodemographic variables. Discussion: Women with young children (n = 477) obtained 634 min in moderate-to-vigorous physical activity per week and this was positively associated with having a higher income (p < 0.001) and the number of children in the home (p < 0.001). In total, 62% of women were meeting the World Health Organization guidelines for aerobic activity. Lower odds of achieving guidelines was associated with being Black (p = 0.004), Mexican American (p = 0.009), or married (p = 0.042) compared with being White or not married. Finally, women accumulated ~5 h of sedentary activity per day, with higher levels associated with race (p = 0.005), education (p = 0.022), and number of children within the home (p < 0.001). Research efforts should continue to focus on strategies to help non-adhering women with young children achieve the physical activity recommendations and reduce time spent in sedentary behaviors.
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Affiliation(s)
- Danae M Dinkel
- School of Health and Kinesiology, College of Education, University of Nebraska Omaha, Omaha, NE, USA
| | - Nicholas Hein
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kailey Snyder
- DDepartment of Physical Therapy, College of Pharmacy and Health Professions, Creighton University, Omaha, NE
| | - Mohammad Siahpush
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Shannon Maloney
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Lynette Smith
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Paraskevi A Farazi
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Corrine Hanson
- Medical Nutrition Education Division, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Aguilar-Cordero MJ, Sánchez-García JC, Rodriguez-Blanque R, Sánchez-López AM, Mur-Villar N. Moderate Physical Activity in an Aquatic Environment During Pregnancy (SWEP Study) and Its Influence in Preventing Postpartum Depression. J Am Psychiatr Nurses Assoc 2019; 25:112-121. [PMID: 29490560 DOI: 10.1177/1078390317753675] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Postpartum depression (PPD) can begin within 6 weeks postpartum (International Classification of Diseases, 10th Revision) and represents a significant health problem for mothers. AIM To determine whether physical activity during pregnancy alleviates PPD. METHOD Randomized controlled trial in which the exercise group practiced moderate physical exercise in an aquatic environment (1-hour sessions, 3 days a week), following the recommendations of the SWEP method. RESULTS The results observed in the Edinburgh Postnatal Depression Scale were significant between the exercise group and the control group ( p < .001). In addition, significant differences were observed according in body mass index between the exercise group and control group in the overweight and obesity categories ( p < .05). CONCLUSION Women who perform moderate physical exercise in an aquatic environment are at lower risk of PPD than sedentary women. Overweight and obesity among sedentary women during pregnancy are closely associated with positive screening for PPD.
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Affiliation(s)
| | | | | | | | - Norma Mur-Villar
- 5 Norma Mur-Villar, PhD, University of Granada, Granada, Spain; Cienfuegos School of Medical Sciences, Cienfuegos, Cuba
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Ongeri L, Wanga V, Otieno P, Mbui J, Juma E, Stoep AV, Mathai M. Demographic, psychosocial and clinical factors associated with postpartum depression in Kenyan women. BMC Psychiatry 2018; 18:318. [PMID: 30285745 PMCID: PMC6167779 DOI: 10.1186/s12888-018-1904-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 09/23/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Few longitudinal studies have examined associations between risk factors during pregnancy and mental health outcomes during the postpartum period. We used a cohort study design to estimate the prevalence, incidence and correlates of significant postpartum depressive symptoms in Kenyan women. METHODS We recruited adult women residing in an urban, resource-poor setting and attending maternal and child health clinics in two public hospitals in Nairobi, Kenya. A translated Kiswahili Edinburgh Postpartum Depression Scale was used to screen for depressive symptoms at baseline assessment in the 3rd trimester and follow up assessment at 6-10 weeks postpartum. Information was collected on potential demographic, psychosocial and clinical risk variables. Potential risk factors for postpartum depression were evaluated using multivariate logistic regression analysis. RESULTS Out of the 171 women who were followed up at 6-10 weeks postpartum, 18.7% (95% CI: 13.3-25.5) were found to have postpartum depression using an EPDS cut off of 10. In multivariate analyses, the odds of having postpartum depression was increased more than seven-fold in the presence of conflict with partner (OR = 7.52, 95% CI: 2.65-23.13). The association between antepartum and postpartum depression was quite strong but did not reach statistical significance (OR = 3.37, 95% CI: 0.98-11.64). CONCLUSIONS The high prevalence of significant postnatal depressive symptoms among Kenyan women underscores the need for addressing this public health burden. Depression screening and psychosocial support interventions that address partner conflict resolution should be offered as part of maternal health care.
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Affiliation(s)
- Linnet Ongeri
- Kenya Medical Research Institute, P.O. Box 54840 00200, Mbagathi Road, Nairobi, Kenya
| | - Valentine Wanga
- University of Washington, Jefferson St. Seattle WA 98104, Nairobi, 908 Kenya
| | - Phelgona Otieno
- Kenya Medical Research Institute, P.O. Box 54840 00200, Mbagathi Road, Nairobi, Kenya
| | - Jane Mbui
- Kenya Medical Research Institute, P.O. Box 54840 00200, Mbagathi Road, Nairobi, Kenya
| | - Elizabeth Juma
- Kenya Medical Research Institute, P.O. Box 54840 00200, Mbagathi Road, Nairobi, Kenya
| | - Ann Vander Stoep
- University of Washington, Jefferson St. Seattle WA 98104, Nairobi, 908 Kenya
| | - Muthoni Mathai
- University of Nairobi, P.O. Box 30197, Off Ngong Road, Nairobi, Kenya
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González-Mesa E, Kabukcuoglu K, Körükcü O, Blasco M, Ibrahim N, Kavas T. Cultural factors influencing antenatal depression: A cross-sectional study in a cohort of Turkish and Spanish women at the beginning of the pregnancy. J Affect Disord 2018; 238:256-260. [PMID: 29890453 DOI: 10.1016/j.jad.2018.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 05/19/2018] [Accepted: 06/01/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Depression is the most frequent mental disorder during pregnancy, and its prevalence is at least as high as that of postnatal depression. Differences between Western and Eastern countries may exist according to cultural and educational factors. OBJECTIVE to determine the influence of social and cultural factors on the mood state of a multicultural sample of 514 Turkish and Spanish pregnant women at the beginning of the pregnancy. METHODS Between October and December 2017 250 Turkish and 264 Spanish pregnant women attending their first pregnancy medical check-up between 10 and 12 weeks of pregnancy were recruited (264 in Málaga, 102 in Istanbul and 148 in Antalya). These women completed a questionnaire that included the Turkish or Spanish validated versions of the Edinburg Postnatal Depression Scale (EDS) and a series of questions related to health status, general mood, and sociodemographic variables. RESULTS Turkish women scored significantly higher with a mean value of 12.1 (SD 4.2) against 7.6 (SD 4.3) of Spanish women. Coping strategies and matters of women´s concern were also different. A total of 9.1% of Spanish and 30% of Turkish scored over cut-off point of 13. We found differences in EDS scores regarding the type of work, working status, and educational level. Family structure and perceived support were identified as specific risk factors for antenatal depression (AD). The multivariate regression model showed that best predictor variables for EDS score in the global sample were the country of recruitment, the number of living children, the pregnancy planning and the perceived partner´s support. CONCLUSIONS Our results confirm the existence of important differences in AD prevalence between Turkish (30.0%) and Spanish (9.9%) pregnant women. Some sociocultural features like having more children, unplanned pregnancies, or perceiving poor support from the partner, become important vulnerability factors.
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Affiliation(s)
| | | | - Oznur Körükcü
- Akdeniz University Nursing Faculty Campus, Antalya 07058, Turkey
| | - Marta Blasco
- Hospital Regional Universitario de Málaga, Spain
| | | | - Türker Kavas
- Obstetrics and Gynaecology Clinic Sisli Istanbul, Turkey
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12
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Gordo L, Oliver-Roig A, Martínez-Pampliega A, Iriarte Elejalde L, Fernández-Alcantara M, Richart-Martínez M. Parental perception of child vulnerability and parental competence: The role of postnatal depression and parental stress in fathers and mothers. PLoS One 2018; 13:e0202894. [PMID: 30148877 PMCID: PMC6110487 DOI: 10.1371/journal.pone.0202894] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 08/10/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Parents' perception that their child may be vulnerable to serious life-threatening illnesses can have negative effects on how they exercise their parenting. No studies have yet been carried out on parent´s perception of their child’s vulnerability, when the child has not suffered a severe illness. This study tries to analyze the relationship between parent´s perception of their children´s vulnerability and parental competence, and analyzes the mediating role of postnatal depression and parental stress. Method The study was carried out on mothers and fathers of full-term infants who did not have any serious illnesses. A total of 965 people (385 fathers and 580 mothers) participated in the study. Results The results revealed an association between parental perception of their child’s vulnerability and parent’s perception of parental competence through depression and parental stress. However, this association was different for fathers and mothers. Conclusion The variable of perception of child’s vulnerability was a relevant factor to understand parental competence.
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Affiliation(s)
- Leire Gordo
- Department of Social and Developmental Psychology, University of Deusto, Bilbao, Spain
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13
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Caparros-Gonzalez RA, Romero-Gonzalez B, Strivens-Vilchez H, Gonzalez-Perez R, Martinez-Augustin O, Peralta-Ramirez MI. Hair cortisol levels, psychological stress and psychopathological symptoms as predictors of postpartum depression. PLoS One 2017; 12:e0182817. [PMID: 28846691 PMCID: PMC5573300 DOI: 10.1371/journal.pone.0182817] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/25/2017] [Indexed: 02/04/2023] Open
Abstract
Postpartum depression affects a huge number of women and has detrimental consequences. Knowing the factors associated with postpartum depression during pregnancy can help its prevention. Although there is evidence surrounding behavioral or psychological predictors of postpartum depression, there is a lack of evidence of biological forecasters. The aim of this study was to analyze the sociodemographic, obstetric, and psychological variables along with hair cortisol levels during the first, second, and third trimesters of pregnancy that could predict postpartum depression symptoms. A sample of 44 pregnant women was assessed during 3 trimesters of pregnancy and the postpartum period using psychological questionnaires and hair cortisol levels. Participants were divided into 2 groups: a group with postpartum depression symptoms and a group with no postpartum depression symptoms. Results showed significant positive differences between groups in the first trimester regarding the Somatization subscale of the SCL-90-R (p < .05). In the second trimester, significant differences were found in the Somatization, Depression, Anxiety, and GSI subscales (p < .05). In the third trimester significant differences between both groups were found regarding pregnancy-specific stress. We found significant positive differences between groups regarding hair cortisol levels in the first and the third trimester. Hair cortisol levels could predict 21.7% of the variance of postpartum depression symptoms. In conclusion, our study provided evidence that psychopathological symptoms, pregnancy-specific stress, and hair cortisol levels can predict postpartum depression symptoms at different time-points during pregnancy. These findings can be applied in future studies and improve maternal care in clinical settings.
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Affiliation(s)
- Rafael A. Caparros-Gonzalez
- Brain, Mind and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada. Granada. Spain
- Gynecology and Obstetrics Department, Hospital de Poniente, El Ejido, Spain
| | - Borja Romero-Gonzalez
- Brain, Mind and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada. Granada. Spain
| | | | - Raquel Gonzalez-Perez
- Department of Pharmacology, CIBERehd, School of Pharmacy, Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Granada, Spain
| | - Olga Martinez-Augustin
- Department of Biochemistry and Molecular Biology II, CIBERehd, School of Pharmacy, Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Granada, Spain
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14
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Chi X, Zhang P, Wu H, Wang J. Screening for Postpartum Depression and Associated Factors Among Women in China: A Cross-Sectional Study. Front Psychol 2016; 7:1668. [PMID: 27847483 PMCID: PMC5088192 DOI: 10.3389/fpsyg.2016.01668] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 10/11/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study examined what percentage of Chinese mothers during a three-year postpartum period were screened for postpartum depression and explored the correlation between postpartum depression and various socio-demographic, psychological, and cultural factors. Study design: Cross-sectional survey. Methods: A total of 506 mothers 23 years of age and older who were within three years postpartum completed the online survey. The survey collected information such as family economic status, a history of depression, preparation for pregnancy, relationships with husbands, and family members, adult attachment types (Adult Attachment Scale, AAS), and depression (The Center for Epidemiologic Studies Depression Scale, CESD). Results: Approximately 30% of mothers 1-3 years postpartum reported symptoms above the CESD cut-off score (≥16 scores) associated with the risk for depression (28.0% in the first year, 30.8% in the second year, and 31.8% in the third year). Factors significantly associated with depression in participants in the correlation analysis were education level; family income; preparation for pregnancy; a history of depression; amount of time spent with their husbands; relationships with husbands, parents, and parents-in-law; and a close, dependent, and/or anxious attachment style. Multiple regression analyses revealed that a history of depression; less preparation for pregnancy; poorer relationships with husbands, parents, and parents-in-law; and a more anxious attachment style were strongly related to a higher risk of postpartum depression. Conclusion: The overall percentage of mothers after delivery who were vulnerable to depression in China remains high. Various factors were significant predictors of postpartum depression. The research findings have several valuable implications for intervention practices. For example, attachment styles and depression history in the assessments of perinatal depression could improve screenings and the design of interventions. Additionally, improving the family relationships and family environments of women post-delivery may be promising approach for postpartum depression prevention or intervention.
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Affiliation(s)
- Xinli Chi
- College of Psychology and Sociology, Shenzhen University, Shenzhen China
| | - Peichao Zhang
- Research Center of Modern Psychology, Wuhan University, Wuhan China
| | - Haiyan Wu
- State Grid Anhui Maintenance Company, Hefei China
| | - Jian Wang
- College of politics and law, Anhui Jianzhu University, Hefei China
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15
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Maternal postpartum depressive symptoms and infant externalizing and internalizing behaviors. Infant Behav Dev 2016; 42:119-27. [DOI: 10.1016/j.infbeh.2015.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/07/2015] [Accepted: 12/10/2015] [Indexed: 11/22/2022]
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16
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Ra JS, Gang M. Depression moderates between physical activity and quality of life in low-income children. Appl Nurs Res 2016; 29:e18-22. [DOI: 10.1016/j.apnr.2015.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/05/2015] [Accepted: 06/08/2015] [Indexed: 10/23/2022]
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17
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MOSHKI M, Kharazmi A. Application of the PRECEDE Model to Understanding Postnatal Depression. IRANIAN JOURNAL OF PUBLIC HEALTH 2015; 44:432-4. [PMID: 25905095 PMCID: PMC4402430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 01/11/2015] [Indexed: 11/14/2022]
Affiliation(s)
- Mahdi MOSHKI
- Dept. of Public Health, School of Health; Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran,Corresponding Author:
| | - Akram Kharazmi
- Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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