Association between Lack of Social Support from Partner or Others and Postpartum Depression among Japanese Mothers: A Population-Based Cross-Sectional Study

Effects of digital health interventions on the psychological outcomes of perinatal women: umbrella review of systematic reviews and meta-analyses

Evidence about the effects of digital health interventions (DHIs) on the psychological outcomes of perinatal women is increasing but remains inconsistent. An umbrella review was conducted to (1) assess the effect of DHIs on depressive, anxiety and stress symptoms and (2) compare the effects of DHIs on different digital platforms and population natures. Ten databases were searched from inception until December 23, 2022. The Hartung-Knapp-Sidik-Jonkman random-effects meta-analyses were utilised. Methodological quality was evaluated using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2). Twenty-four systematic reviews with 41 meta-analyses involving 45,509 perinatal women from 264 primary studies were included. The credibility of the evidence of meta-analyses was rated as highly suggestive (4.88%), suggestive (26.83%), weak (51.22%) or non-significant (17.07%) according to AMSTAR-2. Our findings suggest that DHIs are beneficial for reducing stress symptoms. However, conflicting effects were found on anxiety symptoms. Subgroup and meta-regression analyses suggested that DHIs effectively improve depressive symptoms in postnatal women, and DHIs using the website platform are highly effective in stress reduction. DHIs can be implemented adjuvant to usual obstetric care to improve depressive and stress symptoms. Additional well-designed RCTs with long-term follow-up are warranted.

Association of cognitive reserve with transitions across cognitive states and death in older adults: A 15-year follow-up study

INTRODUCTION

We investigated the association of cognitive reserve (CR) with transitions across cognitive states and death.

METHODS

This population-based cohort study included 2631 participants (age ≥60 years) who were dementia-free at baseline and regularly examined up to 15 years. Data were analyzed using the Markov multistate models.

RESULTS

Each 1-point increase in the composite CR score (range: -4.25 to 3.46) was significantly associated with lower risks of transition from normal cognition to cognitive impairment, no dementia (CIND) (multivariable-adjusted hazards ratio = 0.78; 95% confidence interval = 0.72-0.85) and death (0.85; 0.79-0.93), and from CIND to death (0.82; 0.73-0.91), but not from CIND to normal cognition or dementia. A greater composite CR score was associated with a lower risk of transition from CIND to death in people aged 60-72 but not in those aged ≥ 78 years.

DISCUSSION

CR contributes to cognitive health by delaying cognitive deterioration in the prodromal phase of dementia.

HIGHLIGHTS

We use Markov multistate model to examine the association between cognitive reserve and transitions across cognitive states and death. A great cognitive reserve contributes to cognitive health by delaying cognitive deterioration in the prodromal phase of dementia. A great cognitive reserve is associated with a lower risk of transition from cognitive impairment, no dementia to death in people at the early stage of old age, but not in those at the late stage of old age.

Social Support Postpartum: Bengali Women from India on Their Coping Experiences following Childbirth

Undertaken in Kolkata, India, our study aimed to explore the experiences of Bengali middle-class women on perceived stressful events, social support, and coping experiences following childbirth. Becoming a mother following childbirth is a shared phenomenon irrespective of culture, social strata, or country, while stress during the postpartum period or depression is not. Discrete medical intervention does not sufficiently address the complexities of postpartum experiences since influencing factors also include economic, political, cultural, and social backgrounds. Adopting a feminist and phenomenological approach, individual in-person interviews were conducted with twenty women recruited via snowball sampling. Our findings revealed that events experienced as stressful may lead to poor postpartum well-being. Underpinned by gendered discourse and biases, stressful events included familial imperatives for a male child, poor social and emotional support from the family, mostly partners and fathers, and systemic workplace barriers. The women in our study commonly resided with their mothers postpartum. They expressed feeling sheltered from these experiences, cared for, and supported. We discuss the women's experiences from a feminist pragmatic worldview, which advocates for a flexible feminism recognizant of the unique and nurturing relationship experiences between Bengali middle-class women and their mothers. In conclusion, we advocate for culturally sensitive, women-centered postpartum care practices that may entail the inclusion of intergenerational care during this critical phase of maternal well-being. These insights underscore the necessity of tailoring postpartum support systems to align with the cultural and familial contexts of the individuals they serve.

Postpartum depression and partner support during the period of lactation: Correlation research and its influencing factors

BACKGROUND

Postpartum depression (PPD) not only affects the psychological and physiological aspects of maternal health but can also affect neonatal growth and development. Partners who are in close contact with parturient women play a key role in communication and emotional support. This study explores the PPD support relationship with partners and its influencing factors, which is believed to establish psychological well-being and improve maternal partner support.

AIM

To explore the correlation between PPD and partner support during breastfeeding and its influencing factors.

METHODS

Convenience sampling was used to select lactating women (200 women) who underwent postpartum examinations at the Huzhou Maternity and Child Health Care Hospital from July 2022 to December 2022. A cross-sectional survey was conducted on the basic information (general information questionnaire), depression level [edinburgh postnatal depression scale (EPDS)], and partner support score [dyadic coping inventory (DCI)] of the selected subjects. Pearson's correlation analysis was used to analyze the correlation between PPD and DCI in lactating women. Factors affecting PPD levels during lactation were analyzed using multiple linear regression.

RESULTS

The total average score of EPDS in 200 lactating women was (9.52 ± 1.53), and the total average score of DCI was (115.78 ± 14.90). Dividing the EPDS, the dimension scores were: emotional loss (1.91 ± 0.52), anxiety (3.84 ± 1.05), and depression (3.76 ± 0.96). Each dimension of the DCI was subdivided into: Pressure communication (26.79±6.71), mutual support (39.76 ± 9.63), negative support (24.97 ± 6.68), agent support (6.87 ± 1.92), and joint support (17.39 ± 4.19). Pearson's correlation analysis demonstrated that the total mean score and individual dimension scores of EPDS during breastfeeding were inversely correlated with the total score of partner support, stress communication, mutual support, and co-support (P < 0.05). The total mean score of the EPDS and its dimensions were positively correlated with negative support (P < 0.05). Multiple linear regression analysis showed that the main factors affecting PPD during breastfeeding were marital harmony, newborn health, stress communication, mutual support, negative support, co-support, and the total score of partner support (P < 0.05).

CONCLUSION

PPD during breastfeeding was associated with marital harmony, newborn health, stress communication, mutual support, negative support, joint support, and the total DCI score.

The Lived Experience of Family Support Among Women During and After Childbirth in Jordan: A Phenomenological Study

Introduction

Many studies highlight the importance of family support in enhancing the experience of childbirth among women.

Objective

This qualitative study aimed to describe the lived experience of family support from the perspective of women during and after childbirth in the Jordanian context.

Methods

A qualitative descriptive phenomenological approach was used to explore the experiences of women's family support in the context of their childbirth experiences. A total of 11 Jordanian women participated in the study. Face-to-face semi-structured interviews were conducted to collect data.

Results

Four major themes emerged from the data describing family support provided to women during and after childbirth. These themes were family support during childbirth, family support in the postpartum period, importance of family support during and after childbirth, and challenges related to receiving family support. Supportive family members primarily included the husband, the woman's family, and the family-in-law, according to the traditions inherited in the Jordanian context and culture.

Conclusion

The study findings could help maternal health professionals screen pregnant women who are at risk of receiving low family support, contribute to developing effective interventions regarding family-centered care, and enhance the overall childbirth experience for women in Jordanian cultural contexts.

Exploring the associations between serious psychological distress and the quantity or frequency of tobacco, alcohol, and cannabis use among pregnant women in the United States

Serious Psychological Distress (SPD) and prenatal exposure to substances are associated with adverse outcomes for pregnant individuals and their developing offspring. This study aims to examine the relationship between SPD and quantity, or frequency of substance use among pregnant women in the United States (US). Descriptive and negative binomial regression analyses of the 2015-2019 National Survey on Drug Use and Health (NSDUH) were conducted among 3373 pregnant women (18 to 44 years old) to examine the association between SPD and (1) average number of cigarettes smoked in the past 30 days, (2) number of days of binge drinking in the past 30 days, and (3) number of days of cannabis use in the past 30 days. About 6% of the study population experienced SPD in the past 30 days. Compared to pregnant women who did not report SPD, pregnant women experiencing SPD showed greater rates in the number of cigarettes smoked during the past 30 days (IRR = 2.1, 95%CI = 1.1, 4.5), the number of days of binge drinking in the past 30 days (IRR = 5.1, 95%CI = 1.7, 15.4), and the number of days of cannabis use in the past 30 days (IRR = 2.9, 95%CI = 1.3, 6.5). Our results extend findings from prior research by documenting an association between SPD and the quantity and frequency of substance use among pregnant women in the US. Individual and structural interventions addressing SPD and/or substance might help reduce the impact of these comorbid conditions on expectant parents and their offspring.

Prevalence of postpartum depression & anxiety among women in rural India: Risk factors & psychosocial correlates

BACKGROUND OBJECTIVES

Postpartum depression and anxiety (PPD/A) impact a woman's physical and psychological wellbeing. In the absence of corroboratory evidence from the community setting in India, the present study was undertaken to examine the prevalence, psychosocial correlates and risk factors for PPD/A in the rural community of India.

METHODS

This cross-sectional study included 680 women during the postpartum period from a rural community in northern India. Screening for PPD/A was done using Edinburg Postnatal Depression Scale and State and Trait Anxiety Inventory. Diagnostic assessment of screened-positive women was done using Mini-International Neuropsychiatric Interview (MINI). The psychosocial evaluation was done on parameters including women's social support, bonding with the child, functionality, parental stress, interpersonal violence and marital satisfaction.

RESULTS

The overall prevalence of PPD/A/both in community women was 5.6 per cent, with a specific prevalence of 2.2 per cent for PPD, 0.74 per cent for PPA and 2.8 per cent for both disorders. Comparative analysis indicated that women with PPD/A/both experienced significantly higher levels of parenting stress, poor lifestyle (prior two weeks), less support from their partner, parents-in-law and parents, less marital satisfaction, high intimate partner violence, poor bonding with infants and higher infant-focussed anxiety. On multivariable logistic regression analysis, higher education, marital satisfaction, support from partners and in-laws were associated with reducing the risk of PPD/A/both.

INTERPRETATION CONCLUSIONS

Rural Indian women experience PPD/A/both which causes stress and impacts their functionality, bonding with the infant and relationship with their spouse and parents. Higher education, marital satisfaction and higher support from partners and in-laws reduce the risk of developing PPD/A/both.

Number of Siblings and Social Capital Among Parents Rearing Schoolchildren: Results From the A-CHILD Study

BACKGROUND

Having siblings may foster sociality; however, little is known about whether sibling number determines social capital, the resources obtained through social networks. We examined the association between sibling number and social capital among Japanese parents rearing schoolchildren.

METHODS

We used cross-sectional data from the 2018 and 2019 Adachi Child Health Impact of Living Difficulty (A-CHILD) study, targeting all primary and junior high school students and their parents in Adachi, Tokyo, Japan (n = 8,082). Individual-level social capital was evaluated by assessing caregivers' social cohesion, social support, and group affiliation. All analyses were adjusted for age and sex.

RESULTS

An inverse U-shaped association was found between sibling number and social capital. Adults who grew up with one or two, but not three or more siblings had greater social support (coefficient = 0.23; 95% confidence interval [CI], 0.06-0.40 and coefficient = 0.46; 95% CI, 0.29-0.64, respectively) than those who grew up as an only child, after covariate adjustment. Adults who grew up with two or three, but not one or four or more siblings had greater group affiliation (coefficient = 0.09; 95% CI, 0.03-0.16 and coefficient = 0.09; 95% CI, 0.01-0.18, respectively) than those who grew up as an only child, after covariate adjustment. Sibling number was not associated with social cohesion.

CONCLUSION

Growing up with one to three siblings was associated with higher social capital in adulthood than being an only child. Having siblings may provide an opportunity to foster social capital.

Risk factors for the development of postpartum depression in individuals who screened positive for antenatal depression

BACKGROUND

Women with antenatal depression often have a higher risk of developing postpartum depression (PPD) after delivery. A number of factors associated with the PDD in those previously reporting antenatal depression have been suggested, but further research is needed. This study aimed to investigate factors associated with developing subsequent postnatal depression in women who had screened positive for antenatal depression.

METHODS

This study was carried out in Hangzhou women's Hospital. 578 women who experienced antenatal depression from this cohort were enrolled in this study. The sociodemographic and clinical characteristics of the participants were collected and tabulated against the incidence of postnatal depression. Binary logistic regression was used to estimate the effects of the principal underlying variables. The Chinese-version Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PPD. Antenatal screening for depression was conducted at 28-34 weeks during pregnancy and postpartum depressive symptoms were assessed at 6 weeks after childbirth in the women. Path Analysis of Structural Equation Model (SEM) was employed to explore the direct, indirect, and total effects of risk factors of PPD.

RESULTS

57.6% (n = 333) of the participants subsequently developed PPD in our study. The results of the logistic analysis indicated that ages ≤ 35 years old (OR = 1.852; 95%CI: 1.002-3.423), non-one-child families (OR = 1.518; 95%CI: 1.047-2.200), and rare care from partner during pregnancy (OR = 2.801; 95%CI: 1.038-7.562), the antenatal EPDS score (OR = 1.128; 95%CI: 1.052-1.209), pyrexia during pregnancy (OR = 2.43; 95%CI: 1.358-4.345), fairly good (OR = 1.836; 95%CI: 1.009-3.340), fairly bad (OR = 3.919; 95%CI:2.072-7.414) and very bad postpartum sleep quality (OR = 9.18; 95%CI: 2.335-36.241) were associated with increased risk of PPD (compared to very good postpartum sleep quality). In path analysis model, antenatal EPDS score (standardized total β = 0.173) and pyrexia during pregnancy (standardized total β = 0.132) had both direct and indirect effects (the impact on outcome variables needs to be determined through other variables) on PPD. Sleep quality after delivery (standardized β = 0.226) and one-child family (standardized β = 0.088) had direct effects only on PPD.

CONCLUSION

The results from our study indicated that more than 50% of the women who experienced antepartum depression would subsequently develop PPD. Depressive symptoms and pyrexia during pregnancy increase PPD scores, and these effects were in part mediated via poor sleep quality during the postpartum period.

Nutritional factors and cross-national postpartum depression prevalence: an updated meta-analysis and meta-regression of 412 studies from 46 countries

Background

Postpartum depression (PPD) is the most common complication associated with childbirth and can lead to adverse outcomes for both mothers and their children. A previous meta-analysis found that PPD prevalence varies widely across countries. One potential underexplored contributor to this cross-national variation in PPD is diet, which contributes to mental health and varies significantly around the world. Here, we sought to update the global and national estimates of PPD prevalence using systematic review and meta-analysis. Further, we examined whether cross-national variation in PPD prevalence is associated with cross-national variation in diet using meta-regression.

Methods

To estimate national rates of PPD prevalence, we conducted an updated systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale between 2016-2021 and combined our findings with a previous meta-analysis of articles published between 1985-2015. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To examine dietary predictors, we extracted data on sugar-sweetened beverage, fruit, vegetable, total fiber, yogurt, and seafood consumption from the Global Dietary Database. Random effects meta-regression was used to test whether between-country and within-country variation in dietary factors predicted variation in PPD prevalence, controlling for economic and methodological variables.

Results

412 studies of 792,055 women from 46 countries were identified. The global pooled prevalence of PPD was 19.18% (95% confidence interval: 18.02 to 20.34%), ranging from 3% in Singapore to 44% in South Africa. Countries that consumed more sugar-sweetened beverages (SSBs) had higher rates of PPD (Coef. = 0.325, p = 0.044, CI:0.010-0.680); Moreover, in years when higher rates of sugar-sweetened beverages were consumed in a country, there were correspondingly higher rates of PPD in that country (Coef. = 0.129, p = 0.026, CI: 0.016-0.242).

Conclusion

The global prevalence of PPD is greater than previous calculations, and drastically varies by country. Sugar-sweetened beverage consumption explained some of the national variation in PPD prevalence.

Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort

OBJECTIVE

The risk factors for postnatal depressive symptoms (PNDS) are numerous, but little is known about the protective factors or the interactions between different exposures. The present study explored the pathways between maternal, infant and parenthood vulnerabilities or risk/protective factors and PNDS at 2 months postpartum (PP) in a large sample of women from the general population.

METHODS

We used data from the French ELFE cohort, a nationally representative cohort of children followed-up from birth. The available information about vulnerabilities or risk/protective factors for PNDS was collected during the maternity ward stay (mother or medical records) and at 2 months PP (mother by phone). PNDS were evaluated with the Edinburgh Postnatal Depression Scale (EPDS) at 2 months. A measurement model was built based on the psychosocial model for PNDS of Milgrom and colleagues using exploratory factor analysis. The Structural Equation Model was used to investigate the pathways between vulnerability, risk/protective factors and PNDS at 2 months PP.

RESULTS

In the study sample (n = 11,583), a lack of a partner's perceived antenatal emotional support, consultation with a mental health specialist before pregnancy, family financial difficulties, prenatal psychological distress and a difficult pregnancy experience were directly associated with the severity of maternal PNDS at 2 months PP, as well as lack of perceived postnatal support. Family financial difficulties and consultation with a mental health specialist before pregnancy were also indirectly associated with the intensity of PNDS through a lack of perceived antenatal emotional support, a difficult pregnancy experience, prenatal psychological distress and a lack of perceived postnatal support. Regarding infant and parenthood characteristics, infant self-regulation difficulties, maternal difficulty in understanding infant crying and infant hospitalisation were directly associated with PNDS severity at 2 months PP, while maternal difficulty in understanding an infant's cries was also indirectly associated with infant self-regulation difficulties.

CONCLUSIONS

Perinatal professional support should begin antenatally and target the couple's prenatal functioning, with particular attention to women presenting a history of psychiatric disorders, especially those of low socioeconomic status. After delivery, addressing infant and parenthood characteristics is also recommended.

Parental experiences with changes in maternity care during the Covid-19 pandemic: A mixed-studies systematic review

BACKGROUND

During the COVID-19 pandemic, pregnant women were identified as a high-risk and vulnerable group. To reduce risk of transmission, maternity healthcare services were modified to limit exposure but maintain services for pregnant women. However, the change in hospital practice may have compromised quality maternal care standards. Therefore, this review aims to explore parental experiences and views with maternity care received from healthcare institutions during the COVID-19 pandemic.

METHODS

A mixed studies systematic review was conducted. Six electronic databases (Medline, CINAHL, Embase, PsycInfo, Web of Science, and Maternity and Infant Care) were searched for qualitative, observational, and mixed method studies from the year 2019 to February 2022. Study quality was appraised using the Mixed Methods Appraisal Tool. Quantitative findings were converted to narrative findings. Data was synthesised thematically using a convergent synthesis design.

RESULTS

Fifty-eight articles were included. Four themes were generated: (1) Distress associated with COVID-19 regulations (perception of hospital restrictions, confusion with ever changing policies), (2) adaptability with maternity services (prenatal: changes in birth plans, prenatal: altered antenatal appointments, education, and care, intrapartum: medicalization of birth, postpartum: varied views on care received and Breastfeeding woes, postpartum: skin-to-skin contact and mother infant bonding) (3) importance of support persons, and (4) future direction for maternity services.

CONCLUSIONS

Parental experiences highlighted how maternity care during the COVID-19 pandemic did not adhere to WHO standards of quality maternity care. This calls for healthcare institutions to continuously appraise the implementation of restrictive practices that deviate from evidence-based frameworks underpinning quality care.

Difficulties in Adaptation of the Mother and Newborn via Cesarean Section versus Natural Birth-A Narrative Review

Birth is a physiological act that is part of the morpho-functional economy of the maternal body. Each stage in the act of birth has a predetermined pathway that is neurohormonally induced and morpho-functionally established through specific and characteristic adaptations. Like maternity, childbirth also has an important impact on the maternal body as a biological structure and psycho-emotional behavior. Cesarean section performed at the request of the mother with no medical underlying conditions besides the prolonged hospitalization risk can also cause breathing problems in children, delayed breastfeeding, and possible complications in a future pregnancy. Vaginal birth remains the path of choice for a physiological evolution pregnancy. Although erroneously considered safe and easy today, cesarean section delivery must remain an emergency procedure or a procedure recommended for pregnancies where birth is a risk to the mother and to the child, as cesarean section itself is a risk factor for negative outcomes for both mother and baby. This review summarizes the impact that both cesarean section and natural birth have on mother and newborn in their attempt to adapt to postpartum events and extrauterine life.

Postpartum depression and its correlates: a cross-sectional study in southeast Iran

Background

Postpartum depression has a negative impact on both infants and women. This study aimed to determine the correlates of postpartum depression in women in southern Iran.

Methods

This cross-sectional study was performed on 186 mothers who had recently given birth to a baby. Data were collected using the demographic form, Quality of Prenatal Care Questionnaire, Edinburgh Postnatal Depression Scale (EPDS), Depression, Anxiety and Stress Scale—21 items (DASS-21) 3 days after delivery and EPDS and DASS-21 6 months after childbirth.

Results

Postpartum depression (PPD) was 24.2% and 3.2% 3 days and 6 months after delivery, respectively. Anxiety, Prenatal Care Quality and educational level predicted 34.0% of the variance of PPD 3 days after delivery (R² = 34.0%). Anxiety, type of delivery, and stress predicted 24% of the variance of PPD 6 months after delivery (R² = 24.0%).

Conclusions

With an increase in stress and anxiety and a reduction in the quality of prenatal care, the risk of postpartum depression increases. Therefore, attention to the quality of prenatal care and postpartum stress and anxiety should be carefully evaluated to prevent PPD. Psychological support and interventions are recommended to promote the mental health of women before and after childbirth.

Affective well-being of Chinese urban postpartum women: predictive effect of spousal support and maternal role adaptation

Due to shortage of childcare facilities while high social expectations for mothering, becoming a mother is a big life challenge for most women in urban China. The understandings on Chinese postpartum women's affective well-being and its relation with spousal support and maternal role adaptation remain limited. This study aims to investigate the affective well-being (including both positive and negative affect) of Chinese urban postpartum women and how it is associated with spousal support and maternal role adaptation. A cross-sectional survey was conducted in Shanghai, China, between June and July 2019. A total of 498 urban mothers whose babies were 0 to 1 year old participated in this survey. They completed the Postpartum Social Support Questionnaire (PSSQ), the Maternal Role Adaptation Scale, and the Positive and Negative Affect Scale (PANAS), and reported socio-demographic information. Results showed that positive and negative affect of postpartum women were not significantly associated with each other. Positive affect had a positive correlation with spousal support and maternal role adaptation. Negative affect was negatively associated with maternal role adaptation, while not significantly associated with spousal support. Maternal role adaptation partially mediated the relationship between spousal support and positive affect of the participants, controlling for age, household income, education, birth order, and inter-generational support. The findings indicate that intervention programs towards mental health of postpartum women should focus more on positive affect cultivation; moreover, clinical services should help postpartum women to adapt to maternal role by encouraging new fathers' or partners' involvement in daily childcare-giving.

Prevalence of Postpartum Depression among Women in Childbearing Age Attending Primary Health Care Centres, Qassim Region

Background and Objectives

Postpartum Depression (PPD) is a significant threat to mothering and has negative impact on both mothers and children. There is limited information about PPD prevalence and associated factors in Saudi Arabia particularly in Qassim region. This study aimed to determine the prevalence of PPD and factors associated with PPD among women of childbearing age in Buraidah, Qassim region, Saudi Arabia.

Methods

This was a cross sectional study including 204 mothers aged 18-45 years in postpartum period attending primary health care centres in Buraidah during April to August 2021. A self-administered questionnaire was used to gather data regarding socio-demographic characteristics, newborn related factors, marital and family relationship factors, and social support factors of the participants. Edinburgh Postnatal Depression Scale (EPDS) was used to determine PPD among the participants.

Results

Out of 229 invited women, 204 willingly participated (response rate: 89.1%). More than half of the participants (58.3%) belonged to 18-30 years age group; 62.3% participants had university or above education; 82.4% were housewives; and household income level was considered ‘moderate’ by 65.7% of the participants. According to EPDS, the prevalence of PPD was 13.7% while 17.6% had ‘possible Post-Partum Depression’, and 12.3% had ‘fairly high possibility of Depression’. PPD was significantly associated with friend support (p=0.03) husband support (p=0.01) and absence of conflict with the husband (p=0.02).

Conclusion

More than a quarter of women were likely to have PPD needing monitoring, diagnostic assessment and possible treatment by primary health care physicians or specialists. Comprehensive post-natal care including screening for PPD in primary health care centers is recommended.

Mothers with depressed mood: help-seeking from husbands and child-rearing behaviors

BACKGROUND

Mothers with depressed mood tend not to seek help or support from others. Yet, there is no research providing a detailed examination of the processes that mothers with depressed mood undergo while seeking child-rearing support from their husbands. This study aimed to clarify the processes that mothers with depressed mood go through in seeking child-rearing support from their husbands and performing child-rearing duties.

METHODS

The participants were 10 mothers living in Japan who had given birth within the past three years and were suspected of having depression after screening using the Edinburgh Postnatal Depression Scale. Semi-structured interview data were analyzed based on the grounded theory.

RESULTS

The responses revealed that the mothers felt as though they had insufficient time for themselves, which impelled them to seek support from their husbands, consequently leading them to conclude either that child-rearing and housework are difficult or that child-rearing can be managed some way or another.

CONCLUSION

When the husbands fully cooperated in child-rearing or demonstrated their willingness to cooperate in child-rearing, despite difficulty, the wives accepted their child-rearing support. On the other hand, if the husbands did not recognize their wives' efforts, the wives did not accept their support, even if they had helped with child-rearing. In this way, the wives re-evaluated their relationship with the husbands based on their husbands' attitudes toward child-rearing.

Relationship trajectories of pregnant women with their parents and postpartum depression: A hospital-based prospective cohort study in Japan

BACKGROUNDS

A history of childhood abuse and subsequent poor relationship with parents in adulthood among pregnant women is a known risk factor for postpartum depression (PPD). Although parent-daughter relationship can change during pregnancy, little is known whether the trajectories have an impact on PPD. The aim of this study is to examine whether trajectories of parent-daughter relationship during pregnancy are associated with PPD in Japanese mothers.

METHODS

In a hospital-based prospective cohort study conducted in Japan, 4,772 women were followed from their first visit to their 1-month postpartum check-up (follow-up rate: 77.4%). Parent-daughter relationship was assessed whether participants were satisfied with their parents at first visit and after delivery. We defined four parent-daughter relationship trajectory categories: consistently satisfied, improving, deteriorating, and consistently unsatisfied. PPD was assessed by the Edinburgh Postnatal Depression Scale. Logistic regression model was applied to adjust covariates.

RESULTS

There were 129 (2.7%), 122 (2.6%), and 181 (3.8%) cases of improving, deteriorating, and consistently unsatisfied relationship, respectively. Compared to the group that was consistently satisfied, pregnant women of the deteriorating and consistently unsatisfied group showed 2.81 (95% CI: 1.73-4.55) and 2.39 (95% CI: 1.58-3.62) times, respectively, more likely to show PPD after adjustment for confounders.

CONCLUSION

Women who felt that their relationship with parents "deteriorated" or was "consistently unsatisfactory" during pregnancy showed significant risk of PPD. Paying attention to the pregnant women's feelings about the relationship with their parents and promoting positive change may help predict and prevent PPD.

Lived experiences of Ugandan women who had recovered from a clinical diagnosis of postpartum depression: a phenomenological study

BACKGROUND

Postpartum depression affects a significant proportion of women of childbearing age. The birth of a newborn baby is normally considered a joyful event, inhibiting mothers from expressing their depressive feelings. If the condition is not well understood and managed, mothers with postpartum depression are likely to experience suicidal ideation or even commit suicide. This study explored lived experiences of women who had recovered from a clinical diagnosis of postpartum depression in southwestern Uganda.

METHODS

This phenomenological study adopted the explorative approach through in-depth interviews as guided by the biopsychosocial model of depression. It was conducted in Mbarara Regional Referral Hospital, Bwizibwera Health Centre IV and Kinoni Health Centre IV located in Mbarara and Rwampara districts, southwestern Uganda. Data were collected from 30 postpartum mothers who were purposively selected, between 9th December 2019 and 25th September 2020. We analyzed this work using thematic data analysis and this was steered by the Colaizzi's six-step phenomenological approach of inquiry.

RESULTS

The findings were summarized into five major themes: 1) somatic experiences including insomnia and headache, breast pain, poor breast milk production, weight loss and lack of energy; 2) difficulties in home and family life including overwhelming domestic chores, lack of social support from other family members, fighting at home and financial constraints due to COVID-19 pandemic; 3) negative emotions including anger, self-blame, despondency and feelings of loneliness and regrets of conceiving or marriage; 4) feelings of suicide, homicide and self-harm including suicidal ideation and attempt, homicidal ideations and attempt and feelings of self-harm and 5) coping with postpartum depression including spirituality, termination of or attempt to leave their marital relationships, acceptance, counselling and seeking medical treatment, perseverance.

CONCLUSION AND RECOMMENDATIONS

Suicidal and homicidal thoughts are important parts of the postpartum depression experience, and these may put the lives of the mothers, their spouses and their babies at a great risk. Poor relationship quality, intimate partner violence and lack of financial resources contribute significantly to the negative emotional experiences of mothers with PPD.

The relationship between postpartum depression and social support during the COVID-19 pandemic: A cross-sectional study

AIM

This study aims to examine the prevalence of postpartum depression and its relationship with social support adjusted for self-perceived impact of COVID-19 in parturient women admitted to a perinatal medical center in Japan.

METHODS

This cross-sectional study included 513 women who underwent a 1-month postpartum checkup between August 3 and November 27, 2020. Postpartum depression was measured using the Edinburgh Postnatal Depression Scale. Social support was measured using the Multidimensional Scale of Perceived Social Support and the score was dichotomized using the Youden index. Nineteen demographic and obstetric characteristics were also assessed.

RESULTS

Postpartum depression was observed in 35 (7.6%) of 461 women: 25 (26.6%) and 10 (2.7%) in the low- and high-support groups, respectively. Women in the low-support group were significantly more likely to have postpartum depression than those in the high-support group (odds ratio [OR], 11.7; 95% confidence interval [CI], 5.4-27.3; p < 0.001). Furthermore, no interaction was observed between social support and the impact of COVID-19 for postpartum depression (p = 0.32).

CONCLUSIONS

The prevalence of postpartum depression in the study institution was lower than that reported by previous studies in Japan. Moreover, social support was an important predictive factor for postpartum depression during the COVID-19 pandemic.