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Xiao G, Hu J, Wang H, Li Q, Peng S, Qin C, Li Y. Experience of postpartum depression among Chinese women: A meta-synthesis of qualitative research. Midwifery 2023; 125:103795. [PMID: 37659150 DOI: 10.1016/j.midw.2023.103795] [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: 12/27/2022] [Revised: 03/23/2023] [Accepted: 08/21/2023] [Indexed: 09/04/2023]
Abstract
Postpartum depression (PPD) is associated with various adverse health outcomes among mothers and babies. Meta-synthesis can improve our understanding of postpartum women's experiences. However, the meta-analysis of PPD among Chinese women is limited. Therefore, a meta-analysis was conducted to evaluate the prevalence of PPD among Chinese women and if and how traditional culture may exacerbate PPD. Qualitative studies on the experiences of Chinese women with PPD were searched from database establishment until May 2022 in ten databases. The meta-ethnography reporting guidelines and framework was applied to the writing and reporting of this review. The protocol for this systematic review was registered with the International Prospective Register of Systematic Reviews (CRD42022323388). 2321 studies were retrieved, and 11 studies qualified for the meta-synthesis. The final five themes extracted and re-conceptualized from these studies were as follows: the gap between expectation and reality, conflicts with family, physical and mental frustrations, critical needs for coping with changes, and measures against PPD. Chinese women with PPD frequently feel vulnerable physically, mentally, or both after childbirth and often have conflicts with their families due to the influence of traditional Chinese culture. Family relationships and social support often are factors preventing women from seeking help.
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Affiliation(s)
- Gui Xiao
- School of Xiangya Nursing, Central South University, Changsha, Hunan Province 410000, People's Republic of China; Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province 410000, People's Republic of China; Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation, Central South University, Changsha, Hunan Province 410000, People's Republic of China
| | - Jiaji Hu
- School of Xiangya Nursing, Central South University, Changsha, Hunan Province 410000, People's Republic of China; Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation, Central South University, Changsha, Hunan Province 410000, People's Republic of China
| | - Hu Wang
- School of Xiangya Nursing, Central South University, Changsha, Hunan Province 410000, People's Republic of China; Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation, Central South University, Changsha, Hunan Province 410000, People's Republic of China
| | - Qiyu Li
- School of Xiangya Medicine, Central South University, Changsha, Hunan Province 410000, People's Republic of China
| | - Sha Peng
- School of Xiangya Nursing, Central South University, Changsha, Hunan Province 410000, People's Republic of China; Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation, Central South University, Changsha, Hunan Province 410000, People's Republic of China
| | - Chunxiang Qin
- Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province 410000, People's Republic of China.
| | - Ying Li
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province 410000, People's Republic of China.
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Gao S, Su S, Zhang E, Liu R, Zhang Y, Wang C, Liu J, Xie S, Yin C, Yue W. Psychological health status in postpartum women during COVID-19 pandemic: A systematic review and meta-analysis. J Affect Disord 2022; 319:99-111. [PMID: 36087790 PMCID: PMC9450470 DOI: 10.1016/j.jad.2022.08.107] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/30/2022] [Accepted: 08/26/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND This systematic review and meta-analysis pooled the prevalence of psychological symptoms during the COVID-19 pandemic and examined the effects of the pandemic on psychological health in postpartum women. METHODS A systematic literature search and identification were performed in PubMed, EMBASE, Web of Science, and PsycINFO databases until June 16th, 2021. The fixed or random effect models to estimate the pooled prevalence of postpartum psychological symptoms during the COVID-19 pandemic and the odds ratio (OR) of COVID-19 for psychological symptoms. RESULTS A total of 29 articles including 20,225 postpartum women during the COVID-19 pandemic and 8312 before the COVID-19 pandemic were identified. During the COVID-19 pandemic, the prevalence of postpartum depressive, anxiety, stress, and post-traumatic stress disorder symptoms were 26.7 % (95 % CI: 22.0-31.9 %), 33.8 % (95 % CI: 21.1-49.4 %), 55.0 % (95%CI: 27.9-79.5 %), and 33.7 % (95%CI: 19.6-51.5 %), respectively. The ORs of COVID-19 pandemic for postpartum depressive and anxiety symptoms were 1.54 (95 % CI: 1.00-2.36) and 2.56 (95%CI: 1.62-4.04). Subgroup analyses revealed that women with >6 weeks after delivery, younger than 35 years old, low income, less education and without breastfeeding experienced a higher risk of depressive or anxiety symptoms after delivery. LIMITATIONS Only a few of prospective studies were included, and significant but inevitable heterogeneities were found in some analyses. CONCLUSION A significantly higher proportion of postpartum women were suffered from psychological symptoms during COVID-19 pandemic, particularly in those with >6 weeks after delivery, younger than 35 years old, low income, less education and formula feeding.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Chenghong Yin
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, China.
| | - Wentao Yue
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, China.
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Khoury JE, Atkinson L, Bennett T, Jack SM, Gonzalez A. Prenatal distress, access to services, and birth outcomes during the COVID-19 pandemic: Findings from a longitudinal study. Early Hum Dev 2022; 170:105606. [PMID: 35728399 PMCID: PMC9192354 DOI: 10.1016/j.earlhumdev.2022.105606] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND/AIMS During the COVID-19 pandemic, pregnant people have experienced disruptions to prenatal care, as well elevated rates of mental health problems and distress. The current longitudinal study aims to understand how different forms of prenatal distress (mental health problems, COVID-19 stressful experiences, and access to prenatal services) impact infant birth outcomes during the pandemic. METHODS Participants were 265 pregnant individuals from Ontario, Canada. Maternal depression, pregnancy-related anxiety, COVID-related stressors (i.e., financial difficulties, social isolation), and disruptions to prenatal and health services were assessed during pregnancy. Delivery experiences and birth outcomes were assessed in the early postpartum period. Associations between pregnancy stressors and birth outcomes were assessed using path analyses. RESULTS Participants reported experiencing substantial changes to their prenatal care due to COVID-19; 23.0 % had prenatal appointments cancelled, 47.9 % had difficulty accessing prenatal classes, and 60.8 % reported changes to their birth plans. Results of path analyses showed a unique effect of pregnancy-related anxiety during the pandemic on lower birth weight, younger gestational age at birth, and more infant birth problems. Further, multi-group path analysis revealed these effects were more pronounced in male infants. CONCLUSIONS Findings demonstrate that pregnant individuals in Ontario, Canada have experienced considerable disruptions to services during pregnancy. In addition, pregnancy-related anxiety was uniquely linked to elevated risk for adverse birth outcomes, which more heavily impacted male infants. These findings underscore the need for additional mental health support and access to services for pregnant people and their infants, to reduce long-term adverse maternal and fetal health outcomes.
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Affiliation(s)
- Jennifer E. Khoury
- Department of Psychology, Mount Saint Vincent University; Halifax, NS, Canada,Corresponding author at: Department of Psychology, Mount Saint Vincent University, 166 Bedford Hwy, Halifax B3M 2J6, NS, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Teresa Bennett
- Department of Psychiatry and Behavioural Neurosciences, McMaster University; Hamilton ON, Canada,Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Susan M. Jack
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada,School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University; Hamilton ON, Canada,Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
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Binyamin Y, Wainstock T, Sheiner E, Battat TL, Reuveni I, Leibson T, Pariente G. The association between epidural analgesia during labor and mother-infant bonding. J Clin Anesth 2022; 80:110795. [PMID: 35489303 DOI: 10.1016/j.jclinane.2022.110795] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/19/2022] [Accepted: 03/25/2022] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVE This study was aimed to assess the association between the use of epidural analgesia during labor and mother-infant bonding. DESIGN A cross-sectional study. SETTING Maternity ward at Soroka University Medical Center during 2020. PATIENTS Women who delivered a singleton live-born infant vaginally in their immediate post-partum period. INTERVENTIONS Women completed questionnaires. 25 items post-partum bonding questionnaire (PBQ) to assess mother-infant bonding (A high score on the PBQ indicates impaired mother-infant bonding) and the Edinburgh postnatal depression scale (EPDS) questionnaire to assess risk for post-partum depression. MEASUREMENTS The study used PBQ questionnaire and four sub-scales to assess mother-infant bonding and the EPDS questionnaire to assess risk for post- partum depression. Generalized linear regression models (gamma) were constructed to examine the association between epidural analgesia and mother-infant bonding total score and impaired bonding sub- scale, while adjusting for confounders Additional information such as pregnancy complications and sociodemographic data was drawn from women's medical records. MAIN RESULTS A total of 234 women were included in the final analysis, of them 126 (53.8%) delivered with epidural analgesia. The total PBQ score was significantly lower among women who received epidural analgesia compared to women without epidural analgesia (7.6 vs. 10.2, p = 0.024), demonstrating a better mother -infant bonding. Using two multivariable linear regression models, controlling for confounders such as maternal age and educational status, epidural analgesia during labor was independently associated with a better mother -infant bonding total score and better impaired bonding sub-scale score (Beta coefficient-0.252, 95% CI -0.5; -0.006, p = 0.045 and Beta coefficient - 0.34, 95% CI -0.52; -0.08, p = 0.01 for mother-infant bonding total score and sub-scale score, respectively). No differences in post-partum depression risks were found between the groups (EDPS≥13, 5.7% vs. 13%, p = 0.058). CONCLUSION Our study demonstrated better mother -infant bonding among women delivering with epidural analgesia.
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Affiliation(s)
- Yair Binyamin
- Department of Anesthesiology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Talya Lanxner Battat
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Tom Leibson
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada; Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, Toronto, ON, Canada
| | - Gali Pariente
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel
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Safi-Keykaleh M, Aliakbari F, Safarpour H, Safari M, Tahernejad A, Bardsiri HS, Sahebi A. Prevalence of postpartum depression in women amid the COVID-19 pandemic: A systematic review and meta-analysis. Int J Gynaecol Obstet 2022; 157:240-247. [PMID: 35122433 PMCID: PMC9087783 DOI: 10.1002/ijgo.14129] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 02/02/2022] [Indexed: 11/06/2022]
Abstract
COVID‐19 outbreaks appear to be related to exacerbation of psychological problems such as depression and anxiety in high‐risk population such as pregnant women and the postpartum period due to stress and life‐threatening illnesses. The aim of this study was to evaluate the prevalence of postpartum depression (PPD) during COVID‐19. This study protocol is registered in PROSPERO with CRD42021278425 code. Data sources including Google Scholar, ISC, Magiran, Scopus, PubMed, Embase, and Web of Science and reference list of included articles were used to identify related studies. Observational studies that reported the prevalence of PPD in both Persian and English during COVID‐19 between January 20, 2020 and August 31, 2021 were included. Data were collected and analyzed with a random effects model for meta‐analysis. In this study, 671 initial articles were identified and after removing duplicates, 454 studies were screened and finally 24 studies entered the meta‐analysis stage. According to this study results PPD based on Edinburgh Postnatal Depression Scale (EPDS) ≥9, EPDS ≥10, EPDS ≥11, EPDS ≥12, EPDS ≥13, Postpartum Depression Screening Scale‐Short Form (PDSS‐SF) ≥17 and total prevalence was reported 12% (95% confidence interval [CI] = 0.07–17, I2 = 97%), 27% (95% CI = 15–39, I2 = 99%), 44% (95% CI = 40–49, I2 = 0.0%), 27% (95% CI = 0.06–49, I2 = 97.4%), 28% (95% CI = 18–39, I2 = 98.5%), 37% (95% CI = 32–42), 28% (95% CI = 23–33, I2 = 98.5%). The findings of this study showed that the prevalence of PPD in women is relatively high during COVID‐19. Therefore, considering the psychological consequences of the COVID‐19 pandemic and the importance of pregnancy and the postpartum period in terms of the emergence of mental disorders, especially depression, it seems necessary to perform interventions and physical and psychological support. The present study found that the prevalence of postpartum depression( PPD) in women is relatively high during COVID‐19.
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Affiliation(s)
- Meysam Safi-Keykaleh
- Nahavand School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Aliakbari
- Community-Oriented Nursing and Midwifery Research, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hamid Safarpour
- Non - Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran.,Department of Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Mehdi Safari
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Tahernejad
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hojjat Sheikh Bardsiri
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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