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Seid J, Mohammed E, Cherie N, Yasin H, Addisu E. The magnitude of perinatal depression and associated factors among women in Kutaber woreda public health institution and Boru Meda general hospital, Ethiopia, 2022: a cross-sectional study. Front Psychiatry 2024; 14:1302168. [PMID: 38318482 PMCID: PMC10838999 DOI: 10.3389/fpsyt.2023.1302168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024] Open
Abstract
Background Perinatal depression, characterized by the presence of depressive symptoms during pregnancy and/or within the first 12 months postpartum, poses a significant global public health concern. It contributes to a multitude of health risks for mothers, their infants, and their families. Understanding of perinatal depression and its associated factors is crucial for effective prevention and intervention strategies. However, there is a lack of comprehensive research on this topic in Ethiopia. Therefore, this study aims to determine the prevalence and factors contributing to perinatal depression among Ethiopian women. Methods An institutional-based cross-sectional study was conducted, involving 552 women receiving perinatal services at Kutaber district health institution and Boru Meda General Hospital. Study participants were selected through systematic random sampling techniques. Perinatal depression was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21). The associations between various determinants and perinatal depression were examined using binary logistic regression, and factors with a p-value of less than 0.2 were included in the multiple logistic regression analysis. A p-value less than 0.05 was considered statistically significant. Results The prevalence of perinatal depression was found to be 32.2%. The prevalence of perinatal depression was found to be 32.2%. Factors significantly associated with perinatal depression included being a student [adjusted odds ratio (AOR) = 4.364, 95% confidence interval (CI): 1.386, 13.744], experiencing excessive pregnancy-related concerns (AOR = 1.886, 95% CI: 1.176, 3.041), past substance use (AOR = 2.203, 95% CI: 1.149, 4.225), the presence of anxiety symptoms (AOR = 3.671, 95% CI: 2.122, 6.352), experiencing stress symptoms (AOR = 6.397, 95% CI: 3.394-12.055), and daytime sleepiness (AOR = 2.593, 95% CI: 1.558, 4.316). Conclusion The findings of this study indicate a relatively high prevalence and valuable factors associated with perinatal depression. It highlights the need for a comprehensive approach to perinatal mental health that takes into account not only the biological aspects of pregnancy but also the psychological, social, and lifestyle factors that can impact a person's mental well-being during this critical period.
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Affiliation(s)
- Jemal Seid
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Emam Mohammed
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Nigusie Cherie
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Husnia Yasin
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Elsabeth Addisu
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Postpartum Depression and Anxiety among Lebanese Women: Correlates and Scales Psychometric Properties. Healthcare (Basel) 2023; 11:healthcare11020201. [PMID: 36673569 PMCID: PMC9859353 DOI: 10.3390/healthcare11020201] [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: 12/04/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
Background: We found that it was important to fill a gap in the literature and check the psychometric properties of the Edinburgh Postnatal Depression Scale (EPDS) and Perinatal Anxiety Screening Scale (PASS) in the Arabic language and delineate factors associated with postnatal depression (PPD) and anxiety (PPA) among Lebanese women 4−6 weeks after delivery. Methods: This cross-sectional study carried out between July 2018 and March 2019 enrolled 295 participants who came for a postnatal checkup at four clinics. Results: The EPDS and PASS scales’ items converged over two- and four-factor solutions, explaining 62.51% and 53.33% of the variance, respectively (KMO EPDS = 0.816, αCronbach EPDS = 0.826; KMO PASS = 0.878, αCronbach PASS = 0.920; Bartlett’s test of sphericity p < 0.001). Higher postpartum anxiety (Beta = 0.256), higher postpartum insomnia (Beta = 0.079), having hypotension during pregnancy (Beta = 2.760), and having a second (Beta = 1.663) or a third baby or more (Beta = 2.470) compared with the first one were significantly associated with higher postpartum depression. Higher postpartum depression (Beta = 1.33) was significantly associated with higher postpartum anxiety, whereas having a baby through a planned pregnancy (Beta = −4.365) and having a baby who ate regularly (Beta = −3.639) were significantly associated with lower postpartum anxiety. Conclusion: Depression and anxiety prevalence rates in the Lebanese population were higher compared with other countries, which may be due in part to the differences in regional, social and environmental culture.
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Ngai FW, Gao LL. Effect of couple-based interpersonal psychotherapy on postpartum depressive symptoms: A randomised controlled trial. Asian J Psychiatr 2022; 78:103274. [PMID: 36215873 DOI: 10.1016/j.ajp.2022.103274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/11/2022] [Accepted: 09/28/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Interpersonal psychotherapy (IPT) is one of the most effective interventions for postnatal depression. Few studies have evaluated the effect of IPT on postnatal depression for both mothers and fathers. This aimed to examine the effect of couple-based IPT on postpartum depressive symptoms among Chinese mothers and fathers at 6 weeks and 6 months postpartum. METHODS A randomised controlled trial was conducted with 455 childbearing couples recruited from two hospitals and randomly allocated to the couple-based IPT (n = 224) and usual care (n = 231) groups. Postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). RESULTS Both mothers and fathers in the couple-based IPT demonstrated significant and sustained reduction in depressive symptoms at 6 weeks (mean difference in mothers = 1.91, p < .001; mean difference in fathers = 1.14, p = .005) and 6 months postpartum (mean difference in mothers = 0.89, p = .039; mean difference in fathers = 1.29, p = .003), compared to those in usual care. The proportions of mothers and fathers who were at risk of postnatal depression (EPDS > 9) were significantly lower in the IPT group than in the usual care group at 6 weeks postpartum (difference in mothers = 21.9%, p < .001; difference in fathers = 10.7%, p = .005), but no significant differences were found at 6 months postpartum. CONCLUSIONS The benefits of the couple-based IPT in this study highlights the importance of incorporating IPT into perinatal services to promote perinatal mental health for both partners.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Chen HH, Lai JCY, Wang KL, Chien LY. Bi-dimensional acculturation and social support on perinatal depression in marriage-based immigrant women. Arch Psychiatr Nurs 2022; 41:227-233. [PMID: 36428054 DOI: 10.1016/j.apnu.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Sociocultural factors play critical roles in the mental health of marriage-based immigrant women. However, the effect of bi-dimensional acculturation ("adaptation to host culture" and "maintenance of heritage culture") and social support on perinatal depression across time was unknown among them. OBJECTIVE To examine the effect of bi-dimensional acculturation and social support on perinatal depression among marriage-based immigrant women in Taiwan. METHODS This longitudinal study recruited 310 immigrant mothers to complete structured questionnaires during pregnancy and postpartum periods. Depression was assessed using the Edinburgh Postnatal Depression Scale. Bi-dimensional acculturation was measured using the Bi-dimensional Acculturation Scale for Marriage-Based Immigrant Women. Social support was measured by a three-subscale instrument, namely emotional, instrumental, and informational support. RESULTS Depression scores increased from pregnancy to three months postpartum, and decreased from six to twelve months postpartum. The generalized estimating equation results showed that lower adaptation to host culture, emotional support, and informational support were associated with higher maternal depression scores over time. Maintaining heritage culture has both positive (from pregnancy to three months postpartum) and negative associations (from six to twelve months postpartum) with maternal depression, further, increased emotional support enhanced the protective effect of adaptation to host culture, but decreased the positive effect of maintenance of heritage culture on depression. CONCLUSION Strategies should be developed to assist perinatal immigrant women to adapt to the host culture, maintain their heritage culture, and resolve potential cultural conflicts to decrease their depression. Respect for immigrant mothers' heritage cultures should be accompanied by increased emotional support.
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Affiliation(s)
- Hung-Hui Chen
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan Address: No.1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., Taipei City 100233, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan Address: No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 100225, Taiwan.
| | - Jerry Cheng-Yen Lai
- Department of Medical Research, Taitung MacKay Memorial Hospital, Taitung City, Taiwan Address: No.1, Lane 303, Changsha Street, Taitung, 95054, Taiwan.
| | - Kung-Liahng Wang
- Department of Obstetrics and Gynecology, Taitung MacKay Memorial Hospital, Taitung, Taiwan Address: No.1, Lane 303, Changsha Street, Taitung 95054, Taiwan; Department of Nursing, MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan Address: No.92, Shengjing Rd., Beitou Dist., Taipei City 11272, Taiwan; Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan Address: No.92, Section 2, Zhongshan N. Rd., Zhongzheng Dist., Taipei City 10449, Taiwan; Department of Obstetrics and Gynecology, MacKay Medical College, New Taipei City, Taiwan Address: No.46, Section 3, Zhongzheng Rd., Sanzhi District, New Taipei City 25245, Taiwan.
| | - Li-Yin Chien
- Institute of Community Health Care, Collage of Nursing, National Yang Ming Chiao Tung University/Yang-Ming Campus, Taipei, Taiwan Address: No.155, Sec. 2, Linong St., Beitou Dist., Taipei City 112304, Taiwan.
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Jiang T, Tuxunjiang X, Wumaier G, Li X, Li L. Path analysis of influencing factors for prenatal depressive symptoms in pregnant women. J Affect Disord 2022; 317:397-402. [PMID: 36029871 DOI: 10.1016/j.jad.2022.08.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/20/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To explore the influencing factors and relationships associated with prenatal depressive symptoms in pregnant women. METHODS This study was a survey based cross-sectional investigation conducted on 750 pregnant women who underwent pregnancy and delivery examinations in a third class hospital in Urumqi City, and their general information was collected and a patient health questionnaire using a depression scale (Patients' Health Questionnaire Depression Scale - 9 item, PHQ - 9). Spss25.0 was used to compare the differences between the maternal depressive symptoms group and the non-depressed group, and Amos23.0 was used to construct a structural equation model to explore the influencing factors. RESULTS The incidence of depressive symptoms in 750 pregnant women was 13.6 % (102/750) and maternal prenatal depressive symptoms was related to occupation, total monthly income, physical exercise, psychological preparation for pregnancy, residence status, couple relationship, knowledge about pregnancy and other factors (P < 0.05). Binary logistic regression analysis showed that the independent risk factors for prenatal depressive symptoms in pregnant women included occupation (OR = 2.492), monthly gross income (OR = 1.293), psychological preparation for pregnancy (OR = 1.882), residential status (OR = 1.831), knowledge about pregnancy (OR = 2.028), prenatal anxiety (OR = 1.415), and pregnancy stress (OR = 4.590). The constructed path analysis model had good a fit (x2/DF = 3.805, GFI = 0.976, AGFI = 0.946, NFI = 0.902, CFI = 0.924, RMSEA = 0.061) and the path analysis showed that pregnancy stress had only a direct effect on prenatal depressive symptoms (effect value 0.169). DISCUSSION The binary logistic regression model showed that knowledge about pregnancy had the greatest influence on prenatal depressive symptoms, and the popularization of pregnancy knowledge reduced prenatal depressive symptoms.
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Affiliation(s)
- Ting Jiang
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | | | | | - Xue Li
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | - Ling Li
- Obstetrics Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China.
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Takahashi I, Murakami K, Kobayashi M, Kikuchi S, Igarashi A, Obara T, Ishikuro M, Ueno F, Noda A, Onuma T, Matsuzaki F, Kobayashi N, Hamada H, Iwama N, Saito M, Sugawara J, Tomita H, Yaegashi N, Kure S, Kuriyama S. Association of maternal psychological distress and the use of childcare facilities with children's behavioral problems: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. BMC Psychiatry 2022; 22:693. [PMID: 36357866 PMCID: PMC9650864 DOI: 10.1186/s12888-022-04330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 10/21/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Childcare facilities are a factor that lowers the established association of mother's postnatal psychiatric symptoms with children's behavioral problems. However, no studies have considered the prenatal psychiatric symptoms yet. This study examined whether the use of childcare facilities moderates the association of maternal psychological distress in early pregnancy and at two years postpartum with behavioral problems in children aged four years. METHODS The present study was based on the data from 23,130 mother-child pairs participating in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. K6 was used to classify maternal psychological distress in early pregnancy and at two years postpartum into four categories: none in both prenatal and postnatal periods (none), only the prenatal period (prenatal only); only the postnatal period (postnatal only); both prenatal and postnatal periods (both). The children's behavioral problems were assessed using the Child Behavior Checklist for Ages 1½-5 (CBCL) aged four years. The clinical range of the externalizing, internalizing, and total problem scales of the CBCL was defined as having behavioral problems. To examine whether availing childcare facilities moderates the association between maternal psychological distress and children's behavioral problems, we conducted a stratified analysis based on the use of childcare facilities or not, at two years of age. The interaction term between maternal psychological distress and use of childcare facilities was included as a covariate in the multivariate logistic regression analysis to confirm the p-value for the interaction. RESULTS The prevalence of the clinical ranges of externalizing problems, internalizing problems, and clinical range of total problems were 13.7%, 15.4%, and 5.8%, respectively. The association of maternal psychological distress with a high risk of children's behavioral problems was significant; however, the association between prenatal only psychological distress and externalizing problems in the group that did not use childcare facilities was not significant. Interactions between the use of childcare facilities and maternal psychological distress on behavioral problems in children were not significant. CONCLUSIONS Use of childcare facilities did not moderate the association of maternal psychological distress in early pregnancy and at two years postpartum with behavioral problems in children aged four years.
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Affiliation(s)
- Ippei Takahashi
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiko Murakami
- Tohoku University Graduate School of Medicine, Sendai, Japan. .,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan.
| | - Mika Kobayashi
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan
| | - Saya Kikuchi
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.412757.20000 0004 0641 778XDepartment of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Ayaka Igarashi
- grid.69566.3a0000 0001 2248 6943Tohoku University School of Medicine, Sendai, Japan
| | - Taku Obara
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan ,grid.412757.20000 0004 0641 778XDepartment of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Mami Ishikuro
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan
| | - Fumihiko Ueno
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan
| | - Aoi Noda
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan ,grid.412757.20000 0004 0641 778XDepartment of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Tomomi Onuma
- grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan
| | - Fumiko Matsuzaki
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan
| | - Natsuko Kobayashi
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.412757.20000 0004 0641 778XDepartment of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Hirotaka Hamada
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.412757.20000 0004 0641 778XDepartment of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Noriyuki Iwama
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan ,grid.412757.20000 0004 0641 778XDepartment of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Masatoshi Saito
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.412757.20000 0004 0641 778XDepartment of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Junichi Sugawara
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan ,grid.412757.20000 0004 0641 778XDepartment of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Hiroaki Tomita
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan ,grid.412757.20000 0004 0641 778XDepartment of Psychiatry, Tohoku University Hospital, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Nobuo Yaegashi
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan ,grid.412757.20000 0004 0641 778XDepartment of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Shigeo Kure
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan
| | - Shinichi Kuriyama
- grid.69566.3a0000 0001 2248 6943Tohoku University Graduate School of Medicine, Sendai, Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573 Japan ,grid.69566.3a0000 0001 2248 6943International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
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Association between pre-pregnancy tobacco smoking and postpartum depression: A nationwide cohort study. J Affect Disord 2022; 316:56-62. [PMID: 35940375 DOI: 10.1016/j.jad.2022.07.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 07/23/2022] [Accepted: 07/30/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Prior literature examining the association between cigarette smoking and postpartum depression (PPD) has focused primarily on smoking behaviors during pregnancy or postpartum. However, there is a dearth of studies assessing pre-pregnancy smoking in relation to PPD. METHOD A retrospective national cohort data from the National Health Insurance of South Korea were analyzed. A total of 392,394 women who gave birth between 2011 and 2015 and received health checkups within a year before pregnancy without a history of diagnosed depression were included. During the health checkup, participants self-reported their smoking status, amount, and duration in a health questionnaire. The diagnosis of PPD was defined by ICD-10 codes F32 and F33 during hospital visits within two years postpartum. RESULT Overall, 24,441 (6.2 %) women were newly diagnosed with depression within two years postpartum. Those who reported that they had quit smoking or were currently smoking before pregnancy were more likely to be diagnosed with PPD compared to nonsmokers. A greater number of cigarettes smoked was associated with a higher risk of PPD for both current and former smokers. Results of cumulative lifetime smoking exposure demonstrated that even those with 2 pack-years of smoking had an increased risk of developing PPD within two years postpartum (HR: 1.44, 95 % CI: 1.29-1.60). Those who smoked >10 pack-years had the highest risk of developing PPD (HR: 1.86, 95 % CI: 1.14-3.04) compared to nonsmokers. CONCLUSION Greater amount and duration of cigarette smoking in pre-pregnancy can increase the risk of PPD.
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Lin J, Zhou Y, Gu W. The synergistic effects of short inter-pregnancy interval and micronutrients deficiency on third-trimester depression. Front Nutr 2022; 9:949481. [PMID: 36245527 PMCID: PMC9554465 DOI: 10.3389/fnut.2022.949481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/12/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To explore the effect of inter-pregnancy interval (IPI) and micronutrients on depression in the third trimester of pregnancy. Materials and methods A total of 5,951 eligible pregnant women were included in this single-center retrospective cohort study. Variables with potential effects on third-trimester depression were collected. These variables included: maternal factors [age, pregnancy interval, body mass index (BMI), BMI change, gravidity, native place, education, smoking, and alcohol consumption], previous delivery outcomes [preterm birth, preeclampsia, intrahepatic cholestasis of pregnancy (ICP), gestational diabetes mellitus (GDM), fetal growth restriction (FGR), and delivery mode], and micronutrients in early pregnancy (folic acid, 25-hydroxy vitamin D, vitamin B12, calcium, and ferritin). Univariate and multivariate analyses were used to screen the factors affecting the occurrence of depression. Based on these factors, the nomogram model was established. At the same time, the interaction between IPI and micronutrients was verified. Results The incidence of depression in the third trimester of pregnancy was 4.3%. Univariate and multivariate analysis showed that there were five independent risk factors for third-trimester depression: gravidity, previous cesarean section delivery, folic acid, and vitamin D levels in early pregnancy and IPI. According to the multivariate logistic regression analysis, the prediction model and nomogram were established. The prediction cut-offs of the corresponding factors were calculated according to the Youden index. Finally, the synergistic effect of short IPI and micronutrient deficiency was verified. Conclusion There is a synergistic effect between short IPI and micronutrient deficiency in early pregnancy, which can aggravate the occurrence of depression in late pregnancy.
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Affiliation(s)
- Jing Lin
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Ye Zhou
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Wei Gu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- *Correspondence: Wei Gu,
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Osman DM, Ahmed GK, Farghal MM, Ibrahim AK. Prevalence and predictors of depressive symptoms among married Egyptian women: a multicenter primary healthcare study. BMC Psychiatry 2022; 22:602. [PMID: 36088377 PMCID: PMC9463867 DOI: 10.1186/s12888-022-04239-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Depression affects about 3.8% of the world's population. Although marriage may contribute to subjective well-being, some marital variables could increase women's risk for depression. This study aimed to determine the prevalence of depressive symptoms and their correlates among married females attending primary healthcare facilities. METHODS A cross-sectional study was conducted on a purposive sample of 371 married women at the primary healthcare centers, Assiut Governorate, Upper Egypt. In this study, an interviewer-administered questionnaire was used for data collection. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and marital satisfaction using the ENRICH Marital Satisfaction Scale (EMS). Standardized measurements of weight and height were performed. RESULTS According to the PHQ-9 diagnostic criteria, the prevalence of depressive symptoms among the studied married females was 30.2%. The significant predictors of depressive symptoms were advanced husbands' ages, living with an extended family, exposure to spousal verbal violence, high body weight, and low marital satisfaction levels. CONCLUSIONS Approximately one-third of married Egyptian women experienced depressive symptoms. In addition to high body weight, some social and marital factors contributed to the increase in women's vulnerability to depressive symptoms. Egyptian primary healthcare physicians should be trained to identify females with depressive symptoms and refer them to specialists if need be. To combat depression in women, it may be helpful to construct qualified marital counseling centers. This may improve marital satisfaction, decrease the negative consequences of spousal violence, and ensure the value of independence for new families.
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Affiliation(s)
- Doaa Mohamed Osman
- grid.252487.e0000 0000 8632 679XPublic Health and Community Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Gellan K. Ahmed
- grid.252487.e0000 0000 8632 679XDepartment of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Manal Mukhtar Farghal
- grid.415762.3Family Planning Physician, Egyptian Ministry of Health and Population, Cairo, Egypt
| | - Ahmed K. Ibrahim
- grid.252487.e0000 0000 8632 679XPublic Health and Community Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt
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Yamada M, Tanaka K, Arakawa M, Miyake Y. Perinatal maternal depressive symptoms and risk of behavioral problems at five years. Pediatr Res 2022; 92:315-321. [PMID: 34465880 DOI: 10.1038/s41390-021-01719-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/01/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Evidence on the association between perinatal maternal depression and children's behavioral development is limited. We investigated the association between maternal depressive symptoms during pregnancy and postpartum and the risk of childhood behavioral problems using data from a birth cohort study. METHODS Study subjects were 1199 mother-child pairs. Maternal depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale during pregnancy and the Edinburgh Postnatal Depression Scale at 4 months postpartum. Children's behavioral development at 5 years of age was assessed with the Strengths and Difficulties Questionnaire. RESULTS Compared with children whose mothers did not experience depressive symptoms during pregnancy, those whose mothers did experience depressive symptoms during pregnancy had increased risk of emotional symptoms, conduct problems, hyperactivity, peer problems, and low prosocial behavior. Maternal depressive symptoms at around 4 months postpartum were associated with increased risk of childhood emotional problems. Compared with children whose mothers did not experience depressive symptoms during the perinatal period, those whose mothers did experience depressive symptoms both during pregnancy and postpartum had a fivefold increased risk of childhood emotional symptoms and a threefold increased risk of peer problems. CONCLUSIONS Our findings suggest that perinatal maternal depression is associated with behavioral problems in children. IMPACT Several epidemiological studies in Western countries have examined the association between perinatal maternal depression and children's behavioral development, yet the results are conflicting and inconclusive. There is limited evidence on this topic in Asia. In our study using data from a prospective pregnancy birth cohort, maternal depressive symptoms around 4 months postpartum were associated with an increased risk of emotional symptoms in children aged 5 years. Children whose mothers had exhibited depressive symptoms both during pregnancy and postpartum had a fivefold increased risk of childhood emotional symptoms and a threefold increased risk of peer problems.
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Affiliation(s)
- Maoka Yamada
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan. .,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Ehime, Japan.
| | - Masashi Arakawa
- Wellness Research Fields, Faculty of Global and Regional Studies, University of the Ryukyus, Nishihara, Okinawa, Japan
| | - Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Ehime, Japan
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11
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Shieh PL, Tsai TY. The prediction of perceived parenting style on mother-infant bonding. Acta Psychol (Amst) 2022; 226:103573. [PMID: 35338832 DOI: 10.1016/j.actpsy.2022.103573] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 02/04/2022] [Accepted: 03/20/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There are limited studies on the associations among parenting style, postpartum depression, and mother-infant bonding. OBJECTIVE The aims of this study are investigating how the parenting style of maternal grandparents predicted the mothers' bonding with their infants. The mediating roles of postpartum depression were also explored. PARTICIPANTS AND SETTING A community sample of 227 postpartum women participated in this study. The participants primarily consisted of women who gave birth within six months (89.9%). METHODS A cross-sectional and convenient sampling strategy was applied. Instruments were Parental Bonding Instrument, Edinburgh Postnatal Depression Scale, Postpartum Bonding Questionnaire, and Background Form. RESULTS In the young infant group (i.e. mothers with infants not older than three months), the results indicated that maternal protection could predict "impaired bonding" (β = 0.20, p < .05). This prediction was mediated by postpartum depression (β = 0.32, p < .001). In the older infant group, paternal and maternal care could directly predict "rejection and anger" (β = -0.20, -0.22 respectively, p < .05). Maternal protection could predict three bonding factors (β = 0.25-0.29, p < .05, 0.01). Postpartum depression acted as total mediator for "impaired bonding"(β = 0.45, p <. 001), and acted as partial mediators in "rejection and anger" and "anxiety about care" (β = 0.45, 0.28, ps < .001, .01). CONCLUSIONS Perceived parenting style (especially maternal protection) has impacts on adverse mother-infant bonding. Furthermore, the impact is more prominent on mothers of older infants. "Rejection and anger" could be the most vulnerable bonding factor affected by parenting style. Since postpartum depression mediates the predictions, interventions could concurrently address maternal parenting style and postpartum depression.
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Xayyabouapha A, Sychareun V, Quyen BTT, Thikeo M, Durham J. Prevalence and Risk Factors Associated With Postpartum Depressive Symptoms Among Women in Vientiane Capital, Lao PDR. Front Public Health 2022; 10:791385. [PMID: 35592080 PMCID: PMC9110677 DOI: 10.3389/fpubh.2022.791385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
Postpartum depression (PPD), the onset of depressive episodes after childbirth, is the most common psychological condition following childbirth, and a global public health concern. If undiagnosed and/or untreated, postpartum depression can have negative effects on maternal and child health, however, there are few studies on the prevalence of postpartum depression in low- and middle-income countries. To contribute to filling this gap, this study examined the prevalence and risk factors associated with postpartum depressive symptoms among women after delivery in Vientiane Capital, Lao PDR. The study was a cross-sectional design, with multistage sampling used to identify women between 4 and 24 weeks after giving birth (N = 521). The Edinburgh Postnatal Depression Scale was used to identify women with postpartum depressive symptoms. Univariate and multivariate logistic regressions identified risk factors associated with postpartum depressive symptoms. The prevalence of postpartum depressive symptoms among participants was 21.3%. Associated factors were having at least 2-3 living children (AOR: 1.9, 95% CI: 1.1-3.0), experiencing mental health problems during pregnancy (AOR: 3.3, 95% CI: 1.4-7.6), experiencing conflicts with family members (AOR: 2.5, 95% CI: 1.5-4.0), the experience of intimate partner violence (AOR: 2.6, 95% CI: 1.3-5.5), and receiving moderate social support (AOR: 5.6, 95% CI: 3.2-10.0). In contexts where access to mental health specialists has severely constrained maternal and child healthcare providers at primary health care must be supported to develop the necessary skills to identify risk factors and symptoms and offer basic essential services for postpartum depressive symptom (PDS). The study identified a high proportion of mothers with postnatal depressive symptoms, highlighting the need to screen and treat mothers who present with PDS, as not doing so exposes mother and their children to a range of negative health and social outcomes. Addressing the stigma associated with mental health illness and mental health illness and domestic violence that prevents women from seeking healthcare, must also be developed, implemented, and evaluated.
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Affiliation(s)
- Amkha Xayyabouapha
- Faculty of Public Health, University of Health Sciences and Hanoi University of Public Health, Vientiane, Laos
| | | | - Bui Thi Tu Quyen
- Biostatistics Department, Faculty of Fundamental Sciences, Hanoi University of Public Health, Vietnam, Laos
| | - Manivone Thikeo
- Faculty of Public Health, University of Health Sciences, Vientiane, Laos
| | - Jo Durham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Applying mindfulness techniques to the management of perinatal women with a depressive tendency in Taiwan: A qualitative study. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:149-154. [DOI: 10.1016/j.anr.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/21/2022] Open
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Anjarwati A, Koni Suryaningsih E. The Relationship between Pregnancy-related Anxiety and Maternal-fetal Attachment among Primigravida. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Many studies support the hypothesis that pregnancy-related anxiety (PRA) is strongly linked to postpartum depression, preterm births, low birth weight, fetal growth restriction, pregnancy complications, and negative infant outcomes. PRA has also been associated with mother-fetal bond during pregnancy that a special relationship between the mother and infant and growth beyond before the infant is born. Although extensive studies on PRA and maternal-fetal attachment (MFA) have been carried out, little attention on these issues is done in the Indonesian context.
AIM: To fill such a gap, the present study aimed to investigate the relationship between maternal PRA and MFA.
METHODS: Expectant mothers who visit their antenatal care in the primary health community services at Yogyakarta participated in this study. They were recruited using a purposive sampling technique based on the criteria: (a) The 1st time pregnancy, (b) in the late stage of pregnancy, (c) have no complication, (d) mother at any age range, and (e) mother at any education level. G-power 3.1.9.2 with effect size 0.15 has used to determine the number of samples, 84 people. Statistical analysis Pearson correlation has been applied and calculates the t relationship between two variables. General linier model analysis conducted the contribution of demographic variables to PRA and MFA.
RESULTS: There is a significant relationship between maternal anxiety during pregnancy and MFA (p < 0.001) and a significant correlation between PRA and maternal age. However, there were no correlation between MFA and demographic variables.
IMPLICATION FOR PRACTICE: Findings study provides the crucial information as the new approach to enhance the quality of care of mother’s and infant’s health during pregnancy as well as to promote maternal mental health.
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Ma R, Yang F, Zhang L, Sznajder KK, Zou C, Jia Y, Cui C, Zhang W, Zhang W, Zou N, Yang X. Resilience mediates the effect of self-efficacy on symptoms of prenatal anxiety among pregnant women: a nationwide smartphone cross-sectional study in China. BMC Pregnancy Childbirth 2021; 21:430. [PMID: 34140012 PMCID: PMC8212491 DOI: 10.1186/s12884-021-03911-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background Prenatal anxiety is one of the most prevalent mental disorders during pregnancy. This study assessed the prevalence of prenatal anxiety and examined whether resilience could play the mediating role in the association between self-efficacy and symptoms of prenatal anxiety among pregnant women in China. Methods A nationwide smartphone cross-sectional study was carried out in three cities (Shenyang of Liaoning Province, Zhengzhou of Henan Province and Chongqing Municipality) in China from July 2018 to July 2019. The questionnaire consisted of questions on demographic characteristics, the Generalized Anxiety Disorder Scale (GAD-7), the Chinese version of General Self-efficacy Scale (GSES), and the 14-item Wagnild and Young Resilience Scale (RS-14). A total of 665 pregnant women were recruited in this study. A hierarchical multiple regression model was employed to explore the associate factors and mediators of symptoms of prenatal anxiety. A structural equation model was employed to test the hypothesis that resilience mediates the association between self-efficacy and symptoms of prenatal anxiety. Results The prevalence of symptoms of prenatal anxiety was 36.4% in this study. Self-efficacy was negatively correlated with symptoms of prenatal anxiety (r = -0.366, P < 0.01). Resilience had a significant positive correlation with self-efficacy (r = 0.612, P < 0.01) and had a negative correlation with symptoms of prenatal anxiety (r = -0.427, P < 0.01). The hierarchical multiple regression model indicated that self-efficacy and resilience were the main factors associated with symptoms of prenatal anxiety and contributed to 11.9% and 6.3% to the variance of symptoms of prenatal anxiety, respectively. Resilience served as a mediator between self-efficacy and symptoms of prenatal anxiety (a*b = -0.198, Bias-corrected and accelerated bootstrap 95% Confidence interval: -0.270, -0.126). Conclusions Self-efficacy was a negative predictor of symptoms of prenatal anxiety among pregnant women. Moreover, resilience mediated the relation between self-efficacy and symptoms of prenatal anxiety among pregnant women in China. It was observed in this study that psychological interventions might be beneficial for pregnant women to relieve symptoms of prenatal anxiety through improved self-efficacy and resilience. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03911-5.
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Affiliation(s)
- Ruqing Ma
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Fengzhi Yang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Lijuan Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Kristin K Sznajder
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Changqing Zou
- Department of Humanities and Social Sciences, China Medical University, Shenyang, Liaoning Province, China
| | - Yajing Jia
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Can Cui
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Weiyu Zhang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China
| | - Wenzhu Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Ning Zou
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Xiaoshi Yang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
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Phoosuwan N, Lundberg PC. Knowledge, attitude and self-efficacy program intended to improve public health professionals' ability to identify and manage perinatal depressive symptoms: a quasi-experimental study. BMC Public Health 2020; 20:1926. [PMID: 33380321 PMCID: PMC7774237 DOI: 10.1186/s12889-020-10086-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 12/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During the perinatal period women lack screening and treatments for perinatal depressive symptoms, while public health professionals (PHPs) in primary care centres (PCCs) need training for identification and management of such symptoms. This quasi-experimental study was aimed at evaluating knowledge, attitudes and self-efficacy among PHPs after participating in a Knowledge, Attitude, and Self-efficacy (KAS) program for identification and management of perinatal depressive symptoms. METHOD The KAS-program, carried through in Sakonnakhon in north-eastern Thailand, comprised one day of theory and a four-week period of field practice. Thirty-three PHPs from PCCs participated in the program. Twenty-three of them participated in focus group discussions (FGDs). Chi-square for trend, paired-sample T-tests and content analysis were used. RESULTS Knowledge, attitude and self-efficacy scores increased after the PHPs had fully participated in the KAS-program. Four categories emerged from the FGDs: increased understanding and knowledge, being aware and having a positive attitude, having confidence and ability to work, and need of regular training and feedback. CONCLUSION The KAS-program may contribute to giving PHPs in PCCs the knowledge, positive attitude and self-efficacy they need to identify and manage perinatal depressive symptoms. Implementation of the KAS-program to other healthcare professionals such as nurses/midwives is great of interest.
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Affiliation(s)
- Nitikorn Phoosuwan
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, BMC, Husargatan 3, Box 564, 751 22, Uppsala, Sweden.
- Department of Community Health, Faculty of Public Health, Kasetsart University Chalermphrakiat Sakonnakhon Province Campus, Chiang Khruea sub-district, Muang Sakon Nakhon, Sakon Nakhon Province, Thailand.
| | - Pranee C Lundberg
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, BMC, Husargatan 3, Box 564, 751 22, Uppsala, Sweden
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Tuksanawes P, Kaewkiattikun K, Kerdcharoen N. Prevalence and Associated Factors of Antenatal Depressive Symptoms in Pregnant Women Living in an Urban Area of Thailand. Int J Womens Health 2020; 12:849-858. [PMID: 33116934 PMCID: PMC7573318 DOI: 10.2147/ijwh.s278872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/29/2020] [Indexed: 11/23/2022] Open
Abstract
Background Depression is a major public health problem in middle- and low-income countries. Depression in pregnancy has adverse effects on obstetric outcomes. Maternal depression remains under-recognized, under-diagnosed and undertreated in Thailand. Antenatal screening of depression is an important strategy to improve maternal and neonatal outcomes. This problem has rarely been investigated in Thailand, especially in urban areas. Objective To discover the prevalence, associated factors, and predictive factors of depression in pregnant women living in an urban area. Materials and Methods This cross-sectional study of 402 pregnant women was conducted during antenatal care at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, from 10 September to 31 November 2019. The participants were interviewed using a structured questionnaire that included a demographic profile, obstetric conditions, socio-cultural characteristics, and a Thai language version of the Center for Epidemiologic Studies-Depression Scale to assess depressive symptoms. Results Among a total 402 pregnant women, the prevalence of depressive symptoms in pregnant women in an urban area was 18.9%. Depressive symptoms in pregnant women were significantly associated with divorce (p < 0.001), low family income (p < 0.03), financial insufficiency (p < 0.001), extended family (p < 0.001), history of previous abortion (p = 0.033), history of previous pregnancy complications (p = 0.044), current alcohol use (p = 0.03), current tobacco use (p = 0.009), current substance abuse (p = 0.002), marital conflict (p < 0.001), and family conflict (p < 0.001). The significant factors predicting depression in pregnant women were extended family (AOR 3.0, 95% CI 1.59–5.51, p=0.001) and marital conflict (AOR 4.7, 95% CI 2.37–9.11, p<0.001). Conclusion This study revealed that the prevalence of depressive symptoms in pregnant women living in an urban area in Thailand was 18.9%. The significant associated factors of depressive symptoms were divorce, low family income, financial insufficiency, extended family, previous abortion, previous pregnancy complications, current alcohol use, current tobacco use, current substance abuse, marital conflict, and family conflict. Extended family and marital conflict were significant predictive factors for antenatal depressive symptoms.
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Affiliation(s)
- Pawanruj Tuksanawes
- Department of Obstetrics & Gynecology, Faculty of Medicine Vajira Hospital, Navamindradriraj University, Bangkok, Thailand
| | - Kasemsis Kaewkiattikun
- Department of Obstetrics & Gynecology, Faculty of Medicine Vajira Hospital, Navamindradriraj University, Bangkok, Thailand
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Yu M, Li H, Xu DR, Wu Y, Liu H, Gong W. Trajectories of perinatal depressive symptoms from early pregnancy to six weeks postpartum and their risk factors-a longitudinal study. J Affect Disord 2020; 275:149-156. [PMID: 32734901 DOI: 10.1016/j.jad.2020.07.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Few studies explored trajectories of depressive symptoms from early pregnancy and covered the whole perinatal period. This study aimed to explore the trajectories of perinatal depressive symptoms, their heterogeneity of onsets and peaks, and relations to demographic and psychological factors. METHOD A longitudinal study was conducted at two hospitals in China amongst 1,126 participants. Perinatal depression was measured using the Edinburgh Postnatal Depression Scale. Demographic and psychological factors were collected by self-developed questionnaire and Generalized Anxiety Disorder-7. Women completing at least three depression screens (n = 879) were included. Latent Growth Curve Model and Growth Mixture Model were performed to identify the depression trajectories and logistic regression was used to analyse factors of trajectories. RESULTS Three trajectories were identified: 90.0% of women never presented with depressive symptoms ("Low-throughout"); 5.1% presented with depressive symptoms mainly during the antenatal period ("Antenatal-high"); 4.9% presented with depressive symptoms mainly during the postpartum period ("Postpartum-high"). 52.4% of women experienced their first depressive symptoms during early pregnancy. Suffering from anxiety and being unsatisfied with their marriage were associated with the "Antenatal-high" and "Postpartum-high" trajectories, respectively. LIMITATIONS Response rate was not high. We also do not have information on clinical diagnoses or changes in some variables over time. CONCLUSIONS We identified three trajectories and heterogeneity existed concerning the timing of their peaks. Women should be considered for depression screening and intervention in early pregnancy. Factors associated with each trajectory were different, raising the potential of individualized intervention to reduce the occurrence of depression.
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Affiliation(s)
- Min Yu
- Xiangya School of Public Health, Central South University, Hunan, China
| | - Hui Li
- School of Mathematics and Statistics, University of Birmingham, UK
| | - Dong Roman Xu
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangdong, China
| | - Yinglan Wu
- Department of Maternal Health Care, Hunan Provincial Maternal and Child Health Hospital, Hunan, China
| | - Hua Liu
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital in Ziyang district of Yiyang city, Hunan, China
| | - Wenjie Gong
- Xiangya School of Public Health, Central South University, Hunan, China.
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Bhushan NL, Krupp K, Jaykrishna P, Ravi K, Khan A, Shidhaye R, Kiplagat S, Srinivas V, Madhivanan P. The association between social support through contacts with Accredited Social Health Activists (ASHAs) and antenatal anxiety among women in Mysore, India: a cross-sectional study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1323-1333. [PMID: 32146484 PMCID: PMC7483323 DOI: 10.1007/s00127-020-01854-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/28/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE In India, antenatal anxiety prevalence estimates range from 6 to 48%. Social support is strongly associated with mental wellbeing, yet most studies have examined the impact of support from partners and family members rather than peers, community members, or health care providers. This study explores the supportive role of Accredited Social Health Activists (ASHA) contacts for antenatal anxiety. METHODS Data were analyzed from the Saving Children, Improving Lives project, a quasi-experimental study conducted among rural, pregnant women in India. Regression models were used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals for the relationship frequency of ASHA contacts and antenatal anxiety. Antenatal anxiety was measured using a subscale of the Edinburgh Postnatal Depression Scale. RESULTS The sample consisted of 480 pregnant women. Reported antenatal anxiety prevalence was 27% (95% CI 23%, 31%). Participants who were more frequently visited by ASHAs at home (aPR: 0.90; 95% CI 0.76, 0.98) and more frequently accompanied by ASHAs to their antenatal care visits (aPR: 0.86, 95% CI 0.78, 0.95) were less likely to report antenatal anxiety. ASHA home visits were protective for the most vulnerable women (primigravida and those experiencing domestic violence) and ASHA accompaniment to antenatal care visits was equally protective for all women. CONCLUSIONS ASHAs are valued for their contribution towards maternal health education and linking women of reproductive age to healthcare services. Our findings additionally suggest the important role ASHAs play in providing social support to pregnant women, particularly those who are most vulnerable to experiencing antenatal anxiety.
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Affiliation(s)
- Nivedita L. Bhushan
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Karl Krupp
- Public Health Research Institute of India, Mysore, Karnataka, India,Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | | | - Kavitha Ravi
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Anisa Khan
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Rahul Shidhaye
- Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | | | - Vijaya Srinivas
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Purnima Madhivanan
- Public Health Research Institute of India, Mysore, Karnataka, India,Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA,Division of Infectious Diseases & Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona, USA
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Priyadarshanie MN, Waas MDIA, Goonewardena CSE, Balasuriya A, Senaratna BCV, Fernando DMS. Sinhala translation of the Perinatal Anxiety Screening Scale: a valid and reliable tool to detect anxiety disorders among antenatal women. BMC Psychiatry 2020; 20:381. [PMID: 32693789 PMCID: PMC7374883 DOI: 10.1186/s12888-020-02757-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 06/23/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Anxiety disorders during pregnancy are not routinely assessed in Sri Lanka despite being common and being associated with adverse pregnancy outcomes. Screening can facilitate early detection and management of anxiety and improve pregnancy outcomes. Our aim was to determine the validity of the Sinhala translation of the Perinatal Anxiety Screening Scale (PASS) to detect anxiety among Sri Lankan pregnant women. METHODS A cross-sectional study was conducted in antenatal clinics of a teaching hospital in Colombo District. The PASS was translated to Sinhala using the standard translation/ back-translation method. Pregnant women (n = 221) were sequentially recruited and assessed by a psychiatrist until 81 women with anxiety disorder were diagnosed using the International Classification of Diseases-10 criteria (gold standard). The Sinhala translation of the PASS (PASS-S) was administered to all recruited women, including 140 women without anxiety. Receiver-Operating- Characteristic (ROC) analysis was performed, the optimal cut-off score for PASS-S was determined, and its validity was assessed using sensitivity, specificity, predictive values and positive and negative likelihood ratios. Internal consistency was assessed using Cronbach's alpha. Test-retest and inter-rater reliability for PASS-S score and anxiety classification were assessed using intra class correlation coefficient (ICC) and Cohen's kappa (k), respectively. RESULTS The mean age (±SD) of women was 30(±5.8) years, and 53.7% were multiparous. A psychiatrist diagnosed anxiety disorder was made in 37.0% of women, while the PASS-S, at its optimal cut-off of ≥20, classified 37.5% of women as having anxiety disorders. The area under the ROC curve for the PASS-S was 0.96 (95%CI 0.94-0.99). Sensitivity, specificity and positive and negative predictive values of the PASS-S were 0.93 (95% CI 0.84-0.97), 0.90 (95% CI 0.83-0.94), 0.85 (95% CI 0.75-0.90) and 0.95 (95% CI 0.89-0.98), respectively. Positive and negative likelihood ratios were 8.8 (95% CI 5.3-14.5) and 0.08 (95%CI 0.04-0.18), respectively, and the internal consistency was high (Cronbach's alpha 0.95). Four-factor structures obtained by exploratory factor analysis were "acute anxiety and adjustment", "social anxiety, specific fears and trauma", "perfectionism and control" and "general anxiety".Test-retest reliability was high for the PASS-S score (ICC 0.85[95% CI 0.65-0.96]) and anxiety classification (k 0.77[95% CI 0.34-1.2]). Inter-interviewer reliability was also high (ICC 0.92[95% CI 0.81-0.97] for the PASS-S score and (k0.86 [95% CI 0.59-1.1] for anxiety classification). CONCLUSION The Sinhala translation of the PASS is a valid and reliable instrument to screen for anxiety disorders among antenatal women in Sri Lanka.
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Affiliation(s)
- M. N. Priyadarshanie
- grid.448842.60000 0004 0494 0761Department of Nursing & Midwifery, Faculty of Allied Health Sciences, Kotelawala Defence University, Rathmalana, Sri Lanka
| | - M. D. I. A. Waas
- grid.267198.30000 0001 1091 4496Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - C. S. E. Goonewardena
- grid.267198.30000 0001 1091 4496Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - A. Balasuriya
- grid.448842.60000 0004 0494 0761Department of Public Health, Faculty of Medicine, Kotelawala Defence University, Rathmalana, Sri Lanka
| | - B. C. V. Senaratna
- grid.267198.30000 0001 1091 4496Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka ,grid.267198.30000 0001 1091 4496Non-Communicable Diseases Research Centre, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - D. M. S. Fernando
- grid.267198.30000 0001 1091 4496Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Phoosuwan N, Manasatchakun P, Eriksson L, Lundberg PC. Life situation and support during pregnancy among Thai expectant mothers with depressive symptoms and their partners: a qualitative study. BMC Pregnancy Childbirth 2020; 20:207. [PMID: 32272908 PMCID: PMC7147066 DOI: 10.1186/s12884-020-02914-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/30/2020] [Indexed: 11/12/2022] Open
Abstract
Background Expectant parents may have positive and negative emotions during pregnancy and receive support from different sources. Studies on life situation and support among couples have rarely been conducted. This study aims to explore life situation and support during pregnancy among expectant mothers with depressive symptoms and their partners. Methods Twenty-seven expectant mothers, in the last trimester of pregnancy with depressive symptoms (Edinburgh Postnatal Depression Scale score ≥ 7) from seven public antenatal care clinics in Sakonnakhon, a north-eastern province of Thailand, and their partners were interviewed. In total, 54 semi-structured interviews were subjected to content analysis. Results Four categories emerged: (1) Having obstacles in life, (2) Facing life transition, (3) Enhancing confidence, and (4) Dissatisfaction with support. The informants described obstacles regarding economy, fear of health problems, getting an abnormal child and partners’ behaviours. They received support from family members and social networks, but some were dissatisfied with the support from the healthcare. For example, expectant fathers wished to receive more health information and be more involved. Conclusions Healthcare professionals should be aware of the influence of cultural and contextual factors when providing antenatal care to expectant parents. Male involvement in the care must not be neglected.
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Affiliation(s)
- Nitikorn Phoosuwan
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden. .,Department of Community Health, Faculty of Public Health, Kasetsart University Chalermphrakiat Sakonnakhon Province Campus, Sakon Nakhon, Thailand.
| | | | - Leif Eriksson
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
| | - Pranee C Lundberg
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
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22
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Labrague LJ, McEnroe-Petitte D, Tsaras K, Yboa BC, Rosales RA, Tizon MM, D'souza MS. Predictors of postpartum depression and the utilization of postpartum depression services in rural areas in the Philippines. Perspect Psychiatr Care 2020; 56:308-315. [PMID: 31355473 DOI: 10.1111/ppc.12428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/07/2019] [Accepted: 07/14/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study explored the prevalence and predictors of postpartum depression (PPD) as well as the utilization and evaluation of PPD services among postpartum women in rural areas of the Philippines. DESIGN AND METHODS A cross-sectional study was conducted. One hundred sixty-five women who visited maternal facilities in the rural areas of the Central Philippines completed the Edinburgh Postnatal Depression Scale (EPDS). FINDINGS The prevalence of PPD was 16.4% at the sixth postpartum week. Occupation and marital status had significant direct influences on PPD. PPD services were not routinely provided by doctors and nurses. PRACTICE IMPLICATIONS Our results highlight a greater need to intensify government programs relative to PPD services, specifically related to the early detection and screening of PPD among high-risk pregnancies.
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Affiliation(s)
- Leodoro J Labrague
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | | | - Konstantinos Tsaras
- Department of Nursing, Technological Educational Institute of Thessaly, Larissa, Greece
| | - Begonia C Yboa
- College of Nursing and Health Sciences, Catbalogan, Philippines
| | | | - Maricel M Tizon
- College of Nursing and Health Sciences, Catbalogan, Philippines
| | - Melba S D'souza
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
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23
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Dadi AF, Miller ER, Woodman R, Bisetegn TA, Mwanri L. Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation model. BMC Pregnancy Childbirth 2020; 20:168. [PMID: 32183726 PMCID: PMC7079401 DOI: 10.1186/s12884-020-02859-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 03/06/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Various forms of life stressors have been implicated as causes of antenatal depression. However, there is a lack of understanding of which forms of stress lead to antenatal depression and through what mechanisms. Modeling stress processes within a theoretical model framework can enhance an understanding of the mechanisms underlying relationships between stressors and stress outcomes. This study used the stress process model framework to explore the causal mechanisms underlying antenatal depression in Gondar, Ethiopia. METHODS Questionnaires, using an Online Data collection Kit (ODK) tool were administered face-to-face in 916 pregnant women in their second and third trimesters. Pregnant women were included from six randomly selected urban districts in Gondar, Ethiopia during June and August 2018. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depression. A Structural Equation Model (SEM) was employed to explore the direct, indirect, and total effect of stressors and mediators of antenatal depression. RESULT Sixty-three participants (6.9%) reported symptoms of depression. Of these, 16 (4.7%) and 47 (8.1%) were in their second and third trimesters, respectively. The SEM demonstrated several direct effects on antenatal depression scores including unplanned pregnancy (standardized β = 0.15), having a history of common mental health disorder (standardized β = 0.18) and fear of giving birth to the current pregnancy (standardized β = 0.29), all of which were associated with a higher depression score. Adequate food access for the last 3 months (standardized β = - 0.11) was associated with decreased depression score. Social support (β = - 0.21), marital agreement (β = - 0.28), and partner support (β = -.18) appeared to partially mediate the link between the identified stressors and the risk of antenatal depression. CONCLUSION Both direct and indirect effects contributed to higher antenatal depression score in Ethiopian women. The three psychosocial resources namely marital agreement, social and partner support, mediated reduced antenatal depression scores. Early screening of antenatal depression and enhancing the three psychosocial resources would help to improve maternal resilience.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
- College of Medicine and Public health, Discipline of Public health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia.
| | - Emma R Miller
- College of Medicine and Public health, Discipline of Public health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
| | - Richard Woodman
- College of Medicine and Public health, Center for Epidemiology and Biostatistics, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
| | - Telake Azale Bisetegn
- Department of Health promotion and Behavioral sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lillian Mwanri
- College of Medicine and Public health, Discipline of Public health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
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Babu GR, Murthy GVS, Reddy Y, Deepa R, Yamuna A, Prafulla S, Krishnan A, Lobo E, Rathnaiah M, Kinra S. Small for gestational age babies and depressive symptoms of mothers during pregnancy: Results from a birth cohort in India. Wellcome Open Res 2020. [PMID: 31828224 DOI: 10.12688/wellcomeopenres.14618.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Annually, more than a million low birthweight (LBW) is born in India, often afflicting disadvantaged families. Several studies have undertaken the association of poverty, nutritional status, and obstetric factors with LBW. Through our study, we aimed to examine the possibility of any relation between the Edinburgh Postnatal Depression Scale (EPDS) score measured during pregnancy with the incidence of babies born Small for Gestational Age (SGA). Methods: Pregnant women attending the antenatal clinic at a public hospital between 14 to 32 weeks were recruited from April 2016 to Oct 2017. The EPDS was administered to assess depression through face-to-face interviews. Newborn anthropometry was performed post-delivery. For analysis, birth weight <10 percentile was classified as SGA. Results: Prevalence of depressive symptoms (EPDS score >11) was 16.5% (n=108/654) in antenatal mothers. These women delivered a higher proportion of SGA babies (21.3 v/s 15.8) compared to women with no symptoms. The odds of women giving birth to a child with SGA were twice as high for women with EPDS scores >11 (adjusted OR = 2.03; 95% CI = 1.12 - 3.70) compared to the women with EPDS scores of ≤11, The EPDS 12 (Adjusted OR = 1.96; 95% CI = 1.04 - 3.69) and EPDS 13 (Adjusted OR = 2.42; 95% CI = 1.24 - 4.70) cut-off categories also proved to be a risk factor for SGA with significant p-value (0.0006 and 0.0003) and the individuals with more than 13 EPDS score is found to have the highest odds of SGA. Conclusions: We found a strong association of antenatal depressive symptoms during pregnancy with SGA measured by EPDS. Thus, we recommend the implementation of timely and effective screening, diagnostic services, and evidence-based antenatal mental health services to combat SGA and further associated-metabolic syndromes.
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Affiliation(s)
- Giridhara R Babu
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India.,The Wellcome Trust/DBT India Alliance, New Delhi, 110025, India
| | - G V S Murthy
- Indian Institute of Public Health, Public Health Foundation of India, Madhapur, Hyderabad, 500033, India.,International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Yogesh Reddy
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - R Deepa
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - A Yamuna
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - S Prafulla
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - Anjaly Krishnan
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - Eunice Lobo
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - Mohanbabu Rathnaiah
- Department of Psychiatry, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, UK
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
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25
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Phoosuwan N, Lundberg PC, Phuthomdee S, Eriksson L. Intervention intended to improve public health professionals' self-efficacy in their efforts to detect and manage perinatal depressive symptoms among Thai women: a mixed-methods study. BMC Health Serv Res 2020; 20:138. [PMID: 32093647 PMCID: PMC7038618 DOI: 10.1186/s12913-020-5007-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/17/2020] [Indexed: 12/31/2022] Open
Abstract
Background Targeting perinatal depressive symptoms among women can reduce premature mortality. However, public health professionals (PHPs) in primary healthcare settings often have low self-efficacy for detection and management of perinatal depressive symptoms among women. This mixed-methods study was aimed at developing and evaluating a self-efficacy improvement programme (SIP) intended to increase PHPs’ self-efficacy in efforts to detect and manage perinatal depressive symptoms. Methods The SIP consisted of 1 day of theory and 4 weeks of practice. Sixty-six PHPs from sub-district health promotion hospitals (primary health care level) in Sakonnakhon, a north-eastern province in Thailand, were randomised into an intervention group (n = 33) and a control group (n = 33). Twenty-three of the intervention group participants also took part in focus group discussions (FGDs). Multiple linear regression and qualitative content analysis were used to analyse the data. Results After the SIP, the intervention group participants had higher self-efficacy score than those in the control group (p = 0.004). The FGDs resulted in four categories emerging: Having confidence, Changing knowledge and attitudes, Increasing perception of an important role, and Increasing awareness of performed function. Conclusions To enhance the ability of PHPs to detect and manage perinatal depressive symptoms, an intervention programme based on self-efficacy modification is recommended.
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Affiliation(s)
- Nitikorn Phoosuwan
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, BMC, Husargatan 3, Box 564, 751 22, Uppsala, Sweden. .,Department of Community Health, Faculty of Public Health, Kasetsart University Chalermphrakiat Sakonnakhon Province Campus, Sakonnakhon, Thailand.
| | - Pranee C Lundberg
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, BMC, Husargatan 3, Box 564, 751 22, Uppsala, Sweden
| | - Sadiporn Phuthomdee
- Panyananthaphikkhu Chonprathan Medical Centre, Srinakarinwirot University, Nonthaburi, Thailand
| | - Leif Eriksson
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, BMC, Husargatan 3, Box 564, 751 22, Uppsala, Sweden
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26
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Babu GR, Murthy GVS, Reddy Y, Deepa R, Yamuna A, Prafulla S, Krishnan A, Lobo E, Rathnaiah M, Kinra S. Small for gestational age babies and depressive symptoms of mothers during pregnancy: Results from a birth cohort in India. Wellcome Open Res 2020; 3:76. [PMID: 31828224 DOI: 10.12688/wellcomeopenres.14618.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Annually, more than a million low birthweight (LBW) is born in India, often afflicting disadvantaged families. Several studies have undertaken the association of poverty, nutritional status, and obstetric factors with LBW. Through our study, we aimed to examine the possibility of any relation between the Edinburgh Postnatal Depression Scale (EPDS) score measured during pregnancy with the incidence of babies born Small for Gestational Age (SGA). Methods: Pregnant women attending the antenatal clinic at a public hospital between 14 to 32 weeks were recruited from April 2016 to Oct 2017. The EPDS was administered to assess depression through face-to-face interviews. Newborn anthropometry was performed post-delivery. For analysis, birth weight <10 percentile was classified as SGA. Results: Prevalence of depressive symptoms (EPDS score >11) was 16.5% (n=108/654) in antenatal mothers. These women delivered a higher proportion of SGA babies (21.3 v/s 15.8) compared to women with no symptoms. The odds of women giving birth to a child with SGA were twice as high for women with EPDS scores >11 (adjusted OR = 2.03; 95% CI = 1.12 - 3.70) compared to the women with EPDS scores of ≤11, The EPDS 12 (Adjusted OR = 1.96; 95% CI = 1.04 - 3.69) and EPDS 13 (Adjusted OR = 2.42; 95% CI = 1.24 - 4.70) cut-off categories also proved to be a risk factor for SGA with significant p-value (0.0006 and 0.0003) and the individuals with more than 13 EPDS score is found to have the highest odds of SGA. Conclusions: We found a strong association of antenatal depressive symptoms during pregnancy with SGA measured by EPDS. Thus, we recommend the implementation of timely and effective screening, diagnostic services, and evidence-based antenatal mental health services to combat SGA and further associated-metabolic syndromes.
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Affiliation(s)
- Giridhara R Babu
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India.,The Wellcome Trust/DBT India Alliance, New Delhi, 110025, India
| | - G V S Murthy
- Indian Institute of Public Health, Public Health Foundation of India, Madhapur, Hyderabad, 500033, India.,International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Yogesh Reddy
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - R Deepa
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - A Yamuna
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - S Prafulla
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - Anjaly Krishnan
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - Eunice Lobo
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - Mohanbabu Rathnaiah
- Department of Psychiatry, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, UK
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
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27
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Babu GR, Murthy GVS, Reddy Y, Deepa R, Yamuna A, Prafulla S, Krishnan A, Lobo E, Rathnaiah M, Kinra S. Small for gestational age babies and depressive symptoms of mothers during pregnancy: Results from a birth cohort in India. Wellcome Open Res 2020; 3:76. [PMID: 31828224 PMCID: PMC6892423 DOI: 10.12688/wellcomeopenres.14618.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2020] [Indexed: 01/20/2023] Open
Abstract
Background: Annually, more than a million low birthweight (LBW) is born in India, often afflicting disadvantaged families. Several studies have undertaken the association of poverty, nutritional status, and obstetric factors with LBW. Through our study, we aimed to examine the possibility of any relation between the Edinburgh Postnatal Depression Scale (EPDS) score measured during pregnancy with the incidence of babies born Small for Gestational Age (SGA). Methods: Pregnant women attending the antenatal clinic at a public hospital between 14 to 32 weeks were recruited from April 2016 to Oct 2017. The EPDS was administered to assess depression through face-to-face interviews. Newborn anthropometry was performed post-delivery. For analysis, birth weight <10 percentile was classified as SGA. Results: Prevalence of depressive symptoms (EPDS score >11) was 16.5% (n=108/654) in antenatal mothers. These women delivered a higher proportion of SGA babies (21.3 v/s 15.8) compared to women with no symptoms. The odds of women giving birth to a child with SGA were twice as high for women with EPDS scores >11 (adjusted OR = 2.03; 95% CI = 1.12 – 3.70) compared to the women with EPDS scores of ≤11, The EPDS 12 (Adjusted OR = 1.96; 95% CI = 1.04 – 3.69) and EPDS 13 (Adjusted OR = 2.42; 95% CI = 1.24 – 4.70) cut-off categories also proved to be a risk factor for SGA with significant p-value (0.0006 and 0.0003) and the individuals with more than 13 EPDS score is found to have the highest odds of SGA. Conclusions: We found a strong association of antenatal depressive symptoms during pregnancy with SGA measured by EPDS. Thus, we recommend the implementation of timely and effective screening, diagnostic services, and evidence-based antenatal mental health services to combat SGA and further associated-metabolic syndromes.
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Affiliation(s)
- Giridhara R Babu
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India.,The Wellcome Trust/DBT India Alliance, New Delhi, 110025, India
| | - G V S Murthy
- Indian Institute of Public Health, Public Health Foundation of India, Madhapur, Hyderabad, 500033, India.,International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Yogesh Reddy
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - R Deepa
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - A Yamuna
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - S Prafulla
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - Anjaly Krishnan
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - Eunice Lobo
- Indian Institute of Public Health - Bangalore, Bengaluru, Karnataka , 560023, India
| | - Mohanbabu Rathnaiah
- Department of Psychiatry, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, UK
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
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Dadi AF, Miller ER, Bisetegn TA, Mwanri L. Global burden of antenatal depression and its association with adverse birth outcomes: an umbrella review. BMC Public Health 2020; 20:173. [PMID: 32019560 PMCID: PMC7001252 DOI: 10.1186/s12889-020-8293-9] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 01/28/2020] [Indexed: 02/07/2023] Open
Abstract
Background Women of childbearing age are at high risk of developing depression and antenatal depression is one of the most common mood disorders. Antenatal depression is also associated with a number of poor maternal and infant outcomes, however, there remains a lack of focus on mental issues in antenatal care, particularly in lower income countries. This systematic review of reviews provides useful evidence regarding the burden of antenatal depression which may provide guidance for health policy development and planning. Methods We searched CINAHL(EBSCO), MEDLINE (via Ovid), PsycINFO, Emcare, PubMed, Psychiatry Online, and Scopus databases for systematic reviews that based on observational studies that were published in between January 1st, 2007 and August 31st, 2018. We used the Assessment of Multiple Systematic Reviews (AMSTAR) checklist scores to assess the quality of the included reviews. We applied vote counting and narrative review to summarize the prevalence of antenatal depression and its associated factors, while statistical pooling was conducted for estimating the association of antenatal depression with low birth weight and preterm birth. This systematic review of reviews was registered on PROSPERO with protocol number CRD42018116267. Results We have included ten reviews (306 studies with 877,246 participants) on antenatal depression prevalence and six reviews (39 studies with 75,451 participants) conducted to identify the effect of antenatal depression on preterm and low birth weight. Globally, we found that antenatal depression prevalence ranged from 15 to 65%. We identified the following prominent risk factors based on their degree of influence: Current or previous exposure to different forms of abuse and violence (six reviews and 73 studies); lack of social and/or partner support (four reviews and 47 studies); personal or family history of any common mental disorder (three reviews and 34 studies). The risk of low birth weight and preterm birth was 1.49 (95%CI: 1.32, 1.68; I2 = 0.0%) and 1.40 (95%CI: 1.16, 1.69; I2 = 35.2%) times higher among infants born from depressed mothers. Conclusions Globally, antenatal depression prevalence was high and could be considered a common mental disorder during pregnancy. Though the association between antenatal depression and adverse birth outcomes appeared to be modest, its absolute impact would be significant in lower-income countries with a high prevalence of antenatal depression and poor access to quality mental health services.
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Affiliation(s)
- Abel Fekadu Dadi
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia. .,Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Emma R Miller
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
| | - Telake Azale Bisetegn
- Department of Health promotion and Behavioral sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
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Fekadu Dadi A, Miller ER, Mwanri L. Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis. PLoS One 2020; 15:e0227323. [PMID: 31923245 PMCID: PMC6953869 DOI: 10.1371/journal.pone.0227323] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/12/2019] [Indexed: 01/01/2023] Open
Abstract
Background Depression in pregnancy (antenatal depression) in many low and middle-income countries is not well documented and has not been given priority for intervention due to competing urgencies and the belief that it does not immediately cause fatalities, which mainly emanated from lack of comprehensive research on the area. To fill this research gap, this systematic review was conducted to investigate the burden of antenatal depression and its consequences on birth outcomes in low- and middle-income countries. Methods We systematically searched the databases: CINHAL, MEDLINE, EMCare, PubMed, PSyc Info, Psychiatry online, and Scopus for studies conducted in low and middle-income countries about antenatal depression and its association with adverse birth outcomes. We have included observational studies (case control, cross-sectional and cohort studies), written in English-language, scored in the range of “good quality” on the Newcastle Ottawa Scale (NOS), and were published between January 1, 2007 and December 31, 2017. Studies were excluded if a standardized approach was not used to measure main outcomes, they were conducted on restricted (high risk) populations, or had fair to poor quality score on NOS. We used Higgins and Egger’s to test for heterogeneity and publication bias. Primary estimates were pooled using a random effect meta-analysis. The study protocol was registered in PROSPERO with protocol number CRD42017082624. Result We included 64 studies (with 44, 035 women) on antenatal depression and nine studies (with 5,540 women) on adverse birth outcomes. Antenatal depression was higher in the lower-income countries (Pooled Prevalence (PP) = 34.0%; 95%CI: 33.1%-34.9%) compared to the middle-income countries (PP = 22.7%, 95%CI: 20.1%-25.2%) and increased over the three trimesters. Pregnant women with a history of economic difficulties, poor marital relationships, common mental disorders, poor social support, bad obstetric history, and exposure to violence were more likely to report antenatal depression. The risk of having preterm birth (2.41; 1.47–3.56) and low birth weight (1.66; 1.06–2.61) was higher in depressed mothers compared to mothers without depression. Conclusions Antenatal depression was higher in low-income countries than in middle-income countries and was found to be a risk factor for low birth weight and preterm births. The economic, maternal, and psychosocial risk factors were responsible for the occurrence of antenatal depression. While there could be competing priority agenda to juggle for health policymakers in low-income countries, interventions for antenatal depression should be reprioritized as vitally important in order to prevent the poor maternal and perinatal outcomes identified in this review.
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Affiliation(s)
- Abel Fekadu Dadi
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Adelaide, South Australia
- * E-mail:
| | - Emma R. Miller
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Adelaide, South Australia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Adelaide, South Australia
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Magnitude and Predictors of Antenatal Depression among Pregnant Women Attending Antenatal Care in Sodo Town, Southern Ethiopia: Facility-Based Cross-Sectional Study. DEPRESSION RESEARCH AND TREATMENT 2020; 2020:6718342. [PMID: 32308994 PMCID: PMC7152952 DOI: 10.1155/2020/6718342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/06/2020] [Accepted: 02/21/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depression affects approximately 10 to 20% of pregnant women globally, and one in ten and two in five women in developed and developing countries develop depression during pregnancy, respectively. However, evidence regarding its magnitude and predictors in Southern Ethiopia is limited. The present study is aimed at assessing the magnitude and predictors of antenatal depression among pregnant women attending antenatal care in Sodo town. METHODS A facility-based cross-sectional study was conducted among 403 antenatal care attendants in Sodo town from November 2 to January 30, 2017. Systematic random sampling was used to select the study population, and data were collected by using a pretested and structured questionnaire. Data were entered using Epi-data 4.2 and then exported and analyzed using SPSS version 20. Bivariate and multivariable logistic regression analyses were used to assess the association between the dependent variable and independent variables. Variables with P value less than 0.05 were considered as statistically significant. RESULTS A total of 400 pregnant women were interviewed. The magnitude of antenatal depression was 16.3% (95% CI (12.8%, 19.9%)). Husband's educational status, at the college and above (AOR: 0.09; 95% CI (0.03, 0.34), regular exercise (AOR: 0.16; 95% CI (0.07, 0.36)), planned pregnancy (AOR: 0.16; 95% CI (0.06, 0.44)), use of family planning (AOR: 0.31; 95% CI (0.14, 0.66)), previous history of anxiety (AOR: 2.96; 95% CI (1.30, 6.74)), previous history of obstetric complications (AOR: 19.03; 95% CI (5.89, 61.47)), and current obstetric complications (AOR: 30.38; 95% CI (3.14, 294.19)) were significant predictors of antenatal depression. CONCLUSION Nearly one in six pregnant women had antenatal depression. The husband's educational status, regular exercise, planned pregnancy, use of family planning, previous history of anxiety, previous history of obstetric complications, and current history of obstetric complications were significant predictors of antenatal depression. Screening for depression during routine antenatal care could be essential and recommended to identify early and prevent further morbidities and mortalities due to antenatal depression.
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Phoosuwan N, Manwong M, Eriksson L, Lundberg PC. Perinatal depressive symptoms among Thai women: A hospital-based longitudinal study. Nurs Health Sci 2019; 22:309-317. [PMID: 31821706 DOI: 10.1111/nhs.12669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 10/10/2019] [Accepted: 11/02/2019] [Indexed: 11/29/2022]
Abstract
The authors of this longitudinal study investigated risk factors for postpartum depressive symptoms and differences in depressive symptoms at late pregnancy and at 1 and 3 months postpartum. In Sakhonnakhon Province, in northeastern Thailand, 449 women were recruited during late pregnancy and followed at 1 and 3 months postpartum with the use of psychosocial factors. Depressive symptom scores were measured using the Edinburgh Postnatal Depression Scale (EPDS). The scores were compared using dependent-samples t-tests, and multiple linear regression analyses were used to identify risk factors for depressive symptoms at 1 and 3 months postpartum. EPDS scores decreased from late pregnancy to 1 month postpartum and remained on the same level until 3 months postpartum. Low psychological well-being scores and low personal monthly income were risk factors for increased EPDS scores at 1 and 3 months postpartum. Pregnant women in Thailand who have a low income, have limited social support, and report low psychological well-being are at increased risk for postpartum depression. Results of this study suggest they should be screened for depressive symptoms during pregnancy, referred for diagnosis, and provided treatment to reduce the risk of ongoing depressive symptoms during the postpartum period.
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Affiliation(s)
- Nitikorn Phoosuwan
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden.,Faculty of Public Health, Kasetsart University Chalermphrakiat Sakonnakhon Province Campus, Chiang Khruea, Thailand
| | - Mereerat Manwong
- College of Medicine and Public Health, Ubonratchathani University, Ubon Ratchathani, Thailand
| | - Leif Eriksson
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
| | - Pranee C Lundberg
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
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Habtamu Belete A, Alemayehu Assega M, Alemu Abajobir A, Abebe Belay Y, Kassahun Tariku M. Prevalence of antenatal depression and associated factors among pregnant women in Aneded woreda, North West Ethiopia: a community based cross-sectional study. BMC Res Notes 2019; 12:713. [PMID: 31666120 PMCID: PMC6822359 DOI: 10.1186/s13104-019-4717-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/10/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To assess the prevalence of antenatal depression and factors associated with antenatal depression among pregnant women in Aneded woreda, Northwest Ethiopia, 2019. A community based- cross sectional study was conducted in Aneded woreda among 7 kebles' of North-West, Ethiopia from March 16 to April 23, 2019. A total of 342 pregnant women were recruited using simple random sampling. RESULT The prevalence of antenatal depression was 15.20%. Urban residence [AOR = 6.8; 95% CI (1.97, 23.32)], marital status of being unmarried [AOR = 5.1; 95% CI (1.79, 14.63)], occupation of being government employee [AOR = 8.8; 95% CI (2.06, 37.12)] and merchant [AOR = 3.7; 95% CI (1.27, 10.91)], prim gravid [AOR = 5.3; 95% CI (2.03, 13.82)], not attend ANC follow up [AOR = 8.7; 95% CI (3.46, 21.79)], intimate partner violence [AOR = 4.5; 95% CI (1.28, 15.52)], unplanned pregnancy [AOR = 6.2; 95% CI (2.37, 16.06)], and substance use [AOR = 5.6; 95% CI (2.12, 14.92)] were significantly factors. Strengthen the risk prevention activities so important to tackle the problem of antenatal depression.
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Affiliation(s)
- Abebe Habtamu Belete
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Mulunesh Alemayehu Assega
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Amanuel Alemu Abajobir
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.,Maternal and Child Wellbeing Unit, African Population and Health Research Centre, Nairobi, Kenya
| | - Yihalem Abebe Belay
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mengistie Kassahun Tariku
- Department of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal Stress, anxiety and depression in early pregnancy among women in Chongqing, China. J Affect Disord 2019; 253:292-302. [PMID: 31077972 DOI: 10.1016/j.jad.2019.05.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/29/2019] [Accepted: 05/01/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prenatal mental disorders are associated with maternal and fetal adverse outcomes, while few studies have been performed in mainland China. This study aimed to investigate the prevalence and influencing factors of maternal stress, anxiety and depression in early pregnancy and provide scientific basis for reducing prenatal mental disorders. METHODS Data were obtained from 1220 women with < 15 weeks gestation in a cohort study conducted in Chongqing, China. Prenatal stress, anxiety and depression were assessed using the pregnancy pressure scale, the Hamilton anxiety scale, and the self-rating depression scale, respectively. RESULTS The prevalence of prenatal stress, anxiety and depression in early pregnancy was 91.86%, 15.04% and 5.19%, respectively. Logistic regression analysis revealed that the risk factors for prenatal stress include housewife/unemployment, presence of anxiety and low- and moderate-level social support, besides, the protective factors were exercise, active smoking and no suggestion from parents. Housewife/unemployment, primiparity, presence of stress and depression and low-level social support were found to be associated with the development of anxiety symptoms, whereas exercise had a protective effect on it. Group-oriented personality, presence of anxiety, no suggestion from husband, low- and moderate-level family care, and low-level social support were risk factors for prenatal depression. LIMITATIONS All participants were recruited from one region of China, and none of them have a history of cesarean section. CONCLUSION Early screening and intervention may have great significance for reducing mental disorders of pregnant women, and the family and society support should be brought into the intervention as well.
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Affiliation(s)
- Xian Tang
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Zhuo Lu
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Dihui Hu
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Xiaoni Zhong
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China.
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Mahendran R, Puthussery S, Amalan M. Prevalence of antenatal depression in South Asia: a systematic review and meta-analysis. J Epidemiol Community Health 2019; 73:768-777. [PMID: 31010821 DOI: 10.1136/jech-2018-211819] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To estimate the prevalence of antenatal depression in South Asia and to examine variations by country and study characteristics to inform policy, practice and future research. METHODS We conducted a comprehensive search of 13 databases including international databases and databases covering scientific literature from South Asian countries in addition to Google Scholar and grey sources from 1 January 2007 to 31 May 2018. Studies reporting prevalence estimates of antenatal depression using a validated diagnostic/screening tool were identified, screened, selected and appraised. Primary outcome was proportion (%) of pregnant women identified as having antenatal depression. RESULTS Thirty-three studies involving 13 087 pregnant women were included in the meta-analysis. Twelve studies were rated as high quality and 21 studies were of moderate quality. Overall pooled prevalence of antenatal depression was 24.3 % (95% Confidence Interval (CI) 19.03 to 30.47). Studies showed a high degree of heterogeneity (I2=97.66%) and evidence of publication bias (p=0.668). Prevalence rates for India (17.74%, 95% CI 11.19 to 26.96) and Sri Lanka (12.95%, 95% CI 8.29 to 19.68) were lower compared with the overall prevalence, whereas prevalence rates for Pakistan (32.2%, 95% CI 23.11 to 42.87) and Nepal (50%, 95% CI 35.64 to 64.36) were higher. CONCLUSIONS While robust prevalence studies are sparse in most South Asian countries, available data suggest one in four pregnant women is likely to experience antenatal depression in the region. Findings highlight the need for recognition of the issue in health policy and practice and for resource allocation for capacity building at regional and national levels for prevention, diagnosis and treatment.
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Affiliation(s)
- Rahini Mahendran
- Smile Train Project, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Shuby Puthussery
- Maternal and Child Health Research Centre, University of Bedfordshire, Luton, UK
| | - Mahendran Amalan
- Department of Statistics and Computer Science, Faculty of Science, University of Peradeniya, Peradeniya, Sri Lanka
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Zhang Y, Muyiduli X, Wang S, Jiang W, Wu J, Li M, Mo M, Jiang S, Wang Z, Shao B, Shen Y, Yu Y. Prevalence and relevant factors of anxiety and depression among pregnant women in a cohort study from south-east China. J Reprod Infant Psychol 2018; 36:519-529. [DOI: 10.1080/02646838.2018.1492098] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Youding Zhang
- Department of Neurology, Zhoushan Hospital, Zhoushan, China
| | - Xiamusiye Muyiduli
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Shuojia Wang
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Wen Jiang
- Department of Maternal Health, Zhoushan Maternal & Child Care Hospital, Zhoushan, China
| | - Jinhua Wu
- Department of Maternal Health, Zhoushan Maternal & Child Care Hospital, Zhoushan, China
| | - Minchao Li
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Minjia Mo
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Shuying Jiang
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Zhaopin Wang
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Bule Shao
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Yu Shen
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
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Phoosuwan N, Eriksson L, Lundberg PC. Antenatal depressive symptoms during late pregnancy among women in a north-eastern province of Thailand: Prevalence and associated factors. Asian J Psychiatr 2018; 36:102-107. [PMID: 30055513 DOI: 10.1016/j.ajp.2018.06.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 06/24/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Globally, depression is prevalent during pregnancy and several factors have been associated with antenatal depressive symptoms (ADS). However, ADS have rarely been investigated in Thailand. This study aimed at exploring the prevalence of ADS and factors associated with these symptoms among Thai women in late pregnancy. METHODS A cross-sectional study including 449 women in late pregnancy was carried out. The Edinburgh Postnatal Depression Scale (EPDS) was used to detect depressive symptoms with a score of 10 points or higher. Socio-demographic characteristics and psychosocial risks were measured in association with ADS. Percentage and 95% confidence interval (CI) were used to assess the prevalence of ADS. Odds ratio (OR) and 95%CI were used to determine ADS-related risk factors among women. RESULTS The prevalence of ADS was 46.8% (95%CI 42.3-51.4). Pregnant women aged less than 20 years (OR 2.58, 95%CI 1.14-5.84) and those not having enough money (OR 2.71, 95%CI 1.22-6.05) had an increased risk of ADS. Psychosocial risks related to ADS for women were low psychological well-being (OR 3.12, 95%CI 1.75-5.58), low self-esteem (OR 2.08, 95%CI 1.24-3.49), and low sense of coherence (OR 1.82, 95%CI 1.12-2.95). CONCLUSIONS The prevalence of ADS among Thai women in their late pregnancy is high. Socio-demographic characteristics and psychosocial factors are independently associated with ADS. Healthcare providers in Thailand should consider EPDS as a standardised screening tool for ADS and use it at antenatal care clinics. Implementing programs focusing on both pregnant women and their family might increase the prevention of perinatal depression.
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Affiliation(s)
- Nitikorn Phoosuwan
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden; Department of Community Health, Faculty of Public Health, Kasetsart University Chalermphrakiat Sakonnakhon Province Campus, Thailand.
| | - Leif Eriksson
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden
| | - Pranee C Lundberg
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden
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Azale T, Fekadu A, Hanlon C. Postpartum depressive symptoms in the context of high social adversity and reproductive health threats: a population-based study. Int J Ment Health Syst 2018; 12:42. [PMID: 30069229 PMCID: PMC6064119 DOI: 10.1186/s13033-018-0219-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/14/2018] [Indexed: 01/13/2023] Open
Abstract
Background Postpartum depression is an important but neglected public health issue in low- and middle-income countries. The aim of this study was to assess postpartum depressive (PPD) symptoms and associated factors in a rural Ethiopian setting characterized by high social adversity and reproductive health threats. We hypothesized that infant gender preference would be associated with PPD symptoms. Methods A cross-sectional, population-based study was conducted in Sodo district, southern Ethiopia, between March and June 2014. A total of 3147 postpartum women (one to 12 months after delivery) were recruited and interviewed in their homes. The questionnaire included demographic, reproductive health and psychosocial factors in addition to a culturally validated measure of depressive symptoms, the Patient Health Questionnaire. Scores of 5 or more were indicative of high levels of PPD symptoms. Results The prevalence of high PPD symptoms was 12.2%, with 95% confidence interval (CI) between 11.1 and 13.4. Of these, 12.0% of the study participants had suicidal ideation. Preference of the husband for a boy baby was associated with PPD symptoms in univariate analysis (crude odds ratio 1.43: 95% CI 1.04, 1.91) but became non-significant after adjusting for confounders. In the final multivariable analysis, rural residence [adjusted odds ratio (aOR) 2.56: 95% CI 2.56, 4.19], grand multiparity (aOR 2.00: 1.22, 3.26), perinatal complications (aOR: 2.55: 1.89, 3.44), a past history of abortion (aOR 1.50: 1.07, 2.11), experiencing hunger in the preceding 1 month (aOR 2.38: 1.75, 3.23), lower perceived wealth (aOR 2.11: 1.19, 3.76), poor marital relationship (aOR 2.47: 1.79, 3.42), and one or more stressful events in the preceding 6 months (aOR 2.36: 1.82, 3.06) were associated significantly with high PPD symptoms. Conclusion PPD symptoms affected more than one in 10 women in this Ethiopian community setting. Social adversity and reproductive health threats were associated with poorer mental health. Interventions focusing on poor rural women with low access to care are necessary. This research can serve as an entry point for the adaptation of a psychosocial intervention.
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Affiliation(s)
- Telake Azale
- 1Department of Health Education and Behavioral Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,5Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- 3Center for Innovative Drug Development and Therapeutic Trials for Africa, Addis Ababa University, Addis Ababa, Ethiopia.,4Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,5Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- 2Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,5Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Nasreen HE, Rahman JA, Rus RM, Kartiwi M, Sutan R, Edhborg M. Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia. BMC Psychiatry 2018; 18:195. [PMID: 29902985 PMCID: PMC6002988 DOI: 10.1186/s12888-018-1781-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/07/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers. METHODS We used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS). RESULTS Prevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband's depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife's depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers. CONCLUSION Both ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.
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Affiliation(s)
- Hashima E. Nasreen
- Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Jamalludin Ab Rahman
- Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Razman Mohd Rus
- Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Malaysia
| | - Mira Kartiwi
- Faculty of Information and Communication Technology, International Islamic University Malaysia, Jalan Gombak, 53100 Kuala Lumpur, Malaysia
| | - Rosnah Sutan
- Community Health Department, Universiti Kebangsaan Malaysia, Bandar Tun Razak Cheras, 56000 Kuala Lumpur, Malaysia
| | - Maigun Edhborg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, SE-141 83 Huddinge, Stockholm, Sweden
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Karaçam Z, Çoban A, Akbaş B, Karabulut E. Status of postpartum depression in Turkey: A meta-analysis. Health Care Women Int 2018; 39:821-841. [DOI: 10.1080/07399332.2018.1466144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Zekiye Karaçam
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Ayden Çoban
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Burcu Akbaş
- Department of Midwifery, Institute of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Erdem Karabulut
- Medical Faculty Department of Biostatistics, Hacettepe University, Ankara, Turkey
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Sociodemographic, obstetric characteristics, antenatal morbidities, and perinatal depressive symptoms: A three-wave prospective study. PLoS One 2018; 13:e0188365. [PMID: 29420535 PMCID: PMC5805167 DOI: 10.1371/journal.pone.0188365] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/06/2017] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed (1) to investigate the pattern of perinatal depressive symptoms, and (2) to determine the relationships between sociodemographic characteristics, obstetric factors, antenatal morbidities, postnatal conditions, and perinatal depressive symptoms using a structural equation model (SEM). Method A three-wave prospective longitudinal design was used for 361 women in their second trimester, third trimester, and at six weeks postpartum. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Results The intensity of depressive symptoms was the highest in the second trimester among the three waves. The SEM showed that unmarried status, unplanned pregnancy, gestational diabetes, and headache were significantly associated with EPDS in the first and second waves. The EPDS in the first wave was able to predict the EPDS in the second and third waves. The SEM has satisfactorily fit with the data (chi-square/degree of freedom = 1.42, incremental fit index = 0.91, Tucker-Lewis index = 0.90, comparative fit index = 0.91, and root mean square error of approximation = 0.03). Conclusion The findings highlight the significance of monitoring depressive symptoms in the second trimester. Findings from this study could be useful in the design of effective intervention among women with unmarried status, unplanned pregnancy, gestational diabetes, and headache in order to reduce risk of perinatal depressive symptoms.
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Wang Y, Wang X, Liu F, Jiang X, Xiao Y, Dong X, Kong X, Yang X, Tian D, Qu Z. Negative Life Events and Antenatal Depression among Pregnant Women in Rural China: The Role of Negative Automatic Thoughts. PLoS One 2016; 11:e0167597. [PMID: 27977715 PMCID: PMC5157981 DOI: 10.1371/journal.pone.0167597] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/16/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Few studies have looked at the relationship between psychological and the mental health status of pregnant women in rural China. The current study aims to explore the potential mediating effect of negative automatic thoughts between negative life events and antenatal depression. METHODS Data were collected in June 2012 and October 2012. 495 rural pregnant women were interviewed. Depressive symptoms were measured by the Edinburgh postnatal depression scale, stresses of pregnancy were measured by the pregnancy pressure scale, negative automatic thoughts were measured by the automatic thoughts questionnaire, and negative life events were measured by the life events scale for pregnant women. We used logistic regression and path analysis to test the mediating effect. RESULTS The prevalence of antenatal depression was 13.7%. In the logistic regression, the only socio-demographic and health behavior factor significantly related to antenatal depression was sleep quality. Negative life events were not associated with depression in the fully adjusted model. Path analysis showed that the eventual direct and general effects of negative automatic thoughts were 0.39 and 0.51, which were larger than the effects of negative life events. CONCLUSIONS This study suggested that there was a potentially significant mediating effect of negative automatic thoughts. Pregnant women who had lower scores of negative automatic thoughts were more likely to suffer less from negative life events which might lead to antenatal depression.
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Affiliation(s)
- Yang Wang
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Xiaohua Wang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Fangnan Liu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Xiaoning Jiang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Yun Xiao
- Maternal and Child Health Hospital in Mianzhu County, Deyang, Sichuan, China
| | - Xuehan Dong
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Xianglei Kong
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Xuemei Yang
- Teacher Education College, Sichuan Normal University, Chengdu, Sichuan, China
| | - Donghua Tian
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Zhiyong Qu
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
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Depression and Social Support Trajectories During 1 Year Postpartum Among Marriage-Based Immigrant Mothers in Taiwan. Arch Psychiatr Nurs 2016; 30:350-5. [PMID: 27256940 DOI: 10.1016/j.apnu.2015.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 12/17/2015] [Indexed: 01/26/2023]
Abstract
OBJECTIVES This panel study examined the trajectories of depression and social support during the first year postpartum among marriage-based immigrant mothers in Taiwan, and the effect of social support on depression. METHODS This panel study recruited South-Asia immigrant mothers (mean age: 27years) to complete structured questionnaire at 1month, 6month, and 1year postpartum. A total of 203 immigrant mothers completed structured questionnaires at 1 and 6months, and 163 completed the questionnaires at 1year postpartum. Postpartum depression was measured using the Edinburgh Postpartum Depression Scale. Social support was composed of 3 subscales, emotional, instrumental, and informational support. Hierarchical linear modeling was used to examine the relationships between trajectories and factors associated with depression. RESULTS Depression and instrumental support followed downward curvilinear trajectories, while emotional and informational support followed upward curvilinear trajectories. Depression was highest at 1month, decreased sharply until 6months, and then leveled off between 6 and 12months. Emotional and instrumental support negatively covaried with postpartum depression over time. When the three-dimensional supports were considered together, only emotional support retained its significance. CONCLUSIONS Our results demonstrated that depression was highest at 1month, then decreased, and then leveled off during 1year postpartum, though further study may be needed to confirm the trajectory. The 3 types of social support differed in postpartum trajectory, suggesting the needs to consider them separately in future studies. To decrease postpartum depression among immigrant mothers, strategies should be developed to increase emotional and instrumental support during postpartum period.
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Antenatal depression and hematocrit levels as predictors of postpartum depression and anxiety symptoms. Psychiatry Res 2016; 238:211-217. [PMID: 27086235 DOI: 10.1016/j.psychres.2016.02.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 01/16/2016] [Accepted: 02/16/2016] [Indexed: 01/11/2023]
Abstract
The aim of this study is to delineate the risk factors of antenatal depression and its consequences, including postnatal depression, and to examine whether the hematocrit (Hct) is associated with maternal depression. The Edinburgh Postnatal Depression Scale (EPDS), Spielberger's State Anxiety Inventory (STAI), Kennerley and Gath Maternity Blues Assessment Scale (KGB), Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAMD) were assessed at the end of term (T1) and 2-3 days (T2) and 4-6 weeks (T3) after delivery in 126 women with and without antenatal depression. The Hct was measured at T1. Antenatal depression was significantly predicted by lifetime depression and premenstrual syndrome and less education. Antenatal depression was not associated with obstetric or neonatal outcomes. Antenatal depression symptoms strongly predict depression and anxiety symptoms at T2 and T3. The EPDS, KGB, STAI and BDI, but not the HAMD, scores, were significantly lower at T3 than before. The incidence of depression significantly decreased from T1 (23.8%) to T2 (7.8%) and T3 (5.3%). T1 Hct values significantly predicted the T3 postnatal EPDS, STAI, KGB and BDI scores. Delivery significantly improves depression and anxiety symptoms. Increased Hct in the third trimester is a biomarker of postpartum depression and anxiety symptoms.
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Lau Y, Wang Y, Kwong DHK, Wang Y. Are Different Coping Styles Mitigating Perceived Stress Associated With Depressive Symptoms Among Pregnant Women? Perspect Psychiatr Care 2016; 52:102-12. [PMID: 25639982 DOI: 10.1111/ppc.12105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 12/09/2014] [Accepted: 01/07/2015] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To test the direct and moderating effects of different coping styles in mitigating perceived stress associated with antenatal depressive symptoms among 755 women. DESIGN AND METHODS The Perceived Stress Scale, the Trait Coping Styles Questionnaire, and the Edinburgh Depressive Postnatal Scale were used to test different effects in multiple linear regression models. FINDINGS Direct effects of positive and negative coping styles were found. Positive coping styles have moderating effects on perceived stress but negative coping styles do not. PRACTICE IMPLICATIONS Health services should dedicate resources to teach women positive coping styles to decrease their vulnerability to developing antenatal depressive symptoms.
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Affiliation(s)
- Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,School of Health Sciences, Macao Polytechnic Institute, Macao, China
| | - Yuqiong Wang
- Chengdu Women and Children's Central Hospital, Chengdu, China
| | | | - Ying Wang
- Chengdu Women and Children's Central Hospital, Chengdu, China
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Antenatal and postnatal risk factors of postpartum depression symptoms in Thai women: A case-control study. SEXUAL & REPRODUCTIVE HEALTHCARE 2016; 10:25-31. [PMID: 27938868 DOI: 10.1016/j.srhc.2016.03.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 02/17/2016] [Accepted: 03/04/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the effects of different predictors on the incidence and severity of postpartum depression (PPD) symptoms in a Thai population. METHODS In this case control study we delineate the clinical, demographic and socio-economic risk factors associated with PPD symptoms. We used the Edinburgh Postnatal Depression Scale (EPDS) 4-6 weeks postpartum to divide parturients into those with (n = 53) and without (n = 260) PPD using a cutoff score of 11. RESULTS This study confirms previous risk factors for PPD (i.e. a history of lifetime major depression and PPD, a history of depression during pregnancy, multi-parity, unwanted pregnancy, childcare stress, premenstrual syndrome, pain symptoms in the early puerperium), and describes new risk factors (i.e. use of caffeine during pregnancy and baby feeding problems). There are significant associations between (a) a lifetime history of major depression and depression during pregnancy, a history of postpartum depression and lifetime mania; and (b) a history of lifetime mania and a history of depression during pregnancy and a history of postpartum depression. CONCLUSIONS A history of lifetime major depression and depression during pregnancy are the most important risk factors for postnatal depression, suggesting that sensitization processes increase risk towards postpartum depression. Postpartum depression may be a subtype of unipolar depression or bipolar disorder.
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Cross-Cultural Approach of Postpartum Depression: Manifestation, Practices Applied, Risk Factors and Therapeutic Interventions. Psychiatr Q 2016; 87:129-54. [PMID: 25986531 DOI: 10.1007/s11126-015-9367-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
It is a well known fact that postpartum depression (PPD) is a global phenomenon that women may experience, regardless of cultural identity and beliefs. This literature review presents the cultural beliefs and postnatal practices around the world, in each continent and people's origins, looking through the extent to which they contribute positively or negatively to the onset of the disease. 106 articles were used in this research, through a systematic electronic search of Pubmed (Medline) and Scopus. Comparison is also made between the prevalence, the risk factors and the different ways of appearance of the disease around the world and among immigrants. Finally, the initiatives and interventions made so far by the governments and institutions with a view to prevent and address this global problem are presented. The results showed (a) that different cultures share the same risk factors towards the disease (b) significant differences in the prevalence of the disease among both Western and non Western cultures and between the cultures themselves (c) more tendencies for somatization of depressive symptoms in non-Western cultures, (d) different postnatal practices between cultures, which are not always effective (e) the more non-West a culture is, the less interventions concern on mental health; the same phenomenon is observed on populations burdened by immigration. The beliefs held by culture should be taken seriously in detecting of PPD, as well as the assessment of the needs of women who have recently given birth.
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Abstract
To assess parenting stress and major difficulties experienced in early motherhood among immigrant and Taiwanese women in Pingtung, southern Taiwan. A comparative, descriptive, cohort study of parenting stress and maternal psychological health, using the Child Care Stress Checklist and Edinburgh Postpartum Depression Scale. A purposive sample of 26 foreign-born Vietnamese and 162 Taiwanese mothers were surveyed at 6 weeks' postpartum. Both groups of mothers experienced similar parenting difficulties including the establishment of a regular sleeping schedule for the infant, consoling a crying infant, awareness of infant's needs, conflict with family members, and difficulties managing household chores. Curtailment of social activities was reported more often by Taiwanese mothers, whereas inaccessibility to other experienced mothers and poor maternal-infant bonding were experienced more by immigrant mothers. There were significant differences between groups, with high levels of child care stress and postpartum depression symptoms reported more often by immigrant mothers. Nurses-midwives and community child health nurses need to be sensitive to the particular difficulties and stresses of parenting in mothers from different backgrounds and provide effective interventions and support activities.
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Mohamad Yusuff AS, Tang L, Binns CW, Lee AH. Prevalence of antenatal depressive symptoms among women in Sabah, Malaysia. J Matern Fetal Neonatal Med 2015; 29:1170-4. [PMID: 26037724 DOI: 10.3109/14767058.2015.1039506] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the prevalence of antenatal depression and to assess whether the common risk factors identified in previous studies were applicable to women in Sabah, Malaysia. METHODS A prospective cohort study of 2072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36-38 weeks of gestation to complete a self-administered questionnaire regarding their demographic, socioeconomic and health characteristics. The presence of depression was assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale. RESULTS The prevalence of antenatal depression was 13.8% [95% confidence interval (CI) 12.3%, 15.3%]. Women who were happy with the pregnancy [odds ratio (OR) 0.43, 95% CI 0.21, 0.89] and those with a planned pregnancy (OR 0.45, 95% CI 0.33, 0.60) were less likely to suffer from antenatal depression. Pregnant mothers who were taking oral contraceptives before pregnancy (OR 1.63, 95% CI 1.20, 2.22) and women who experienced antenatal anxiety (OR 3.17, 95% CI 2.35, 4.26) appeared to have an increased risk of antenatal depression. CONCLUSION A substantial proportion of women suffered from antenatal depression in Sabah, Malaysia. Screening and culturally tailored intervention programs targeting vulnerable subgroups of women in the early stage of pregnancy are recommended to deal with the problem.
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Affiliation(s)
| | - Li Tang
- b School of Public Health, Curtin University , Perth , Australia
| | - Colin W Binns
- b School of Public Health, Curtin University , Perth , Australia
| | - Andy H Lee
- b School of Public Health, Curtin University , Perth , Australia
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Norhayati MN, Hazlina NHN, Asrenee AR, Emilin WMAW. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord 2015; 175:34-52. [PMID: 25590764 DOI: 10.1016/j.jad.2014.12.041] [Citation(s) in RCA: 444] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 12/15/2014] [Accepted: 12/15/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND The prevalence of postpartum depression worldwide varies from 0.5% to 60.8% in the first 12 months postpartum using self-reported questionnaire. This review aims to update the current magnitude of postpartum depression based on self-reported questionnaire and clinical interview and explore its associated factors in developed and developing countries. METHODS A literature search conducted between 2005 and 2014 identified 203 studies, of which 191 used self-reported questionnaire in 42 countries and 21 used structured clinical interview in 15 countries. Nine studies used a combination of self-reported questionnaire and clinical interview. RESULT The prevalence of postpartum depression varies from 1.9% to 82.1% in developing countries and from 5.2% to 74.0% in developed countries using self-reported questionnaire. Structured clinical interview shows a much lower prevalence range from 0.1% in Finland to 26.3% in India. Antenatal depression and anxiety, previous psychiatric illness, poor marital relationship, stressful life events, negative attitude towards pregnancy, and lack of social support are significant contributors to postpartum depression. LIMITATION All studies are included irrespective of the methodological quality, such as small sample size and their inclusion could affect the generalizability of the results. CONCLUSION The current prevalence of postpartum depression is much higher than that previously reported, and similar risk factors are documented. A culturally sensitive cut-off score with adequate psychometric properties of the screening instruments should be available. In future studies, examining the physical, biological, and cultural factors in qualitative studies and in those with adequate methodological qualities is recommended.
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Affiliation(s)
- M N Norhayati
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
| | - N H Nik Hazlina
- Women Health Development Unit, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - A R Asrenee
- Department of Psychiatry, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - W M A Wan Emilin
- Perpustakaan Hamdan Tahir, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
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Development and psychometric testing of the Chinese Postnatal Risk Factors Questionnaire (CPRFQ) for postpartum depression. Arch Womens Ment Health 2015; 18:229-237. [PMID: 25142052 DOI: 10.1007/s00737-014-0451-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022]
Abstract
This article describes the development and psychometric assessment of the Chinese Postnatal Risk Factors Questionnaire (CPRFQ). There were four phases in this process: (1) the items were generated using a literature review and a focus group, (2) content validity was evaluated by an expert panel, (3) a pilot study was conducted with 45 postpartum women to refine the scale, and (4) a convenience sample of 256 postpartum women in China was recruited to complete the questionnaire. Construct validity was established by exploratory factor analysis; a four-factor structure of the scale was accepted (social and family, personality and relationship, mother and infant, maternal feelings and 'doing the month'). These factors explained 47.46 % of the variance. Pearson's correlation coefficient was conducted to test convergent validity with the Edinburgh Postnatal Depression Scale (EPDS) (r = 0.54; p < 0.001). The Cronbach's alpha coefficient of the four subscales ranged from 0.58 to 0.71. The final 18-item version of the questionnaire is potentially a valuable tool for assessing postnatal risk factors in Chinese postpartum mothers.
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