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Klein S, Błażek M, Świetlik D. Risk and protective factors for postpartum depression among Polish women - a prospective study. J Psychosom Obstet Gynaecol 2024; 45:2291634. [PMID: 38064700 DOI: 10.1080/0167482x.2023.2291634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
This prospective study conducted at a single center in 2022 aims to identify risk and protective factors for postpartum depression (PPD) in Polish women and to assess the impact of pregnancy, delivery, the postpartum period, and psychosocial factors on PPD. After delivery and 4 weeks later, 311 women filled out two questionnaires of our design related to risk factors for PPD. Immune Power Personality Questionnaire, Walsh Family Resilience Questionnaire, and Edinburg Postnatal Depression Scale were also applied. The predictors of PPD identified at two time points included: use of antidepressants, previous depressive episodes, family history of depression, risk of preterm delivery, anxiety about child's health, and breastfeeding and sleep problems. Risk factors for PPD found only after delivery were: suicidal ideation before pregnancy, stressful life events, premature rupture of the membranes, and cesarean section. Inhalation analgesia during labor reduced the PPD frequency. At 4 weeks' postpartum, regular physical activity was also predictive of PPD, while breastfeeding, financial satisfaction, and sufficient sleep duration were protective factors. PPD after delivery was negatively correlated with capacity to confide, hardiness, assertiveness, self-complexity, and communication. PPD at 4 weeks postpartum decreased belief systems, organization patterns, and communication. Two proposed self-designed questionnaires can be useful for effectively screening PPD in the Polish population.
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Affiliation(s)
- Sebastian Klein
- Department of Obstetrics and Gynecology, Pomeranian Hospitals, Wejherowo, Poland
| | - Magdalena Błażek
- Department of Quality of Life Research, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Dariusz Świetlik
- Division of Biostatistics and Neural Networks, Medical University of Gdansk, Gdansk, Poland
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Abboud N, Wainstock T, Sheiner E, Nassar R, Leibson T, Pariente G, Reuveni I. Adverse life events among bedouin and jewish women and the risk for postpartum depressive symptoms. Arch Womens Ment Health 2024. [DOI: 10.1007/s00737-024-01496-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 07/29/2024] [Indexed: 08/25/2024]
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El-Salahi S, Knowles Bevis R, Hogg L. The relationship between traumatic childbirth and first-time mothers' social identity and wellbeing: a cross-sectional observational study. BMC Pregnancy Childbirth 2024; 24:437. [PMID: 38907211 PMCID: PMC11193172 DOI: 10.1186/s12884-024-06288-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/22/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Experiencing childbirth as traumatic is common and can have long-lasting negative consequences for women's mental health. However, fostering a sense of social identity has been shown to protect psychological wellbeing and mental health during life transitions, such as entering parenthood. This study therefore investigated the relationship between traumatic childbirth and first-time mothers' social identity and their psychological wellbeing, and more specifically whether strength of identity as a first-time mother protected psychological wellbeing following traumatic childbirth. METHOD Women over the age of 18 who were living in the UK and had given birth to their first child in the past nine months were recruited to the study from clinical and community settings. They completed digital self-report questionnaires about their birth experience, social identity, mental health, and psychological wellbeing. Women who perceived themselves to have had a traumatic birth (the trauma group; N = 84) were compared to women who did not perceive themselves to have had a traumatic birth (the control group, N = 39). T-tests and chi square tests assessed preliminary group differences before multivariate analyses of covariance controlled for covariates. Post-hoc tests identified the direction of differences. Multiple regression and moderation analyses analysed interaction effects. RESULTS The trauma group had significantly lower psychological wellbeing (mean = 41.5, 95% CI [39.4-43.7], p = .008, partial η2 = 0.059), compared to the control group (mean = 48.4, 95% CI [45.3-51.5]), but the two groups did not differ in the strength of their first-time mother identity, which was high across both groups. Strength of identity did not moderate the relationship between traumatic childbirth and psychological wellbeing. Giving birth by caesarean section independently reduced the strength of the first-time mother identity (p = .017, partial η2 = 0.049). All analyses controlled for emotional and practical support, perceptions of healthcare staff, and mode of birth. CONCLUSIONS Having a traumatic birth was associated with lower psychological wellbeing, and the strength of first-time mother identity does not appear to moderate this relationship. Factors such as mode of birth may be more important. Further research, including longitudinal designs, is needed to understand the relationship between these constructs and identify more effective ways of protecting first-time mothers' mental health.
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Affiliation(s)
- Shama El-Salahi
- Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, OX3 7JX, Oxford, UK
| | - Rebecca Knowles Bevis
- Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, University of Oxford, Warneford Hospital, Warneford Lane, OX3 7JX, Oxford, UK
| | - Lorna Hogg
- Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, University of Oxford, Warneford Hospital, Warneford Lane, OX3 7JX, Oxford, UK.
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Uçakcı Asalıoğlu C, Yaman Sözbir Ş. Effect of online health training/counseling and progressive muscle relaxation exercise on postpartum depression and maternal attachment: A randomized controlled trial. Int J Gynaecol Obstet 2024; 165:1218-1228. [PMID: 38294240 DOI: 10.1002/ijgo.15359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/15/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE To evaluate the effect of online health training/counseling and a progressive muscle relaxation exercise (PMRE) program on postpartum depression and maternal attachment. METHODS The present study was a randomized, controlled, experimental trial. Participants were asked to complete the Prenatal Attachment Inventory (PAI) and the Edinburgh Postpartum Depression Scale (EPDS) at 35 weeks of pregnancy. Group assignment was done by stratified block randomization according to EPDS score (0-9, 10-30) and parity. Women in the experimental group received training in progressive muscle relaxation, postpartum depression, and maternal attachment via online video calls twice a week starting at 36-37 weeks of pregnancy. They were asked to complete the PMRE program from 36 weeks of pregnancy until 6 months postpartum, and online counseling was provided throughout this period. Participants completed the Maternal Postpartum Attachment Scale (MPAS) and the EPDS at 6 weeks postpartum. RESULTS Mean PAI score was 64.24 ± 9.61 in the experimental group before the intervention and 62.14 ± 10.13 in the control group. The mean EPDS score of the experimental group was 9.12 ± 5.05 and the mean score of the control group was 9.77 ± 6.30 (P > 0.05). The mean MPAS score after the intervention was 13.92 ± 5.54 in the experimental group and 17.51 ± 6.12 in the control group. The mean EPDS score of the experimental group was 3.40 ± 3.00 and the mean score of the control group was 11.40 ± 5.91 (P < 0.05). CONCLUSION Online health training/counseling and PMRE reduce the risk of postpartum depression and increase maternal attachment.
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Affiliation(s)
| | - Şengül Yaman Sözbir
- Department of Nursing, Gazi University Faculty of Nursing, Çankaya, Ankara, Turkey
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Khademi K, Kaveh MH. Social support as a coping resource for psychosocial conditions in postpartum period: a systematic review and logic framework. BMC Psychol 2024; 12:301. [PMID: 38807228 PMCID: PMC11131291 DOI: 10.1186/s40359-024-01814-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 05/23/2024] [Indexed: 05/30/2024] Open
Abstract
PURPOSE This review seeks to examine the current state of postpartum social support and psychosocial conditions among women around the world, as well as explore the relationship between these factors. Additionally, it aims to propose a logical framework for enhancing postpartum social support and psychosocial conditions in this population. METHODS Following the development of a search strategy, two databases, PubMed and Science Direct, were searched for studies published between January 2019 and May 2023. The search was conducted throughout the entire month of May 2023. The risk of bias in the included cross-sectional studies was assessed using the Newcastle-Ottawa Quality Assessment Scale, which was adapted for this specific study design. To determine if the main objective of the cross-sectional studies was to investigate the relationship between social support and postpartum psychosocial conditions, a review was conducted based on the AMSTAR checklist, PRISMA checklist and PRISMA flow diagram. Data extraction was performed with the consensus of two authors, and a narrative synthesis approach was chosen for data synthesis, following the guidelines provided by the Centre for Reviews and Dissemination (CRD). RESULTS Eleven cross-sectional studies were included in the final analysis. Our findings revealed that all reviewed studies provided evidence of a positive association between social support and healthy psychosocial conditions in postpartum period. However, due to the absence of standardized measurement indicators to identify and compare the outcomes of various studies, there was a need to develop a conceptual framework that could enhance our understanding of the postpartum psychosocial condition including anxiety, depression, unfavorable quality of life and social support status up to 24 month after child birth. This framework aimed to incorporate childbirth and motherhood as "stressful events," while considering social support as a crucial "coping resource." Furthermore, it acknowledged empowerment, help-seeking behavior, and peer support as important "coping actions," alongside implementing client-centered interventions. Lastly, it recognized postpartum mental health and optimal quality of life as significant "effects" of these factors. CONCLUSIONS The proposed conceptual framework could define postpartum women's health as "the ability to adapt and self-manage."
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Affiliation(s)
- Khadijeh Khademi
- Student Research Committee, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71536-75541, Iran.
| | - Mohammad Hossein Kaveh
- Research Center for Health Sciences, Department of Health Promotion, School of Health, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Zhao X, Liu L. Mendelian randomization analyses for the causal relationship between early age at first sexual intercourse, early age at first live birth, and postpartum depression in pregnant women. Front Psychiatry 2024; 15:1287934. [PMID: 38651010 PMCID: PMC11033313 DOI: 10.3389/fpsyt.2024.1287934] [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: 09/08/2023] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction There are insufficient epidemiological studies on the impact of age at first sexual intercourse (AFS) and age at first live birth (AFB) on postpartum depression (PPD) in pregnant women, and the conclusions of these studies are inconsistent. Methods We performed a Mendelian randomization (MR) study to determine the causal relationship between AFS or AFB and the risk of PPD. The summary data were extracted from genome-wide association study (GWAS) summary datasets. We selected the instrumental variables according to the P value of exposure-related single nucleotide polymorphisms (P<5 ×10-9 for AFS and P<5 ×10-8 for AFB) and estimated the linkage disequilibrium using the clump parameter (10,000 kb, r2 < 0.001). Single nucleotide polymorphisms were considered instrumental variables that were significantly associated with exposure factors without linkage disequilibrium. The F-statistics of the instrumental variables should all be larger than 10. A random-effects model of IVW was constructed as the main method in our study. Results and discussion MR studies based on GWAS data revealed that both AFS (OR = 0.4, P <0.001) and AFB (OR = 0.38, P <0.001) were negatively correlated with the risk of PPD. Early AFS and early AFB should be studied as possible risk factors for PPD in the future. Public health departments should attach importance to sex education for young girls. The results of our TSMR should be verified by high-quality prospective epidemiological studies in the future.
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Affiliation(s)
- Xuemin Zhao
- Department of Internal Medicine, Chengde Medical University, Chengde, China
| | - Linfei Liu
- Sericultural Research Institute, Chengde Medical University, Chengde, China
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Bonanni G, Longo VL, Airoldi C, Meli F, Familiari A, Romanzi F, Pellegrino M, Visconti D, Serio A, Lanzone A, Bevilacqua E. Is the mental health of couples with twins more at risk? Results from an Italian cohort study. Front Psychiatry 2024; 15:1284090. [PMID: 38347879 PMCID: PMC10859489 DOI: 10.3389/fpsyt.2024.1284090] [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: 08/27/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
Introduction Our retrospective study aimed to investigate whether parents of twins encounter heightened psychological and emotional distress one year after childbirth, in comparison to parents of singletons within an Italian cohort. Methods Exclusion criteria included multiparity, preterm birth, congenital anomalies, stillbirth, >2 fetus pregnancies, and pre-existing maternal mental health disorders. Out of the 300 couples (600 parents) invited to participate, 286 parents (158 mothers, 128 fathers) successfully completed a self-administered survey. We analyzed three scores separately for mothers and fathers, differentiating between singleton and twin pregnancies: the Edinburgh Postnatal Depression Scale (EPDS) score, the State and Trait Anxiety Inventory (STAI)-Y1 score, and the STAI-Y2 score. Results Logistic models were used to assess the influence of age, BMI, marital status, education, and employment on the three binary scores (EPDS, STAI-Y1, and STAI-Y2), revealing no significant differences in absolute scores between parents of singletons and twins. Paired analysis revealed significantly higher EPDS (mean increase: 3.8, SD: 6.5), STAI-Y1 (mean increase: 5.4, SD: 12.5), and STAI-Y2 (mean increase: 4.5, SD: 12.4) scores for mothers (p < 0.0001). Approximately 10% of women and 8% of men reported suicidal thoughts. Discussion Contrary to expectations, no substantial psychological differences emerged between parents of twins and singletons. Adjusting for confounders through univariate analysis maintained nonsignificant trends. Nevertheless, caution in interpretation is warranted due to strict inclusion criteria favoring twin pregnancies with better outcomes. Unintended bias could have resulted from routine psychological support offered to mothers of twins in our clinic. This presents an important framework for future research, including randomized controlled trials comparing parents of multiples with psychological support to those without.Finally, the elevated prevalence of depression symptoms and suicidal thoughts in our cohort underscores the importance of mental health during pregnancy and early parenting. We advocate for the screening of parents for postpartum depression and various psychological conditions, encompassing a spectrum of anxiety disorders. Those at elevated risk of mental distress should be proactively offered appropriate support.
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Affiliation(s)
- Giulia Bonanni
- Unit of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Valentina Laurita Longo
- Unit of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Chiara Airoldi
- Department of Translation Medicine, University of Piemonte Orientale, Novara, Italy
| | - Federica Meli
- Unit of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alessandra Familiari
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Federica Romanzi
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Marcella Pellegrino
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniela Visconti
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Annamaria Serio
- Department of Clinical Psychology, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio Lanzone
- Unit of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Elisa Bevilacqua
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Vanderkruik RC, Ferguson C, Kobylski LA, Locascio JJ, Hamlett GE, Killenberg PC, Lewis R, Jones N, Rossa ET, Dineen H, Picard R, Cohen LS. Testing a Behavioral Activation Gaming App for Depression During Pregnancy: Multimethod Pilot Study. JMIR Form Res 2024; 8:e44029. [PMID: 38277191 PMCID: PMC10858420 DOI: 10.2196/44029] [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: 11/06/2022] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Depression during pregnancy is increasingly recognized as a worldwide public health problem. If untreated, there can be detrimental outcomes for the mother and child. Anxiety is also often comorbid with depression. Although effective treatments exist, most women do not receive treatment. Technology is a mechanism to increase access to and engagement in mental health services. OBJECTIVE The Guardians is a mobile app, grounded in behavioral activation principles, which seeks to leverage mobile game mechanics and in-game rewards to encourage user engagement. This study seeks to assess app satisfaction and engagement and to explore changes in clinical symptoms of depression and anxiety among a sample of pregnant women with elevated depressive symptoms. METHODS This multimethod pilot test consisted of a single-arm, proof-of-concept trial to examine the feasibility and acceptability of The Guardians among a pregnant sample with depression (N=18). Participation included two web-based study visits: (1) a baseline assessment to collect demographic and obstetric information and to assess clinical symptoms and (2) an exit interview to administer follow-up measures and explore user experience. Participants completed biweekly questionnaires (ie, Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7) during the trial to assess depression and anxiety symptom severity. App satisfaction was measured using 2 self-report scales (ie, Mobile Application Rating Scale and Player Experience of Needs Satisfaction scale). Engagement with The Guardians was captured using game interaction metric data. We used backward-eliminated mixed effects longitudinal models to examine the effects of app engagement and satisfaction and length of time in the study on symptoms of depression and anxiety. Content analysis was conducted on qualitative data from exit interviews. RESULTS The 15-day and 30-day overall app retention rates were 26.6% and 15.1%, respectively. Mixed effects models found significant negative main effects of week in study (β=-.35; t61=-3.05; P=.003), number of activities completed (β=-.12; t61=-2.05; P=.04), days played (β=-.12; t58=-2.9; P=.005), and satisfaction, according to the Mobile Application Rating Scale (β=-3.05; t45=-2.19; P=.03) on depressive symptoms. We have reported about similar analyses for anxiety. There is preliminary evidence suggesting harder activities are associated with greater mood improvement than easier activities. Qualitative content analysis resulted in feedback falling under the following themes: activities, app design, engagement, fit of the app with lifestyle, perceived impact of the app on mood, and suggestions for app modifications. CONCLUSIONS Preliminary results from this multimethod study of The Guardians indicate feasibility and acceptability among pregnant women with depression. Retention and engagement levels were more than double those of previous public mental health apps, and use of the app was associated with significant decrease in depressive symptom scores over the 10-week trial. The Guardians shows promise as an effective and scalable digital intervention to support women experiencing depression.
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Affiliation(s)
- Rachel C Vanderkruik
- Center for Women's Mental Health, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Craig Ferguson
- MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Lauren A Kobylski
- Center for Women's Mental Health, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychological & Brain Sciences, George Washington University, Washington, DC, United States
| | - Joseph J Locascio
- Department of Neurology, Harvard Medical School, Boston, MA, United States
| | | | - Parker C Killenberg
- Center for Women's Mental Health, Massachusetts General Hospital, Boston, MA, United States
| | - Robert Lewis
- MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Noah Jones
- MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Ella T Rossa
- Center for Women's Mental Health, Massachusetts General Hospital, Boston, MA, United States
| | - Hannah Dineen
- Center for Women's Mental Health, Massachusetts General Hospital, Boston, MA, United States
| | - Rosalind Picard
- MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Lee S Cohen
- Center for Women's Mental Health, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Pacho M, Aymerich C, Pedruzo B, Salazar de Pablo G, Sesma E, Bordenave M, Dieguez R, Lopez-Zorroza I, Herrero J, Laborda M, Fernandez-Rivas A, Garcia-Rizo C, Gonzalez-Torres MA, Catalan A. Substance use during pregnancy and risk of postpartum depression: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1264998. [PMID: 38025481 PMCID: PMC10666188 DOI: 10.3389/fpsyt.2023.1264998] [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: 07/21/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Postpartum depression (PPD) is a prevalent mental health condition affecting women globally within the first year following childbirth. Substance use during pregnancy has been associated with an increased risk of developing PPD, but the evidence remains inconclusive. This meta-analysis aims to comprehensively assess the effects of different substances on PPD risk, exploring potential modifiers and confounding factors. Objectives To examine the proportion of PPD among substance users during pregnancy, compared to non-users, and investigate the specific risk associated with different substances (tobacco, alcohol, and non-specified substance use/multiple substance use). Methods A systematic literature search was conducted from inception to November 2022 using the Web of Science database (Clarivate Analytics), incorporating Web of Science Core Collection, the BIOSIS Citation Index, the KCI-Korean Journal Database, MEDLINE®, the Russian Science Citation Index, the SciELO Citation Index, and the Cochrane Central Register of Reviews, and Ovid/PsycINFO databases. Inclusion criteria comprised original studies with pregnant women, using validated depression scales and substance use reporting. Results Among the 26 included studies, encompassing 514,441 women, the pooled prevalence of PPD among substance users during pregnancy was 29% (95% CI 25-33). Meta-analyzes revealed an overall odds ratio (OR) of 3.67 (95% CI 2.31-5.85, p < 0.01) indicating a significantly higher risk of PPD among substance users compared to non-users. Subgroup analyzes demonstrated a higher risk for women with non-specified or multiple substance use (OR 4.67, 95% CI 2.59-8.41; p < 0.01) and tobacco use (OR 4.01, 95% CI 2.23-7.20; p < 0.01). Alcohol use showed a trend toward higher risk that did not reach statistical significance (OR 1.88, 95% CI 1.00-3.55; p = 0.051). Conclusion This meta-analysis provides evidence of an increased risk of PPD among pregnant substance users, particularly those using multiple substances or tobacco. However, caution is needed in interpreting the association with alcohol use due to its non-significant result. Systematic review registration This study protocol was registered at PROSPERO (registration number: CCRD42022375500).
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Affiliation(s)
- Malein Pacho
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Eva Sesma
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Marta Bordenave
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Rodrigo Dieguez
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Itziar Lopez-Zorroza
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Jon Herrero
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Maria Laborda
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Aranzazu Fernandez-Rivas
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Medicine, Institut de Neurociències, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Miguel Angel Gonzalez-Torres
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- NIH Oxford Health Biomedical Research Centre, Oxford, United Kingdom
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
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Javadekar A, Karmarkar A, Chaudhury S, Saldanha D, Patil J. Biopsychosocial correlates of emotional problems in women during pregnancy and postpartum period. Ind Psychiatry J 2023; 32:S141-S146. [PMID: 38370921 PMCID: PMC10871396 DOI: 10.4103/ipj.ipj_225_23] [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: 11/25/2022] [Revised: 05/11/2023] [Accepted: 07/02/2023] [Indexed: 02/20/2024] Open
Abstract
Background Transition to motherhood is associated with several emotional problems that can have long-term consequences on the mother and baby. Aim To examine the association of various biomedical and cultural factors with the new onset of emotional problems during pregnancy and postpartum period. Materials and Methods This prospective longitudinal study included 300 pregnant women interviewed in the third trimester. Results The prevalence of emotional problems in the study group was 31.58%. The prevalence of anxiety disorder NOS and mixed anxiety and depressive disorder in the last trimester of pregnancy in our study was 4% and 1.33%, respectively, and 0.67% and 1.33%, respectively, at 4 days postpartum. At 6 weeks postpartum, the prevalence of anxiety disorder NOS was 1.33%, generalized anxiety disorder was 0.67%, and major depression was 1.33. The prevalence of postpartum blues in our study was 25.33%. Conclusion There was a significant association between psychiatric disorders during and postpartum period and the following factors: higher parity, increased maternal age, low hemoglobin levels, cesarean section, planned pregnancy, and extended family. Postpartum blues was associated with higher parity and low blood pressure.
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Affiliation(s)
- Archana Javadekar
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
| | - Arpita Karmarkar
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
| | - Daniel Saldanha
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
| | - Jaideep Patil
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. PatilVidyapeeth, Pune, Maharashtra, India
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