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Ayrout RA, Kookash MH, Kalalib Al Ashabi K, Safiah MH, Latifeh Y. Exploring prenatal depression and postpartum depression: Findings from a prospective cohort study at University Hospital Obstetrics in Damascus. Medicine (Baltimore) 2024; 103:e38170. [PMID: 38758898 PMCID: PMC11098259 DOI: 10.1097/md.0000000000038170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/17/2024] [Indexed: 05/19/2024] Open
Abstract
The perinatal period is crucial for both mother and newborn, and mental health, including prenatal and postpartum depression (PPD), is a significant aspect. Screening for these disorders allows for early treatment and helps prevent risks to both mother and child. This prospective cohort study was carried out at University Hospital Obstetrics in Damascus City. The first phase was during the third trimester of pregnancy and the second phase involved a follow-up assessment after 6 weeks of delivery. The Arabic-validated version of the Edinburgh Postnatal Depression Scale questionnaire (EPDS) was used. A cutoff of 13 or higher was used to determine the presence of probable depression in both assessments. Of 347 pregnant women, 38.6% had prenatal depression (PND). 295 patients have achieved the second assessment, of which 30.2% had PPD. Furthermore, 42.6% who had PND developed PPD on follow-up. Binary logistic regression indicated that PND was predicted by non-Syrian nationality, paternal absence, poor financial status, number of previous pregnancies, and a history of depression independent of pregnancy. PPD was predicted by a history of PPD, and work status. Findings underscore potential value of early screening for depressive symptoms as a predictive measure. It is recommended that women with a history of depression receive heightened attention and care, irrespective of the timing of their depressive episodes.
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Affiliation(s)
- Ramah Abdo Ayrout
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Majd Hatem Kookash
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | | | - Mhd Homam Safiah
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Youssef Latifeh
- Department of Psychiatry, Damascus University, Damascus, Syrian Arab Republic
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LeBrón AMW, Rodriguez VE, Sinco BR, Caldwell CH, Kieffer EC. Racialization processes and depressive symptoms among pregnant Mexican-origin immigrant women. Am J Community Psychol 2024. [PMID: 38713848 DOI: 10.1002/ajcp.12755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/22/2024] [Accepted: 04/24/2024] [Indexed: 05/09/2024]
Abstract
This study examines how racialization processes (conceptualized as multilevel and dynamic processes) shape prenatal mental health by testing the association of discrimination and the John Henryism hypothesis on depressive symptoms for pregnant Mexican-origin immigrant women. We analyzed baseline data (n = 218) from a healthy lifestyle intervention for pregnant Latinas in Detroit, Michigan. Using separate multiple linear regression models, we examined the independent and joint associations of discrimination and John Henryism with depressive symptoms and effect modification by socioeconomic position. Discrimination was positively associated with depressive symptoms (β = 2.84; p < .001) when adjusting for covariates. This association did not vary by socioeconomic position. Women primarily attributed discrimination to language use, racial background, and nativity. We did not find support for the John Henryism hypothesis, meaning that the hypothesized association between John Henryism and depressive symptoms did not vary by socioeconomic position. Examinations of joint associations of discrimination and John Henryism on depressive symptoms indicate a positive association between discrimination and depressive symptoms (β = 2.81; p < .001) and no association of John Henryism and depressive symptoms (β = -0.83; p > .05). Results suggest complex pathways by which racialization processes affect health and highlight the importance of considering experiences of race, class, and gender within racialization processes.
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Affiliation(s)
- Alana M W LeBrón
- Department of Health, Society, and Behavior, Program in Public Health, University of California, Irvine, Irvine, California, USA
- Department of Chicano/Latino Studies, School of Social Sciences, University of California, Irvine, Irvine, California, USA
| | - Victoria E Rodriguez
- Department of Health, Society, and Behavior, Program in Public Health, University of California, Irvine, Irvine, California, USA
| | - Brandy R Sinco
- School of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Edith C Kieffer
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
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Sobol M, Błachnio A, Meisner M, Wdowiak A, Wdowiak N, Gorbaniuk O, Jankowski KS. Circadian rhythm and sleep disruptions in relation to prenatal stress and depression symptoms. Chronobiol Int 2024; 41:294-303. [PMID: 38297459 DOI: 10.1080/07420528.2024.2303985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024]
Abstract
Circadian rhythm and sleep are related to health, but there is little data on the relationship between the sleep/wake rhythm and mood at different stages of pregnancy. The aim of this prospective, longitudinal study was to investigate the associations of circadian rhythm and sleep disruptions with stress and depression among women in early and late pregnancy. The participants were 26 pregnant women. Objective and subjective estimations of circadian rhythm and sleep were administered, namely actigraphy and the Biological Rhythms Interview of Assessment in Neuropsychiatry in the form of a questionnaire. The Perceived Stress Scale and the Edinburgh Postnatal Depression Scale were also used. Subjectively perceived circadian rhythm disruptions were positively related to stress. Tendency to maintain a regular rhythm of sleep and activity in early pregnancy and subjectively perceived disruptions of circadian rhythms in late pregnancy were positively associated with prenatal depression in late pregnancy. Sleep fragmentation and long time spent in bed at night in early pregnancy were positively associated with stress and depression in late pregnancy. The results suggest the importance of flexibility and the ability to adapt one's circadian activities to the demands of the situation of pregnancy-related changes in lifestyle. They also indicate the significance of good-quality uninterrupted night sleep in early pregnancy.
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Affiliation(s)
| | - Agata Błachnio
- Department of Psychology, John Paul II Catholic University of Lublin, Lublin, Poland
| | - Michał Meisner
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Artur Wdowiak
- Faculty of Medicine and Dentistry, Medical University of Lublin, Lublin, Poland
| | - Natalia Wdowiak
- Faculty of Medicine and Dentistry, Medical University of Lublin, Lublin, Poland
| | - Oleg Gorbaniuk
- Institute of Psychology, Maria Curie-Skłodowska University, Lublin, Poland
- Department of Psychology, Casimir Pulaski Radom University, Radom, Poland
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Costin MR, Taut D, Baban A, Ionescu T, Murray A, Lindsay C, Secara E, Abbasi F, Sarfo Acheampong I, Katus L, Luong Thanh Bao Y, Hernandez SCLS, Randeny S, Du Toit S, Valdebenito S, Eisner MP. The Role of Maternal Depression Symptoms and Maternal Attachment in Predicting Exclusive Breastfeeding: A Multisite Prospective Study. J Womens Health (Larchmt) 2024; 33:187-197. [PMID: 38011004 DOI: 10.1089/jwh.2023.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Background: Previous research shows that 61% of children younger than 6 months in low- and middle-income countries (LMICs) are not exclusively breastfed. Although data on the role of pre- and postnatal depression on breastfeeding exclusivity is mixed, fetomaternal attachment might foster breastfeeding exclusivity. Thus, we tested the potential mediating role of fetomaternal attachment and postnatal depression in the relationship between maternal prenatal depression and exclusive breastfeeding. Materials and Methods: Data were collected as part of a prospective, cross-cultural project, Evidence for Better Lives Study, which enrolled 1208 expectant mothers, in their third trimester of pregnancy across eight sites, from LMICs. Of the whole sample, 1185 women (mean age = 28.32, standard deviation [SD] = 5.77) completed Computer-Aided Personal Interviews on prenatal depressive symptoms, fetomaternal attachment, and socioeconomic status. A total of 1054 women provided follow-up data at 3-6 months after birth, about postnatal depressive symptoms, exclusive breastfeeding, and infant health indicators. Path analysis was used to assess parallel mediation. Results: In the whole sample, the effect of prenatal depression on breastfeeding exclusivity was completely mediated by postnatal depression, whereas fetomaternal attachment did not mediate the relationship. The full mediation effect was replicated individually in Pakistan and Sri Lanka. Conclusions: The study results indicate that prenatal depression symptoms contributed to the development of depressive symptoms after birth, negatively affecting the probability of exclusive breastfeeding. Future research should explore this in early prevention interventions, increasing the chances of healthy child development in LMICs. Considering the mixed results around the sites, it is important to better understand the relationship between maternal depression, fetomaternal attachment and breastfeeding behavior in each site's socio-cultural context.
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Affiliation(s)
| | - Diana Taut
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Thea Ionescu
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Aja Murray
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Carene Lindsay
- Department of Basic Medical Sciences, Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Eugen Secara
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Fahad Abbasi
- Department of Jhpiego-Gender and Research, Fazaia Medical College, Islamabad, Pakistan
| | - Isaac Sarfo Acheampong
- Department of Medical Laboratory Science, Koforidua Technical University, Koforidua, Ghana
| | - Laura Katus
- Institute for Lifecourse Development, School of Human Sciences, University of Greenwich, London, United Kingdom
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom
| | - Yen Luong Thanh Bao
- Department of Epidemiology-Biostatistics and Demography, Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | | | - Shobhavi Randeny
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Stefani Du Toit
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Manuel P Eisner
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
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Pingeton BC, Goodman SH, Lavner JA, LaFever K, Marchuck N. Perinatal depression in transgender and gender expansive individuals. BJOG 2024. [PMID: 38272844 DOI: 10.1111/1471-0528.17757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/17/2023] [Accepted: 01/01/2024] [Indexed: 01/27/2024]
Affiliation(s)
| | | | - Justin A Lavner
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Kat LaFever
- Department of Psychology, Emory University, Atlanta, Georgia, USA
| | - Noah Marchuck
- Department of Psychology, Emory University, Atlanta, Georgia, USA
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Obikane E, Nishi D, Morisaki N, Tabuchi T. Risk factors of paternal perinatal depression during the COVID-19 pandemic in Japan. J Psychosom Obstet Gynaecol 2023; 44:2245556. [PMID: 37615367 DOI: 10.1080/0167482x.2023.2245556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/25/2023] Open
Abstract
PURPOSE The study aims to investigate risk factors of paternal perinatal depression during the COVID-19 pandemic. METHODS We conducted an online cross-sectional study of 473 prenatal fathers and 1246 postnatal fathers in August 2021. We applied a modified Poisson regression to estimate relative risk ratios of possible factors for paternal perinatal depression (measured by Edinburgh Postnatal Depression Scale), sequentially introducing the following factors into the model: individual factors, interpersonal factors, obstetric/pediatric factors, and service utilization factors. RESULTS Prenatal fathers with the following risk factors were at an increased risk for having depressive symptoms: adverse childhood experiences (risk ratio; RR 1.61), past depression (RR 1.63), fear of COVID-19 (RR 2.09), lower social support (RR 1.91), low family resources (RR 1.95), and intimate partner violence (IPV) victimization (RR 1.29). Postnatal fathers having the following risk factors were at an increased risk for having depressive symptoms: past depression (RR 1.67), fear of COVID-19 (RR 1.26), low family resources (RR 1.85), IPV victimization. (RR 1.18), and preterm birth (RR 1.18). CONCLUSION The study showed risk factors such as past history of depression, high fear of COVID-19, low family functionality, and IPV victimization were associated with perinatal depressive symptoms. The findings should contribute to future directions of interventions for paternal perinatal mental health.
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Affiliation(s)
- Erika Obikane
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
- Department of Mental Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
- The Tokyo Foundation for Policy Research, Tokyo, Japan
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Oddo VM, Moise C, Welke L, Bernabé BP, Maki P, Koenig MD, Pezley L, Xia Y, Tussing-Humphreys L. Mediterranean Diet Adherence and Depressive Symptoms among a Nationally Representative Sample of Pregnant Women in the United States. J Nutr 2023; 153:3041-3048. [PMID: 37598749 PMCID: PMC10613757 DOI: 10.1016/j.tjnut.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/29/2023] [Accepted: 08/16/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Prenatal depression affects ∼12% of pregnant women in the United States and is associated with an increased risk of adverse birth outcomes and maternal mortality. Adherence to a healthy dietary pattern may reduce and/or protect against depressive symptoms. OBJECTIVES To investigate the relationship between adherence to a Mediterranean diet and depressive symptoms among pregnant women in the United States. METHODS We used data from the National Health and Nutrition Examination Survey (2005-2018, N = 540) and included pregnant women aged 18-44 y with a positive urine pregnancy test. The Mediterranean diet score (aMED) was calculated from 1 24-h recall; aMED typically ranges from 0-9, but in these analyses, it ranged from 0-8 because alcohol was not included. The aMED score was dichotomized as high (>3) compared with low (≤3). The Patient Health Questionnaire-9 (PHQ-9), which measures depressive symptoms, was dichotomized as lower compared with higher (PHQ-9 score ≥10), based on the clinical cutoff for patient referral. Our primary model employed logistic regression to investigate the association between aMED adherence and high depressive symptoms when controlling for socio-demographics (age, racial/ethnicity, education, poverty, and relationship status), total calories, and prepregnancy body mass index (kg/m2). We also modeled the PHQ-9 score as a continuous variable using a random-effects model. RESULTS About 5% of pregnant women had moderate to severe depressive symptoms, and 45% were highly adherent to a Mediterranean diet. Higher adherence to a Mediterranean diet was associated with lower odds of depressive symptoms (odds ratio: 0.31, 95% confidence interval: 0.10, 0.98). Results were not significant for the continuous PHQ-9 score (β: -0.30; 95% confidence interval: -0.90, 0.30). CONCLUSIONS Adherence to a Mediterranean diet may have the potential to lower depressive symptoms among pregnant women; however, these results should be interpreted with caution. Nevertheless, considering the public health significance of promoting mental wellness among pregnant women, this relationship merits further examination using experimental designs.
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Affiliation(s)
- Vanessa M Oddo
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States.
| | - Crussie Moise
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States
| | | | - Beatriz Peñalver Bernabé
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL, United States
| | - Pauline Maki
- Department of Psychology, University of Illinois Chicago, Chicago, IL, United States; Department of Psychiatry, University of Illinois Chicago, Chicago, IL, United States
| | - Mary Dawn Koenig
- Department of Human Development Nursing Science, University of Illinois Chicago, Chicago, IL, United States
| | - Lacey Pezley
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States
| | - Yinglin Xia
- Department of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States; University of Illinois Cancer Center, University of Illinois Chicago, Chicago, IL United States
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Ackerman‐Banks CM, Lipkind HS, Palmsten K, Pfeiffer M, Gelsinger C, Ahrens KA. Association of Prenatal Depression With New Cardiovascular Disease Within 24 Months Postpartum. J Am Heart Assoc 2023; 12:e028133. [PMID: 37073814 PMCID: PMC10227220 DOI: 10.1161/jaha.122.028133] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/10/2023] [Indexed: 04/20/2023]
Abstract
Background Although depression is well established as an independent risk factor for cardiovascular disease (CVD) in the nonpregnant population, this association has largely not been investigated in pregnant populations. We aimed to estimate the cumulative risk of new CVD in the first 24 months postpartum among pregnant individuals diagnosed with prenatal depression compared with patients without depression diagnosed during pregnancy. Methods and Results Our longitudinal population-based study included pregnant individuals with deliveries during 2007 to 2019 in the Maine Health Data Organization's All Payer Claims Data. We excluded those with prepregnancy CVD, multifetal gestations, or no continuous health insurance during pregnancy. Prenatal depression and CVD (heart failure, ischemic heart disease, arrhythmia/cardiac arrest, cardiomyopathy, cerebrovascular disease, and chronic hypertension) were identified by International Classification of Diseases, Ninth Revision (ICD-9)/International Classification of Diseases, Tenth Revision (ICD-10) codes. Cox models were used to estimate hazard ratios (HRs), adjusting for potential confounding factors. Analyses were stratified by hypertensive disorder of pregnancy. A total of 119 422 pregnancies were examined. Pregnant individuals with prenatal depression had an increased risk of ischemic heart disease, arrhythmia/cardiac arrest, cardiomyopathy, and new hypertension (adjusted HR [aHR], 1.83 [95% CI, 1.20-2.80], aHR, 1.60 [95% CI, 1.10-2.31], aHR, 1.61 [95% CI, 1.15-2.24], and aHR, 1.32 [95% CI, 1.17-1.50], respectively). When the analyses were stratified by co-occurring hypertensive disorders of pregnancy, several of these associations persisted. Conclusions The cumulative risk of a new CVD diagnosis postpartum was elevated among individuals with prenatal depression and persists even in the absence of co-occurring hypertensive disorders of pregnancy. Further research to determine the causal pathway can inform postpartum CVD preventive measures.
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Affiliation(s)
| | - Heather S. Lipkind
- Yale School of MedicineNew HavenCT
- Cornell Medical CollegeNew York CityNY
| | - Kristin Palmsten
- Pregnancy and Child Health Research Center, Health Partners InstituteMinneapolisMN
| | - Mariah Pfeiffer
- Muskie School of Public ServiceUniversity of Southern MainePortlandME
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Tuxunjiang X, Li L, Zhang W, Sailike B, Wumaier G, Jiang T. Mediation effect of resilience on pregnancy stress and prenatal depression in pregnant women. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2023; 48:557-564. [PMID: 37385618 PMCID: PMC10930246 DOI: 10.11817/j.issn.1672-7347.2023.220338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Indexed: 07/01/2023]
Abstract
OBJECTIVES Pregnancy stress is the psychological confusion or threat caused by various stress events and adverse factors during pregnancy. Pregnant women exposed to many stressors, they will be easy to produce bad mood and prenatal depression if they cannot adapt to their own changes. Prenatal depression is one of the major global public health problems, with a higher incidence in developing countries and a negative impact on the health of pregnant women and fetus. Resilience refers to pregnant women using their own positive psychological capital, can self-emotional adjustment and improve their ability to adapt to the response state. A better level of resilience can enable pregnant women to face various negative and adaptive problems positively. This study aims to investigate the relationship between pregnancy stress, resilience and prenatal depression through a mental health survey of pregnant women. METHODS A total of 750 pregnant women in a Grade A tertiary hospital in Urumqi were investigated by self-designed demographic questionnaire, Pregnancy Pressure Scale (PPS) and Patient Health Questionnaire-9 (PHQ-9), Connor-Davidson Resilience Scale (CD-RISC), and the levels of stress during pregnancy, prenatal depression and resilience were analyzed. Pearson correlation analysis was used to explore the correlation between the three. Bootstrap mediation effect test was used to test the mediation effect relationship among the three. If the mediation effect was confirmed, AMOS software was used to establish the mediation effect structural equation model to analyze the mediation effect among the three. RESULTS Among 750 respondents, 709 (94.53%) had mild or above pregnancy pressure, 459 (61.20%) had mild or above depressive symptoms and 241 (32.13%) had a good or above level of resilience. Pearson correlation analysis showed that prenatal depression was significantly positively correlated with pregnancy stress (P<0.01), prenatal depression and pregnancy stress were significantly negatively correlated with resilience (all P<0.01). Mediation effect test analysis showed that all the pathways were statistically significant (P<0.01). Mediation effect of resilience between pregnancy stress and prenatal depression was significantly found (95% CI 0.022-0.068, P<0.001). Pregnancy pressure negatively affected resilience (β=-0.38, P<0.01), and resilience negatively affected prenatal depression (β=-0.10, P<0.01). The mediation effect of resilience was 6.5%. CONCLUSIONS Pregnant women's pregnancy pressure, resilience and prenatal depression are significantly correlated, and the mediation variable resilience plays a partial mediating role in the impact of pregnancy pressure on prenatal depression. Pregnant women can reduce the incidence of prenatal depression and promote their physical and mental health by exercising their resilience.
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Affiliation(s)
| | - Ling Li
- Department of Obstetrics, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - Wei Zhang
- School of Public Health, Xinjiang Medical University, Urumqi 830011
| | - Bahedana Sailike
- School of Public Health, Xinjiang Medical University, Urumqi 830011
| | | | - Ting Jiang
- School of Public Health, Xinjiang Medical University, Urumqi 830011.
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10
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Donnici C, Long X, Reynolds J, Giesbrecht GF, Dewey D, Letourneau N, Huo Y, Landman B, Lebel C. Prenatal depressive symptoms and childhood development of brain limbic and default mode network structure. Hum Brain Mapp 2023; 44:2380-2394. [PMID: 36691973 PMCID: PMC10028635 DOI: 10.1002/hbm.26216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/25/2023] Open
Abstract
Prenatal depressive symptoms are linked to negative child behavioral and cognitive outcomes and predict later psychopathology in adolescent children. Prior work links prenatal depressive symptoms to child brain structure in regions like the amygdala; however, the relationship between symptoms and the development of brain structure over time remains unclear. We measured maternal depressive symptoms during pregnancy and acquired longitudinal T1-weighted and diffusion imaging data in children (n = 111; 60 females) between 2.6 and 8 years of age. Controlling for postnatal symptoms, we used linear mixed effects models to test relationships between prenatal depressive symptoms and age-related changes in (i) amygdala and hippocampal volume and (ii) structural properties of the limbic and default-mode networks using graph theory. Higher prenatal depressive symptoms in the second trimester were associated with more curvilinear trajectories of left amygdala volume changes. Higher prenatal depressive symptoms in the third trimester were associated with slower age-related changes in limbic global efficiency and average node degree across childhood. Our work provides evidence that moderate symptoms of prenatal depression in a low sociodemographic risk sample are associated with structural brain development in regions and networks implicated in emotion processing.
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Affiliation(s)
- Claire Donnici
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Xiangyu Long
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Jess Reynolds
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Gerald F Giesbrecht
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Deborah Dewey
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Nicole Letourneau
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Yuankai Huo
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee, USA
| | - Bennett Landman
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee, USA
| | - Catherine Lebel
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
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Ward K, Herekar A, Wang P, Lindsay KL. Feasibility and Acceptability of a Mindfulness-Based Smartphone App among Pregnant Women with Obesity. Int J Environ Res Public Health 2023; 20:5421. [PMID: 37048035 PMCID: PMC10094241 DOI: 10.3390/ijerph20075421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 06/19/2023]
Abstract
Maternal obesity is associated with an increased risk for prenatal depressive symptoms. Mindfulness-based interventions (MBIs) have been shown to reduce the risk of prenatal depression. This pilot study assesses the feasibility and acceptability of a smartphone-based MBI among pregnant women with obesity, and its potential for improving maternal mental and behavioral health outcomes. Five second-trimester pregnant women with a prepregnancy body mass index > 30 kg/m2 participated in a 30-day audio-guided mindfulness practice using the Headspace app. All participants engaged in the pregnancy module, while three concurrently engaged in the mindful eating module. Daily engagement with the app was tracked and a post-trial survey assessed maternal acceptability. Validated pre- and post-trial questionnaires explored changes in perceived stress, anxiety, depression, and eating habits. All participants completed the study with varying levels of adherence to the prescribed daily practice; the average number of days of engagement was 23/30 (77%) for the pregnancy module and 20/30 (67%) for the mindful eating module. All subjects reported some degree of perceived benefit, and none reported negative experiences. Trends were observed for improvements in maternal mental wellbeing and eating behaviors. This pilot study shows that a smartphone-based MBI is feasible, acceptable, and perceived to provide benefit among pregnant women with obesity.
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Affiliation(s)
- Kerrie Ward
- School of Medicine, University of California, Irvine, 1001 Health Sciences Road, Irvine, CA 92617, USA
| | - Anjali Herekar
- School of Medicine, University of California, Irvine, 1001 Health Sciences Road, Irvine, CA 92617, USA
| | - Peiyi Wang
- Department of Psychological Science, University of California, Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine, CA 92617, USA
| | - Karen L. Lindsay
- Department of Pediatrics, School of Medicine, University of California, Irvine, 3800 Chapman Ave. Suite 2200, Orange, CA 92868, USA
- UCI Susan Samueli Integrative Health Institute, College of Health Sciences, 856 Health Sciences Road, Suite 4600, Irvine, CA 92617, USA
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12
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Bengtson L, Aubuchon-Endsley NL. Prenatal depression moderates the relationship between maternal trauma exposure and cortisol production and predicts breastfeeding behavior. Women Health 2023:1-12. [PMID: 37020338 DOI: 10.1080/03630242.2023.2195951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Trauma exposure is associated with many negative outcomes for women during the prenatal and postnatal periods, including increased antenatal depressive symptomatology and dysregulation of the body's stress responses. Trauma exposure and its consequences are also tied to women's ability to breastfeed, a crucial component in maternal and infant health. Cortisol is biologically relevant to the breastfeeding process, and is also associated with depressive symptoms, which may interfere with women's ability to successfully maintain breastfeeding. However, no known studies integrate prenatal cortisol and depressive symptom severity into models of relations between trauma exposure and breastfeeding, particularly while considering trauma timing and type. Therefore, the current study did so using data from a historically understudied sample. Data were drawn from a community sample of 96 women residing in a health professional shortage area for mental health and primary care. Participants provided data during their third trimester of pregnancy and 6 months postpartum. Three moderated mediation models were tested to explore relations among history of trauma, breastfeeding, and related variables. Increased prenatal depressive symptoms were related to elevated prenatal cortisol awakening response, as well as moderated the relationship between interpersonal trauma exposure and greater prenatal cortisol awakening response. A significant positive correlation was also found between trauma and prenatal depressive symptoms, as well as a significant negative correlation between prenatal depressive symptoms and breastfeeding frequency. Results suggest that subclinical prenatal depressive symptoms may interact with trauma symptoms to affect women's stress responses and breastfeeding behaviors, and that women at risk for breastfeeding difficulty may be identified prenatally.
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Affiliation(s)
- Lillian Bengtson
- Department of Psychology, Idaho State University, Pocatello, Idaho, USA
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13
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Danaher BG, Seeley JR, Silver RK, Tyler MS, Kim JJ, La Porte LM, Cleveland E, Smith DR, Milgrom J, Gau JM. Trial of a patient-directed eHealth program to ameliorate perinatal depression: the MomMoodBooster2 practical effectiveness study. Am J Obstet Gynecol 2023; 228:453.e1-453.e10. [PMID: 36174746 PMCID: PMC10039954 DOI: 10.1016/j.ajog.2022.09.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Depression is one of the most common complications of childbirth, and is experienced by approximately 17% of pregnant women and 13% of postpartum women. An estimated 85% of these women go untreated-an alarming statistic given the serious consequences for the mother, her child, other family members, and society. Professional societies (the American College of Obstetricians and Gynecologists and American Academy of Pediatrics) have recommended improvements in screening and treatment. Meta-analyses indicate that cognitive behavioral therapy eHealth interventions are efficacious for depression, generally, and for perinatal depression, specifically. Earlier controlled trials have established the effectiveness and acceptability of MomMoodBooster (including an Australian version, MumMoodBooster), an eHealth program for ameliorating postpartum depression. OBJECTIVE This study aimed to evaluate the effectiveness of a perinatal version of MomMoodBooster encompassing both prenatal and postpartum content in a healthcare delivery setting already providing universal screening and referral of at-risk patients as part of routine care. STUDY DESIGN A practical effectiveness study randomly assigned 95 pregnant and 96 postpartum women screened as depressed and satisfying eligibility criteria to experimental groups: the healthcare organization's perinatal depression care program (routine-care group) and routine care+MomMoodBooster2 program (eHealth group). Eligibility criteria included: pregnant or <1 year postpartum, ≥18 years of age, no active suicidal ideation, access to broadband internet via desktop/laptop, tablet, or smartphone, and English language proficiency. RESULTS Intent-to-treat analyses of group effects used fixed-effects growth models to assess 12-week posttest change in outcomes. Results showed that both groups had significantly decreased depression severity, anxiety, stress, and automatic thoughts, and increased behavioral activation and self-efficacy. Relative to the routine-care group, the eHealth group displayed significantly greater decreases in depression severity and stress. These group comparisons were not moderated by depression severity (screening or baseline), anxiety, stress, or pregnant/postpartum status. Almost all (93%; n=89) women in the eHealth group visited their program, of whom 99% visited program sessions (M sessions visited=4.3±2.0; M total session duration=73.0±70.2 minutes; 49% viewed all 6 sessions). Among confirmed eHealth program users who provided ratings, 96% (79/82) rated their program as easy to use, 83% rated it helpful, and 93% (76/82) indicated that they would recommend it. CONCLUSION Results support the effectiveness of using MomMoodBooster2 as a treatment option for perinatal women with depression, especially when combined with universal depression screening and referral. Consequently, the eHealth program shows promise as a tool to increase the reach of treatment delivery and to potentially reduce the number of untreated perinatal women with depression.
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Affiliation(s)
- Brian G Danaher
- Influents Innovations, Eugene, OR; Oregon Research Institute, Eugene, OR.
| | | | | | | | - J Jo Kim
- NorthShore University HealthSystem, Chicago, IL
| | | | | | | | - Jeannette Milgrom
- Parent-Infant Research Institute, Melbourne, Australia; The University of Melbourne, Melbourne, Australia
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14
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Gao Y, Tang X, Deng R, Liu J, Zhong X. Latent Trajectories and Risk Factors of Prenatal Stress, Anxiety, and Depression in Southwestern China-A Longitudinal Study. Int J Environ Res Public Health 2023; 20:3818. [PMID: 36900833 PMCID: PMC10001100 DOI: 10.3390/ijerph20053818] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/11/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Few studies have explored the heterogeneity of trajectories of stress, anxiety, and depressive symptoms during pregnancy. This study aimed to explore the trajectory groups of stress, anxiety, and depressive symptoms in women during pregnancy and the risk factors associated with those groups. (2) Methods: Data came from pregnant women recruited from January to September 2018 in four hospitals in Chongqing Province, China. A structured questionnaire was given to pregnant women, which collected basic information, including personal, family, and social information. The growth mixture model was applied to identify potential trajectory groups, and multinomial logistic regression was applied to analyze factors of trajectory groups. (3) Results: We identified three stress trajectory groups, three anxiety trajectory groups, and four depression trajectory groups. Less developed regions, inadequate family care, and inadequate social support were associated with a high risk of stress; residence, use of potentially teratogenic drugs, owning pets, family care, and social support were strongly associated with the anxiety trajectory group; family care and social support were the most critical factors for the depression trajectory group. (4) Conclusions: The trajectories of prenatal stress, anxiety, and depressive symptoms are dynamic and heterogeneous. This study may provide some critical insights into the characteristics of women in the high-risk trajectory groups for early intervention to mitigate worsening symptoms.
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Affiliation(s)
- Yuwen Gao
- Department of Medical Record Management, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Xian Tang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
| | - Ruibin Deng
- Chongqing Shapingba District Center for Disease Control and Prevention, Chongqing 400030, China
| | - Jiaxiu Liu
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Xiaoni Zhong
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
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15
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Tuxunjiang X, Wumaier G, Zhang W, Sailike B, Wang X, Jiang T. The relationship between positive psychological qualities and prenatal negative emotion in pregnant women: A path analysis. Front Psychol 2023; 13:1067757. [PMID: 36687899 PMCID: PMC9849688 DOI: 10.3389/fpsyg.2022.1067757] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023] Open
Abstract
Objective The objective of this study was to investigate the relationship between positive psychological qualities and negative emotions of pregnant women. Methods We surveyed 774 pregnant women in a tertiary hospital in Urumqi using the following measures: a self-report general demographic data questionnaire, Generalized Anxiety Disorder scale (GAD-7), Patients Health Questionnaire depression scale (PHQ-9), Pregnancy Pressure Scale (stocktickerPPS), Perceived Social Support Scale (PSSS), General Self-Efficacy Scale (GSES), and Connor-Davidson Resilience scale (CD-RISC). We used the Amos2.03 system to build a structural equation model. Results A total of 774 subjects had an average age of 30 years and an average gestational age of 23 weeks. Among the 774 respondents, 122 (15.8%) had moderate or above pregnancy stress (stocktickerPPS > 1), 376 (48.6%) had mild or above anxiety symptoms (GAD-7 ≥ 5), 456 (58.9%) had mild or above depression symptoms (PHQ-9 ≥ 5), 740 (95.6%) had moderate or above social support scores (PSSS ≥ 37), and 124 (16.0%) had good or above psychological resilience scores (CD-RISC ≥ 60). Notably, 372 (48.1%) people had a self-efficacy score above the overall average (GSES ≥ 2.6). Pregnancy stress had positive correlations with anxiety and depression (β = 0.57, 0.30, P < 0.01) and negative correlations with self-efficacy (β = -0.19, P < 0.01). Anxiety had positive correlations with depression (β = 0.54, P < 0.01) and negative correlations with social support (β = -0.45, P < 0.01). Social support had positive correlations with self-efficacy and resilience (β = 0.37, 0.47, P < 0.01). Resilience had negative correlations with anxiety (β = -0.09, P < 0.01), and self-efficacy had positive correlations with resilience (β = 0.41, P < 0.01). Conclusion Identification of pregnancy stress should be emphasized in pregnant women with negative emotions. Efforts to strengthen the positive psychological qualities of pregnant women should focus on cultivating psychological resilience to reduce the occurrence of anxiety, and improving social support should be a priority because it can enhance psychological resilience and self-efficacy. We provide a reason to intervene in the negative emotions of pregnant women from the perspective of the positive psychology of pregnant women.
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Affiliation(s)
| | - Gulijianati Wumaier
- Xinjiang Production and Construction Corps 13th Division Red Star Hospital, Hami, China
| | - Wei Zhang
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Bahedana Sailike
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Xiaoting Wang
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Ting Jiang
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
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16
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Beck-Pancer D, Aghaee S, Swint A, Acker J, Deardorff J, Kubo A. Maternal Depression and Antidepressant Use During Pregnancy and Associations with Depressive Symptoms and Suicidality in Adolescent Children. Clin Epidemiol 2023; 15:613-628. [PMID: 37187769 PMCID: PMC10179337 DOI: 10.2147/clep.s380894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/20/2023] [Indexed: 05/17/2023] Open
Abstract
Purpose Children of mothers with prenatal depression have elevated risk for depression later in life. Pregnant women are hesitant to use antidepressants due to fear of adverse fetal effects. To inform prevention, this study examined associations between maternal prenatal depression and antidepressant use, and adolescent depressive symptoms and suicidality. Patients and Methods Prospective data from 74,695 mother-adolescent dyads from the Kaiser Permanente Northern California integrated healthcare delivery system were used. Three prenatal exposure groups were examined: maternal depression and antidepressants (Med); depression and no antidepressants (No-Med); neither depression nor antidepressants (NDNM). Adolescent depressive symptoms (Patient Health Questionnaire-2 score ≥3) and suicidality were assessed for 12- to 18-year-olds. Associations were analyzed using mixed effects logistic regression, adjusted for confounders. Results Maternal prenatal depression was associated with higher odds of adolescent depressive symptoms (Med odds ratio [OR]: 1.50, 95% confidence interval [CI]: 1.23-1.84; No-Med OR: 1.59, CI: 1.34-1.88) and suicidality (Med OR: 2.36, CI: 1.67-3.34; No-Med OR: 1.54, CI: 1.10-2.14) compared to no prenatal depression (NDNM). Adolescents exposed to prenatal depression and antidepressants were not at greater odds of depressive symptoms (Med OR: 0.95, CI: 0.74-1.21) compared to those not exposed to antidepressants (No-Med). However, they showed non-significant but greater odds of suicidality (Med OR: 1.54, CI: 0.99-2.39). Conclusion Our findings suggest that maternal prenatal depression is associated with adolescent depressive symptoms and suicidality, and that exposure to antidepressants in utero does not increase risk of depressive symptoms, specifically. While not statistically significant, the increased odds of suicidality among adolescents exposed to antidepressants suggest a possible association; however, further investigation is needed. After replication, the findings of this study may inform shared clinical decision-making when considering options regarding antidepressant use for the treatment of maternal prenatal depression.
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Affiliation(s)
- Devora Beck-Pancer
- School of Public Health, University of California, Berkeley, CA, USA
- School of Medicine, University of California, San Francisco, CA, USA
- Correspondence: Devora Beck-Pancer, UCSF School of Medicine, 513 Parnassus Ave., Suite S-245, San Francisco, CA, 94143-0454, USA, Email
| | - Sara Aghaee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Alysia Swint
- School of Public Health, University of California, Berkeley, CA, USA
- School of Medicine, George Washington University, Washington, DC, USA
| | - Julia Acker
- School of Public Health, University of California, Berkeley, CA, USA
| | - Julianna Deardorff
- School of Public Health, University of California, Berkeley, CA, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Ai Kubo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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Sasaki N, Akiyama H, Kawakami N, Nishi D. Preconception menstrual cycle disorder and antenatal depression: a cross-sectional study with prerecorded information. J Psychosom Obstet Gynaecol 2022; 43:411-418. [PMID: 34882063 DOI: 10.1080/0167482x.2021.2010699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the association between pre-pregnancy menstrual cycle characteristics (i.e. cycle-length variability and cycle length) and antenatal depression. METHODS This study retrieved the data from the baseline survey of the randomized controlled trial with pregnant women at 16-20 weeks gestation who used a pregnancy tracking app. The antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 16-20 weeks gestation, and the cutoff point of 10/11 was adopted. Pre-conceptional menstrual cycle information was obtained via a prerecorded period tracking app. Cycle-length variability was defined as the average difference in the lengths between cycles, dichotomized into regular (≤6 days) and irregular (>6 days). Cycle length was coded as a categorical variable: <25 days, 25-26 days, 27-29 days (regular), 30-31 days, 32-33 days, and 34+ days. The associations of cycle disorders with EPDS scores were examined using regression analysis and a multiple logistic regression model adjusted for covariates. RESULTS The total of 3473 participants were analyzed in this study. Irregular cycle variability (>6 days) was significantly associated with high EPDS scores (adjusted: standardized beta = 0.049, p = 0.003) and with high cutoff EPDS scores (over 11) (adjusted OR = 1.40 [1.02-1.94], p = 0.038) but not with cycle length. CONCLUSION Irregular menstrual cycle before pregnancy was associated with depression during pregnancy. The health of the menstrual cycle during preconception needs to be further explored to promote healthy maternal mental health.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Hiroto Akiyama
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan.,Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
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Accortt E, Mirocha J, Jackman S, Coussons-Read M, Dunkel Schetter C, Hobel C. Association between diagnosed perinatal mood and anxiety disorders and adverse perinatal outcomes. J Matern Fetal Neonatal Med 2022; 35:9066-9070. [PMID: 34879772 PMCID: PMC10024940 DOI: 10.1080/14767058.2021.2014450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine whether a diagnosis of a perinatal mood and anxiety disorder (PMAD) is associated with adverse perinatal outcomes. METHODS Mental health symptom screening and diagnostic data from 82 women with single gestation in the Healthy Babies Before Birth study conducted from 2013 to 2018 were obtained by clinic interview. If a woman scored over 10 on the Patient Health Questionnaire (PHQ-9) or endorsed the suicidality item; or scored over 7 on the Overall Anxiety Severity and Impairment Scale (OASIS), a Structured Clinical Interview for DSM-IV (SCID) Axis I Disorders was administered. An adverse perinatal outcome was operationalized as a diagnosis of gestational diabetes mellitus, intrauterine growth restriction, preeclampsia, chorioamnionitis, hemorrhage, fetal death, preterm birth, or a low birthweight baby, and abstracted from the medical records. RESULTS Women were between 22.0 and 45.0 years old (Mean age = 33.1 ± 4.3). Mean BMI was 24.7 ± 5.6 (Range 16.8 to 47.1). Nineteen percent (16) of the 82 women had a SCID diagnosis of a PMAD. Thirty-seven percent (30) had a diagnosed adverse perinatal outcome. Multiple logistic regression was conducted with these predictors: SCID diagnosis of a PMAD, maternal age, BMI. All predictors were significant with respective odds ratios as follows: OR = 3.58, 95% CI 1.03-12.44, p = .045; OR = 2.30, 95% CI 1.21-4.38, p = .011; OR = 1.69, 95% CI 1.06-2.69, p = .027. CONCLUSIONS A PMAD diagnosis was associated with 3.5 times higher odds of having an adverse perinatal outcome. For every 5 years a woman aged or every five units her BMI increased her odds of having an adverse perinatal outcome increased. Older age and increased BMI are well established adverse perinatal outcome risk factors. These results suggest that mental illness risk should also be consistently assessed in obstetric settings.
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Affiliation(s)
- Eynav Accortt
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - James Mirocha
- Cedars-Sinai Biostatistics Core, Research Institute, Clinical and Translational Science Institute (CTSI), Clinical and Translational Research Center (CTRC), Los Angeles, CA, USA
| | - Susan Jackman
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mary Coussons-Read
- Department of Psychology, University of Colorado, Colorado Springs, CO, USA
| | | | - Calvin Hobel
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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19
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Han RR, Sun K, Zheng J, Gao LL. Perceived stress, marital satisfaction, and prenatal depression among couples with gestational diabetes mellitus. J Reprod Infant Psychol 2022:1-14. [PMID: 36284371 DOI: 10.1080/02646838.2022.2135175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/06/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This study aimed to explore the prevalence of prenatal depression and to determine the dyadic relationship between perceived stress, marital satisfaction, and prenatal depression in pregnant women with gestational diabetes mellitus (GDM) and their partners. BACKGROUND GDM during pregnancy is a very stressful event for couples. However, previous studies have largely focused on pregnant women, with few including their partners. METHODS A cross-sectional study was conducted in Guangzhou, China, from 30 July to 2 December 2021. Three hundred fourteen couples with GDM completed the Perceived Stress Scale, Locke-Wallace Marital Adjustment Scale, and Edinburgh Postnatal Depression Scale. Dyadic analysis was conducted using the actor-partner interdependence mediation model. RESULTS The prevalence of depressive symptoms was 13.4% in pregnant women with GDM and 8.3% in their partners. Regarding the actor effects, perceived stress was positively associated with prenatal depression in pregnant women with GDM and their partners, respectively, and marital satisfaction acted as a mediating role. Regarding the partner effects, paternal perceived stress was negatively associated with maternal marital satisfaction, and maternal marital satisfaction mediated the association between paternal perceived stress and maternal prenatal depression. CONCLUSIONS Dyadic effects of perceived stress, marital satisfaction, and prenatal depression exist in couples with GDM.
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Affiliation(s)
- Rong-Rong Han
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Ke Sun
- Obstetrics & Gynecology Department, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jie Zheng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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20
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Studniczek A, Kossakowska K. Experiencing Pregnancy during the COVID-19 Lockdown in Poland: A Cross-Sectional Study of the Mediating Effect of Resiliency on Prenatal Depression Symptoms. Behav Sci (Basel) 2022; 12:bs12100371. [PMID: 36285940 PMCID: PMC9598781 DOI: 10.3390/bs12100371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 11/28/2022] Open
Abstract
The COVID-19 pandemic in Poland brought uncertainty, not only to the general population but also to women preparing for childbirth, which increased the risk of mental health illnesses during this special period of life. Resilience, which refers to positive adaptation or the ability to maintain good mental health, can be a protective factor against the development of psychiatric problems such as depressive symptoms. This study aimed to assess the protective role of resilience in the relationship of such risk factors as traumatic childbirth perception and pandemic-related pregnancy stress with prenatal depressive symptoms. The study was performed at the end of the first wave of the COVID-19 pandemic. A total of 80 pregnant women took part. A mediation analysis, an independent t-test, and a Pearson correlation analysis were conducted. The lower resilience group declared the inclusion of slightly more participants (n = 41; 51.2%); 39 women (48.8%) demonstrated a higher risk of prenatal depression. The analysis revealed a significant direct effect between pandemic-related stress and prenatal depression (βc = 0.285, SE = 0.05, t = 2.63, p < 0.05) as well as between pandemic-related stress and resilience (βa = −0.283, SE = 0.07, t = −2.61, p < 0.05) and between resilience and prenatal depression (βb = −0.585, SE = 0.07, t = −6.34, p < 0.001). After the introduction of resilience as a mediator, the strength of the relationship not only decreased, but also ceased to be statistically significant (βc′ = 0.120, SE = 0.04, t = 1.29, p = 0.19), which indicates that it was in a full mediation state (R2 = 0.39, F = 25.31, p < 0.001; Z = 2.43, p < 0.05). The results indicate that in pregnant women, a high level of resilience protects them from the effects of pandemic-related stress on perinatal depression symptoms.
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Affiliation(s)
- Anna Studniczek
- Expert’s Antenatal School, St. Family’s Maternity Hospital in Warsaw, 02-544 Warsaw, Poland
| | - Karolina Kossakowska
- Department of Clinical Psychology and Psychopathology, Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Rodziny Scheiblerów Avenue 2, 90-128 Lodz, Poland
- Correspondence: ; Tel.: +48-426655581
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Andreu‐Pejó L, Martínez‐Borba V, Osma López J, Suso‐Ribera C, Crespo Delgado E. Perinatal mental e-health: What is the profile of pregnant women interested in online assessment of their emotional state? Nurs Open 2022; 10:901-914. [PMID: 36068679 PMCID: PMC9834155 DOI: 10.1002/nop2.1358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/06/2022] [Accepted: 08/23/2022] [Indexed: 01/19/2023] Open
Abstract
AIM This study explores the profile of pregnant women interested in the online assessment of their emotional status according to their sociodemographic and obstetric characteristics, history of psychopathology, and healthcare setting used (private vs. public). DESIGN This is a comparative and descriptive cross-sectional study. METHOD Participants were 281 Spanish pregnant women assessed with the MamáFeliz (HappyMom) website. RESULTS Participants were probably to be unemployed, in a relationship, and generally had a high educational level and an intermediate economic status. Most of them were primiparous, had non-complicated natural pregnancies and presented healthy habits and good physical and emotional health, despite 31.3% of them had a history of psychological treatment. Our results reveal the profile of women interested in the online assessment of their emotional status, which can contribute to improving future initiatives to facilitate rapid screenings of perinatal mental health by nurses in both public and private settings.
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Affiliation(s)
- Laura Andreu‐Pejó
- Nursing DepartmentUniversity Jaume ICastellón de la PlanaSpain,Health Research Institute of AragonZaragozaSpain
| | - Verónica Martínez‐Borba
- Health Research Institute of AragonZaragozaSpain,Basic Psychology, Clinic and Psychobiology DepartmentUniversity Jaume ICastellón de la PlanaSpain
| | - Jorge Osma López
- Health Research Institute of AragonZaragozaSpain,Department of Psychology and SociologyUniversity of ZaragozaZaragozaSpain
| | - Carlos Suso‐Ribera
- Basic Psychology, Clinic and Psychobiology DepartmentUniversity Jaume ICastellón de la PlanaSpain
| | - Elena Crespo Delgado
- Health Research Institute of AragonZaragozaSpain,Basic Psychology, Clinic and Psychobiology DepartmentUniversity Jaume ICastellón de la PlanaSpain
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Gordon Green C, Szekely E, Babineau V, Jolicoeur-Martineau A, Bouvette-Turcot AA, Minde K, Sassi R, Atkinson L, Kennedy JL, Steiner M, Lydon J, Gaudreau H, Burack JA, Herba C, Pennestri MH, Levitan R, Meaney MJ, Wazana A; MAVAN Research Team. Negative emotionality as a candidate mediating mechanism linking prenatal maternal mood problems and offspring internalizing behaviour. Dev Psychopathol 2022;:1-15. [PMID: 35440354 DOI: 10.1017/S0954579421001747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Negative emotionality (NE) was evaluated as a candidate mechanism linking prenatal maternal affective symptoms and offspring internalizing problems during the preschool/early school age period. The participants were 335 mother-infant dyads from the Maternal Adversity, Vulnerability and Neurodevelopment project. A Confirmatory Bifactor Analysis (CFA) based on self-report measures of prenatal depression and pregnancy-specific anxiety generated a general factor representing overlapping symptoms of prenatal maternal psychopathology and four distinct symptom factors representing pregnancy-specific anxiety, negative affect, anhedonia and somatization. NE was rated by the mother at 18 and 36 months. CFA based on measures of father, mother, child-rated measures and a semistructured interview generated a general internalizing factor representing overlapping symptoms of child internalizing psychopathology accounting for the unique contribution of each informant. Path analyses revealed significant relationships among the general maternal affective psychopathology, the pregnancy- specific anxiety, and the child internalizing factors. Child NE mediated only the relationship between pregnancy-specific anxiety and the child internalizing factors. We highlighted the conditions in which prenatal maternal affective symptoms predicts child internalizing problems emerging early in development, including consideration of different mechanistic pathways for different maternal prenatal symptom presentations and child temperament.
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Porter AC, Hunter S, Noonan K, Hoffman MC. A Mindfulness Application for Reducing Prenatal Stress. J Midwifery Womens Health 2022; 67:442-447. [PMID: 35403807 PMCID: PMC9540335 DOI: 10.1111/jmwh.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Up to 40% of patients report depression or anxiety symptoms in pregnancy; feelings of increased stress are nearly universal. Antepartum stress is linked to adverse outcomes including preterm birth, low birthweight, postpartum depression, and maternal self harm. Unfortunately, limited treatment options exist, and patients are often hesitant to initiate medications prenatally. Thus, the development of efficacious nonpharmacologic interventions is crucial. This pilot study investigated the feasibility and impact of an application (app)-based mindfulness practice, begun in the first trimester, on maternal stress and pregnancy outcomes. METHODS The study enrolled patients prior to 15 weeks' gestation and followed them prospectively through birth. Patients were provided with a free subscription to Expectful, a commercially available prenatal mindfulness app, and asked to complete daily meditations. Patients completed the Perceived Stress Scale (PSS) self-assessment at 15 weeks and 28 weeks. PSS scores and pregnancy outcomes were compared with a historical control group of pregnant people who did not use the app. RESULTS Of 68 patients approached, 59 consented to enrollment. Of these, 21 used the app, with an average use of 170 minutes (range, 1.3-1315 min). The average PSS score was significantly lower in the app group at 28 weeks. Additionally, the change in PSS score for app users was greater compared with that of the historical control between enrollment and 28 weeks (-6.3 vs -0.95, P = .0008). Pregnancy outcomes were similar for app users and the historical control. DISCUSSION Our recruitment rate suggests pregnant patients are eager for a nonmedication intervention to decrease stress. However, adherence after enrollment was limited. For a subset of motivated patients, an app-based mindfulness practice significantly reduced perceived stress between the second and third trimesters compared with non-app users. Prenatal mindfulness apps represent an important low-intervention, low-cost, highly accessible tool for managing perinatal mood and stress.
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Affiliation(s)
- Anne C Porter
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
| | - Sharon Hunter
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
| | - Kate Noonan
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
| | - M Camille Hoffman
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
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Goldstein A, Borelli JL, Shai D. In her shoes: Partner reflective functioning promotes family-level resilience to maternal depression. Dev Psychopathol 2022;:1-14. [PMID: 35314013 DOI: 10.1017/S0954579422000189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Parental depression has significant implications for family functioning, yet much of the literature does not consider family-level dynamics in investigating individual, parenting and child outcomes. In the current study we apply a new index of couple-level support, partner reflective functioning (RF), or the romantic partner's ability to consider how the partner's mental states can guide behavior, to study familial resiliency in the face of prenatal parental depression among first-time parents. We investigate how partner RF buffers the association between prenatal parental depression and outcomes of postnatal parental depression, parenting style, and child effortful control. Maternal and paternal depression were measured in 91 primiparous couples during the sixth month of pregnancy and parental depression, partner RF, parental RF at 6 months postnatally. Outcomes of parental depression, permissive parenting, and children's effortful control were assessed 24 months postnatally. Results indicate that average and high levels of paternal partner (not parental) RF attenuate risk for maternal postnatal depression, maternal permissive parenting, and deficits in child effortful control. Implications are discussed from a family systems approach.
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25
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Acheanpong K, Pan X, Kaminga AC, Liu A. Prevalence and risk factors of prenatal depression among pregnant women attending antenatal clinic at Adventist Hospital, Bekwai Municipality, Ghana. Medicine (Baltimore) 2022; 101:e28862. [PMID: 35451379 PMCID: PMC8913126 DOI: 10.1097/md.0000000000028862] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/31/2022] [Indexed: 01/04/2023] Open
Abstract
Depression, arising in the perinatal period are a major health issue in low- and middle-income countries. However, little attention has been paid in the research of depression symptoms. This study aimed to estimate the prevalence and risk factors of depression during pregnancy.A cross-sectional study was conducted in pregnant women attending antenatal clinic at Adventist Hospital in the Bekwai Municipality, Ghana, between February and May 2020. Information on sociodemographic, medical, and obstetric factors were collected from the antenatal booklet and prenatal depression symptoms was defined as a patient health questionnaire scores ≥10. Descriptive statistics, Chi-Squared test, and Fisher exact test were used to analyze dichotomous variables. Multivariate logistic regression model was applied to estimate the adjusted odds ratios (AOR) and 95% confidence interval (95% confidence interval [CI]) for risk factors associated with prenatal depression. All statistical analyses were performed using SPSS version 20.0.The prevalence of prenatal depression in this study was 26.9% (95% CI; 24.6%-29.2%). Advance maternal age ≥35years (AOR = 1.49, 95% CI 1.05-2.11, P < .026) and low educational attainment (AOR 2.15, 95% CI 1.23-2.34, P < .007) were significantly higher among women with parental depression compared with maternal age <35years and higher educational attainment respectively. Similarly, nulliparous women (AOR = 4.93, 95% CI 1.60-15.16, P < .005), primiparous women (AOR = 5.42, 95% CI 1.76-16.71, P < .003) and multiparous women (AOR = 4.79, 95% CI 1.61-14.22, P < .005) were significantly higher among women with parental depression compared with grand multiparous woman (≥7 deliveries). Finally, prenatal depression was found to be significantly associated with hypertension in pregnancy (AOR = 1.71, 95% CI: 1.12-2.60, P < .013).Depression during pregnancy is high in the study area and is significantly associated with advance maternal age, low educational attainment, parity less than 7 deliveries, and hypertension during pregnancy.
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Affiliation(s)
- Kwabena Acheanpong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, China
- Department of Public Health, Adventist University of Africa, Kenya
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiongfeng Pan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, China
| | - Atipasa Chiwanda Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, China
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26
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Bublitz MH, Freeburg T, Sharp M, Salameh M, Bourjeily G. Childhood adversity, prenatal depression, and maternal inflammation across pregnancy. Obstet Med 2022; 15:25-30. [PMID: 35444718 PMCID: PMC9014541 DOI: 10.1177/1753495x211011910] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/04/2021] [Accepted: 03/25/2021] [Indexed: 01/04/2023] Open
Abstract
Background To examine whether change in neutrophil-lymphocyte ratio, a marker of systemic inflammation, differs by childhood adversity and prenatal depression. Methods Prenatal complete blood count data were used to calculate neutrophil-lymphocyte ratio in first and third trimesters. The Adverse Childhood Experiences scale measured childhood adversity, and the Patient Health Questionnaire-9 measured depression. This is a secondary analysis of a study of predictors of risk for sleep-disordered breathing. Results Participants were 98 pregnant women, mean age 30 years (SD = 5), mean body mass index of 35 kg/m2 (SD = 7), 61% identified as white, and 28% identified as Hispanic. Women who reported childhood sexual abuse history displayed greater increase in neutrophil-lymphocyte ratio over pregnancy relative to women without childhood sexual abuse. Change in neutrophil-lymphocyte ratio across pregnancy did not differ by prenatal depression. Conclusion Experiences of sexual abuse in childhood may impact markers of systemic inflammation in pregnancy.
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Affiliation(s)
- Margaret H Bublitz
- Department of Psychiatry and Human Behavior, The Warren Alpert
Medical School of Brown University, Providence, RI, USA,Department of Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA,Women’s Medicine Collaborative, The Miriam Hospital, Providence,
RI, USA,Margaret H Bublitz Department of Psychiatry
and Human Behavior, The Warren Alpert Medical School of Brown University, 146
West River Street, Providence, RI 02904, USA.
| | - Taylor Freeburg
- Department of Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | - Meghan Sharp
- Department of Psychiatry and Human Behavior, The Warren Alpert
Medical School of Brown University, Providence, RI, USA,Women’s Medicine Collaborative, The Miriam Hospital, Providence,
RI, USA
| | - Myriam Salameh
- Women’s Medicine Collaborative, The Miriam Hospital, Providence,
RI, USA
| | - Ghada Bourjeily
- Department of Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA,Women’s Medicine Collaborative, The Miriam Hospital, Providence,
RI, USA
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Harris RA, Chen D, Santos HP. Which roads lead to depression in Latinas? A network analysis of prenatal depressive symptoms, discrimination, acculturative stress, and low birth weight. Res Nurs Health 2022; 45:350-363. [PMID: 35088896 PMCID: PMC9064940 DOI: 10.1002/nur.22210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 12/17/2022]
Abstract
Although immigrant mothers from some Latinx subgroups initially achieve healthy birth outcomes despite lower socioeconomic status, this advantage deteriorates across generations in the United States. Interpersonal discrimination and acculturative stress may interact with economic hardship to predict an intergenerational cascade of emotional and biological vulnerabilities, particularly perinatal depression. Network analyses may elucidate not only how and which psychosocial experiences relate to depressive symptoms, but which symptom-to-symptom relationships emerge. This study aims to understand (1) how economic, acculturative, and discrimination stressors relate to prenatal depression and low birth weight and (2) how Latinas may respond to and cope with stressors by exploring symptom-symptom and symptom-experience relationships. A sample of 151 pregnant Latinas (predominantly foreign-born and Mexican and Central American descent) completed the EPDS and psychosocial questionnaires (discrimination, acculturation, acculturative stress, economic hardship) during pregnancy (24-32 weeks). Birth weights were recorded from postpartum medical records. We created network models using the Extended Bayesian Information Criterion Graphical Least Absolute Shrinkage and Selection Operator to estimate the relationship between variables. Discrimination exposure connected psychosocial stressors to depressive symptoms, particularly worry, crying, sadness, and self-blame. Discrimination also revealed a connection between acculturation and low birth weight. Furthermore, younger age of migration and greater acculturation levels were correlated to greater discrimination stress and low birth weights. Perinatal research in Latinas must account not only for measures of cultural adaptation but recognize how developmental exposures across the life span, including discrimination, may be associated with adverse health trajectories for a mother and her child.
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Affiliation(s)
- Rebeca Alvarado Harris
- Biobehavioral Laboratory, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daqi Chen
- Statistics and Operational Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hudson P Santos
- Biobehavioral Laboratory, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Avalos LA, Nance N, Zhu Y, Croen LA, Young-Wolff KC, Zerbo O, Hedderson MM, Ferrara A, Ames JL, Badon SE. Contributions of COVID-19 Pandemic-Related Stressors to Racial and Ethnic Disparities in Mental Health During Pregnancy. Front Psychiatry 2022; 13:837659. [PMID: 35360124 PMCID: PMC8964047 DOI: 10.3389/fpsyt.2022.837659] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/11/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This study aimed to identify racial and ethnic disparities in prenatal mental health and identify COVID-19 pandemic-related health/healthcare and economic contributors to these disparities, using an established framework for disparity investigation. METHODS This cross-sectional study includes 10,930 pregnant people at Kaiser Permanente Northern California who completed an online survey between June 22, 2020 and April 28, 2021 on COVID-19 pandemic-related health/healthcare and economic stressors, depression, and anxiety. Self-reported race and ethnicity were extracted from electronic health records. Weighted analyses were used to evaluate the association between racial and ethnic category and prenatal depression and anxiety; the prevalence of each stressor by race and ethnicity; and the relationship between each stressor and prenatal depression and anxiety in each racial and ethnic category. RESULTS The sample was 22% Asian, 3% Black, 20% Hispanic, 5% Other/Multiracial/Unknown, and 49% White. Compared to White people, Black and Hispanic people had a higher prevalence of prenatal depression (aPR: 1.85, 95% CI: 1.45, 2.35 and aPR: 1.17, 95% CI: 1.00, 1.37, respectively) and anxiety (aPR: 1.71, 95% CI: 1.34, 2.18 and aPR: 1.10, 95% CI: 0.94, 1.29, respectively). Compared to White people, Black and Hispanic people had a higher prevalence of moderate/severe distress due to changes in prenatal care (24 vs. 34 and 31%), and food insecurity (9 vs. 31 and 24%). Among Black and Hispanic people, distress due to changes in prenatal care was associated with a greater prevalence of prenatal depression (aPR: 2.27, 95% CI: 1.41, 3.64 and aPR: 2.76, 95% CI: 2.12, 3.58, respectively) and prenatal anxiety (aPR: 3.00, 95% CI: 1.85, 4.84 and aPR: 2.82, 95% CI: 2.15, 3.71, respectively). Additionally, among Hispanic people, high-risk employment and food insecurity were associated with a greater prevalence of prenatal depression and anxiety. CONCLUSIONS This study identified racial and ethnic disparities in mental health for pregnant Black and Hispanic people. Distress due to prenatal care changes contributed to the observed disparities in prenatal depression and anxiety for Black and Hispanic people and food insecurity additionally contributed to the observed disparities for Hispanic people. Addressing distress due to changes to prenatal care and food insecurity specifically in Black and Hispanic people may help reduce the high burden of poor mental health and reduce observed disparities in these communities.
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Affiliation(s)
- Lyndsay A Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Nerissa Nance
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Kelly C Young-Wolff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Ousseny Zerbo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Monique M Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Jennifer L Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Sylvia E Badon
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
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29
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Zhuo R, Li G. Association between Second-Time Mother's Prenatal Depression and Firstborn's Behaviour Problems: The Mediation Role of Parenting Daily Hassles. Int J Environ Res Public Health 2021; 18:12794. [PMID: 34886521 DOI: 10.3390/ijerph182312794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022]
Abstract
Background: With the relaxation of birth control policy in China in recent years, second-time mothers’ mental health has raised concerns. However, the impact of firstborn children’s behaviour problems on second-time mothers’ prenatal depression in families transitioning to siblinghood has received little attention from family psychologists. Aims: This research aims to investigate whether firstborn children’s behaviour problems affect second-time mothers’ prenatal depression and the mediation role of daily parenting hassles, i.e., minor stressors associated with parenting, on this relationship. Methods: Data about second-time mothers’ prenatal depression, parenting daily hassles, and firstborn children’s behaviour problems were collected from 105 families transitioning to two children families using mother-reported questionnaires. Regressions were used to analyze the data. Results: About half of the mothers in the sample have depressive symptoms. Firstborns’ behaviour problems did not have a direct effect on the mother’s prenatal depression, but the problems did have an indirect effect via parenting daily hassles. The mothers’ age was significantly associated with prenatal depression. Conclusions: The mediation role of parenting daily hassles in the association with firstborn’s behaviour problems and mother’s prenatal depression suggests the need for support that reduce the levels of daily parenting hassles from firstborn children.
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30
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Antoniou E, Stamoulou P, Tzanoulinou MD, Orovou E. Perinatal Mental Health; The Role and the Effect of the Partner: A Systematic Review. Healthcare (Basel) 2021; 9:1572. [PMID: 34828618 DOI: 10.3390/healthcare9111572] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022] Open
Abstract
Pregnancy is a transitional period involving the most complex experiences in a woman's life, during which the woman's psychological status can be affected by a wide range of psychosocial variables. However, positive interpersonal relationships appear to constitute a supportive network that significantly influences perinatal mental health. Therefore, the presence of a supportive partner works psycho-protectively against the difficulties and pressures created by the transition to maternity. The aim of this study was to review systematically the influence of the partner on the woman's psychology during the perinatal period. Fourteen research articles from PubMed/Medline, Google Scholar and PsycINFO were included in the review from a total of 1846 articles. Most studies have shown a correlation between the support from the partner and prenatal depression and anxiety. Support from the spouse during childbirth is related to the extent to which women feel safe during labor as well as the stress during childbirth. The role of the partner is very important in the occurrence of perinatal mental disorders in women. Of course, more research needs to be done in the field of perinatal mental health. The risk factors that lead to mental disorders need to be clarified and the role of the partner in the perinatal period requires reinforcement and needs to be given the necessary importance.
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Abstract
BACKGROUND Exclusive breastfeeding has a wide range of benefits for maternal health. However, the benefit of exclusive breastfeeding for maternal mental health needs to be further explored. RESEARCH AIM To determine the moderating role of exclusive breastfeeding at 3 months on the association between prenatal and postpartum depression. METHODS This study had a prospective, longitudinal, and comparative design with two groups and three assessment waves. The sample comprised 334 participants (70 depressed and 264 non-depressed) recruited at public health services in northern Portugal. Participants completed a measure of depression symptoms between the second and the third trimester of pregnancy and between 3 and 6 months, and a measure of breastfeeding status at 3 months. RESULTS Exclusive breastfeeding at 3 months moderated the association between prenatal and postpartum depression. Participants with prenatal depression who were exclusively breastfeeding at 3 months showed fewer symptoms of depression and lower rates of depression between 3 and 6 months postpartum, compared to participants with prenatal depression who were not exclusively breastfeeding. Participants without prenatal depression who were exclusively breastfeeding at 3 months showed similar depression symptoms and similar rates of depression between 3 and 6 months postpartum, compared to participants without prenatal depression who were not exclusively breastfeeding. CONCLUSION Exclusive breastfeeding has a potential protective influence on postpartum depression among women with prenatal depression. Public health policies targeting women with prenatal depression should be implemented and include practices to promote and support exclusive breastfeeding in order to enhance women's exclusive breastfeeding and mental health.
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Affiliation(s)
- Bárbara Figueiredo
- 56059 School of Psychology, University of Minho, Campus of Gualtar, Braga, Portugal
| | - Tiago Miguel Pinto
- 56059 School of Psychology, University of Minho, Campus of Gualtar, Braga, Portugal
| | - Raquel Costa
- 26706 EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Universidade Europeia, Lisboa, Portugal
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32
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Mangialavori S, Cacioppo M, Terrone G, O'Hara MW. A dyadic approach to stress and prenatal depression in first-time parents: The mediating role of marital satisfaction. Stress Health 2021; 37:755-765. [PMID: 33620738 DOI: 10.1002/smi.3036] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 11/11/2022]
Abstract
In the field of perinatal clinical psychology, most studies focus on mothers' psychological states during pregnancy, neglecting the role of their partners. This study used an Actor-Partner Interdependence Mediation Model to evaluate the mediating role of dyadic satisfaction on the relationship between perceived stress and prenatal depressive symptomatology in both members of male-female-mixed-gender couples who were expecting their first child. One hundred thirty-eight couples in their third trimester of pregnancy were asked to complete questionnaires about perceived stress, dyadic adjustment, and depression. The model revealed that there was an intrapersonal indirect effect of fathers' perceived stress on prenatal paternal depression through their marital satisfaction. Moreover, an interpersonal indirect effect was found with mothers' perceived stress being associated with prenatal paternal depression through fathers' dyadic satisfaction. Maternal indirect effects were all non-significant, suggesting that their dyadic satisfaction and that of their partner did not mediate the relation between their perceived stress and that of their partner and their prenatal depression. Findings support the importance of assessing the dyadic satisfaction of couples during pregnancy, especially in expectant fathers, and targeting it in the psychological support offered to couples as a way of improving their prenatal distress, and consequently, their mental health.
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Affiliation(s)
| | - Marco Cacioppo
- Department of Human Sciences, LUMSA, University of Rome, Rome, Italy
| | - Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, Rome, Italy
| | - Michael W O'Hara
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, Iowa, USA
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Eilertsen EM, Hannigan LJ, McAdams TA, Rijsdijk FV, Czajkowski N, Reichborn-Kjennerud T, Ystrom E, Gjerde LC. Parental Prenatal Symptoms of Depression and Offspring Symptoms of ADHD: A Genetically Informed Intergenerational Study. J Atten Disord 2021; 25:1554-1563. [PMID: 32338109 DOI: 10.1177/1087054720914386] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Objective: The primary aim of the present study was to separate the direct effect of maternal prenatal depression on offspring ADHD from the passive transmission of genetic liability. Method: A children-of-twins and siblings design including 17,070 extended-family units participating in the Norwegian Mother and Child Cohort Study was used. Self-ratings were obtained from parents using the Symptom Checklist during pregnancy. Maternal ratings using Conner's Parent Rating Scale were obtained when the children were 5 years of age. Results: Genetic influences were important for explaining similarity between parents and offspring. There was also evidence for a maternal effect after accounting for genetic transmission (m = 0.06, 95% confidence interval [CI] = [0.02, 0.09]). Conclusion: Our results were consistent with hypotheses suggesting that maternal prenatal depression influences symptoms of ADHD in offspring. However, the effect was weak and a substantial portion of the association could be accounted for by shared genetic influences.
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Affiliation(s)
| | | | | | | | - Nikolai Czajkowski
- Norwegian Institute of Public Health, Oslo, Norway.,University of Oslo, Norway
| | | | - Eivind Ystrom
- Norwegian Institute of Public Health, Oslo, Norway.,University of Oslo, Norway
| | - Line C Gjerde
- Norwegian Institute of Public Health, Oslo, Norway.,University of Oslo, Norway
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34
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Rodriguez N, Tun HM, Field CJ, Mandhane PJ, Scott JA, Kozyrskyj AL. Prenatal Depression, Breastfeeding, and Infant Gut Microbiota. Front Microbiol 2021; 12:664257. [PMID: 34394021 PMCID: PMC8363245 DOI: 10.3389/fmicb.2021.664257] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/23/2021] [Indexed: 02/01/2023] Open
Abstract
Depressive symptoms are common during pregnancy and are estimated to affect 7-20% of pregnant women, with higher prevalence found in those with a prior history of depression, in ethnic minorities, and those with increased exposure to stressful life events. Maternal depression often remains undiagnosed, and its symptoms can increase adverse health risks to the infant, including impaired cognitive development, behavioral problems, and higher susceptibility to physical illnesses. Accumulating research evidence supports the association between maternal physical health elements to infant gut health, including factors such as mode of delivery, medication, feeding status, and antibiotic use. However, specific maternal prenatal psychosocial factors and their effect on infant gut microbiota and immunity remains an area that is not well understood. This article reviews the literature and supplements it with new findings to show that prenatal depression alters: (i) gut microbial composition in partially and fully formula-fed infants at 3-4 months of age, and (ii) gut immunity (i.e., secretory Immunoglobulin A) in all infants independent of breastfeeding status. Understanding the implications of maternal depression on the infant gut microbiome is important to enhance both maternal and child health and to better inform disease outcomes and management.
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Affiliation(s)
- Nicole Rodriguez
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Hein M Tun
- HKU-Pasteur Research Pole, Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | | | - James A Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Maschke J, Roetner J, Bösl S, Plank AC, Rohleder N, Goecke TW, Fasching PA, Beckmann MW, Kratz O, Moll GH, Lenz B, Kornhuber J, Eichler A. Association of Prenatal Alcohol Exposure and Prenatal Maternal Depression with Offspring Low-Grade Inflammation in Early Adolescence. Int J Environ Res Public Health 2021; 18:ijerph18157920. [PMID: 34360212 PMCID: PMC8345560 DOI: 10.3390/ijerph18157920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 12/27/2022]
Abstract
(1) This longitudinal study aimed to investigate the link between prenatal alcohol exposure and prenatal maternal depression with the offspring’s low-grade inflammatory status. (2) Prenatal alcohol exposure was determined via maternal self-report during the 3rd trimester of pregnancy (self-report+: n = 29) and the meconium alcohol metabolite Ethyl Glucuronide (EtG), collected at birth (≥30 ng/g: n = 23). The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for prenatal maternal depressive symptoms during the 3rd trimester (≥10: n = 35). Fifteen years later, 122 adolescents (M = 13.32 years; 48.4% female) provided blood samples for the analysis of high sensitivity C-reactive protein (hsCRP; M = 0.91; SD = 1.28). (3) Higher hsCRP levels were found in EtG positive adolescents (p = 0.036, ηp2 = 0.04) and an inverse non-significant dose–response relation with hsCRP (r = −0.35, p = 0.113). For maternal self-reported prenatal alcohol consumption (p = 0.780, ηp2 = 0.00) and prenatal depressive symptoms (p = 0.360, ηp2 = 0.01) no differences for hsCRP levels between the affected and unaffected groups were found. (4) Adolescents with prenatal alcohol exposure are at risk for low-grade systemic inflammation. The EtG biomarker may be more accurate compared to self-reports. The findings suggest that prenatal maternal depression does not evoke low-grade systemic inflammation.
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Affiliation(s)
- Janina Maschke
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.R.); (S.B.); (A.-C.P.); (O.K.); (G.H.M.); (A.E.)
- Correspondence: ; Tel.: +49-9131-8544657
| | - Jakob Roetner
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.R.); (S.B.); (A.-C.P.); (O.K.); (G.H.M.); (A.E.)
| | - Sophia Bösl
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.R.); (S.B.); (A.-C.P.); (O.K.); (G.H.M.); (A.E.)
| | - Anne-Christine Plank
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.R.); (S.B.); (A.-C.P.); (O.K.); (G.H.M.); (A.E.)
| | - Nicolas Rohleder
- Department of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, 91052 Erlangen, Germany;
| | - Tamme W. Goecke
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.W.G.); (P.A.F.); (M.W.B.)
- Department of Obstetrics and Gynecology, RoMed Klinikum Rosenheim, 83022 Rosenheim, Germany
| | - Peter A. Fasching
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.W.G.); (P.A.F.); (M.W.B.)
| | - Matthias W. Beckmann
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.W.G.); (P.A.F.); (M.W.B.)
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.R.); (S.B.); (A.-C.P.); (O.K.); (G.H.M.); (A.E.)
| | - Gunther H. Moll
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.R.); (S.B.); (A.-C.P.); (O.K.); (G.H.M.); (A.E.)
| | - Bernd Lenz
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (B.L.); (J.K.)
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (B.L.); (J.K.)
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.R.); (S.B.); (A.-C.P.); (O.K.); (G.H.M.); (A.E.)
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Garcia-Martin I, Penketh RJA, Garay SM, Jones RE, Grimstead JW, Baird DM, John RM. Symptoms of Prenatal Depression Associated with Shorter Telomeres in Female Placenta. Int J Mol Sci 2021; 22:7458. [PMID: 34299077 PMCID: PMC8306199 DOI: 10.3390/ijms22147458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Depression is a common mood disorder during pregnancy impacting one in every seven women. Children exposed to prenatal depression are more likely to be born at a low birth weight and develop chronic diseases later in life. A proposed hypothesis for this relationship between early exposure to adversity and poor outcomes is accelerated aging. Telomere length has been used as a biomarker of cellular aging. We used high-resolution telomere length analysis to examine the relationship between placental telomere length distributions and maternal mood symptoms in pregnancy. METHODS This study utilised samples from the longitudinal Grown in Wales (GiW) study. Women participating in this study were recruited at their presurgical appointment prior to a term elective caesarean section (ELCS). Women completed the Edinburgh Postnatal Depression Scale (EPDS) and trait subscale of the State-Trait Anxiety Inventory (STAI). Telomere length distributions were generated using single telomere length analysis (STELA) in 109 term placenta (37-42 weeks). Multiple linear regression was performed to examine the relationship between maternally reported symptoms of depression and anxiety at term and mean placental telomere length. RESULTS Prenatal depression symptoms were significantly negatively associated with XpYp telomere length in female placenta (B = -0.098, p = 0.026, 95% CI -0.184, -0.012). There was no association between maternal depression symptoms and telomere length in male placenta (B = 0.022, p = 0.586, 95% CI -0.059, 0.103). There was no association with anxiety symptoms and telomere length for either sex. CONCLUSION Maternal prenatal depression is associated with sex-specific differences in term placental telomeres. Telomere shortening in female placenta may indicate accelerated placental aging.
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Affiliation(s)
- Isabel Garcia-Martin
- Division of Biomedicine, Cardiff School of Biosciences, Cardiff University, Cardiff, Wales CF10 3AX, UK; (I.G.-M.); (S.M.G.)
| | - Richard J. A. Penketh
- Department of Obstetrics and Gynaecology, University Hospital Wales, Cardiff, Wales CF14 4XW, UK;
| | - Samantha M. Garay
- Division of Biomedicine, Cardiff School of Biosciences, Cardiff University, Cardiff, Wales CF10 3AX, UK; (I.G.-M.); (S.M.G.)
| | - Rhiannon E. Jones
- Division of Cancer and Genetics, Cardiff School of Medicine, Cardiff University, Cardiff, Wales CF14 4XW, UK; (R.E.J.); (J.W.G.); (D.M.B.)
| | - Julia W. Grimstead
- Division of Cancer and Genetics, Cardiff School of Medicine, Cardiff University, Cardiff, Wales CF14 4XW, UK; (R.E.J.); (J.W.G.); (D.M.B.)
| | - Duncan M. Baird
- Division of Cancer and Genetics, Cardiff School of Medicine, Cardiff University, Cardiff, Wales CF14 4XW, UK; (R.E.J.); (J.W.G.); (D.M.B.)
| | - Rosalind M. John
- Division of Biomedicine, Cardiff School of Biosciences, Cardiff University, Cardiff, Wales CF10 3AX, UK; (I.G.-M.); (S.M.G.)
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Bohne A, Nordahl D, Lindahl ÅAW, Ulvenes P, Wang CEA, Pfuhl G. Emotional Infant Face Processing in Women With Major Depression and Expecting Parents With Depressive Symptoms. Front Psychol 2021; 12:657269. [PMID: 34276481 PMCID: PMC8283203 DOI: 10.3389/fpsyg.2021.657269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Processing of emotional facial expressions is of great importance in interpersonal relationships. Aberrant engagement with facial expressions, particularly an engagement with sad faces, loss of engagement with happy faces, and enhanced memory of sadness has been found in depression. Since most studies used adult faces, we here examined if such biases also occur in processing of infant faces in those with depression or depressive symptoms. In study 1, we recruited 25 inpatient women with major depression and 25 matched controls. In study 2, we extracted a sample of expecting parents from the NorBaby study, where 29 reported elevated levels of depressive symptoms, and 29 were matched controls. In both studies, we assessed attentional bias with a dot-probe task using happy, sad and neutral infant faces, and facial memory bias with a recognition task using happy, sad, angry, afraid, surprised, disgusted and neutral infant and adult faces. Participants also completed the Ruminative Responses Scale and Becks Depression Inventory-II. In study 1, we found no group difference in either attention to or memory accuracy for emotional infant faces. Neither attention nor recognition was associated with rumination. In study 2, we found that the group with depressive symptoms disengaged more slowly than healthy controls from sad infant faces, and this was related to rumination. The results place emphasis on the importance of emotional self-relevant material when examining cognitive processing in depression. Together, these studies demonstrate that a mood-congruent attentional bias to infant faces is present in expecting parents with depressive symptoms, but not in inpatients with Major Depression Disorder who do not have younger children.
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Affiliation(s)
- Agnes Bohne
- Department of Psychology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Dag Nordahl
- Department of Psychology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Åsne A W Lindahl
- Department of Psychology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Pål Ulvenes
- Modum Bad Research Institute, Vikersund, Norway
| | - Catharina E A Wang
- Department of Psychology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Gerit Pfuhl
- Department of Psychology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
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Sánchez-Polán M, Franco E, Silva-José C, Gil-Ares J, Pérez-Tejero J, Barakat R, Refoyo I. Exercise During Pregnancy and Prenatal Depression: A Systematic Review and Meta-Analysis. Front Physiol 2021; 12:640024. [PMID: 34262468 PMCID: PMC8273431 DOI: 10.3389/fphys.2021.640024] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/24/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Prenatal depression is associated with an increased risk of physical, physiological, cardiovascular, and psychological diseases for mothers and future newborns. Prenatal depression and depressive symptoms could have negative effects on the cognitive, emotional, social, and behavioral development of children. Objective: This study aimed to examine the influence of exercise during pregnancy on the prevalence of prenatal depression and depressive symptoms in the scientific literature. Data Sources: A search was carried out examining different online databases up to November 2020. Methods of Study Selection: A systematic review with random effects meta-analysis was performed. Only randomized controlled trials published in English or Spanish with pregnant populations and interventions with exercise programs carried out during pregnancy were included. The scores obtained by the tools that measured the emotional state and depressive symptoms as well as the number and percentage of depressed women of the study groups were analyzed. Tabulation, Integration, and Results: We analyzed 15 studies and found a negative association between moderate exercise during pregnancy and prenatal depression (ES = -0.36, 95% CI = -0.58, -13, I 2 = 80.2%, Pheterogeneity = 0.001). In addition, the studies also showed that women who were inactive during pregnancy had a 16% higher probability of suffering prenatal depression [RR = 0.84 (95% IC = 0.74, 0.96) I 2 = 61.9%, Pheterogeneity = 0.010]. Conclusion: Supervised exercise during pregnancy may be useful for the prevention and reduction of prenatal depression and depressive symptoms. Systematic Review Registration: Registered in PROSPERO (Registration No. CRD42020164819).
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Affiliation(s)
| | - Evelia Franco
- Department of Education, Research Methods and Evaluation, Comillas Pontifical University, Madrid, Spain
| | | | - Javier Gil-Ares
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Physical Activity, Sports and Leisure Social Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Javier Pérez-Tejero
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Rubén Barakat
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Physical Activity, Sports and Leisure Social Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Ignacio Refoyo
- Department of Sports, Universidad Politécnica de Madrid, Madrid, Spain
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Yakupova V, Liutsko L. Perinatal Depression, Birth Experience, Marital Satisfaction and Childcare Sharing: A Study in Russian Mothers. Int J Environ Res Public Health 2021; 18:6086. [PMID: 34200046 DOI: 10.3390/ijerph18116086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/06/2021] [Accepted: 05/31/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Over 300,000 women in Russia face perinatal depressive disorders every year, according to the data for middle-income countries. This study is the first attempt to perform a two-phase study of perinatal depressive disorders in Russia. The paper examines risk factors for perinatal depressive symptoms, such as marital satisfaction, birth experience, and childcare sharing. METHODS At 15-40 gestational weeks (M = 30.7, SD = 6.6), 343 Russian-speaking women, with a mean age of 32 years (SD = 4.4), completed the Edinburgh Postnatal Depression Scale, Couples Satisfaction Index, Birth Satisfaction Scale, and provided socio-demographic data. Two months after childbirth, 190 of them participated in the follow-up. RESULTS The follow-up indicated that 36.4% of participants suffered from prenatal depression and 34.3% of participants had postnatal depression. Significant predictors of prenatal depression were physical well-being during pregnancy (β = -0.25; p = 0.002) and marital satisfaction during pregnancy (β = -0.01; p = 0.018). Birth satisfaction (β = -0.08; p = 0.001), physical well-being at two months after delivery (β = -0.36; p < 0.01), and marital satisfaction during pregnancy (β = 0.01; p = 0.016) and after delivery (β = -0.02; p < 0.01) significantly predicted postnatal depression at 2 months after delivery. CONCLUSION Our study identified that physical well-being during pregnancy and marital satisfaction during pregnancy significantly predicted prenatal depression. Birth satisfaction, physical well-being at 2 months after delivery, and marital satisfaction during pregnancy and after delivery significantly predicted postnatal depression. To our knowledge, this is the first study of perinatal depressive disorders in the context of marital satisfaction and birth satisfaction in the Russian sample. The problem of unequal childcare sharing is widely spread in Russia. Adjusting spousal expectations and making arrangements for childcare may become the focus of psychological work with the family. The availability of psychological support during pregnancy and labor may be important in the context of reducing perinatal depression risks.
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Faisal-Cury A, Levy RB, Azeredo CM, Matijasevich A. Prevalence and associated risk factors of prenatal depression underdiagnosis: A population-based study. Int J Gynaecol Obstet 2021; 153:469-475. [PMID: 33448023 DOI: 10.1002/ijgo.13593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/26/2020] [Accepted: 01/11/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To estimate prenatal depression underdiagnosis prevalence and its associated sociodemographic and obstetric risk factors among a population-based sample of Brazilian pregnant women with depression. METHODS We used data from the Brazilian National Survey (PNS 2013). Of the 22 445 women of reproductive age, 800 reported being pregnant. Participants answered the Patient Health Questionnaire-9 (PHQ-9) and a questionnaire with sociodemographic, obstetric, and clinical data. Classification of prenatal depression underdiagnosis was made using the comparison between results obtained from the self-referred question evaluating clinical diagnosis of depression and the results of the PHQ-9. Pregnant women with a PHQ-9 score greater than 8 and with a "No" answer in the clinical question were classified as prenatal depression underdiagnosis. Logistic regression models were performed to obtain crude and adjusted odds ratios (OR) between variables and prenatal depression underdiagnosis. RESULTS Prevalence of prenatal depression underdiagnosis was 82.3% (74.8%-87.8%). Pregnant women with non-white skin color and pregnant women with an elementary school degree were more likely to be underdiagnosed with prenatal depression in comparison with women with white skin color (adjusted OR 2.42, 95% confidence interval [CI] 0.99-5.91) and with women with higher education (adjusted OR 4.07, 95% CI 2.05-8.09). CONCLUSION Equitable mental health assistance for pregnant women should considered prenatal depression social risk factors.
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Affiliation(s)
- Alexandre Faisal-Cury
- Departamento de Medicina Preventiva I Hospital das Clinicas HCFMUSP I Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Renata Bertazzi Levy
- Departamento de Medicina Preventiva I Hospital das Clinicas HCFMUSP I Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Alicia Matijasevich
- Departamento de Medicina Preventiva I Hospital das Clinicas HCFMUSP I Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Medina NY, Edwards RC, Zhang Y, Hans SL. A longitudinal investigation of young mothers' prenatal attachment, depressive symptoms, and early parenting behaviour. J Reprod Infant Psychol 2021; 40:196-211. [PMID: 33586534 DOI: 10.1080/02646838.2021.1886257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: This study explores whether young, low-income mothers' prenatal attachment to their infants is related to attachment and parenting behaviour postnatally.Background: A small literature has documented continuity in maternal attachment from pregnancy to postpartum and shown that early maternal attachment is associated with positive parenting behaviour. Less is known about whether prenatal attachment has a unique impact on parenting behaviour, or if it is primarily a step in the development of postnatal attachment, which in turn influences parenting. Additionally, it is unclear whether associations between attachment and early parenting might be attributable to other factors such as depressive symptoms.Method: This longitudinal study followed young primiparous mothers from pregnancy through 3-weeks postnatal. 240 ethnically/racially diverse low-income American women reported their attachment-related thoughts and feelings and their depressive symptoms during pregnancy and postnatally. At 3 weeks postpartum, mothers were observed interacting with their infant.Results: There was stability in attachment and depressive symptoms from pregnancy to postpartum. In multivariate path models, prenatal attachment was directly associated with two types of parenting behaviour: positive engagement and encouragement of learning, even when accounting for depressive symptoms and postnatal attachment. There was an indirect effect of prenatal attachment on sensitivity through postnatal attachment.Conclusion: The foundation of a mother's emotional connection to her infant begins before birth. Parenting support programmes for young mothers should begin during pregnancy. Supporting the establishment of positive prenatal attachment may also have a positive influence on later parenting behaviour among mothers, including mothers experiencing depressive symptoms.
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Affiliation(s)
- Nora Y Medina
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
| | - Renee C Edwards
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
| | - Yudong Zhang
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
| | - Sydney L Hans
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
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Zhang L, Wang L, Cui S, Yuan Q, Huang C, Zhou X. Prenatal Depression in Women in the Third Trimester: Prevalence, Predictive Factors, and Relationship With Maternal-Fetal Attachment. Front Public Health 2021; 8:602005. [PMID: 33575242 PMCID: PMC7870992 DOI: 10.3389/fpubh.2020.602005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/23/2020] [Indexed: 12/11/2022] Open
Abstract
Objective: The prevalence of prenatal depression in pregnant women has found to be high, which may adversely affect the intimacy of a mother to her fetus. Few studies have investigated the relationship between prenatal depression and maternal-fetal attachment in pregnant Chinese women. This study is thus designed to evaluate the prevalence rate, predictive factors of prenatal depression in Chinese pregnant women in the third trimester of pregnancy, and the effect of prenatal depression on maternal-fetal attachment. Methods: A total of 340 pregnant women in the third trimester of pregnancy were recruited from a hospital in Anhui Province. The Edinburgh Postpartum Depression Scale (EPDS) was rated to assess the prenatal depression; the Pittsburgh Sleep Quality Index (PSQI) and Zung Self-Rating Anxiety Scale (SAS) were used to assess sleep quality and anxiety level for all participants. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal-fetal attachment. Results: The prevalence of prenatal depression in the participants was high (19.1%) in our study. The scores of prenatal anxiety and sleep disorders were higher with prenatal depression than in those without prenatal depression (47.6 ± 9.5 vs. 38.9 ± 6.9; 8.3 ± 3.3 vs. 6.1 ± 2.7, all p < 0.01). MAAS quality was lower in prenatal depression women than those in non-prenatal depression women (43.8 ± 5.6 vs. 46.4 ± 4.5, p < 0.01). Correlation analysis showed that prenatal depression was associated with parity, prenatal education, education level, marital satisfaction, anxiety and sleep disorders (all p < 0.05). Furthermore, binary logistic regression results showed that anxiety and sleep disorders were risk factors for prenatal depression. Prenatal education, higher marriage satisfaction were protective factors for prenatal depression. In addition, correlation analysis also showed that prenatal depression was positively correlated with MAAS intensity, but negatively correlated with MAAS quality. Conclusions: Our results indicated a high prevalence of prenatal depression in women in the third trimester. Prenatal education and higher marital satisfaction were protective factors for prenatal depression; antenatal anxiety and sleep disorders during pregnancy were risk factors for prenatal depression. Prenatal depression was negatively correlated with MAAS quality, but positively correlated with MAAS intensity.
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Affiliation(s)
- Ling Zhang
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Lei Wang
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Shu Cui
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Qiuyu Yuan
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Cui Huang
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Xiaoqin Zhou
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
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Magnusson FL, Rogathi JJ, Sigalla GN, Manongi R, Rasch V, Gammeltoft T, Meyrowitsch DW. Does resilience moderate the effect of intimate partner violence on signs of depression among Tanzanian pregnant women: A cross-sectional study. Acta Obstet Gynecol Scand 2021; 100:768-774. [PMID: 33316080 DOI: 10.1111/aogs.14062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Exposure to intimate partner violence (IPV) has been found to be associated with a multitude of poor health and quality of life outcomes. Among the risks exacerbated by IPV is prenatal depression. Resilience is hypothesized to protect against psychopathology after exposure to a traumatic influence. The present study aims to investigate resilience as a moderator of the effect of exposure to IPV on prenatal depression among pregnant women in Moshi, Tanzania. MATERIAL AND METHODS In this cross-sectional study, nested within a larger longitudinal study, pregnant women receiving antenatal care were interviewed about exposure to IPV, signs of depression using the Edinburgh Postpartum Depression Scale, and resilience using the abbreviated Connor-Davidson Resilience Scale. Logistic regression was used to test the effect of the interaction term of resilience and exposure to IPV during pregnancy on the risk of high level of signs of depression. RESULTS In total, 1013 women completed all interviews, 300 women reported exposure to IPV, and 113 had high levels of signs of depression. Mean resilience score was 14.26 (SD 9.45). Exposure to IPV was correlated with signs of depression (adjusted odds ratio 6.49, 95% CI 3.75-11.24). Resilience was not correlated with signs of depression, nor was the interaction term of resilience and exposure to IPV. CONCLUSIONS The study did not find that resilience acted as a moderator of the effect of exposure to IPV during pregnancy on the risk of prenatal depression. The cross-sectional design of the study may not be well suited to investigate resilience, which could take time to manifest. The abbreviated Connor-Davidson Resilience Scale has not been validated in a Tanzanian setting, or in the Swahili version. Practitioners should take note that all women and families affected by IPV should be afforded relevant assistance from social services, law enforcement, healthcare practitioners, and other relevant services, regardless of their apparent level of resilience.
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Affiliation(s)
- Frederik L Magnusson
- Department of Public Health, School of Global Health, University of Copenhagen, Copenhagen, Denmark
| | - Jane J Rogathi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Community Health Department, Kilimanjaro Christian Medical Center, Moshi, Tanzania
| | - Geofrey N Sigalla
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Department of Health Services, Marie Stopes Tanzania, Dar es Salaam, Tanzania
| | - Rachel Manongi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Vibeke Rasch
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Tine Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Dan W Meyrowitsch
- Department of Public Health, School of Global Health, University of Copenhagen, Copenhagen, Denmark
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Lee M, Kim YS, Lee MK. The Mediating Effect of Marital Intimacy on the Relationship between Spouse-Related Stress and Prenatal Depression in Pregnant Couples: An Actor-Partner Interdependent Model Test. Int J Environ Res Public Health 2021; 18:E487. [PMID: 33435308 PMCID: PMC7827389 DOI: 10.3390/ijerph18020487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/27/2020] [Accepted: 12/31/2020] [Indexed: 11/16/2022]
Abstract
Prenatal depression is an important factor in predicting postpartum depression. Most studies have assessed factors affecting prenatal depression by focusing on pregnant wives. However, the emotional and psychological aspects of both expectant parents need to be considered. Therefore, the purpose of this study was to examine the effect of spouse-related stress in expectant couples on prenatal depression and investigate the mediating effects of marital intimacy on this relationship. A total of 120 expectant couples from two cities in Korea at more than 15 weeks of completed pregnancy participated in the study. Using a structured questionnaire, we assessed the general characteristics of the participants, spouse-related stress, prenatal depression, and marital intimacy. The results revealed that four actor effects and one partner effect were significant. Marital intimacy and prenatal depression among expectant parents were affected by spouse-related stress. Moreover, spouse-related stress in the husbands completely mediated marital intimacy in pregnant wives, demonstrating partner effects on prenatal depression in pregnant wives. Therefore, it was observed that paternal factors affect prenatal depression in pregnant wives. This warrants the inclusion of husbands in marital interventions and strategies to improve marital intimacy in pregnant wives.
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Affiliation(s)
| | | | - Mi-Kyoung Lee
- College of Nursing, Eulji University, 77, Gyeryong-ro, 771 beon-gil, Jung-gu, Daejeon 34824, Korea; (M.L.); (Y.-S.K.)
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Khan R, Waqas A, Mustehsan ZH, Khan AS, Sikander S, Ahmad I, Jamil A, Sharif M, Bilal S, Zulfiqar S, Bibi A, Rahman A. Predictors of Prenatal Depression: A Cross-Sectional Study in Rural Pakistan. Front Psychiatry 2021; 12:584287. [PMID: 34566707 PMCID: PMC8461022 DOI: 10.3389/fpsyt.2021.584287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To determine the prevalence and association of prenatal depression with socioeconomic, demographic and personal factors among pregnant women living in Kallar Syedan, Rawalpindi, Pakistan. Methods: Five hundred women in the second and third trimester of pregnancy, living in Kallar Syedan, a rural area of district Rawalpindi Pakistan, were included in the study. Depression was assessed using "Patient health questionnaire" (PHQ9) in Urdu, with a cut-off score of 10. Multi-dimensional scale of perceived social support (MSPSS) was used to assess perceived social support. Life Events and Difficulties Schedule (LEDS) were used to measure stressful life events in past 1 year. Tool to assess intimate partner violence (IPV) was based on WHO Multi Country Study on "Women's Health and Domestic Violence against Women." Results: Prevalence of prenatal depression was found to be 27%. Number of pregnancies was significantly associated with prenatal depression (p < 0.01). Women living in a joint family and those who perceived themselves as moderately satisfied or not satisfied with their life in the next 4 years were found to be depressed (p < 0.01, OR 6.9, CI 1.77-26.73). Depressive symptomatology in women who experienced more than five stressful life events in last 1 year was three times higher (p < 0.001, OR 3.2, CI 1.68-5.98) than in women with 1-2 stressful events. Women who were supported by their significant others or their family members had 0.9 times (p < 0.01, OR 0.9, CI 0.85-0.96) less chance of getting depressed. Pregnant women who were psychologically abused by their partners were 1.5 times more depressed (p < 0.05 CI 1.12-2.51). Odds of having depression was also high in women who had less mean score of MSSI (p < 0.05, OR 1.1, CI 1.01-1.09). Women who had suitable accommodation had 0.5 times less chance of having depression than others (p < 0.05, OR 0.5, CI 0.27-0.92). Conclusion: Over a quarter of the women in the study population reported prenatal depression, which were predicted predominantly by psychosocial variables.
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Affiliation(s)
- Rukhsana Khan
- Department of Community Medicine Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Ahmed Waqas
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom.,Human Development Research Foundation, Islamabad, Pakistan
| | - Zille Huma Mustehsan
- Department of Community Medicine Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Amna Saeed Khan
- Department of Community Medicine Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan.,Health Services Academy, Islamabad, Pakistan
| | - Ikhlaq Ahmad
- Human Development Research Foundation, Islamabad, Pakistan.,Health Services Academy, Islamabad, Pakistan
| | - Anam Jamil
- Human Development Research Foundation, Islamabad, Pakistan
| | - Maria Sharif
- Human Development Research Foundation, Islamabad, Pakistan
| | - Samina Bilal
- Human Development Research Foundation, Islamabad, Pakistan
| | | | - Amina Bibi
- Human Development Research Foundation, Islamabad, Pakistan
| | - Atif Rahman
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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Szekely E, Neumann A, Sallis H, Jolicoeur-Martineau A, Verhulst FC, Meaney MJ, Pearson RM, Levitan RD, Kennedy JL, Lydon JE, Steiner M, Greenwood CMT, Tiemeier H, Evans J, Wazana A. Maternal Prenatal Mood, Pregnancy-Specific Worries, and Early Child Psychopathology: Findings From the DREAM BIG Consortium. J Am Acad Child Adolesc Psychiatry 2021; 60:186-197. [PMID: 32278003 DOI: 10.1016/j.jaac.2020.02.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/06/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Few studies have attempted to identify how distinct dimensions of maternal prenatal affective symptoms relate to offspring psychopathology. We defined latent dimensions of women's prenatal affective symptoms and pregnancy-specific worries to examine their association with early offspring psychopathology in three prenatal cohorts. METHOD Data were used from three cohorts of the DREAM-BIG consortium: Avon Longitudinal Study of Parents and Children (ALSPAC [N = 12,515]), Generation R (N = 6,803), and the Canadian prenatal cohort Maternal Adversity, Vulnerability, and Neurodevelopment (MAVAN [N = 578]). Maternal prenatal affective symptoms and pregnancy-specific worries were assessed using different measures in each cohort. Through confirmatory factor analyses, we determined whether comparable latent dimensions of prenatal maternal affective symptoms existed across the cohorts. We used structural equation models to examine cohort-specific associations between these dimensions and offspring psychopathology at 4 to 8 years of age (general psychopathology, specific internalizing and externalizing previously derived using confirmatory factor analyses). Cohort-based estimates were meta-analyzed using inverse variance-weighing. RESULTS Four prenatal maternal factors were similar in all cohorts: a general affective symptoms factor and three specific factors-an anxiety/depression factor, a somatic factor, and a pregnancy-specific worries factor. In meta-analyses, both the general affective symptoms factor and pregnancy-specific worries factor were independently associated with offspring general psychopathology. The general affective symptoms factor was further associated with offspring specific internalizing problems. There were no associations with specific externalizing problems. CONCLUSION These replicated findings of independent and adverse effects for prenatal general affective symptoms and pregnancy-specific worries on child mental health support the need for specific interventions in pregnancy.
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Affiliation(s)
- Eszter Szekely
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Alexander Neumann
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Hannah Sallis
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | | | - Frank C Verhulst
- Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark, and the Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Michael J Meaney
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Douglas Mental Health Institute, Montreal, Quebec, Canada, and Singapore Institute for Clinical Sciences, Singapore City, Singapore
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Robert D Levitan
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - James L Kennedy
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - John E Lydon
- McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | | | - Celia M T Greenwood
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Henning Tiemeier
- Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ashley Wazana
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Centre for Child Development and Mental Health, Jewish General Hospital, Montreal, Quebec, Canada.
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Przybyła-Basista H, Kwiecińska E, Ilska M. Body Acceptance by Pregnant Women and Their Attitudes toward Pregnancy and Maternity as Predictors of Prenatal Depression. Int J Environ Res Public Health 2020; 17:E9436. [PMID: 33339240 DOI: 10.3390/ijerph17249436] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/10/2020] [Accepted: 12/13/2020] [Indexed: 01/09/2023]
Abstract
Background: Depressive symptoms during pregnancy may cause unfavorable consequences for both the mother and the infant's physiological and psychological health. Recent evidence indicates that body image plays an important role in prenatal depression. The present study's main purpose was to investigate the level of acceptance of physical appearance in pregnant women, their attitudes toward pregnancy and maternity, and some obstetric characteristics as significant predictors in the development of depression. Methods: A sample of 150 Polish pregnant women completed a set of self-report questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS), Attitudes toward Maternity and Pregnancy Questionnaire (PRE-MAMA), and the Body-Self Questionnaire (EA-BSQ). All participants also answered a brief sociodemographic and obstetric information questionnaire. Results: A hierarchical binary logistic regression was conducted to predict prenatal depression from selected obstetric variables (unplanned pregnancy, multiparity, and miscarriages) and psychological variables (appearance evaluation and positive or anxious attitudes toward pregnancy and maternity). It was found that higher levels of negative evaluation of appearance increased chances of depression in pregnant women by almost one-and-a-half. The analysis revealed that positive attitudes toward pregnancy and maternity were the most important protective factor for depression. Conclusions: The results confirmed the importance of dissatisfaction with body image during pregnancy as a predictor of the onset of prenatal depression. However, in clinical practice, this risk factor should be considered in combination with positive maternal attitudes, not separately. The implications for future studies and interventions in the field of prenatal depression are discussed in this work.
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Porthan E, Lindberg M, Ekholm E, Scheinin NM, Karlsson L, Karlsson H, Härkönen J. Parental divorce in childhood does not independently predict maternal depressive symptoms during pregnancy. BMC Pregnancy Childbirth 2020; 20:520. [PMID: 32894091 PMCID: PMC7487523 DOI: 10.1186/s12884-020-03227-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022] Open
Abstract
Background This study sought to investigate if parental divorce in childhood increases the risk for depressive symptoms in pregnancy. Methods Women were recruited during their ultrasound screening in gestational week (gwk) 12. The final study sample consisted of 2,899 pregnant women. Questionnaires (including the Edinburgh Postnatal Depression Scale) were completed at three measurement points (gwk 14, 24 and 34). Prenatal depressive symptoms were defined as Edinburgh Postnatal Depression Scale score ≥ 13. Parental divorce and other stressful life events in childhood were assessed at gwk 14. Parental divorce was defined as separation of parents who were married or cohabiting. Questionnaire data was supplemented with data from Statistics Finland and the Finnish Medical Birth Register. Results Parental divorce in childhood increased the risk for depressive symptoms during pregnancy (OR 1.47; 95% CI 1.02–2.13), but the connection was no longer significant after adjusting for socioeconomic status, family conflicts and witnessing domestic violence in the childhood family (OR 0.80; 95% CI 0.54–1.18). Conclusions Parental divorce alone does not predict depressive symptoms during pregnancy.
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Affiliation(s)
- Elviira Porthan
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center and Centre for Population Health Research, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20520, Turku, Finland.
| | - Matti Lindberg
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center and Centre for Population Health Research, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20520, Turku, Finland.,Faculty of Social Sciences, Department of Social Research, University of Turku, Turku, Finland
| | - Eeva Ekholm
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center and Centre for Population Health Research, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20520, Turku, Finland.,Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center and Centre for Population Health Research, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20520, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center and Centre for Population Health Research, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20520, Turku, Finland.,Department of Child Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center and Centre for Population Health Research, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20520, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Juho Härkönen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center and Centre for Population Health Research, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20520, Turku, Finland.,Department of Political and Social Sciences, European University Institute, Firenze, Italy.,Department of Sociology, Stockholm University, Stockholm, Finland
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VOEGTLINE KM, JOHNSON SB, HUANG RB, DIPIETRO JA. The bloom is (slightly) off the rose: the motherhood effect on psychological functioning in successive pregnancies. J Psychosom Obstet Gynaecol 2020; 41:177-182. [PMID: 31466499 PMCID: PMC7048633 DOI: 10.1080/0167482x.2019.1657089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective: To examine the maternal psychological state during the course of two successive pregnancies.Methods: The sample consisted of 73 women drawn from a larger maternal-fetal cohort that participated during two pregnancies. Women completed self-report psychological questionnaires at 24, 30, and 36 weeks gestation to index maternal depressive symptoms, trait anxiety, and pregnancy hassles and uplifts. Analyses examined stability of maternal symptoms across successive pregnancies in the same women.Results: Antenatal symptoms of depression and anxiety exhibited strong intra-individual stability between successive pregnancies. Mean differences in maternal symptoms were not detected for either at 24, 30, or 36 weeks gestation, excepting elevated anxiety symptoms at the mid-point due to greater fluctuation in maternal anxiety during the prior pregnancy. Subsequent pregnancies were associated with less intense uplifting feelings about the pregnancy on each measurement occasion.Conclusions: Findings suggest marked consistency in maternal psychological orientation across subsequent pregnancies, though parity also plays a role in the maternal experience.
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Affiliation(s)
| | - Sara B. JOHNSON
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Ruthe B. HUANG
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Janet A. DIPIETRO
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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Chrzan-Dętkoś M, Pietkiewicz A, Żołnowska J, Pizuńska D. The program of psychological and breastfeeding support "Maternity step by step": an example of effective solution for the prevention, diagnostics and treatment of prenatal and postpartum depression. Psychiatr Pol 2020; 54:613-629. [PMID: 33038891 DOI: 10.12740/pp/105494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Postpartum depression affects about 13-20% of women. Depression during pregnancy is observed in 19% of pregnant women. In Poland we lack asupport system for this group of patients. This article presents the elements of the pilot program of psychological interventions and breastfeeding support "Motherhood: step by step", financed by the municipality of Gdansk. The aim of the program was to provide inhabitants of Gdansk with professional breastfeeding support and psychological help during pregnancy and in the first year of infant's life. METHODS The study involved three groups of women: 36 mothers participating in psychological consultations and short-term therapy, 123 women from breastfeeding support group and 104 women in the control group. The evaluation was based on questionnaires prepared by the researchers, the General Health Questionnaire-28 and the Parenting Stress Index -3rd version. RESULTS The evaluation showed a significant decrease in symptoms of mental disorders in both groups of treated women: women from psychological intervention and breastfeeding intervention group. In women from psychological intervention group a significant decrease in parental stress was observed. CONCLUSIONS Conducted analyses showed that the implemented program is characterized by high effectiveness and may be recommended for the continuation in the subsequent years. It may be considered as asolution for changes in the new standards for perinatal care in Poland.
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Affiliation(s)
| | | | - Joanna Żołnowska
- Szpital Św. Wojciecha w Gdańsku, Copernicus Podmiot Leczniczy Sp. z o.o
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