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International Journal of Environmental... Jan 2024There is body of evidence supporting a role for maternal exposure to ambient air pollutants and postpartum depression (PPD). We attempted to review the literature... (Meta-Analysis)
Meta-Analysis Review
There is body of evidence supporting a role for maternal exposure to ambient air pollutants and postpartum depression (PPD). We attempted to review the literature systematically to assess the association between exposure to both ambient air particulate matters within pregnancy and PPD. The effect estimates extracting across each study were standardized to a 10 μg/m3 change. The random-effects model was applied to pool odds ratios. According to the three included cohort articles, exposure to PM10 within second trimester (OR = 1.26, 95% CI = 1.15-1.37) was significantly associated with higher odds of PPD. However, there was no significant association between having exposure to other ambient air pollutants and PPD. This meta-analysis showed that air pollutants could be associated with an increased risk of PPD.
Topics: Female; Humans; Pregnancy; Air Pollutants; Air Pollution; Depression, Postpartum; Environmental Exposure; Maternal Exposure; Particulate Matter
PubMed: 36469809
DOI: 10.1080/09603123.2022.2153808 -
Combinatorial Chemistry & High... Mar 2024Benzodiazepines (BZD) and Z-drugs are often prescribed for alleviating such symptoms and treating maternal psychiatric disorders and epilepsy. However, their use is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Benzodiazepines (BZD) and Z-drugs are often prescribed for alleviating such symptoms and treating maternal psychiatric disorders and epilepsy. However, their use is limited due to the apprehensions and risks related to poor maternal and neonatal outcomes.
OBJECTIVE
This meta-analysis evaluated the rationality and efficacy of using Benzodiazepines and Z-drugs for managing anxiety and depression in pregnant women.
METHODS
The meta-analysis was based on a systematic review through keyword search utilizing Scopus, Pubmed, and Cochrane databases. One hundred three articles were deemed eligible, but only 21 articles were selected for the meta-analysis.
RESULTS
The meta-analysis showed that despite the indication for anxiety and depression in pregnant women, the usage of BZD and Z-drugs was significantly low compared to other psychotropic medications, with no therapy or non-pharmacological interventions. Our study shows that, during the antenatal and postnatal period, women required more anti-depressants, anti-psychotics, and anxiolytic drugs.
CONCLUSION
Although BZDs and Z-drugs are effective in managing insomnia during peripartum and post-partum, they are either ineffective or contraindicated for managing anxiety and depression in pregnant women compared to anxiolytics and anti-depressants.
PubMed: 38551056
DOI: 10.2174/0113862073278815240325045209 -
BMC Pregnancy and Childbirth Apr 2024Postpartum anemia, characterized by hematocrit or hemoglobin levels below the defined cutoff point (< 11gm/dl or hematocrit < 33%), is a prevalent global issue. It... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Postpartum anemia, characterized by hematocrit or hemoglobin levels below the defined cutoff point (< 11gm/dl or hematocrit < 33%), is a prevalent global issue. It serves as an indirect contributor to maternal mortality and morbidity. Mothers in the postpartum period experience diminished quality of life, impaired cognitive function, emotional instability, and an increased risk of postpartum depression due to anemia. Additionally, infants of affected mothers may face challenges such as insufficient breast milk supply and a lack of proper care. Examining the combined prevalence and factors associated with postpartum anemia is crucial for addressing maternal health risks and complications during the postnatal phase attributed to anemia.
OBJECTIVE
The study aimed to synthesize the existing literature on the prevalence and associated factors of postpartum anemia in public health facilities of Ethiopia, in 2024.
METHODS
The study was conducted by searching through the Google Scholar, PubMed, and Cochrane Library search engines. The search utilized keywords and MeSH terms such as anemia, low hemoglobin, postpartum, postnatal women, and Ethiopia. The collected data underwent analysis and comparison with the WHO criteria to determine if it met the threshold for declaring a public health concern. Heterogeneity was evaluated through the Cochran Q test and I2 statistics. Prevalence and odds ratio estimations were performed using a random-effects model with a 95% confidence interval.
RESULT
Four studies were included in this systematic review and meta-analysis. The overall pooled prevalence of anemia among postpartum women in Ethiopia was 69% (95% CI: 60- 77%).Lack of formal education(OR = 3.5;CI:2.639,4.408),Low Pre-delivery hemoglobin (OR = 4.2;CI: 1.768-6.668), Postpartum women < 4 ANC visit (OR = 2.72; 95% CI:2.14,3.3 ),history of post partum hemorrhage (OR = 2.49; CI: 1.075-3.978),history of Forceps/vacuum delivery(OR = 3.96; CI:2.986-4.947), Poor iron and folic acid adherence (OR = 2.8;95% CI:2.311,3.297), C/S (OR = 4.04; 95% CI: 3.426,4.671),lower dietary diversity (OR = 4.295% CI:1.768,6.668) were significantly associated postpartum anemia.
CONCLUSION
Postpartum women in Ethiopia continue to face a considerable public health challenge in the form of anemia. Consequently, there is a pressing need for the government to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the substantial regional disparities influenced by interconnected factors, with the aim of reducing the prevalence of anemia among postpartum women in Ethiopia.
Topics: Humans; Ethiopia; Female; Prevalence; Anemia; Postpartum Period; Risk Factors; Pregnancy; Mothers; Adult; Health Facilities
PubMed: 38678183
DOI: 10.1186/s12884-024-06525-9 -
PloS One 2023Most empirically researched interventions for postpartum depression (PPD) tend to target mothers' depression alone. Harmful effects of PPD on physical and mental health...
Comparing the effectiveness of mother-focused interventions to that of mother-child focused interventions in improving maternal postpartum depression outcomes: A systematic review.
BACKGROUND
Most empirically researched interventions for postpartum depression (PPD) tend to target mothers' depression alone. Harmful effects of PPD on physical and mental health of both mother and child has led researchers to investigate the impact of interventions on PPD and child outcomes together. So far, the evidence is limited regarding how these interventions compare with those focusing only on mothers' depression. This review compares the effectiveness of PPD-improving interventions focusing only on mothers with those focusing on mother and child together.
METHODS
Nine electronic databases were searched. Thirty-seven studies evaluating mother-focused (n = 30) and mother-child focused interventions (n = 7) were included. Under each category, three theoretical approaches-psychological, psychosocial and mixed-were compared using standardized qualitative procedures. The review's primary outcome was maternal PPD.
RESULTS
A higher proportion of mother-focussed interventions [20/30 (66.7%)] brought significant reduction in PPD outcomes as compared to a lower proportion of mother-child focused interventions [4/7 (57.14%)]. Mother-focused mixed approaches [3/3 (100%)] performed better in improving PPD than psychological [16/24 (67%)] or psychosocial approaches [1/3 (33.3%)] alone. Amongst mother-child focused interventions, psychosocial approaches performed well with two-thirds demonstrating positive effects on PPD.
CONCLUSION
The evidence strongly favors mother-focused interventions for improving PPD with mixed interventions being more effective. Psychosocial approaches performed better with PPD once child-related elements were added, and also seemed best for child outcomes. Psychological approaches were most practiced and effective for PPD, irrespective of the intervention's focus. Further trials are needed to unpack intervention components that improve PPD and increase uptake, especially in lower-and middle-income countries.
Topics: Female; Humans; Mothers; Depression, Postpartum; Postpartum Period; Mental Health; Mother-Child Relations
PubMed: 38117801
DOI: 10.1371/journal.pone.0295955 -
International Journal of Medical... May 2024Parenting self-efficacy is essential for the transition to parenthood. As digital parenting educational interventions are rapidly being developed, their effects have not... (Meta-Analysis)
Meta-Analysis Review
Effects of digital parenting interventions on self-efficacy, social support, and depressive symptoms in the transition to parenthood: A systematic review and meta-analysis.
BACKGROUND
Parenting self-efficacy is essential for the transition to parenthood. As digital parenting educational interventions are rapidly being developed, their effects have not been examined by pooling available randomized controlled trials (RCTs).
OBJECTIVES
To comprehensively investigate the effects of digital educational interventions on parents' self-efficacy, social support, and depressive symptoms in the first year after childbirth and identify the significant associated factors.
METHODS
This study searched six electronic databases for relevant RCTs examining the efficacy of digital parenting interventions from inception to September 2022. The studied outcomes included changes in parent's self-efficacy, social support, and depressive symptoms observed after participating in a digital parenting program. The random-effects model was used to pool results. Subgroup and moderator analyses were performed.
RESULTS
In total, seven RCTs enrolling 1342 participants were included. The parents who received digital parenting interventions had higher parenting self-efficacy (standardized mean difference [SMD]: 1.06, 95 % confidence interval [CI]: 0.40-1.71, p =.002) and social support (SMD: 2.72, 95 % CI: 0.38-5.07, p =.02) and decreased depressive symptoms at 3 months postpartum (SMD: -0.39, 95 % CI: -0.73 to - 0.04, p =.03). Providing the interventions for ≥ 6 weeks (SMD: 1.62, 95 % CI: 1.18-2.06, p <.001), providing in-person orientation (SMD: 1.88, 95 % CI: 1.32-2.44, p <.001), including a guided curriculum (SMD: 2.00, 95 % CI: 1.78-2.22, p <.001), and conducting interventions in Organisation for Economic Co-operation and Development countries (SMD: 1.98, 95 % CI: 1.78-2.19, p <.001) were identified as significant moderators.
CONCLUSIONS
Digital parenting interventions significantly increase parenting self-efficacy and social support as well as alleviate depressive symptoms for parents during their first year after childbirth. Such interventions can be beneficial for parents who prefer online education. Future studies investigating the long-term effects of these interventions are warranted.
REGISTRATION
The protocol for this systematic review and meta-analysis is registered in PROSPERO (registration number: CRD42021243641).
Topics: Female; Humans; Parenting; Depression; Self Efficacy; Parents; Social Support
PubMed: 38471407
DOI: 10.1016/j.ijmedinf.2024.105405 -
Clinical and Translational Allergy Mar 2024The incidence of atopic dermatitis (AD) in children is increasing. Early exposure to stress factors may be associated with the AD development. This study aimed to... (Review)
Review
BACKGROUND
The incidence of atopic dermatitis (AD) in children is increasing. Early exposure to stress factors may be associated with the AD development. This study aimed to summarize studies that reported an association between stress exposure and AD development in later life.
METHODS AND FINDINGS
A comprehensive literature search was performed using online databases (PubMed, EMBASE, PsycINFO, and Web of Science) for articles published up to May 1, 2023. Eligible studies were screened and selected based on the inclusion criteria. We incorporated cohort or case-control studies published in English which explored the relationship between stress experienced by parents or children and AD. The pooled odds ratio (OR) was calculated according to the type of stress using a random-effects model. Twenty-two studies were included. AD was related to maternal distress (OR 1.29, 95% Confidence Interval [CI]: 1.13-1.47), maternal anxiety (OR 1.31, 95% CI: 1.18-1.46), and negative life events (OR 2.00, 95% CI: 1.46-2.76). Maternal depression during pregnancy was associated with AD (OR 1.21, 95% CI: 1.09-1.33), whereas no significant association was found for postpartum depression. Research on stress experienced by paternal or children is scare.
CONCLUSIONS
Early maternal stress may potentially elevate the risk of AD in their offspring. Importantly, rigorously designed studies are required to corroborate the link between maternal stress and AD in children. These studies should aim to gather insights about the impact of stress during specific trimesters of pregnancy, postnatal stress, and paternal stress, and to identify potential prevention strategies.
PubMed: 38488856
DOI: 10.1002/clt2.12346 -
Frontiers in Pharmacology 2023As a novel antidepressant drug, zuranolone has been initially applied in treating depression. This study investigated the efficacy and safety of its administration in...
As a novel antidepressant drug, zuranolone has been initially applied in treating depression. This study investigated the efficacy and safety of its administration in patients with depression. The Embase, PubMed, and Cochrane library databases were searched for available studies up to 1 Nov 2023. The primary outcome was the change on day 15 depression severity scores compared to baseline. Secondary outcomes included remission and response rates on day 15. Safety outcomes included incidence of treatment-emergent adverse events (TEAEs) and individual AEs. Trial sequential analysis (TSA) was used to evaluate the ideal samplesize. Six studies with 1884 patients were included. Zuranolone offered significantly greater changes in day 15 depression severity scores (mean difference = 2.43, 95% confidence interval [CI]: 1.36 to 3.49, < 0.00001) compared to placebo; this was also observed at other time points. Differences in response (relative risk [RR] = 1.33, 95% CI: 1.15 to 1.54, < 0.0001) and remission (RR = 1.46, 95% CI: 1.15 to 1.85, = 0.002) rates were also statistically significant. For safety outcomes, zuranolone group showed more incidence of TEAE than the placebo group (RR: 1.15, 95% CI: 1.06 to 1.25, = 0.0005, = 0%). As for individual AEs, significant differences were observed in dizziness (RR = 2.17, 95% CI: 1.22 to 3.86, = 0.008) and somnolence (RR = 2.43, 95% CI: 1.35 to 4.37, = 0.003. No significant difference was observed in other AEs. The result of TSA indicated that the cumulative curve crossed the conventional (Z = 1.96) boundary but not reach TSA boundary (RIS = 1910). Our findings suggest that zuranolone has a rapid short-term antidepressant effect during administration. Although more TEAEs were observed in zuranolone, most of them were slight and temporary. However, studies with larger sample sizes and longer follow-up are needed. https://inplasy.com/inplasy-2023-5-0104/, identifier INPLASY202350104.
PubMed: 38288088
DOI: 10.3389/fphar.2023.1334694 -
General Hospital Psychiatry 2024Screening for perinatal depression is recommended by many guidelines to reduce the disease burden, but current implementation practices require clarification. (Review)
Review
OBJECTIVE
Screening for perinatal depression is recommended by many guidelines to reduce the disease burden, but current implementation practices require clarification.
METHOD
Fifteen databases were searched for observational studies using a pre-tested search strategy. In addition, the websites of academic organizations were searched for guidelines, recommendations, and reports. Literature published between January 1, 2010, and December 19, 2021, in either English or Chinese, was included. The standard form of the Joanna Briggs Institute (JBI) was used to assess risk of bias of the included studies.
RESULTS
The data analysis covered 103 studies, 21 guidelines, 11 recommendations, five position statements, three reports, two committee opinions, three consensuses, one consultation, and one policy statement. All but one guideline recommended that mothers be routinely screened for perinatal depression at least once during the perinatal period. In addition, 39 documents recommended that perinatal mothers at risk of perinatal depression be provided with or referred to counseling services. In original studies, however, only 8.7% of the original studies conducted routine screenings, and only one-third offered referral services after the screening process. The EPDS emerged as the most frequently used screening tool to measure perinatal depression. 32% (n = 33) of studies reported the technology used for screening. The most commonly used method was face-to-face interviews (n = 22). Screening personnel the agents conducting the screening comprised researchers (n = 26), nurses (n = 15), doctors (n = 11).
CONCLUSIONS
A significant disparity was observed between the recommendations and implementation of perinatal depression screening, highlighting the need to integrate routine screening and referral processes into maternal care services.
Topics: Humans; Pregnancy; Female; Practice Guidelines as Topic; Pregnancy Complications; Perinatal Care; Depression; Professional Practice Gaps; Depressive Disorder; Depression, Postpartum
PubMed: 38733723
DOI: 10.1016/j.genhosppsych.2024.04.011 -
BMC Pregnancy and Childbirth May 2024
PubMed: 38760768
DOI: 10.1186/s12884-024-06576-y -
PloS One 2023Postnatal depression is a significant public health issue which may escalate and lead to adverse outcomes for women, infants, their family and the wider society. The aim...
INTRODUCTION
Postnatal depression is a significant public health issue which may escalate and lead to adverse outcomes for women, infants, their family and the wider society. The aim of this review was to examine the effectiveness and experiences of mother-led infant massage on symptoms of maternal postnatal depression and to synthesise these findings to inform policy, practice and further research.
METHODS
A systematic search of five academic databases was conducted: CINAHL, MEDLINE, EMBASE, PsycINFO and Allied and Complementary Medicine Database in February 2023 with no date or geographic limiters set owing to the paucity of research on this subject area. Quality appraisal was undertaken using the Joanna Briggs Institute quality appraisal tools and all included RCT's were assessed separately using the Cochrane Risk of Bias Tool. Narrative synthesis was used to analyse the data.
FINDINGS
A total of (n = 323) studies were returned of which (n = 8) met the inclusion criteria for the review. This review identified a total sampling of (n = 521) women with maternal postnatal depression. The results are presented under three themes: 1) the effectiveness of mother-led infant massage on symptoms of postnatal depression; 2) women's experiences of mother-led infant massage; and 3) the effects of mother-led infant massage on the mother-infant relationship.
DISCUSSION
The review highlights women who used infant massage displayed a reduction in symptoms of postnatal depression, improved mother-infant interactions and improved self-efficacy in addition to benefits for infants. Public Health Nurse/Community Midwife-led infant massage may help to relieve such symptoms and empower women.
Topics: Infant; Humans; Female; Depression, Postpartum; Mothers; Mother-Child Relations; Massage
PubMed: 38091329
DOI: 10.1371/journal.pone.0294156