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PloS One 2023Aerobic exercise is widely recognized for improving mental health and reducing negative emotions, including anxiety. However, research on its role in preventing and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Aerobic exercise is widely recognized for improving mental health and reducing negative emotions, including anxiety. However, research on its role in preventing and treating postpartum depression (PPD) has yielded inconsistent results. Some studies show positive effects on PPD symptoms, while others find limited impact, suggesting various factors at play, such as exercise type, intensity, and individual differences. To address this gap, our study aims to comprehensively gather evidence on the preventive and therapeutic effects of aerobic exercise for PPD. We'll focus on differences in exercise program design and implementation, exploring how these factors impact intervention outcomes. By identifying effective exercise approaches, we aim to provide more comprehensive exercise prescription recommendations for this vulnerable population.
METHODS
We conducted a quantitative systematic review of the study in 5 representative databases for the effect of aerobic exercise on PPD. Meta-analysis and network meta-analysis were performed with Review-Manager.5.4 and Stata.16.0 software, respectively. This study has been registered on the official Prospero website, and the registration code is CRD42023398221.
RESULTS
Twenty-six studies with 2,867 participants were eventually included and the efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care. (MD = -1.90; 95%CL: -2.58 to -1.21; I2 = 86%). Subgroup analysis suggests that the intervention objective (prevention vs. treatment) of exercise could potentially be a source of heterogeneity in this study, as the "Test for subgroup difference" revealed the presence of significant distinctions (p = 0.02<0.05). The "Test for subgroup difference" yielded non-significant results for both the supervised vs. unsupervised subgroup comparison (p = 0.55 > 0.05) and the individual vs. team subgroup comparison (p = 0.78 > 0.05). Nonetheless, when assessing their effect sizes [Subtotal (95%CL)], the supervised exercise group [-1.66 (-2.48, -0.85)] exhibited a slightly better performance than the unsupervised exercise group [-1.37 (-1.86, -0.88)], while the team exercise group [-1.43 (-1.94, -0.93)] slightly outperformed the individual exercise group [-1.28 (-2.23, -0.33)]. Network meta-analysis indicated that moderate intensity (35~45 min) group demonstrated a more pronounced intervention effect compared to low intensity (50~60 min) group [-2.63 (-4.05, -1.21)] and high intensity (20~30 min) group [-2.96 (-4.51, -1.41)], while the 3~4 times/week group had a more significant intervention effect compared to 1~2 times/week groups [-2.91 (-3.99, -1.83)] and 5~6 times/week groups [-3.28 (-4.75, -1.81)]. No significant differences were observed in pairwise comparisons of intervention effects among the five common types of aerobic exercises. (95%CL including 0). The Surface Under the Cumulative Ranking curve (SUCRA) results align with the findings mentioned above and will not be reiterated here.
CONCLUSION
The efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care, with a greater emphasis on prevention. The optimal prescribed exercise volume for intervention comprises a frequency of 3~4 exercise sessions per week, moderate intensity (35~45 minutes). Currently, several uncharted internal factors influence the optimal intervention effect of aerobic exercise, such as the potential enhancement brought by team-based and supervised exercise. Given the absence of significant differences in certain results and the limitations of the study, it is essential to exercise caution when interpreting the outcomes. Further research is needed in the future to provide a more comprehensive understanding.
Topics: Female; Humans; Depression, Postpartum; Network Meta-Analysis; Exercise; Exercise Therapy
PubMed: 38019729
DOI: 10.1371/journal.pone.0287650 -
BMC Pregnancy and Childbirth Jun 2024Postpartum depression is a complex mental health condition that often occurs after childbirth and is characterized by persistent sadness, anxiety, and fatigue. Recent...
BACKGROUND
Postpartum depression is a complex mental health condition that often occurs after childbirth and is characterized by persistent sadness, anxiety, and fatigue. Recent research suggests a metabolic component to the disorder. This study aims to investigate the causal relationship between blood metabolites and postpartum depression using mendelian randomization (MR).
METHODS
This study used a bi-directional MR framework to investigate the causal relationship between 1,400 metabolic biomarkers and postpartum depression. We used two specific genome-wide association studies datasets: one with single nucleotide polymorphisms data from mothers diagnosed with postpartum depression and another with blood metabolite data, both of which focused on people of European ancestry. Genetic variants were chosen as instrumental variables from both datasets using strict criteria to improve the robustness of the MR analysis. The combination of these datasets enabled a thorough examination of genetic influences on metabolic profiles associated with postpartum depression. Statistical analyses were conducted using techniques such as inverse variance weighting, weighted median, and model-based estimation, which enabled rigorous causal inference from the observed associations. postpartum depression was defined using endpoint definitions approved by the FinnGen study's clinical expert groups, which included leading experts in their respective medical fields.
RESULTS
The MR analysis identified seven metabolites that could be linked to postpartum depression. Out of these, one metabolite was found to be protective, while six were associated with an increased risk of developing the condition. The results were consistent across multiple MR methods, indicating a significant correlation.
CONCLUSIONS
This study emphasizes the potential of metabolomics for understanding postpartum depression. The discovery of specific metabolites associated with the condition sheds new insights on its pathophysiology and opens up possibilities for future research into targeted treatment strategies.
Topics: Humans; Depression, Postpartum; Female; Mendelian Randomization Analysis; Genome-Wide Association Study; Polymorphism, Single Nucleotide; Metabolomics; Biomarkers; Adult; White People; Pregnancy
PubMed: 38877415
DOI: 10.1186/s12884-024-06628-3 -
European Journal of Clinical Nutrition Apr 2024To determine the prevalence of eating disorders and orthorexia in postpartum women and examine the relationship with postpartum depression.
OBJECTIVE
To determine the prevalence of eating disorders and orthorexia in postpartum women and examine the relationship with postpartum depression.
STUDY DESIGN
Included in this study were 227 postpartum women. The Eating Attitude Test-26 (EAT-26) was used to determine the risk of eating disorders in the women, followed by the Orthorexia 11 Scale (ORTO-11) to identify orthorexia, and the Edinburgh Postpartum Depression Scale (EPDS) to identify postpartum depression.
RESULTS
63 of the women (27.8%) exhibited an orthorexic tendency, which was also related to eating disorders and postpartum depression. Each one-point increase in the EAT-26 score led to a decrease of 0.32 points in the ORTO-11 score. Similarly, each one-point increase in the EPDS score caused a reduction of 0.18 points in the ORTO-11 score. The ORTO-11 score increased by 0.26 points per each live birth.
CONCLUSION
An obsessive focus on healthful nutrition may result in the impairment of health and numerous adverse psychological and physiological outcomes in the future. Healthy eating habits should be maintained to improve the quality of life without causing an obsession with healthy eating.
Topics: Humans; Female; Health Behavior; Depression, Postpartum; Quality of Life; Depression; Feeding Behavior; Feeding and Eating Disorders; Postpartum Period; Surveys and Questionnaires
PubMed: 38093097
DOI: 10.1038/s41430-023-01384-7 -
Journal of Psychosomatic Obstetrics and... Dec 2023This study aimed to examine the association between social support, postpartum depression (PPD), anxiety and perceived stress among women within 12 months of childbirth...
PURPOSE
This study aimed to examine the association between social support, postpartum depression (PPD), anxiety and perceived stress among women within 12 months of childbirth in South Korea.
METHODS
A cross-sectional, web-based survey was conducted from 21 to 30 September 2022 and included women within 12 months of childbirth in Chungnam Province, South Korea. A total of 1486 participants were included. Multiple linear regression models were used to evaluate the association between social support and mental health.
RESULTS
In total, 40.0% of the participants had mild to moderate PPD; 12.0%, anxiety symptoms; and 8.2%, perceived severe stress. Social support (from family and significant others) is significantly associated with PPD, anxiety and perceived severe stress. Current maternal health problems, unplanned pregnancy and low household income were risk factors for PPD, anxiety and perceived stress. The increase in the time elapsed after childbirth showed a positive association with PPD and perceived severe stress.
CONCLUSIONS
Our findings provide insights to identify at-risk mothers and emphasize the importance of social support in families, early screening and continuous monitoring for postpartum women to prevent PPD, anxiety and stress.
Topics: Pregnancy; Female; Humans; Depression, Postpartum; Cross-Sectional Studies; Postpartum Period; Mothers; Anxiety; Risk Factors; Social Support; Stress, Psychological
PubMed: 37428880
DOI: 10.1080/0167482X.2023.2231629 -
Canadian Journal of Anaesthesia =... Dec 2023Peripartum pain has been associated with postpartum depression (PPD), and labour epidural analgesia (LEA) may be able to modify this risk. The objective of this...
PURPOSE
Peripartum pain has been associated with postpartum depression (PPD), and labour epidural analgesia (LEA) may be able to modify this risk. The objective of this historical cohort study was to examine the association between LEA and PPD among primiparous patients.
METHODS
With institutional research ethics board approval, a provincial perinatal database was searched for primiparous patients who delivered a liveborn singleton infant between 2004 and 2018. Those patients who experienced PPD following their first delivery were identified by a history of PPD in the perinatal records of their second pregnancy. We used logistic regression to compute odds ratios (ORs) for the association between LEA and PPD and performed an adjusted analysis to control for confounding variables.
RESULTS
A total of 35,437 primiparous patients were identified, 67% (n = 23,599) of whom received LEA. In the cohort, 3.7% (n = 1,296) of patients developed PPD. Patients who received LEA had increased odds of developing PPD compared with patients who did not receive LEA (adjusted OR, 1.29; 95% confidence interval [CI], 1.12 to 1.48). In a multivariable regression model, LEA remained a significant predictor for PPD, as did body mass index, pre-existing anxiety, and maternal antidepressant use.
CONCLUSION
This historical cohort study found an association between LEA and PPD among primiparous patients who subsequently had a second pregnancy in the same province. The findings call into question the hypothesis that LEA decreases the risk for PPD and further illustrates the complexities of PPD.
Topics: Pregnancy; Female; Humans; Analgesia, Epidural; Cohort Studies; Depression, Postpartum; Labor, Obstetric; Anxiety
PubMed: 37726496
DOI: 10.1007/s12630-023-02568-2 -
The Journal of Rheumatology Oct 2023To examine postpartum depression (PPD) among women with axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), or rheumatoid arthritis (RA) in comparison with a...
OBJECTIVE
To examine postpartum depression (PPD) among women with axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), or rheumatoid arthritis (RA) in comparison with a matched population without rheumatic disease (RD).
METHODS
A retrospective analysis using the 2013-2018 IBM MarketScan Commercial Claims and Encounters Database was conducted. Pregnant women with axSpA, PsA, or RA were identified, and the delivery date was used as the index date. We restricted the sample to women ≤ 55 years with continuous enrollment ≥ 6 months before date of last menstrual period and throughout pregnancy. Each patient was matched with 4 individuals without RD on: (1) maternal age at delivery, (2) prior history of depression, and (3) duration of depression before delivery. Cox frailty proportional hazards models estimated the crude and adjusted hazard ratios (aHR) and 95% CI of incident postpartum depression within 1 year among women with axSpA, PsA, or RA (axSpA/PsA/RA cohort) compared to the matched non-RD comparison group.
RESULTS
Overall, 2667 women with axSpA, PsA, or RA and 10,668 patients without any RD were included. The median follow-up time in days was 256 (IQR 93-366) and 265 (IQR 99-366) for the axSpA/PsA/RA cohort and matched non-RD comparison group, respectively. Development of PPD was more common in the axSpA/PsA/RA cohort relative to the matched non-RD comparison group (axSpA/PsA/RA cohort: 17.2%; matched non-RD comparison group: 12.8%; aHR 1.22, 95% CI 1.09-1.36).
CONCLUSION
Postpartum depression is significantly higher in women of reproductive age with axSpA/PsA/RA when compared to those without RD.
Topics: Humans; Female; Pregnancy; Arthritis, Psoriatic; Cohort Studies; Retrospective Studies; Depression, Postpartum; Arthritis, Rheumatoid; Axial Spondyloarthritis; Spondylarthritis
PubMed: 37399461
DOI: 10.3899/jrheum.2023-0105 -
The Journal of Maternal-fetal &... Dec 2023To describe the prevalence and predictors of postpartum sleep disorders.
OBJECTIVE
To describe the prevalence and predictors of postpartum sleep disorders.
DESIGN
A retrospective cohort study.
SETTING
Postpartum.
POPULATION
Commercially insured women delivering in California (USA) between 2011 and 2014.
METHODS
Using the Optum Clinformatics Datamart Database.
MAIN OUTCOME MEASURES
Prevalence of a postpartum sleep disorder diagnosis with and without a depression diagnosis up to 12 months following hospital discharge for inpatient delivery. We also identified predictors of a postpartum sleep disorder diagnosis using multivariable logistic regression.
RESULTS
We identified 3535 (1.9%) women with a postpartum sleep disorder diagnosis. The prevalence of sleep disorder diagnoses was insomnia (1.3%), sleep apnea (0.25%), and other sleep disorder (0.25%). The odds of a postpartum sleep disorder were highest among women with a history of drug abuse (adjusted odds ratio (aOR): 2.70, 95% confidence interval (CI): 1.79-4.09); a stillbirth delivery (aOR: 2.15, 95% CI: 1.53-3.01); and chronic hypertension (aOR: 1.82; 95% CI: 1.57-2.11). A comorbid diagnosis of a postpartum sleep disorder and depression occurred in 1182 women (0.6%). These women accounted for 33.4% of all women with a postpartum sleep disorder. The strongest predictors of a comorbid diagnosis were a history of drug abuse (aOR: 4.13; 95% CI: 2.37-7.21) and a stillbirth delivery (aOR: 2.93; 95% CI: 1.74-4.92).
CONCLUSIONS
Postpartum sleep disorders are underdiagnosed conditions, with only 2% of postpartum women in this cohort receiving a sleep diagnosis using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Insomnia was the most common disorder and one-third of women diagnosed with a postpartum sleep disorder had a co-morbid diagnosis of depression. Future studies are needed to improve the screening and diagnostic accuracy of postpartum sleep disorders.
Topics: Pregnancy; Humans; Female; Male; Prevalence; Retrospective Studies; Sleep Initiation and Maintenance Disorders; Stillbirth; Postpartum Period; Puerperal Disorders; Sleep Wake Disorders; Substance-Related Disorders; Sleep; Depression, Postpartum
PubMed: 36710393
DOI: 10.1080/14767058.2023.2170749 -
Journal of Affective Disorders Oct 2023The current study endeavored to systematically integrate and quantitatively evaluate the effectiveness of interpersonal psychological interventions for postpartum... (Review)
Review
BACKGROUND
The current study endeavored to systematically integrate and quantitatively evaluate the effectiveness of interpersonal psychological interventions for postpartum depression patients.
METHODS
Four electronic databases Pubmed, Embase, Cochrane and Web of Science were employed for literature retrieval, and the search time was from the inception of the database to May 30, 2022. Literature screening and data extraction were performed independently by two researchers.
RESULTS
A total of 528 studies were screened, and 9 of them were finally included. There were 1012 subjects, 518 of them were assigned in experimental group and 494 in control. Evidence from interpersonal psychological interventions indicated that the data on postpartum depression, satisfaction with family, and social support in both groups after intervention included: depression score [MD = -2.80, 95%CI (-3.86 to -1.74), P < 0.05], satisfaction score [MD = 8.41, 95%CI (1.49 to -15.33), P < 0.05], and social support score [MD = 1.83, 95%CI (-2.10 to -5.76)] of postpartum depression patients. P values < 0.05 indicated substantial improvement as compared to control.
LIMITATIONS
During the research process, it is impossible for the experimental group and the researchers to use double-blind trials simultaneously, which may present a Hawthorne effect, but this can be avoided by general psychological intervention for the control.
CONCLUSIONS
Interpersonal psychotherapy could improve depression in patients with postpartum depression, but the appropriate intervention time was between 4 and 8 weeks, and it also improved satisfaction with family of patients, and the longer the intervention, the higher the satisfaction with the family.
Topics: Female; Humans; Depression, Postpartum; Psychotherapy; Depression; Interpersonal Psychotherapy; Social Support; Randomized Controlled Trials as Topic
PubMed: 37459968
DOI: 10.1016/j.jad.2023.07.067 -
Scientific Reports Feb 2024Postpartum Depression Disorder (PPDD) is a prevalent mental health condition and results in severe depression and suicide attempts in the social community. Prompt...
Postpartum Depression Disorder (PPDD) is a prevalent mental health condition and results in severe depression and suicide attempts in the social community. Prompt actions are crucial in tackling PPDD, which requires a quick recognition and accurate analysis of the probability factors associated with this condition. This concern requires attention. The primary aim of our research is to investigate the feasibility of anticipating an individual's mental state by categorizing individuals with depression from those without depression using a dataset consisting of text along with audio recordings from patients diagnosed with PPDD. This research proposes a hybrid PPDD framework that combines Improved Bi-directional Long Short-Term Memory (IBi-LSTM) with Transfer Learning (TL) based on two Convolutional Neural Network (CNN) architectures, respectively CNN-text and CNN audio. In the proposed model, the CNN section efficiently utilizes TL to obtain crucial knowledge from text and audio characteristics, whereas the improved Bi-LSTM module combines written material and sound data to obtain intricate chronological interpersonal relationships. The proposed model incorporates an attention technique to augment the effectiveness of the Bi-LSTM scheme. An experimental analysis is conducted on the PPDD online textual and speech audio dataset collected from UCI. It includes textual features such as age, women's health tracks, medical histories, demographic information, daily life metrics, psychological evaluations, and 'speech records' of PPDD patients. Data pre-processing is applied to maintain the data integrity and achieve reliable model performance. The proposed model demonstrates a great performance in better precision, recall, accuracy, and F1-score over existing deep learning models, including VGG-16, Base-CNN, and CNN-LSTM. These metrics indicate the model's ability to differentiate among women at risk of PPDD vs. non-PPDD. In addition, the feature importance analysis demonstrates that specific risk factors substantially impact the prediction of PPDD. The findings of this research establish a basis for improved precision and promptness in assessing the risk of PPDD, which may ultimately result in earlier implementation of interventions and the establishment of support networks for women who are susceptible to PPDD.
Topics: Humans; Female; Depression, Postpartum; Prevalence; Deep Learning; Risk Factors; Depressive Disorder
PubMed: 38402249
DOI: 10.1038/s41598-024-54927-8 -
Journal of Psychosomatic Obstetrics and... Dec 2023Postpartum depression (PPD) is classified under postpartum psychiatric disorders and initiates soon after birthing, eliciting neuropsychological and behavioral deficits... (Review)
Review
Postpartum depression (PPD) is classified under postpartum psychiatric disorders and initiates soon after birthing, eliciting neuropsychological and behavioral deficits in mothers and offspring. Globally, PPD is estimated to be associated with 130-190 per 1000 birthing. The severity and incidences of PPD have aggravated in the recent years due to the several unfavorable environmental and geopolitical circumstances. The purpose of this systematic review hence is to explore the contributions of recent circumstances on the pathogenesis and incidence of PPD. The search, selection and retrieval of the articles published during the last three years were systematically performed. The results from the primary studies indicate that unfavorable contemporary socio-geopolitical and environmental circumstances (e.g. Covid-19 pandemic, political conflicts/wars, and natural calamities; such as floods and earthquakes) detrimentally affect PPD etiology. A combination of socio-economic and psychological factors, including perceived lack of support and anxiousness about the future may contribute to drastic aggravation of PPD incidences. Finally, we outline some of the potential treatment regimens (e.g. inter-personal psycho- and art-based therapies) that may prove to be effective in amelioration of PPD-linked symptoms in birthing women, either alone or in complementation with traditional pharmacological interventions. We propose these psychological and art-based intervention strategies may beneficially counteract the negative influences of the unfortunate recent events across multiple cultures, societies and geographical regions.
Topics: Female; Humans; Depression, Postpartum; Pandemics; Incidence; Postpartum Period; Mothers; Risk Factors; Natural Disasters
PubMed: 38050938
DOI: 10.1080/0167482X.2023.2278016