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Brain, Behavior, and Immunity Jul 2024Postpartum depression (PPD) is a severe mental disorder that affects approximately 10---20% of women after childbirth. The precise mechanism underlying PPD pathogenesis...
Postpartum depression (PPD) is a severe mental disorder that affects approximately 10---20% of women after childbirth. The precise mechanism underlying PPD pathogenesis remains elusive, thus limiting the development of therapeutics. Gut microbiota dysbiosis is considered to contribute to major depressive disorder. However, the associations between gut microbiota and PPD remain unanswered. Here, we established a mouse PPD model by sudden ovarian steroid withdrawal after hormone-simulated pseudopregnancy-human (HSP-H) in ovariectomy (OVX) mouse. Ovarian hormone withdrawal induced depression-like and anxiety-like behaviors and an altered gut microbiota composition. Fecal microbiota transplantation (FMT) from PPD mice to antibiotic cocktail-treated mice induced depression-like and anxiety-like behaviors and neuropathological changes in the hippocampus of the recipient mice. FMT from healthy mice to PPD mice attenuated the depression-like and anxiety-like behaviors as well as the inflammation mediated by the NOD-like receptor protein (NLRP)-3/caspase-1 signaling pathway both in the gut and the hippocampus, increased fecal short-chain fatty acids (SCFAs) levels and alleviated gut dysbiosis with increased SCFA-producing bacteria and reduced Akkermansia in the PPD mice. Also, downregulation of NLRP3 in the hippocampus mitigated depression-like behaviors in PPD mice and overexpression of NLRP3 in the hippocampal dentate gyrus induced depression-like behaviors in naïve female mice. Intriguingly, FMT from healthy mice failed to alleviate depression-like behaviors in PPD mice with NLRP3 overexpression in the hippocampus. Our results highlighted the NLRP3 inflammasome as a key component within the microbiota-gut-brain axis, suggesting that targeting the gut microbiota may be a therapeutic strategy for PPD.
Topics: Animals; Female; Dysbiosis; Hippocampus; Mice; Gastrointestinal Microbiome; NLR Family, Pyrin Domain-Containing 3 Protein; Disease Models, Animal; Fecal Microbiota Transplantation; Depression, Postpartum; Mice, Inbred C57BL; Depression; Neuroinflammatory Diseases; Behavior, Animal; Anxiety; Brain-Gut Axis; Inflammation; Ovariectomy
PubMed: 38599497
DOI: 10.1016/j.bbi.2024.04.002 -
The Journal of Maternal-fetal &... Dec 2023Maternal hypothyroidism has been associated with multiple adverse pregnancy outcomes. These findings have not been confirmed in a large population database study....
BACKGROUND
Maternal hypothyroidism has been associated with multiple adverse pregnancy outcomes. These findings have not been confirmed in a large population database study. Therefore, a large population-based cohort study was established to study the associations between maternal hypothyroidism and pregnancy and perinatal complications.
METHODS
This is a retrospective population-based cohort study utilizing data from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) over 11 years from 2004 to 2014. A cohort of all deliveries between 2004 and 2014 inclusive, was created. Within this group, all deliveries to women with hypothyroidism were identified as part of the study group ( = 184,869), and the remaining deliveries were categorized as non-hypothyroidism births and comprised the reference group ( = 8,911,919). The main outcome measures were pregnancy and perinatal complications.
RESULTS
Maternal hypothyroidism is associated with several pregnancy and perinatal complications, including gestational diabetes mellitus (aOR 1.43, 95%CI 1.38-1.47), gestational hypertension (aOR 1.17, 95%CI 1.11-1.22) and preeclampsia (aOR 1.21, 95%CI 1.16-1.27) (all < 0.001). These patients are more likely to experience preterm premature rupture of membranes (aOR 1.19, 95%CI 1.09-1.29, < 0.001), preterm delivery (aOR 1.12 95%CI 1.08-1.17, < 0.001), are more likely to deliver by cesarean section (aOR 1.21, 95% CI 1.18-1.24, < 0.001), and suffer from postpartum hemorrhage (aOR 1.07, 95%CI 1.01-1.13, = 0.012), disseminated intravascular coagulation (aOR 1.20, 95%CI 1.00-1.43, = 0.046), and undergo hysterectomy (aOR 1.42, 95% CI 1.13-1.80, = 0.003).As for neonatal outcomes, small for gestational age and congenital anomalies are more likely to occur in the offspring of women with hypothyroidism (aOR 1.20, 95% CI 1.14-1.27 and aOR 1.34, 95% CI 1.22-1.48, both < 0.001).
CONCLUSIONS
Women with hypothyroidism are more likely to experience pregnancy, delivery and neonatal complications. We found an association between hypothyroidism and hypertensive disorders, postpartum hemorrhage, transfusions, infections, preterm delivery and hysterectomy, among other problems. This data from a population sized database confirms the findings of smaller previous studies in the literature.
Topics: Infant, Newborn; Pregnancy; Humans; Female; Pregnancy Complications; Premature Birth; Cesarean Section; Retrospective Studies; Postpartum Hemorrhage; Cohort Studies; Pregnancy Outcome; Hypothyroidism
PubMed: 37935517
DOI: 10.1080/14767058.2023.2278027 -
Schweizer Archiv Fur Tierheilkunde Jul 2023Determination of somatic cell counts (SCC) becomes more and more important also for ewe's milk. SCC can be a useful indicator of milk quality for milk processors while...
Determination of somatic cell counts (SCC) becomes more and more important also for ewe's milk. SCC can be a useful indicator of milk quality for milk processors while it can be a mastitis indicator for sheep keepers and an important selection criterion for breeders. The objective of our study was to acquire basic information about factors influencing SCC variability in lambing ewes of the Tsigai (T) and Improved Valachian (IV) breeds. Somatic cell counts (SCC) were determined in 866 milk samples in 2017 and 2018, during lamb sucking and during milking period. An instrument Fossomatic 90 (Foss Electric, Hillerød, Denmark) was used for analysis. Average SCC varied from 270 to 1897 × 103 cells/ml during lamb sucking and from 268 to 2139 × 103 cells/ml during milking period. Differences between the sampling periods were statistically significant in 2017. An increase in SCC was observed at the end of both sucking and milking periods. An overall evaluation of lactation brought about the average SCC at 364 × 103 cells/ml in 2017 (log(10) SCC - 2,25) and at 1,091 × 103 cells/ml in 2018 (log(10) SCC - 2,68). The indicator log(10) was significantly influenced by breed in 2017 (T - 2,61; IV - 2,75). The effect of lactation number and number of sucking lambs did not have any significant influence on SCC.
Topics: Sheep; Animals; Female; Milk; Lactation; Mastitis; Cell Count; Sheep Diseases
PubMed: 37403592
DOI: 10.17236/sat00400 -
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 -
Comprehensive Psychiatry Apr 2024Peripartum depression (PPD) is a major depression disorder (MDD) episode with onset during pregnancy or within four weeks after childbirth, as defined in DSM-5. However,... (Review)
Review
BACKGROUND
Peripartum depression (PPD) is a major depression disorder (MDD) episode with onset during pregnancy or within four weeks after childbirth, as defined in DSM-5. However, research suggests that PPD may be a distinct diagnosis. The goal of this study was to summarize the similarities and differences between PPD and MDD by synthesizing the current research on PPD diagnosis concerning different clinical features and give directions for improving diagnosis of PPD in clinical practice.
METHODS
To lay the groundwork for this narrative review, several databases were searched using general search phrases on PPD and its components of clinical diagnosis.
RESULTS
When compared to MDD, peripartum depression exhibits several distinct characteristics. PPD manifests with a variety of symptoms, i.e., more anxiety, psychomotor symptoms, obsessive thoughts, impaired concentration, fatigue and loss of energy, but less sad mood and suicidal ideation, compared to MDD. Although PPD and MDD prevalence rates are comparable, there are greater cross-cultural variances for PPD. Additionally, PPD has some distinct risk factors and mechanisms such as distinct ovarian tissue expression, premenstrual syndrome, unintended pregnancy, and obstetric complications.
CONCLUSION
There is a need for more in-depth research comparing MDD with depression during pregnancy and the entire postpartum year. The diagnostic criteria should be modified, particularly with (i) addition of specific symptoms (i.e., anxiety), (ii) onset specifier extending to the first year following childbirth, (iii) and change the peripartum onset specifier to either "pregnancy onset" or "postpartum onset". Diagnostic criteria for PPD are further discussed.
Topics: Pregnancy; Female; Humans; Depression, Postpartum; Depression; Peripartum Period; Depressive Disorder, Major; Postpartum Period; Risk Factors
PubMed: 38306851
DOI: 10.1016/j.comppsych.2024.152456 -
Asian Journal of Surgery Sep 2023
Topics: Female; Humans; Granulomatous Mastitis
PubMed: 37080808
DOI: 10.1016/j.asjsur.2023.04.008 -
Journal of Affective Disorders Nov 2023There is a need for effective interventions to reduce symptomatology of postpartum depression. The objective of this study was to test whether providing an ergonomic... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
There is a need for effective interventions to reduce symptomatology of postpartum depression. The objective of this study was to test whether providing an ergonomic infant carrier would reduce postpartum depression symptomatology.
METHODS
A randomized two-arm, parallel-group trial with 100 participants was conducted between February 2018 and June 2019 in a low-income community. At 30-weeks' gestation, 50 participants were randomly assigned to receive an ergonomic infant carrier and instructions on proper use (intervention group), and 50 participants were assigned to a waitlist (control group). Participants tracked the extent of their infant carrier use and completed the Edinburgh Postpartum Depression Scale (EPDS) to assess postpartum depression symptomatology at 6-weeks postpartum.
RESULTS
Participants in the intervention group reported using an infant carrier significantly more often than the control group (β = 2.69, SE = 0.347, p < .001, 95 % CI = 2.08-3.41). The intervention group reported fewer depressive symptoms at 6-weeks postpartum than the control group (β = -0.541, p = .042).
LIMITATIONS
The sample size was relatively small and thus our results may not be generalizable to the general population.
CONCLUSION
Infant carrying may be a cost-effective intervention to reduce postpartum depression symptomatology. Large-scale studies are warranted to further examine the efficacy and cost-effectiveness of providing carriers as an intervention to reduce postpartum depression symptomatology.
CLINICAL TRIAL REGISTRATION
Clinicaltrials.gov id: NCT04376021. Data Sharing Statement: Deidentified individual participant data will not be made available because we did not obtain permission to share individual data.
CLINICAL TRIAL REGISTRATION NUMBER
NCT0437602; https://beta.
CLINICALTRIALS
gov/study/NCT04376021.
Topics: Female; Humans; Infant; Depression, Postpartum; Postpartum Period; Psychiatric Status Rating Scales
PubMed: 37586649
DOI: 10.1016/j.jad.2023.08.044 -
JAMA Network Open Nov 2023Postpartum depression (PPD) is a debilitating condition with higher rates among Black individuals. Increasingly, neighborhood disadvantage is being recognized as a...
IMPORTANCE
Postpartum depression (PPD) is a debilitating condition with higher rates among Black individuals. Increasingly, neighborhood disadvantage is being recognized as a contributor to poor health and may be associated with adverse postpartum mental health; however, associations between neighborhood disadvantage, race and ethnicity, and PPD have not been examined.
OBJECTIVE
To investigate the association between neighborhood disadvantage and PPD and evaluate the extent to which these associations may differ by race and ethnicity.
DESIGN, SETTING, AND PARTICIPANTS
This population-based cross-sectional study included 122 995 postpartum Kaiser Permanente Northern California members 15 years or older with a live birth between October 7, 2012, and May 31, 2017, and an address in the electronic health record. Analyses were conducted from June 1, 2022, through June 30, 2023.
EXPOSURES
Neighborhood disadvantage defined using quartiles of the Neighborhood Deprivation Index (NDI), a validated census-based socioeconomic status measure; self-reported race and ethnicity ascertained from Kaiser Permanente Northern California electronic health records.
MAIN OUTCOMES AND MEASURES
Multivariable Poisson regression was conducted to assess associations between neighborhood disadvantage, race and ethnicity, and a diagnosis of PPD.
RESULTS
Of 122 995 included postpartum individuals, 17 554 (14.3%) were younger than 25 years, 29 933 (24.3%) were Asian, 8125 (6.6%) were Black, 31 968 (26.0%) were Hispanic, 47 527 (38.6%) were White, 5442 (4.4%) were of other race and ethnicity, and 15 436 (12.6%) had PPD. Higher neighborhood disadvantage and race and ethnicity were associated with PPD after covariate adjustment. Compared with White individuals, Black individuals were more likely to have PPD (adjusted relative risk [ARR], 1.30; 95% CI, 1.24-1.37), whereas Asian (ARR, 0.48; 95% CI, 0.46-0.50), and Hispanic (ARR, 0.92; 95% CI, 0.89-0.96) individuals and those identified as having other race and ethnicity (ARR, 95% CI, 0.90; 0.85-0.98) were less likely to have PPD. Associations between NDI and PPD differed by race and ethnicity (likelihood ratio test for interaction, χ212 = 41.36; P < .001). Among Black individuals, the risk of PPD was the greatest overall and increased with neighborhood disadvantage in a dose-response manner (quartile [Q] 2 ARR, 1.39 [95% CI, 1.13-1.71]; Q3 ARR, 1.50 [95% CI, 1.23-1.83]; Q4 ARR, 1.60 [95% CI, 1.32-1.93]; Cochrane-Armitage test for trend, P < .001). Neighborhood disadvantage was associated with PPD among Asian (Q2 ARR, 1.17 [95% CI, 1.04-1.31]; Q3 ARR, 1.20 [95% CI, 1.06-1.35]) and White (Q3 ARR, 1.14 [95% CI, 1.07-1.21]; Q4 ARR, 1.17 [95% CI, 1.09-1.26]) individuals and those of other race and ethnicity (Q3 ARR, 1.34 [95% CI, 1.09-1.63]; Q4 ARR, 1.28 [95% CI, 1.03-1.58]), but the magnitude of risk was lower. Neighborhood disadvantage was not associated with PPD among Hispanic individuals (eg, Q2 ARR, 1.04 [95% CI, 0.94-1.14]; Q3 ARR, 1.00 [95% CI, 0.91-1.10]; Q4 ARR, 0.98 [95% CI, 0.90-1.08]).
CONCLUSIONS AND RELEVANCE
In this cross-sectional study of postpartum individuals, residing in more disadvantaged neighborhoods was associated with PPD, except among Hispanic individuals. Neighborhood disadvantage may be associated with racial and ethnic differences in postpartum mental health. Geographic targeting of mental health interventions may decrease postpartum mental health inequities.
Topics: Female; Humans; Pregnancy; Cross-Sectional Studies; Depression, Postpartum; Ethnicity; Neighborhood Characteristics; Racial Groups; California
PubMed: 37955900
DOI: 10.1001/jamanetworkopen.2023.42398 -
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 -
Archives of Women's Mental Health Aug 2023Social support is an influential component of postpartum recovery, adjustment, and bonding, which was disrupted by social distancing recommendations related to the...
Social support is an influential component of postpartum recovery, adjustment, and bonding, which was disrupted by social distancing recommendations related to the COVID-19 pandemic. This study reports on changes in the availability of social support for postpartum women during the pandemic, investigates how those changes may have contributed to postpartum mental health, and probes how specific types of social support buffered against poor postpartum mental health and maternal-infant bonding impairment. Participants were 833 pregnant patients receiving prenatal care in an urban USA setting and using an electronic patient portal to access self-report surveys at two time points, during pregnancy (April-July 2020) and at ~12 weeks postpartum (August 2020-March 2021). Measures included an assessment of COVID-19 pandemic-related change in social support, sources of social support, ratings of emotional and practical support, and postpartum outcomes including depression, anxiety, and maternal-infant bonding. Overall self-reported social support decreased during the pandemic. Decreased social support was associated with an increased risk of postpartum depression, postpartum anxiety, and impaired parent-infant bonding. Among women reporting low practical support, emotional support appeared to protect against clinically significant depressive symptoms and impaired bonding with the infant. Decreases in social support are associated with a risk for poor postpartum mental health outcomes and impaired maternal-infant bonding. Evaluation and promotion of social support are recommended for healthy adjustment and functioning of postpartum women and families.
Topics: Pregnancy; Infant; Female; Humans; Pandemics; Mother-Child Relations; COVID-19; Postpartum Period; Depression, Postpartum; Anxiety; Social Support; Outcome Assessment, Health Care; Depression
PubMed: 37268777
DOI: 10.1007/s00737-023-01330-3