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Current Psychiatry Reports Dec 2022As maternal mortality climbs in the USA with mental health conditions driving these preventable deaths, the field of reproductive psychiatry must shift towards... (Review)
Review
PURPOSE OF REVIEW
As maternal mortality climbs in the USA with mental health conditions driving these preventable deaths, the field of reproductive psychiatry must shift towards identification of women and other birthing individuals at risk and facilitating access. This review brings together recent studies regarding risk of perinatal depression and highlights important comorbidities that place individuals at higher vulnerability to poor perinatal outcomes.
RECENT FINDINGS
Recent research suggests that identifying risk for perinatal depression including historical diagnoses of depression, anxiety, trauma, and comorbid substance use and intimate partner violence may move the field to focus on preventive care in peripartum populations. Emerging data shows stark health inequities in racial and ethnic minority populations historically marginalized by the health system and in other vulnerable groups such as LGBTQ+ individuals and those with severe mental illness. Innovative models of care using systems-level approaches can provide opportunities for identification and risk analyses of vulnerable peripartum patients and facilitate access to therapeutic or preventive interventions. Utilizing intergenerational approaches and leveraging multidisciplinary teams that thoughtfully target high-risk women and other birthing individuals could promote significant changes to population-level care in maternal health.
Topics: Pregnancy; Female; Humans; Depression, Postpartum; Ethnicity; Minority Groups; Anxiety Disorders; Anxiety; Depression; Postpartum Period
PubMed: 36422834
DOI: 10.1007/s11920-022-01392-7 -
Journal of Clinical Nursing Oct 2022The current systematic review aimed to present the pooled estimated prevalence and risk factors of PPD. (Meta-Analysis)
Meta-Analysis Review
AIM
The current systematic review aimed to present the pooled estimated prevalence and risk factors of PPD.
BACKGROUND
Postpartum depression seriously affects the physical and mental health of the mother and child. However, high-quality meta-analysis is limited, which restricts the screening and intervention of postpartum depression.
DESIGN
A systematic review and meta-analysis.
METHODS
Cochrane Library, PubMed, Embase and Web of Science were searched for cohort and case-control studies investigating the prevalence and risk factors of postpartum depression from inception to December 31st, 2020. Meta-analyses were performed to identify postpartum depression prevalence and risk factors using a random-effects model.
RESULTS
Of the 33 citations evaluated, 27 reported the prevalence of postpartum depression in 33 separate study populations containing 133,313.
SUBJECTS
Pooled prevalence in all studies was 14.0% (95%CI, 12.0%-15.0%). The prevalence varied according to country (from 5.0% to 26.32%) and developing countries, especially China, have a high prevalence of postpartum depression. The following risk factors were associated with postpartum depression: gestational diabetes mellitus(OR = 2.71, 95%CI 1.78-4.14, I = 0.0%), depression during pregnancy(OR = 2.40, 95%CI 1.96-2.93, I = 96.7%), pregnant women give birth to boys(OR = 1.62; 95%CI 1.28-2.05; I = 0.0%), history of depression during pregnancy(OR = 4.82, 95%CI 1.32-17.54, I = 74.9%), history of depression(OR = 3.09, 95%CI 1.62-5.93, I = 86.5%) and epidural anaesthesia during delivery(OR = .81, 95%CI .13-4.87, I = 90.1%).
CONCLUSIONS
The prevalence of postpartum depression seems to be high, especially in developing countries. Gestational diabetes mellitus, depression during pregnancy, pregnant women give birth to boys, history of depression during pregnancy, history of depression, epidural anaesthesia during delivery were identified as risk factors for postpartum depression. Understanding the risk factors of PPD can provide the healthcare personnel with the theoretical basis for the patients' management and treatment.
IMPLICATIONS FOR PRACTICE
This systematic review and meta-analysis identified six significant risk factors for PPD, which provides nurses with a theoretical basis for managing and treating women with PPD to effectively improve the screening rate, intervention rate and referral rate of women with PPD.
Topics: Depression, Postpartum; Diabetes, Gestational; Female; Humans; Male; Mothers; Pregnancy; Prevalence; Risk Factors
PubMed: 34750904
DOI: 10.1111/jocn.16121 -
Obstetrics and Gynecology Clinics of... Sep 2020Perinatal care, including the management of mental health issues, often falls under the auspices of primary care providers. Postpartum depression (PPD) is a common... (Review)
Review
Perinatal care, including the management of mental health issues, often falls under the auspices of primary care providers. Postpartum depression (PPD) is a common problem that affects up to 15% of women. Most women at risk can be identified before delivery based on psychiatric history, symptoms during pregnancy, and recent psychosocial stressors. Fortunately, there have been a variety of treatment studies using antidepressants, nonpharmacologic interactions, and most recently, allopregnanolone (Brexanolone) infusion that have shown benefits. The most commonly used screening scale, Edinburgh Postnatal Depression Scale, a 10-item self-rated scale, has been translated into a variety of languages.
Topics: Adult; Antidepressive Agents; Depression, Postpartum; Drug Combinations; Female; Humans; Infant; Mass Screening; Neurosteroids; Perinatal Care; Postpartum Period; Pregnancy; Pregnanolone; Prevalence; Psychiatric Status Rating Scales; Psychotherapy; Risk Factors; Selective Serotonin Reuptake Inhibitors; Surveys and Questionnaires; beta-Cyclodextrins
PubMed: 32762926
DOI: 10.1016/j.ogc.2020.05.001 -
Asian Journal of Psychiatry Oct 2020Postpartum depression (PPD) is the most common psychiatric condition after childbirth which not only effects the mother's health, but also might have impact on child's... (Review)
Review
PURPOSE
Postpartum depression (PPD) is the most common psychiatric condition after childbirth which not only effects the mother's health, but also might have impact on child's development and parenting behaviors. Because the etiology of PPD has not been fully cleared, the efforts towards identification of risk factors are crucial for both the children and mother's health.
METHOD
PubMed, EMBASE and PsycINFO databases were searched since inception until July 2019 to collect data about the risk factors of PPD and only systematic review and meta-analysis can be included.
RESULT
To identify the real risk factors, protective factors and controversial factors, nineteen parts of the interpretation were adopted. The risk factors are mainly concentrated in the following aspects: violence and abuse, immigration status, gestational diabetes, cesarean section, depressive history, vitamin D deficiency, obese and overweight, postpartum sleep disruption and poor postpartum sleep, lack of social support, traditional dietary pattern (Japanese, Indian, United Kingdom, and Brazilian dietary pattern), multiple births, preterm and low-birth-weight infants, postpartum anemia, negative birth experience. The controversial factors are serum level of cortisol, thyroid peroxidase autoantibodies status, acculturation, traditional confinement practices. Skin-to-skin care, higher concentrations of DHA in mothers' milk, greater seafood consumption, healthy dietary patterns, multivitamin supplementation, fish and PUFA intake, calcium, Vitamin D, zinc and possibly selenium are protective factors.
CONCLUSION
Thirteen risk factors were identified, but five factors still controversial due to the insufficient of the evidence. What's more, skin-to-skin care and some nutrition related factors are protective factors against PPD.
Topics: Child; Female; Humans; Infant; Infant, Newborn; Pregnancy; Brazil; Cesarean Section; Depression, Postpartum; Meta-Analysis as Topic; Risk Factors; Systematic Reviews as Topic; United Kingdom
PubMed: 32927309
DOI: 10.1016/j.ajp.2020.102353 -
Archivos Argentinos de Pediatria Jun 2020
Topics: Adult; Depression, Postpartum; Early Diagnosis; Female; Humans; Risk Factors
PubMed: 32470247
DOI: 10.5546/aap.2020.eng.154 -
The Nursing Clinics of North America Dec 2019Postpartum depression (PPD) affects10% to 20% of women within the first year after birth and 25% beyond the first year. PPD, despite advances in diagnosis and treatment,... (Review)
Review
Postpartum depression (PPD) affects10% to 20% of women within the first year after birth and 25% beyond the first year. PPD, despite advances in diagnosis and treatment, remains underdiagnosed and misunderstood. Women do not always display signs of PPD while in care for delivery of the infant and may not discuss mood changes to their primary care provider at discharge and first post-delivery appointment. Identifying screening and treatment options for non-mental health providers was the purpose of this article.
Topics: Depression, Postpartum; Drug Therapy; Female; Humans; Mass Screening; Nurse's Role; Psychiatric Status Rating Scales; Risk Factors
PubMed: 31703781
DOI: 10.1016/j.cnur.2019.07.006 -
Current Opinion in Anaesthesiology Jun 2021Perinatal depression is a common and debilitating complication of pregnancy and childbirth. Recent studies have elucidated relationships between acute birth events on... (Review)
Review
PURPOSE OF REVIEW
Perinatal depression is a common and debilitating complication of pregnancy and childbirth. Recent studies have elucidated relationships between acute birth events on depression risk, and novel treatments for postpartum depression have been discovered and approved. This article reviews current understandings about birth events on depression, new screening standards, and novel treatments for postpartum depression.
RECENT FINDINGS
Pain, analgesia, and depression are complex traits that are inter-related during and after pregnancy. Certain individuals may benefit more than others from addressing pain and suffering around childbirth. Exposures to general anesthesia or postdural puncture headache are associated with postpartum depression symptoms, although a causal relationship is unlikely. Brexanolone, ketamine and its related compounds, and nonpharmacologic options offer new or alternative therapies for depression, although safety information for some of these treatments in pregnancy and lactation are needed. Maternal health bundles call for close attention to perinatal mental health screening with validated instruments, and for timely treatment referrals in the 'fourth trimester'.
SUMMARY
Clinical monitoring and timely treatment of depression in the perinatal and postpartum periods is critical for maternal postpartum health and recovery. Perinatal specialists and researchers should continue to focus on tailored treatments specific to this special population.
Topics: Delivery, Obstetric; Depression; Depression, Postpartum; Female; Humans; Mass Screening; Postpartum Period; Pregnancy
PubMed: 33935170
DOI: 10.1097/ACO.0000000000000998 -
The American Journal of Nursing Jul 2021Despite extensive research, the etiology behind postpartum depression (PPD) remains a mystery. Experts have theorized about various potential risk factors, including... (Review)
Review
Despite extensive research, the etiology behind postpartum depression (PPD) remains a mystery. Experts have theorized about various potential risk factors, including hormonal fluctuations, genetics, prior history of depression, low socioeconomic status, adolescent pregnancy, and certain personality traits. This article provides foundational information about PPD, reviewing the risk factors for and the consequences of this mood disorder. Postpartum blues and postpartum psychosis are briefly discussed for context, although they differ from PPD. Screening and treatment options are explained, and nursing implications for practice are presented.
Topics: Depression, Postpartum; Female; Humans; Maternal-Child Nursing; Mother-Child Relations; Risk Factors; Sexual Partners
PubMed: 34117132
DOI: 10.1097/01.NAJ.0000756516.95992.8e -
Primary Care Mar 2023Perinatal mood disorders are a leading cause of disability worldwide and suicide is a leading cause of maternal death in the first year after giving birth. The three... (Review)
Review
Perinatal mood disorders are a leading cause of disability worldwide and suicide is a leading cause of maternal death in the first year after giving birth. The three categories of perinatal mood disorders are postpartum blues, postpartum depression, and postpartum psychosis. Identifying risk factors may allow clinicians to provide patients with interventions to potentially prevent development of these disorders. Universal screening for perinatal mood disorders can lead to earlier identification and treatment. Collaborative care methods, incorporating the entire family into treatment, therapy service, and providing support services are recommended as first-line intervention strategies before moving on to pharmacologic management.
Topics: Female; Pregnancy; Humans; Depression, Postpartum; Mood Disorders; Affect; Risk Factors; Depression; Mass Screening
PubMed: 36822723
DOI: 10.1016/j.pop.2022.10.011 -
Cleveland Clinic Journal of Medicine May 2020Perinatal depression affects 10% to 20% of women in the United States during pregnancy, the postpartum period, or both, but it can be difficult to recognize. Identifying... (Review)
Review
Perinatal depression affects 10% to 20% of women in the United States during pregnancy, the postpartum period, or both, but it can be difficult to recognize. Identifying and treating this problem can reduce the alarming number of suicides among depressed perinatal women and the possible adverse effects of untreated maternal depression on their child's cognitive and behavioral development. In this review, we discuss the latest developments in screening, treatment, and prevention methods.
Topics: Depression; Depression, Postpartum; Disease Management; Female; Humans; Pregnancy; Pregnancy Complications; Suicide; Suicide Prevention
PubMed: 32357982
DOI: 10.3949/ccjm.87a.19054