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The Nursing Clinics of North America Sep 2021This article provides an overview of the prevalence and cause of postpartum depression in women and postnatal depression among their male partners, as well as a review... (Review)
Review
This article provides an overview of the prevalence and cause of postpartum depression in women and postnatal depression among their male partners, as well as a review of related symptoms, risk factors, and effects on children. Evidence-based screening tools, management options, and resources for patients and providers are also presented.
Topics: Adaptation, Psychological; Adult; Depression, Postpartum; Fathers; Female; Humans; Male; Mothers; Nurse's Role; Postpartum Period; Risk Factors
PubMed: 34366154
DOI: 10.1016/j.cnur.2021.04.001 -
BMC Psychiatry Oct 2021Despite the increased global interest from researchers in postpartum depression (PPD) and postpartum post-traumatic stress disorder (PP-PTSD), studies of PPD in China...
BACKGROUND
Despite the increased global interest from researchers in postpartum depression (PPD) and postpartum post-traumatic stress disorder (PP-PTSD), studies of PPD in China have shown a wide range of variability. Indeed, the prevalence and risk factors for PP-PTSD have received little attention in China.
AIM
To determine the prevalence of PPD and PP-PTSD in China, and to examine the relationships between a range of sociodemographic, pregnancy-related, and newborn-related variables, and PPD and PP-PTSD.
METHODS
A cross-sectional study involving 1136 women who returned to the obstetrics clinic for routine postpartum examination were enrolled. The sociodemographic, pregnancy-related, and newborn-related characteristics were collected. Social support, and PPD and PP-PTSD symptoms were measured by the Perceived Social Support Scale (PSSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Post-traumatic Stress Questionnaire (PPQ).
RESULTS
The prevalence rates of PPD and PP-PTSD symptoms were 23.5 and 6.1%, respectively. A multivariate model showed that the presence of PP-PTSD was the strongest risk factor for PPD symptoms and vice versa. Other risk factors for PPD included low sleep quality, low social support and newborn's incubator admission. In terms of PP-PTSD symptoms, risk factors included the presence of PPD symptoms, non-Han ethnicity, and low social support, while having one child was a protective factor.
CONCLUSIONS
This study addressed some gaps in the literature and provided a better understanding of PPD and PP-PTSD in China, which may contribute to early detection and intervention. Attention should be paid to women who are most susceptible to PPD and/or PP-PTSD, including those with low social support, low sleep quality, newborn's incubator admission, non-Han ethnicity, and women with siblings.
Topics: Child; Cross-Sectional Studies; Depression, Postpartum; Female; Humans; Infant, Newborn; Postpartum Period; Pregnancy; Prevalence; Risk Factors; Stress Disorders, Post-Traumatic
PubMed: 34610797
DOI: 10.1186/s12888-021-03432-7 -
Ginekologia Polska 2021Epidemiological data clearly indicate that depression is becoming an increasingly important health and social problem today. According to the World Health Organization...
Epidemiological data clearly indicate that depression is becoming an increasingly important health and social problem today. According to the World Health Organization (WHO), depression currently affects 350 million people worldwide and is considered the second most common cause of disability in Europe after ischemic heart disease. It is estimated that this health problem may affect as many as five million people in Poland. The gap between the reported number of patients treated and the prevalence of depression, highlights the scale of unmet needs. With the limited availability of specialists in psychiatric care, the most appropriate measures seem to be those aimed at increasing the competence of doctors of other specialties in the diagnosis and treatment of depression. Early detection and treatment results in faster remission, reduces relapses and mortality. The recommendations concerning prevention of depression were commissioned by the Polish Ministry of Health as a part of the Depression Prevention Program for 2016-2020. The Program has developed recommendations addressed to specialists in various fields of medicine, other than psychiatry, focusing on three risk groups: children and adolescents, women in the perinatal period and the elderly. These recommendations focus on the management of suspected postpartum depression and provide specific guidelines for medical staff having contact with pregnant and postpartum women (gynecologists, midwives, pediatricians).
Topics: Adolescent; Adult; Depression; Depression, Postpartum; Female; Humans; Poland; Pregnancy; Pregnancy Complications; Risk Factors
PubMed: 33448014
DOI: 10.5603/GP.a2020.0141 -
JAMA Dec 2023
Topics: Female; Humans; Pregnancy; Depression; Depression, Postpartum; Postpartum Period; Prenatal Care; Mass Screening
PubMed: 38010647
DOI: 10.1001/jama.2023.21311 -
Archives of Gynecology and Obstetrics May 2023To compare the predictive validity of the Edinburgh Postnatal Depression Scale (EPDS) and other tools for screening depression in pregnant and postpartum women through a... (Meta-Analysis)
Meta-Analysis Review
Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis.
PURPOSE
To compare the predictive validity of the Edinburgh Postnatal Depression Scale (EPDS) and other tools for screening depression in pregnant and postpartum women through a systematic review and meta-analysis.
METHODS
An electronic search of MEDLINE, EMBASE, CINAHL, and PsycArticles databases was conducted using the following keywords: depression, perinatal-related terms, and EPDS. Quality Assessment of Diagnostic Accuracy Studies-2 was used to assess the risk of bias in diagnostic studies.
RESULTS
The search identified 823 articles, of which 17 studies met the inclusion criteria. In 1831 pregnant women from nine studies, pooled sensitivity and specificity of the EPDS were 0.81 and 0.87, respectively, with summary receiver operating characteristic (sROC) curve of 0.90. In 515 postpartum women from six studies, pooled sensitivity, specificity, and sROC were 0.79, 0.92, and 0.90, respectively. We then compared the EPDS with other tools using three or more studies. The sROC curve of the Patient Health Questionnaire-9 was 0.74, which was lower than that (0.86) of the EPDS. The sROC curve of the Beck Depression Inventory and the ten-item Kessler Psychological Distress Scale was 0.91, similar to that of the EPDS (0.90 and 0.87). However, in comparison with the Postpartum Depression Screening Scale (0.98), the sROC curve of the EPDS was 0.54.
CONCLUSION
As a tool specialized for screening depression in pregnant and postpartum women, the EPDS showed excellent performance. Thus, the EPDS can be used in preference to other tools to screen for depression in perinatal women at a primary care setting or a midwifery center.
Topics: Female; Pregnancy; Humans; Depression, Postpartum; Depression; Mass Screening; Postpartum Period; Psychiatric Status Rating Scales
PubMed: 35416478
DOI: 10.1007/s00404-022-06525-0 -
Revista Brasileira de Ginecologia E... May 2022To detect depression during pregnancy and in the immediate postpartum period using the Edinburgh postpartum depression scale (EPDS).
OBJECTIVE
To detect depression during pregnancy and in the immediate postpartum period using the Edinburgh postpartum depression scale (EPDS).
METHODS
Cross sectional study of 315 women, aged between 14 and 44 years, who received perinatal care at the Leonor Mendes de Barros Hospital, in São Paulo, between July 1st, 2019 and October 30th, 2020. The cutoff point suggesting depression was ≥ 12.
RESULTS
The screening indicated 62 (19.7%) patients experiencing depression. Low family income, multiparity, fewer prenatal appointments, antecedents of emotional disorders, dissatisfaction with the pregnancy, poor relationship with the partner, and psychological aggression were all risk factors associated with depression in pregnancy or in the immediate postpartum period. Antecedents of depression and psychology aggression during pregnancy were significant variables for predicting perinatal depression in the multivariate analysis.
CONCLUSION
There is a significant association between the occurrence of perinatal depression and the aforementioned psychosocial factors. Screening patients with the EPDS during perinatal and postpartum care could facilitate establishing a line of care to improve the wellbeing of mother and infant.
Topics: Adolescent; Adult; Brazil; Cross-Sectional Studies; Depression; Depression, Postpartum; Female; Humans; Mass Screening; Postpartum Period; Pregnancy; Psychiatric Status Rating Scales; Risk Factors; Young Adult
PubMed: 35253138
DOI: 10.1055/s-0042-1743095 -
The Psychiatric Clinics of North America Sep 2023Perinatal depression is a common psychiatric condition that has negative effects on pregnancy and infant outcomes. Screening for the condition is relatively easy and... (Review)
Review
Perinatal depression is a common psychiatric condition that has negative effects on pregnancy and infant outcomes. Screening for the condition is relatively easy and should be done routinely in all medical care of the pregnant and postpartum woman and her infant. The risk-benefit analysis favors the use of antidepressant medications during pregnancy and lactation compared with the risk of untreated maternal depression. Other, nonpharmacological treatments will be discussed as well as new treatments, including a new class of medications that act on the inhibitory GABAergic neurotransmitter system.
Topics: Pregnancy; Female; Infant; Humans; Depression; Depression, Postpartum; Depressive Disorder; Antidepressive Agents; Pregnancy Complications
PubMed: 37500243
DOI: 10.1016/j.psc.2023.04.003 -
Psychiatry Research Feb 2020Postpartum stress has been shown to have an association with infant growth, nutrition, bonding, temperament and ultimately childhood mental wellbeing. When persistent,... (Review)
Review
Postpartum stress has been shown to have an association with infant growth, nutrition, bonding, temperament and ultimately childhood mental wellbeing. When persistent, recurring or chronic, it can negatively impact infant outcome, including the subscales of mental wellbeing such as growth, development, feeding, attachment and sleep. This study aims to define the physical and functional effect of postpartum stress on measures of infant mental wellbeing. A systematic review of English language articles published between 1995 and 2019 on PubMed, Medline and Psych base databases was carried out. Search terms used included postpartum, stress, infant, growth, development, nutrition, attachment and sleep. Both qualitative and quantitative studies were reviewed with eligibility criteria. Inclusion criteria of human studies, mothers diagnosed with depressive and anxiety symptoms postpartum with infant correlates were used. All animal studies and studies with women already on medication were excluded. A total of 74 articles were reviewed and summarized into postpartum stress associations with infant growth, development, nutrition, sleep and maternal fetal attachment. Postpartum stress is negatively associated with poor developmental trajectories and linear growth deficits, causing stunting in growth; poor language and cognitive development; poor gross and fine motor movement, and infant sleep. An inverse relationship exists with breast feeding and postpartum depression. More importantly, breastfeeding efficacy is important for sustaining positive infant feeding outcome. Increased maternal age during postpartum depression has been linked, as a contributing factor, to decreased maternal fetal attachment/bonding. A ripple effect exists from the association between postpartum stress and poor infant sleep. There is strong evidence that correlates PPS to infant outcome, mediated through many external factors. More research needs to be conducted to delineate and potentially mitigate the impact of modifiable factors. Not all articles in the literature were reviewed.
Topics: Anxiety; Breast Feeding; Child Development; Cognition; Depression, Postpartum; Female; Humans; Infant; Infant, Newborn; Male; Mothers; Postpartum Period; Sleep; Social Support; Stress, Psychological; Temperament
PubMed: 31962260
DOI: 10.1016/j.psychres.2020.112769 -
Breastfeeding Medicine : the Official... Apr 2022Previous research has noted an association between breastfeeding and a reduced risk of postpartum depression (PPD). This article provides a systematic review and... (Meta-Analysis)
Meta-Analysis Review
Previous research has noted an association between breastfeeding and a reduced risk of postpartum depression (PPD). This article provides a systematic review and meta-analysis on the possible association of the type and degree of breastfeeding and PPD. A systematic literature search in English was conducted by using PubMed, Google Scholar, Scopus, Web of Science, and Cochrane Library Databases from their start dates until January 2021. Outcome estimates were pooled by odds ratios (ORs) or standardized mean differences. Women who did not exclusively breastfeed had 89% higher odds of PPD (OR = 1.89, 95% confidence interval [CI]: 1.50-2.39). Included studies used different cutoff points for the diagnosis of PPD. Therefore, PPD in nonexclusive breastfeeding mothers was more in studies using the cutoff point 9/10 (OR 1.97, 95% CI 1.46-2.64) as symptoms of depression than those using the cutoff point 12 (OR 1.78, 95% CI 1.21-2.61). Some studies reported PPD based on means and the others reported it based on OR. Accordingly, nonexclusive breastfeeding mothers had higher odds of PPD in studies calculating the effect size based on means (OR 1.62, 95% CI 1.19-2.19) and OR (OR 2.36, 95% CI 1.65-3.39) than in other studies. This review showed that exclusive breastfeeding is associated with a reduced risk for PPD.
Topics: Breast Feeding; Depression, Postpartum; Female; Humans; Mothers; Odds Ratio
PubMed: 34964664
DOI: 10.1089/bfm.2021.0183 -
Medicine Nov 2022The aim of this randomized double-blind placebo controlled clinical trial was to investigate the effects of different doses of esketamine combined with sufentanil for... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The aim of this randomized double-blind placebo controlled clinical trial was to investigate the effects of different doses of esketamine combined with sufentanil for postoperative intravenous controlled analgesia after cesarean section and the incidence of postpartum depression.
METHODS
One hundred and sixty patients undergoing elective cesarean section, with a singleton term pregnancy and American Society of Anesthesiologists physical status II were selected. All patients were treated by a combined epidural with spinal anesthesia. They were randomly divided into 4 groups according to patient controlled intravenous analgesia formula. The consumption of sufentanil, times of effective press and remediate analgesia at 48 hours after cesarean section, incidence of postpartum depression (PPD) at 1 week and 6 weeks after the operation were recorded.
RESULTS
Comparison of cumulated dosage of sufentanil, times of effective press and rescue analgesia at 48 hours after operation: Group H was significantly lower than Group M, Group L, and Group C (P < .05), Group M significantly lower than group L and Group C (P < .05), and Group L significantly lower than Group C (P < .05). Comparison of the incidence of PPD at 1 week and 6 weeks later: Group H was significantly lower than Group M, Group L, and Group C (P < .01), Group M significantly lower than Group L and Group C (P < .01) and Group L significantly lower than Group C (P < .01). Compared with Group C, the incidence of nausea and vomiting was significantly reduced in Group H, Group M, and Group L (P < .05).
CONCLUSION
Esketamine combined with sufentanil used for patient controlled intravenous analgesia after elective cesarean section can reduce the consumption of sufentanil, improve postoperative analgesia, decrease the incidence of PPD at 1 week and 6 weeks and postoperative nausea and vomiting.
Topics: Female; Humans; Pregnancy; Analgesia, Patient-Controlled; Cesarean Section; Depression, Postpartum; Postoperative Nausea and Vomiting; Sufentanil; Antidepressive Agents; Pain, Postoperative
PubMed: 36451452
DOI: 10.1097/MD.0000000000032010