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Archives of Women's Mental Health Aug 2022Postpartum depression (PPD) is common and disproportionately affects people of color. Experiences of emotional upset due to racism (EUR) may be an important predictor of...
Postpartum depression (PPD) is common and disproportionately affects people of color. Experiences of emotional upset due to racism (EUR) may be an important predictor of PPD outcomes. Therefore, we aimed to determine if EUR during the 12 months before delivery was associated with PPD symptomology, asking for help for depression, and depression diagnosis among postpartum people of color (PPOC). We conducted a cross-sectional secondary data analysis among PPOC from 11 states and New York City using PRAMS data, 1/1/2015-12/31/2017. We assessed symptomology using an unvalidated PHQ-2. Logistic regression was performed without and with stratification by ethnicity (non-Hispanic PPOC vs Hispanic PPOC) to estimate whether EUR during 12 months before delivery was associated with (1) PPD symptoms, (2) asking for help for depression, and (3) depression diagnosis. Models adjusted for age, educational attainment, timely prenatal care, payment method, stress during pregnancy, and pre-pregnancy depression. Seventy-four thousand nine hundred nine (11.8%) PPOC reported EUR in the 12 months before delivery. After adjustment, EUR was associated with a 10.3 percentage point (%pt; 95% CI: 6.8, 13.8), 13.6%pt (95% CI: 8.8, 18.5), and 4.1%pt (95% CI: 1.4, 8.0) higher probability of positive PPD screening among all PPOC, non-Hispanic PPOC, and Hispanic PPOC, respectively. EUR was not associated with asking for help for depression but was associated with a higher prevalence of depression diagnosis among all PPOC (4.6%pt; 95% CI: 1.0, 8.4) and non-Hispanic PPOC (6.0%pt; 95% CI: 0.8, 11.2).Experiences of EUR are associated with an increased prevalence of PPD symptoms. Additional prospective research spanning the pre-pregnancy through postpartum periods is needed to examine the dynamic relationship between racism, symptomology, help-seeking, and diagnosis of depression.
Topics: Cross-Sectional Studies; Depression, Postpartum; Female; Humans; Postpartum Period; Pregnancy; Prospective Studies; Racism; Risk Factors
PubMed: 35504987
DOI: 10.1007/s00737-022-01232-w -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: To find association between postpostpartum depression incidence and mode of labour analgesia. (Observational Study)
Observational Study
OBJECTIVE
The aim: To find association between postpostpartum depression incidence and mode of labour analgesia.
PATIENTS AND METHODS
Materials and methods: This is a prospective observational study conducted at the Kyiv City Maternity Hospital №5 (from March 2020 to May 2021). Using google-form and face-to-face interviews, 321 women completed Childbirth Experience Questionnaire on the 2- 3-rd day in the postpartum period. After the first survey, only 35% of women agreed to screen for postpartum depression (PPD) by Edinburgh Postnatal Depression Scale. Univariate logistic regression method was used to assess the risk relation between PPD and factors.
RESULTS
Results: Women who used nitrous oxide (50:50) and non-pharmacological methods of labour analgesia were associated with the decreased risk of PPD (p = 0,044), OR = 2.83 (95% CI 1,03-7,79), compared to women with patient-control epidural analgesia. On the other hand, there are factors which do not have impact on the risk of depressive symptoms, such as age (p = 0,266); parity (p = 0,713); mode of delivery (p=0,959); pain intensity (p=0,931).
CONCLUSION
Conclusions: Our findings confirmed the association between nitrous oxide and the alternative methods of labour analgesia usage and decreased risk of development PPD.
Topics: Pregnancy; Female; Humans; Labor, Obstetric; Nitrous Oxide; Depression, Postpartum; Analgesia, Epidural; Analgesics
PubMed: 36723308
DOI: 10.36740/WLek202212109 -
Expert Review of Neurotherapeutics Sep 2021
Topics: Bipolar Disorder; Depression; Depression, Postpartum; Female; Humans; Psychiatric Status Rating Scales
PubMed: 34369247
DOI: 10.1080/14737175.2021.1966300 -
The Journal of Maternal-fetal &... Sep 2021Postpartum depression (PPD) is a mild to severe mood disorder, starting at 6 weeks after birth and with an incidence of approximately 25% in Brazilian puerperae. Its...
BACKGROUND
Postpartum depression (PPD) is a mild to severe mood disorder, starting at 6 weeks after birth and with an incidence of approximately 25% in Brazilian puerperae. Its occurrence induce significant aggravations to maternal and child health, however, its risk factors, although known, are little explored for the appropriate diagnosis.
PURPOSE
To correlate PPD with anxiety, smoking, alcoholism, parity, type of birth, gestational and maternal age, identifying the possible risk factors that increase the probability of a puerpera developing a depressive episode.
MATERIALS AND METHODS
A case-control study performed at the Alzir Bernardino Alves Infant and Maternity Hospital in the city of Vila Velha, Espirito Santo, Brazil. The sample consisted of 227 puerperae. The cutoff point for depression was defined as >10 points according to the Edinburgh Postnatal Depression Scale (EPDS), and cutoff points for anxiety were defined as <33 points for low anxiety, between 33 and 49 for moderate anxiety and >49 for high anxiety according to the State - Trait Anxiety Inventory (STAI-T).
RESULTS
29.1% of the 227 interviewed puerperae presented PPD and were considered "cases", with the remaining being considered as "control". There was a positive correlation between PPD and anxiety. No significant correlation was observed for the other risk factors. Women with moderate anxiety presented 17.38 times more probability to develop depressive episodes, and puerperae with high anxiety presented 273 times more chance of developing PPD.
CONCLUSIONS
Our results evidenced a high percentage of puerperae with PPD related to maternal anxiety, demonstrating the importance and the necessity of increasing care for women's mental health in the gestational and puerperal periods.
Topics: Anxiety; Brazil; Case-Control Studies; Child; Depression; Depression, Postpartum; Female; Humans; Postpartum Period; Pregnancy; Psychiatric Status Rating Scales; Risk Factors
PubMed: 31581862
DOI: 10.1080/14767058.2019.1671335 -
Journal of Affective Disorders Aug 2022Labor and delivery complications, particularly pain, are important risk factors for postpartum depression (PPD). Neuraxial labor analgesia can effectively relieve labor... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Labor and delivery complications, particularly pain, are important risk factors for postpartum depression (PPD). Neuraxial labor analgesia can effectively relieve labor pain; however, the association between neuraxial labor analgesia and PPD, if any, has not been established.
METHODS
PubMed, MEDLINE, EMBASE, ClinicalTrials.gov, and Cochrane Library were searched. The incidence of PPD was the primary outcome. The secondary outcome was the difference in postpartum Edinburgh Postpartum Depression Scale scores between the neuraxial labor analgesia and control groups. Subgroup analyses and post-hoc meta-regression were performed.
RESULTS
Nineteen studies with a total of 8758 parturients were identified. Neuraxial labor analgesia did not decrease PPD risk compared to the control group (OR = 0.84, 95% CI: 0.58-1.23); however, after being stratified by PPD prevalence, neuraxial labor analgesia decreased the risk for PPD in the high prevalence (>14%) subgroup (OR = 0.61, 95% CI: 0.39-0.94) and increased the risk for PPD in the low prevalence (<14%) subgroup (OR = 1.56, 95% CI: 1.16-2.10) compared to the control group. Meta-regression analysis showed that the association between neuraxial labor analgesia and PPD was influenced by PPD prevalence. There was no difference in the postpartum Edinburgh Postpartum Depression Scale scores between the neuraxial labor analgesia and control groups (WMD = -0.11, 95% CI: -0.56-0.34).
LIMITATION
Heterogeneity and a limited number of randomized controlled trials may bias the interpretation of the results.
CONCLUSION
Neuraxial labor analgesia had a protective effect when administered to parturients in the region with a high prevalence of PPD, but became a risk factor when administered to parturients in the region with a low prevalence of PPD.
Topics: Analgesia, Epidural; Analgesics; Depression, Postpartum; Female; Humans; Pain Management; Pregnancy; Prospective Studies
PubMed: 35594971
DOI: 10.1016/j.jad.2022.05.095 -
Psychiatry Research Dec 2021The objective of this study was to identify differences in the longitudinal course anhedonia symptoms during postpartum in women diagnosed with unipolar or bipolar... (Review)
Review
The objective of this study was to identify differences in the longitudinal course anhedonia symptoms during postpartum in women diagnosed with unipolar or bipolar disorder. Female participants diagnosed with either bipolar (n = 104) or unipolar (n = 136) depression at week 20 during pregnancy were evaluated prospectively at weeks 2, 12, 26, and 52 postpartum using clinical interviews. A semi-parametric, group-based mixture model was applied to separate distinct longitudinal patterns of symptoms of anhedonia. Across time, among those who reported anhedonia, twice as many women had the diagnoses of bipolar depression relative to unipolar depression (65.03% versus 39.47%, respectively). Moreover, the rate and stability of anhedonia was higher in women with bipolar relative to unipolar depression. Across groups, anhedonia was associated with significantly higher depressive symptom severity. Anhedonia is a more stable and frequent symptom in women with postpartum bipolar relative to unipolar depressive disorder.
Topics: Anhedonia; Bipolar Disorder; Depression, Postpartum; Depressive Disorder; Female; Humans; Postpartum Period; Pregnancy
PubMed: 34837882
DOI: 10.1016/j.psychres.2021.114274 -
Molecular Neurobiology Jul 2023Postpartum depression (PPD) is a serious mood disorder that tends to occur after the delivery, which may bring lifelong consequences to women and their families in terms... (Review)
Review
Postpartum depression (PPD) is a serious mood disorder that tends to occur after the delivery, which may bring lifelong consequences to women and their families in terms of family relationships, social relationships, and mental health. Currently, various risk factors including environmental factors and genetic factors that may induce postpartum depression have been extensively studied. In this review, we suggest that postpartum women's susceptibility to postpartum depression may be the result of the interaction between the genes associated with postpartum depression as well as the interaction between genetic and environmental factors. We reviewed the genes that have been studied in postpartum depression, including genes related to the synthesis, metabolism, and transport of monoamine neurotransmitters, key molecules of the HPA axis, and the kynurenine pathway. These studies have found more or less gene-gene and gene-environment interactions, so we will discuss these issues in more detail. However, so far, the conclusions of these risk factors, especially genetic factors, are not completely consistent in the occurrence and exacerbation of symptoms in postpartum depression, and it is not clear how these risk factors specifically participate in the pathological mechanism of the disease and play a role. We conclude that the role of genetic polymorphisms, including genetic and epigenetic processes, in the occurrence and development of postpartum depression, is complex and ambiguous. We also note that interactions between multiple candidate genes and the environment have been suggested as causes of depression, suggesting that more definitive research is needed to understand the heritability and susceptibility of PPD. Overall, our work supports the hypothesis that postpartum depression is more likely to be caused by a combination of multiple genetic and environmental factors than by a single genetic or environmental influence.
Topics: Female; Humans; Depression, Postpartum; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Risk Factors; Polymorphism, Genetic
PubMed: 37004608
DOI: 10.1007/s12035-023-03313-y -
BMC Research Notes Mar 2022To describe postpartum depression and associated risk factors among postpartum patients in the United States (US) between February and July 2020. This study used a...
OBJECTIVE
To describe postpartum depression and associated risk factors among postpartum patients in the United States (US) between February and July 2020. This study used a cross-sectional descriptive design to collect survey data from a convenience sample of postpartum patients who lived in the US and delivered a live infant after the US declared COVID-19 a public health emergency.
RESULTS
Our sample included 670 postpartum patients who completed an online survey inclusive of the Edinburgh Postnatal Depression Scale (EPDS) and selected demographic items (e.g. NICU admission status, infant gestational age, infant feeding method). In our sample, 1 in 3 participants screened positive for postpartum depression and 1 in 5 had major depressive symptoms. Participants who fed their infants formula had 92% greater odds of screening positive for postpartum depression and were 73% more likely to screen positive for major depressive symptoms compared to those who breastfed or bottle-fed with their own human milk. Participants with infants admitted to a NICU had 74% greater odds of screening positive. Each 1 week increase in weeks postpartum increased the odds of screening positive by 4%. Participants who worried about themselves and their infants contracting COVID-19 had 71% greater odds of screening positive.
Topics: COVID-19; Cross-Sectional Studies; Depression, Postpartum; Depressive Disorder, Major; Female; Humans; Infant; Pandemics; Risk Factors
PubMed: 35287695
DOI: 10.1186/s13104-022-05991-8 -
The Journal of Clinical Psychiatry Aug 2023Perinatal depression (PND) is one of the most common medical conditions associated with pregnancy, with 1 in 7 women impacted by PND symptoms and 1 in 13 meeting...
Perinatal depression (PND) is one of the most common medical conditions associated with pregnancy, with 1 in 7 women impacted by PND symptoms and 1 in 13 meeting criteria for major depressive disorder. Unfortunately, half of postpartum depression (PPD) cases begin during pregnancy but are not diagnosed until postpartum. Delayed diagnosis and treatment of PND lead to poor outcomes for both mother and child. The American College of Obstetricians and Gynecologists recently updated its recommendation that screening for perinatal depression and anxiety occur at the initial prenatal visit, later in pregnancy, and at postpartum. Several hypotheses have been developed to explain the pathophysiology of PND including endocrine, epigenetic, synaptic transmission, neural network, neurosteroid, stress, and inflammatory mechanisms. Researchers believe that the answer lies in a synthesized mechanism of all of these models. Novel and emerging therapeutics are focusing on the neurosteroid mechanism within the integrated hypothesis. Neuroactive steroids are changing the understanding of the pathophysiology of depression and PPD, and novel and emerging therapeutics with new mechanisms of action based on these findings are impacting the treatment paradigm for this widespread and burdensome disorder.
Topics: Female; Humans; Pregnancy; Anxiety; Depression; Depression, Postpartum; Depressive Disorder, Major; Neurosteroids; Postpartum Period
PubMed: 37585246
DOI: 10.4088/JCP.sagppd3003sho -
BMC Women's Health Jul 2023Postpartum depression (PPD) is a major health issue that can affect both mothers and their newborn children. In Vietnam, approximately 20% of mothers suffer from PPD.... (Review)
Review
BACKGROUND
Postpartum depression (PPD) is a major health issue that can affect both mothers and their newborn children. In Vietnam, approximately 20% of mothers suffer from PPD. However, there is a lack of synthesized evidence regarding the case management of PPD in the Vietnamese context. A review of early symptoms, consequences, and management strategies of PPD will help to inform best practices to reduce complications and shorten the recovery time after parturition.
METHODS
This scoping review aims to analyze and synthesize the findings of studies on PPD examining the symptoms, consequences, and management strategies among Vietnamese women. MEDLINE, CINAHL, PubMed, ScienceDirect, EBSCOHost, Google Scholar, and a networked digital library of projects, theses, and dissertations published between 2010 and 2022 in Vietnam were accessed following search terms including "Vietnam", "depression", "postpartum", "symptom/experience", "consequence", and "management".
FINDINGS
The most-reported symptoms were sadness, tiredness, the feeling of being ignored, lack of interest in the baby, reduced appetite, and sleep disturbance. The recognized consequences were child stunting and slow growth, without mentioning its long-term effects on mothers. Our findings indicated that PPD in Vietnam has not been sufficiently managed; mothers tend to seek help from 'fortune-tellers' or 'word-of-mouth' practices rather than from evidence-based modern medicine.
CONCLUSION
This scoping review provides an initial stage of PPD symptoms, consequences, and management along with facilitating an interventional program to support this vulnerable group of women. A large survey of Vietnamese mothers' symptoms, effects, and management strategies is needed.
Topics: Pregnancy; Infant; Infant, Newborn; Humans; Female; Depression, Postpartum; Postpartum Period; Mothers; Parturition; Vietnam
PubMed: 37496038
DOI: 10.1186/s12905-023-02519-5