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JAMA Apr 2024
Topics: Female; Humans; Infant, Newborn; Pregnancy; Depression; Depression, Postpartum; Mass Screening; Perinatal Care; Pregnancy Complications; Psychotherapy; Antidepressive Agents
PubMed: 38483381
DOI: 10.1001/jama.2024.0434 -
Current Opinion in Pediatrics Jun 2021Postpartum depression (PPD) negatively impacts caregivers, infants, siblings, and entire families. Mothers with infants admitted to the neonatal intensive care unit... (Review)
Review
PURPOSE OF REVIEW
Postpartum depression (PPD) negatively impacts caregivers, infants, siblings, and entire families. Mothers with infants admitted to the neonatal intensive care unit (NICU) face additional risk for PPD, coupled with risk factors extending beyond a NICU admision. The novelty of this review is the focus on maternal PPD for mothers with infants admitted to the NICU. Interventions aimed at limiting and preventing PPD in this population include: prenatal and postpartum depression screening, PPD symptom awareness and monitoring, and trauma-informed care.
RECENT FINDINGS
PPD, the most frequent complication of childbirth, affects approximately 10-15% of mothers worldwide. Prevalence rates increase to 40% for mothers whose infant is admitted to the NICU. PPD can affect maternal and child health across the life course and predispose future generations to a myriad of developmental, psychosocial, and physical challenges. Prevalence rates are higher for racial and ethnic minorities, immigrant and refugee populations, and mothers in rural locations. Trauma-informed care is suggested at individual and organizational levels, leading to better care for those with and without previous trauma exposure.
SUMMARY
Increasing PPD symptom awareness, screening for PPD, and connections with resources should begin during prenatal visits. Care teams should discuss barriers to resources for mothers, children, and families to improve access and support.
Topics: Child; Depression, Postpartum; Female; Humans; Infant; Infant, Newborn; Intensive Care Units, Neonatal; Mothers; Pregnancy; Refugees; Risk Factors
PubMed: 33797463
DOI: 10.1097/MOP.0000000000001011 -
Nursing For Women's Health Apr 2022To examine the relationships among depression and anxiety symptomatology, stigma of mental illness, levels of social support, and select demographics among hospitalized...
OBJECTIVE
To examine the relationships among depression and anxiety symptomatology, stigma of mental illness, levels of social support, and select demographics among hospitalized women in the postpartum period.
DESIGN
Descriptive, cross-sectional, correlational.
SETTING
A convenience sample of 105 English-speaking and Spanish-speaking women was recruited and enrolled from a 208-bed free-standing Southern California women's community hospital postpartum unit serving a diverse community.
MEASUREMENTS
Data were collected on potential covariates including participants' characteristics, depression and anxiety symptomatology, social support, and stigma.
RESULTS
Sixteen participants were classified as high risk for depression or anxiety based on the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7. Anxiety was significantly associated with all stigma subscales; the strongest association was with Internal Stigma (r = .46, p < .001, moderate effect), followed by Disclosure Stigma (r = .36, p < .001, moderate effect) and External Stigma (r = .30, p = .002, moderate effect). All social support subscales were negatively associated with depression and anxiety; the Friends subscale had the strongest correlations with depression (r = -.27, p = .006, small effect) and anxiety (r = .34, p = .001, moderate effect). Firth (penalized likelihood) logistic regression analysis was conducted to ascertain the effects of study covariates on the likelihood of participants being at risk for postnatal depression or anxiety. The significant factor that increased the odds of participants being in the high-risk group was decreased social support (adjusted OR = 0.46, 95% CI [0.24, 0.76], p = .003).
CONCLUSION
These results show the enduring prevalence of postnatal depression and anxiety and the relevance of stigma and social support in aggravating or mitigating symptomatology. There is a need for comprehensive standardized screening to ensure the identification of and referral to treatment for women at risk.
Topics: Anxiety; Anxiety Disorders; Cross-Sectional Studies; Depression; Depression, Postpartum; Female; Humans; Postpartum Period; Social Support
PubMed: 35231418
DOI: 10.1016/j.nwh.2022.01.008 -
Journal of Sleep Research Aug 2021Postpartum emotional distress is very common, with 10%-20% of postpartum women reporting depressive or anxiety disorders. Sleep is a modifiable risk factor for emotional...
Postpartum emotional distress is very common, with 10%-20% of postpartum women reporting depressive or anxiety disorders. Sleep is a modifiable risk factor for emotional distress that has a pivotal role in postpartum adjustment. The present study aimed to examine whether sleep duration and quality during pregnancy predict trajectories of emotional distress in the postpartum period. Participants were 215 women that were assessed from the third trimester of pregnancy to 18-months postpartum. At all five time points (third trimester, 3-, 6-, 12-, and 18-months postpartum), measures of sleep duration and quality (measured by wake time after sleep onset; WASO) were derived from both actiography and diary-based measures. Repeated measures of depression and anxiety symptoms were collected using self-report measures. Results indicated four bivariate postpartum depression and anxiety growth trajectories, including (a) high comorbidity (5.4%); (b) moderate comorbidity (19.4%); (c) low anxiety and decreasing depression symptomology (18.6%); and (d) low symptomology (56.6%). Multinomial logistic regression analyses showed that mothers with shorter sleep durations during pregnancy were more likely to belong to the high comorbidity or moderate symptoms classes compared to the low symptomology class. In addition, mothers with higher WASO (i.e. lower sleep quality) at 3-months postpartum were more likely to belong to the moderate class compared to the low symptomology class. Given the potential negative implications of disrupted sleep in the perinatal period, the present study may inform future intervention studies that target sleep problems during pregnancy.
Topics: Anxiety; Depression, Postpartum; Female; Humans; Infant; Infant, Newborn; Mothers; Postpartum Period; Pregnancy; Sleep
PubMed: 33321551
DOI: 10.1111/jsr.13258 -
Canadian Journal of Diabetes Aug 2020The rates of both gestational diabetes mellitus (GDM) and mental illness in pregnancy are rising. There is an association between type 2 diabetes and major depressive... (Review)
Review
The rates of both gestational diabetes mellitus (GDM) and mental illness in pregnancy are rising. There is an association between type 2 diabetes and major depressive disorder, anxiety and schizophrenia, thus there is a need for greater understanding of the relationship between GDM and mental illness. This review suggests that there is a bidirectional and complex relationship between antenatal depression, gestational diabetes and postpartum depression. The combined effect of both a history of depression and gestational diabetes significantly increases the risk of postpartum depression. There is an association between severe mental illness and GDM; however, it is strongly mediated by antipsychotic medications and psychosocial factors, in addition to the disease itself. Medication has a major role in treating mental illness during pregnancy and is not directly linked with GDM in either depression or psychosis. Health-care providers should be mindful of the association between GDM and mental illness to appropriately screen and treat both disorders.
Topics: Canada; Depression, Postpartum; Depressive Disorder; Diabetes, Gestational; Female; Humans; Pregnancy; Prognosis
PubMed: 32792108
DOI: 10.1016/j.jcjd.2020.06.014 -
Pediatrics in Review Oct 2022Postpartum depression in new mothers has become a widely recognized public health concern. Paternal perinatal depression (PPND) and the mental health of fathers in the...
Postpartum depression in new mothers has become a widely recognized public health concern. Paternal perinatal depression (PPND) and the mental health of fathers in the perinatal period continues to receive significantly less public attention. Overall prevalence rates of up to 25% have been documented in first-time fathers. The presence of maternal depression, unsatisfactory couple relationships, and certain psychosocial and biological risk factors are associated with poor paternal bonding and increased depression risk. Depressed fathers experience excessive self-criticism, restlessness, irritability, and aggression rather than low mood. Depression in new fathers can lead to drug and alcohol abuse, food behavior disorders, and lack of impulse control. PPND leads to developmental delay, mental health disorders, and emotional or behavioral problems in the offspring. PPND may also adversely affect a child's ability to learn new information, with lasting intellectual and scholastic consequences. There currently are no official criteria to diagnose PPND, and neither are there validated screening tools available to fathers. A family-focused approach should be considered in place of the historically gender-focused mood assessment. Nontraditional interventions such as Internet communities, e-therapy, or group workshops are shown to combat a father's contextual understanding of therapy. Group therapy with integrated cognitive behavioral therapy can address masculine norms surrounding the parenting roles of fathers and can help cultivate support networks that are otherwise absent among new dads. PPND is ideally addressed by the adoption of a father-inclusive model of care that shifts the parenting paradigm and provides emotional and parenting support to men as they experience their new role as dad.
Topics: Anxiety; Child; Depression; Depression, Postpartum; Fathers; Female; Humans; Male; Parenting; Pregnancy
PubMed: 36180540
DOI: 10.1542/pir.2021-005488 -
Journal of Obstetrics and Gynaecology :... Jul 2022This cross-sectional study aimed to evaluate the prevalence of postpartum depression and the associated risk factors in a sample of Italian women at three months after...
This cross-sectional study aimed to evaluate the prevalence of postpartum depression and the associated risk factors in a sample of Italian women at three months after delivery. Eighty women were screened by completing the Edinburgh Postnatal Depression Scale (EPDS). Women with a score ≥10 were evaluated as positive and other variables were detected through the administration of the Postpartum Depression Predictors Inventory.The prevalence of postpartum depression in the sample was 11.25% (EPDS score >10). A statistically significant relationship was found between the predisposition to postnatal depression and various risk factors such as prenatal depression, stressful life experiences marital problems. Furthermore, strong emotional and instrumental support from the partner and a good economic status can represent protective factors. It is essential to promote an integrated approach to postpartum affective disorders in which psychosocial risk factors are taken into account, and adequate screening programs are implemented.Impact Statement Pregnancy can cause emotional stress for women with consequent development, in some cases, of mood disorders such as postpartum depression. According to this study, women suffering from postpartum depression showed a significant tendency to anxiety and depression, low perceived support from the partner, and low socio-economic status. It would be desirable to promote an integrated approach to postpartum affective disorders in which psychosocial risk factors are taken into account and adequate screening programs are implemented.
Topics: Cross-Sectional Studies; Depression; Depression, Postpartum; Female; Humans; Postpartum Period; Pregnancy; Prevalence; Psychiatric Status Rating Scales; Risk Factors
PubMed: 34907860
DOI: 10.1080/01443615.2021.1980512 -
Neuropsychopharmacology Reports Jun 2023Postpartum depression (PPD) may have negative effects on the parents and lead to impaired cognitive, socioemotional, and behavioral development in their children. The...
AIM
Postpartum depression (PPD) may have negative effects on the parents and lead to impaired cognitive, socioemotional, and behavioral development in their children. The purpose of this study was to examine factors associated with PPD in parents during the first year after delivery.
METHODS
This study used a self-administered questionnaire. Questionnaires were mailed at 5 days, 3 months, 6 months, and 1 year after delivery, respectively. The particpants were 107 pairs of mothers and fathers. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Data on sense of coherence (SOC), Quality Marriage Index, Social Support Scale, Mother-to-Infant Bonding Scale, and sociodemographic variables were collected. Multiple regression analysis was performed to examine the strength of the association between several variables and the EPDS at each survey period for fathers and mothers, respectively.
RESULTS
The prevalence of PPD in the first-year postpartum ranged from 12.1%-23.4% to 7.5%-8.4% for fathers and mothers, respectively. SOC had the strongest impact on EPDS scores for both fathers and mothers at all four survey periods.
CONCLUSIONS
Our findings suggest that stress coping skills are an important factor affecting PPD throughout the first-year postpartum for both fathers and mothers.
Topics: Female; Humans; Infant; Male; Depression, Postpartum; East Asian People; Longitudinal Studies; Prospective Studies; Parents
PubMed: 36915226
DOI: 10.1002/npr2.12326 -
Journal of Affective Disorders Nov 2023Suicidal ideation (SI) is a severe mental health issue in the postpartum period. As depression is a major risk factor of SI, it is often considered that the risk factors...
AIM
Suicidal ideation (SI) is a severe mental health issue in the postpartum period. As depression is a major risk factor of SI, it is often considered that the risk factors of SI are the same as those of postpartum depression. However, SI occurs in women without postpartum depression as well. The aim of this study is to separately examine the prevalence and risk factors of SI in postpartum women with and without depression.
METHODS
We used data of 5688 postpartum women from a 2021 Japanese nation-wide survey, whose age and geographical distributions were nationally representative. Postpartum depression was evaluated with the Edinburgh Postnatal Depression Scale (EPDS) and SI was measured with the 10th item of EPDS.
RESULTS
The prevalence of SI in women with and without depression (EPDS≥9) was 51.8 % and 3.3 %, respectively. Younger age and low family support were risk factors common to both women with and without depression. Being single, currently working, history of depressive disorders, and family members' visits to support being cancelled were risk factors of SI for women with depression. In contrast, primipara, history of psychiatric disorders other than depressive disorders, infectious disease other than colds during pregnancy, and feeling of loneliness increased since COVID-19 were risk factor of SI for women without depression.
CONCLUSION
Although with a low prevalence, SI occurs in women without postpartum depression, which has unique risk factors indicating distinct psychopathological mechanisms. These findings call for tailored SI intervention strategies according to whether postpartum depression is present or not.
Topics: Pregnancy; Female; Humans; Depression, Postpartum; Suicidal Ideation; Prevalence; COVID-19; Postpartum Period; Risk Factors; Psychiatric Status Rating Scales
PubMed: 37572702
DOI: 10.1016/j.jad.2023.08.051 -
Health Care For Women International Dec 2021This study was conducted to investigate the relationship between postpartum depression (PPD) and women's perceived spousal support during the early postpartum period and...
This study was conducted to investigate the relationship between postpartum depression (PPD) and women's perceived spousal support during the early postpartum period and the prevalence of PPD and affecting factors. Data were collected using a Personal Information Form, the Edinburgh Postpartum Depression Scale (EPDS) and the Perceived Spousal Support among Women in Early Postpartum Period Scale (PSSAWEPP). The study was completed with 181 women. The prevalence of PPD was found as 28.2%. A significant negative correlation was found between the total EPDS score and total PSSAWEPP score and subscale scores of emotional support, social support and physical support (<0.01). It was also found that as spousal support perceived by women increased, PPD risk decreased. In our study, it was observed that spousal violence (aOR = 5.69, 95% CI: 1.65-19.55) and having an unintended pregnancy (aOR = 0.24, CI: 0.11-0.54) were two factors that significantly affected PPD.
Topics: Depression; Depression, Postpartum; Female; Humans; Postpartum Period; Pregnancy; Psychiatric Status Rating Scales; Risk Factors; Social Support
PubMed: 32407210
DOI: 10.1080/07399332.2020.1764562