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Maternal and Child Health Journal Aug 2020Compelling evidence from observational studies shows that dietary patterns play a role in the development of depression and depressive symptoms in the general...
OBJECTIVES
Compelling evidence from observational studies shows that dietary patterns play a role in the development of depression and depressive symptoms in the general population. However, few studies have specifically sought to explore the association between maternal diet in the postpartum period and PPD. The purpose of this literature review was to synthesise data from existing published studies, examining the association between maternal postpartum diet and PPD symptoms.
METHODS
Relevant studies were identified by systematic search from the Cochrane, MEDLINE, EMBASE, CINAHL, PubMed and PsycInfo databases for articles published between 1835 and April 2020.
RESULTS
Of the 931 articles identified, six met eligibility criteria and were included. Four were cross-sectional and two were a cohort design. All but one study showed at least one inverse association, such that greater adherence to a healthy diet in the postpartum period was associated with fewer PPD symptoms. Specifically, if confirmed in further longitudinal and intervention studies, a balanced maternal diet with an emphasis on fruits, vegetables, fish, grains, legumes, and herbs could be a potential option for helping reduce the incidence of PPD.
CONCLUSIONS
This review provides evidence that the postnatal diet could have an effect on PPD symptoms, although further longitudinal and intervention research is warranted.
Topics: Depression, Postpartum; Feeding Behavior; Female; Humans; Mothers; Postpartum Period
PubMed: 32367245
DOI: 10.1007/s10995-020-02949-9 -
Depression and Anxiety Mar 2022Many psychological and obstetrical factors contribute to the development of postpartum depression. However, little is known about how postpartum hemorrhage (PPH)...
BACKGROUND
Many psychological and obstetrical factors contribute to the development of postpartum depression. However, little is known about how postpartum hemorrhage (PPH) influences postpartum depressive symptoms. This study explored the relationship between PPH and postpartum depressive symptoms in the Chinese population.
METHODS
A retrospective cohort study was conducted at the Baoan Maternal and Child Health Hospital in Shenzhen, China, from January 2016 to June 2020. The Edinburgh Postnatal Depression Scale was used to assess postpartum depressive symptoms. A multivariate logistic regression model was used to estimate the odds ratios (ORs) with 95% confidence intervals (95% CIs) between PPH and risk of postpartum depressive symptoms.
RESULTS
Of the 7734 respondents, 293 (3.8%) and 7441 were in the PPH and control groups, respectively. Puerperal women with PPH were more likely to screen positive for postpartum depressive symptoms than those without PPH (16.4% vs. 11.7%, p = .016). Adjusting for other covariates, women with PPH still had higher risk of postpartum depressive symptoms (OR = 1.68, 95% CI: 1.16-2.42). Stratification analyses revealed no interaction between PPH and maternal age, prepregnancy body mass index, mode of delivery, and fetal sex in developing depressive symptoms (p for interaction > .05).
CONCLUSIONS
PPH may increase the risk of postpartum depressive symptoms. Therefore, women with PPH should be actively screened for depressive symptoms in the immediate postpartum period.
Topics: Child; Depression; Depression, Postpartum; Female; Humans; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Retrospective Studies; Risk Factors
PubMed: 35167153
DOI: 10.1002/da.23245 -
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 -
Birth (Berkeley, Calif.) Dec 2023Postpartum depression (PPD) is increasingly common in the United States and poses a significant threat to maternal and neonatal health. Universal screening for...
BACKGROUND
Postpartum depression (PPD) is increasingly common in the United States and poses a significant threat to maternal and neonatal health. Universal screening for postpartum depression is recommended by numerous organizations, including the American College of Obstetricians and Gynecologists, but is not achieved in practice.
METHODS
A cross-sectional, weighted, state-representative study of California residents who gave birth in 2016 using the Listening to Mothers in California 2018 data set. Primary exposure was type of maternity care professional providing care during pregnancy, and the primary outcome was PPD screening. The secondary exposure was self-reported depression or anxiety during pregnancy, and the secondary outcome was attending a postpartum office visit. Bivariate analyses were conducted using Rao-Scott chi-square tests, and multivariate analyses were conducted using logistic regression.
RESULTS
Compared to participants cared for by obstetricians, participants cared for by midwives had 2.6 times the odds of reporting being screened for PPD after controlling for covariates (95% CI = 1.5, 4.4). Receiving care from any other practitioner type compared with an obstetrician was not associated with a different rate of postpartum depression screening. Reporting depression or anxiety during pregnancy was associated with 0.7 times the odds (95% CI = 0.5, 1.0) of returning for postpartum care after controlling for covariates.
CONCLUSIONS
Being cared for by a midwife during pregnancy increases the likelihood of being screened for postpartum depression. In addition, even perfectly implemented universal screening will miss a vulnerable sector of the population that is at high risk for postpartum depression and is less likely to return for postpartum care.
Topics: Infant, Newborn; Female; Humans; Pregnancy; Depression, Postpartum; Cross-Sectional Studies; Maternal Health Services; Postpartum Period; Anxiety
PubMed: 37435935
DOI: 10.1111/birt.12735 -
Archives of Women's Mental Health Oct 2022Preterm birth (PTB) and postpartum depression (PPD) are important public health issues, and although literature mainly supports the association between them, some...
Preterm birth (PTB) and postpartum depression (PPD) are important public health issues, and although literature mainly supports the association between them, some reviews have highlighted methodological limitations in the studies in this field, restricting the interpretation of such finding. This study aimed at assessing the association between PTB and PPD, by comparing groups of preterm and full-term mothers in two Brazilian cities with contrasting sociodemographic indicators. This prospective convenience cohort study assessed 1421 women during pregnancy, at childbirth, and in the postpartum period. The Edinburgh Postnatal Depression Scale (EPDS) was administrated to assess PPD within 6 months after delivery and women were considered probably depressed if scores were EDPS ≥ 12. PTB was defined as the delivery before 37 completed weeks of pregnancy. A multivariate Poisson regression was used to estimate relative risk for PPD in mothers of preterm infants, and the final analysis models were adjusted for psychosocial variables, selected according to the directed acyclic graph (DAG) approach. Frequencies of PPD were not significantly different in mothers of preterm and full-term infants, in neither city. In the final adjusted model, PTB was not associated with PPD. The association between PTB and PPD was not confirmed in two large samples from two Brazilian cities with contrasting socioeconomic profile. However, maternal health during pregnancy plays an important role in predicting PPD. Prenatal care should promote maternal mental health as an effort towards decreasing unfavored outcomes for mothers, infants, and families.
Topics: Brazil; Cohort Studies; Depression, Postpartum; Female; Humans; Infant; Infant, Newborn; Infant, Premature; Pregnancy; Premature Birth; Prospective Studies
PubMed: 35849216
DOI: 10.1007/s00737-022-01248-2 -
MCN. the American Journal of Maternal...To identify postpartum depression risk and describe experiences of women in the first 6 weeks after giving birth during the COVID-19 pandemic.
PURPOSE
To identify postpartum depression risk and describe experiences of women in the first 6 weeks after giving birth during the COVID-19 pandemic.
STUDY DESIGN AND METHODS
Using a convergent mixed-methods approach, we recruited a convenience sample of women living in the United States who gave birth March 1, 2020 or later from social media Web sites. Participants completed the Postpartum Depression Screening Scale-Short Form and provided written answers to open-ended questions regarding their experiences at home with their new infant.
RESULTS
Our 262 participants were on average 32.6 years of age, the majority were White (82%), married or partnered (91.9%), and college educated (87.4%). Mean postpartum depression score was 17.7 (SD = 5.9) with 75% scoring ≥14, indicating significant postpartum depressive symptoms. Qualitative content analysis revealed five themes: Isolation and seclusion continue; Fear, anxiety, and stress filled the days; Grieving the loss of normal: It's just so sad; Complicated by postpartum depression: A dark time; and There is a silver lining. Quantitative and qualitative findings provided a holistic view of women's depressive symptoms and experiences at home with their infants during the COVID-19 pandemic.
CLINICAL IMPLICATIONS
Although policies that reduce risk of COVID-19 exposure and infection for patients and the health care team must continue to be implemented, the adverse effects of depressive symptoms on maternal-infant wellbeing within the context of increased isolation due to the pandemic need to be kept at the forefront. Nurses need to be aware of the consequences of women sheltering in place and social distancing on maternal-infant outcomes, particularly on depression and likelihood of breastfeeding.
Topics: COVID-19; Depression; Depression, Postpartum; Female; Humans; Infant; Pandemics; Postpartum Period; Pregnancy; SARS-CoV-2; United States
PubMed: 34845175
DOI: 10.1097/NMC.0000000000000802 -
PloS One 2021Postpartum hemorrhage is an important cause of maternal death and morbidity. However, it is unclear whether women who experience postpartum hemorrhage are at an...
BACKGROUND
Postpartum hemorrhage is an important cause of maternal death and morbidity. However, it is unclear whether women who experience postpartum hemorrhage are at an increased risk of postpartum depression.
OBJECTIVES
To examine whether postpartum hemorrhage is associated with postpartum depression.
METHODS
We conducted a national register-based cohort study of 486,476 Swedish-born women who had a singleton livebirth between 2007 and 2014. We excluded women with pre-existing depression or who filled a prescription for an antidepressant before childbirth. We classified postpartum depression up to 12 months after giving birth by the presence of an International Classification of Diseases, version 10 (ICD-10) diagnosis code for depression or a filled outpatient prescription for an antidepressant. We used Cox proportional hazard models, adjusting for maternal sociodemographic and obstetric factors.
RESULTS
Postpartum depression was identified in 2.0% (630/31,663) of women with postpartum hemorrhage and 1.9% (8601/455,059) of women without postpartum hemorrhage. In our unadjusted analysis, postpartum hemorrhage was not associated with postpartum depression (unadjusted hazard ratio (HR) = 1.06, 95% confidence interval (CI) 0.97-1.15). After adjusting for maternal age, parity, education, cohabitation status, maternal smoking status, and early pregnancy maternal BMI, gestational age, and birthweight, the association did not appreciably change, with confidence intervals overlapping the null (adjusted HR = 1.08, 95% CI 0.99, 1.17).
CONCLUSIONS
Within a population-based cohort of singleton women in Sweden with no prior history of depression, postpartum hemorrhage was not associated with postpartum depression.
Topics: Adolescent; Adult; Cohort Studies; Depression, Postpartum; Educational Status; Female; Humans; Maternal Age; Postpartum Hemorrhage; Pregnancy; Proportional Hazards Models; Registries; Retrospective Studies; Sweden; Young Adult
PubMed: 34379698
DOI: 10.1371/journal.pone.0255938 -
Journal of Affective Disorders Nov 2022Prior literature examining the association between cigarette smoking and postpartum depression (PPD) has focused primarily on smoking behaviors during pregnancy or...
BACKGROUND
Prior literature examining the association between cigarette smoking and postpartum depression (PPD) has focused primarily on smoking behaviors during pregnancy or postpartum. However, there is a dearth of studies assessing pre-pregnancy smoking in relation to PPD.
METHOD
A retrospective national cohort data from the National Health Insurance of South Korea were analyzed. A total of 392,394 women who gave birth between 2011 and 2015 and received health checkups within a year before pregnancy without a history of diagnosed depression were included. During the health checkup, participants self-reported their smoking status, amount, and duration in a health questionnaire. The diagnosis of PPD was defined by ICD-10 codes F32 and F33 during hospital visits within two years postpartum.
RESULT
Overall, 24,441 (6.2 %) women were newly diagnosed with depression within two years postpartum. Those who reported that they had quit smoking or were currently smoking before pregnancy were more likely to be diagnosed with PPD compared to nonsmokers. A greater number of cigarettes smoked was associated with a higher risk of PPD for both current and former smokers. Results of cumulative lifetime smoking exposure demonstrated that even those with 2 pack-years of smoking had an increased risk of developing PPD within two years postpartum (HR: 1.44, 95 % CI: 1.29-1.60). Those who smoked >10 pack-years had the highest risk of developing PPD (HR: 1.86, 95 % CI: 1.14-3.04) compared to nonsmokers.
CONCLUSION
Greater amount and duration of cigarette smoking in pre-pregnancy can increase the risk of PPD.
Topics: Cigarette Smoking; Cohort Studies; Depression, Postpartum; Female; Humans; Male; Postpartum Period; Pregnancy; Retrospective Studies; Risk Factors
PubMed: 35940375
DOI: 10.1016/j.jad.2022.07.065 -
Expert Review of Neurotherapeutics 2023Women are at a high risk of recurrence of depression in the postpartum period. Given the circumscribed duration of the risk period and knowledge of its triggers,... (Review)
Review
INTRODUCTION
Women are at a high risk of recurrence of depression in the postpartum period. Given the circumscribed duration of the risk period and knowledge of its triggers, postpartum depression should be easily preventable. However, prophylactic drug studies have reported contradictory findings partly due to the heterogeneity of the disorder. Currently, there are no studies on the efficacy of psychotherapy in the prevention of postpartum depression in women with major depressive or bipolar disorder.
AREAS COVERED
This review evaluates the results of controlled medication and psychotherapeutic studies in the prevention of depression in women with major depressive disorder or bipolar disorder; it further suggests that the management of sleep loss/insomnia may be an effective strategy in the prevention of postpartum depression.
EXPERT OPINION
A thorough understanding of the clinical course of the antecedent mood disorder and historical treatment response is necessary before the implementation of strategies for the prevention of postpartum depression. Targeting disturbed and/or insufficient sleep - a common and early transdiagnostic symptom of peripartum psychiatric disorders - may be a more effective intervention for the prevention of postpartum depression and psychiatric comorbidities in some individuals than the traditional approach of antidepressant use.
Topics: Female; Humans; Depression, Postpartum; Depressive Disorder, Major; Postpartum Period; Bipolar Disorder; Sleep; Depression; Recurrence
PubMed: 37462620
DOI: 10.1080/14737175.2023.2237194 -
The Journal of Obstetrics and... Dec 2021This study aims to determine the relationship between the late pregnancy and postpartum oxytocin levels and postpartum depression (PPD) symptoms.
AIM
This study aims to determine the relationship between the late pregnancy and postpartum oxytocin levels and postpartum depression (PPD) symptoms.
METHODS
This longitudinal study was conducted with 70 pregnant women. Data collection was performed through two interviews. While the first interview was conducted in the 30th to 38th gestational weeks, the second interview was conducted in the 4th to 12th weeks in the postpartum period. Oxytocin level measurement was performed with a saliva sample. Saliva samples were analyzed with enzyme-linked immunosorbent assay kits.
RESULTS
The prevalence of depressive symptoms in the postpartum period was found significantly higher than the prevalence in late pregnancy. Depression symptoms reached the highest level in the 12th week. The late pregnancy oxytocin level was significantly higher than the postpartum oxytocin level. A weak, negative correlation was found between PPD symptoms and the late pregnancy oxytocin level. However, when linear regression analysis was performed, it was concluded that there was a medium, negative relationship model between PPD symptoms and the late pregnancy oxytocin level. However, no relationships were found between PPD symptoms and oxytocin level.
CONCLUSION
In conclusion, this study found that the late pregnancy oxytocin level could be a predictive biomarker for postpartum depression. Predicting the risk of PPD in the pregnancy period could provide an opportunity for early diagnosis and treatment.
Topics: Biomarkers; Depression; Depression, Postpartum; Female; Humans; Longitudinal Studies; Oxytocin; Postpartum Period; Pregnancy; Risk Factors
PubMed: 34545656
DOI: 10.1111/jog.15023