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Medicine May 2024The perinatal period is crucial for both mother and newborn, and mental health, including prenatal and postpartum depression (PPD), is a significant aspect. Screening... (Observational Study)
Observational Study
The perinatal period is crucial for both mother and newborn, and mental health, including prenatal and postpartum depression (PPD), is a significant aspect. Screening for these disorders allows for early treatment and helps prevent risks to both mother and child. This prospective cohort study was carried out at University Hospital Obstetrics in Damascus City. The first phase was during the third trimester of pregnancy and the second phase involved a follow-up assessment after 6 weeks of delivery. The Arabic-validated version of the Edinburgh Postnatal Depression Scale questionnaire (EPDS) was used. A cutoff of 13 or higher was used to determine the presence of probable depression in both assessments. Of 347 pregnant women, 38.6% had prenatal depression (PND). 295 patients have achieved the second assessment, of which 30.2% had PPD. Furthermore, 42.6% who had PND developed PPD on follow-up. Binary logistic regression indicated that PND was predicted by non-Syrian nationality, paternal absence, poor financial status, number of previous pregnancies, and a history of depression independent of pregnancy. PPD was predicted by a history of PPD, and work status. Findings underscore potential value of early screening for depressive symptoms as a predictive measure. It is recommended that women with a history of depression receive heightened attention and care, irrespective of the timing of their depressive episodes.
Topics: Humans; Female; Pregnancy; Depression, Postpartum; Prospective Studies; Adult; Hospitals, University; Pregnancy Complications; Depression; Psychiatric Status Rating Scales; Young Adult; Risk Factors
PubMed: 38758898
DOI: 10.1097/MD.0000000000038170 -
Rural and Remote Health Jan 2023Maternal mental illness has a significant influence on negative maternal and childhood outcomes. Few studies have focused on both maternal depression and anxiety, or...
AIMS
Maternal mental illness has a significant influence on negative maternal and childhood outcomes. Few studies have focused on both maternal depression and anxiety, or explored the interplay of maternal mental illness and the mother-infant bond. We aimed to examine the relationship between early postnatal attachment and mental illness at 4 and 18 months postpartum.
METHODS
This was a secondary analysis of 168 mothers recruited from the BabySmart Study. All women delivered healthy term infants. Depression and anxiety symptoms were measured via the Edinburgh Postnatal Depression Scale (EPDS) and Beck's Depression and Anxiety Inventory at 4 and 18 months respectively. Maternal Postnatal Attachment Scale (MPAS) was completed at 4 months. Negative binomial regression analysis investigated associated risk factors at both time points.
RESULTS
The prevalence of postpartum depression fell from 12.5% at 4 months to 10.7% at 18 months. Anxiety rates increased from 13.1% to 17.9% at similar time points. At 18 months, both symptoms were new in almost two-thirds of women, 61.1% and 73.3% respectively. There was a strong correlation between the anxiety scale of the EPDS and the total EPDS p-score (R=0.887, p<0.001). Early postpartum anxiety was an independent risk factor for later anxiety and depression. High attachment scores were an independent protective factor for depression at 4 months (RR=0.943, 95%CI: 0.924-0.962, p<0.001) and 18 months (RR=0.971, 95%CI: 0.949-0.997, p=0.026), and protected against early postpartum anxiety (RR=0.952, 95%CI: 0.933-0.97, p<0.001).
CONCLUSION
The prevalence of postnatal depression at 4 months was similar to national and international rates, although clinical anxiety increased over time with almost 1 in 5 women scoring in the clinical anxiety range at 18 months. Strong maternal attachment was associated with decreased reported symptoms of both depression and anxiety. The effect of persistent maternal anxiety on maternal and infant health needs to be determined.
Topics: Infant; Female; Humans; Child; Depression; Mental Health; Depression, Postpartum; Mothers; Postpartum Period
PubMed: 36802669
DOI: 10.22605/RRH8126 -
Social Cognitive and Affective... Aug 2022Postpartum depression (PPD) is the most common psychological health issue among women, which often comorbids with anxiety (PPD-A). PPD and PPD-A showed highly...
Postpartum depression (PPD) is the most common psychological health issue among women, which often comorbids with anxiety (PPD-A). PPD and PPD-A showed highly overlapping clinical symptoms. Identifying disorder-specific neurophysiological markers of PDD and PPD-A is important for better clinical diagnosis and treatments. Here, we performed functional connectivity density (FCD) and resting-state functional connectivity (rsFC) analyses in 138 participants (45 unmedicated patients with first-episode PPD, 31 PDD-A patients and 62 healthy postnatal women, respectively). FCD mapping revealed specifically weaker long-range FCD in right lingual gyrus (LG.R) for PPD patients and significantly stronger long-range FCD in left ventral striatum (VS.L) for PPD-A patients. The follow-up rsFC analyses further revealed reduced functional connectivity between dorsomedial prefrontal cortex (dmPFC) and VS.L in both PPD and PPD-A. PPD showed specific changes of rsFC between LG.R and dmPFC, right angular gyrus and left precentral gyrus, while PPD-A represented specifically abnormal rsFC between VS.L and left ventrolateral prefrontal cortex. Moreover, the altered FCD and rsFC were closely associated with depression and anxiety symptoms load. Taken together, our study is the first to identify common and disorder-specific neural circuit disruptions in PPD and PPD-A, which may facilitate more effective diagnosis and treatments.
Topics: Anxiety; Anxiety Disorders; Cerebral Cortex; Depression, Postpartum; Female; Humans; Magnetic Resonance Imaging
PubMed: 34904174
DOI: 10.1093/scan/nsab127 -
Archivos Argentinos de Pediatria Jun 2024Maternal mental health problems during pregnancy, childbirth, and the postpartum period are a challenge for public health. Not recognizing them hinders a timely...
Maternal mental health problems during pregnancy, childbirth, and the postpartum period are a challenge for public health. Not recognizing them hinders a timely diagnosis and treatment and has an impact on the mother and the establishment of the fundamental bond of the mother-child dyad. We must recognize the risk factors (age, socioeconomic status, mental health history, family dysfunction, unfavorable environment), clinical manifestations, and screening tools. There is evidence that the effect of stress, anxiety, and depression during pregnancy negatively affect fetal neurodevelopment and condition child developmental outcomes. Here we describe the negative impact of postpartum depression during the first months of life, which affects mother-child bonding, postnatal development (emotional, behavioral, cognitive, language), and the maintenance of breastfeeding. We also recognize protective factors that mitigate its effects. It is essential to establish preventive strategies and interdisciplinary diagnostic and therapeutic approaches to minimize the risks to the mother and her children.
Topics: Humans; Female; Pregnancy; Infant; Depression, Postpartum; Pregnant Women; Mother-Child Relations; Mothers; Parturition; Cognition
PubMed: 38231589
DOI: 10.5546/aap.2023-10217.eng -
Journal of Ayub Medical College,... 2021The present study intended to examine the direct effects of perceived spousal support and postpartum depression on postpartum maternal bonding. Furthermore, it also...
BACKGROUND
The present study intended to examine the direct effects of perceived spousal support and postpartum depression on postpartum maternal bonding. Furthermore, it also explored the mediating role of postpartum depression between perceived spousal support and postpartum maternal bonding.
METHODS
This study was based on a cross-sectional survey research design. A purposive sample of 170 women who were already diagnosed by the doctor/psychiatrist as suffering from postpartum depression was recruited from different hospitals of Gujrat district. Urdu translated versions of The Marital Empathy Scale, Postpartum Bonding Questionnaire, and the Edinburgh Postnatal Depression Scale were used to measure the focal constructs of the study.
RESULTS
IBM Amos was used to test the proposed model of the present study. Path analysis revealed that perceived spousal support had negative significant direct effects on postpartum depression and postpartum maternal bonding. Postpartum depression had significant positive direct effect on postpartum maternal bonding. Finally, the significant indirect effect of perceived spousal support through postpartum depression on postpartum maternal bonding was negative.
CONCLUSIONS
The mediation found in the present study suggested that perceived spousal support reduced the postpartum depression, which in turn, lowered the chances of dysfunctional postpartum maternal bonding with the baby. Implications of the study along with the recommendations for future studies have been reflected upon.
Topics: Cross-Sectional Studies; Depression, Postpartum; Female; Humans; Infant; Infant, Newborn; Male; Mother-Child Relations; Social Support; Spouses; Surveys and Questionnaires
PubMed: 33774957
DOI: No ID Found -
Brazilian Journal of Anesthesiology... 2021Postpartum depression affects women, manifesting with depressed mood, insomnia, psychomotor retardation, and suicidal thoughts. Our study examined if there is an... (Observational Study)
Observational Study
BACKGROUND AND OBJECTIVES
Postpartum depression affects women, manifesting with depressed mood, insomnia, psychomotor retardation, and suicidal thoughts. Our study examined if there is an association between epidural analgesia use and postpartum depression.
METHODS
Patients were divided into two groups. One group received epidural analgesia during labor while the second group did not. The Edinburgh postnatal depression scale (EPDS) was administered to patients prior to birth and 6 weeks postpartum. Pain severity was assessed by the Visual Analogue Scale (VAS) during labor and at 24hours postpartum.
RESULTS
Of the 92 patients analyzed, 47.8% (n=44) received epidural analgesia. We detected significantly higher VAS score during labor (p= 0.007) and 24 hours postpartum (p = 0.0001) in the group without epidural analgesia. At 6 weeks postpartum, a significant difference was observed between the EPDS scores of both groups (p= 0.0001). Regression analysis revealed higher depression scores in patients experiencing higher levels of pain during labor (OR = 0.572, p= 0.039). Epidural analgesia strongly correlated with lower scores of depression (OR = 0.29, p= 0.0001).
CONCLUSION
The group that received epidural analgesia had lower pain scores. A high correlation between epidural analgesia and lower depression levels was found. Pregnant women giving birth via the vaginal route and having high pain scores could reduce postnatal depression scores using epidural labor analgesia. Pregnant women should opt for epidural analgesia during labor to lessen postpartum depression levels.
Topics: Analgesia, Epidural; Analgesia, Obstetrical; Anesthesia, Epidural; Depression, Postpartum; Female; Humans; Labor, Obstetric; Pain Management; Pregnancy
PubMed: 33941362
DOI: 10.1016/j.bjane.2021.02.021 -
BMC Public Health Dec 2022Exposure to stressful situations, such as emergencies, infectious diseases, and natural disasters, may lead to a heightened risk of perinatal mental health problems....
OBJECTIVE
Exposure to stressful situations, such as emergencies, infectious diseases, and natural disasters, may lead to a heightened risk of perinatal mental health problems. Declared on March 11th, 2020, the global COVID-19 pandemic triggered an additional burden on women in the perinatal period. Safety recommendations, such as social distancing and isolation, were opposite to the usual advice given to new mothers. Besides fear, changes in financial stability and daily life reorganization contributed to increased depressive symptoms. As the periods of epidemic waves and lockdowns were associated with a more significant burden for young families, we aimed to assess the intensification of depressive and anxiety symptoms during the pandemic concerning the time intervals of the three lockdowns introduced in Poland.
METHODS
1588 postpartum women took part in the online self-assessment with the Edinburgh Postnatal Depression Scale (EPDS) and General Anxiety Disorder 2 (GAD-2) questionnaire between January 1, 2020, and March 31, 2021. This self-screening is a part of a prevention program The Next Stop: Mum, implemented in the North of Poland.
RESULTS
The highest severity of PPD symptoms and anxiety were observed during the second lockdown in Poland: the mean score in the EPDS and anxiety assessment was significantly higher than the mean scores from previous pandemic periods. Since the second lockdown, the average EPDS and GAD-2 scores remained similarly high. Moreover, with the duration of the COVID-19 pandemic, the percentage of women with elevated symptoms of postpartum depression and anxiety began to increase. However, the Polish National Health Fund data indicate that only 0,7% of women giving birth in the northern macro-region of Poland received diagnosis and help from public funds. In The Next Stop: Mum project, 250 women benefited from psychological consultations.
CONCLUSION
Increased severity of depression and anxiety symptoms during the pandemic indicates the need for additional psychological support for postpartum women. However, very few women are diagnosed in health facilities in the first year postpartum and thus are rarely referred for further treatment. The study shows that the availability of services and the focus on social and individual barriers may be critical factors in implementing perinatal mental health programs and practices. This may be especially needed in a country where the screening obligation is new. In case of a further pandemic, policymakers and health care professionals should be aware that the duration of the restrictions and the repetition of lockdowns are associated with the aggravation of symptoms. The online screening without the possibility to discuss the results is only partially effective in increasing referrals for possibly affected women.
Topics: Pregnancy; Female; Humans; Depression, Postpartum; Pandemics; COVID-19; Communicable Disease Control; Postpartum Period; Anxiety; Depression
PubMed: 36539811
DOI: 10.1186/s12889-022-14705-5 -
BMC Pregnancy and Childbirth Jun 2024Postpartum depression is a complex mental health condition that often occurs after childbirth and is characterized by persistent sadness, anxiety, and fatigue. Recent...
BACKGROUND
Postpartum depression is a complex mental health condition that often occurs after childbirth and is characterized by persistent sadness, anxiety, and fatigue. Recent research suggests a metabolic component to the disorder. This study aims to investigate the causal relationship between blood metabolites and postpartum depression using mendelian randomization (MR).
METHODS
This study used a bi-directional MR framework to investigate the causal relationship between 1,400 metabolic biomarkers and postpartum depression. We used two specific genome-wide association studies datasets: one with single nucleotide polymorphisms data from mothers diagnosed with postpartum depression and another with blood metabolite data, both of which focused on people of European ancestry. Genetic variants were chosen as instrumental variables from both datasets using strict criteria to improve the robustness of the MR analysis. The combination of these datasets enabled a thorough examination of genetic influences on metabolic profiles associated with postpartum depression. Statistical analyses were conducted using techniques such as inverse variance weighting, weighted median, and model-based estimation, which enabled rigorous causal inference from the observed associations. postpartum depression was defined using endpoint definitions approved by the FinnGen study's clinical expert groups, which included leading experts in their respective medical fields.
RESULTS
The MR analysis identified seven metabolites that could be linked to postpartum depression. Out of these, one metabolite was found to be protective, while six were associated with an increased risk of developing the condition. The results were consistent across multiple MR methods, indicating a significant correlation.
CONCLUSIONS
This study emphasizes the potential of metabolomics for understanding postpartum depression. The discovery of specific metabolites associated with the condition sheds new insights on its pathophysiology and opens up possibilities for future research into targeted treatment strategies.
Topics: Humans; Depression, Postpartum; Female; Mendelian Randomization Analysis; Genome-Wide Association Study; Polymorphism, Single Nucleotide; Metabolomics; Biomarkers; Adult; White People; Pregnancy
PubMed: 38877415
DOI: 10.1186/s12884-024-06628-3 -
Translational Psychiatry Sep 2022Postpartum depression (PPD) is a serious condition associated with potentially tragic outcomes, and in an ideal world PPDs should be prevented. Risk prediction models...
Postpartum depression (PPD) is a serious condition associated with potentially tragic outcomes, and in an ideal world PPDs should be prevented. Risk prediction models have been developed in psychiatry estimating an individual's probability of developing a specific condition, and recently a few models have also emerged within the field of PPD research, although none are implemented in clinical care. For the present study we aimed to develop and validate a prediction model to assess individualized risk of PPD and provide a tentative template for individualized risk calculation offering opportunities for additional external validation of this tool. Danish population registers served as our data sources and PPD was defined as recorded contact to a psychiatric treatment facility (ICD-10 code DF32-33) or redeemed antidepressant prescriptions (ATC code N06A), resulting in a sample of 6,402 PPD cases (development sample) and 2,379 (validation sample). Candidate predictors covered background information including cohabitating status, age, education, and previous psychiatric episodes in index mother (Core model), additional variables related to pregnancy and childbirth (Extended model), and further health information about the mother and her family (Extended+ model). Results indicated our recalibrated Extended model with 14 variables achieved highest performance with satisfying calibration and discrimination. Previous psychiatric history, maternal age, low education, and hyperemesis gravidarum were the most important predictors. Moving forward, external validation of the model represents the next step, while considering who will benefit from preventive PPD interventions, as well as considering potential consequences from false positive and negative test results, defined through different threshold values.
Topics: Antidepressive Agents; Depression, Postpartum; Female; Humans; Mothers; Pregnancy; Risk Factors
PubMed: 36180471
DOI: 10.1038/s41398-022-02190-8 -
Taiwanese Journal of Obstetrics &... Nov 2022Postpartum depression (PPD) can occur in women soon after childbirth. The aim of this study was to investigate the risk and protective factors for immediate PPD in a...
OBJECTIVE
Postpartum depression (PPD) can occur in women soon after childbirth. The aim of this study was to investigate the risk and protective factors for immediate PPD in a baby-friendly hospital.
MATERIALS AND METHODS
This cross-sectional study of singleton term pregnancies was performed at MacKay Memorial Hospital in Taiwan from January to September 2019. The enrolled women completed the Edinburgh Postnatal Depression Scale (EPDS) within 48 h after childbirth. Maternal characteristics, pregnancy and delivery factors, maternal comorbidities, supportive and childbirth factors, and neonatal outcomes were investigated.
RESULTS
Of the 1197 enrolled women, 1104 (92.23%) were at low risk (EPDS score ≤9), 66 (5.51%) were at moderate risk (EPDS score 10 to 12), and 27 (2.26%) were at high risk (EPDS score ≥13) of PPD. Significant independent risk factors for immediate PPD included the number of miscarriages (adjusted odds ratio (aOR) 1.33, 95% confidence interval (CI) 1.03-1.72, p = 0.031) and intermediate care nursery (ICN) or neonatal intensive care unit (NICU) admission (aOR 2.29, 95% CI 1.13-4.64, p = 0.022). Significant independent protective factors included planned pregnancy (aOR 0.51, 95% CI 0.28-0.92, p = 0.026), husband accompanying his wife (aOR 0.41, 95% CI 0.22-0.75, p = 0.004), early mother and newborn skin-to-skin contact (aOR 0.44, 95% CI 0.24-0.84, p = 0.012), and breastfeeding (aOR 0.23, 95% CI 0.08-0.71, p = 0.010).
CONCLUSION
The number of miscarriages and ICN or NICU admission were independent risk factors for immediate PPD. Planned pregnancy, husband accompanying his wife, early skin-to-skin contact, and breastfeeding were independent protective factors for immediate PPD. Health care providers should pay attention to the risk factors and promote the protective factors into hospital policies to prevent the consequences of PPD.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Depression, Postpartum; Protective Factors; Cross-Sectional Studies; Abortion, Spontaneous; Taiwan; Hospitals
PubMed: 36428001
DOI: 10.1016/j.tjog.2022.08.004