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Discover Mental Health Jun 2024Postpartum depression and anxiety are major public health concerns that affect 3-39% of women after childbearing and can adversely affect maternal and child health. Most...
Prevalence and predictors of postpartum depression and generalized anxiety symptoms among women who delivered at a tertiary hospital in Mwanza Tanzania: a cross-sectional study.
BACKGROUND
Postpartum depression and anxiety are major public health concerns that affect 3-39% of women after childbearing and can adversely affect maternal and child health. Most studies have investigated postpartum depression and anxiety and their associated factors among women 4-12 weeks after delivery. There is a scarcity of research among women immediately after delivery from low- and middle-income countries, the gap this study aimed to fill.
METHODS
A descriptive cross-sectional study was conducted among 386 postpartum women within one week after delivery. The Edinburg Postnatal Depression Scale was used to assess depressive symptoms and the Generalized Anxiety Disorder - 7 scale was used to screen for symptoms of generalized anxiety disorder. Participants were systematically selected from the postnatal wards and interviewed by trained research assistants from November 2019 to March 2020.
RESULTS
Using standard cut points, the prevalence of depressive and anxiety symptoms was 25.39%, and 37.31% respectively. Having a baby with a weight of 2.5 kgs or more and having partner support were associated with decreased odds of both depression and anxiety symptoms. In contrast, complications during delivery, caesarian section, marital status, and partner violence, were associated with increased odds of depressive and anxiety symptoms post-delivery.
CONCLUSION
There was a high prevalence of postpartum depression and anxiety symptoms among the study participants in the first week post-delivery, with delivery complications and outcome and psychosocial supports identified as associated factors for depression and anxiety symptoms. These findings highlight the need for early screening to identify those at risk for appropriate intervention.
PubMed: 38849688
DOI: 10.1007/s44192-024-00074-5 -
International Journal of Gynaecology... Jun 2024To assess the feasibility of universal screening of postpartum depression (PPD), using the Edinburgh Postpartum Depression Scale (EPDS) in the general population. To...
OBJECTIVES
To assess the feasibility of universal screening of postpartum depression (PPD), using the Edinburgh Postpartum Depression Scale (EPDS) in the general population. To investigate the proportion of women identified as being at risk of PPD and with confirmed PPD or other mental disorders after a psychiatric consultation.
METHODS
A multicenter prospective cohort study in four French maternities conducted between 2020 and 2023. All women aged over 18 years, who delivered following a singleton pregnancy after 37 weeks of gestation were eligible for inclusion. The exclusion criteria were pre-existing psychiatric disorders such as depressive syndrome. The EPDS was completed at 8 weeks postpartum via an online self-administered questionnaire. If the response to the questionnaire suggested a mental disorder, a psychiatric consultation was proposed to the women concerned. The endpoints were the proportion of women completing the EPDS, the EPDS score, the proportion of women at risk of PPD, the proportion of psychiatric consultation, and the subsequent diagnosis.
RESULTS
The study included 923 women, of whom 55.0% (508/923) completed the EPDS. Among them, 28.1% (143/508) had an EPDS score of 10 or more, and 11.2% (57/508) received a psychiatric consultation. PPD was confirmed in 8.8% (5/57) of women. Other disorders detected were mood disorders, disorders specifically associated with stress, and anxiety/fear-related disorders, in 33.3%, 28.1%, and 14.0% of the women, respectively.
CONCLUSIONS
Screening with self-administered EPDS is feasible, with a good response rate, making it possible to suspect mental disorders, including PPD, and to offer psychological support when needed.
PubMed: 38837447
DOI: 10.1002/ijgo.15722 -
Anaesthesia Jun 2024
PubMed: 38837374
DOI: 10.1111/anae.16356 -
Infant Mental Health Journal Jun 2024Mother-infant bonding is influenced by several risk and protective factors, and the literature has investigated the relationships between these factors independently....
Mother-infant bonding is influenced by several risk and protective factors, and the literature has investigated the relationships between these factors independently. This study aimed to verify the interrelationships of some of these factors and how they influence mother-infant bonding in Brazil. In this study, 361 mothers participated, and the outcome variable of mother-infant bonding was assessed using the Postpartum Bonding Questionnaire (PBQ). Multivariate regression analysis was performed using a hierarchical model with three blocks structured according to the influence exerted on mother-infant bonding. The PBQ's factor scores were estimated and used in the subsequent analyses to decrease measurement error. The variable "violence experienced by mothers" was statistically significant for explaining the second block model but not significant for the third block. Network analysis was performed after multiple regression, showing that the violence experienced by mothers does not directly influence mother-infant bonding but rather is mediated by postpartum depression. This explains why violence is not significant in the hierarchical multiple regression when maternal depression is added to the model. This study's strengths lie in its utilization of PBQ factor scores and network analysis, enabling the estimation of conditional relationships among variables. This approach provides deeper insights into factors affecting mother-infant bonding.
PubMed: 38837243
DOI: 10.1002/imhj.22126 -
Research Quarterly For Exercise and... Jun 2024Pilates-based programs can help pregnant women deal with the physical and psychological burden derived by major changes in their body. This study was designed to...
Pilates-based programs can help pregnant women deal with the physical and psychological burden derived by major changes in their body. This study was designed to primarily test, in pregnant women, the dose-response and health effects of both pre-partum and post-partum, online Pilates-based program on weight control, low back pain (LBP) severity, sleep disturbances, mood and depression levels. A total of 136 pregnant women were screened for eligibility (low-risk pregnancy; aged 18-45 years; single pregnancy; 20-28-week gestational age, normal BMI). Participants completed an online Pilates-based program during pregnancy and after delivery, through an online platform guided by a Pilates, Yoga and Lagree certified instructor. Main outcomes (weight control, LBP disability, sleep quality, mood, and mental health) were assessed at baseline and at the completion of pre- and post-partum programs. Regarding pre-partum, significant gains in weight were observed only in low- and intermediate-amount exercisers. Only high-amount exercisers did not display significant increase in LBP-related disability (+42.7%; = .21) unlike low (+12.2%; < .0001) and intermediate exercisers (+9.6%; < .0001). Sleep disturbances increased significantly in low- (+24.3%; = .005) but not in intermediate- (+4.6%; = .50) and high-amount exercisers (-0.1%; = .91). Regardless of the amount of exercise, depression scores improved in all groups. Following post-partum intervention ( = 40), only intermediate-amount exercisers showed significant reductions in sleep disturbances (-24.1%; = .003) and depression (15.9%; = .04). Approximately 270 min/week of an online Pilates-based program were needed to prevent LBP worsening, and sleep deterioration in pregnant women. A different pattern was outlined for those women resuming the Pilates-based intervention at post-partum, with 150 min/week emerging as the "dose" of exercise capable of inducing the largest improvements in LBP, sleep, and mood disturbances.
PubMed: 38837186
DOI: 10.1080/02701367.2024.2340047 -
Alternative Therapies in Health and... Jun 2024This study investigated the impact of the use of a family-based delivery room on primiparous women's clinical outcomes and psychological well-being during childbirth. It...
Comparison of Clinical Outcomes and Postpartum Psychological Status Scores in Primiparous Women Delivered with Family Members in a Family-Based Room vs Women Delivered in a General Ward.
BACKGROUND
This study investigated the impact of the use of a family-based delivery room on primiparous women's clinical outcomes and psychological well-being during childbirth. It addressed the growing interest in family-centered care and assessed the effectiveness of a family-based room in providing a supportive environment for delivery.
OBJECTIVE
We aimed to compare the clinical outcomes and postpartum scores regarding the psychological status of primiparous women who delivered with their families in a home-based labor ward and women who delivered in a general labor ward.
METHODS
In this retrospective study, 158 primiparous women, recruited between October 2021 and July 2022, were categorized into 2 groups based on their choice of delivery room: a family group (n=77) and a general group (n=81). Baseline data, indicators related to maternal role adjustment, pregnancy outcomes, psychological status, self-efficacy and quality of life (QoL) data were collected and compared between the 2 groups.
RESULTS
More women in the family group were well- and generally adapted than in the general group, and fewer were poorly adapted than in the general group (P < .05). There were more spontaneous deliveries in the family group than in the general group, and fewer cesarean deliveries, postpartum hemorrhages and cases of neonatal asphyxia than in the general group; lower postpartum Numerical Rating Scale (NRS) scores and higher Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores than in the general group, with notably better pregnancy outcomes in the family group (P < .05). Postpartum State Anxiety Inventory (S-AI) and Edinburgh Postnatal Depression Scale (EPDS) scores in the family group (50.25±1.58 and 8.02±0.35, respectively) were remarkably lower than in the general group (59.89±1.98 and 9.84±0.69, respectively) (P < .05). The family group exhibited a postpartum score of self-efficacy higher compared with the general group (P < .05). The QoL score in the family group was noticeably higher than in the general group (P < .05). The time of colostrum secretion in the family group was significantly earlier compared with the control group, and milk production within 48 hours postpartum was significantly higher in the family group (P < .05).
CONCLUSION
The family-based delivery room model significantly enhanced maternal role adaptation, increased the rate of spontaneous delivery, reduced the risk for cesarean conversion and diminished adverse maternal and infant outcomes. In addition, it substantially improved postpartum psychological status and positively influenced maternal self-efficacy and QoL. These findings hold significant reference value for maternal care practices.
PubMed: 38836737
DOI: No ID Found -
Neonatology Today Apr 2024The COVID-19 pandemic posed challenges to measuring mother-infant interactions, a critical outcome for many interventions to support mothers with postpartum depression...
PURPOSE
The COVID-19 pandemic posed challenges to measuring mother-infant interactions, a critical outcome for many interventions to support mothers with postpartum depression symptoms and their new infants. The current study describes the process and lessons learned from implementing a remote assessment of mother-infant interactions during the pandemic.
DESCRIPTION
At the onset of the COVID-19 pandemic, we pivoted from in-person to using two different strategies to remotely assess mother-infant interactions: (1) participants independently recorded and uploaded videos of free-play with their child; and (2) research team conducted a live-video recording of the free-play.
ASSESSMENT
We found initial barriers including technical and video quality issues but overall, a remote option could increase enrollment and retention rates in a sample of postpartum women across various racial/ethnic groups and economic levels.
CONCLUSION
Our experiences in conducting remote assessments with postpartum women add to growing evidence for the feasibility and validity of remote visits. This showed how our methods can be implemented in future research and in practice with postpartum mothers and their infants.
PubMed: 38836047
DOI: No ID Found -
Frontiers in Immunology 2024Depressive syndrome (DS) is a common complication during pregnancy and the postpartum period, and is triggered by multiple organic/genetic and environmental factors....
INTRODUCTION
Depressive syndrome (DS) is a common complication during pregnancy and the postpartum period, and is triggered by multiple organic/genetic and environmental factors. Clinical and biochemical follow-up is essential for the early diagnosis and prognosis of DS. The protozoan Toxoplasma gondii causes infectious damage to the fetus during parasite primary-infection. However, in long-term infections, pregnant women develop immune protection to protect the fetus, although they remain susceptible to pathological or inflammatory effects induced by T. gondii. This study aimed to investigate plasma inflammatory biomarkers in pregnant women seropositive and seronegative for T. gondii, with diagnoses of minor and moderate/severe DS.
METHODS
Pregnant women (n=45; age=18-39 years) were recruited during prenatal care at health centers in Ouro Preto, Minas Gerais, Brazil. Participants were asked to complete a socio-demographic questionnaire to be submitted to well-standardized DS scale calculators (Beck Depression Inventory Questionnaire, Edinburgh Postnatal Depression Scale, and Major Depressive Episode Module). Additionally, 4 mL of blood was collected for plasma neuroserpin, CCL2, IL-17A, and IL-33 analysis.
RESULTS
Pregnant volunteers with chronic T. gondii contact were all IgG+ (44%; n=21) and exhibited increased plasma IL-33, IL-17A, and neuroserpin levels, but not CCL2, compared to uninfected pregnant women. Using Beck's depression inventory, we observed an increase in plasma IL-17A and IL-33 in women with T. gondii infeCction diagnosed with mild DS, whereas neuroserpin was associated with minor and moderate/severe DS.
DISCUSSION
Our data suggest a close relationship between DS in pregnant women with chronic T. gondii infection and neurological conditions, which may be partially mediated by plasma neuroserpin, IL-33, and IL-17A levels.
Topics: Humans; Female; Pregnancy; Interleukin-17; Adult; Toxoplasmosis; Biomarkers; Interleukin-33; Young Adult; Toxoplasma; Adolescent; Pregnancy Complications, Parasitic; Depression
PubMed: 38835777
DOI: 10.3389/fimmu.2024.1394456 -
Frontiers in Psychiatry 2024Understanding the mechanisms underlying maternal postpartum depression (PPD) and its effects on offspring development is crucial. However, research on the association...
INTRODUCTION
Understanding the mechanisms underlying maternal postpartum depression (PPD) and its effects on offspring development is crucial. However, research on the association between maternal PPD, gut microbiota, and offspring neurodevelopment remains limited. This study aimed to examine the association of maternal PPD symptoms with early gut microbiome, gut metabolome, and neurodevelopment in infants at 6 months.
METHODS
Maternal PPD symptoms were assessed using the Edinburgh Postpartum Depression Scale (EPDS) at 42 days postpartum. Infants stool samples collected at 42 days after birth were analyzed using 16S rRNA sequencing and liquid chromatography-mass spectrometry (LC-MS) detection. Infant neurodevelopment was measured at 6 months using the Ages and Stages Questionnaire, Third Edition (ASQ-3). Correlations between gut microbiota, metabolites and neurodevelopment were identified through co-occurrence network analysis. Finally, mediation analyses were conducted to determine potential causal pathways.
RESULTS
A total of 101 mother-infant dyads were included in the final analysis. Infants born to mothers with PPD symptoms at 42 days postpartum had lower neurodevelopmental scores at 6 months. These infants also had increased alpha diversity of gut microbiota and were abundant in and , while depleted abundance of , , and Furthermore, alterations were observed in metabolite levels linked to the Alanine, aspartate, and glutamate metabolic pathway, primarily characterized by decreases in N-Acetyl-L-aspartic acid, L-Aspartic acid, and L-Asparagine. Co-occurrence network and mediation analyses revealed that N-Acetyl-L-aspartic acid and L-Aspartic acid levels mediated the relationship between maternal PPD symptoms and the development of infant problem-solving skills.
CONCLUSIONS
Maternal PPD symptoms are associated with alterations in the gut microbiota and neurodevelopment in infants. This study provides new insights into potential early intervention for infants whose mother experienced PPD. Further research is warranted to elucidate the biological mechanisms underlying these associations.
PubMed: 38835546
DOI: 10.3389/fpsyt.2024.1385229 -
Archives of Women's Mental Health Jun 2024This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation...
PURPOSE
This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation (giving the baby any breastmilk during the first week of life) and breastfeeding maintenance (giving the baby breastmilk for at least 6 months), and a greater likelihood of reporting breastfeeding problems.
METHODS
We analyzed data from the Norwegian Mother, Father, and Child cohort study (MoBa), N = 78,307. Mothers reported a lifetime history of depression during the second trimester of pregnancy, and current symptoms of depression during the third trimester using the Hopkins Symptoms Checklist short version (SCL-8). At six months postpartum, mothers self-reported breastfeeding initiation, maintenance, and difficulties.
RESULTS
Using binary logistic regression analyses, we report that a lifetime history of depression is associated with a lower likelihood of breastfeeding initiation (OR = 0.751, 95%CI = 0.650-0.938), breastfeeding maintenance (OR = 0.712, 95%CI = 0.669-0.785), and a greater likelihood of breastfeeding difficulties (OR = 1.86, 95%CI = 1.72-2.06). Similarly, prenatal depression was associated with a lower likelihood of breastfeeding initiation (OR = 0.904, 95%CI = 0.878-0.929), breastfeeding maintenance (OR = 0.929, 95%CI = 0.920-0.938), and a greater likelihood of breastfeeding difficulties (OR = 1.10, 95%CI = 1.09-1.12). Results remained largely unchanged when covaried for several confounding variables, including medication use.
CONCLUSION
We provide novel evidence that pre-conception and prenatal symptoms of depression are associated with breastfeeding outcomes. This information could be used to identify women very early in pregnancy who may need additional support with breastfeeding. There is also a need to fully understand the biopsychosocial mechanisms that mediate the relationship between depression prior to birth and breastfeeding outcomes.
PubMed: 38834917
DOI: 10.1007/s00737-024-01479-5