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Gates K, Chahin S, Damashek A, Dickson C, Lubwama G, Lenz D, Bautista T, Kothari C. The Relation of Maternal Psychosocial Risk Factors to Infant Safe Sleep Practices. Matern Child Health J 2024; 28:1061-1071. [PMID: 38460074 DOI: 10.1007/s10995-023-03880-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 03/11/2024]
Abstract
OBJECTIVES Sleep-related infant deaths are a common and preventable cause of infant mortality in the United States. Moreover, infants of color are at a greater risk of sleep-related deaths than are White infants. The American Academy of Pediatrics (AAP) published safe sleep guidelines to minimize the number of sleep-related infant deaths; however, many families face barriers to following these guidelines. Research on the role of psychosocial risk factors (i.e., depression, stress, domestic violence, substance use) in mothers' engagement in safe sleep practices is limited. The present study examined the role of maternal psychosocial risk factors on maternal safe sleep practices and the moderating effects of maternal race on this relationship. METHODS Participants in this study were mothers (N = 274) who were recruited from a Midwestern hospital postpartum. Data on the participants' psychosocial risk factors, and safe sleep practices were collected via telephone interview 2-4 months following the birth of their infant. RESULTS Predictive models indicated that depression and stress impacted mothers' engagement in following the safe sleep guidelines. Specifically, higher levels of maternal depression predicted greater likelihood of co-sleeping, regardless of mothers' race. Higher levels of maternal stress also predicted lower engagement in safe sleep behaviors for White mothers only. CONCLUSION FOR PRACTICE Early interventions to address stress and depression may help to increase maternal adherence to the AAP's safe sleep guidelines. Additional research on the underlying mechanisms of depression and stress on maternal safe sleep engagement is needed.
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Affiliation(s)
- Kalani Gates
- Department of Psychology, Western Michigan University, 1903 W. Michigan, Kalamazoo, MI, 49008, USA
| | - Summer Chahin
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 300 Portage St., Kalamazoo, MI, 49007, USA
| | - Amy Damashek
- Department of Psychology, Western Michigan University, 1903 W. Michigan, Kalamazoo, MI, 49008, USA.
| | - Cheryl Dickson
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 300 Portage St., Kalamazoo, MI, 49007, USA
| | - Grace Lubwama
- Kalamazoo Community Foundation, 402 E. Michigan, Kalamazoo, MI, 49007, USA
| | - Debra Lenz
- Kalamazoo County Health and Community Services Department, 311 E. Alcott St., Kalamazoo, MI, 49006, USA
| | | | - Catherine Kothari
- Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Dr., Kalamazoo, MI, 49008, USA
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Deligiannidis KM, Bullock A, Nandy I, Dunbar J, Lasser R, Witte M, Leclair B, Wald J. Zuranolone Concentrations in the Breast Milk of Healthy, Lactating Individuals: Results From a Phase 1 Open-Label Study. J Clin Psychopharmacol 2024:00004714-990000000-00252. [PMID: 38739007 DOI: 10.1097/jcp.0000000000001873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
PURPOSE/BACKGROUND Zuranolone is a positive allosteric modulator of both synaptic and extrasynaptic γ-aminobutyric acid type A receptors and a neuroactive steroid approved as an oral, once-daily, 14-day treatment course for adults with postpartum depression in the United States. This study assessed zuranolone transfer into breast milk. METHODS/PROCEDURES Healthy, nonpregnant, lactating adult female participants received once-daily 30 mg zuranolone from day (D)1 through D5 in this phase 1 open-label study. The relative infant dose (RID; weight-adjusted proportion of the maternal dose in breast milk over 24 hours) for 30 mg zuranolone was assessed at D5. An RID for 50 mg zuranolone was estimated using a simulation approach across a range of infant ages and weights. FINDINGS/RESULTS Of 15 enrolled participants (mean age, 30.1 years), 14 completed the study. The mean RID for 30 mg zuranolone at D5 was 0.357%; the mean steady-state milk volume over D3 to D5 decreased from baseline by 8.3%. Overall unbound zuranolone in plasma was low (≤0.49%). Plasma concentrations peaked at D5 before decreasing in a biexponential manner. There was strong concordance between the temporal evolution of zuranolone concentrations in plasma and breast milk. The estimated mean RID for 50 mg zuranolone based on a milk intake of 200 mL/kg per day was 0.984%. All treatment-emergent adverse events reported by participants were mild, the most common being dizziness (n = 3). IMPLICATIONS/CONCLUSIONS Zuranolone transfer into the breast milk of healthy, nonpregnant, lactating adult female participants was low; the estimated RID for 50 mg zuranolone was <1%, well below the <10% threshold generally considered compatible with breastfeeding.
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Shrestha D, K C Bhandari A, Ogawa K, Tanaka H, Miyayama C, Horikawa R, Urayama KY, Morisaki N. Effect of postpartum depression and role of infant feeding practices on relative weight of child at 1 and 3 years of age. BMC Pregnancy Childbirth 2024; 24:336. [PMID: 38698333 PMCID: PMC11067203 DOI: 10.1186/s12884-024-06483-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Childhood obesity has increased and is considered one of the most serious public health challenges of the 21st century globally, and may be exacerbated by postpartum depression (PPD). The purpose of this study was to examine the association between PPD at 1st and 6th month postpartum, infant feeding practices, and body mass index (BMI) z-score of the child at one and three years of age. METHODS This study used data from an ongoing prospective maternal-child birth cohort performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan with the period of recruitment from May 13, 2010 to November 28, 2013. Out of 2,309 total number of mothers, 1,279 mother-child dyads were assessed in the study. We performed multivariable linear regression analysis to examine the association between PPD and child's BMI z-score stratified by the child's age at 1 year and 3 years of age. RESULTS The prevalence of PPD at 1 month postpartum (17%) was found to be higher than at 6 months (12%). In multivariable linear regression analysis we observed that children at 3 years who had mothers with PPD at 6 months had, on average, a BMI z-score 0.25 higher than children of mothers who did not have PPD at 6 months (ß coefficient 0.25, 95% CI [0.04 to 0.46], p value 0.02), holding all other covariates constant. Also, initiation of weaning food when child is at six months of age was associated with higher BMI z-score of the child at 3 years after adjusting for all covariates (ß coefficient = 0.18, 95% CI [0.03 to 0.34], p-value < 0.05). CONCLUSION The significant association between PPD at 6 months and child's BMI z-score at 3 years of age, in conjunction with birth trends and high prevalence of PPD, can add to the body of evidence that there is need for multiple assessment across the first postpartum year to rule out PPD as early screening and early interventions may benefit both maternal health and child development outcomes. These findings can indicate the need for establishing support systems for care-giving activities for mothers with PPD.
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Affiliation(s)
- Drishti Shrestha
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.
| | - Aliza K C Bhandari
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kohei Ogawa
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Hisako Tanaka
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Chiharu Miyayama
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Kevin Y Urayama
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.
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Wu Q. The Degree of Fluctuations in Maternal Depressive Symptoms in Early Childhood is Associated with Children's Depression Risk: Initial Evidence and Replication Between Two Independent Samples. Res Child Adolesc Psychopathol 2024; 52:727-741. [PMID: 38047971 DOI: 10.1007/s10802-023-01159-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
Guided by life history theory, the present study examined whether the degree of fluctuations in maternal depressive symptoms in early childhood was prospectively linked to children's risk for depression. This was the first study to present preliminary evidence on this topic and replicated main findings across two large, independent longitudinal samples. Study 1 included 1,364 families where maternal depressive symptoms were longitudinally assessed at child ages 1, 6, 15, 24, and 36, and 54 months, where child depressed/anxious behaviors at Grade 1 were reported. Study 2 included 1,292 families where maternal depressive symptoms were assessed at child ages 2, 6, 15, and 24 months. At 36 months, child internalizing symptoms and inhibitory control were assessed. In Study 1, findings revealed that the degree of fluctuations in maternal depressive symptoms over 54 months was associated with higher child depressed/anxious behaviors at Grade 1, only when mothers had higher but decreasing depressive symptoms. Study 2 revealed that the degree of fluctuations in maternal depressive symptoms over 24 months was related to higher child internalizing symptoms at 36 months, for mothers whose depressive symptoms were higher but decreasing, higher and increasing, and lower and decreasing. In addition, the degree of fluctuations in maternal depressive symptoms over 24 months was related to lower child inhibitory control at 36 months, for mothers who had higher but decreasing depressive symptoms. Findings highlighted the degree of fluctuations in maternal depressive symptoms during early childhood can contribute to environmental unpredictability, which can increase children's depression risks.
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Affiliation(s)
- Qiong Wu
- Department of Human Development & Family Science, College of Education, Health, and Human Sciences, Florida State University, Sandels 322, 120 Convocation Way, Tallahassee, FL, 32306, USA.
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Constable R, Price S, Mallan KM. Paternal postnatal depression and parenting behaviours in the first year of life. Child Care Health Dev 2024; 50:e13219. [PMID: 38265141 DOI: 10.1111/cch.13219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 08/04/2023] [Accepted: 12/03/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Paternal postnatal depression (PPD) symptomology has been positively associated with poorer outcomes for children. One mechanism by which PPD is thought to influence child outcomes is through parenting. The current study investigated the association between paternal postnatal depressive symptoms and parenting behaviours. METHOD Fathers (N = 213) with an infant (mean age = 7 months, 46% female) between 2 and 12 months old were recruited through community and social media advertisements, as well as a paid survey recruitment website. Fathers completed a questionnaire on their symptoms of PPD and how they care for and raise their child (parental warmth, irritability, engagement in enrichment, play and safety behaviours). RESULTS Fathers experiencing greater levels of PPD symptomatology self-reported higher irritability, lower warmth and fewer safe parenting behaviours but did not report lower enrichment or play with their infants. CONCLUSION Overall, findings suggest that PPD symptomology may impact negatively on aspects of fathers' parenting behaviours. Further research using larger and more diverse samples is needed to assess the generalisability of these findings.
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Affiliation(s)
- Remy Constable
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Shelby Price
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Queensland, Australia
| | - Kimberley M Mallan
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Queensland, Australia
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Meltzer-Brody S, Gerbasi ME, Mak C, Toubouti Y, Smith S, Roskell N, Tan R, Chen SYS, Deligiannidis KM. Indirect comparisons of relative efficacy estimates of zuranolone and selective serotonin reuptake inhibitors for postpartum depression. J Med Econ 2024; 27:582-595. [PMID: 38523596 DOI: 10.1080/13696998.2024.2334160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/20/2024] [Indexed: 03/26/2024]
Abstract
AIMS Estimate relative efficacy of zuranolone, a novel oral, Food and Drug Administration-approved treatment for postpartum depression (PPD) in adults vs. selective serotonin reuptake inhibitors (SSRIs) and combination therapies used for PPD in the United States. MATERIALS AND METHODS Randomized controlled trials (RCTs) for zuranolone and SSRIs, identified from systematic review, were used to construct evidence networks, linking via common comparator arms. Due to heterogeneity in placebo responses, matching-adjusted indirect comparison (MAIC) was applied, statistically weighting the zuranolone treatment arm of Phase 3 SKYLARK Study (NCT04442503) to the placebo arm of RCTs investigating SSRIs for PPD. MAIC outputs were applied in Bucher indirect treatment comparisons (ITCs) and network meta-analysis (NMA), using Edinburgh Postnatal Depression Scale (EPDS) and 17-item Hamilton Rating Scale for Depression (HAMD-17) change from baseline (CFB) on Days 3, 15, 28 (Month 1), 45, and last observation (Day 45, Week 12/18). RESULTS Larger EPDS CFB was observed among zuranolone-treated vs. SSRI-treated patients from Day 15 onward. Zuranolone-treated (vs. SSRI-treated) patients exhibited 4.22-point larger reduction in EPDS by Day 15 (95% confidence interval: -6.16, -2.28) and 7.43-point larger reduction at Day 45 (-9.84, -5.02) with Bucher ITC. NMA showed EPDS reduction for zuranolone was 4.52 (-6.40, -2.65) points larger than SSRIs by Day 15 and 7.16 (-9.47, -4.85) larger at Day 45. Lack of overlap between study populations substantially reduced effective sample size post-matching, making HAMD-17 CFB analysis infeasible. LIMITATIONS Limited population overlap between SKYLARK Study and RCTs reduced feasibility of undertaking HAMD-17 CFB ITCs and may introduce uncertainty to EPDS CFB ITC results. CONCLUSIONS Analysis showed zuranolone-treated patients with PPD experienced greater symptom improvement than SSRI-treated patients from Day 15 onward, with largest mean difference at Day 45. Adjusting for differences between placebo arms, zuranolone may be associated with greater PPD symptom improvement (measured by EPDS) vs. SSRIs.
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Affiliation(s)
- Samantha Meltzer-Brody
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | | | | | | | | | | | - Robin Tan
- Sage Therapeutics, Inc., Cambridge, MA, USA
| | - Shih-Yin Sharon Chen
- Sage Therapeutics, Inc., Cambridge, MA, USA
- Biogen Inc., Cambridge, MA, USA
- Lumanity Inc., Sheffield, UK
| | - Kristina M Deligiannidis
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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Shriyan P, Khetrapal S, van Schayck OCP, Babu GR. Maternal depressiveness and infant growth outcomes: Findings from the MAASTHI cohort study in India. J Psychosom Res 2023; 170:111378. [PMID: 37244068 PMCID: PMC7614640 DOI: 10.1016/j.jpsychores.2023.111378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The study aims to examine the association between depressiveness in mothers on infant obesity and stunting at one year of age. METHODS We enrolled 4829 pregnant women, followed them up at public health facilities in Bengaluru for one year after birth. We collected information on women's sociodemographic characteristics, obstetric history, depressive symptoms during pregnancy and delivery within 48 h. We took infant anthropometric measurements at birth and one year. We used chi-square tests, and calculated an unadjusted odds ratio using univariate logistic regression. We used multivariate logistic regression to examine the association between maternal depressiveness, childhood adiposity, and stunting. RESULTS We found that the prevalence of depressiveness was 31.8% in mothers who delivered in public health facilities in Bengaluru. Infants born to mothers with depressiveness at birth had 3.9 times higher odds of having larger waist circumference than infants born to mothers with no depressiveness (AOR: 3.96, 95% Confidence Interval: 1.24,12.58) and 1.9 times higher odds of having a larger sum of skinfold thickness (AOR: 1.99, 95% CI: 1.18,3.38). Additionally, we found that infants born to mothers with depressiveness at birth had 1.7 times higher odds of stunting than infants born to mothers with no depressiveness (AOR: 1.72; 95%CI: 1.22,2.43) after adjusting for confounders. CONCLUSION Our study highlights a high prevalence of depressiveness among mothers seeking antenatal care at a public hospital is associated with an increased risk of infant adiposity and stunting at one year. Further research is needed to understand the underlying mechanisms and identify effective interventions.
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Affiliation(s)
- Prafulla Shriyan
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka 560023, India
| | | | - Onno C P van Schayck
- Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Giridhara R Babu
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka 560023, India; The Wellcome Trust/DBT India Alliance, New Delhi 110025, India.
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Akselrod S, Banerjee A, Collins TE, Acharya S, Artykova N, Askew I, Berdzuli N, Diorditsa S, Eggers R, Farrington J, Jakab Z, Ferreira-Borges C, Mikkelsen B, Azzopardi-Muscat N, Olsavszky V, Park K, Sobel H, Tran H, Vujnovic M, Weber M, Were W, Yaqub N, Berlina D, Dunlop CL, Allen LN. Integrating maternal, newborn, child health and non-communicable disease care in the sustainable development goal era. Front Public Health 2023; 11:1183712. [PMID: 37483915 PMCID: PMC10362386 DOI: 10.3389/fpubh.2023.1183712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Noncommunicable diseases (NCDs) and maternal newborn and child health (MNCH) are two deeply intertwined health areas that have been artificially separated by global health policies, resource allocations and programming. Optimal MNCH care can provide a unique opportunity to screen for, prevent and manage early signs of NCDs developing in both the woman and the neonate. This paper considers how NCDs, NCD modifiable risk factors, and NCD metabolic risk factors impact MNCH. We argue that integrated management is essential, but this faces challenges that manifest across all levels of domestic health systems. Progress toward Sustainable Development targets requires joined-up action.
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Affiliation(s)
| | - Anshu Banerjee
- Maternal, Newborn, Child and Adolescent Health, and Ageing, World Health Organization, Geneva, Switzerland
| | - Téa E. Collins
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Shambhu Acharya
- Country Strategy and Support, World Health Organization, Geneva, Switzerland
| | - Nazira Artykova
- WHO European Region Country Office in Kyrgyzstan, Bishkek, Kyrgyzstan
| | - Ian Askew
- Sexual and Reproductive Health, World Health Organization, Geneva, Switzerland
| | - Nino Berdzuli
- Division of Country Health Programmes, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Sergey Diorditsa
- WHO Representative's Office, WHO European Region Country Office in Belarus, Minsk, City of Minsk, Belarus
| | - Rudolf Eggers
- Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Jill Farrington
- Deputy Director-General Office, World Health Organization, Geneva, Switzerland
| | - Zsuzsanna Jakab
- Deputy Director-General Office, World Health Organization, Geneva, Switzerland
| | - Carina Ferreira-Borges
- Division of Country Health Programmes, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Bente Mikkelsen
- NCD Department, World Health Organization, Geneva, Switzerland
| | - Natasha Azzopardi-Muscat
- Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Victor Olsavszky
- WHO European Region Tajikistan Country Office, Dushanbe, Tajikistan
| | - Kidong Park
- Data, Strategy and Innovation Group, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Howard Sobel
- WHO Regional Office for the Western Pacific Country Office in the Solomon Islands, Manila, Philippines
| | - Huong Tran
- Division of Programmes for Disease Control, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Melita Vujnovic
- WHO European Region Office for the Russian Federation, Moscow, Russia
| | - Martin Weber
- Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe Country Office in Greece, Copenhagen, Denmark
| | - Wilson Were
- Child Health and Development, World Health Organization, Geneva, Switzerland
| | - Nuhu Yaqub
- Child Health and Development, World Health Organization, Geneva, Switzerland
| | - Daria Berlina
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Catherine L. Dunlop
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Luke N. Allen
- Global NCD Platform, World Health Organization, Geneva, Switzerland
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Hasan MM, Kader A, Asif CAA, Talukder A. Seasonal variation in the association between household food insecurity and child undernutrition in Bangladesh: Mediating role of child dietary diversity. MATERNAL & CHILD NUTRITION 2023; 19:e13465. [PMID: 36478358 PMCID: PMC10019058 DOI: 10.1111/mcn.13465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022]
Abstract
Household food insecurity (HFI) and child dietary diversity (CDD) are variable across seasons. We examined seasonal variation in HFI and child undernutrition association and tested how CDD mediates this association. We analyzed data for 26,353 children aged 6-59 months drawn from nationally representative cross-sectional Food Security and Nutrition Surveillance Project data collected during 2012-2014 in Bangladesh across three seasons annually: Post-Aman harvest (January-April); Monsoon (May-August); and Post-Aus harvest (September-December). Multivariable logistic regression analysis adjusted for individual, maternal, household and geographical characteristics reveals that children of food-insecure households were more likely than food-secure households to be stunted (adjusted odds ratio, AOR: 1.12; 95% confidence interval, CI: 1.02-1.23; p < 0.05), wasted (AOR: 1.21; 95% CI: 1.05-1.39; p < 0.01) and underweight (AOR: 1.16; 95% CI: 1.04-1.3; p < 0.01). CDD mediated 6.1% of the total effect of HFI on underweight. These findings varied across seasons. HFI was associated with greater odds of underweight during Monsoon (AOR: 1.32; 95% CI: 1.08-1.62; p < 0.01) and Post-Aus (AOR: 1.21; 95% CI: 1.06-1.37; p < 0.01) while wasting during Post-Aus (AOR: 1.65; 95% CI: 1.35-2.01; p < 0.001). CDD largely mediated the total effect of HFI on underweight during the Post-Aman in 2012-2014 (23.2%). CDD largely mediated the total effect of HFI on wasting (39.7%) during Post-Aman season in 2014 and on underweight (13.7%) during the same season in 2012. These findings demonstrate that HFI is seasonally associated with child undernutrition and mediated by CDD as well in Bangladesh and seasonality and diversity should be considered while designing appropriate population-level food-based interventions to resolve child undernutrition.
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Affiliation(s)
| | - Abdul Kader
- Helen Keller IntlCountry OfficeDhakaBangladesh
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Lucarelli L, Vismara L, Chatoor I, Sechi C. Parental Pre and Postnatal Depression: The Longitudinal Associations with Child Negative Affectivity and Dysfunctional Mother–Child Feeding Interactions. CHILDREN 2023; 10:children10030565. [PMID: 36980124 PMCID: PMC10047090 DOI: 10.3390/children10030565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
Background: Many studies have shown the influence of maternal perinatal depression on a child’s emotional and behavioral regulation ability; yet there is scarce research on the impact of the father’s perinatal depression on the caregiver–infant relationship and the child’s development. Methods: Through a longitudinal study, we investigated maternal and paternal depression and its association with infants’ emotionality and mother–infant feeding interactions The sample was constituted of 136 first-time parents (68 couples, and their full-term babies at 3 and 6 months old). At T1 (28th week of pregnancy), T2 (three months old), and T3 (at six months age) parents responded to the Edinburgh Postpartum Depression Scale. At Times 2 and 3, mothers and fathers completed the Infant Behavior Questionnaire, and recorded mother–infant interactions were coded by means of the Feeding Scale. Results: Statistical analyses indicated stability of maternal and paternal depression over time. Correlations emerged between mother’s higher depression scores, negative affective state during interactions at three months age, infant food refusal and mother–infant interactional conflict at six months age. Paternal higher depressive scores were associated with the mother–child interactional conflict. To finish, higher parental depression scores were related with infant negative emotionality. Conclusion: The current study confirms the relevance of embracing a cumulative risk model to support the child’s development with early caregiver-child interventions.
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Affiliation(s)
- Loredana Lucarelli
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy
| | - Laura Vismara
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy
- Correspondence: ; Tel.: +39-333-5301106
| | - Irene Chatoor
- Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC 20052, USA
- Children’s National, Washington, DC 20010, USA
| | - Cristina Sechi
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy
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Domek GJ, Heller Szafran L, Jimenez-Zambrano A, Silveira L. Impact on Maternal Postpartum Depressive Symptoms of a Primary Care Intervention Promoting Early Language: A Pilot Study. Matern Child Health J 2023; 27:346-355. [PMID: 36525167 DOI: 10.1007/s10995-022-03550-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Maternal depressive symptoms are an important risk factor for adverse child outcomes, especially in the perinatal period. We studied whether introducing finger puppets in the primary care setting to promote infant language improves maternal postpartum depressive symptoms. METHODS An intervention cohort was enrolled and given a finger puppet at the 2-month infant well visit. Two usual care cohorts were enrolled at either the 6- or 12-month well visit as part of a larger study. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), which was administered by clinic providers as part of routine screening done at both the 2- and 4-month well visits. EPDS scores were obtained retrospectively through the electronic medical record. RESULTS Included mothers (n = 127) completed the EPDS at 2 and 4 months postpartum. Most children (83%) were on government-sponsored insurance. Mean EPDS scores and scores classified as possible depression (≥ 10) did not differ between cohorts. However, the change in scores between visits was significantly different for intervention (n = 46) compared to usual care (n = 81) participants (-1.1 vs. +0.4, p = 0.001). More intervention scores improved (n = 17, 37%) compared to usual care (n = 14, 17%), while more usual care scores worsened (n = 28, 35%) compared to intervention (n = 6, 13%) (p = 0.008). CONCLUSION Finger puppets introduced during infant primary care visits to support language-rich maternal-infant interactions may provide a simple, low-cost way to improve maternal postpartum depressive symptoms. Larger studies with more diverse populations are needed to determine if effects are replicable, generalizable, and translate into better clinical outcomes.
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Affiliation(s)
- Gretchen J Domek
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Center for Global Health, Colorado School of Public Health, Mail Stop A090, 13199 E Montview Blvd, Suite 310, 80045, Aurora, CO, USA.
| | - Lauren Heller Szafran
- Center for Global Health, Colorado School of Public Health, Mail Stop A090, 13199 E Montview Blvd, Suite 310, 80045, Aurora, CO, USA
| | - Andrea Jimenez-Zambrano
- Center for Global Health, Colorado School of Public Health, Mail Stop A090, 13199 E Montview Blvd, Suite 310, 80045, Aurora, CO, USA.,Adult & Child Center for Outcomes Research & Delivery Science , University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lori Silveira
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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12
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Epperson CN, Rubinow DR, Meltzer-Brody S, Deligiannidis KM, Riesenberg R, Krystal AD, Bankole K, Huang MY, Li H, Brown C, Kanes SJ, Lasser R. Effect of brexanolone on depressive symptoms, anxiety, and insomnia in women with postpartum depression: Pooled analyses from 3 double-blind, randomized, placebo-controlled clinical trials in the HUMMINGBIRD clinical program. J Affect Disord 2023; 320:353-359. [PMID: 36191643 DOI: 10.1016/j.jad.2022.09.143] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/26/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Brexanolone is currently the only treatment specifically approved for postpartum depression (PPD) in the United States, based on the results from one Phase 2 and two Phase 3 double-blind, randomized, controlled trials in the HUMMINGBIRD program. METHODS Adults with PPD randomized to a 60-h infusion of brexanolone 90 μg/kg/h (BRX90) or placebo from the 3 trials were included in these post hoc analyses. Data on change from baseline (CFB) in the 17-item Hamilton Rating Scale for Depression (HAMD-17) total score, HAMD-17 Anxiety/Somatization and Insomnia subscales, and Clinical Global Impression of Improvement (CGI-I) scale were pooled. Response rates for HAMD-17 (≥50 % reduction from baseline) and CGI-I (score of 1 or 2) scales and time to response were analyzed. RESULTS Patients receiving BRX90 (n = 102) versus placebo (n = 107) achieved a more rapid HAMD-17 response (median, 24 vs 36 h; p = 0.0265), with an Hour-60 cumulative response rate of 81.4 % versus 67.3 %; results were similar for time to CGI-I response (median, 24 vs 36 h; p = 0.0058), with an Hour-60 cumulative response rate of 81.4 % versus 61.7 %. CFB in HAMD-17 Anxiety/Somatization and Insomnia subscales also favored BRX90 versus placebo, starting at Hour 24 through Day 30 (all p < 0.05), and response rates for both subscales were higher with BRX90. LIMITATIONS The study was not powered to assess exploratory outcomes. CONCLUSIONS Brexanolone was associated with rapid improvement in depressive symptoms and symptoms of anxiety and insomnia compared with placebo in women with PPD. These data continue to support the use of brexanolone to treat adults with PPD.
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Affiliation(s)
- C Neill Epperson
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States of America.
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America
| | - Samantha Meltzer-Brody
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America
| | - Kristina M Deligiannidis
- Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States of America; Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States of America
| | - Robert Riesenberg
- Atlanta Center for Medical Research, Atlanta, GA, United States of America
| | - Andrew D Krystal
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
| | - Kemi Bankole
- Sage Therapeutics, Inc., Cambridge, MA, United States of America
| | - Ming-Yi Huang
- Sage Therapeutics, Inc., Cambridge, MA, United States of America
| | - Haihong Li
- Sage Therapeutics, Inc., Cambridge, MA, United States of America
| | - Colville Brown
- Sage Therapeutics, Inc., Cambridge, MA, United States of America
| | - Stephen J Kanes
- Sage Therapeutics, Inc., Cambridge, MA, United States of America
| | - Robert Lasser
- Sage Therapeutics, Inc., Cambridge, MA, United States of America
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Alcala CS, Orozco Scott P, Tamayo‐Ortiz M, Hernández Chávez MDC, Schnaas L, Carroll KN, Niedzwiecki MM, Wright RO, Téllez‐Rojo MM, Wright RJ, Hsu HL, Rosa MJ. Longitudinal assessment of maternal depression and early childhood asthma and wheeze: Effect modification by child sex. Pediatr Pulmonol 2023; 58:98-106. [PMID: 36128727 PMCID: PMC9771993 DOI: 10.1002/ppul.26164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Studies report associations between maternal mental health and adverse respiratory outcomes in children; however, the impact of timing and duration of maternal distress remains understudied. We sought to longitudinally examine associations between maternal depression and childhood asthma and wheeze, and explore sex differences. METHODS Maternal depression (n = 601) was assessed using the Edinburgh Depression Scale questionnaire, dichotomized at a clinically relevant cutoff (>12) (a) during pregnancy, (b) postpartum, and (c) postpartum and subsequent time points postnatally (recurrent depression). Report of wheeze in the past 12 months (current wheeze) and asthma were obtained using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire at 48 and 72 months. Associations were analyzed using a modified Poisson regression adjusted for covariates, and in interaction models. RESULTS Both postpartum and recurrent depression were associated with higher risk of current wheeze (relative risk [RR]: 1.87, 95% confidence interval [CI]: 1.21, 2.90; RR: 2.41, 95% CI: 1.53, 3.79) and asthma at 48 months (RR: 2.42, 95% CI: 1.01, 5.84; RR: 2.45, 95% CI: 1.02, 5.84). In interaction analyses, associations were stronger in females. Recurrent depression was associated with a higher risk of current wheeze at 48 months in females (RR: 4.34, 95% CI: 2.02, 9.32) when compared to males (RR: 1.89, 95% CI: 1.05, 3.39). CONCLUSIONS Postpartum and recurrent depression were associated with a higher risk of wheeze and asthma in children. Understanding the temporal- and sex-specific effects of maternal depression may better inform prevention strategies.
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Affiliation(s)
- Cecilia S. Alcala
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Paloma Orozco Scott
- Department of MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Marcela Tamayo‐Ortiz
- Occupational Health Research UnitMexican Social Security InstituteMexico CityMexico
| | | | - Lourdes Schnaas
- Department of Developmental NeurobiologyNational Institute of PerinatologyMexico CityMexico
| | - Kecia N. Carroll
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Pediatrics, Icahn School of Medicine at Mount SinaiKravis Children's HospitalNew YorkNew YorkUSA
| | - Megan M. Niedzwiecki
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Robert O. Wright
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Institute for Exposomic ResearchIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Martha Maria Téllez‐Rojo
- Center for Nutrition and Health ResearchNational Institute of Public HealthCuernavaca, MorelosMexico
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Pediatrics, Icahn School of Medicine at Mount SinaiKravis Children's HospitalNew YorkNew YorkUSA
- Institute for Exposomic ResearchIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Hsiao‐Hsien Leon Hsu
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Maria José Rosa
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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14
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Postpartum depression and ADHD in the offspring: Systematic review and meta-analysis. J Affect Disord 2022; 318:314-330. [PMID: 36096371 DOI: 10.1016/j.jad.2022.08.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/08/2022] [Accepted: 08/21/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is a disorder that has a severe impact on a woman's mental state and mood after birth. Research has shown that postnatal levels of family adversity and maternal psychopathology are associated with Attention Deficit Hyperactivity Disorder (ADHD). This paper is intended to examine the association among maternal PPD and the risk of ADHD in the offspring. METHODS Keyword search was conducted for PsycINFO, PubMed, Google Scholar, and Embase up to Feb 28, 2021; studies in English were deemed eligible. Random-effects meta-analysis and meta-regression analysis took place. Subgroup analyses by study design, geographical region, level of adjustment and study setting were performed. RESULTS Nine cohort studies and two case-control studies published from 2003 to 2019 were included in the qualitative synthesis; among them, eight studies were synthesized in the meta-analysis. Overall, maternal PPD was associated with an increased risk of ADHD in the offspring (pooled relative risk, RR = 1.69, 95%CI: 1.27-2.26). Significant associations were noted in the subsets of cohort studies, studies implementing multivariate analyses and registry-based surveys. LIMITATIONS Overall, a larger number of studies of the field are needed. Data collection relied on self-report and attrition bias limited the validity of eligible studies. Studies from developing countries were underrepresented. There was significant publication bias (p = 0.035, Egger's test). CONCLUSIONS The relationship between PPD and ADHD in children was found to be significant in this systematic review and meta-analysis and reveals the need for further investigation in various geographical regions.
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Dadhwal V, Sagar R, Choudhary V, Kant S, Perumal V, Misra P, Bhattacharya D. A Single-Arm Pilot Study of Multicomponent Psychoeducational Intervention for Postpartum Depression and Anxiety in a Rural Community. Indian J Psychol Med 2022; 44:567-574. [PMID: 36339693 PMCID: PMC9615458 DOI: 10.1177/02537176211072690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The prevalence of postpartum depression (PPD) and anxiety (PPA) is rising in India and efforts at generating local evidence for psychological intervention are scanty. We conducted a single-arm pilot study in an Indian rural community to test the impact of multicomponent psychoeducational intervention (MCPI) on women with PPD and PPA. METHODS Forty-three women with PPD/PPA/both received MCPI, which comprised three phases with in-person sessions held once weekly for a minimum of six and a maximum of ten weeks. Primary outcome variables were scores on depression and anxiety, assessed using the Edinburg postnatal depression scale and the state and trait anxiety inventory, along with evaluating the compliance rate to the intervention. The Mini-international neuropsychiatric interview (MINI) neuropsychiatric interview was used to confirm the diagnosis of depression and anxiety. Secondary outcome variables assessed were social support, functionality, parental stress, interpersonal violence, and marital satisfaction. We used Cohen's d effect size method for assessing the mean differences. RESULTS MCPI resulted in the improvement of 72% women (95% CI = 56.3%-84.7%). The overall compliance rate to the intervention was 85.63%, which was higher for responders than nonresponders (92.9% vs. 69.8%; P < 0.001). MCPI resulted in statistically significant improvement in the mean score of depression (P = 0.001, d = 0.95) and anxiety (P = 0.001, d = 1.30). On secondary outcome variables, significant improvement was obtained in the overall present social support (P = 0.001; d = 4.65), present social support from partner (P = 0.027; d = 0.45) and parents (P = 0.001; d = 0.74), future social support from parents (P = 0.001; d = 0.81), the performance of household responsibility (P = 0.001; d = 0.97), lifestyle in the last two weeks (P = 0.001; d = 3.57), parental stress (P = 0.001; d = 1.04), and marital satisfaction (P = 0.014; d = 0.52). CONCLUSION This pilot study shows that MCPI has a promising role in relieving depression and anxiety. It also improved the perception of social support from partner and parents, functionality, marital satisfaction, and reduced parental stress.
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Affiliation(s)
- Vatsla Dadhwal
- Dept. of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Rajesh Sagar
- Dept. of Psychiatry, All India institute of Medical Sciences, New Delhi, Delhi, India
| | - Vandana Choudhary
- Dept. of Psychiatry (Clinical Psychology), All India institute of Medical Sciences, New Delhi, Delhi, India
| | - Shashi Kant
- Dept. of Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Vanamail Perumal
- Dept. of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Puneet Misra
- Dept. of Community Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Debabani Bhattacharya
- Dept. of Psychiatry (Clinical Psychology), All India institute of Medical Sciences, New Delhi, Delhi, India
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16
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Wald J, Henningsson A, Hanze E, Hoffmann E, Li H, Colquhoun H, Deligiannidis KM. Allopregnanolone Concentrations in Breast Milk and Plasma from Healthy Volunteers Receiving Brexanolone Injection, With Population Pharmacokinetic Modeling of Potential Relative Infant Dose. Clin Pharmacokinet 2022; 61:1307-1319. [PMID: 35869362 PMCID: PMC9439988 DOI: 10.1007/s40262-022-01155-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/25/2022]
Abstract
Background and Objective Women with postpartum depression (PPD) may expose their infants to antidepressants via breast milk. Brexanolone is the only FDA-approved antidepressant specifically indicated for the treatment of PPD. This open-label, phase Ib study of healthy lactating volunteers assessed pharmacokinetic (PK) properties of brexanolone and a population PK (PopPK) model determined the relative infant dose (RID) in breastfeeding mothers. Methods Twelve participants received a 60-h infusion of brexanolone (titration up to 90 µg/kg/h). Allopregnanolone concentration was measured in breast milk and plasma. The RID was computed using a nonlinear mixed-effects PopPK model of patients with PPD and healthy women (N = 156). Model results were extended across an integrated dataset of participants through day 7. Results Allopregnanolone concentration–time profiles were similar between breast milk and plasma (partition coefficient for concentration gradient [milk : plasma] 1.36). Mean (95% CI) Cmax was 89.7 ng/mL (74.19–108.39), and median (95% CI) tmax was 47.8 h (47.8–55.8) in plasma. The overall PK profile was best described by a two-compartment model with linear elimination and distribution. Body weight was the only significant covariate identified. There were no apparent differences in PopPK AUC and Cmax between participants with or without concomitant antidepressant treatment. Maximum RID was 1.3%. Conclusion The PopPK model successfully described the variability and concentration–time profiles of allopregnanolone in breast milk and plasma in healthy participants and in the plasma of brexanolone-treated patients with PPD. The rapid elimination of allopregnanolone from plasma and breast milk, and low RID, suggests the appropriateness of brexanolone weight-based dosing and supports other PK-related labeling recommendations. Supplementary Information The online version contains supplementary material available at 10.1007/s40262-022-01155-w.
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Affiliation(s)
- Jeffrey Wald
- Sage Therapeutics, Inc., 215 First Street, Cambridge, MA, 02142, USA.
| | | | | | - Ethan Hoffmann
- Sage Therapeutics, Inc., 215 First Street, Cambridge, MA, 02142, USA
| | - Haihong Li
- Sage Therapeutics, Inc., 215 First Street, Cambridge, MA, 02142, USA
| | - Helen Colquhoun
- Sage Therapeutics, Inc., 215 First Street, Cambridge, MA, 02142, USA
| | - Kristina M Deligiannidis
- Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
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Hunt AM, Uthirasamy N, Porter S, Jimenez ME. Parental Depression Screening in Pediatric Health Care Settings: A Scoping Review. Pediatrics 2022; 150:188354. [PMID: 35762257 DOI: 10.1542/peds.2021-055804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Parental depression affects as many as 1 in 5 US families. Pediatric professionals can play an important role in detecting parental depression, yet most studies on parental depression screening focus only on the postpartum period. The authors performed this scoping review to understand the existing literature on parental depression screening outside the postpartum period (child >12 months old) and to identify knowledge gaps. METHODS Sources for this research include PubMed, CINAHL, SCOPUS, Web of Science, and APA Psych Info. We included English language papers concerning screening for maternal and/or paternal depression or mood disorders outside of the postpartum period by pediatric clinicians or in a pediatric health care setting. Extracted variables included publication year, title, author(s), country, geographic setting, clinical setting, child age range (in years), parental focus, sample size, study type, approach, screening instrument(s), and findings. RESULTS Forty-one papers were included. The proportion of positive parental depression screens was consistently high across the included studies. Relatively few structured screening programs outside of the postpartum period were identified, especially for fathers. The included studies suggest that screening can be accomplished in pediatric settings, but appropriate referral and follow-up of positive screens poses a major challenge. This review was limited to English language papers concerning parental depression outside of the postpartum period. CONCLUSIONS These findings suggest that screening for parental depressive symptoms outside the postpartum period could identify families in need of support. Research is required to identify best practices for referral and follow-up of parents who screen positive.
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Affiliation(s)
- Ava Marie Hunt
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Sallie Porter
- Rutgers School of Nursing, Rutgers University, Newark, New Jersey
| | - Manuel E Jimenez
- Departments of Pediatrics.,Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.,Children's Specialized Hospital, New Brunswick, New Jersey
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Tomioka Y. Relationship between physical activity and mental health in women after childbirth: a cross-sectional exploratory study. BMC Pregnancy Childbirth 2022; 22:430. [PMID: 35606714 PMCID: PMC9125919 DOI: 10.1186/s12884-022-04758-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/09/2022] [Indexed: 11/29/2022] Open
Abstract
Background Physical activity (PA) is recommended for women after childbirth. However, it is unknown whether PA, such as housework and child-rearing, is associated with mental health. This study aimed to measure daily PA in women 2 months postpartum as well as investigate the relationship between daily PA and mental health. Methods In this cross-sectional quantitative exploratory study conducted between September 2017 and May 2018, 110 women were approached for participation. Mental health was evaluated using the General Health Questionnaire-28, and PA measurements were performed using accelerometers that the participants wore for 2 days. Welch’s t-test and linear regression analysis were performed to assess the relationship between PA and mental health. Results This study included 99 participants. The mean amount of daily activities from housework and child-rearing was 3.21 ± 1.14 metabolic equivalent of tasks (METs)-h/day and that of time spent sitting was at least 7.5 h/12.5 h. PA time spent in light child-rearing and housework activities was significantly longer among multiparous women than among primiparous women (t = − 3.41). PA time comprising the duration of moderate (3 METs) or more vigorous PA was 73 min/day. No significant relationship between mental health and PA was observed. However, the amount of daily activities tended to increase with an improvement in mental health. The amount of daily activities exceeded 3 METs-h/day regardless of the mental health status. Conclusions No significant relationship was found between the amount of daily activities and mental health. The former increased as the latter improved. The amount of daily activities met the standard recommended by the World Health Organization, regardless of the mental health status.
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Affiliation(s)
- Yumi Tomioka
- Faculty of Nursing, Toho University, 4-16-20 Omori-nishi, Ota-ku, Tokyo, 143-0015, Japan.
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Weinfield NS, Anderson CE. Postpartum Symptoms of Depression are Related to Infant Feeding Practices in a National WIC Sample. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:118-124. [PMID: 34930709 DOI: 10.1016/j.jneb.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To examine the association between elevated maternal postpartum depression symptoms and select targets of nutrition education within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), including infant feeding beliefs, feeding practices, and dietary intake choices. DESIGN Longitudinal analysis of secondary data from the WIC Infant and Toddler Feeding Practices Study-2. SETTING Eighty WIC sites. PARTICIPANTS The WIC Infant and Toddler Feeding Practices Study-2 participants interviewed through 13 months postpartum (n = 1,851). MAIN OUTCOME MEASURES Latent factor variables for infant feeding beliefs, feeding practices, and dietary intake choices. ANALYSIS Confirmatory factor analysis using structural equation modeling; multivariable linear regression models. RESULTS Biological mothers with elevated postpartum depression symptoms engaged in significantly less optimal feeding practices than biological mothers with fewer symptoms of depression, in multivariable analyses controlling for sociodemographic variables (β = -0.26; P = 0.02). Maternal depression symptoms were not significantly associated with infant feeding beliefs or dietary intake choices. CONCLUSIONS AND IMPLICATIONS Maternal depression symptoms are specifically associated with infant feeding practices. The Special Supplemental Nutrition Program for Women, Infants, and Children could consider screening for depressive symptoms and referring mothers for treatment. For mothers with elevated depression symptoms, nutrition education may need greater emphasis on healthy and safe feeding practices.
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Affiliation(s)
- Nancy S Weinfield
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD.
| | - Christopher E Anderson
- Public Health Foundation Enterprises WIC Program, Division of Research and Evaluation, Irwindale, CA
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Surkan PJ, Park S, Ridgeway K, Ribeiro M, Fidalgo TM, Martins SS, Caetano SC. Caregiver Social Capital and Supportive Relationships are Associated with Better Child Social-Emotional Development. Child Psychiatry Hum Dev 2022:10.1007/s10578-021-01292-6. [PMID: 35088156 DOI: 10.1007/s10578-021-01292-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2021] [Indexed: 11/27/2022]
Abstract
This study examined how different domains of social capital and of social support among caregivers are associated with social-emotional development in children ages 4-6 and how caregiver depressive symptoms modify these associations. Using a stratified random sample of preschools, data included a cross-sectional study of 1147 child-caregiver pairs (543 girls) in a low-income municipality in Brazil. Crude and adjusted linear regression models revealed that all domains of social support and two domains of social capital were associated with less social-emotional development delay in children. Given a significant proportion of children in low- and middle-income countries do not meet developmental milestones, strengthening caregiver social capital and support in these settings may have the potential to improve child social-emotional development.
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Affiliation(s)
- Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Soim Park
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Kathleen Ridgeway
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Marcos Ribeiro
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Thiago M Fidalgo
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Silvia S Martins
- Department of Epidemiology, Columbia University, New York, NY, 10023, USA
| | - Sheila C Caetano
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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21
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Cimino S, Tambelli R, Di Vito P, D'Angeli G, Cerniglia L. The quality of father-child feeding interactions mediates the effect of maternal depression on children's psychopathological symptoms. Front Psychiatry 2022; 13:968171. [PMID: 36072463 PMCID: PMC9444047 DOI: 10.3389/fpsyt.2022.968171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Research has shown that Postnatal maternal depression (PND) is associated with children's emotional and behavioral problems during infancy, but the possible effect of father-child relationship quality on this association is yet to be thoroughly investigated. We recruited 401 families (802 parents; 401 children) via mental health clinics in Central Italy. We divided families into two groups: Group 1 included families with mothers with PND; Group 2 included families with mothers without PND (control group). The assessment took place at T1 (18 months of age of children) and T2 (36 months of age of children): postnatal maternal depression was measured through the Edinburgh Postnatal Depression Scale (EPDS); parent-child relationship quality was assessed through the Scale for the Assessment of Feeding Interactions (SVIA); and the child emotional-behavioral functioning was evaluated with the Child-Behavior-Checklist (CBCL). Compared to the control group, the children of the groups where mothers had PND, showed overall higher scores (i.e., more maladaptive) on the CBCL. A direct effect of postnatal maternal depression on children's emotional-behavioral functioning was found, both at T1 and at T2. A mediation effect of father-child relationship quality between postnatal maternal depression and child outcomes was also found. These results could inform prevention and intervention programs in families with mothers with PND.
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Renata Tambelli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Paola Di Vito
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Gessica D'Angeli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Luca Cerniglia
- International Telematic University Uninettuno, Rome, Italy
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22
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Gollan JK, Yang A, Ciolino JD, Sit D, Wisner KL. Postpartum anhedonia: Emergent patterns in bipolar and unipolar depression. Psychiatry Res 2021; 306:114274. [PMID: 34837882 DOI: 10.1016/j.psychres.2021.114274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Jacqueline K Gollan
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 1000, Chicago, IL, 60611 USA.
| | - Amy Yang
- Department of Preventive Medicine-Biostatistics, Northwestern University Feinberg School of Medicine, 680N Lake Shore Drive, Suite 1400, Chicago IL 60611 USA
| | - Jody D Ciolino
- Department of Preventive Medicine-Biostatistics, Northwestern University Feinberg School of Medicine, 680N Lake Shore Drive, Suite 1400, Chicago IL 60611 USA
| | - Dorothy Sit
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 1000, Chicago, IL, 60611 USA
| | - Katherine L Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 1000, Chicago, IL, 60611 USA
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23
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Infant media use: A harm reduction approach. Infant Behav Dev 2021; 64:101610. [PMID: 34298189 DOI: 10.1016/j.infbeh.2021.101610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 05/28/2021] [Accepted: 07/05/2021] [Indexed: 11/23/2022]
Abstract
There are a myriad of potentially harmful developmental outcomes associated with infant digital media use. Studies revealing risk associated with early media use have informed the current American Academy of Pediatrics (AAP) recommendations that discourage most digital media use among children under 18 months of age. Recent research advances, however, suggest potential benefits of technology engagement in this age group. Additionally, surveys of parents reveal that most infants engage with digital media for at least 30 min a day, exceeding the AAP recommendations. In response to these discoveries and cultural trends, some scholars have made compelling cases to adapt the AAP guidelines for infants. A helpful model for developing infant digital media use guidelines for families may be the harm reduction approach. The intent of this review is to suggest adaptations to the AAP guidelines for infant media engagement using a harm reduction framework. This review describes the challenge of restrictive guidelines, briefly summarizes the harm reduction approach, provides a review of risks and benefits associated with infant media use in each developmental domain (physical, cognitive, and socioemotional), summarizes correlates of infant screen media use, and examines intervention strategies for reducing screen time. The paper concludes with examples of possible adaptations to current AAP infant media use recommendations using harm reduction and bioecological frameworks.
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24
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Nidey NL, Momany AM, Strathearn L, Carter KD, Wehby GL, Bao W, Xu G, Scheiber FA, Tabb K, Froehlich TE, Ryckman K. Association between perinatal depression and risk of attention deficit hyperactivity disorder among children: a retrospective cohort study. Ann Epidemiol 2021; 63:1-6. [PMID: 34186179 DOI: 10.1016/j.annepidem.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Perinatal depression has previously been identified as a risk factor for attention deficit hyperactivity disorder (ADHD) in the offspring. Population-based studies utilizing diagnosis data are needed to better understand the relationship between these two variables. The objective of this study was to examine the association between perinatal depression and the risk of ADHD among children born during a 5 or-more-year follow-up period. METHODS The sample was drawn from a population-based cohort of privately insured mother-child pairs within the state of Iowa. Hazard ratios for risk of ADHD by exposure to perinatal depression were estimated using adjusted Cox proportional-hazard models. RESULTS Among the 5,635 mother-child pairs, 484 mothers were diagnosed with depression during the perinatal period, and 269 children were diagnosed with ADHD. After adjustment for confounders, children born to mothers with perinatal depression were over three times more likely to be diagnosed with ADHD (HR 3.16 (95% CI 2.35, 4.23)). CONCLUSIONS Children born to mothers with perinatal depression were found to be at increased risk of ADHD. This finding suggests that ADHD and its adverse sequelae could be mitigated by increasing maternal depression intervention efforts as well as ADHD screening and treatment efforts targeted to this vulnerable population.
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Affiliation(s)
- Nichole L Nidey
- Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, Ohio; Cincinnati Children's Hospital Medical Center, Division of Developmental and Behavioral Pediatrics, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.
| | - Allison M Momany
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City
| | - Lane Strathearn
- Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City; Stead Family Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, University of Iowa Carver College of Medicine, Iowa City
| | - Knute D Carter
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City
| | - George L Wehby
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City
| | - Wei Bao
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City
| | - Guifeng Xu
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City
| | | | - Karen Tabb
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana
| | - Tanya E Froehlich
- Cincinnati Children's Hospital Medical Center, Division of Developmental and Behavioral Pediatrics, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | - Kelli Ryckman
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City
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25
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Mezzavilla RDS, Vianna GVDB, Lindsay AC, Hasselmann MH. Intimate partner violence, breastfeeding, breastmilk substitutes and baby bottle use in the first year of life. CIENCIA & SAUDE COLETIVA 2021; 26:1955-1964. [PMID: 34076135 DOI: 10.1590/1413-81232021265.10012019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/26/2019] [Indexed: 11/21/2022] Open
Abstract
This article aims to investigate the relationship between intimate partner physical violence (IPPV) and breastfeeding (BF), use of breastmilk substitutes (BMS) and bottle-feeding among children aged 12 to 15 months. This is a cross-sectional study with mothers in primary care facilities of the city of Rio de Janeiro. IPPV was identified by the Brazilian version of the Conflict Tactics Scales 1-Form R and feeding practices were identified by a 24-hour Dietary Recall. Associations were verified by logistic regression with odds ratio (OR) estimates and 95% confidence intervals. BF was offered to 58.5% of the children and BMS to 88.5%. Also, 70.5% of the children used a baby bottle. Physical violence was observed in 26.7% of couples. Households where couples physically abuse each other are more likely to not breastfeed (OR=2.14, p-value=0.030), to use breastmilk substitutes (OR=5.15, p-value=0.03) and bottle-feed (OR=2.71; p-value=0.01), when compared to households without physical violence. The results highlight the need to investigate intrafamily relationships in cases where inadequate breastfeeding practices are identified, and to enable health professionals to support families in conflict situations.
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Affiliation(s)
- Raquel de Souza Mezzavilla
- Departamento ou Programa de Pós-Graduação, Universidade do Estado do Rio de Janeiro. Rua São Francisco Xavier 524 bloco D 12º andar sala 12024 Maracanã. 20559-900 Rio de Janeiro RJ Brasil.
| | | | - Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston EUA
| | - Maria Helena Hasselmann
- Departamento de Nutrição Social, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil
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26
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Kundu S, Banna MHA, Sayeed A, Sultana MS, Brazendale K, Harris J, Mandal M, Jahan I, Abid MT, Khan MSI. Determinants of household food security and dietary diversity during the COVID-19 pandemic in Bangladesh. Public Health Nutr 2021; 24:1079-1087. [PMID: 33317657 PMCID: PMC8025083 DOI: 10.1017/s1368980020005042] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The study aimed to determine the associated factors of household food security (HFS) and household dietary diversity (HDD) during the COVID-19 pandemic in Bangladesh. DESIGN Both online survey and face-to-face interviews were employed in this cross-sectional study. The Household Food Security Scale and Household Dietary Diversity Score were used to access HFS and HDD, respectively. The HDD scores were derived from a 24-h recall of food intake from 12 groups. SETTING Bangladesh. PARTICIPANTS A total sample of 1876 households were recruited. RESULTS The overall mean scores of HFS and HDD were 31·86 (sd 2·52) and 6·22 (sd 5·49), respectively. Being a rural resident, having no formal education, occupation of household head other than government job and low monthly income were potential determinants of lower HFS and HDD. Approximately 45 % and 61 % of Bangladeshi households did not get the same quantity and same type of food, respectively, as they got before the pandemic. Over 10 % of respondents reported that they lost their job or had to close their businesses, and income reduction was reported by over 70 % of household income earners during the COVID-19 pandemic, which in turn was negatively associated with HFS and HDD. CONCLUSION Household socio-economic variables and COVID-19 effects on occupation and income are potential predictors of lower HFS and HDD scores. HFS and HDD deserve more attention during this pandemic particularly with reference to low-earning households and the households whose earning persons' occupation has been negatively impacted during the COVID-19 pandemic.
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Affiliation(s)
- Satyajit Kundu
- Department of Biochemistry and Food Analysis, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Md. Hasan Al Banna
- Department of Food Microbiology, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Abu Sayeed
- Department of Post-Harvest Technology and Marketing, Patuakhali Science and Technology University, Patuakhali8602, Bangladesh
| | - Mst. Sadia Sultana
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, USA
| | | | - Moumita Mandal
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Ishrat Jahan
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Mohammad Tazrian Abid
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Md Shafiqul Islam Khan
- Department of Food Microbiology, Patuakhali Science and Technology University, Patuakhali, Bangladesh
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27
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Woldeyohannes D, Tekalegn Y, Sahiledengle B, Ermias D, Ejajo T, Mwanri L. Effect of postpartum depression on exclusive breast-feeding practices in sub-Saharan Africa countries: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2021; 21:113. [PMID: 33557766 PMCID: PMC7869485 DOI: 10.1186/s12884-020-03535-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/29/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a serious mood disorder that affects behavioural, physical and mental health of women and newborn after childbirth. Although a wide range of research have been conducted on maternal and infant health outcomes, the effect of postpartum depression on exclusive breastfeeding practices remains ambiguous, and needs addressing. The aim of this study was to assess the effect of postpartum depression on exclusive breast feeding practices in sub-Saharan African countries. METHODS PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles published between 2001 and 2020. STATA version 14 was used to calculate the pooled odd ratio with 95% confidence intervals (95% CI). The DerSimonian and Laird random effects meta-analysis was used to measure the effect of postpartum depression on exclusive breast feeding practices. The heterogeneity and publication bias were assessed by using I2 test statistics and Egger's test, respectively. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. RESULT A total of 1482 published articles and gray literatures were retrieved from different databases. Additional articles were identified from the reference list of identified reports and articles. After assessment of obtained articles, studies not meeting the inclusion criteria were excluded. Twenty six studies involving 30,021 population met the inclusion criteria were included in this review. In sub Saharan Africa the overall estimated level of postpartum depression was 18.6% (95% CI: 13.8, 23.4). This review found that postpartum depression had no significant effect on exclusive breast feeding practices (OR = 0.46, 95% CI: 0.18, 1.14). CONCLUSION In Sub Saharan Africa, the prevalence of postpartum depression was lower than the report of World Health Organization for developing Country in 2020. This review reveled that maternal postpartum depression has no significant effect on exclusive breast feeding practices. Thus, the investigators strongly recommend the researchers to conduct primary studies using strong study design in sub-Saharan Africa.
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Affiliation(s)
- Demelash Woldeyohannes
- Department of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia.
| | - Yohannes Tekalegn
- Department of Public Health, College Health Science, Madda Walabu University, Bale Robe, Ethiopia
| | - Biniyam Sahiledengle
- Department of Public Health, College Health Science, Madda Walabu University, Bale Robe, Ethiopia
| | - Dejene Ermias
- Department of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | - Tekele Ejajo
- Department of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
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28
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Gómez L, Verd S, de-la-Banda G, Cardo E, Servera M, Filgueira A, Ponce-Taylor J, Mulet M. Perinatal psychological interventions to promote breastfeeding: a narrative review. Int Breastfeed J 2021; 16:8. [PMID: 33407656 PMCID: PMC7789781 DOI: 10.1186/s13006-020-00348-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 12/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background Emotional distress in mothers inhibits the let-down reflex, thus affecting breastfeeding self-efficacy. A breastfeeding mother may have to cope with both physical discomfort and psychological distress. However, literature on initiatives to improve breastfeeding rates has focused mainly on providing community-based peer support, or social policies. The aim of this review is to assess evidence on the effectiveness of a broad range of psychological interventions to facilitate breastfeeding for mothers facing difficulties around the time of delivery. Methods The review of the literature is derived from a search on Cochrane Library, PubMed, EBSCOhost, and PsycINFO for papers published since 1980. The approach was to explore quantitative and qualitative parameters. Quantitative parameters included breastfeeding initiation, duration, and composition. Qualitative parameters recorded the evaluation of maternal perceptions on breastfeeding success. The high heterogeneity of the studies led to a narrative review; 20 selected papers that report on breastfeeding outcomes and psychological programs met the inclusion criteria. Results The evidence on breastfeeding support through psychotherapy is heterogeneous and scant. Out of the included studies, 11 were randomized controlled trials, two were non-randomised trials, and two used a quasi-experimental design. None of the studies reported an increase in adverse breastfeeding outcomes. Three studies failed to report an association between psychological procedures and improved breastfeeding outcomes. A literature review showed that 17 (85%) analyses support stress-releasing techniques to facilitate breastfeeding. Conclusions This review suggests that relaxation interventions carefully tailored to address perinatal emotional distress may lead to important health benefits, including improvement in breastfeeding outcomes. There is also some indication that psychotherapy support while breastfeeding may have more impact than routine counselling. Conversely, this review did not find an association between self-hypnosis and breastfeeding outcomes. Data from this study can be used in designing prevention programs and future research with appropriate theoretical underpinning.
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Affiliation(s)
- Lidia Gómez
- Department of Child Psychiatry, Son Espases Hospital, Valldemossa road, 07120, Palma de Mallorca, Spain.,Baleares Medical Research Council (IdISBa), Valldemossa road, 07120, Palma de Mallorca, Spain
| | - Sergio Verd
- Baleares Medical Research Council (IdISBa), Valldemossa road, 07120, Palma de Mallorca, Spain. .,Pediatric Unit, La Vileta Surgery, Department of Primary Care, Matamusinos street, 07013, Palma de Mallorca, Spain.
| | - Gloria de-la-Banda
- Department of Psychology, Baleares Islands University, Valldemossa road, 07122, Palma de Mallorca, Spain
| | - Esther Cardo
- Pediatric Unit, La Vileta Surgery, Department of Primary Care, Matamusinos street, 07013, Palma de Mallorca, Spain.,Department of Paediatrics, Hospital Son Llatzer, Manacor road, 07128, Palma de Mallorca, Spain
| | - Mateu Servera
- Department of Psychology, Baleares Islands University, Valldemossa road, 07122, Palma de Mallorca, Spain
| | - Ana Filgueira
- Department of Paediatrics, Hospital Son Llatzer, Manacor road, 07128, Palma de Mallorca, Spain
| | - Jaume Ponce-Taylor
- Accidents & Emergency Unit, Department of Primary Care, Illes Balears street., 07014, Palma de Mallorca, Spain
| | - Margarita Mulet
- Mental Health Unit, Department of Primary Care, Simo Tort street, 07500, Mallorca, Manacor, Spain
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29
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Manickam S, Vivier PM, Rogers ML, McGowan EC, Smego R, Tucker R, Vohr BR. Neighborhood Inequality and Emergency Department Use in Neonatal Intensive Care Unit Graduates. J Pediatr 2020; 226:294-298.e1. [PMID: 32621816 DOI: 10.1016/j.jpeds.2020.06.074] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022]
Abstract
Neonatal intensive care unit graduates residing in high-risk neighborhoods were at increased risk of emergency department use and had higher rates of social/environmental risk factors. Distances to primary care provider and emergency department did not contribute to emergency department use. Knowledge of neighborhood risk is important for preventative service reform.
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Affiliation(s)
- Surya Manickam
- The Warren Alpert Medical School of Brown University, Providence, RI; Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI
| | - Patrick M Vivier
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI; Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI
| | - Michelle L Rogers
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI
| | - Elisabeth C McGowan
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI; Women & Infants Hospital, Providence, RI
| | - Raul Smego
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI
| | | | - Betty R Vohr
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI; Women & Infants Hospital, Providence, RI.
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30
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Tsedal DM, Yitayal M, Abebe Z, Tsegaye AT. Effect of intimate partner violence of women on minimum acceptable diet of children aged 6-23 months in Ethiopia: evidence from 2016 Ethiopian demographic and health survey. BMC Nutr 2020; 6:28. [PMID: 32742712 PMCID: PMC7385870 DOI: 10.1186/s40795-020-00354-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background The absence of proper infant and young child feeding practice results in malnutrition. Intimate Partner Violence (IPV) is potentially a major factor affecting child feeding practices. However, there is limited evidence about the effect of intimate partner violence (IPV) on a minimum acceptable diet. Therefore, in this study, we hypothesized that IPV will be associated with a lack of a minimum acceptable diet among children aged 6–23 months. Methods We conducted a cross-sectional analysis using the Ethiopian Demographic and Health Survey (EDHS) 2016. All child-mother pairs that participated in EDHS 2016 from all regions of Ethiopia were included. The analysis included mother-child pairs where 6–23 months aged children with mothers who were ever in a committed partnership and interviewed for domestic violence were involved. The data were weighted considering enumeration areas as a cluster and place of residence as a stratum. A binary logistic regression analysis was done to identify factors independently associated with a minimum acceptable diet. Result Totally, 1307 observations were included in the final analysis. The mean age of mothers was 29 years (standard deviation ±6.54 years), the mean age of children was 14. ± 5.02 months, and 32% of women had intimate partner violence (IPV). Of the children, 8% had a minimum acceptable diet (minimum acceptable diet), 15% had a minimum dietary diversity, and 43% had a minimum meal frequency. Having intimate partner violence decreases children minimum acceptable diet by 65% (AOR: 0.35; 95% CI: 0.16, 0.77). The other factors associated with the minimum acceptable diet were caregivers attaining a secondary level of education (AOR: 4.01; 95% CI: 1.04, 15.45), currently working (AOR: 2.26; 95% CI: 1.01, 5.11), and undecided fertility desire (AOR: 4.72; 95% CI: 1.37, 16.28). Conclusion Intimate partner violence against women had a negative association with the minimum acceptable diet children have received. Decreasing violence against women, educating, and increasing work opportunities for them would help in improving child feeding practice and reducing malnutrition and its consequences. Further studies that focus on possible community-based interventions aiming to decrease IPV are recommended.
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Affiliation(s)
- Desta Melaku Tsedal
- Department of Anesthesia, School of Medicine, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Mezgebu Yitayal
- Department of Health System and Policy, Institute of Public Health, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Zegeye Abebe
- Department of Human Nutrition, Institute of Public Health, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Adino Tesfahun Tsegaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia
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31
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Basnet S, Frongillo EA, Nguyen PH, Moore S, Arabi M. Associations of maternal resources with care behaviours differ by resource and behaviour. MATERNAL & CHILD NUTRITION 2020; 16:e12977. [PMID: 32216037 PMCID: PMC7296814 DOI: 10.1111/mcn.12977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/06/2020] [Accepted: 01/16/2020] [Indexed: 11/29/2022]
Abstract
Care is important for children's growth and development, but lack or inadequacy of resources for care can constrain appropriate caregiving. The objectives of this study were to examine whether maternal resources for care are associated with care behaviours specifically infant and young child feeding, hygiene, health-seeking, and family care behaviours. The study also examined if some resources for care are more important than others. This study used baseline Alive & Thrive household surveys from Bangladesh, Vietnam, and Ethiopia. Measures of resources for care were maternal education, knowledge, height, nourishment, mental well-being, decision-making autonomy, employment, support in chores, and perceived instrumental support. Multiple regression analyses were conducted to examine the associations of resources for care with child-feeding practices (exclusive breastfeeding, minimum meal frequency, dietary and diversity), hygiene practices (improved drinking water source, improved sanitation, and cleanliness), health-seeking (full immunization), and family care (psychosocial stimulation and availability of adequate caregiver). The models were adjusted for covariates at child, parents, and household levels and accounted for geographic clustering. All measures of resources for care had positive associations with care behaviours; in a few instances, however, the associations between the resources for care and care behaviours were in the negative direction. Improving education, knowledge, nutritional status, mental well-being, autonomy, and social support among mothers would facilitate provision of optimal care for children.
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Affiliation(s)
- Sulochana Basnet
- Department of Health Promotion, Education, and BehaviorUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and BehaviorUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Phuong Hong Nguyen
- Poverty, Health, and Nutrition DivisionInternational Food Policy Research InstituteWashingtonDCUSA
| | - Spencer Moore
- Department of Health Promotion, Education, and BehaviorUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Mandana Arabi
- Global Technical ServicesNutrition InternationalOttawaCanada
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Lu L, Duan Z, Wang Y, Wilson A, Yang Y, Zhu L, Guo Y, Lv Y, Yang X, Yu R, Wang S, Wu Z, Jiang P, Xia M, Wang G, Wang X, Tao Y, Li X, Ma L, Huang L, Dong Q, Shen H, Sun J, Li S, Deng W, Chen R. Mental health outcomes among Chinese prenatal and postpartum women after the implementation of universal two-child policy. J Affect Disord 2020; 264:187-192. [PMID: 32056749 DOI: 10.1016/j.jad.2019.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/26/2019] [Accepted: 12/05/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Poor mental health status among both pregnant and postpartum women is commonly reported worldwide. The associations between mental health outcomes and giving birth to the second child since the implementation of China's universal two-child policy have not been identified. METHODS A large-scale based mental health survey was conducted between March 2017 and December 2018 in Suzhou, China. The survey evaluated the symptoms of anxiety, hypomania, depression and poor sleep quality among both pregnant and postpartum women. RESULTS A total of 3113 questionnaires were collected, the prevalence of anxiety, hypomanic and depressive symptoms and poor sleep quality in our sample were 3.2% (95%CI: 2.6%-3.9%), 51.7% (95%CI: 49.9%-53.4%), 12.4% (95%CI: 11.3%-13.6%) and 37.8% (95%CI: 36.0%-39.5%), respectively. Logistic regression showed that giving birth to the second child was positively associated with women's age, and was negatively correlated with higher educational level and living in rented housing. Women with the second pregnancy or child were positively associated with anxiety symptoms in the whole sample (OR = 1.75, 95%CI: 1.11-2.75) and among prenatal women (OR = 2.11, 95%CI: 1.16-3.83), while it was inversely correlated with depressive symptoms among postpartum women (OR = 0.63, 95%CI: 0.41-0.99). CONCLUSIONS Women giving birth a second time were more prone to have anxiety symptoms among the prenatal women and the whole sample, and less likely to have depressive symptoms among the postpartum women. Efficacious measures and interventions are essential to improve maternal mental health.
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Affiliation(s)
- Li Lu
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China; Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Zhizhou Duan
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders & Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China; School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Yuanyuan Wang
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yong Yang
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China.
| | - Longjun Zhu
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Yan Guo
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Yonglang Lv
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Xiaonan Yang
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Renjie Yu
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Shuilan Wang
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Zhengyan Wu
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Ping Jiang
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Mengqing Xia
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Guosheng Wang
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Xiuxia Wang
- Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Ye Tao
- Suzhou Science and Technology Town Hospital, Suzhou, China
| | - Xiaohong Li
- Suzhou Science and Technology Town Hospital, Suzhou, China
| | - Ling Ma
- Suzhou Science and Technology Town Hospital, Suzhou, China
| | - Liming Huang
- Suzhou Science and Technology Town Hospital, Suzhou, China
| | - Qin Dong
- Suzhou Science and Technology Town Hospital, Suzhou, China
| | - Hong Shen
- Suzhou Science and Technology Town Hospital, Suzhou, China
| | - Jue Sun
- Gusu District Wumenqiao Street Canglang Xincheng Community Health Service Center, Suzhou, China
| | - Shun Li
- Gusu District Wumenqiao Street Canglang Xincheng Community Health Service Center, Suzhou, China
| | - Wei Deng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Runsen Chen
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders & Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China; Department of Psychiatry, University of Oxford, Oxford, UK.
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Fink E, Browne WV, Kirk I, Hughes C. Couple relationship quality and the infant home language environment: Gender-specific findings. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:155-164. [PMID: 31436443 PMCID: PMC7008754 DOI: 10.1037/fam0000590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 07/19/2019] [Accepted: 07/26/2019] [Indexed: 06/10/2023]
Abstract
Couple relationship quality is known to drop significantly across the transition to parenthood (Ahlborg & Strandmark, 2001; Doss, Rhoades, Stanley, & Markman, 2009), yet individual differences in the amount of parent-to-infant talk have rarely been studied in relation to variation in couple relationship quality. Addressing this gap, the current study of 93 first-time parents with 4-month-old infants included multimeasure reports of couple relationship quality from both mothers and fathers and examined associations between couple relationship quality and the home language environment, assessed via the Language Environment Analysis (LENA), when infants were approximately 7 months old. LENA consists of a wearable talk pedometer that records a full day of naturalistic parent-infant talk and is coupled to software that provides automated analysis. Given the covariation between depression and both couple relationship quality and parental infant-directed talk, both maternal and paternal depression were controlled for in all analyses. Results showed that, for mothers of sons, frequency of infant-directed talk was inversely related to couple relationship quality. Consistent with family systems theory, this finding provides partial support for the compensation hypothesis. However, variation in couple relationship quality was unrelated to infant-directed speech in fathers or in mothers of daughters. Together, these findings demonstrate that the gender composition of the parent-infant dyads plays a moderating role on the association between couple relationship quality and parent-infant talk. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. ACTA ACUST UNITED AC 2020; 15:1745506519844044. [PMID: 31035856 PMCID: PMC6492376 DOI: 10.1177/1745506519844044] [Citation(s) in RCA: 403] [Impact Index Per Article: 100.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: The postpartum period represents the time of risk for the emergence of
maternal postpartum depression. There are no systematic reviews of the
overall maternal outcomes of maternal postpartum depression. The aim of this
study was to evaluate both the infant and the maternal consequences of
untreated maternal postpartum depression. Methods: We searched for studies published between 1 January 2005 and 17 August 2016,
using the following databases: MEDLINE via Ovid, PsycINFO, and the Cochrane
Pregnancy and Childbirth Group trials registry. Results: A total of 122 studies (out of 3712 references retrieved from bibliographic
databases) were included in this systematic review. The results of the
studies were synthetized into three categories: (a) the maternal
consequences of postpartum depression, including physical health,
psychological health, relationship, and risky behaviors; (b) the infant
consequences of postpartum depression, including anthropometry, physical
health, sleep, and motor, cognitive, language, emotional, social, and
behavioral development; and (c) mother–child interactions, including
bonding, breastfeeding, and the maternal role. Discussion: The results suggest that postpartum depression creates an environment that is
not conducive to the personal development of mothers or the optimal
development of a child. It therefore seems important to detect and treat
depression during the postnatal period as early as possible to avoid harmful
consequences.
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Affiliation(s)
- Justine Slomian
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Germain Honvo
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Patrick Emonts
- 2 Department of Obstetrics and Gynaecology, CHU Liège, Liège, Belgium
| | - Jean-Yves Reginster
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.,3 Department of Sport Science, University of Liège, Liège, Belgium
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Bhat A, Hoeft T, McCoy E, Unutzer J, Reed SD. Parenting and perinatal depression: meeting women's needs. J Psychosom Obstet Gynaecol 2019; 40:274-282. [PMID: 30111227 PMCID: PMC6377349 DOI: 10.1080/0167482x.2018.1490723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Introduction: Symptoms of depression during pregnancy and the postpartum period can negatively impact parenting. It is important to understand the parenting experiences of women with depression, and what parenting support they need. Methods: This is a mixed methods analysis of data (demographic data, depression outcomes, patient survey results, and transcripts of patient and care manager focus groups) from an open treatment trial of the feasibility of delivering perinatal depression treatment using collaborative care in a rural obstetric setting. Results: Patients who attended focus groups did not differ significantly from those who did not. Qualitative analysis of focus groups revealed the following themes: Maternal mood and parenting difficulties are interrelated; Access to depression treatment is complicated by expectations for the perinatal period and by factors related to parenting; Women want parenting support in the context of treatment for perinatal depression. Conclusion: Women receiving perinatal depression treatment experience unique parenting challenges and desire parenting support. Healthcare providers caring for these women should be mindful of their patients' parenting needs. Future research should explore ways to integrate parenting interventions with depression treatments. Mother-infant interaction is a key determinant of optimal infant development and integrating parenting support with perinatal depression treatments can have significant public health impact.
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Affiliation(s)
- Amritha Bhat
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Theresa Hoeft
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Erin McCoy
- Department of Obstetrics and Gynecology, University of Washington, Seattle
| | - Jurgen Unutzer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Susan D. Reed
- Department of Obstetrics and Gynecology, University of Washington, Seattle
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Schuler BR. Social work and toddler overweight risk: Identifying modifiable child and parent factors across the socioeconomic gradient. SOCIAL WORK IN HEALTH CARE 2019; 58:952-969. [PMID: 31671025 DOI: 10.1080/00981389.2019.1680478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/19/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
Objective: Childhood obesity is associated with long-term health consequences, yet little is known about the prevalence of child and parent risk factors of overweight across the socioeconomic gradient in early life. This exploratory study documents the prevalence of risk factors that contribute to overweight among toddlers within and across socioeconomic status (SES). Methods: Obesity risk factors were examined within and across SES quintiles in a nationally representative sample. Data were collected from 5,100 mothers and 2-year-old children. Weighted regression models assessed child and parent characteristics that predict toddler weight status in a national sample and samples stratified by SES quintiles. Results: Higher rates of overweight were observed in Q1 (29.2%) and reduced with each successive SES quintile (16.9%-Q5), suggesting a gradient effect. Results indicated factors unique within quintiles, distinct from the full national sample: Q1-motor development; Q2-motor and mental development, maternal BMI, breastfeeding, bottle feeding, introduction of solid foods; Q3-breastfeeding; and Q4-5-introduction of solid foods. Discussion: Findings further existing knowledge of toddler obesity by uncovering risks relevant for specific SES groups. Results yield implications for social workers to refine strategies for improving toddler health and preventing overweight/obesity.
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Affiliation(s)
- Brittany R Schuler
- School of Social Work, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
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Sha T, Gao X, Chen C, Li L, Cheng G, Wu X, Tian Q, Yang F, He Q, Yan Y. A prospective study of maternal postnatal depressive symptoms with infant-feeding practices in a Chinese birth cohort. BMC Pregnancy Childbirth 2019; 19:388. [PMID: 31660900 PMCID: PMC6819524 DOI: 10.1186/s12884-019-2559-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 10/14/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The first few weeks after childbirth are critical, as women may encounter lactation problems and postpartum depression during this period. However, it is still unclear whether early breastfeeding behaviours are related to the symptoms of postnatal depression (PND) in Chinese populations. Therefore, the current study aimed to investigate the association between symptoms of PND and infant feeding practices based on a large-scale Chinese cohort. METHODS A prospective study of the community-based cohort was conducted from January 2015 to December 2016. Infant feeding outcomes, including exclusive/partial breastfeeding and formula feeding, were assessed according to the WHO guidelines. Symptoms of PND were assessed by the Edinburgh Postnatal Depression Scale at 4 weeks postpartum. Multivariate generalized estimating equation models were applied to investigate the associations between depressive symptoms and infant feeding behaviours. RESULTS A total of 956 mother-infant pairs were included. Fifty-six mothers presented screen-positive symptoms of PND with a cut-off ≥10. The percentage of early breastfeeding initiation was 75.8%, while the average duration of exclusive breastfeeding was 3.90 ± 2.33 months. Postnatal depressive symptoms were associated with a shorter breastfeeding duration (8.02 vs. 6.32 months, P < 0.05) and earlier formula introduction (4.98 vs. 3.60 months, P < 0.05). After adjustments were made for covariates, postnatal depressive symptoms were associated with an increased risk of the discontinuation of exclusive and partial breastfeeding (β = - 0.049, P = 0.047 and β = - 0.082, P = 0.006, respectively). Compared to mothers without symptoms of PND, mothers with depressive symptoms were more likely to supplement formula for their infants in the first year of life (β =0.074, P = 0.016). These associations were still significant in the sensitivity analyses, using an EPDS cut-off of ≥13. CONCLUSIONS Our findings indicate that depressive symptoms at 4 weeks postpartum are associated with the cessation of exclusive and partial breastfeeding duration and the introduction of formula in the 12 months of delivery. Early psychosocial assessment and social support should be offered to mothers in the early postpartum period to indirectly prevent adverse breastfeeding outcomes.
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Affiliation(s)
- Tingting Sha
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Xiao Gao
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Cheng Chen
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Ling Li
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Gang Cheng
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Xialing Wu
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Qianling Tian
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Fan Yang
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Qiong He
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Yan Yan
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
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Sudhanthar S, Sheikh ZEH, Thakur K. Postpartum depression screening: are we doing a competent job? BMJ Open Qual 2019; 8:e000616. [PMID: 31673639 PMCID: PMC6797414 DOI: 10.1136/bmjoq-2018-000616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 09/06/2019] [Accepted: 09/30/2019] [Indexed: 11/16/2022] Open
Abstract
Postpartum depression (PPD) is one of the most common and severe postpartum morbidity, affecting 10%–20% of mothers within the first year of childbirth. The adverse effects of PPD, namely, prevention of mother-baby bonding and early cessation of breastfeeding, adversely affects infant growth and brain development. Studies have found that up to 50% of women with PPD go undiagnosed. Despite the American Academy of Pediatrics (AAP) recommendations, only a small percentage of paediatricians are currently screening for PPD. This project aimed to improve PPD screening using a validated tool to 75% in a primary care inner-city clinic serving a predominantly underserved population as per AAP recommendations. Baseline data for 40 charts of 2-month-old and 4-month-old well-child visits showed no documentation of PPD screening. The screening tool used for this project was the Edinburgh Postpartum Depression Scale (EPDS), which is a validated 10-item screening questionnaire for PPD. Three Plan-Do-Study-Act (PDSA) cycles were implemented involving educational strategies, system-based practice improvement and stakeholder participation. Improvement seen after PDSA cycle 1 was minimal. At the end of cycle 2, 16/50 (33%) charts had documentation of screening using EPDS. At the end of cycle 3, 33/40 (82%) charts had EPDS documentation, an increase of 49% from cycle 2. There were eight in total positive PPD screenings between cycles 2 and 3. These patients were provided counselling support through a social worker and referral services through the local community mental health organisation. We achieved more than our 75% target goal for PPD screening implementation at the residency clinic, thereby increasing residents’ awareness of PPD and the importance of PPD screening. Poststudy follow-up shows that screening was maintained at a higher rate but never reached 100%.
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Affiliation(s)
- Sathyanarayan Sudhanthar
- Pediatrics and Human Development, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Zile-E-Huma Sheikh
- Pediatrics and Human Development, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Kripa Thakur
- Pediatrics and Human Development, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
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Swain JE, Ho SS. Early postpartum resting-state functional connectivity for mothers receiving buprenorphine treatment for opioid use disorder: A pilot study. J Neuroendocrinol 2019; 31:e12770. [PMID: 31287922 PMCID: PMC7195812 DOI: 10.1111/jne.12770] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/14/2022]
Abstract
Between 1999 and 2014, the prevalence of opioid use disorder (OUD) among pregnant women quadrupled in the USA. The standard treatment for peripartum women with OUD is buprenorphine. However, the maternal behavior neurocircuit that regulates maternal behavior and mother-infant bonding has not been previously studied for human mothers receiving buprenorphine treatment for OUD (BT). Rodent research shows opioid effects on reciprocal inhibition between maternal care and defence maternal brain subsystems: the hypothalamus and periaqueductal gray, respectively. We conducted a longitudinal functional magnetic resonance imaging (fMRI) pilot study in humans to specifically examine resting-state functional connectivity (rs-FC) between the periaqueductal gray and hypothalamus, as well as to explore associations with maternal bonding for BT. We studied 32 mothers who completed fMRI scans at 1 month (T1) and 4 months postpartum (T2), including seven mothers receiving buprenorphine for OUD and 25 non-OUD mothers as a comparison group (CG). The participants underwent a 6-minute resting-state fMRI scan at each time point. We measured potential bonding impairments using the Postpartum Bonding Questionnaire to explore how rs-FC with periaqueductal gray is associated with bonding impairments. Compared to CG, BT mothers differed in periaqueductal gray-dependent rs-FC with the hypothalamus, amygdala, insular cortex and other brain regions at T1, with many of these differences disappearing at T2, suggesting potential therapeutic effects of continuing buprenorphine treatment. In contrast, the "rejection and pathological anger" subscale of the Postpartum Bonding Questionnaire at T1 and T2 was associated with the T1-to-T2 increases in periaqueductal gray-dependent rs-FC with the hypothalamus and amygdala. Preliminary evidence links maternal bonding problems for mothers with OUD early in the postpartum to connectivity between specific care and defence maternal brain circuits, which may be mitigated by buprenorphine treatment. This exploratory study supports a potential mechanism for investigating both the therapeutic benefits and risks of opioids for maternal care and bonding with infants.
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Affiliation(s)
- James E. Swain
- Department of Psychiatry and Behavioral Health & Psychology, Stony Brook University Medical Center, Stony Brook, NY, USA
- Department of Psychiatry, Psychology and Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - S. Shaun Ho
- Department of Psychiatry and Behavioral Health & Psychology, Stony Brook University Medical Center, Stony Brook, NY, USA
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Abstract
OBJECTIVE To describe the prevalence, use of antidepressants, and predictors of major and minor depression among nonpregnant women of childbearing age. METHODS Using data from the National Health and Nutrition Examination Surveys 2007-2014, we performed a cross-sectional study of 3,705 nonpregnant women of childbearing age. The primary outcome is the prevalence of major depression, and secondary outcomes are the prevalence of minor depression, rates of antidepressant use, and predictors of major and minor depression. Major and minor depression were classified using the Patient Health Questionnaire 9. Univariate and multivariate associations between major depression and minor depression with potential predictors were estimated using multinomial logistic regression. RESULTS The overall prevalences of major and minor depression were 4.8% (95% CI 4.0-5.7%) and 4.3% (95% CI 3.5-5.2%), respectively. The prevalences of antidepressant use among women with major depression and minor depression were 32.4% (95% CI 25.3-40.4%) and 20.0% (95% CI 12.9-29.7%), respectively. Factors most strongly associated with major depression were government insurance (adjusted relative risk [RR] ratio 2.49, 95% CI 1.56-3.96) and hypertension (adjusted RR 2.09, 95% CI 1.25-3.50); for minor depression, these were education less than high school (adjusted RR 4.34, 95% CI 2.09-9.01) or high school education (adjusted RR 2.92, 95% CI 1.35-6.31). CONCLUSION Our analysis indicates that 1 in 20 nonpregnant women of childbearing age experience major depression. Antidepressants are used by one third of those with major depression and one fifth of those with minor depression.
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Swain JE, Ho SS, Fox H, Garry D, Brummelte S. Effects of opioids on the parental brain in health and disease. Front Neuroendocrinol 2019; 54:100766. [PMID: 31128130 PMCID: PMC8318357 DOI: 10.1016/j.yfrne.2019.100766] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 12/20/2022]
Abstract
The epidemic of opioid use disorder (OUD) directly affects millions of women of child-bearing age. Unfortunately, parenting behaviors - among the most important processes for human survival - are vulnerable to the effects of OUD. The standard of care for pregnant women with OUD is opioid maintenance therapy (OMT), of which the primary objective is to mitigate addiction-related stress. The aim of this review is to synthesize current information specific to pregnancy and parenting that may be affected by OUD. We first summarize a model of the parental brain supported by animal research and human neuroimaging. We then review animal models of exogenous opioid effects on parental brain and behavior. We also present preliminary data for a unifying hypothesis that may link different effects of exogenous opioids on parenting across species and in the context of OMT. Finally, we discuss future directions that may inform research and clinical decision making for peripartum women with OUD.
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Affiliation(s)
- James E Swain
- Department of Psychiatry and Behavioral Health, and Psychology, Stony Brook University, Stony Brook, NY, United States; Department of Psychiatry, Psychology, and Center for Human Growth & Development, University of Michigan, Ann Arbor, MI, United States.
| | - S Shaun Ho
- Department of Psychiatry and Behavioral Health, and Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Helen Fox
- Department of Psychiatry and Behavioral Health, and Psychology, Stony Brook University, Stony Brook, NY, United States
| | - David Garry
- Department of Obstetrics and Gynecology, Stony Brook University, Stony Brook, NY, United States
| | - Susanne Brummelte
- Department of Psychology, Wayne State University, Detroit, MI, United States.
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Goodman JH. Perinatal depression and infant mental health. Arch Psychiatr Nurs 2019; 33:217-224. [PMID: 31227073 DOI: 10.1016/j.apnu.2019.01.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/24/2019] [Indexed: 12/19/2022]
Abstract
A mother's mental health during pregnancy and the first year postpartum is of the utmost importance to the cognitive, social, and emotional development of her child. Perinatal depression is associated with increased risk for wide-ranging adverse child development effects that can affect infant and early childhood mental health. Although effective treatments for perinatal depression exist, it is currently unclear if treatment of maternal depression alone is sufficient to ameliorate the negative effects of maternal depression on child outcomes. Interventions focused on the mother-infant relationship and dyadic interaction may be required to address the potential effect of maternal depression on the child. This paper provides an overview of maternal perinatal depression, the risk it poses for infant/early-childhood mental health, strategies for intervention that include mitigating depression and decreasing risk to the child, and implications for psychiatric nurses who work with perinatal women. Early identification and treatment of perinatal depression are critical to ensure optimal infant development and the child's future mental health.
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Affiliation(s)
- Janice H Goodman
- MGH Institute of Health Professions, School of Nursing, 36 1st Avenue, Boston, MA 02129, United States of America.
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Whalen OM, Campbell LE, Murphy VE, Lane AE, Gibson PG, Mattes J, Collison A, Mallise CA, Woolard A, Karayanidis F. Observational study of mental health in asthmatic women during the prenatal and postnatal periods. J Asthma 2019; 57:829-841. [PMID: 31148493 DOI: 10.1080/02770903.2019.1621888] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Objective: We aimed to examine the prevalence and severity of psychological distress of women with asthma in both the prenatal and postnatal periods, and to determine whether asthmatic women with and without mental health problems differ in self-management, medications knowledge, and asthma symptoms.Methods: We assessed spirometry performance and asthma symptoms in 120 women (mean age 29.8 years) before 23 weeks gestation, as part of the Breathing for Life Trial (Trial ID: ACTRN12613000202763). Prenatal depression data was obtained from medical records. At 6 weeks postpartum, we assessed general health, self-reported asthma control, depression symptoms (with the Edinburgh Postnatal Depression Scale) and adaptive functioning (with the Achenbach System of Empirically Based Assessment scales).Results: Twenty percent of our sample reported having a current mental health diagnosis, 14% reported currently receiving mental health care, while 47% reported having received mental health care in the past (and may/may not have received a diagnosis). The sample scored high on the Aggressive Behavior, Avoidant Personality, and Attention Deficit/Hyperactivity scales. Poorer self-reported postnatal asthma control was strongly correlated with elevated somatic complaints, externalizing problems, antisocial personality problems, and greater withdrawal. Prenatal spirometry or asthma severity and control were largely not associated with measures of psychopathology.Conclusions: These findings indicate that pregnant women with asthma frequently report issues with psychopathology during the prenatal and postnatal periods, and that the subjective perception of asthma control may be more related to psychopathology than objective asthma measures. However, due to sample bias, these findings are likely to be understated.
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Affiliation(s)
- Olivia M Whalen
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre GrowUpWell, University of Newcastle, Callaghan, NSW, Australia
| | - Linda E Campbell
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre GrowUpWell, University of Newcastle, Callaghan, NSW, Australia
| | - Vanessa E Murphy
- Priority Research Centre GrowUpWell, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Alison E Lane
- Priority Research Centre GrowUpWell, University of Newcastle, Callaghan, NSW, Australia.,School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Peter G Gibson
- Hunter Medical Research Institute, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia.,Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, NSW, Australia
| | - Joerg Mattes
- Priority Research Centre GrowUpWell, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Department of Paediatric Respiratory and Sleep Medicine, John Hunter Children's Hospital, Newcastle, NSW, Australia
| | - Adam Collison
- Priority Research Centre GrowUpWell, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Carly A Mallise
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre GrowUpWell, University of Newcastle, Callaghan, NSW, Australia
| | - Alix Woolard
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre GrowUpWell, University of Newcastle, Callaghan, NSW, Australia
| | - Frini Karayanidis
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, NSW, Australia
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44
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Thompson SM, Jiang L, Hammen C, Whaley SE. Association of Maternal Depressive Symptoms and Offspring Physical Health in Low-Income Families. Matern Child Health J 2019; 22:874-882. [PMID: 29417362 DOI: 10.1007/s10995-018-2462-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives The present study sought to examine the association between maternal depressive symptoms and characteristics of offspring physical health, including health status, health behaviors, and healthcare utilization, among low-income families. Maternal engagement was explored as a mediator of observed effects. Methods Cross-sectional survey data from a community sample of 4589 low-income women and their preschool-age children participating in the WIC program in Los Angeles County were analyzed using logistic, Poisson, and zero-inflated negative binomial regression. Mediation was tested via conditional process analyses. Results After controlling for the effects of demographic characteristics including maternal health insurance coverage, employment status, education, and preferred language, children of depressed women (N = 1025) were significantly more likely than children of non-depressed women (N = 3564) to receive a "poor" or "fair" maternal rating of general health (OR 2.34), eat fewer vegetables (IRR: 0.94) more sweets (IRR: 1.20) and sugary drinks daily (IRR: 1.32), and consume fast food more often (OR 1.21). These children were also less likely to have health insurance (OR 1.59) and more likely to receive medical care from a public medical clinic or hospital emergency room (OR 1.30). Reduced maternal engagement partially mediated associations between maternal depressive symptoms and several child health outcomes including poor diet, health insurance coverage, and use of public medical services. Conclusions for Practice Maternal depressive symptoms are associated with poor health among preschool-age children in low-income families. Prevention, screening, and treatment efforts aimed at reducing the prevalence of maternal depression may positively affect young children's health.
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Affiliation(s)
- Sarah M Thompson
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095, USA.
| | - Lu Jiang
- Public Health Foundation Enterprises (PHFE), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), 12781 Schabarum Avenue, Irwindale, CA, 91706, USA
| | - Constance Hammen
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095, USA
| | - Shannon E Whaley
- Public Health Foundation Enterprises (PHFE), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), 12781 Schabarum Avenue, Irwindale, CA, 91706, USA
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45
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Salcan S, Topal I, Ates I. The Frequency and Effective Factors of Exclusive Breastfeeding for the First Six Months in Babies Born in Erzincan Province in 2016. Eurasian J Med 2018; 51:145-149. [PMID: 31258354 DOI: 10.5152/eurasianjmed.2018.18310] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 12/14/2022] Open
Abstract
Objective The World Health Organization emphasizes that it is essential that infants be fed only breast milk for the first six months. This study is designed to investigate the frequency of exclusive breastfeeding and the related factors during the first six months in infants born in 2016 in Erzincan province. Materials and Methods Our study is a cross-sectional study, and the study population consisted of 2166 babies born in 2016, and registered with the family physicians. The sample size was calculated as 635 with a 95% confidence interval and 3% error margin, assuming that the frequency of exclusive breastfeeding in first six months is 30%. The family physicians were randomly selected. Mothers included in the study were determined by random sampling method. The data were collected by interviewing the mothers individually, and then analyzed in the SPSS (IBM, SPSS Corp.; Armonk, NY, USA) 21.0 package program. Results In this study, the rate of infants who received only breast milk for the first six months was calculated as 45.7%. The average period of exclusive breastfeeding was 4.4±2.03 months. It was observed that the children of mothers with prenatal and postnatal education received only breast milk for longer time. Also, mothers who do not work, those who do not use tobacco after birth, and those without depression also fed their children with only breast milk for longer time. In pacifiers or bottle users, infants receiving other nutrients after birth had a lower rate of exclusive breastfeeding for the first six months. Conclusion In our study, it has been observed that to increase the rate of exclusive breastfeeding, it is necessary to increase the education before and after the birth; to not use any other nutrients, pacifier, or bottle after delivery; and to spend adequate time with the baby.
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Affiliation(s)
- Sara Salcan
- Department of Public Health, Erzincan University School of Medicine, Erzincan, Turkey
| | - Ismail Topal
- Department of Pediatric Diseases, Erzincan University School of Medicine, Erzincan, Turkey
| | - Irem Ates
- Clinic of Anesthesia and Reanimation, Palandöken Public Hospital, Erzurum, Turkey
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46
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Access to Maternal Mental Health Services: Trends in State Legislation. J Pediatr Health Care 2018; 32:644-647. [PMID: 30368311 DOI: 10.1016/j.pedhc.2018.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/10/2018] [Accepted: 08/12/2018] [Indexed: 10/28/2022]
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47
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Ahun MN, Consoli A, Pingault JB, Falissard B, Battaglia M, Boivin M, Tremblay RE, Côté SM. Maternal depression symptoms and internalising problems in the offspring: the role of maternal and family factors. Eur Child Adolesc Psychiatry 2018; 27:921-932. [PMID: 29273860 DOI: 10.1007/s00787-017-1096-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 12/02/2017] [Indexed: 11/28/2022]
Abstract
Maternal depression symptoms (MDS) are a robust risk factor for internalising problems (IP) in the offspring. However, the relative importance of MDS and other factors associated with it (i.e. other types of maternal psychopathology, maternal parenting practices, family characteristics) is not well understood. To (a) identify a group of children with high levels of IP between 6 and 12 years using combined maternal and teacher assessments and (b) to quantify the associations between trajectories of MDS during early childhood and children's IP trajectories before and after controlling for family factors associated with MDS. MDS and family factors were assessed in a population-based sample in Canada (n = 1537) between 5 months and 5 years. The outcome variable was membership in trajectories of teacher- and mother-rated IP between ages 6 and 12 years. Family factors were included as covariates in a multinomial logistic regression model. There was a strong association between MDS and children's atypically high levels of IP in unadjusted analyses [OR 4.14 (95% CI 2.60; 6.61)]. The association was reduced, but remained strong [2.60 (1.55; 4.36)] when maternal psychopathology, maternal parenting, and family socioeconomic status were entered in the model. MDS, maternal anxiety, and low parental self-efficacy were associated with offspring's high IP trajectories. MDS is associated with high levels of children's IP independently of other maternal and family characteristics. Intervention targeting maternal psychopathology and parenting self-efficacy and testing the impact on children's IP would provide information on the putative causal pathways between maternal and offspring's symptomatology.
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Affiliation(s)
- Marilyn N Ahun
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal and Sainte-Justine Hospital, Montreal, Quebec, Canada
| | - Angele Consoli
- Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie, GH Pitié-Salpêtrière, Paris, France.,INSERM U669, Universities of Paris-Descartes and Paris-Sud, Paris, France
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London and Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom.,CESP, INSERM U1018 University of Paris-Sud, University of Paris-Saclay, UVSQ, Paris, France
| | - Bruno Falissard
- CESP, INSERM U1018 University of Paris-Sud, University of Paris-Saclay, UVSQ, Paris, France
| | - Marco Battaglia
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Division of Child, Youth and Emerging Adulthood, Centre for Addiction and Mental Health, Toronto, Canada
| | - Michel Boivin
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal and Sainte-Justine Hospital, Montreal, Quebec, Canada.,Tomsk State University, Siberia, Russia.,École de psychologie, Université Laval, Quebec, Canada
| | - Richard E Tremblay
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal and Sainte-Justine Hospital, Montreal, Quebec, Canada.,International Laboratory for Child and Adolescent Mental Health Development, University of Montreal, Montreal, Quebec, Canada.,University College Dublin, Dublin, Ireland
| | - Sylvana M Côté
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal and Sainte-Justine Hospital, Montreal, Quebec, Canada. .,Tomsk State University, Siberia, Russia. .,International Laboratory for Child and Adolescent Mental Health Development, University of Montreal, Montreal, Quebec, Canada.
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48
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Sipsma HL, Ruiz E, Jones K, Magriples U, Kersahw T. Effect of breastfeeding on postpartum depressive symptoms among adolescent and young adult mothers. J Matern Fetal Neonatal Med 2018; 31:1442-1447. [PMID: 28412876 PMCID: PMC8094923 DOI: 10.1080/14767058.2017.1319351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 04/11/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe the association between breastfeeding and postpartum depressive symptoms among a sample of adolescent and young adult mothers and to determine whether breastfeeding difficulty moderates this association. MATERIALS AND METHODS Data were derived from a prospective cohort of pregnant adolescent and young adult females (ages 14-21) as they transitioned to parenthood. This analysis uses data collected during pregnancy and at 6 months postpartum among mothers (n = 137) who initiated breastfeeding. Multivariable linear regression was used to adjust for prenatal depressive symptoms and other potential confounders. RESULTS Postpartum depressive symptoms were not significantly associated with breastfeeding duration or breastfeeding at 6 months. Early breastfeeding difficulty moderated the association between depressive symptoms and breastfeeding at 6 months. Among young mothers who were still breastfeeding at 6 months, those who reported no early breastfeeding difficulties had the lowest depressive scores and those who reported much early breastfeeding difficulty had the highest depressive scores at 6 months. CONCLUSIONS Minimizing challenges with breastfeeding may help improve postpartum mental health among adolescent and young adult mothers. Health care providers should help young pregnant women manage expectations about breastfeeding and ensure that they are linked to appropriate professional breastfeeding support during the early postpartum period.
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Affiliation(s)
- Heather L. Sipsma
- Department of Women, Children and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health University of Chicago, Chicago, IL
| | - Elizabeth Ruiz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Krista Jones
- Department of Health System Science, University of Illinois at Chicago College of Nursing, Urbana, IL
| | - Urania Magriples
- Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT
| | - Trace Kersahw
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
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49
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Park M, Brain U, Grunau RE, Diamond A, Oberlander TF. Maternal depression trajectories from pregnancy to 3 years postpartum are associated with children's behavior and executive functions at 3 and 6 years. Arch Womens Ment Health 2018; 21:353-363. [PMID: 29340801 DOI: 10.1007/s00737-017-0803-0] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 12/06/2017] [Indexed: 01/17/2023]
Abstract
The objective of this study was to investigate how patterns of maternal depressive symptoms from mid-pregnancy to 3 years postpartum are associated with children's behavior at age 3 years and executive functions. Maternal depressive symptoms were measured from mid-pregnancy to 3 years postpartum. Growth mixture modeling was used on standardized maternal depression scores (n = 147) to identify trajectories. Children's behavioral problems and mental health symptomatology (internalizing, externalizing, and attention deficit hyperactivity disorder) were obtained at 3 and 6 years. EFs were assessed by a laboratory-based computerized task and maternal-report at 6 years. Multivariable linear regressions of children's outcomes against maternal depressive symptom trajectories were conducted (n = 103). Three distinct patterns of maternal depressive symptom trajectories were identified: low (n = 105), increasing (n = 27), and decreasing (n = 15). Children of mothers whose depressive symptoms increased reported more problem behaviors at 3 years and poorer EFs at 6 years as assessed by both instruments, but no significant differences in mental health symptomatology at 6 years, relative to those whose mothers had consistently low depressive symptoms. Children whose mothers became less depressed over time had comparable levels of behavioral problems at age 3, executive functions, and internalizing and externalizing scores at age 6; and fewer reported ADHD behaviors at age 6, than those whose mothers remained less depressed over time. If mothers' depressive symptoms improve over the first 3 years postpartum, their children's outlook may be comparable to those whose mothers had consistently low depressive symptoms.
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Affiliation(s)
- Mina Park
- School of Population and Public Health, University of British Columbia, and British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Ursula Brain
- Department of Pediatrics, University of British Columbia, and British Columbia Children's Hospital Research Institute, F605 - 4480 Oak Street, Vancouver, BC, Canada
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia, and British Columbia Children's Hospital Research Institute, F605 - 4480 Oak Street, Vancouver, BC, Canada
| | - Adele Diamond
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Tim F Oberlander
- School of Population and Public Health, University of British Columbia, and British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada. .,Department of Pediatrics, University of British Columbia, and British Columbia Children's Hospital Research Institute, F605 - 4480 Oak Street, Vancouver, BC, Canada.
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50
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Marshall SA, Ip EH, Suerken CK, Arcury TA, Saldana S, Daniel SS, Quandt SA. Relationship between maternal depression symptoms and child weight outcomes in Latino farmworker families. MATERNAL AND CHILD NUTRITION 2018; 14:e12614. [PMID: 29740933 DOI: 10.1111/mcn.12614] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 03/06/2018] [Accepted: 03/15/2018] [Indexed: 12/14/2022]
Abstract
This study sought to characterize depressive symptoms among mothers in Latino farmworker families, determine if maternal depression increases children's risk of obesity, and ascertain whether relevant risk factors such as physical activity, diet, and feeding style mediate this relationship. Mothers from 248 families completed the 10-item Center for Epidemiologic Studies Depression Scale 9 times over a 2-year period. Four distinct patterns were used to describe mothers: few symptoms, moderate episodic symptoms, severe episodic symptoms, and chronic symptoms. Approximately two-thirds of women experienced moderate symptoms of depression at least once. Children of mothers fitting each pattern were compared. At the end of the study, children of mothers with severe episodic and chronic symptoms were significantly more likely to be overweight and obese than children of mothers with few symptoms (p < .05). After controlling for covariates, differences in weight status for children of mothers with severe episodic symptoms remained significant. Children of mothers with either moderate episodic or chronic symptoms were fed in a less responsive fashion (p < .05), and children of chronically symptomatic mothers had lower diet quality (p < .01). Although nonresponsive feeding has been linked to childhood obesity, in this analysis, feeding style did not mediate the relationship between maternal depression and diet quality. Elevated levels of depressive symptoms are common in this population, and those symptoms, especially when severe or chronic in nature, may increase children's risk of obesity. Additional research is needed to characterize the pathways through which maternal depression influences children's weight.
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Affiliation(s)
- Sarah A Marshall
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Edward H Ip
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Thomas A Arcury
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Santiago Saldana
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Sara A Quandt
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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