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Seid J, Mohammed E, Cherie N, Yasin H, Addisu E. The magnitude of perinatal depression and associated factors among women in Kutaber woreda public health institution and Boru Meda general hospital, Ethiopia, 2022: a cross-sectional study. Front Psychiatry 2024; 14:1302168. [PMID: 38318482 PMCID: PMC10838999 DOI: 10.3389/fpsyt.2023.1302168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024] Open
Abstract
Background Perinatal depression, characterized by the presence of depressive symptoms during pregnancy and/or within the first 12 months postpartum, poses a significant global public health concern. It contributes to a multitude of health risks for mothers, their infants, and their families. Understanding of perinatal depression and its associated factors is crucial for effective prevention and intervention strategies. However, there is a lack of comprehensive research on this topic in Ethiopia. Therefore, this study aims to determine the prevalence and factors contributing to perinatal depression among Ethiopian women. Methods An institutional-based cross-sectional study was conducted, involving 552 women receiving perinatal services at Kutaber district health institution and Boru Meda General Hospital. Study participants were selected through systematic random sampling techniques. Perinatal depression was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21). The associations between various determinants and perinatal depression were examined using binary logistic regression, and factors with a p-value of less than 0.2 were included in the multiple logistic regression analysis. A p-value less than 0.05 was considered statistically significant. Results The prevalence of perinatal depression was found to be 32.2%. The prevalence of perinatal depression was found to be 32.2%. Factors significantly associated with perinatal depression included being a student [adjusted odds ratio (AOR) = 4.364, 95% confidence interval (CI): 1.386, 13.744], experiencing excessive pregnancy-related concerns (AOR = 1.886, 95% CI: 1.176, 3.041), past substance use (AOR = 2.203, 95% CI: 1.149, 4.225), the presence of anxiety symptoms (AOR = 3.671, 95% CI: 2.122, 6.352), experiencing stress symptoms (AOR = 6.397, 95% CI: 3.394-12.055), and daytime sleepiness (AOR = 2.593, 95% CI: 1.558, 4.316). Conclusion The findings of this study indicate a relatively high prevalence and valuable factors associated with perinatal depression. It highlights the need for a comprehensive approach to perinatal mental health that takes into account not only the biological aspects of pregnancy but also the psychological, social, and lifestyle factors that can impact a person's mental well-being during this critical period.
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Affiliation(s)
- Jemal Seid
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Emam Mohammed
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Nigusie Cherie
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Husnia Yasin
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Elsabeth Addisu
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Ozer O, Keles E, Eker HH, Baydili KN, Osman MM. Postpartum depressive symptoms in women with female genital mutilation in Somalia. J Matern Fetal Neonatal Med 2023; 36:2256445. [PMID: 37748867 DOI: 10.1080/14767058.2023.2256445] [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] [Received: 05/18/2022] [Accepted: 09/02/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES This study aimed to identify associated factors for postpartum depression (PPD) among women with female genital mutilation (FGM) in Somalia. METHODS This was a cross-sectional study conducted between February and May 2021 in Somalia Mogadishu-Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia. Mothers with any known chronic disease, or psychiatric disorders and who refused to participate were excluded from the study. The cutoff point for depression was defined as ≥13 points according to the Edinburgh Postnatal Depression Scale. RESULTS Out of 446 postpartum mothers, 267 (59.9%) had increased depressive symptoms in the early postpartum period. PPD scale scores of mothers who were very poor were significantly higher depression scores than their counterparts (p = .002). Education level, place of residence, occupational status, number of children, type of FGM, and the presence of perineal tear did not differ significantly between depressed and non-depressed groups. CONCLUSIONS Women with FGM had increased depressive symptoms in the early postpartum period in Somalia. In addition, women who had lower income had higher PPD scores than their counterparts. Further studies are needed to develop a deeper understanding of the relationships between FGM and PPD and its causes.
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Affiliation(s)
- Ozgur Ozer
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
| | - Esra Keles
- Department of Gynecologic Oncology, Zeynep Kamil Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Hasan Huseyin Eker
- Department of Public Health, Hamidiye Faculty of Medicine, University of Health Sciences Turkey, Istanbul, Turkey
- Department of Public Health, University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
| | - Kurşad Nuri Baydili
- Department of Biostatistics, Hamidiye Faculty of Medicine, University of Health Sciences Turkey, Istanbul, Turkey
| | - Marian Muse Osman
- Department of Public Health, University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
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Salameh TN, Nyakeriga DB, Hall LA. Telehealth Care for Perinatal Depression in Immigrant and Refugee Women: A Scoping Review. Issues Ment Health Nurs 2023; 44:1216-1225. [PMID: 37832145 DOI: 10.1080/01612840.2023.2258222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Immigrant and refugee women have higher rates of perinatal depression compared to native-born women. Innovative telehealth interventions provide opportunities for prevention and treatment of perinatal depression. However, little is known about telehealth for perinatal immigrant and refugee women with depression. The aims of this scoping review were to identify available literature addressing the use of telehealth care for perinatal depression in immigrant and refugee women, and to determine the content, mode of delivery, and outcomes of telehealth care when provided for this population. A systematic literature search from 2000 to July 2023 was conducted in six databases and grey literature. The initial search resulted in 988 articles which were screened for their titles and abstracts. Eighty-one full-text articles were reviewed, yielding five articles included in this review. One quantitative study (a feasibility descriptive study), three qualitative studies, and a commentary supported the user satisfaction and potential effectiveness of telehealth care, delivered via telephone and text messaging, in improving perinatal depression symptoms. This review revealed a dearth of data-based studies on the outcomes of telehealth care for perinatal depression among immigrant and refugee women. Collaboration among researchers, healthcare providers, and technology engineers is required to improve telehealth care for this population.
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Affiliation(s)
- Taghreed N Salameh
- School of Nursing Women's Health Department, Koç University, İstanbul, Turkey
| | | | - Lynne A Hall
- School of Nursing, University of Louisville, Louisville, Kentucky, USA
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Pacho M, Aymerich C, Pedruzo B, Salazar de Pablo G, Sesma E, Bordenave M, Dieguez R, Lopez-Zorroza I, Herrero J, Laborda M, Fernandez-Rivas A, Garcia-Rizo C, Gonzalez-Torres MA, Catalan A. Substance use during pregnancy and risk of postpartum depression: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1264998. [PMID: 38025481 PMCID: PMC10666188 DOI: 10.3389/fpsyt.2023.1264998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Postpartum depression (PPD) is a prevalent mental health condition affecting women globally within the first year following childbirth. Substance use during pregnancy has been associated with an increased risk of developing PPD, but the evidence remains inconclusive. This meta-analysis aims to comprehensively assess the effects of different substances on PPD risk, exploring potential modifiers and confounding factors. Objectives To examine the proportion of PPD among substance users during pregnancy, compared to non-users, and investigate the specific risk associated with different substances (tobacco, alcohol, and non-specified substance use/multiple substance use). Methods A systematic literature search was conducted from inception to November 2022 using the Web of Science database (Clarivate Analytics), incorporating Web of Science Core Collection, the BIOSIS Citation Index, the KCI-Korean Journal Database, MEDLINE®, the Russian Science Citation Index, the SciELO Citation Index, and the Cochrane Central Register of Reviews, and Ovid/PsycINFO databases. Inclusion criteria comprised original studies with pregnant women, using validated depression scales and substance use reporting. Results Among the 26 included studies, encompassing 514,441 women, the pooled prevalence of PPD among substance users during pregnancy was 29% (95% CI 25-33). Meta-analyzes revealed an overall odds ratio (OR) of 3.67 (95% CI 2.31-5.85, p < 0.01) indicating a significantly higher risk of PPD among substance users compared to non-users. Subgroup analyzes demonstrated a higher risk for women with non-specified or multiple substance use (OR 4.67, 95% CI 2.59-8.41; p < 0.01) and tobacco use (OR 4.01, 95% CI 2.23-7.20; p < 0.01). Alcohol use showed a trend toward higher risk that did not reach statistical significance (OR 1.88, 95% CI 1.00-3.55; p = 0.051). Conclusion This meta-analysis provides evidence of an increased risk of PPD among pregnant substance users, particularly those using multiple substances or tobacco. However, caution is needed in interpreting the association with alcohol use due to its non-significant result. Systematic review registration This study protocol was registered at PROSPERO (registration number: CCRD42022375500).
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Affiliation(s)
- Malein Pacho
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Eva Sesma
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Marta Bordenave
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Rodrigo Dieguez
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Itziar Lopez-Zorroza
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Jon Herrero
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Maria Laborda
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Aranzazu Fernandez-Rivas
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Medicine, Institut de Neurociències, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Miguel Angel Gonzalez-Torres
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- NIH Oxford Health Biomedical Research Centre, Oxford, United Kingdom
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
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Tsai JM, Tsai LY, Tsay SL, Chen YH. The prevalence and risk factors of postpartum depression among women during the early postpartum period: a retrospective secondary data analysis. Taiwan J Obstet Gynecol 2023; 62:406-411. [PMID: 37188444 DOI: 10.1016/j.tjog.2023.03.003] [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: 03/14/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE Postpartum depression (PPD) is common and detrimental affecting both maternal health and child development. The purpose of this study was to determine the prevalence and factors of PPD screened immediately after delivery. MATERIALS AND METHODS A retrospective study design using secondary data analysis is applied. Four years of data, containing linkable maternal, neonate and PPD screen records between 2014 and 2018, was retrieved and combined from the electronic medical systems of MacKay Memorial Hospital in Taiwan. For each woman, the PPD screen record contained self-reported depressive symptoms assessed by the Edinburgh Postnatal Depression Scale (EPDS) within 48-72 h after delivery. A set of factors pertaining to maternal, pregnancy and obstetric, neonatal and breastfeeding were selected from the combined data set. RESULTS In total, 10.2% (1244 of 12,198) of women reported with the symptoms of PPD (EPDS ≥10). Through logistic regression analysis, eight predictors of PPD were identified. Specifically, PPD was shown to be associated with educational level of high school or lower (odds ratio (OR) = 1.57, 95% confidence interval (CI) 1.27-1.93), marital status of unmarried (OR = 1.52, 95% CI 1.18-1.99), unemployed (OR = 1.26, 95% CI 1.11-1.42), Cesarean section (OR = 1.7, 95% CI 1.5-1.93), unplanned pregnancy (OR = 1.38, 95% CI = 1.22-1.57), gestational age at 24-36 weeks (OR = 1.3, 95% CI 1.08-1.56), non-intention of breastfeeding (OR = 1.7, 95% CI 1.18-2.45) and Apgar at 5 min < 7 (OR = 2.18, 95% CI 1.11-4.29). CONCLUSION Low educational level, unmarried, unemployed, Caesarean section, unplanned pregnancy, preterm delivery, not breastfeeding and low Apgar at 5 min are predictors for postpartum women to develop PPD. These predictors are easily recognized in the clinical environment for patient guidance, support and referral as early as possible to ensure the health and well-being of the mothers and the neonates.
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Affiliation(s)
- Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, No. 168, University Rd., Dacun, Changhua, 515006, Taiwan; Mackay Memorial Hospital, Taipei City, Taiwan; Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| | - Li-Yun Tsai
- College of Nursing, Central Taiwan University of Science and Technology, No. 666, Buzih Rd., Beitun Dist., Taichung, 406053, Taiwan.
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Dayeh University, No. 168, University Rd., Dacun, Changhua, 515006, Taiwan.
| | - Yi-Heng Chen
- Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
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Koendjbiharie AP, Hindori-Mohangoo AD, Zijlmans WCWR, Wickliffe JK, Shankar A, Covert HH, Lichtveld MY, Grünberg AW, Drury SS. The Single and Combined Effects of Prenatal Nonchemical Stressors and Lead Exposure on Neurodevelopmental Outcomes in Toddlers: Results from the CCREOH Environmental Epidemiologic Study in Suriname. CHILDREN (BASEL, SWITZERLAND) 2023; 10:287. [PMID: 36832416 PMCID: PMC9954975 DOI: 10.3390/children10020287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
The primary aim of this prospective study was to examine the single and combined effect of prenatal exposure to perceived stress, probable depression, and lead on toddlers' neurodevelopment using the Bayley Scales of Infant and Toddler Development, third edition. Data from 363 mother-toddler pairs enrolled in the Caribbean Consortium for Research in Environmental and Occupational Health prospective cohort study were analyzed. A prenatal lead exposure of ≥3.5 µg/dL was associated with significantly lower receptive (p = 0.008) and expressive (p = 0.006) communication scaled scores. Moderate and severe maternal prenatal probable depression scores were associated with significantly lower fine (p = 0.009) and gross (p = 0.009) motor scaled scores. However, a maternal report of prenatal stress was not associated with neurodevelopmental outcomes. After adjusting for maternal demographics, prenatal stress and lead exposure, prenatal probable depression remained predictive of the toddlers' gross motor scaled scores (β -0.13, 95% CI [-0.24--0.02]). Similarly, when adjusting for demographics, prenatal stress and probable depression, prenatal lead exposure remained a significant predictor of their receptive communication scaled scores (β -0.26, 95% CI [-0.49--0.02]). An analysis testing combined exposure to perceived stress, probable depression, and lead exposure, measured using a cumulative risk index, significantly predicted the child fine motor scaled scores after adjusting for other covariates (β -0.74, 95% CI: [-1.41--0.01]).
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Affiliation(s)
- Aloysius Ph. Koendjbiharie
- Community Health Department, Regional Health Services, Paramaribo, Suriname
- Faculty of Medical Science, Anton De Kom University, Paramaribo, Suriname
| | - Ashna D. Hindori-Mohangoo
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Wilco C. W. R. Zijlmans
- Faculty of Medical Science, Anton De Kom University, Paramaribo, Suriname
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Jeffrey K. Wickliffe
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Arti Shankar
- Department of Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Hannah H. Covert
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
- Department of Environmental and Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Maureen Y. Lichtveld
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
- Department of Environmental and Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Antoon W. Grünberg
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - Stacy S. Drury
- Department of Psychiatry, School of Medicine, Tulane University, New Orleans, LA 70112, USA
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Almuqbil M, Kraidiye N, Alshmaimri H, Ali kaabi A, Almutiri A, Alanazi A, Hjeij A, Alamri AS, Alsanie WF, Alhomrani M, Asdaq SMB. Postpartum depression and health-related quality of life: a Saudi Arabian perspective. PeerJ 2022; 10:e14240. [PMID: 36262413 PMCID: PMC9575671 DOI: 10.7717/peerj.14240] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023] Open
Abstract
Background and Objectives The mental and physical functioning of an individual is partly determined by their health-related quality of life (HRQOL), which is a multifaceted component. Women who have recently given birth must have a good quality of life to provide proper care and development for their infant. The purpose of this study was to assess the relationship between postpartum depression (PPD) and HRQOL in Saudi Arabian women and to identify potential risk factors that could influence them. Methods This study comprised 253 mothers aged 1-24 weeks postpartum from several health centers in Saudi Arabia, recruited by random purposive sampling. The study's questionnaire featured three sections: the first section had demographic information; the second and third sections contained the Edinburgh Postnatal Depression Scale (EPDS) scale and the HRQOL scale (SF-12), respectively. Data were analyzed using descriptive statistics, chi square analyses, independent samples t-tests and binary logistic regression analysis using IBM SPSS 25. Results Results of current study indicate that 59.68% of the patients exhibited probable post-partum depression symptoms. Participants who were depressed had significantly lower mental component (MCS) and physical component scores than participants who were in good health. When compared to non-smokers, smokers have a 21-fold higher risk of developing depression. Similar to this, mothers who worked had a 3.98 times higher risk of depression, and patients with a history of depression had a 3.6 times higher chance of getting PPD. The probability of developing PPD was also significantly higher in those who lived outside the Riyadh region, had given birth more than twice before this time, and had experienced undesired pregnancies. Conclusion Our study demonstrated an inverse correlation between postpartum depression and health-related quality of life scores. Treatment for depression, particularly among mothers, is crucial for improving their quality of life and, as a result, creating a favorable environment for the development of newborn babies.
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Affiliation(s)
- Mansour Almuqbil
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Riyadh, Saudi Arabia
| | | | | | | | | | | | - Ayat Hjeij
- AlMaarefa University, Dariyah, Saudi Arabia
| | - Abdulhakeem S. Alamri
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia,Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia
| | - Wala F. Alsanie
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia,Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia
| | - Majid Alhomrani
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia,Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia
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Hamed SA, Elwasify M, Abdelhafez M, Fawzy M. Peripartum depression and its predictors: A longitudinal observational hospital-based study. World J Psychiatry 2022; 12:1061-1075. [PMID: 36158302 PMCID: PMC9476840 DOI: 10.5498/wjp.v12.i8.1061] [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: 10/04/2021] [Revised: 01/08/2022] [Accepted: 07/18/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Depression is a common problem in women in childbearing years due to burdens of motherhood and building a family. Few studies estimate the prevalence of antepartum depression compared to those in the postpartum period.
AIM To estimate the prevalence and the severities of peripartum depression and major depressive disorder and their predictors.
METHODS This is a longitudinal observation study. It included 200 women scoring ≥ 13 with the Edinburgh Postpartum Depression Scale, indicating presence of symptoms of depression. They had a gestational age of ≥ 6 wk and did follow-ups until the 10th week to 12th weeks postpartum. Information of women's reactions to life circumstances and stressors during the current pregnancy were gathered from answers to questions of the designed unstructured clinical questionnaire. Severities of depression, anxiety, and parenting stress were determined by the Beck Depre-ssion Inventory, State-Trait Anxiety Inventory for Adults, and Parenting Stress Index-Short Form, respectively. Psychiatric interviewing was done to confirm the diagnosis of major depression. Measuring the levels of triiodothronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) was done in both antepartum and postpartum periods.
RESULTS Out of 968 (mean age = 27.35 ± 6.42 years), 20.66% (n = 200) of the patients had clinically significant symptoms of depression and 7.44% had major depression. Previous premenstrual dysphoria, post-abortive depression, and depression unrelated to pregnancy and were reported in 43%, 8%, and 4.5% of the patients, respectively. Psychosocial stressors were reported in 15.5% of the patients. Antepartum anxiety and parenting stress were reported in 90.5% and 65% of the patients, respectively. Postpartum T3, T4, and TSH levels did not significantly differ from reference values. Regression analysis showed that anxiety trait was a predictor for antepartum (standardized regression coefficients = 0.514, t = 8.507, P = 0.001) and postpartum (standardized regression coefficients = 0.573, t = 0.040, P = 0.041) depression. Antepartum depression (standardized regression coefficients = -0.086, t = -2.750, P = 0.007), and parenting stress (standardized regression coefficients = 0.080, t = 14.34, P = 0.0001) were also predictors for postpartum depression.
CONCLUSION Results showed that 20.66% of the patients had clinically significant symptoms of depression and 7.44% had major depression. Anxiety was a predictor for antepartum and postpartum depression. Antepartum depression and parenting stress were also predictors for postpartum depression.
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Affiliation(s)
- Sherifa Ahmed Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut 71516, Egypt
| | - Mohamed Elwasify
- Department of Psychiatry, Mansoura University, Mansoura 11001, Egypt
| | - Mohamed Abdelhafez
- Department of Obstetrics and Gynecology, Mansoura University, Mansoura 11001, Egypt
| | - Mohamed Fawzy
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut 71516, Egypt
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9
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Adverse childhood experiences combined with emotional and physical abuse by the partner predict antenatal depression. J Affect Disord 2022; 298:194-201. [PMID: 34715193 DOI: 10.1016/j.jad.2021.10.099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/21/2021] [Accepted: 10/23/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Few studies examined the contributions of childhood adversities, intimate partner violence and social support to antenatal depression (AD). This study aims to 1) evaluate association of these psychosocial factors with AD symptoms in pregnancy; and 2) examine the mediating effect of social support on the relationship between psychosocial stressors and AD symptoms. METHODS Participants were 120 pregnant women aged from 18 to 49 in less than 16 gestational weeks and attending at Antenatal Care Center at Khon Kaen hospital, Thailand. AD symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS). Childhood adversities, intimate partner violence and social support were measured using the Adverse Childhood Experiences Questionnaire (ACE questionnaire), Abuse Assessment Screen (AAS), and Multidimensional Scale of Perceived Social Support (MSPSS). RESULTS We found that the EPDS score was significantly and positively associated with adverse childhood experiences (ACEs) and negatively with social support. Partial Least Square analysis showed that 49.1% of the variance in the depressive subdomain of the EPDS score was predicted by ACEs, namely psychological and physical abuse and neglect, emotional or physical abuse by the partner, unplanned pregnancy, and no satisfaction with their relationship. The effects of adverse childhood experience due to neglect on the EDPS score was mediated by social support by friends. LIMITATIONS ACEs were assessed retrospectively and, therefore, may be susceptible to recall bias. CONCLUSION Prenatal depression scores are to a large extent predicted by psychological distress as indicated by early lifetime trauma, abuse by partner, relation satisfaction, and implications of unintended pregnancy.
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Yang K, Wu J, Chen X. Risk factors of perinatal depression in women: a systematic review and meta-analysis. BMC Psychiatry 2022; 22:63. [PMID: 35086502 PMCID: PMC8793194 DOI: 10.1186/s12888-021-03684-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/29/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Perinatal depression in women is associated with high morbidity and mortality, and has attracted increasing attention. The investigation of risk factors of perinatal depression in women may contribute to the early identification of depressed or depression-prone women in clinical practice. MATERIAL AND METHODS A computerized systematic literature search was made in Cochrane Library, PubMed, Web of Science, and EMBASE from January 2009 to October 2021. All included articles were published in English, which evaluated factors influencing perinatal depression in women. Based on the recommendations of the Cochrane Collaboration protocols, Review Manager 5.3 was used as a statistical platform. RESULTS Thirty-one studies with an overall sample size of 79,043 women were included in the review. Educational level (P = 0.0001, odds ratio [OR]: 1.40, 95% CI: [1.18,1.67]), economic status of families (P = 0.0001, OR: 1.69, 95%CI: [1.29,2.22]), history of mental illness (P < 0.00001, OR: 0.29, 95% CI: [0.18, 0.47]), domestic violence (P < 0.00001, OR: 0.24, 95% CI: [0.17,0.34]), perinatal smoking or drinking (P = 0.005, OR: 0.63; 95% CI [0.45, 0.87]; P = 0.008, OR: 0.43, 95% CI, [0.23 to 0.80]; respectively), and multiparity(P = 0.0003, OR: 0.74, 95% CI: [0.63, 0.87]) were correlated with perinatal depression in women. The stability of our pooled results was verified by sensitivity analysis and publication bias was not observed based on funnel plot results. CONCLUSION Lower educational level, poor economic status of families, history of mental illness, domestic violence, perinatal smoking or drinking, and multiparity serve as risk factors of perinatal depression in women.
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Affiliation(s)
- Kai Yang
- grid.33199.310000 0004 0368 7223Department of Anesthesiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Jing Wu
- grid.33199.310000 0004 0368 7223Department of Anesthesiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Xiangdong Chen
- Department of Anesthesiology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430022, China.
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Schier de Fraga F, Wan-Dall BSL, Garcia GHDO, Pandolfo H, Sequinel AMTDS, Alvin P, Serman EJ, do Amaral VF. Antenatal screening of depressive and manic symptoms in south Brazilian childbearing women: A transversal study in advance of the pandemic scenario. PLoS One 2021; 16:e0261874. [PMID: 34962942 PMCID: PMC8714122 DOI: 10.1371/journal.pone.0261874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/10/2021] [Indexed: 11/18/2022] Open
Abstract
Background The diagnosis of mood disorders (MD) during pregnancy is challenging and may bring negative consequences to the maternal-fetal binomial. The long waitlist for specialized psychiatric evaluation in Brazil contributes to the treatment omission. Almost 20.0% of women treated with antidepressants have a positive screening for bipolar disorder. Therefore, it has been recommended the investigation of depressive and bipolar disorder during prenatal care. Unfortunately, the screening for mood disorders is not a reality in Brazil and many childbearing women remain undiagnosed. The objective of this study is to observe the frequency of MD and the effectiveness of screening scales for routine use by health professionals during prenatal care in high-risk pregnancies. Methodology/Principal findings This cross-sectional study included 61 childbearing women in their second trimester who were interviewed using the Edinburgh Postnatal Depression Scale (EPDS) and the Mood Disorder Questionnaire (MDQ). The cut-off point was EPDS ≥ 13 and MDQ ≥ 7 and the SCID-5 was the gold standard diagnosis. MD were diagnosed in 24.6% of the high-risk pregnancies. EDPS was positive in 19.7% and the frequency of major depression was 8.2%. 16.4% of the childbearing women were diagnosed with bipolar disorder, while MDQ was positive in 36.1%. 11.5% of the women had EPDS and MDQ positive. EPDS sensitivity was 80.0% and specificity 92.1%, whereas MDQ presented a sensitivity of 70.0% and specificity of 70.6%. Conclusion/Significance There is a high prevalence of MD in high-risk pregnancies. The routine use of EPDS simultaneously to MDQ during antenatal care is effective and plays an important role in early diagnosis, counselling, and promotion of perinatal mental health.
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Affiliation(s)
- Fernanda Schier de Fraga
- Department of Obstetrics and Gynaecology, Health Science Sector of Federal University of Parana, Curitiba, Parana, Brazil
- * E-mail:
| | | | | | - Henrique Pandolfo
- Department of Psychiatry, Health Science Sector of Federal University of Parana, Curitiba, Parana, Brazil
| | | | - Pedro Alvin
- Department of Psychiatry, Health Science Sector of Federal University of Parana, Curitiba, Parana, Brazil
| | - Eduardo Jonson Serman
- Department of Obstetrics and Gynaecology, Health Science Sector of Federal University of Parana, Curitiba, Parana, Brazil
| | - Vivian Ferreira do Amaral
- Department of Obstetrics and Gynaecology, Health Science Sector of Federal University of Parana, Curitiba, Parana, Brazil
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Social inequalities in maternal depressive symptomatology after childbirth: Comparison across birth cohorts in Brazil. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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13
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Pedraza DF, Lins ACDL. [Clinical complications during pregnancy: a systematic review of studies with pregnant Brazilian women]. CIENCIA & SAUDE COLETIVA 2021; 26:5329-5350. [PMID: 34787223 DOI: 10.1590/1413-812320212611.3.33202019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 11/21/2019] [Indexed: 11/22/2022] Open
Abstract
The scope of this paper was to describe the main clinical complications among pregnant Brazilian women reported in the literature, identifying the most relevant exposure factors and their outcomes in maternal and child health. This is a systematic review of articles published between 2010 and 2018. Three reviews and 36 empirical articles were included; mental disorders (n=9), infectious diseases (n=9) and severe maternal morbidity (n=8) were the main clinical complications during pregnancy. In addition, four articles focused on determining the main conditions or causes of hospitalization, with a higher frequency of Urinary Tract Infection, anemia and hypertensive diseases. Maternal age at reproductive extremes, lower schooling, socioeconomic vulnerability, racial characteristics and the use of public health services were the most relevant exposure factors. Unfavorable health outcomes associated with clinical complications in pregnancy were verified in the eight articles with this profile. The frequency of pregnant women with potential life-threatening clinical complications is high in the country, highlighting the importance of primary care coverage and the implementation of interventions to reduce and prevent adverse maternal and child outcomes.
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Affiliation(s)
- Dixis Figueroa Pedraza
- Universidade Estadual da Paraíba. Av. das Baraúnas 351, Campus Universitário, Bodocongó. 58109-753 Campina Grande PB Brasil.
| | - Anahi Cézar de Lima Lins
- Universidade Estadual da Paraíba. Av. das Baraúnas 351, Campus Universitário, Bodocongó. 58109-753 Campina Grande PB Brasil.
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Bedaso A, Adams J, Peng W, Sibbritt D. The association between social support and antenatal depressive and anxiety symptoms among Australian women. BMC Pregnancy Childbirth 2021; 21:708. [PMID: 34686140 PMCID: PMC8532351 DOI: 10.1186/s12884-021-04188-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
Background Antenatal depression and antenatal anxiety adversely affect several obstetric and foetal outcomes, and increase the rate of postnatal mental illness. Thus, to tackle these challenges the need for social support during pregnancy is vital. However, an extensive literature search failed to show a published study on the relationship between domains of social support and antenatal depressive, as well as antenatal anxiety symptoms in Australia. This study examined the association between domains of social support and antenatal depressive and anxiety symptoms among Australian women. Methods The current study used data obtained from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH), focusing upon women who reported being pregnant (n = 493). Depression and anxiety were assessed using the 10 item Center for Epidemiological Studies Depression (CES-D-10) scale, and the 9-item Goldberg Anxiety and Depression scale (GADS) respectively. The 19 item-Medical Outcomes Study Social Support index (MOSS) was used to assess social support. A logistic regression model was used to examine the associations between domains of social support and antenatal depressive and anxiety symptoms after adjusting for potential confounders. Result The current study found 24.7 and 20.9% of pregnant women screened positive for depressive and anxiety symptoms respectively. After adjusting for potential confounders, our study found that the odds of antenatal depressive symptoms was about four and threefold higher among pregnant women who reported low emotional/informational support (AOR = 4.75; 95% CI: 1.45, 15.66; p = 0.010) and low social support (overall support) (AOR = 3.26; 95%CI: 1.05, 10.10, p = 0.040) respectively compared with their counterpart. In addition, the odds of antenatal anxiety symptoms was seven times higher among pregnant women who reported low affectionate support/positive social interaction (AOR = 7.43; 95%CI: 1.75, 31.55; p = 0.006). Conclusion A considerable proportion of pregnant Australian women had depressive symptoms and/or anxiety symptoms, which poses serious health concerns. Low emotional/informational support and low affectionate support/positive social interaction have a significant association with antenatal depressive and anxiety symptoms respectively. As such, targeted screening of expectant women for social support is essential. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04188-4.
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Affiliation(s)
- Asres Bedaso
- Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia. .,Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Jon Adams
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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15
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Míguez MC, Vázquez MB. Risk factors for antenatal depression: A review. World J Psychiatry 2021; 11:325-336. [PMID: 34327125 PMCID: PMC8311510 DOI: 10.5498/wjp.v11.i7.325] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/20/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
Depression is the most prevalent mental disorder in pregnancy, and yet it is less studied than postpartum depression despite the consequences it may have on both the pregnant woman and her offspring. Therefore, it would be important to know which risk factors may favour the appearance of antenatal depression in order to carry out appropriate prevention interventions. The aim of the present review was to identify the main risk factors of antenatal depression. We searched in databases PubMed and PsycINFO for articles published about the factors associated with antenatal depression from January 2010 through December 2020. The literature review identified three main groups of antenatal depression risk factors: sociodemographic, obstetric, and psychological. First, among the sociodemographic variables, the low level of studies and the economic income clearly stood out from the rest. Then, not having planned the pregnancy was the main obstetric variable, and finally, the main psychological risk factors were having a history of psychological disorders and/or depression as well as presenting anxiety, stress, and/or low social support during pregnancy. This review shows that the antenatal depression is affected by multiple factors. Most can be identified at the beginning of the pregnancy, and some are risk factors potentially modifiable through appropriate interventions, such as psychological factors. For this reason, it is important to carry out a good screening for depression during pregnancy and consequently, be able to prevent its appearance or treat it if necessary.
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Affiliation(s)
- M Carmen Míguez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - M Belén Vázquez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela 15782, Spain
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Faisal-Cury A, Rocha AC, Elise Machado Ribeiro Silotto A, Maurício de Oliveira Rodrigues D. Prevalence and associated risk factors of antenatal depression among Brazilian pregnant women: A population-based study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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17
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Gokoel AR, Abdoel Wahid F, Zijlmans WCWR, Shankar A, Hindori-Mohangoo AD, Covert HH, MacDonald-Ottevanger MS, Lichtveld MY, Harville EW. Influence of perceived stress on prenatal depression in Surinamese women enrolled in the CCREOH study. Reprod Health 2021; 18:136. [PMID: 34193196 PMCID: PMC8243817 DOI: 10.1186/s12978-021-01184-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/19/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Prenatal depression may have adverse health effects on mothers and their offspring. Perceived stress is an important risk factor for depression during pregnancy. Studies have shown that both perceived stress and depression may negatively influence birth outcomes. While 20% of pregnancies in Suriname, a middle-income Caribbean country located in northern South America, results in adverse birth outcomes, data on prenatal depression and its risk factors are lacking. This study aimed to assess the influence of perceived stress on depression during pregnancy in Surinamese women. METHODS Survey data were used from 1143 pregnant women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study that addresses the impact of chemical and non-chemical environmental exposures in mother/child dyads in Suriname. The Edinburgh Depression Scale and Cohen Perceived Stress Scale were used to screen for probable depression (cut-off ≥ 12) and high stress (cut-off ≥ 20), respectively. The association between perceived stress and depression was examined using bivariate and multiple logistic regression analyses, adjusted for social support (including resilience) and maternal demographics. RESULTS The prevalence of high perceived stress during the first two trimesters and the third trimester were 27.2% and 24.7% respectively. 22.4% of the participants had probable depression during first or second trimester and 17.6% during the third trimester. Women experiencing high stress levels during the first two trimesters had 1.92 increased odds (95% CI 1.18-3.11, p = 0.008) of having probable depression during the third trimester of pregnancy than those with low stress levels. Pregnant women with low individual resilience during early pregnancy (52.1%) had 1.65 (95% CI 1.03-2.63, p = 0.038) increased odds of having probable depression during later stages of pregnancy compared to those with high individual resilience. Low educational level (p = 0.004) and age of the mother (20-34 years) (p = 0.023) were significantly associated with probable depression during the third trimester. CONCLUSIONS Early detection and management of stress and depression during pregnancy are important. Health education programs, targeting the reduction of stress during pregnancy, may help to reduce depression and its potential adverse health effects on the mother and child.
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Affiliation(s)
- Anisma R Gokoel
- Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname.
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname.
| | - Firoz Abdoel Wahid
- Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Wilco C W R Zijlmans
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
- Foundation for Perinatal Interventions and Research in Suriname (PeriSur), Paramaribo, Suriname
| | - Arti Shankar
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Ashna D Hindori-Mohangoo
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Foundation for Perinatal Interventions and Research in Suriname (PeriSur), Paramaribo, Suriname
| | - Hannah H Covert
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Meerte-Sigrid MacDonald-Ottevanger
- Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
- Department of Medical Microbiology, Academic University Medical Center, Amsterdam, The Netherlands
| | - Maureen Y Lichtveld
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Emily W Harville
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
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18
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Are pregnant women at higher risk of depression underdiagnosis? J Affect Disord 2021; 283:192-197. [PMID: 33561799 DOI: 10.1016/j.jad.2021.01.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/04/2021] [Accepted: 01/28/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND we aim to estimate the prevalence of depression underdiagnosis among women and whether pregnant women are at higher risk STUDY DESIGN: we used data from the Brazilian National Survey (PNS 2013), a population-based study. All 22.455 women (18-49 years old) answered the Patient Health Questionnaire-9 (PHQ-9) and a questionnaire with sociodemographic, obstetric and clinical data. There were 2.605 (2.491 non-pregnant and 114 pregnant women) depressed women (PHQ-9 >8)with a clinical diagnosis of depression, in the last 30 days. Classification of depression underdiagnosis was made using the comparison between results obtained from the self-referred question evaluating clinical diagnosis of depression by providers and the results of the PHQ-9 application. Women with a PHQ-9 score > 8 and with a "No" answer in the clinical question were classified as depression underdiagnosis. Logistic regression models were performed to obtain crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI) RESULTS: Depression underdiagnosis prevalence was 71.2% and was more frequent among pregnant women in comparison with non-pregnant women (88.1% vs 68.0%; p = 0.002). In the adjusted analysis, being pregnant was significantly associated with depression underdiagnosis (aOR 3.55, 95% CI 1.66:7.60). Nonwhite skin color women were also at higher risk of depression underdiagnosis (aOR 1.53, 95% CI 1.09:2.14). LIMITATIONS the cross-sectional design and the lack of medical records data about assessment of mental health CONCLUSION(S): in Brazil, depression underdiagnosis by providers is prevalent and pregnant women and minority women are at higher risk of not receiving a correct mental health diagnosis.
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Mwita M, Kasongi D, Bernard E, Gunda D, Mmbaga B. The magnitude and determinants of antepartum depression among women attending antenatal clinic at a tertiary hospital, in Mwanza Tanzania: a cross-sectional study. Pan Afr Med J 2021; 38:258. [PMID: 34104306 PMCID: PMC8164423 DOI: 10.11604/pamj.2021.38.258.27023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/05/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction there is an increased vulnerability for the development of common mental disorders during the peripartum period as evidenced in depressive disorder. Methods a cross sectional study was used to determine the prevalence and risk factors associated with depression among pregnant women attending antenatal clinic (ANC) at Bugando Medical Centre (BMC), a tertiary level hospital in Mwanza Tanzania. A total of 380 pregnant women were recruited and interviewed by using Edinburg Postnatal Depression Scale. The sample size was randomly selected from the clinic. Results the mean age of the participants was 30.35 years, with minimum and maximum age of 20 years and 47 years respectively with 89.74% of the participants being married. Almost half of the participants, 53.68% were on the third trimester, with about two-third of the participants, 76.84% reports to have planned for their current pregnancies. The overall prevalence of depression was 15% with middle age of the partner (31-40 years), been married, high level of education, partner and family support were found to be statistically protective for depression while polygamy and partner violence were statistically risk factor for depression. Conclusion the results showed high prevalence of antepartum depression which emphasizes the importance of earlier screening, detection and intervention to reduce the burden of morbidity and disability.
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Affiliation(s)
- Matiko Mwita
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania.,Bugando Medical Centre, Psychiatry Department, Mwanza, Tanzania
| | - Doreen Kasongi
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Eliya Bernard
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Daniel Gunda
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Blandina Mmbaga
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Matsuoka H, Iwami S, Maeda M, Suizu A, Fujii T. Edinburgh Postnatal Depression Scale scores at 2-week post-partum may reflect those at 4-week post-partum: A single-center retrospective observational study. J Obstet Gynaecol Res 2020; 47:508-514. [PMID: 33145872 DOI: 10.1111/jog.14540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/12/2020] [Accepted: 10/16/2020] [Indexed: 11/27/2022]
Abstract
AIM Most Japanese institutions screen for post-partum depression (PPD) using the Edinburgh Postnatal Depression Scale (EPDS) at outpatient visits conducted at 2- and 4-week post-partum, but there are no published data on the usefulness of EPDS scores 2-week post-partum. In the present study, relationships between 2-week post-partum EPDS scores and 4-week post-partum EPDS scores were investigated to determine whether 2-week scores may facilitate early intervention in high-risk mothers. METHODS A retrospective analysis of 451 deliveries from 2017 to 2019 was conducted at a single institution. EPDS scores were obtained using the Japanese EPDS 2- and 4-week post-partum, in conjunction with other perinatal data from medical records. RESULTS In total, 334 of 451 mothers (74.1%) completed the EPDS at both 2- and 4-week post-partum and were included in the analysis. Of 48 who had higher scores 2-week post-partum, 21 (43.8%) continued to be at high risk of PPD. Of 284 who had lower scores 2-week post-partum, 9 (3.2%) transitioned to scores indicating high risk. Women considered high-risk 4-week post-partum tended to have exhibited higher scores 2-week post-partum. Women who had experienced more deliveries tended to exhibit lower scores, and psychiatric illness was strongly associated with higher EPDS scores (odds ratio 11.2, 95% confidence interval 3.7-33.8, P < 0.01). CONCLUSION Two-week EPDS scores closely reflected 4-week scores, and may facilitate early intervention to prevent PPD. Primiparous mothers and those with a history of psychiatric illness should be followed-up closely.
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Affiliation(s)
- Hideki Matsuoka
- Department of Gynecology and Obstetrics, Kyoto Katsura Hospital, Kyoto, Japan
| | - Shuichiro Iwami
- Department of Gynecology and Obstetrics, Kyoto Katsura Hospital, Kyoto, Japan
| | - Marisa Maeda
- Department of Gynecology and Obstetrics, Kyoto Katsura Hospital, Kyoto, Japan
| | - Ai Suizu
- Department of Gynecology and Obstetrics, Kyoto Katsura Hospital, Kyoto, Japan
| | - Tsuyoshi Fujii
- Department of Gynecology and Obstetrics, Rakuwakai Otowa Hospital, Kyoto, Japan
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VanderWall R, Haefner J, Wehbe-Alamah H. Use of an educational intervention to increase screening for antenatal depression in an obstetrics and gynecology practice. J Am Assoc Nurse Pract 2020; 33:1093-1099. [PMID: 32976252 DOI: 10.1097/jxx.0000000000000494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/24/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Depression affects approximately 12% of pregnant women and increases maternal and fetal risk during pregnancy and the postpartum period. The United States Preventative Services Task Force and the American College of Obstetricians and Gynecologists recommend that all prenatal care include depression screening. This study assessed the effectiveness of an educational intervention to increase screening for depression during prenatal care. LOCAL PROBLEM The clinical site serves a socioeconomically and culturally high-risk population. Prior to the intervention, prenatal depression screening was not incorporated into prenatal care. METHODS Health records of patients presenting for prenatal care to an obstetrics and gynecology clinic were analyzed before an educational intervention on prenatal depression was delivered to providers at the practice site. Data for prenatal depression screening rates, treatment plans, and patient demographic information were extracted and compared to determine compliance with antenatal depression screening guidelines. INTERVENTIONS The primary intervention of this initiative is the provision of education on the importance of and techniques for prenatal depression screening, diagnosis, and treatment. RESULTS Prenatal depression screening increased from 0% to 27% of patients following the intervention. No significant correlation was found between factors of age, gestational age, gravidity, parity, or marital status. A total of 2.8% of screened patients scored positive for severe depression, 5.7% indicated moderate depression, and 51% indicated mild depression. CONCLUSIONS Education and training improves provision of prenatal depression screening, but further work is needed to improve the accurate and timely identification of depression, as well as its appropriate treatment, referral, and follow-up.
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Affiliation(s)
- Rachel VanderWall
- University of Michigan-Flint, Flint, Michigan. Dr. VanderWall is now at the Jamesfield Drive, Hudsonville, Michigan
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Dadi AF, Miller ER, Mwanri L. Postnatal depression and its association with adverse infant health outcomes in low- and middle-income countries: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:416. [PMID: 32698779 PMCID: PMC7374875 DOI: 10.1186/s12884-020-03092-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 07/03/2020] [Indexed: 02/08/2023] Open
Abstract
Background Postnatal Depression (PND) is a mood disorder that steals motherhood and affects the health and development of a newborn. While the impact of PND on motherhood and newborn in developed countries are well described, its epidemiology and health consequences in infant is not well known in middle-and low-income countries. The objective of this review was to determine the burden and association of PND with adverse infant health outcomes in low-and middle- income countries. Methods We searched observational studies written in the English language and conducted in middle-and low-income countries between December 1st, 2007, and December 31st, 2017. The CINHAL, MEDLINE, Emcare, PubMed, Psych Info, and Scopus databases were searched for the following search terms: PND, acute respiratory infection, pneumonia, diarrhea, exclusive breastfeeding, common infant illnesses, and malnutrition. We excluded studies in which the primary outcomes were not measured following a standardized approach. We have meta-analyzed the estimates from primary studies by adjusting for possible publication bias and heterogeneity. The analysis was conducted in Stata 14. The study was registered in PROSPERO protocol number CRD42017082624. Result Fifty-eight studies on PND prevalence (among 63,293 women) and 17 studies (among 32,454 infants) on infant health outcomes were included. PND prevalence was higher in the low-income countries (Pooled prevalence (PP) = 25.8%; 95%CI: 17.9–33.8%) than in the middle-income countries (PP = 20.8%; 95%CI: 18.4–23.1%) and reached its peak in five to ten weeks after birth. Poor obstetric history and social support, low economic and educational status, and history of exposure to violence were associated with an increased risk of PND. The risk of having adverse infant health outcomes was 31% higher among depressed compared to non-depressed postnatal mothers (Pooled relative risk (PRR) = 1.31; 95%CI: 1.17–1.48). Malnutrition (1.39; 1.21–1.61), non-exclusive breastfeeding (1.55; 1.39–1.74), and common infant illnesses (2.55; 1.41–4.61) were the main adverse health outcomes identified. Conclusions One in four and one in five postnatal mothers were depressed in low and middle-income countries, respectively. Causes of depression could be explained by social, maternal, and psychological constructs. High risk of adverse infant health outcomes was associated with PND. Timely screening of PND and evidence-based interventions were a pressing need in low and middle-income countries.
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Affiliation(s)
- Abel Fekadu Dadi
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. .,College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia.
| | - Emma R Miller
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
| | - 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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Al Rawahi A, Al Kiyumi MH, Al Kimyani R, Al-Lawati I, Murthi S, Davidson R, Al Maniri A, Al Azri M. The Effect of Antepartum Depression on the Outcomes of Pregnancy and Development of Postpartum Depression: A prospective cohort study of Omani women. Sultan Qaboos Univ Med J 2020; 20:e179-e186. [PMID: 32655910 PMCID: PMC7328833 DOI: 10.18295/squmj.2020.20.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/28/2019] [Accepted: 01/19/2020] [Indexed: 01/20/2023] Open
Abstract
Objectives This study aimed to identify the relationship between antenatal depression and pregnancy outcomes, including the risk of developing postpartum depression in Oman. Methods This follow-up prospective longitudinal cohort study included pregnant women attending primary healthcare institutions in Muscat, Oman from January to November 2014. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal and postnatal depression. Pregnant Omani women with a gestational age ≥32 weeks attending 12 local health centres for antenatal care in Muscat were invited to participate. Recruited women were followed-up at 6–8 weeks after delivery. The following pregnancy outcomes were assessed: mode of delivery (normal or Caesarean section [CS]), gestational age at delivery (preterm or full-term), baby’s birth weight and development of postnatal depression. Results A total of 959 women participated in this study (response rate: 97.3%). In total, 233 women (24.4%) had antenatal depression with a score of ≥13 on the EPDS. Of the 592 participants (61.7%) who attended postnatal clinics at 6–8 weeks post-delivery, 126 (21.3%) were positive for postnatal depression. Logistic multivariate regression analysis showed that antenatal depression was associated with increased risk of CS (odds ratio [OR] = 1.79; 95% confidence interval [CI]: 1.20–2.66) and postnatal depression (OR = 8.63; 95% CI: 5.56–13.39). Conclusion Screening women for antenatal depression and providing appropriate management may reduce adverse pregnancy outcomes and the risk of developing postnatal depression.
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Affiliation(s)
- Aisha Al Rawahi
- Department of Family Medicine, Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Maisa H Al Kiyumi
- Department of Family Medicine & Public Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Raya Al Kimyani
- Department of Woman and Child Health, Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Iman Al-Lawati
- Department of Family Medicine, Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Sathiya Murthi
- Research Section, Oman Medical Specialty Board, Muscat, Oman
| | | | - Abdullah Al Maniri
- Department of Strategy and Planning, Oman Medical Specialty Board, Muscat, Oman
| | - Mohammed Al Azri
- Department of Family Medicine & Public Health, Sultan Qaboos University Hospital, Muscat, Oman
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The impact of intimate partner violence on the trajectory of perinatal depression: a cohort study in a Chinese sample. Epidemiol Psychiatr Sci 2020; 29:e133. [PMID: 32482189 PMCID: PMC7303793 DOI: 10.1017/s2045796020000463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
UNLABELLED Abstract. AIMS Intimate partner violence (IPV) is an important risk factor for perinatal depression (PND). But IPV's impact on the natural prognosis of PND symptoms is not well understood. We tested two hypotheses: (1) pregnant women with IPV experiences will exhibit more severe PND symptoms than women without IPV experience; (2) IPV experience will impede the recovery prognosis of PND. We also explored the contribution of IPV to PND comparing with other risk factors. METHOD The sample is comprised of 813 pregnant women followed through perinatal period in Hunan, China. We assessed IPV experience using items from the Short Form of the Revised Conflict Tactics Scale (CTS2S), and PND symptoms via the Edinburgh Postnatal Depression Scale (EPSD). We conducted Linear Mixed-effects Model to compare the trajectories of PND symptoms between victims and non-victims and a multistage Generalised Estimating Equations Model to explore salient factors on the trajectory of PND symptoms. RESULTS There were 90 participants (11.07%) who reported IPV experience in the past 12 months. With respect to physical, psychological and sexual violence, the prevalence was 4.55% (37/813), 9.23% (75/813) and 2.34% (19/813). Victims reported more severe PND symptoms (t = 5.30, p < 0.01) and slower decreasing slope of trajectories (t = 28.89, p < 0.01). The PND trajectory was associated with IPV experience (OR = 3.78; 95% CI 1.39-10.26), social support (OR = 0.93; 95% CI 0.88-0.97), positive coping strategies (OR = 0.85; 95% CI 0.80-0.91), negative coping strategies (OR = 1.25; 95% CI 1.14-1.37) and monthly income of $0.15-$298.36 (compared to no income, OR = 0.0075; 95% CI 0.00052-0.11). CONCLUSIONS The findings suggest the reported prevalence of IPV is lower in Hunan than most of the previous studies during perinatal period in other provinces of China, and IPV victimisation is associated with increased severity and slowed prognosis of PND symptoms. Future studies that screen for victimisation and establish its explicit mechanism to the poorer prognosis of PND symptoms would benefit the prevention and treatment of PND.
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Al Nasr RS, Altharwi K, Derbah MS, Gharibo SO, Fallatah SA, Alotaibi SG, Almutairi KA, Asdaq SMB. Prevalence and predictors of postpartum depression in Riyadh, Saudi Arabia: A cross sectional study. PLoS One 2020; 15:e0228666. [PMID: 32040495 PMCID: PMC7010279 DOI: 10.1371/journal.pone.0228666] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/20/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Postpartum depression (PPD) is inversely correlated with women's functioning, marital and personal relationships, mother-infant interaction quality, and children's social, behavioural, and cognitive development. The purpose of this study was to determine the prevalence of postpartum depression (PPD) in Riyadh and correlate them with possible predictors by a cross-sectional approach. METHODS In this study, 174 mothers receiving treatments in different hospitals of Riyadh completed self-administered measures of the Edinburgh Postnatal Depression Scale (EPDS) along with a list of probable predictors. The data was analyzed by logistic regression analysis using SPSS-IBM 25. RESULTS Of 174 participants of the study, 38.50% (n = 67) reported postpartum depression. Around (115) of the participants were in an age group of 25-45 years with most of them highly educated (101) but unemployed (136). Significant association was noted between occurrence of PPD with unsupportive spouse (P value = 0.023) and recent stressful life events (P value = 0.003). The significant predictors for PPD were unsupportive spouse (OR = 4.53, P = 0.049), recent stressful life events (OR = 2.677, P = 0.005), and Caesarean section as a mode of delivery (OR = 1.958, P = 0.049). CONCLUSION The prevalence of PPD among the study participants was high, especially those with recent stressful life event and unsupportive spouse. To promote health and wellbeing of mothers, it was recommended to screen all high-risk mothers for PPD, when they visit hospitals for postnatal follow ups. Prevention of PPD is not only essential for wellbeing of mothers but it is important to provide good conducive atmosphere for the new born.
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Fekadu Dadi A, Miller ER, Mwanri L. Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis. PLoS One 2020; 15:e0227323. [PMID: 31923245 PMCID: PMC6953869 DOI: 10.1371/journal.pone.0227323] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/12/2019] [Indexed: 01/01/2023] Open
Abstract
Background Depression in pregnancy (antenatal depression) in many low and middle-income countries is not well documented and has not been given priority for intervention due to competing urgencies and the belief that it does not immediately cause fatalities, which mainly emanated from lack of comprehensive research on the area. To fill this research gap, this systematic review was conducted to investigate the burden of antenatal depression and its consequences on birth outcomes in low- and middle-income countries. Methods We systematically searched the databases: CINHAL, MEDLINE, EMCare, PubMed, PSyc Info, Psychiatry online, and Scopus for studies conducted in low and middle-income countries about antenatal depression and its association with adverse birth outcomes. We have included observational studies (case control, cross-sectional and cohort studies), written in English-language, scored in the range of “good quality” on the Newcastle Ottawa Scale (NOS), and were published between January 1, 2007 and December 31, 2017. Studies were excluded if a standardized approach was not used to measure main outcomes, they were conducted on restricted (high risk) populations, or had fair to poor quality score on NOS. We used Higgins and Egger’s to test for heterogeneity and publication bias. Primary estimates were pooled using a random effect meta-analysis. The study protocol was registered in PROSPERO with protocol number CRD42017082624. Result We included 64 studies (with 44, 035 women) on antenatal depression and nine studies (with 5,540 women) on adverse birth outcomes. Antenatal depression was higher in the lower-income countries (Pooled Prevalence (PP) = 34.0%; 95%CI: 33.1%-34.9%) compared to the middle-income countries (PP = 22.7%, 95%CI: 20.1%-25.2%) and increased over the three trimesters. Pregnant women with a history of economic difficulties, poor marital relationships, common mental disorders, poor social support, bad obstetric history, and exposure to violence were more likely to report antenatal depression. The risk of having preterm birth (2.41; 1.47–3.56) and low birth weight (1.66; 1.06–2.61) was higher in depressed mothers compared to mothers without depression. Conclusions Antenatal depression was higher in low-income countries than in middle-income countries and was found to be a risk factor for low birth weight and preterm births. The economic, maternal, and psychosocial risk factors were responsible for the occurrence of antenatal depression. While there could be competing priority agenda to juggle for health policymakers in low-income countries, interventions for antenatal depression should be reprioritized as vitally important in order to prevent the poor maternal and perinatal outcomes identified in this review.
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Affiliation(s)
- Abel Fekadu Dadi
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Adelaide, South Australia
- * E-mail:
| | - Emma R. Miller
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Adelaide, South Australia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Adelaide, South Australia
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Salehi‐Pourmehr H, Dolatkhah N, Gassab‐Abdollahi N, Farrin N, Mojtahedi M, Farshbaf‐Khalili A. Screening of depression in overweight and obese pregnant women and its predictors. J Obstet Gynaecol Res 2019; 45:2169-2177. [DOI: 10.1111/jog.14100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/14/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Hanieh Salehi‐Pourmehr
- Research Center for Evidence‐Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated GroupTabriz University of Medical Sciences Tabriz Iran
| | - Neda Dolatkhah
- Aging Research Institute, Physical Medicine and Rehabilitation Research CentreTabriz University of Medical Sciences Tabriz Iran
| | - Nafiseh Gassab‐Abdollahi
- Department of Midwifery, Faculty of Nursing and MidwiferyTabriz University of Medical sciences Tabriz Iran
| | - Nazila Farrin
- Nutrition Research CentreTabriz University of Medical Sciences Tabriz Iran
| | - Mandana Mojtahedi
- Faculty of Nursing and MidwiferyTabriz University of Medical Sciences Tabriz Iran
| | - Azizeh Farshbaf‐Khalili
- Aging Research Institute, Physical medicine and rehabilitation Research CentreTabriz University of Medical Sciences Tabriz Iran
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Epidemiology of antenatal depression among women with high-risk pregnancies due to obstetric complications: a scoping review. Arch Gynecol Obstet 2019; 300:849-859. [DOI: 10.1007/s00404-019-05270-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023]
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Okagbue HI, Adamu PI, Bishop SA, Oguntunde PE, Opanuga AA, Akhmetshin EM. Systematic Review of Prevalence of Antepartum Depression during the Trimesters of Pregnancy. Open Access Maced J Med Sci 2019; 7:1555-1560. [PMID: 31198472 PMCID: PMC6542400 DOI: 10.3889/oamjms.2019.270] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Depression is prevalent during antenatal and postnatal stages of pregnancy. The effect of depression can be seen in complications during and after pregnancy, fetal growth retardation, abortions and preterm births. The literature abounds on postpartum depression (PD) while few studies are on antepartum depression (AD). AIM The systematic review aims to compute the prevalence of AD from published articles. MATERIAL AND METHODS The published articles (26) used in this review were obtained from the search of the search keywords "Depressive conditions in pregnancy AND trimesters". All the articles were considered irrespective of language and their citation status as of the time of the query. Only articles that presented the prevalence mean and sample size were included. Articles on questionnaires filled by nonpregnant women and men were excluded. Articles that presented the prevalence of depression for the postpartum period only were excluded but were included if they addressed depression at both postpartum and trimester(s) of pregnancy. P-value of less than or equal to 0.05 was considered significant. RESULTS Analysis of the 26 articles showed that 4,303 subjects tested positive for depression in a sample of 28,248 pregnant mothers, giving the prevalence rate as 15%. Confounding was removed, and the sample size was adjusted to be 25,771 and 4,223 were screened to have depressive symptoms, thereby giving a new prevalence rate as 16.4%. It was also revealed that AD is most prevalent in the last trimester of pregnancy and least in the second trimester. Pregnancy duration and PD are not correlated with AD. This implies that AD can be observed in any period of the pregnancy and cannot predict the incidence of PD. CONCLUSION Efforts must be intensified to monitor pregnant women during the third trimester to reduce the incidence of maternal depression during pregnancy, thereby reducing the prevalence.
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Affiliation(s)
- Hilary I. Okagbue
- Department of Mathematics, College of Science and Technology, Covenant University, Ota, Nigeria
| | - Patience I. Adamu
- Department of Mathematics, College of Science and Technology, Covenant University, Ota, Nigeria
| | - Sheila A. Bishop
- Department of Mathematics, College of Science and Technology, Covenant University, Ota, Nigeria
| | - Pelumi E. Oguntunde
- Department of Mathematics, College of Science and Technology, Covenant University, Ota, Nigeria
| | - Abiodun A. Opanuga
- Department of Mathematics, College of Science and Technology, Covenant University, Ota, Nigeria
| | - Elvir M. Akhmetshin
- Department of Mathematics, College of Science and Technology, Covenant University, Ota, Nigeria
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Shakeel N, Sletner L, Falk RS, Slinning K, Martinsen EW, Jenum AK, Eberhard-Gran M. Prevalence of postpartum depressive symptoms in a multiethnic population and the role of ethnicity and integration. J Affect Disord 2018; 241:49-58. [PMID: 30096592 DOI: 10.1016/j.jad.2018.07.056] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 06/11/2018] [Accepted: 07/22/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Postpartum depression (PPD) may have adverse effects on both mother and child. The aims were to determine the prevalence of postpartum depressive symptoms, PPDS, identify associations with ethnicity and with the level of social integration. METHOD Population-based, prospective cohort study of 643 pregnant women (58% ethnic minorities) attending primary antenatal care in Oslo. Questionnaires regarding demographics and health issues were collected through interviews. PPDS was defined as a sum score ≥ 10 by the Edinburgh Postnatal Depression Scale, used as the main outcome in logistic regression analyses, first with ethnicity, second with level of integration as main explanatory factors. RESULTS The prevalence of PPDS was higher in ethnic minorities 12.7% (95% CI: 9.31-16.09) than in Western Europeans 4.8% (2.26-7.34). Adverse life events, lack of social support and depressive symptoms during the index pregnancy were other significant risk factors. Western European with PPDS were more likely to have had depressive symptoms also during pregnancy than women from ethnic minorities (72.2% versus 33.3%, p = 0.041). When replacing ethnicity with integration, a low level of integration was independently associated with PPDS (2.1 (1.11-3.95)). LIMITATIONS Cases with PPDS were limited. Heterogeneity in the ethnic groups is a concern. CONCLUSION Both point prevalence and new onset of PPDS was higher among ethnic minorities than among Western Europeans. Low level of integration was associated with PPDS. Our findings suggest that clinicians should be aware of the increased risk of new cases of PPDS among ethnic minorities compared to Western European women and offer evidence-based care accordingly.
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Affiliation(s)
- Nilam Shakeel
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway.
| | - Line Sletner
- Department of Pediatrics and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway.
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Norway.
| | - Kari Slinning
- Center for Child and Adolescent Mental Health Eastern and Southern Norway (R.BUP Oslo), Norway.
| | - Egil W Martinsen
- Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Norway.
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway.
| | - Malin Eberhard-Gran
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway; Health Services Research Centre, Akershus University Hospital, Lørenskog; Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway.
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Figueiredo B, Canário C, Tendais I, Pinto TM, Kenny DA, Field T. Couples' relationship affects mothers' and fathers' anxiety and depression trajectories over the transition to parenthood. J Affect Disord 2018; 238:204-212. [PMID: 29886200 DOI: 10.1016/j.jad.2018.05.064] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 05/04/2018] [Accepted: 05/28/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND The association between the couple relationship and the mothers' and fathers' psychological adjustment to the transition to parenthood has been examined in the literature. However, the direction of effects between these variables has not been extensively explored. This study aimed to assess the direction of effects between mothers' and fathers' positive and negative interactions and anxiety and depression symptoms trajectories over the transition to parenthood. METHODS A sample of 129 couples (N = 258) completed self-report measures of positive and negative interactions, anxiety and depression symptoms at each trimester of pregnancy, at childbirth, and at 3- and 30-months postpartum. Dyadic growth curve models were performed using multilevel modeling. RESULTS Whereas anxiety and depression showed no moderation effect on positive and negative interactions over time, negative interaction moderated depression from 3- to 30-months postpartum. Mothers and fathers with high negative interaction scores experienced a steeper increase in depression from 3- to 30-months postpartum. Additionally, gender moderated the effect of positive interaction on anxiety from 3- to 30-months postpartum. Fathers with low positive interaction scores experienced an increase in anxiety, whereas fathers with high positive interaction scores and mothers with high or low positive interaction scores did not experience changes in anxiety from 3- to 30-months postpartum. LIMITATIONS Despite the longitudinal aspect of the models, a possible causal relationship need to be taken with caution. CONCLUSIONS Our results suggest that mothers' and fathers' positive and negative interactions affect their anxiety and depression symptoms trajectories: negative interaction raises mothers' and fathers' depression symptoms and positive interaction prevents the increase of fathers' anxiety symptoms over the postpartum period.
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Affiliation(s)
- Bárbara Figueiredo
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
| | - Catarina Canário
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Iva Tendais
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Tiago Miguel Pinto
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - David A Kenny
- Department of Psychology, University of Connecticut, USA
| | - Tiffany Field
- Department of Pediatrics, School of Medicine, University of Miami, USA
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Smolen JR, Araújo EMD. Race/skin color and mental health disorders in Brazil: a systematic review of the literature. CIENCIA & SAUDE COLETIVA 2018; 22:4021-4030. [PMID: 29267719 DOI: 10.1590/1413-812320172212.19782016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 09/08/2016] [Indexed: 11/21/2022] Open
Abstract
Mental health disorders contribute a significant burden to society. This systematic literature review aims to summarize the current state of the literature on race/skin color and mental health disorders in Brazil. METHODS PubMed and Lilacs were searched using descriptors for mental health disorders (depression, anxiety, Common Mental Disorders, psychiatric morbidity, etc.) and race to find studies conducted in Brazil. Studies of non-population groups, that did not analyze race/skin color, or for which the mental disorder was not the object of study were excluded. After evaluation of quality, 14 articles were selected for inclusion. There was an overall higher prevalence of mental health disorders in non-Whites. Of the six multivariate analyses that found statistically significant results, five indicated a greater prevalence or odds of mental health disorder in non-Whites compared to Whites (measure of association between 1.18-1.85). This review identified the trend in the literature regarding the association between race and mental health disorders. However, important difficulties complicate the comparability of the studies, principally in function of the differences in the mental health disorders studied, the method of categorizing race/skin color, and the screening tools used in the studies analyzed.
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Affiliation(s)
- Jenny Rose Smolen
- Núcleo de Pesquisa em Desigualdades em Saúde, Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
| | - Edna Maria de Araújo
- Núcleo de Pesquisa em Desigualdades em Saúde, Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
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Arifin SRM, Cheyne H, Maxwell M. Review of the prevalence of postnatal depression across cultures. AIMS Public Health 2018; 5:260-295. [PMID: 30280116 PMCID: PMC6141558 DOI: 10.3934/publichealth.2018.3.260] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 07/12/2018] [Indexed: 12/15/2022] Open
Abstract
The purpose of this review was to examine articles related to recent epidemiological evidence of the prevalence of maternal postnatal depression (PND) across different countries and cultures and to identify specific epidemiological studies that have been carried out exclusively in Malaysia on the prevalence of maternal PND. The review was undertaken in two stages, an initial review and an updated review. At both stages systematic literature searches of online databases were performed to identify articles on the prevalence of maternal PND. A total of 124 articles concerning research conducted in more than 50 countries were included in the final analysis. There were wide variations in the screening instruments and diagnostic tools used although the Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument applied to identify PND. The prevalence of maternal PND ranged from 4.0% to 63.9%, with Japan and America recording the lowest and highest rates, respectively. Within continents, a wide variation in reported prevalence was also found. The reported rates of maternal PND in Malaysia were much higher than that previously documented with a range of 6.8–27.3%. This review indicated that the widely cited prevalence of maternal PND of 10–15% underestimates rates of PND worldwide. The reasons for this variability may not be fully explained by review methods. Future studies should evaluate the nature of women's PND experiences across cultures to explain these wide variations.
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Affiliation(s)
- Siti Roshaidai Mohd Arifin
- Department of Special Care Nursing, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling Scotland, United Kingdom
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling Scotland, United Kingdom
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Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries. Front Psychiatry 2018; 8:248. [PMID: 29449816 PMCID: PMC5799244 DOI: 10.3389/fpsyt.2017.00248] [Citation(s) in RCA: 297] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/07/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD and a meta-regression to identify economic, health, social, or policy factors associated with national PPD prevalence. METHODS We conducted a systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To test for country level predictors, we drew on data from UNICEF, WHO, and the World Bank. Random effects meta-regression was used to test national predictors of PPD prevalence. FINDINGS 291 studies of 296284 women from 56 countries were identified. The global pooled prevalence of PPD was 17.7% (95% confidence interval: 16.6-18.8%), with significant heterogeneity across nations (Q = 16,823, p = 0.000, I2 = 98%), ranging from 3% (2-5%) in Singapore to 38% (35-41%) in Chile. Nations with significantly higher rates of income inequality (R2 = 41%), maternal mortality (R2 = 19%), infant mortality (R2 = 16%), or women of childbearing age working ≥40 h a week (R2 = 31%) have higher rates of PPD. Together, these factors explain 73% of the national variation in PPD prevalence. INTERPRETATION The global prevalence of PPD is greater than previously thought and varies dramatically by nation. Disparities in wealth inequality and maternal-child-health factors explain much of the national variation in PPD prevalence.
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Affiliation(s)
- Jennifer Hahn-Holbrook
- Department of Psychology, University of California, Merced, Merced, CA, United States
- Center for Excellence in Biopsychosocial Approaches to Health, Chapman University, Orange, CA, United States
| | | | - Itzel Anaya
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
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Canário C, Figueiredo B. Anxiety and depressive symptoms in women and men from early pregnancy to 30 months postpartum. J Reprod Infant Psychol 2017. [DOI: 10.1080/02646838.2017.1368464] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Silva CS, Lima MC, Sequeira‐de‐Andrade LA, Oliveira JS, Monteiro JS, Lima NM, Santos RM, Lira PI. Association between postpartum depression and the practice of exclusive breastfeeding in the first three months of life. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2017.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Silva CS, Lima MC, Sequeira-de-Andrade LAS, Oliveira JS, Monteiro JS, Lima NMS, Santos RMAB, Lira PIC. Association between postpartum depression and the practice of exclusive breastfeeding in the first three months of life. J Pediatr (Rio J) 2017; 93:356-364. [PMID: 28034730 DOI: 10.1016/j.jped.2016.08.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 08/02/2016] [Accepted: 08/09/2016] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To investigate the association between postpartum depression and the occurrence of exclusive breastfeeding. METHOD This is a cross-sectional study conducted in the states of the Northeast region, during the vaccination campaign in 2010. The sample consisted of 2583 mother-child pairs, with children aged from 15 days to 3 months. The Edinburgh Postnatal Depression Scale was used to screen for postpartum depression. The outcome was lack of exclusive breastfeeding, defined as the occurrence of this practice in the 24h preceding the interview. Postpartum depression was the explanatory variable of interest and the covariates were: socioeconomic and demographic conditions; maternal health care; prenatal, delivery, and postnatal care; and the child's biological factors. Multivariate logistic regression analysis was conducted to control for possible confounding factors. RESULTS Exclusive breastfeeding was observed in 50.8% of the infants and 11.8% of women had symptoms of postpartum depression. In the multivariate logistic regression analysis, a higher chance of exclusive breastfeeding absence was found among mothers with symptoms of postpartum depression (OR=1.67; p<0.001), among younger subjects (OR=1.89; p<0.001), those who reported receiving benefits from the Bolsa Família Program (OR=1.25; p=0.016), and those started antenatal care later during pregnancy (OR=2.14; p=0.032). CONCLUSIONS Postpartum depression contributed to reducing the practice of exclusive breastfeeding. Therefore, this disorder should be included in the prenatal and early postpartum support guidelines for breastfeeding, especially in low socioeconomic status women.
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Affiliation(s)
- Catarine S Silva
- Centro Acadêmico de Vitória, Universidade Federal de Pernambuco (UFPE), Núcleo de Nutrição, Vitória de Santo Antão, PE, Brazil.
| | - Marilia C Lima
- Universidade Federal de Pernambuco (UFPE), Departamento Materno Infantil, Recife, PE, Brazil
| | | | - Juliana S Oliveira
- Centro Acadêmico de Vitória, Universidade Federal de Pernambuco (UFPE), Núcleo de Nutrição, Vitória de Santo Antão, PE, Brazil
| | - Jailma S Monteiro
- Universidade Federal de Pernambuco (UFPE), Departamento de Nutrição, Recife, PE, Brazil
| | - Niedja M S Lima
- Centro Acadêmico de Vitória, Universidade Federal de Pernambuco (UFPE), Vitória de Santo Antão, PE, Brazil
| | | | - Pedro I C Lira
- Universidade Federal de Pernambuco (UFPE), Departamento de Nutrição, Recife, PE, Brazil
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Lange S, Probst C, Heer N, Roerecke M, Rehm J, Monteiro MG, Shield K, de Oliveira C, Popova S. Actual and predicted prevalence of alcohol consumption during pregnancy in Latin America and the Caribbean: systematic literature review and meta-analysis. Rev Panam Salud Publica 2017. [PMID: 28614487 PMCID: PMC6645189 DOI: 10.26633/rpsp.2017.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To estimate the prevalence of alcohol consumption during pregnancy among the general population of Latin America and the Caribbean, by country, in 2012. Methods Three steps were taken: a comprehensive, systematic literature search; meta-analyses, assuming a random-effects model for countries with published studies; and regression modelling (data prediction) for countries with either no published studies or too few to obtain an estimate. Results Based on 24 existing studies, the pooled prevalence of alcohol consumption during pregnancy among the general population was estimated for Brazil (15.2%; 95% confidence interval [95%CI]: 10.4%–20.8%) and Mexico (1.2%; 95%CI: 0.0%–2.7%). The prevalence of alcohol consumption during pregnancy among the general population was predicted for 31 countries and ranged from 4.8% (95%CI: 4.2%–5.4%) in Cuba to 23.3% (95%CI: 20.1%–26.5%) in Grenada. Conclusions Greater prevention efforts and measures are needed in the countries of Latin America and the Caribbean to prevent pregnant women from consuming alcohol during pregnancy and decrease the rates of Fetal Alcohol Spectrum Disorder. Additional high quality studies on the prevalence of alcohol consumption during pregnancy in Latin America and the Caribbean are also needed.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Navrose Heer
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michael Roerecke
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Kevin Shield
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Claire de Oliveira
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Svetlana Popova
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
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Dagklis T, Tsakiridis I, Chouliara F, Mamopoulos A, Rousso D, Athanasiadis A, Papazisis G. Antenatal depression among women hospitalized due to threatened preterm labor in a high-risk pregnancy unit in Greece. J Matern Fetal Neonatal Med 2017; 31:919-925. [DOI: 10.1080/14767058.2017.1301926] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Themistoklis Dagklis
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Ioannis Tsakiridis
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Foteini Chouliara
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Apostolos Mamopoulos
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - David Rousso
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Apostolos Athanasiadis
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Georgios Papazisis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
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Fiala A, Švancara J, Klánová J, Kašpárek T. Sociodemographic and delivery risk factors for developing postpartum depression in a sample of 3233 mothers from the Czech ELSPAC study. BMC Psychiatry 2017; 17:104. [PMID: 28327118 PMCID: PMC5361789 DOI: 10.1186/s12888-017-1261-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 03/09/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In the postpartum period, certain groups of women are at a higher risk for developing depressive episodes. Several studies have described risk factors for developing postpartum depression (PPD). However, these studies have used limited numbers of participants, and therefore the estimated prevalence of PPD varies greatly. METHODS The objective of this study is to identify the main risk factors for developing PPD by using data collected via the Czech version of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC). This database provides a representative sample (n = 7589) observed prospectively and a large amount of data on depressive symptoms and on biological, socioeconomic, and environmental factors. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for incidence of PPD. The affective pathology was examined at three time points: before delivery, 6 weeks after delivery, and 6 months after delivery. RESULTS The prevalence of depressive symptoms before delivery was 12.8%, 6 weeks after delivery 11.8%, and 6 months after delivery 10.1%. The prevalence rates are based on women who completed questionnaires at all three time-points (N = 3233). At all three time points, the main risk factors for developing PPD identified as significant by both univariate and multivariate analysis were personal history of depressive episodes and mothers experiencing psychosocial stressors. Other risk factors occurring in both types of analysis were: family history of depression from expectant mother's paternal side (prenatal), mothers living without partners (6 weeks postpartum) and feelings of unhappiness about being pregnant (6 months postpartum). Several protective factors were also observed: male child gender (prenatal), primiparous mothers (6 months postpartum), and secondary education (prenatal, only by multivariate analysis). Significant risk factors found solely by univariate analysis were family history of depression in both parents of the expectant mother (prenatal and 6 weeks postpartum), family history of depression from subject's maternal side (6 months postpartum), unintentional pregnancy (prenatal and 6 weeks postpartum), feelings of unhappiness about being pregnant (prenatal and 6 weeks postpartum), primary education (prenatal and 6 weeks postpartum), mothers who opted not to breastfeed (6 months postpartum) and mothers living without partners (prenatal and 6 months postpartum). Family savings were identified as protective factor (prenatal and 6 months postpartum). CONCLUSIONS We identified significant predictors of PPD. These predictors can be easily detected in clinical practice, and systematic screening can lead to identifying potentially at risk mothers. Since the risk is linked with experience of psychosocial stressors it seems that they might benefit from increased psychosocial support to prevent affective pathology.
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Affiliation(s)
- Adam Fiala
- Department of Psychiatry, Masaryk University, Brno, Czech Republic.
| | - Jan Švancara
- 0000 0001 2194 0956grid.10267.32Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic ,0000 0001 2194 0956grid.10267.32Institute of Biostatistics and Analyses, Faculty of Medicine and Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Jana Klánová
- 0000 0001 2194 0956grid.10267.32Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Tomáš Kašpárek
- 0000 0001 2194 0956grid.10267.32Department of Psychiatry, Masaryk University, Brno, Czech Republic
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Coll CDVN, da Silveira MF, Bassani DG, Netsi E, Wehrmeister FC, Barros FC, Stein A. Antenatal depressive symptoms among pregnant women: Evidence from a Southern Brazilian population-based cohort study. J Affect Disord 2017; 209:140-146. [PMID: 27914247 PMCID: PMC5282400 DOI: 10.1016/j.jad.2016.11.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 11/17/2016] [Accepted: 11/19/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Antenatal depression (AD) is a major public health issue but evidence regarding its prevalence and associated factors in low and middle-income countries (LMICs) is limited. The aim of the study was to estimate the prevalence and identify risk factors for AD among Brazilian pregnant women. METHODS All women living in the urban area of the city of Pelotas, Southern Brazil, with confirmed pregnancy and estimated delivery date in the year 2015, were invited to take part. Eligible pregnant women were recruited from health services. Symptoms of antenatal depression were assessed using the Edinburgh Postnatal Depression Scale (EPDS) by face-to-face interviews. A cutoff-point of 13 or more was used to define probable AD. RESULTS EPDS scores were available for 4130 women. The prevalence of AD was 16% (95%CI 14·9-17·1). After adjustment for potential confounders, the factors most strongly associated with higher EPDS scores were a previous history of depression (PR 2·81; 95%CI 2·44-3·25), high parity (PR 1·72; 95%CI 1·38-2·15 - ≥2 children vs. 1 child) and maternal education (PR 5·47; 95%CI 4·22-7·09 - 0-4 vs. ≥12 years of formal education). LIMITATIONS EPDS was administered through face-to-face interviews rather than questionnaires and some women may have felt uncomfortable reporting their symptoms leading to underreporting and consequently underestimation of the prevalence found. CONCLUSION AD prevalence is substantially higher in Brazil than in high-income countries (HICs) but similar to other LMICs. Our study identified relevant risk factors that may be potential targets to plan interventions, particularly a history of depression.
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Affiliation(s)
| | | | - Diego Garcia Bassani
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada,Department of Paediatrics and Dalla Lana School of Public Health, University of Toronto, Canada
| | - Elena Netsi
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Fernando César Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil,Catholic University of Pelotas, Brazil
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
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Damé P, Cherubini K, Goveia P, Pena G, Galliano L, Façanha C, Nunes MA. Depressive Symptoms in Women with Gestational Diabetes Mellitus: The LINDA-Brazil Study. J Diabetes Res 2017; 2017:7341893. [PMID: 28685151 PMCID: PMC5480043 DOI: 10.1155/2017/7341893] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 04/06/2017] [Accepted: 05/10/2017] [Indexed: 11/17/2022] Open
Abstract
This study aimed to assess the frequency and severity of depressive symptoms and their relationship with sociodemographic characteristics in women with gestational diabetes mellitus (GDM) who participated in the LINDA-Brazil study. We conducted cross-sectional analyses of 820 women with GDM who were receiving prenatal care in the public health system. We conducted structured interviews to obtain clinical and sociodemographic information and applied the Edinburgh Postnatal Depression Scale (EPDS) to assess depressive symptoms. We classified the presence and severity of depressive symptoms using scores of ≥12 and ≥18, respectively. We used Poisson regression to estimate prevalence ratios (PR). Most of the women lived with a partner (88%), 50% were between 30 and 39 years old, 39% had finished high school, 39% had a family income of 1-2 minimum wages, and 47% were obese before their pregnancies. The presence of depressive symptoms was observed in 31% of the women, and severe depressive symptoms were observed in 10%; 8.3% reported self-harm intent. Lower parity and higher educational levels were associated with lower EPDS score. Depressive symptoms were common and frequently severe among women with GDM, indicating the need to consider this situation when treating such women, especially those who are more socially vulnerable. This trial is registered with NCT02327286, registered on 23 December 2014.
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Affiliation(s)
- Patrícia Damé
- Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Kadhija Cherubini
- Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Pâmella Goveia
- Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Geórgia Pena
- Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Leony Galliano
- Postgraduate Program in Physical Education, Superior School of Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Cristina Façanha
- Integrated Center for Diabetes and Hypertension, Ceará State Health Department, Fortaleza, CE, Brazil
- School of Medicine, Unichristus University Center, Fortaleza, CE, Brazil
| | - Maria Angélica Nunes
- Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- *Maria Angélica Nunes:
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Corrêa H, Castro E Couto T, Santos W, Romano-Silva MA, Santos LMP. Postpartum depression symptoms among Amazonian and Northeast Brazilian women. J Affect Disord 2016; 204:214-8. [PMID: 27372408 DOI: 10.1016/j.jad.2016.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/06/2016] [Accepted: 06/11/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Studies analyzing the prevalence of postpartum depression in Brazil have recently increased. However, few studies have examined the Northeast region of Brazil, and no studies have investigated the Amazon region. Therefore, the aim of this study was to investigate postpartum depression in these two regions. METHODS We administered the Edinburgh Postnatal Depression Scale to a total of 3060 women who used the Brazilian public health system and had given birth between one and three months prior to the interview. A cut-off score ≥11 was used to indicate symptoms of postpartum depression. After calculating the prevalence, univariate logistic regressions were performed separately for several possible risk factors (p<0.05). RESULTS The overall rate of reported symptoms of postpartum depression was 19.5%. The prevalence in the northeast region and Amazon region were 19.0% and 20.3%, respectively (p=0.36). In the univariate logistic regression, low education level (<7 years: p<0.001; 8-10 years: p=0.003), ethnicity (Black: p=0.02; Pardo: p=0.02), few prenatal visits (1 or 2 visits: p=0.04), prenatal care self-assessed as "not very good" (p<0.001) and the prenatal care adequacy index of partially suitable (p=0.01) or not suitable (p<0.001) were identified as significant risk factors for postpartum depression symptoms. LIMITATIONS Mothers who did not bring their children for immunization. The cross-sectional study does not allow for causality to be established. CONCLUSION the prevalence rates of postpartum depression were similar to the rates observed for developing countries and higher than the rates observed in developed countries. Based on these findings, we recommend that screening and treatment of pregnant women should be considered a public health priority.
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Affiliation(s)
- H Corrêa
- Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Department of Mental Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; National Institute of Science and Technology-Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - T Castro E Couto
- Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - W Santos
- Postgraduation Program in Collective Health, University of Brasília, Brasília, DF, Brazil
| | - M A Romano-Silva
- Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Department of Mental Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; National Institute of Science and Technology-Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - L M P Santos
- Postgraduation Program in Collective Health, University of Brasília, Brasília, DF, Brazil; Department of Collective Health, University of Brasília, Brasília, DF, Brazil
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Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry 2016; 3:973-982. [PMID: 27650773 PMCID: PMC5155709 DOI: 10.1016/s2215-0366(16)30284-x] [Citation(s) in RCA: 589] [Impact Index Per Article: 73.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/19/2016] [Accepted: 08/22/2016] [Indexed: 12/11/2022]
Abstract
Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries.
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Affiliation(s)
- Bizu Gelaye
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Marta B Rondon
- Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru
| | - Ricardo Araya
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Michelle A Williams
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
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Theme Filha MM, Ayers S, da Gama SGN, Leal MDC. Factors associated with postpartum depressive symptomatology in Brazil: The Birth in Brazil National Research Study, 2011/2012. J Affect Disord 2016; 194:159-67. [PMID: 26826865 DOI: 10.1016/j.jad.2016.01.020] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/28/2015] [Accepted: 01/08/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Depression is one of the most common postpartum mental disorders. Many sociodemographic and individuals risk factors are associated with maternal depression but the impact of high levels of birth intervention is unclear. The Brazilian context is characterized by excessive intervention and frequent non-compliance with recommended obstetric protocols. This study therefore examined the impact of sociodemographic, individual, and obstetric risk factors in postpartum depression. METHODS The Birth in Brazil research study is a national study of 23,894 postpartum women. Information about depression was obtained by telephone interview at 6-18 months after birth and was measured using the Edinburgh Postnatal Depression Scale. RESULTS The prevalence of probable cases of depression was 26.3%. A multiple logistic regression model identified significant sociodemographic and individual risk factors as: brown skin color (OR=1.15 CI 1.01-1.31), lower economic class (OR=1.70 CI 1.41-2.06), alcohol use (OR=1.41 CI 1.09-1.84) and a history of mental disorders (OR=3.13 CI 1.80-5.44). Significant obstetric factors were unplanned pregnancy (OR=1.22 CI 1.05-1.43 for wanted later and OR=1.38 CI 1.20-1.60 for never wanted), multiparity (OR=1.97 CI 1.58-2.47 for 3 or more children), and poor care during birth (OR=2.02 CI 1.28-3.20) or of the newborn (OR=2.16 CI 1.51-3.10). Obstetric interventions and complications were not associated with maternal depression. LIMITATIONS Depression was measured only once so we are not able to examine the course over time. The associational and reverse causality cannot be ruled out for some variables. CONCLUSIONS The prevalence of postpartum depression is high in Brazilian women six months after birth. Poor care of women and babies during birth is more important in postpartum depression than physical obstetric or neonatal intervention and complications.
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Affiliation(s)
- Mariza Miranda Theme Filha
- Department of Epidemiology and Quantitative Methods on Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City University, London, UK.
| | | | - Maria do Carmo Leal
- Department of Epidemiology and Quantitative Methods on Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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Al-Azri M, Al-Lawati I, Al-Kamyani R, Al-Kiyumi M, Al-Rawahi A, Davidson R, Al-Maniri A. Prevalence and Risk Factors of Antenatal Depression among Omani Women in a Primary Care Setting: Cross-sectional study. Sultan Qaboos Univ Med J 2016; 16:e35-41. [PMID: 26909211 DOI: 10.18295/squmj.2016.16.01.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 11/10/2015] [Accepted: 12/10/2015] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES This study aimed to identify the prevalence of antenatal depression and the risk factors associated with its development among Omani women. No previous studies on antenatal depression have been conducted in Oman. METHODS This descriptive cross-sectional study was carried out between January and November 2014 in Muscat, Oman. Pregnant Omani women ≥32 gestational weeks who were attending one of 12 local primary care health centres in Muscat for routine antenatal care were invited to participate in the study (n = 986). An Arabic version of the validated self-administered Edinburgh Postnatal Depression Scale questionnaire was used to measure antenatal depression. A cut-off score of ≥13 was considered to indicate probable depression. RESULTS A total of 959 women participated in the study (response rate: 97.3%). Of these, 233 were found to have antenatal depression (24.3%). A bivariate analysis showed that antenatal depression was associated with unplanned pregnancies (P = 0.010), marital conflict (P = 0.001) and a family history of depression (P = 0.019). The adjusted odds ratio (OR) after logistic multivariate regression analysis showed that antenatal depression was significantly associated with unplanned pregnancies (OR: 1.37; 95% confidence interval [CI]: 1.02-1.86) and marital conflict (OR: 13.83; 95% CI: 2.99-63.93). CONCLUSION The prevalence of antenatal depression among the studied Omani women was high, particularly in comparison to findings from other Arab countries. Thus, antenatal screening for depression should be considered in routine primary antenatal care. Couples should also be encouraged to seek psychological support should marital conflicts develop during pregnancy.
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Affiliation(s)
- Mohammed Al-Azri
- Department of Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Iman Al-Lawati
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Raya Al-Kamyani
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Maisa Al-Kiyumi
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Aisha Al-Rawahi
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Robin Davidson
- Department of Family Medicine & Public Health, Sultan Qaboos University Hospital, Muscat, Oman
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Barrera AZ, Wickham RE, Muñoz RF. Online prevention of postpartum depression for Spanish- and English-speaking pregnant women: A pilot randomized controlled trial. Internet Interv 2015; 2:257-265. [PMID: 26273567 PMCID: PMC4530522 DOI: 10.1016/j.invent.2015.06.002] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a maternal mental health problem that affects women from all regions of the world. Unfortunately, even in developed countries, half of the cases go undetected and, consequently, untreated. Individuals from low and middle income countries trend toward underutilization of mental health services, partly due to the limited number of available psychological resources. The primary aims of this pilot randomized controlled trial were to adapt to the Internet the Mothers and Babies Course/Curso Mamás y Bebés, a prevention of PPD intervention, to describe the characteristics of the pregnant women who engaged in the intervention site, and to obtain preliminary data on the efficacy of the Internet intervention to reduce the risk of PPD. METHODS Pregnant women, 18 years or older who were interested in using the site for themselves were recruited and randomly assigned to a fully-automated self-help Internet intervention or to an information-only control condition. Randomized participants were invited to complete monthly depression assessments up to six months postpartum. To examine the prevention effects of the Internet intervention, pregnant women who did not meet current criteria for a major depressive episode, who engaged with the study website, and who provided depression data during the postpartum follow-up period were included in the study analyses. RESULTS Participants were 111 predominantly Spanish-speaking (82.9%) and Latino/Hispanic (71.3%) pregnant women residing in 23 countries worldwide. The effect of the prevention intervention condition failed to reach significance at the a priori alpha-level. However, the observed coefficient trended in the hypothesized direction (b = -0.514, χ2 (1) = 3.43, p = .061; HR = 0.598). The benefits of receiving the e-MB Internet intervention was greater for pregnant women reporting high (vs. low) levels of prenatal depression symptoms (b = -0.605, χ2 (1) = 5.20, p =.023). CONCLUSIONS This study provides preliminary evidence that Internet interventions are a promising method toward expanding the reach of psychological resources to perinatal women at-risk for PPD.
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Affiliation(s)
- Alinne Z. Barrera
- Palo Alto University, Palo Alto, California, USA, Institute for International Internet Interventions for Health (i4Health), Palo Alto, California, USA
| | | | - Ricardo F. Muñoz
- Palo Alto University, Palo Alto, California, USA, Institute for International Internet Interventions for Health (i4Health), Palo Alto, California, USA
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Lara MA, Navarrete L, Nieto L, Le HN. Childhood abuse increases the risk of depressive and anxiety symptoms and history of suicidal behavior in Mexican pregnant women. ACTA ACUST UNITED AC 2015; 37:203-10. [PMID: 26039189 DOI: 10.1590/1516-4446-2014-1479] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the relationship between individual and co-occurring childhood sexual, physical, and verbal abuse, prenatal depressive (PDS) and anxiety symptoms (PAS), and history of suicidal behavior (HSB) among Mexican pregnant women at risk of depression. METHODS A sample of 357 women screened for PDS was interviewed using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q), the Beck Depression Inventory (BDI-II), the anxiety subscale of the Hopkins Symptoms Checklist (SCL-90), and specific questions on verbal abuse and HSB. RESULTS Logistic regression analyses showed that women who had experienced childhood sexual abuse (CSA) were 2.60 times more likely to develop PDS, 2.58 times more likely to develop PAS, and 3.71 times more likely to have HSB. Childhood physical abuse (CPA) increased the risk of PAS (odds ratio [OR] = 2.51) and HSB (OR = 2.62), while childhood verbal abuse (CVA) increased PDS (OR = 1.92). Experiencing multiple abuses increased the risk of PDS (OR = 3.01), PAS (OR = 3.73), and HSB (OR = 13.73). CONCLUSIONS Childhood sexual, physical, and verbal abuse, especially when they co-occur, have an impact on PDS and PAS and lifetime HSB. These findings suggest that pregnant women at risk for depression should also be screened for trauma as a risk factor for perinatal psychopathology.
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Affiliation(s)
- Ma Asunción Lara
- Instituto Nacional de Psiquiatría Ramón de la Fuente Mu÷iz, Ciudad de México, DF, MX
| | - Laura Navarrete
- Instituto Nacional de Psiquiatría Ramón de la Fuente Mu÷iz, Ciudad de México, DF, MX
| | - Lourdes Nieto
- Instituto Nacional de Psiquiatría Ramón de la Fuente Mu÷iz, Ciudad de México, DF, MX
| | - Huynh-Nhu Le
- Department of Psychology, George Washington University, Washington, DC, US
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Lara MA, Navarrete L, Nieto L, Martín JPB, Navarro JL, Lara-Tapia H. Prevalence and incidence of perinatal depression and depressive symptoms among Mexican women. J Affect Disord 2015; 175:18-24. [PMID: 25590762 DOI: 10.1016/j.jad.2014.12.035] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 12/05/2014] [Accepted: 12/11/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim of this study was to assess point and period prevalence and incidence of perinatal depression in Mexican women. METHODS The Structured Clinical Interview for DSM-IV and the Patient Health Questionnaire (PHQ-9) were administered at three points in time to 210 women: during the third trimester of pregnancy, at six weeks and at six months after delivery. RESULTS Prevalence of prenatal depression was 9.0%, and 13.8% at six weeks and 13.3% at six months postpartum. Incidence of postpartum depression (PPD) was 10.0% at six weeks and 8.2% at six months. Prevalence of prenatal depressive symptoms was 16.6%; and 17.1% at six weeks and 20.0% at six months postpartum. Incidence of postpartum depressive symptoms (PPDS) was 11.4% at six weeks and 9.0% at six months. At six months postpartum, women with depression were younger (OR=2.45, p=0.02), had fewer years׳ schooling (OR=5.61, p=0.00), were unpartnered (OR=3.03, p=0.01), unemployed (OR=3.48, p=0.00) and poorer (OR=4.00, p=0.00) than women without depression. LIMITATIONS 25% of the initial sample was not retained to complete the three assessments. Non completers were younger, less educated and reported more depressive symptoms. This may have resulted in an underestimation of prevalence. CONCLUSIONS This is the first longitudinal study in Latin America to assess perinatal depression at three different points in times, reporting point and period prevalence and incidence of clinical depression and depressive symptoms. Most LA countries have yet to recognize the importance of providing mental health care for expectant and postpartum mothers to reduce disability in mothers and infants.
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Affiliation(s)
- M Asunción Lara
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México D. F. 14370, Mexico.
| | - Laura Navarrete
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México D. F. 14370, Mexico
| | - Lourdes Nieto
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, México D. F. 14370, Mexico
| | - Juan Pablo Barba Martín
- Hospital Regional "Lic. Adolfo Lopez Mateos" Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, ISSSTE, México D. F., Mexico
| | - José Luis Navarro
- Delegación Regional Poniente. Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, ISSSTE,. México D. F., México
| | - Héctor Lara-Tapia
- Hospital Regional "Lic. Adolfo Lopez Mateos" Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, ISSSTE, México D. F., Mexico
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Fonseca-Machado MDO, Alves LC, Monteiro JCDS, Stefanello J, Nakano AMS, Haas VJ, Gomes-Sponholz F. Depressive disorder in pregnant Latin women: does intimate partner violence matter? J Clin Nurs 2015; 24:1289-99. [PMID: 25581085 DOI: 10.1111/jocn.12728] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2014] [Indexed: 12/29/2022]
Abstract
AIMS AND OBJECTIVES To identify the association of antenatal depressive symptoms with intimate partner violence during the current pregnancy in Brazilian women. BACKGROUND Intimate partner violence is an important risk factor for antenatal depression. To the authors' knowledge, there has been no study to date that assessed the association between intimate partner violence during pregnancy and antenatal depressive symptoms among Brazilian women. DESIGN Cross-sectional study. METHODS Three hundred and fifty-eight pregnant women were enrolled in the study. The Edinburgh Postnatal Depression Scale and an adapted version of the instrument used in the World Health Organization Multi-country Study on Women's Health and Domestic Violence were used to measure antenatal depressive symptoms and psychological, physical and sexual acts of intimate partner violence during the current pregnancy respectively. Multiple logistic regression and multiple linear regression were used for data analysis. RESULTS The prevalence of antenatal depressive symptoms, as determined by the cut-off score of 12 in the Edinburgh Postnatal Depression Scale, was 28·2% (101). Of the participants, 63 (17·6%) reported some type of intimate partner violence during pregnancy. Among them, 60 (95·2%) reported suffering psychological violence, 23 (36·5%) physical violence and one (1·6%) sexual violence. Multiple logistic regression and multiple linear regression indicated that antenatal depressive symptoms are extremely associated with intimate partner violence during pregnancy. CONCLUSION Among Brazilian women, exposure to intimate partner violence during pregnancy increases the chances of experiencing antenatal depressive symptoms. RELEVANCE TO CLINICAL PRACTICE Clinical nurses and nurses midwifes should pay attention to the particularities of Brazilian women, especially with regard to the occurrence of intimate partner violence, whose impacts on the mental health of this population are extremely significant, both during the gestational period and postpartum.
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