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Dai J, Huang Y, Liu J, Sun Y, Fan X, Tu Y, Huang Y, Lin Y, Zhang M, Bai J, Liu Y. Effect of the thinking healthy programme-based internet intervention model for maternal perinatal depression: A pilot study. J Affect Disord 2025; 374:294-302. [PMID: 39805502 DOI: 10.1016/j.jad.2025.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 11/26/2024] [Accepted: 01/09/2025] [Indexed: 01/16/2025]
Abstract
BACKGROUND Thinking Healthy Programme (THP) is an evidence-based psychosocial intervention that can be delivered by non-psychologists and does not require the implementer to have a mental health background or field experience. The THP has been tested in maternal health in many countries. However, the application of the THP model in Chinese maternal and child health has not been reported. OBJECTIVE This study aimed to explore the feasibility of the Thinking Healthy Programme (THP) model for improving perinatal depressive symptoms and infant growth when implemented by non-psychologists (e.g., nurses) for Chinese pregnant women. METHODS 122 pregnant women with Edinburgh Postnatal Depression Scale (EPDS) ≥ 10 were selected from a tertiary hospital in Fujian Province between January 2022 to May 2022. Participants were randomly assigned to the intervention group (n = 61) and the control group (n = 61). The intervention group received the THP-based online delivery intervention and enhanced usual care (EUC), while the control group only received EUC. The outcomes were maternal depressive symptoms, infant growth, and other maternal and infant outcomes. Outcomes were assessed at baseline (during pregnancy), 3 months postpartum, and 6 months postpartum. RESULTS The Generalized Linear Mixed Model (GLMM) showed that there were significant time effects for EPDS scores and PHQ-9 scores between the two groups over time (p < 0.001, p = 0.040). The depression subscale of EPDS and PHQ-9 scores decreased significantly only within the intervention group between 6 months postpartum and baseline (p = 0.003, p = 0.023), the comparison group did not. Compared with the control group, the intervention group had a statistically significantly longer breastfeeding time (5.52 ± 1.25 vs. 4.50 ± 1.69, p = 0.012) at 6 months postpartum, and a lower absolute value of BMI-for-age z-score at post intervention and follow up post intervention (3 and 6 months post-delivery) (-0.87 ± 1.41 vs. -1.41 ± 2.53, p = 0.229; -0.14 ± 1.19 vs. -0.29 ± 1.11, p = 0.539) although no statistically significant difference. LIMITATIONS This study had several limitations. First, it was a single-center study and the sample size was small, which may limit the results. This finding needs to be confirmed by further large multicenter studies. Second, the outcomes were based on maternal self-report alone, which was subjected to social desirability and recall bias. Third, the study only monitored the effects up to the 6-month endpoint. Future studies should incorporate a longer-term evaluation of its effects on infant behavioral and temperament outcomes. CONCLUSION The THP-based online delivery intervention model helped to improve maternal perinatal depressive symptoms, with important benefits for improving maternal and infant health. This suggested the feasibility for non-psychologists to implement the THP model.
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Affiliation(s)
- Jiamiao Dai
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 115 Donghu Road, Wuhan 430071, Hubei, China
| | - Yingjuan Huang
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 115 Donghu Road, Wuhan 430071, Hubei, China
| | - Jun Liu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 115 Donghu Road, Wuhan 430071, Hubei, China
| | - Yu Sun
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 115 Donghu Road, Wuhan 430071, Hubei, China
| | - Xiaoxiao Fan
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 115 Donghu Road, Wuhan 430071, Hubei, China.
| | - Yiming Tu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 115 Donghu Road, Wuhan 430071, Hubei, China.
| | - Yinying Huang
- Women and Children's Hospital, School of Medicine, Xiamen University, 10 Zhenhai Road, Xiamen, China
| | - Yumin Lin
- Women and Children's Hospital, School of Medicine, Xiamen University, 10 Zhenhai Road, Xiamen, China
| | - Mingjing Zhang
- Women and Children's Hospital, School of Medicine, Xiamen University, 10 Zhenhai Road, Xiamen, China
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Yanqun Liu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 115 Donghu Road, Wuhan 430071, Hubei, China.
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Jin Y, Wu C, Chen W, Li J, Jiang H. Gestational diabetes and risk of perinatal depression in low- and middle-income countries: a meta-analysis. Front Psychiatry 2024; 15:1331415. [PMID: 38414505 PMCID: PMC10897974 DOI: 10.3389/fpsyt.2024.1331415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/24/2024] [Indexed: 02/29/2024] Open
Abstract
Background The relationship between gestational diabetes (GDM) and the risk of depression has been thoroughly investigated in high-income countries on their financial basis, while it is largely unexplored in low- and middle- income countries. This meta-analysis aims to assess how GDM influences the risk of perinatal depression by searching multiple electronic databases for studies measuring the odds ratios between them in low- and middle-income countries. Methods Two independent reviewers searched multiple electronic databases for studies that investigated GDM and perinatal mental disorders on August 31, 2023. Pooled odds ratios (ORs) and confidence intervals (CIs) were calculated using the random effect model. Subgroup analyses were further conducted based on the type of study design and country income level. Results In total, 16 observational studies met the inclusion criteria. Only the number of studies on depression (n=10) satisfied the conditions to conduct a meta-analysis, showing the relationship between mental illness and GDM has been overlooked in low- and middle-income countries. Evidence shows an elevated risk of perinatal depression in women with GDM (pooled OR 1.92; 95% CI 1.24, 2.97; 10 studies). The increased risk of perinatal depression in patients with GDM was not significantly different between cross-sectional and prospective design. Country income level is a significant factor that adversely influences the risk of perinatal depression in GDM patients. Conclusion Our findings suggested that women with GDM are vulnerable to perinatal depressive symptoms, and a deeper understanding of potential risk factors and mechanisms may help inform strategies aimed at prevention of exposure to these complications during pregnancy.
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Affiliation(s)
- Yuqing Jin
- Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine, Hangzhou, China
- Research Center for Healthcare Data Science, Zhejiang Laboratory, Hangzhou, China
| | - Chengkai Wu
- Research Center for Healthcare Data Science, Zhejiang Laboratory, Hangzhou, China
| | - Wanlin Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jingsong Li
- Research Center for Healthcare Data Science, Zhejiang Laboratory, Hangzhou, China
- Engineering Research Center of Electronic Medical Record (EMR) and Intelligent Expert System, Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Haiteng Jiang
- Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine, Hangzhou, China
- Liangzhu Laboratory, Ministry of Education (MOE) Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
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Tu Y, Li Y, Fan X, Gui Z, Dai J, Fang Q, Qiu T, Bai J, Liu Y. Combined impact of Hepatitis B virus and gestational diabetes mellitus on ultrasound-measured fetal growth and adverse perinatal outcomes: A seven-year retrospective study. Diabetes Res Clin Pract 2024; 207:111092. [PMID: 38219600 DOI: 10.1016/j.diabres.2024.111092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
AIMS To investigate the impact of pregnancy with combined hepatitis B virus (HBV) infection and Gestational diabetes mellitus (GDM) on fetal growth and adverse perinatal outcomes. METHODS All the pregnant women with HBV infection and/or GDM who delivered at Women's Hospital, Zhejiang University between January 2015, and September 2022 were included. A total of 1633 pregnant women were recruited in the final analysis, including 409 women with HBV infection and GDM, 396 with HBV infection only, 430 with GDM only, and 398 without HBV infection and GDM. Linear and logistic regression models were used to study the impact of pregnancy with combined HBV infection and GDM on fetal growth and adverse perinatal outcomes. RESULTS Pregnancy with combined HBV infection and GDM was associated with increased Z-scores on primary fetal ultrasound parameters and significantly increased the risk of fetal femur length overgrowth (OR: 2.88, 95 % CI: 1.13 ∼ 7.35), placental abruption (OR: 3.64, 95 % CI: 1.18 ∼ 11.22), and macrosomia (OR: 4.19, 95 % CI: 1.66 ∼ 10.56) compared to pregnancy without HBV infection and GDM. CONCLUSIONS Both maternal HBV infection and GDM are independently associated with adverse perinatal outcomes. Their combination further increases the risk of adverse perinatal outcomes.
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Affiliation(s)
- Yiming Tu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Yanting Li
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Xiaoxiao Fan
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Zaidi Gui
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China; Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
| | - Jiamiao Dai
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Qingbo Fang
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Tianlai Qiu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Yanqun Liu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
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