Precarious working conditions and psychosocial work stress act as a risk factor for symptoms of postpartum depression during maternity leave: results from a longitudinal cohort study

Awareness of postpartum depression among midwives and pregnant women in Arkhangelsk, Arctic Russia

BACKGROUND

Postpartum depression (PPD) affects approximately 17% of the women worldwide with nearly half of all cases going undetected. More research on maternal mental health, particularly among healthcare professionals and pregnant mothers, could help identify PPD risks and reduce its prevalence.

OBJECTIVE

Given that awareness of PPD is a crucial preventive factor, we studied PPD awareness among midwives and pregnant women in Arkhangelsk, Arctic Russia.

METHODS

A qualitative study was conducted using in-depth semi-structured interviews. Midwives and pregnant women were recruited from the women's clinic of the Arkhangelsk municipal polyclinic. Seven midwives and 12 pregnant mothers were interviewed.

RESULTS

Midwives described limited time for psychological counselling of pregnant women; they reported that their primary focus was on the physiological well-being of women. Pregnant women have expressed a desire for their families to share responsibilities. The participants considered PPD as a mix of psychological and physiological symptoms, and they also highlighted a discrepancy between the expectations of pregnant women and the reality of motherhood. The present study underscored the limited understanding of PPD identification.

CONCLUSIONS

The findings suggest that there is a need for increased awareness among midwives and pregnant women regarding PPD. Prevention programs targeting PPD with a specific emphasis on enhancing maternal mental health knowledge are warranted.

Associations between precarious employment trajectories and mental health among older workers in Germany: Vertical and horizontal inequalities

OBJECTIVE

The aim of the study was to investigate the longitudinal association between multi-dimensionally measured precarious employment (PE) trajectories and mental health among older employees in Germany.

METHODS

Current data from the German lidA study was used, including panel cases, who participated in all four survey waves (2011, 2014, 2018, 2022). The study comprised 1636 subjects, aged 46 and 52 years at baseline. Group-based trajectory modelling was used to model PE trajectories based on a score combining multiple items from the dimensions employment insecurity and income inadequacy. The association between PE trajectories (2011-2022) and mental health (2022) was tested using weighted logistic regression.

RESULTS

We identified a PE trajectory with upward movement that best described 13.6% of the study sample. Representation in this group was socially unequally distributed with noticeably larger shares of female, lower-educated and lower-skilled workers in PE. Women following this trajectory had increased odds [odds ratio (OR) 1.68-1.82] of reporting poor mental health in 2022 compared to their counterparts in constant non-PE. This was not the case for men (OR 0.37-0.51).

CONCLUSIONS

Our findings highlight horizontal and vertical inequalities with respect to exposure to and consequences of PE. Future labor market reforms should improve protection of women, who will likely be disadvantaged by accumulating employment-related mental health risks over the course of their lives.

Exploring the association between non-regular employment and adverse birth outcomes: an analysis of national data in Japan

Background

As few studies have explored the association between non-regular or precarious employment in parents and adverse birth outcomes, this study aimed to investigate this association using national data in Japan.

Methods

This study utilized the census data from 2020 and birth data from the vital statistics in 2021 and 2022 in the analysis. Adverse birth outcomes, including preterm birth, term low birth weight (TLBW), and small-for-gestational-age, were examined. Data linkage was conducted between birth data and census data to link parental employment statuses and educational attainments with birth data. Rates of adverse birth outcomes were calculated for each parental employment status. Additionally, regression analysis was used to determine adjusted risk ratios (RRs) of parental employment statuses for each birth outcome.

Results

After data linkage, 334,110 birth records were included in the statistical analysis. Rates for non-regular workers were consistently higher than those for regular workers across all adverse birth outcomes for maternal employment status. Results of regression analyses indicated that the risks of preterm birth for non-regular workers were statistically significantly higher than those for regular workers, both in mothers and fathers with a RR (95% confidence intervals [CIs]) of 1.053 (1.004-1.104) and 1.142 (1.032-1.264), respectively. Furthermore, the risk of TLBW birth for non-regular workers was statistically significantly higher than that for regular workers in fathers (RR [95% CI]: 1.092 [1.043-1.143]).

Conclusions

Our findings demonstrate that non-regular workers have a higher risk of some adverse birth outcomes compared to regular workers.

The role of stress in perinatal depression and anxiety - A systematic review

Perinatal depression (PND) and anxiety affect around 20% of women, but available pharmacotherapy is not sufficiently effective in 20-60% of them, indicating a need for better understanding of these diseases. Since stress is a significant risk factor for PND, the aim was to examine the role of biological, environmental and psychological stress in PND and anxiety through a systematic literature search. Overall 210 studies were included, among which numerous rodent studies showed that perinatal stress induced depressive-like and anxious behavior, which was associated with HPA-axis alterations and morphological brain changes. Human studies indicated that the relationship between cortisol and perinatal depression/anxiety was not as clear and with many contradictions, although social and psychological stress were clearly positively associated with PND. Finally, oxytocin, synthetic neuroactive steroid and n-3 PUFA diet have been identified as potentially beneficial in the therapy of PND and anxiety, worth to be investigated in the future.

Quality of Life and Sexual Satisfaction in the Early Period of Motherhood-A Cross-Sectional Preliminary Study

The aim of the study was to assess the impact of breastfeeding-related fatigue and family support on the sexuality and quality of life of mothers during early motherhood. A cross-sectional preliminary study was conducted between 1 October 2021 and 15 May 2022 in 65 women being in early postpartum period. We used the authors' questionnaire developed for the purposes of the study; the Sexual Satisfaction Scale for Women-SSS-W; the Mell-Krat scale for women; and the General Health Questionnaire-GHQ28. A significant negative correlation was found between the age of the patients and the reduction in somatic symptoms (GHQ28 questionnaire) (r = -0.315, p = 0.011). Women working professionally achieved significantly higher results in the SSS-W contentment category (r = 0.313, p = 0.014). Frequent sexual activity reduced disorders in social functioning (the GHQ28 questionnaire) (r = -0.107, p = 0.283). Women who breastfed up to 5 times a day (p = 0.033) reached significantly higher SSS-W scores in terms of communication. The partner's help significantly contributed to higher sexual satisfaction in the aspect of compatibility (p = 0.004) and the overall level of satisfaction determined with the SSS-W questionnaire (p = 0.016). The presented study suggests that older mothers who are employed and supported by a partner have a higher level of contentment, sexual satisfaction and quality of life.

Barriers and facilitators of psychological help-seeking behaviors for perinatal women with depressive symptoms: A qualitative systematic review based on the Consolidated Framework for Implementation Research

OBJECTIVE

To identify barriers and facilitators related to psychological help-seeking behaviors of perinatal depression from all related stakeholders (e.g., perinatal women, family members, mental health care providers, and policymakers).

DESIGN

A literature search of six English-language databases (PubMed, Web of Science, Embase, PsycINFO, the Cochrane Library, CINAHL) and three Chinese-language databases (China National Knowledge Infrastructure, Wan Fang, Chinese Biomedical Literature Databases). Studies published in English or Chinese using qualitative or mixed methods to explore the psychological help-seeking behaviors of women with perinatal depression were included. Data extraction was synthesized for common themes based on the Consolidated Framework for Implementation Research. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise methodologic quality.

PARTICIPANTS AND SETTINGS

Perinatal women with depression, mental health care providers (e.g., pediatricians/nurses, social workers, nurse-midwives, perinatal psychiatrists, community health workers, and administrators), partners and informal caregivers (e.g., community birth attendants, elderly mothers, and men of reproductive age) based in high, middle and low income countries.

FINDINGS

Forty-three articles were included in this review and presented according to the Consolidated Framework for Implementation Research domains (in parentheses). The most common barriers to help seeking were stigma (individual characteristics), misconceptions (individual characteristics), cultural beliefs (inner setting), and lack of social support (outer setting). The most common facilitators were providing adequate support (outer setting) and perinatal health care professional training on how to detect, manage and discuss depression; establishing supportive relationships with mental health care providers; and eroding stigma (all three implementation processes).

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

This systematic review could serve as a reference framework for health authorities to develop diverse strategies for improving the psychological help-seeking behaviors of women with perinatal depression. More high-quality studies focused on the Consolidated Framework for Implementation Research characteristics of available interventions, and implementation processes are needed in future research.

The effects of dyadic coping strategies and dyadic conflict resolution styles on postpartum depression of mothers in heterosexual marriages in Turkey

The authors of this study aimed to determine the effects of coping strategies and conflict resolution styles on postpartum depression in heterosexual mothers in the postpartum period in Turkey. A descriptive, cross-sectional study was conducted with 369 mothers with babies aged 1-12 months. The study was carried out between October 1, 2021, and December 1, 2021, in the pediatric outpatient clinic of the Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Seventy-four (20.1%) mothers had scores above the depression scale cu-off point (>13). Having problems in marriage, getting a low score on the spouse's self-perception scale of dyadic coping with stress, and having negative, nonsubmissive, and retreating conflict resolution styles were found to be important factors associated with postpartum depression (p < .05). The incidence of postpartum depression was found to be associated with having problems in the marriage, not having good dyadic coping strategies, and having negative conflict resolution styles.

Risk Factors for Working Pregnant Women and Potential Adverse Consequences of Exposure: A Systematic Review

Objective: To assess the risk factors perceived as stressors by pregnant women in the work environment and the possible adverse consequences of such exposure for the normal development of pregnancy. Methods: Systematic review, guided by the PRISMA guidelines, and using Pubmed, Web of Science, Dialnet, SciELO, and REDIB databases. Methodological quality was assessed using the critical appraisal tools for non-randomised studies of the Joanna Briggs Institute. Results: A total of 38 studies were included. The main risk factors found in the work environment of pregnant women were chemical, psychosocial, physical-ergonomic-mechanical factors, and other work-related factors. The main adverse consequences of exposure to these factors include low birth weight, preterm birth, miscarriage, hypertension and pre-eclampsia, as well as various obstetric complications. Conclusion: During pregnancy, working conditions that are considered acceptable in normal situations may not be so during this stage due to the major changes that occur during pregnancy. Many obstetric effects may have an important impact in the mother's psychological status; therefore, it is important to optimise working conditions during this stage and to reduce or eliminate possible risks.

Mental health of working parents during the COVID-19 pandemic: can resilience buffer the impact of psychosocial work stress on depressive symptoms?

BACKGROUND

The COVID-19 pandemic has confronted working parents with an accumulation of stressors regarding changes in work, family, and social life, putting their mental health at risk. Stressors include altered working conditions such as working from home or changes in working hours as well as the difficulty to reconcile work and childcare due to the closure of childcare facilities. The present study examined the relationship of psychosocial work stress (i.e., work-privacy conflict and effort-reward imbalance at work) and depressive symptoms in working parents and whether this association was moderated by individual resilience.

METHODS

Data of the present study (n = 452) were collected in Germany between May and June 2020 as part of the DREAM_CORONA study. A subsample of working mothers (n = 191) and fathers (n = 261) completed the subscale for work-privacy conflict (WPC) of the Copenhagen Psychosocial Questionnaire, the Effort-Reward Imbalance (ERI) Questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the Edinburgh Postnatal Depression Scale (EPDS). Multiple linear regression analyses including moderation were performed, controlling for gender, working hours per week, and a lifetime history of depression as potential confounders.

RESULTS

Both WPC (β = 0.336, p < .001) and ERI (β = 0.254, p < .001) were significantly associated with depressive symptoms. Resilience moderated the relationship between ERI and depressive symptoms (β = - 0.101, p = .018), indicating that higher resilience weakened the relationship. However, this effect was not found regarding the relationship between WPC and depressive symptoms (β = 0.055, p = .167).

CONCLUSIONS

The results highlight the need for measures to reduce psychosocial work stressors such as WPC and ERI during the COVID-19 pandemic on the one hand and to promote resilience on the other hand. The findings partially support the potential protective role of resilience buffering the association between psychosocial stress and mental health in working parents. Longitudinal studies are needed to confirm this effect.

Mild-to-moderate iodine deficiency and symptoms of emotional distress and depression in pregnancy and six months postpartum - Results from a large pregnancy cohort

BACKGROUND

The relationship between iodine intake and depression is unknown. The aim of the present study was to investigate whether iodine intake was associated with symptoms of perinatal emotional distress and depression in a mild- to moderately iodine deficient population.

METHODS

The study population comprised 67,812 women with 77,927 pregnancies participating in the Norwegian Mother, Father and Child Cohort Study. Self-reported emotional distress and depressive symptoms were reported in pregnancy and at six months postpartum. Iodine intake was assessed by a food frequency questionnaire in mid-pregnancy. Urinary iodine concentration (UIC) was available for 2792 pregnancies.

RESULTS

The median iodine intake from food was 121 μg/day and the median UIC was 68 μg/L. The prevalence of high scores for emotional distress was 6.6 % in pregnancy and 5.8 % six months postpartum, and for high scores on postpartum depression it was 10.3 %. In non-users of iodine supplements (63 %), a low maternal iodine intake from food (lower than ~100-150 μg/day) was associated with increased risk of high scores of emotional distress and depression both in pregnancy and six months postpartum (p < 0.001). Iodine supplement use was associated with increased risk of high scores of emotional distress in pregnancy compared to no supplement use or use of supplements without iodine.

LIMITATIONS

Observational design, self-report information, and short scales to assess symptoms of emotional distress and depression.

CONCLUSION

A low habitual iodine intake was associated with increased prevalence of perinatal emotional distress and depression. The potential non-beneficial effect of iodine supplements may have biological explanations. More studies are needed.

Exploration for biomarkers of postpartum depression based on metabolomics: A systematic review

BACKGROUND

Postpartum depression (PPD) is the most frequent psychiatric complication during the postnatal period and its mechanisms are not fully understood. Metabolomics, can quantitatively measure metabolites in a high-throughput method, and thus uncover the underlying pathophysiology of disease.

OBJECTIVES

In this study, we reviewed metabolomics studies conducted on PPD, aiming to understand the changes of metabolites in PPD patients and analyze the potential application of metabolomics in PPD prediction and diagnosis.

METHODS

Relevant articles were searched in PubMed, Google scholar, and Web of Science databases from January 2011 to July 2022. The metabolites involved were systematically examined and compared. MetaboAnalyst online software was applied to analyze metabolic pathways.

RESULTS

A total of 14 papers were included in this study. There were several highly reported metabolites, such as kynurenine, kynurenic acid, and eicosapentaenoic acid. Dysregulation of metabolic pathways involved amino acids metabolism, fatty acids metabolism, and steroids metabolism.

LIMITATIONS

The included studies are relatively inadequate, and further work is needed.

CONCLUSIONS

This study summarized significant metabolic alterations that provided clues for the prediction, diagnosis, and pathogenesis of PPD.

Perceived discrimination at work: examining social, health and work-related factors as determinants among breast cancer survivors – evidence from the prospective CANTO cohort

Background

We assessed the prevalence of self-reported perceived discrimination in the workplace after the end of treatment among breast cancer (BC) survivors and studied its association with social, health-related and work-related factors.

Methods

We used data from a French prospective cohort (CANcer TOxicities) including women diagnosed with stage I–III BC. Our analysis included 2130 women who were employed, <57 years old at BC diagnosis and were working 2 years afterwards. We assessed the association between social, health-related and work-related factors and perceived discrimination in the workplace using logistic regression models.

Results

Overall, 26% of women reported perceived discrimination in the workplace after the end of treatment. Women working for a small company, in the public sector or with better overall health status were less likely to report perceived discrimination. Women who benefited from easing dispositions at their workplace, who did not feel supported by their colleagues and those who returned to work because of fear of job loss were more likely to report perceived discrimination.

Conclusions

One in four BC survivors perceives discrimination in the workplace. Health and work-related factors are associated with increased likelihood of reporting perceived discrimination.

Trial registration number

NCT01993498.

Factors associated with utilization of quality antenatal care: a secondary data analysis of Rwandan Demographic Health Survey 2020

Background

Over the last decade, progress in reducing maternal mortality in Rwanda has been slow, from 210 deaths per 100,000 live births in 2015 to 203 deaths per 100,000 live births in 2020. Access to quality antenatal care (ANC) can substantially reduce maternal and newborn mortality. Several studies have investigated factors that influence the use of ANC, but information on its quality is limited. Therefore, this study aimed to identify the determinants of quality antenatal care among pregnant women in Rwanda using a nationally representative sample.

Methods

We analyzed secondary data of 6,302 women aged 15–49 years who had given birth five years prior the survey from the Rwanda Demographic and Health Survey (RDHS) of 2020 data. Multistage sampling was used to select RDHS participants. Good quality was considered as having utilized all the ANC components. Multivariable logistic regression was conducted to explore the associated factors using SPSS version 25.

Results

Out of the 6,302 women, 825 (13.1%, 95% CI: 12.4–14.1) utilized all the ANC indicators of good quality ANC); 3,696 (60%, 95% CI: 58.6–61.1) initiated ANC within the first trimester, 2,975 (47.2%, 95% CI: 46.1–48.6) had 4 or more ANC contacts, 16 (0.3%, 95% CI: 0.1–0.4) had 8 or more ANC contacts. Exposure to newspapers/magazines at least once a week (aOR 1.48, 95% CI: 1.09–2.02), lower parity (para1: aOR 6.04, 95% CI: 3.82–9.57) and having been visited by a field worker (aOR 1.47, 95% CI: 1.23–1.76) were associated with more odds of receiving all ANC components. In addition, belonging to smaller households (aOR 1.34, 95% CI: 1.10–1.63), initiating ANC in the first trimester (aOR 1.45, 95% CI: 1.18–1.79) and having had 4 or more ANC contacts (aOR 1.52, 95% CI: 1.25–1.85) were associated with more odds of receiving all ANC components. Working women had lower odds of receiving all ANC components (aOR 0.79, 95% CI: 0.66–0.95).

Conclusion

The utilization of ANC components (13.1%) is low with components such as having at least two tetanus injections (33.6%) and receiving drugs for intestinal parasites (43%) being highly underutilized. Therefore, programs aimed at increasing utilization of ANC components need to prioritize high parity and working women residing in larger households. Promoting use of field health workers, timely initiation and increased frequency of ANC might enhance the quality of care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08169-x.

Postpartum Depression in Surgeons and Workplace Support for Obstetric and Neonatal Complication: Results of a National Study of US Surgeons

BACKGROUND

Postpartum depression has well-established long-term adverse effects on maternal and infant health. Surgeons with rigorous operative schedules are at higher risk of obstetric complications, but they rarely reduce their workload during pregnancy. We evaluated whether lack of workplace support for work reductions during difficult pregnancies or after neonatal complications is associated with surgeon postpartum depression.

STUDY DESIGN

An electronic survey was sent to practicing and resident surgeons of both sexes in the US. Female surgeons who had at least one live birth were included. Lack of workplace support was defined as: (1) disagreeing that colleagues/leadership were supportive of obstetric-mandated bedrest or time off to care for an infant in the neonatal intensive care unit; (2) feeling unable to reduce clinical duties during pregnancy despite health concerns or to care for an infant in the neonatal intensive care unit. Multivariate logistic regression was used to determine the association of lack of workplace support with postpartum depression.

RESULTS

Six hundred ninety-two surgeons were included. The 441 (63.7%) respondents who perceived a lack of workplace support had a higher risk of postpartum depression than those who did not perceive a lack of workplace support (odds ratio 2.21, 95% CI 1.09 to 4.46), controlling for age, race, career stage, and pregnancy/neonatal complications. Of the surgeons with obstetric-related work restrictions, 22.6% experienced loss of income and 38.5% reported >$50,000 loss.

CONCLUSION

Lack of workplace support for surgeons with obstetric or neonatal health concerns is associated with a higher risk of postpartum depression. Institutional policies must address the needs of surgeons facing difficult pregnancies to improve mental health outcomes and promote career longevity.

Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

Background

Within Sub-Saharan Africa, some countries still report unacceptably high rates of maternal and perinatal morbidity and mortality, despite improvements in the utilisation of maternity care services. Postnatal care (PNC) is one of the recommended packages in the continuum of maternity care aimed at reducing maternal and neonatal mortality. This study aimed to determine the prevalence and factors associated with PNC utilisation in Sierra Leone.

Methods

We used Sierra Leone Demographic and Health Survey (UDHS) 2019 data of 7326 women aged 15 to 49 years. We conducted multivariable logistic regression to determine the factors associated with PNC utilisation, using SPSS version 25.

Results

Out of 7326 women, 6625 (90.4, 95% CI: 89.9–91.2) had at least one PNC contact for their newborn, 6646 (90.7, 95% CI: 90.2–91.5) had a postnatal check after childbirth and 6274 (85.6, 95% CI: 85.0–86.6) had PNC for both their babies and themselves. Delivery by caesarean section (aOR 8.01, 95% CI: 3.37–19.07), having a visit by a health field worker (aOR 1.80, 95% CI: 1.46–2.20), having had eight or more ANC contacts (aOR 1.37, 95% CI: 1.08–1.73), having tertiary education (aOR 2.71, 95% CI: 1.32–5.56) and having no big problems seeking permission to access healthcare (aOR 1.51, 95% CI: 1.19–1.90) were associated with higher odds of PNC utilisation. On the other hand, being resident in the Northern (aOR 0.48, 95% CI: 0.29–0.78) and Northwestern regions (aOR 0.54, 95% CI: 0.36–0.80), belonging to a female headed household (aOR 0.69, 95% CI: 0.56–0.85) and being a working woman (aOR 0.66, 95% CI: 0.52–0.84) were associated with lower odds of utilizing PNC.

Conclusion

Factors associated with utilisation of PNC services operate at individual, household, community and health system/policy levels. Some of them can be ameliorated by targeted government interventions to improve utilisation of PNC services.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12494-5.

Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature

Depression is one of the leading causes of disability, and, if left unmanaged, it can increase the risk for suicide. The evidence base on the determinants of depression is fragmented, which makes the interpretation of the results across studies difficult. The objective of this study is to conduct a thorough synthesis of the literature assessing the biological, psychological, and social determinants of depression in order to piece together the puzzle of the key factors that are related to this condition. Titles and abstracts published between 2017 and 2020 were identified in PubMed, as well as Medline, Scopus, and PsycInfo. Key words relating to biological, social, and psychological determinants as well as depression were applied to the databases, and the screening and data charting of the documents took place. We included 470 documents in this literature review. The findings showed that there are a plethora of risk and protective factors (relating to biological, psychological, and social determinants) that are related to depression; these determinants are interlinked and influence depression outcomes through a web of causation. In this paper, we describe and present the vast, fragmented, and complex literature related to this topic. This review may be used to guide practice, public health efforts, policy, and research related to mental health and, specifically, depression.

Perceived Symptoms of Depression, Anxiety and Stress amongst Staff in a Malaysian Public University: A Workers Survey

Mental health conditions are a major part of workers’ health that predisposes to poor self-motivation for sustaining productivity. This study was aimed to determine the prevalence of depression, anxiety, and stress among staff in a Malaysian public university and its associated factors. A cross-sectional study was conducted among 459 staff from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. A questionnaire that consisted of items on socio-demographic and socioeconomic characteristics, employment description, lifestyle risk behaviors, personal medical history, and symptoms of depression, anxiety, and stress was administered to participants. Descriptive and inferential statistics were conducted using SPSS version 22.0. The prevalence of perceived symptoms of depression, anxiety, and stress among the respondents was 28.7%, 50.1%, and 14.8%, respectively. Over one-quarter (26.5%) of the participants presented symptoms of two or more mental disorders. Women, those aged less than 40 years old, and non-academic professionals were more likely to exhibit depressive symptoms, while those with medical conditions that required hospitalizations sustained anxiety symptoms. Perceived stress was more likely to be prevalent among staff with secondary education or less and smokers. Proactive support for staff needs to be offered in sustaining their emotional well-being.

Differential predictors of birth-related posttraumatic stress disorder symptoms in mothers and fathers - A longitudinal cohort study

BACKGROUND

Evidence on risk factors of birth-related posttraumatic stress disorder (PTSD) symptoms in mothers is increasing, whereas fathers are less examined. This study aims to determine differential predictors of PTSD symptoms in mothers and fathers.

METHODS

Data derive from the DREAM study, including 1,146 mothers and 828 fathers. We assessed mental health, work, and sociodemographic factors during pregnancy, pregnancy- and birth-related factors, and birth-related PTSD symptoms using the Impact of Event Scale-Revised 8 weeks postpartum. Structural equation models were estimated to examine associations between predictors and latent factors of PTSD symptoms for mothers and fathers simultaneously. Scaled chi-square difference tests were used to investigate differences between both groups in predictors.

RESULTS

Clinically relevant birth-related PTSD symptoms were found in 2.3% of mothers and 0.7% of fathers. Depressive and anxiety symptoms, pregnancy complications, and poorer subjective birth experience predicted PTSD symptoms in both groups. Additionally, lower support during birth and an unplanned cesarean section predicted PTSD symptoms in mothers, whereas lower job satisfaction, higher job burden, being first-time father, lower education, and mothers' lower support during birth were predictors for fathers. We found significant differences between groups regarding job burden during pregnancy, support during birth, and an unplanned cesarean section.

LIMITATIONS

Generalization of findings might be limited by self-selection bias and some systematic dropout.

CONCLUSIONS

Our results suggest differential predictors of PTSD symptoms in mothers and fathers. For fathers, less examined factors such as work factors may be important. Identifying differential risk factors may lead to customized prevention and treatment offers.

Postpartum depression and family function in Chinese women within 1 year after childbirth: A cross-sectional study

Family-related factors are reported to influence the development of postpartum depression (PPD), but limited studies have considered the role of family function in this condition. This study aimed to describe the proportion of people with probable or suspected PPD and to determine the relationships among PPD, family function, and obstetric factors. A cross-sectional study was conducted with 630 women who attended six integrated teaching and scientific research communities in Changsha, China. Instruments included the Edinburgh Postpartum Depression Scale and the Family Assessment Device (FAD). A multivariate logistic regression model was used to determine the risk factors of PPD. The prevalence of probable or suspected PPD was 37% in this sample. We found communication (odds ratio [OR] = 3.795, 95% confidence interval [CI] = 1.619-8.897), affective responsiveness (OR = 2.685, 95% CI = 1.642-4.301), role (OR = 2.483, 95% CI = 1.041-5.922), and general functioning (OR = 5.704，95% CI = 2.233-14.569) dimensions of FAD, and type of feeding (OR = 2.700, 95% CI = 1.285-5.671) influenced PPD in the context of Chinese culture. To decrease the prevalence of PPD, interventions such as health education programs and cognitive behavior therapy to strengthen family function are recommended among couples during and after pregnancy.