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Kim J, Hurh K, Kim H, Park EC, Ha MJ. Effect of the peripartum depressive symptoms on the Internet use disorder of their offspring in late childhood: retrospective longitudinal study. Sci Rep 2024; 14:417. [PMID: 38172226 PMCID: PMC10764353 DOI: 10.1038/s41598-023-50603-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Internet use disorder (IUD) is an emerging social and mental health concern. This study aimed to analyze the relative risk of IUD in late childhood among children whose mothers experienced peripartum depressive symptoms. This study included 762 participants (397 boys and 365 girls) and was conducted in 2017 (aged 9) and 2019 (aged 11). We analyzed the adjusted relative risk of being at high risk for IUD based on whether the mother experienced depressive symptoms during pregnancy or one month after delivery. We also considered the persistence of depressed mood for 4 months after delivery and the severity of peripartum depressive symptoms. From 2017, 20.7% of boys and 14.0% of girls were at high risk of developing IUD. Compared to the non-peripartum depressive group, girls whose mothers experienced peripartum depressive symptoms and those that persisted for 4 months were 1.084 and 1.124 times more likely to be at high risk of IUD (95% confidence interval = 1.005-1.170 and 1.013-1.248), respectively. There were no statistically significant differences among boys. Peripartum depressed mood could be one of risk factors of IUD. IUD needs to be monitored in children whose mothers experienced peripartum depressive symptoms.
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Affiliation(s)
- Jinhyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungduk Hurh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Min Jin Ha
- Department of Health Informatics and Biostatistics, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Ibiwoye OH, Thomson G. COVID-19 pandemic and perinatal mental health: A commentary on the impact, risk factors, and protective factors. Birth 2023; 50:651-656. [PMID: 37455498 DOI: 10.1111/birt.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/31/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
In summary, birthing women are at risk of poor mental health particularly in a pandemic. Identified protective factors such as social support, good sleep, exercise, and access to prenatal care, among others are pertinent to reducing negative effects on perinatal mental health should future crises occur.
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Affiliation(s)
- Oluwaseun Helen Ibiwoye
- University of Central Lancashire, Preston, UK
- NIHR Applied Research Collaboration - Northwest Coast (ARC-NWC), Manchester, UK
| | - Gill Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
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Valdes EG, Sparkman L, Aamar R, Steiner L, Gorman JM, Ittel V, Bethea JJ, Reist C. Improving maternal mental health: assessing the extent of screening and training about peripartum depression. J Matern Fetal Neonatal Med 2023; 36:2155042. [PMID: 36514834 DOI: 10.1080/14767058.2022.2155042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Peripartum depression (PPD) is a common mental health complication of pregnancy and increases risk for maternal mortality and poorer outcomes for children. Despite its importance, screening rates vary across organizations and care team members. The goal of the current study was to explore the perspectives from care team members in both behavioral health and acute care settings about how they screen and refer pregnant and post pregnant women for PPD, what training around PPD is currently offered by their organization, and if they could benefit from additional PPD training. METHODS Data were collected from an online self-report survey of care team members from behavioral health and acute care settings in the US. Questions focused on (1) when/if the care teams had a screening protocol for PPD, (2) beliefs about the efficacy of their organization's PPD screening, identification, and referral process, and (3) if their organization currently offered or needed training around the topic of PPD. RESULTS A total of 794 care team members in behavioral health and acute care responded to the survey between December 2021 and May 2022. Nearly, all (96.7%) reported having a specific protocol for screening for PPD when they know a patient is pregnant; however, only 69.6% of respondents routinely screen regardless of symptoms being reported by the patient. While 93.3% of the sample believed their organization does a good job screening for and identifying PPD, gaps in the referral processes were described, especially in acute settings. 95.3% of the sample reported their organization currently gives training in screening, identifying, or treating PPD or in the process for establishing outpatient referrals for PPD care for care team members who have direct contact with pregnant patients; however, 96.5% also reported their organization would benefit from additional training in one or more of these areas. CONCLUSION High rates of self-reported PPD screening and training indicate that care team members in both behavioral health and acute care are aware of the importance of maternal mental health issues. However, other research indicates that high rates of screening may not lead to improved outcomes, and there are still high rates of maternal suicide and suicidal ideation in the US. It is possible that high self-reported screening rates may indicate a false sense of security such that care team members feel the issue is addressed while problems remain. Alternatively, many respondents felt their organizations would benefit from further training, perhaps indicating an awareness of this gap. Care team members in behavioral health and acute care settings should increase collaboration to ensure high rates of screening lead to improved maternal mental health care.
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Affiliation(s)
| | | | | | | | | | | | | | - Christopher Reist
- Relias, LLC, Morrisville, NC, USA.,Mindx Sciences, Indianapolis, IN, USA
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Hobday SB, Armache M, Frost AS, Lu J, De Ravin E, Shanti RM, Jazayeri HE, Newman JG, Brody RM, Cannady SB, Wax MK, Mady LJ. Gender Differences Among Head and Neck Microvascular Reconstructive Surgeons. Otolaryngol Head Neck Surg 2023; 169:1143-1153. [PMID: 37130508 DOI: 10.1002/ohn.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/03/2023] [Accepted: 03/31/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To determine whether gender differences exist in the training history, practice patterns, and home lives of surgeons who perform microvascular reconstruction of the head and neck. STUDY DESIGN Cross-sectional survey. SETTING Medical facilities that employ surgeons who practice head and neck microvascular reconstruction in the United States. METHODS A survey was created using the Research Electronic Data Capture Framework and was distributed via email to microvascular reconstructive surgeons. Descriptive statistics were performed using Stata software. RESULTS No significant differences were found in training or current practice patterns between microvascular surgeons who identify as men versus those who identify as women. Women had fewer children (p = .020) and were more likely to be childless (p = .002). Whereas men were more likely to report a spouse/partner as primary caretaker, women were more likely to hire a professional caretaker or cite themselves as a primary caretaker (p < .001). Women were more likely to have finished residency (p = .015) and fellowship (p = .014) more recently and to practice in the Southeast (p = .006). Of the microvascular surgeons who reported practice setting switches, men more commonly changed positions for career advancement, whereas women were more likely to switch due to burnout (p = .002). CONCLUSION This study found no gender-based differences in training or practice patterns. However, significant differences were identified in childbearing, family structure, geographic practice location, and motives for switching practice.
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Affiliation(s)
- Sara B Hobday
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Maria Armache
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ariel S Frost
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Joseph Lu
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Emma De Ravin
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Rabie M Shanti
- Department of Oral and Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, New Jersey, USA
| | - Hossein E Jazayeri
- Section of Oral and Maxillofacial Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jason G Newman
- MUSC Hollings Cancer Center, Charleston, South Carolina, USA
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Robert M Brody
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Steven B Cannady
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Mark K Wax
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, Oregon, USA
| | - Leila J Mady
- Department of Otolaryngology, Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abstract
Perinatal depression (PND) is a significant contributor to maternal morbidity globally. Recognized as a major cause of poor infant development, epidemiological and interventional research on it has increased over the last decade. Recently, studies have pointed out that PND is a heterogeneous condition, with variability in its phenotypes, rather than a homogenous latent entity and a concrete diagnosis, as previously conceptualized in psychometric literature and diagnostic systems. Therefore, it is pertinent that researchers recognize this to progress in elucidating its aetiology and developing efficacious interventions.This systematic review is conducted in accordance with the Meta-analysis of observational studies in epidemiology (MOOSE). It aims to provide an updated and comprehensive account of research on heterogeneity in phenotypes of PND and its implications in research, public health, and clinical practice. It provides a synthesis and quality assessment of studies reporting heterogeneity in PND using cutting-edge statistical techniques and machine learning algorithms. After reporting the phenotypes of PND, based on heterogeneous trajectories and symptom profiles, it also elucidates the risk factors associated with severe forms of PND, followed by robust evidence for adverse child outcomes. Furthermore, recommendations are made to improve public health and clinical practice in screening, diagnosis, and treatment of PND.
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Affiliation(s)
- Ahmed Waqas
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK.
| | | | - Atif Rahman
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
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Kim YM, Oh R, Cho SH, June KJ, Lee JY, Cho HJ, Khang YH. The association of women's experience of abuse in childhood with depression during pregnancy and the role of emotional support as a moderator. PLoS One 2023; 18:e0289044. [PMID: 37494390 PMCID: PMC10370752 DOI: 10.1371/journal.pone.0289044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND This study aimed to examine the prevalence of antenatal depression and experience of abuse during childhood, to analyze the association between having experienced childhood abuse and depression during pregnancy, and to explore the role of emotional support as a moderator of that association. METHODS In total, 44,770 pregnant women were analyzed from the self-administered registry for risk assessment at community public health centers in Seoul, Republic of Korea, for home visiting service provision between 2015 and 2019. The Edinburgh Postnatal Depression Scale (EPDS) was applied for the assessment of depression. The adjusted effects of childhood abuse experience on antepartum depression according to emotional support as an effect moderator were estimated. RESULTS Depression was present in 2,451 pregnant women (5.5%), and 1,506 (3.4%) reported having experienced physical, emotional, or sexual abuse in childhood. After adjustment of covariates, pregnant women who had experienced abuse during childhood had EPDS scores 2.79 points higher than pregnant women without such experiences, and those who lacked emotional support during adulthood had 4.96 points higher than their counterparts. The difference in EPDS scores based on childhood abuse experience among women who reported emotional support (2.86) was larger than the difference in EPDS scores among those with no emotional support (1.91) (P for interaction = 0.0106). CONCLUSIONS The experience of abuse in early life and emotional support in later life are both independently important for understanding antenatal depression in Korean women. More comprehensive emotional support is needed for pregnant women who experienced abuse in childhood.
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Affiliation(s)
- Yu-Mi Kim
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University College of Medicine, Seoul, Korea
| | - Rora Oh
- School of Public Health, Seoul National University, Seoul, Korea
| | - Sung-Hyun Cho
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea
| | - Kyung Ja June
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- Department of Nursing, Soonchunhyang University, Cheonan, Korea
| | - Ji Yun Lee
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- College of Nursing, Kangwon National University, Chuncheon, Korea
| | - Hong-Jun Cho
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Ho Khang
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
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Wang C, Hou J, Li A, Kong W. Trajectory of Perinatal Depressive Symptoms from the Second Trimester to Three Months Postpartum and Its Association with Sleep Quality. Int J Womens Health 2023; 15:711-723. [PMID: 37193223 PMCID: PMC10182768 DOI: 10.2147/ijwh.s408347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/05/2023] [Indexed: 05/18/2023] Open
Abstract
Purpose Few studies have explored the association between sleep quality and depressive symptoms in perinatal women from the second trimester to the postpartum period. This study aims to explore this relationship using a longitudinal design. Patients and Methods Participants were enrolled at 15 gestational weeks. Demographic information was collected. Perinatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Sleep quality was measured employing the Pittsburgh Sleep Quality Index (PSQI) at five timepoints from enrollment to three months postpartum. Overall, 1416 women completed the questionnaires at least thrice. A Latent Growth Curve (LGC) model was performed to identify the relationship between the trajectories of perinatal depressive symptoms and sleep quality. Results Of the participants, 23.7% screened positive at least once on the EPDS. The perinatal depressive symptoms trajectory, fitted by the LGC model, decreased at early pregnancy and increased from 15 gestational weeks to three months postpartum. The intercept of sleep trajectory positively affected the intercept of perinatal depressive symptoms' trajectory; the slope of sleep trajectory positively affected both the slope and the quadratic coefficient of perinatal depressive symptoms' trajectory. Conclusion The trajectory of perinatal depressive symptoms increased from 15 gestational weeks to three months postpartum following a quadratic trend. Poor sleep quality was associated with depression symptoms beginning at the onset of pregnancy. Moreover, rapidly declining sleep quality could be a significant risk factor for perinatal depression (PND). These findings call for greater attention to perinatal women who report poor and persistently deteriorating sleep quality. Additional sleep-quality evaluations, depression assessments, and referrals to mental health care providers may benefit these women and support PND prevention, screening, and early diagnosis.
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Affiliation(s)
- Chen Wang
- Department of Perinatal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, People’s Republic of China
| | - Jinqin Hou
- Department of Special Education and Psychology, China National Academy of Educational Sciences, Beijing, People’s Republic of China
| | - Anning Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Weimin Kong
- Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, People’s Republic of China
- Correspondence: Weimin Kong, Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, People’s Republic of China, Tel +8618611942798, Email
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Vanwetswinkel F, Bruffaerts R, Arif U, Hompes T. The longitudinal course of depressive symptoms during the perinatal period: A systematic review. J Affect Disord 2022; 315:213-223. [PMID: 35803394 DOI: 10.1016/j.jad.2022.06.087] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Perinatal Depression (PND) is one of the most common complications (10-20 %) during the perinatal period and its clinical course and phenotypes are still an area of research. It is becoming increasingly clear that pregnant women and mothers with depression are not a homogeneous clinical group. METHODS A systematic literature search in 4 databases revealed 359 studies, 33 relevant studies met the inclusion criteria. We only included studies with at least three assessment points in total. RESULTS Two to six trajectory classes were identified. A three trajectories solution was most observed. All the included studies reported a low symptom trajectory but ranged from 6.5 % to 92 %. The high-symptom group was in most of the studies the smallest subgroup (1.1 % - 14.6 %). Most of the studies described episodic trajectories of depressive symptoms during the peripartum. The most common risk factor associated with a high-symptom trajectory of depressive symptoms in our study was a history of depression. Important socio-demographic predictors were: young age, ethnicity, low maternal education, low income, single relationship status or relationship problems, unplanned or unintended pregnancy and experiencing high stress levels. LIMITATIONS The methodology and the observed PND trajectories of the included studies differed, which makes generalizability difficult in this review. CONCLUSIONS PND is a frequent but heterogeneous disorder. Globally, four major groups could be distinguished: low, medium, high and episodic trajectories. There is a need for consensus regarding which assessment instruments to use, validated cutoff scores and similar time points of assessment.
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Affiliation(s)
- Femke Vanwetswinkel
- Adult Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium; Department of Neurosciences, Faculty of Medicine, Research Group Psychiatry, University of Leuven, Leuven, Belgium.
| | - Ronny Bruffaerts
- Adult Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium; Department of Neurosciences, Faculty of Medicine, Research Group Psychiatry, University of Leuven, Leuven, Belgium
| | - Umesa Arif
- Biomedical Sciences, Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Titia Hompes
- Adult Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium; Department of Neurosciences, Faculty of Medicine, Research Group Psychiatry, University of Leuven, Leuven, Belgium
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Premji SS, Khademi S, Forcheh N, Lalani S, Shaikh K, Javed A, Saleem E, Babar N, Muhabat Q, Jabeen N, Nausheen S, Shahid Ali S. Psychological and situational factors associated with COVID-19 vaccine intention among postpartum women in Pakistan: a cross-sectional study. BMJ Open 2022; 12:e063469. [PMID: 36137631 PMCID: PMC9511008 DOI: 10.1136/bmjopen-2022-063469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Contributing factors to COVID-19 vaccination intention in low-income and middle-income countries have received little attention. This study examined COVID-19-related anxiety and obsessive thoughts and situational factors associated with Pakistani postpartum women's intention to get COVID-19 vaccination. DESIGN Cross-sectional study administering a survey by a telephone interview format between 15 July and 10 September 2020. SETTING Four centres of Aga Khan Hospital for Women and Children-Garden, Kharadar, Karimabad and Hyderabad-in Sindh Province, Pakistan. PARTICIPANTS Women who were enrolled in our longitudinal Pakistani cohort study were approached (n=1395), and 990 women (71%) participated in the survey, of which 941 women who were in their postpartum period were included in the final analysis. PRIMARY OUTCOME MEASURE AND FACTORS COVID-19 vaccine intention, sociodemographic and COVID-19-related factors, Coronavirus anxiety, obsession with COVID-19 and work and social adjustment were assessed. Multiple multinomial logistic regression analysis was used to identify factors associated with women's intentions. RESULTS Most women would accept a COVID-19 vaccine for themselves (66.7%). Only 24.4% of women were undecided about vaccination against COVID-19, and a small number of women rejected the COVID-19 vaccine (8.8%). Women with primary education were less likely to take a COVID-19 vaccine willingly than those with higher education. COVID-19 vaccine uncertainty and refusal were predicted by having no experience of COVID-19 infection, childbirth during the pandemic, having no symptoms of Coronavirus anxiety and obsession with COVID-19. Predictors for women's intention to vaccinate themselves and their children against COVID-19 were similar. CONCLUSION Understanding the factors shaping women's intention to vaccinate themselves or their children would enable evidence-based strategies by healthcare providers to enhance the uptake of the COVID-19 vaccine and achieve herd immunity against Coronavirus.
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Affiliation(s)
| | - Sahar Khademi
- Faculty of Health, School of Nursing, York University, Toronto, Ontario, Canada
| | - Ntonghanwah Forcheh
- Faculty of Health, School of Nursing, York University, Toronto, Ontario, Canada
| | - Sharifa Lalani
- School of Nursing and Midwifery, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Kiran Shaikh
- School of Nursing and Midwifery, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Arshia Javed
- Department of Obstetrics & Gynecology, The Aga Khan Hospital for Women & Children, Garden, Karachi, Sindh, Pakistan
| | - Erum Saleem
- Department of Obstetrics & Gynecology, The Aga Khan Hospital for Women & Children, Garden, Karachi, Sindh, Pakistan
| | - Neelofur Babar
- Department of Obstetrics & Gynecology, The Aga Khan Hospital for Women, Karimabad, Karachi, Sindh, Pakistan
| | - Qamarunissa Muhabat
- Department of Obstetrics & Gynecology, The Aga Khan Maternity & Child Care Centre, Hyderabad, Karachi, Sindh, Pakistan
| | - Nigar Jabeen
- Department of Obstetrics & Gynecology, The Aga Khan Maternity & Child Care Centre, Hyderabad, Karachi, Sindh, Pakistan
| | - Sidrah Nausheen
- Department of Obstetrics & Gynecology, The Aga Khan University, Karachi, Pakistan
| | - Shahnaz Shahid Ali
- School of Nursing and Midwifery, The Aga Khan University, Karachi, Sindh, Pakistan
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Yan P, Liu X, Xu J. Trajectories and Predictors of Symptoms of Depression in Chinese Women From Early Pregnancy to the Early Postpartum Period. J Obstet Gynecol Neonatal Nurs 2022; 51:577-589. [PMID: 35987260 DOI: 10.1016/j.jogn.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore the trajectories and predictors of symptoms of depression in Chinese women from early pregnancy to 3 months after birth. DESIGN Prospective cohort study. SETTING Several maternal and child health care institutions and obstetric departments of general hospitals in Beijing, Jiangsu, Hunan, Sichuan, Shandong, Guangdong, and Shanxi provinces in China. PARTICIPANTS Chinese women (N = 667) during pregnancy and the postpartum period. METHODS From August 2019 to June 2020, participants from several tertiary hospitals in China who completed at least three measurements during early pregnancy to 3 months after birth (from time point 1 to time point 5) were included for data analysis. We used the self-administered basic information questionnaire and the Edinburgh Postnatal Depression Scale for follow-up. We used Mplus version 8.3 to construct the growth mixture modeling and SPSS version 25.0 to carry out logistic regression analysis. RESULTS We found three potential trajectories of symptoms of depression during pregnancy and the postpartum period: the down-then-up healthy group (Class 1, 68.5%), steady-growth moderate-risk group (Class 2, 27.5%), and up-then-down high-risk group (Class 3, 4.0%). Multinomial logistic regression analysis showed that being pregnant for the first time, being a company employee, being less satisfied with the living environment, and the occurrence of negative life events were significant predictors of the Class 2 trajectory, whereas younger age, being less satisfied with food, and the occurrence of negative life events were predictors of the Class 3 trajectory. CONCLUSION The trajectories of symptoms of depression during pregnancy and the postpartum period among Chinese women showed significant group heterogeneity. The trajectory categories were influenced not only by demographics and pregnancy-related factors but also by maternal subjective feelings.
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Liu T, Peng H, Chen C, Chen C. Mode of Delivery Is Associated with Postpartum Depression: Do Women with and without Depression History Exhibit a Difference? Healthcare (Basel) 2022; 10:1308. [PMID: 35885834 PMCID: PMC9317972 DOI: 10.3390/healthcare10071308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 11/23/2022] Open
Abstract
Whether the mode of birth delivery correlates with the incidence of postpartum depression (PPD) is still under debate. This study seeks to clarify such a correlation and to further investigate if there are any differences in the likelihood of PPD medical care use among women with and without a history of depression. A logistic regression at two assessment points (6-month and 12-month postpartum) on the National Health Insurance Database in Taiwan is performed. In total, 32,729 women were included who gave first birth from 2007 to 2011 via cesarean section (CS), elective CS, and vaginal delivery, of whom 3580 (10.9%) were diagnosed with a history of depression. Findings show that CS was associated with a higher likelihood of PPD doctor visits regardless of whether the women have a history of depression or not, but elective CS tended to have different impacts for these two groups of women. Mentally healthy women who experienced elective CS had 1.36- and 1.64-times higher risk of PDD medical care use than those who delivered vaginally, whereas previous depressive women undertaking an elective cesarean birth had no significant difference observed in incidences. A notably higher risk of elective CS delivery versus vaginal delivery for mentally healthy women suggests that elective CS is not clinically appropriate, yet it might be an alternative to vaginal delivery with careful counseling for pregnant women who experience a history of depression.
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Cao S, Jones M, Tooth L, Mishra GD. Generational differences in the prevalence of postpartum depression among young Australians: a comparison of two cohorts born 17 years apart. Arch Womens Ment Health 2022; 25:199-214. [PMID: 34528134 DOI: 10.1007/s00737-021-01182-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Abstract
Whether there has been an increase in postpartum depression (PPD) over the generation remains unknown. This study aimed to compare the prevalence in two cohorts of young Australian women born 17 years apart and identified the factors associated with any generational differences. Participants were from the Australian Longitudinal Study on Women's Health, who gave birth between ages 18 and 27 (born in 1973-78 and 1989-95). PPD prevalence was calculated as the percentage of births associated with PPD. Both the prevalence of PPD diagnoses (among 1,610 births) and PPD symptoms (among 953 births) were compared. Relative risks (RRs) and 95% confidence intervals (CIs) were used to report generational differences in the prevalence for PPD diagnoses; Hazard ratios (HRs) and 95% CIs used for PPD symptoms. Factors that differed between cohorts and were associated with PPD diagnoses or PPD symptoms were adjusted. The prevalence of both PPD diagnoses (21.4% vs 10.3%; crude RR: 2.03, 95% CI: 1.59-2.60) and symptoms (20.1% vs 13.3%; crude HR: 1.60, 95% CI: 1.15-2.34) were higher in the 1989-1995 cohort than the 1973-1978 cohort. Generational differences in PPD diagnoses persisted after controlling for potential contributors (RR: 1.53, 95% CI: 1.15-2.04), while generational differences in PPD symptoms were attenuated (HR: 0.98, 95% CI: 0.64-1.49). Of all contributing factors, a history of depression explained most of the generational differences, especially in PPD symptoms (49%), to the extent that when the study sample was stratified by history of depression, no generational differences were detected (without prior depression, HR: 0.65, 95% CI: 0.20-2.08; with prior depression, HR: 1.18, 95% CI: 0.71-1.96). The higher prevalence of PPD in the recent generation was mainly due to the high prevalence of depression. Strategies that well manage pre-existing depression may benefit the prevention of PPD for the current young generation. Further research is warranted to inform detailed prevention approaches.
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Affiliation(s)
- Sifan Cao
- Faculty of Medicine, School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, QLD, Australia.
| | - Mark Jones
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD, Australia
| | - Leigh Tooth
- Faculty of Medicine, School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, QLD, Australia
| | - Gita Devi Mishra
- Faculty of Medicine, School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, QLD, Australia
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Hong L, Le T, Lu Y, Shi X, Xiang L, Liu M, Zhang W, Zhou M, Wang J, Xu D, Yu X, Zhao K. Distinct trajectories of perinatal depression in Chinese women: application of latent growth mixture modelling. BMC Pregnancy Childbirth 2022; 22:24. [PMID: 35012496 PMCID: PMC8751241 DOI: 10.1186/s12884-021-04316-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 12/03/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Current research on perinatal depression rarely pays attention to the continuity and volatility of depression symptoms over time, which is very important for the early prediction and prognostic evaluation of perinatal depression. This study investigated the trajectories of perinatal depression symptoms and aimed to explore the factors related to these trajectories. METHODS The study recruited 550 women during late pregnancy (32 ± 4 weeks of gestation) and followed them up 1 and 6 weeks postpartum. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Latent growth mixture modelling (LGMM) was used to identify trajectories of depressive symptoms during pregnancy. RESULTS Two trajectories of perinatal depressive symptoms were identified: "decreasing" (n = 524, 95.3%) and "increasing" (n = 26, 4.7%). History of smoking, alcohol use and gestational hypertension increased the chance of belonging to the increasing trajectories, and a high level of social support was a protective factor for maintaining a decreasing trajectory. CONCLUSIONS This study identified two trajectories of perinatal depression and the factors associated with each trajectory. Paying attention to these factors and providing necessary psychological support services during pregnancy would effectively reduce the incidence of perinatal depression and improve patient prognosis.
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Affiliation(s)
- Lan Hong
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Tao Le
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yinping Lu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Xiang Shi
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Ludan Xiang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Meng Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Wenmiao Zhang
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meixi Zhou
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiangling Wang
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongwu Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Xin Yu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Ke Zhao
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, 325035, China.
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14
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Lee Y, Kim KH, Lee BH, Kim YK. Plasma level of brain-derived neurotrophic factor (BDNF) in patients with postpartum depression. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110245. [PMID: 33444650 DOI: 10.1016/j.pnpbp.2021.110245] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/23/2020] [Accepted: 01/07/2021] [Indexed: 11/19/2022]
Abstract
Postpartum depression occurs in 10-15% of mothers. Brain-derived neurotrophic factor (BDNF) is a nerve growth factor that plays a role in neuroplasticity. We hypothesized that the concentration of BDNF is related to reproduction and childbirth, and that women with postpartum depression show alteration in BDNF level. A total of 104 pregnant women was selected as subjects, and 60 non-pregnant women were selected as normal controls. Symptoms of depression were evaluated in the pregnant study subjects using the diagnostic criteria outlined in the Edinburgh Postnatal Depression Scale (EPDS). The pregnant subjects were divided into three groups of perinatal non-depressed controls (n = 61), postpartum depression-recovery (n = 18), and postpartum depression (n = 25). The plasma concentration of BDNF was higher in the pregnant group than in non-pregnant controls and lower in the postpartum depression group at 6 weeks after delivery than in the perinatal non-depressed group. In the postpartum depression-recovery group, the BDNF concentration increased at 6 weeks after delivery compared to that at 24 weeks of gestation. This study found significant changes in plasma BDNF concentration in depressed pregnant women.
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Affiliation(s)
- Younjung Lee
- Department of Psychiatry, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
| | - Kye-Hyun Kim
- Department of Obstetrics & Gynecology, KangBuk Samsung Hospital, College of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Bun-Hee Lee
- Maum & Maum Psychiatric Clinic, Seoul 02566, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea.
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15
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Abstract
PURPOSE OF REVIEW Perinatal depression is a common and debilitating complication of pregnancy and childbirth. Recent studies have elucidated relationships between acute birth events on depression risk, and novel treatments for postpartum depression have been discovered and approved. This article reviews current understandings about birth events on depression, new screening standards, and novel treatments for postpartum depression. RECENT FINDINGS Pain, analgesia, and depression are complex traits that are inter-related during and after pregnancy. Certain individuals may benefit more than others from addressing pain and suffering around childbirth. Exposures to general anesthesia or postdural puncture headache are associated with postpartum depression symptoms, although a causal relationship is unlikely. Brexanolone, ketamine and its related compounds, and nonpharmacologic options offer new or alternative therapies for depression, although safety information for some of these treatments in pregnancy and lactation are needed. Maternal health bundles call for close attention to perinatal mental health screening with validated instruments, and for timely treatment referrals in the 'fourth trimester'. SUMMARY Clinical monitoring and timely treatment of depression in the perinatal and postpartum periods is critical for maternal postpartum health and recovery. Perinatal specialists and researchers should continue to focus on tailored treatments specific to this special population.
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Affiliation(s)
- Grace Lim
- University of Pittsburgh Department of Anesthesiology & Perioperative Medicine
- University of Pittsburgh Department of Obstetrics & Gynecology, UPMC Magee-Women’s Hospital
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16
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Yu M, Li H, Xu DR, Wu Y, Liu H, Gong W. Trajectories of perinatal depressive symptoms from early pregnancy to six weeks postpartum and their risk factors-a longitudinal study. J Affect Disord 2020; 275:149-156. [PMID: 32734901 DOI: 10.1016/j.jad.2020.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Few studies explored trajectories of depressive symptoms from early pregnancy and covered the whole perinatal period. This study aimed to explore the trajectories of perinatal depressive symptoms, their heterogeneity of onsets and peaks, and relations to demographic and psychological factors. METHOD A longitudinal study was conducted at two hospitals in China amongst 1,126 participants. Perinatal depression was measured using the Edinburgh Postnatal Depression Scale. Demographic and psychological factors were collected by self-developed questionnaire and Generalized Anxiety Disorder-7. Women completing at least three depression screens (n = 879) were included. Latent Growth Curve Model and Growth Mixture Model were performed to identify the depression trajectories and logistic regression was used to analyse factors of trajectories. RESULTS Three trajectories were identified: 90.0% of women never presented with depressive symptoms ("Low-throughout"); 5.1% presented with depressive symptoms mainly during the antenatal period ("Antenatal-high"); 4.9% presented with depressive symptoms mainly during the postpartum period ("Postpartum-high"). 52.4% of women experienced their first depressive symptoms during early pregnancy. Suffering from anxiety and being unsatisfied with their marriage were associated with the "Antenatal-high" and "Postpartum-high" trajectories, respectively. LIMITATIONS Response rate was not high. We also do not have information on clinical diagnoses or changes in some variables over time. CONCLUSIONS We identified three trajectories and heterogeneity existed concerning the timing of their peaks. Women should be considered for depression screening and intervention in early pregnancy. Factors associated with each trajectory were different, raising the potential of individualized intervention to reduce the occurrence of depression.
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Affiliation(s)
- Min Yu
- Xiangya School of Public Health, Central South University, Hunan, China
| | - Hui Li
- School of Mathematics and Statistics, University of Birmingham, UK
| | - Dong Roman Xu
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangdong, China
| | - Yinglan Wu
- Department of Maternal Health Care, Hunan Provincial Maternal and Child Health Hospital, Hunan, China
| | - Hua Liu
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital in Ziyang district of Yiyang city, Hunan, China
| | - Wenjie Gong
- Xiangya School of Public Health, Central South University, Hunan, China.
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17
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Qiu W, Hodges TE, Clark EL, Blankers SA, Galea LAM. Perinatal depression: Heterogeneity of disease and in animal models. Front Neuroendocrinol 2020; 59:100854. [PMID: 32750403 DOI: 10.1016/j.yfrne.2020.100854] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/14/2020] [Accepted: 07/21/2020] [Indexed: 12/15/2022]
Abstract
Perinatal depression (PND) can have either an antepartum or postpartum onset. Although the greatest risk factor for PND is previous depression history,de novoPND occurs with the majority of cases occurring in the postpartum. Timing of depression can impact etiology, prognosis, and response to treatment. Thus, it is crucial to study the impact of the heterogeneity of PND for better health outcomes. In this review, we outline the differences between antepartum and postpartum depression onset of PND. We discuss maternal physiological changes that differ between pregnancy and postpartum and how these may differentially impact depression susceptibility. We highlight changes in the maternal steroid and peptide hormone levels, immune signalling, serotonergic tone, metabolic factors, brain morphology, and the gut microbiome. Finally, we argue that studying the heterogeneity of PND in clinical and preclinical models can lead to improved knowledge of disease etiopathology and treatment outcomes.
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Affiliation(s)
- Wansu Qiu
- Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Travis E Hodges
- Department of Psychology, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Emily L Clark
- Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Samantha A Blankers
- Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Liisa A M Galea
- Graduate Program in Neuroscience, University of British Columbia, Canada; Department of Psychology, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada.
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18
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Chan SJ, Ein-Dor T, Mayopoulos PA, Mesa MM, Sunda RM, McCarthy BF, Kaimal AJ, Dekel S. Risk factors for developing posttraumatic stress disorder following childbirth. Psychiatry Res 2020; 290:113090. [PMID: 32480118 DOI: 10.1016/j.psychres.2020.113090] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/08/2020] [Accepted: 05/09/2020] [Indexed: 11/25/2022]
Abstract
Women can develop childbirth-related posttraumatic stress disorder (CB-PTSD) in at-term delivery with healthy baby outcome as well as following pre-term delivery and neonatal complications, a potential added stressor. No study compares risk factors of CB-PTSD associated with different infant outcomes. We investigated CB-PTSD risk factors by comparing women with or without neonatal complications. Analysis reveals the importance of antepartum and birth-related risk factors in CB-PTSD above and beyond child outcomes, suggesting childbirth is an independent stressor capable of evoking CB-PTSD.
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Affiliation(s)
- Sabrina J Chan
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Tsachi Ein-Dor
- School of Psychology, Interdisciplinary Center (IDC) Herzliya, Israel
| | | | - Michelle M Mesa
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Ryan M Sunda
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Brenna F McCarthy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Anjali J Kaimal
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA; Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, MA
| | - Sharon Dekel
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA.
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19
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Dekel S, Ein-Dor T, Dishy GA, Mayopoulos PA. Beyond postpartum depression: posttraumatic stress-depressive response following childbirth. Arch Womens Ment Health 2020; 23:557-64. [PMID: 31650283 DOI: 10.1007/s00737-019-01006-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 10/04/2019] [Indexed: 12/15/2022]
Abstract
Although depression following childbirth is well recognized, much less is known about comorbid postpartum psychiatric conditions. Some women can endorse posttraumatic stress related to the childbirth experience accompanied by symptoms of depression. The objective of our study was to examine the nature of the comorbidity of symptoms of childbirth-related posttraumatic stress disorder (PTSD) and postpartum depression. We studied a sample of 685 women who were on average 3 months following childbirth and collected data about their mental health pertaining to PTSD, depression, general distress, and childbirth experience. The vast majority of women with elevated childbirth-related PTSD symptoms also endorsed elevated postpartum depression symptoms. Factor analysis revealed that symptoms of childbirth-related PTSD and postpartum depression loaded onto one single factor rather than two factors. Stepwise multi-nominal regression analysis revealed that childbirth stressors, including obstetric complications and peritraumatic distress in birth, predicted the likelihood of developing comorbid childbirth-related PTSD and postpartum depression, but not depression alone. The findings suggest that beyond postpartum depression, postpartum women suffer from a posttraumatic stress-depressive response in the wake of a traumatic childbirth experience. Increasing awareness in routine postpartum care about traumatic childbirth and its associated emotional sequela is warranted.
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20
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Kaźmierczak M, Gebuza G, Gierszewska M, Bannach M, Mieczkowska E, Dombrowska-Pali A, Czubkowska M. Screening for Detection of the Risk of Perinatal Mental Disorders among Women in Poland. Issues Ment Health Nurs 2020; 41:438-444. [PMID: 32202956 DOI: 10.1080/01612840.2019.1677829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of the study was to assess the severity of depressive symptoms, to analyze risk factors for perinatal mental disorders and to assess dispositional optimism. A total of 106 women from Poland were included in the study at 37-week pregnant and 6 weeks after giving birth. It was demonstrated that the main predictors of perinatal mental disorders were the variables: mental health disorders before pregnancy, subjectively reported decreased mood in pregnancy, the lack of social (instrumental) support and the tendency to pessimism. The results of the study suggest how important it is to introduce clinical practice in Poland to screen for early detection of the risk of depression during pregnancy and postpartum depression.
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Affiliation(s)
| | - Grażyna Gebuza
- Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Poland
| | | | - Małgorzata Bannach
- Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Poland
| | - Estera Mieczkowska
- Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Poland
| | | | - Martyna Czubkowska
- Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Poland
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21
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Dekel S, Ein-Dor T, Berman Z, Barsoumian I, Agarwal S, Pitman RK. Delivery mode is associated with maternal mental health following childbirth. Arch Womens Ment Health 2019; 22:817-824. [PMID: 31041603 PMCID: PMC6821585 DOI: 10.1007/s00737-019-00968-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
Childbirth is a life-transforming event often followed by a time of heightened psychological vulnerability in the mother. There is a growing recognition of the importance of obstetrics aspects in maternal well-being with the way of labor potentially influencing psychological adjustment following parturition or failure thereof. Empirical scrutiny on the association between mode of delivery and postpartum well-being remains limited. We studied 685 women who were on average 3 months following childbirth and collected information concerning mode of delivery and pre- and postpartum mental health. Analysis of variance revealed that women who had cesarean section or vaginal instrumental delivery had higher somatization, obsessive compulsive, depression, and anxiety symptom levels than those who had natural or vaginal delivery as well as overall general distress, controlling for premorbid mental health, maternal age, education, primiparity, and medical complication in newborn. Women who underwent unplanned cesarean also had higher levels of childbirth-related PTSD symptoms excluding those with vaginal instrumental. The risk for endorsing psychiatric symptoms reflecting clinically relevant cases increased by twofold following unplanned cesarean and was threefold for probable childbirth-related PTSD. Maternal well-being following childbirth is associated with the experienced mode of delivery. Increasing awareness in routine care of the implications of operative delivery and obstetric interventions in delivery on a woman's mental health is needed. Screening at-risk women could improve the quality of care and prevent enduring symptoms. Research is warranted on the psychological and biological factors implicated in the mode of delivery and their role in postpartum adjustment.
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Affiliation(s)
- Sharon Dekel
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA, 02129, USA. .,Harvard Medical School, Harvard University, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Tsachi Ein-Dor
- Interdisciplinary Center, Kanfei Nesharim, Herzliya, 4610101, Israel
| | - Zohar Berman
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA 02129, United States,Harvard Medical School, Harvard University, 25 Shattuck St, Boston, MA 02115, United States
| | - Ida Barsoumian
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA 02129, United States
| | - Sonika Agarwal
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA 02129, United States
| | - Roger K. Pitman
- Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA 02129, United States,Harvard Medical School, Harvard University, 25 Shattuck St, Boston, MA 02115, United States
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