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Sun R, Zhao M, Ma L, Duan Y, Wei J. High psychological stress levels related to delivery can increase the occurrence of postpartum mental disorders. Front Psychiatry 2023; 14:1273647. [PMID: 38188054 PMCID: PMC10769493 DOI: 10.3389/fpsyt.2023.1273647] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Objective The study sought to explore the relationship between high psychological stress levels related to delivery and postpartum mental disorders. Methods A total of 284 parturients were included in the study from July 2021 to January 2022. The stress level at 1 month postpartum was assessed by the Impact of Event Scale-Revised (IES-R). Parturients with an IES-R score ≤ 9 were included in the low psychological stress level group, and those with an IES-R score > 9 were included in the high psychological stress level group. The Edinburgh Postnatal Depression Scale (EPDS), Union Physio-Psycho-Social Assessment Questionnaire (UPPSAQ-70), Symptom Checklist-90 (SCL-90) and Mini-International Neuropsychiatric Interview (M.I.N.I.) were conducted at 42 ± 7 days postpartum to assess the mental health of parturients.The parturients' mental health after birth was assessed by the EPDS, UPPSAQ-70, and SCL-90. Semi-structured diagnostic interviews were conducted at 42 ± 7 days postpartum by using the M.I.N.I. Results The incidence rate of postpartum mental disorders was 20.42% (58/284), the incidence rates of postpartum depression, anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder were 17.96% (51/284), 11.97% (34/284), 4.58% (13/284) and 1.41% (4/284), respectively, and the comorbidity rate was 58.62% (34/58). A history of mental disorders and pregnancy complications were risk factors for postpartum depression (p = 0.028, p = 0.040, respectively); a history of mental disorders, a lack of physical exercise, partner violence and pregnancy complications were risk factors for postpartum anxiety disorders (p = 0.003, p = 0.007, p = 0.031, p = 0.048, respectively); and the delivery of female infants was a risk factor for postpartum obsessive-compulsive disorder (p = 0.022).The risk of postpartum depression, anxiety disorders and obsessive-compulsive disorder was 9.125 times (95% CI = 3.900 ~ 21.349, p < 0.01), 7.310 times (95% CI = 2.588 ~ 20.649, p < 0.01) and 6.259 times (95% CI = 1.347 ~ 29.093, p < 0.01) higher in postpartum women with high psychological stress levels related to delivery than in those with low psychological stress levels, respectively. Conclusion The incidence of postpartum mental disorders is high and has a positive correlation with the level of psychological stress. This may lead to a new perspective of the effect of psychological stress on postpartum mental disorders and attract more attention to other mental disorders in addition to postpartum depression.
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Affiliation(s)
- Ruixue Sun
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingzhe Zhao
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liangkun Ma
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanping Duan
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Tsai JM, Tsai LY, Tsay SL, Chen YH. The prevalence and risk factors of postpartum depression among women during the early postpartum period: a retrospective secondary data analysis. Taiwan J Obstet Gynecol 2023; 62:406-411. [PMID: 37188444 DOI: 10.1016/j.tjog.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE Postpartum depression (PPD) is common and detrimental affecting both maternal health and child development. The purpose of this study was to determine the prevalence and factors of PPD screened immediately after delivery. MATERIALS AND METHODS A retrospective study design using secondary data analysis is applied. Four years of data, containing linkable maternal, neonate and PPD screen records between 2014 and 2018, was retrieved and combined from the electronic medical systems of MacKay Memorial Hospital in Taiwan. For each woman, the PPD screen record contained self-reported depressive symptoms assessed by the Edinburgh Postnatal Depression Scale (EPDS) within 48-72 h after delivery. A set of factors pertaining to maternal, pregnancy and obstetric, neonatal and breastfeeding were selected from the combined data set. RESULTS In total, 10.2% (1244 of 12,198) of women reported with the symptoms of PPD (EPDS ≥10). Through logistic regression analysis, eight predictors of PPD were identified. Specifically, PPD was shown to be associated with educational level of high school or lower (odds ratio (OR) = 1.57, 95% confidence interval (CI) 1.27-1.93), marital status of unmarried (OR = 1.52, 95% CI 1.18-1.99), unemployed (OR = 1.26, 95% CI 1.11-1.42), Cesarean section (OR = 1.7, 95% CI 1.5-1.93), unplanned pregnancy (OR = 1.38, 95% CI = 1.22-1.57), gestational age at 24-36 weeks (OR = 1.3, 95% CI 1.08-1.56), non-intention of breastfeeding (OR = 1.7, 95% CI 1.18-2.45) and Apgar at 5 min < 7 (OR = 2.18, 95% CI 1.11-4.29). CONCLUSION Low educational level, unmarried, unemployed, Caesarean section, unplanned pregnancy, preterm delivery, not breastfeeding and low Apgar at 5 min are predictors for postpartum women to develop PPD. These predictors are easily recognized in the clinical environment for patient guidance, support and referral as early as possible to ensure the health and well-being of the mothers and the neonates.
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Affiliation(s)
- Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, No. 168, University Rd., Dacun, Changhua, 515006, Taiwan; Mackay Memorial Hospital, Taipei City, Taiwan; Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| | - Li-Yun Tsai
- College of Nursing, Central Taiwan University of Science and Technology, No. 666, Buzih Rd., Beitun Dist., Taichung, 406053, Taiwan.
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Dayeh University, No. 168, University Rd., Dacun, Changhua, 515006, Taiwan.
| | - Yi-Heng Chen
- Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
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Zhang X, Zuo X, Matheï C, Aertgeerts B, Afnan M, Li T, Buntinx F, Vermandere M. Impact of a postpartum care rehabilitation program to prevent postpartum depression at a secondary municipal hospital in Qingdao China: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:239. [PMID: 37041524 PMCID: PMC10088113 DOI: 10.1186/s12884-023-05547-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/25/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The emerging postpartum rehabilitation (PPR) program in Chinese hospitals characterized by applying ongoing medical care through traditional cultural practices shows a protective effect in early puerperium in China. This study explores the benefit of PPR program practices to postpartum depression (PPD) and the influencing factors for PPD among Chinese women during the first postnatal six weeks. METHODS The cross-sectional study included 403 participants and was conducted in a Secondary Municipal Hospital in Qingdao, China, from 01 to 2018 to 31 December 2021. Information on this PPR program was collected during the six-weeks postpartum consultation, including the Edinburgh postnatal depression scale (EPDS) scores, the measurement results for diastasis recti abdominis, and the international physical activity questionnaire (long form) (IPAQ-L) scores. Logistic regression models were used to examine the effect of the PPR program on PPD among the local population. The secondary aim of this study was to investigate possible influencing factors for PPD, such as coronavirus disease 2019 (COVID-19), physical exercises, etc. RESULTS: PPR program has shown a positive effect in preventing PPD (p < 0.001) and diastasis recti prevalence (p < 0.001) during the six-weeks postnatal control in Qingdao, China. Better post-pregnancy weight reduction (p = 0.04) and higher metabolic equivalent of task (MET) value (p < 0.001) were noticed in the non-PPR group. Furthermore, lower PPD risk was associated with factors such as longer relationship duration years (2-5 years) (p = 0.04) and exercising one to three times a week (p = 0.01). A higher PPD risk was related to factors such as urinary incontinence during the postpartum period (p = 0.04) and subjective insomnia (p < 0.001). No significant effect was shown between COVID-19 and the EPDS score in this study (p = 0.50). CONCLUSION Our results suggested that the PPR program provided protection against PPD and diastasis recti during the first six weeks after delivery. Urinary incontinence and subjective insomnia were the main risk factors for PPD, while longer relationship duration years and exercising one to three times a week gave protective effects to PPD. This study emphasized that a comprehensive ongoing medical care program, such as the PPR program, effectively improves women's mental and physical health in the early postpartum in China.
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Affiliation(s)
- Xiaoqian Zhang
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium.
- Qingdao United Family Hospital, Qingdao, China.
| | - Xiaoli Zuo
- Qingdao United Family Hospital, Qingdao, China
| | - Catharina Matheï
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | - Bert Aertgeerts
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | | | - Tang Li
- Qingdao University Medical College, Qingdao, China
| | - Frank Buntinx
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | - Mieke Vermandere
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
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Kashkouli M, Jahanian Sadatmahalleh S, Ziaei S, Kazemnejad A, Saber A, Darvishnia H, Azarbayjani K. Relationship between postpartum depression and plasma vasopressin level at 6-8 weeks postpartum: a cross-sectional study. Sci Rep 2023; 13:3518. [PMID: 36864065 PMCID: PMC9981712 DOI: 10.1038/s41598-022-27223-6] [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] [Received: 05/08/2022] [Accepted: 12/28/2022] [Indexed: 03/04/2023] Open
Abstract
Postpartum depression (PPD) is the most important postpartum mood disorder due to its significant effect on both the infant and family health. Arginine vasopressin (AVP) has been suggested as a hormonal agent involved in the development of depression. The purpose of this study was to investigate the relationship between the plasma concentrations of AVP and the score of Edinburgh Postnatal Depression Scale (EPDS). This cross-sectional study was conducted in 2016-2017 in Darehshahr Township, Ilam Province, Iran. In the first phase, 303 pregnant women, who were at 38 weeks, met the inclusion criteria, and were not depressed (according to their EPDS scores) were included in the study. In the 6-8 week postpartum follow-up, using the EPDS, 31 depressed individuals were diagnosed and referred to a psychiatrist for confirmation. The maternal venous blood samples of 24 depressed individuals still meeting the inclusion criteria and 66 randomly selected non-depressed subjects were obtained to measure their AVP plasma concentrations with ELISA assay. There was a significant positive relationship between plasma AVP levels and the EPDS score (P = 0.000, r = 0.658). Also the mean plasma concentration of AVP was significantly higher in the depressed group (41.35 ± 13.75 ng/ml) than in the non-depressed group (26.01 ± 7.83 ng/ml) (P < 0.001). In a multiple logistic regression model for various parameters, increased vasopressin levels were associated with increased odds of PPD (OR = 1.15, 95% CI = 1.07-1.24, P = 0.000). Furthermore, multiparity (OR = 5.45, 95% CI = 1.21-24.43, P = 0.027) and non-exclusive breastfeeding (OR = 13.06, 95% CI = 1.36-125, P = 0.026) were associated with increased odds of PPD. Maternal gender preference (having a baby of desired and desired sex) decreased the odds of PPD (OR = 0.13, 95% CI = 0.02-0.79, P = 0.027 and OR = 0.08, 95% CI = 0.01-0.5, P = 0.007). AVP seems to be a contributor to clinical PPD by affecting the hypothalamic-pituitary-adrenal (HPA) axis activity. Furthermore, primiparous women had significantly lower EPDS scores.
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Affiliation(s)
- Masoumeh Kashkouli
- grid.412266.50000 0001 1781 3962Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Shahideh Jahanian Sadatmahalleh
- grid.412266.50000 0001 1781 3962Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Saeideh Ziaei
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Anoshirvan Kazemnejad
- grid.412266.50000 0001 1781 3962Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ashraf Saber
- Department of Nursing, Faculty of Medical Sciences, Esfarayen, Iran
| | - Hamid Darvishnia
- grid.412462.70000 0000 8810 3346Department of Biology, Payame Noor University (PNU), Tehran, Iran
| | - Khadijeh Azarbayjani
- grid.412266.50000 0001 1781 3962Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Zhuang J, Chen Q, Liu C, Zuo R, Zhang Y, Dang J, Wang Z. Investigating the association between maternal childbirth intention, labor epidural analgesia, and postpartum depression: A prospective cohort study. J Affect Disord 2023; 324:502-510. [PMID: 36586623 DOI: 10.1016/j.jad.2022.12.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/06/2021] [Revised: 08/26/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is a general depressive episode after childbirth. Studies have shown that unmatched analgesic intention increases the risk of PPD, but the use of labor epidural analgesia (LEA) during childbirth can reduce this risk. We aimed to investigate the association between maternal childbirth intention, LEA, and PPD and risk factors that may be related to PPD. METHODS A total of 590 mothers were included in this prospective cohort study. Demographic, prenatal, intrapartum and postpartum data were recorded. We investigated the association between childbirth intention, LEA and PPD and assessed the interactions between two factors. Logistic regression analysis was used to screen variables that might be associated with the occurrence of PPD. RESULTS Overall, 130 of 451 women completing the study at 3 months had PPD (28.8 %). We did not find an association between unmatched childbirth intention, use of LEA and PPD (adjustOR = 0.684 CI 0.335-1.396, p = 0.296; adjustOR = 0.892, CI 0.508-1.565, p = 0.690). Chronic pain affecting daily life, prenatal EPDS, SAS, SSRS score, family accompaniment during labor, and 1-day numerical rating scale (NRS) score were significantly associated with PPD (p < 0.05). LIMITATIONS In the 3-month follow-up, we only recorded the EPDS score, not the pain score, and did not evaluate the association between postpartum chronic pain and PPD. CONCLUSIONS The association between maternal childbirth intention, LEA and PPD was not significant. Chronic pain affecting daily life, prenatal EPDS, SAS, SSRS score, family accompaniment during labor, and 1-day NRS score were significantly related to the occurrence of PPD (p < 0.05).
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Affiliation(s)
- Jingwen Zhuang
- Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Qianmin Chen
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Chao Liu
- Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Ronghua Zuo
- Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Yuhan Zhang
- Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Jingjing Dang
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Zhiping Wang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, 209 Tongshan Road, Xuzhou 221004, Jiangsu, China; Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221004, Jiangsu, China.
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Rong XF, Li MQ, Pérez-López FR, Wu JN, Zhang B. Maternal expectations of fetal gender and risk of postpartum depression. BMC Pregnancy Childbirth 2023; 23:112. [PMID: 36782142 PMCID: PMC9926541 DOI: 10.1186/s12884-023-05419-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/31/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Female offspring was associated with a high risk of postpartum depression (PPD) during the one-child policy period in China. However, little is known about the association between maternal expectations on fetal gender and the risk of PPD in the context of the new two children policy implemented in 2016. METHODS We conducted a hospital-based cohort study of women with singleton pregnancies between 2017 and 2018 (n = 991) to address this concern. Logistic regression was run to estimate the association between unexpected fetal gender and the risk of PPD. RESULTS A total of 127 women (12.8%) were diagnosed with PPD. Compared with women who achieved fetal gender expectations, the odds ratio (OR) for PPD among those who had an unexpected fetal gender was 2.44 (95% confidence interval (CI): 1.30-4.58) (in the backward method logistic regression model) and 2.25 (95% CI: 1.21-4.18) (in the forward method model), respectively. The disparity of the association was significant among primiparous and pluriparous women (OR, 2.52, 95% CI: 1.32-4.84, P = 0.005 vs. OR, 0.91, 95% CI: 0.09-8.75, P = 0.932). Fetal gender expectations accounted for about 15% of the risk of PPD in the structural equation models. CONCLUSIONS These results indicated that unexpected fetal gender was associated with an increased risk of PPD among Chinese primiparous women.
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Affiliation(s)
- Xiao-Fan Rong
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200001 China ,grid.8547.e0000 0001 0125 2443Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, 201700 China
| | - Ming-Qing Li
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200001 China ,grid.412312.70000 0004 1755 1415Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, 200011 China
| | - Faustino R. Pérez-López
- Aragón Health Research Institute, San Juan Bosco 13, 50009 Zaragoza, Spain ,grid.11205.370000 0001 2152 8769Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Jiang-Nan Wu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200001, China. .,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, 200011, China.
| | - Bin Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200001, China.
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Yao Y, Cui Y, Zhang Y, Li H, Zeng W. Population mental health matters child health disparity: a national level analysis. BMC Public Health 2022; 22:2372. [PMID: 36528613 PMCID: PMC9759864 DOI: 10.1186/s12889-022-14530-w] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/02/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The association between social distress and child health is important and attracts research interest. This study aims to examine the trend of inequality in the mortality rate for children under five (U5MR) over time and decompose the population mental health (PMH)-gradient in U5MR into different drivers at the national level. METHODS Data from 1990 to 2019 on the U5MR, PMH, and potential risk factors, such as socioeconomic status, environmental exposures at the national level, health behavior, basic water and sanitation services, urbanization, healthcare level, and HIV prevalence, were collected from online databases. We described the trend of U5MR and broke down U5MR based on the countries' risk factor status and PMH. We constructed regression models and decomposed the drivers of change in U5MR disparity based on PMH-gradient. RESULTS The difference in U5MR between countries with different levels of air pollution and income status was narrowed since 1990 for the high PMH groups. Countries with a higher level of PMH had less significant differences in U5MR between low- and middle-income groups than those with a lower level of PMH. The development of PMH-related gradient in child health is not consistent thoroughly. Before 2000, boys experienced a sharper decline in PMH-related gradient in health than girls did. The decomposition shows that the changes in PMH-gradient in child health were mainly caused by changes in the return to risk factors. The mental health of female population matters more in child health outcomes. CONCLUSION Although the U5MR converges across countries, the reason varies. The PMH gradient in child mortality is mainly explained by the change in the return to risk factors. The PMH-gradient health disparity in boys is larger than that in girls in 2019, which indicates that boys' health may be more vulnerable to the development of PMH recently. The findings remind us that we need to pay attention to the hidden reasons for the growth of disparity. It also suggests that improving PMH has a great impact on reducing PMH-related health disparity, especially for boys. Our research contributes to the understanding of the transition of PMH-related health disparity in U5MR and provides policy implications for reducing gender disparity in child health.
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Affiliation(s)
- Yao Yao
- grid.16821.3c0000 0004 0368 8293Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, 200025 P.R. China ,grid.16821.3c0000 0004 0368 8293China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yujie Cui
- grid.16821.3c0000 0004 0368 8293Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai, 200025 P.R. China ,grid.16821.3c0000 0004 0368 8293China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yanfeng Zhang
- grid.33764.350000 0001 0476 2430School of Economics and Management, Harbin Engineering University, 145, Nantong Street, Nangang District, Harbin, 150001 P.R. China
| | - Heng Li
- grid.443524.00000 0000 9001 9434Public Health Governance Research Center, East China University of Political Science and Law, 1575 Wandu Hang Road, Songjiang District, Shanghai, 200042 P.R. China
| | - Wu Zeng
- grid.213910.80000 0001 1955 1644Department of Global Health, School of Health, Georgetown University, 3700 Reservoir Rd NW, Washington, DC, USA
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Wang K, Qiu J, Meng L, Lai X, Yao Z, Peng S. Postpartum hemorrhage and postpartum depressive symptoms: A retrospective cohort study. Depress Anxiety 2022; 39:246-253. [PMID: 35167153 DOI: 10.1002/da.23245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 11/16/2021] [Revised: 12/14/2021] [Accepted: 02/03/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Many psychological and obstetrical factors contribute to the development of postpartum depression. However, little is known about how postpartum hemorrhage (PPH) influences postpartum depressive symptoms. This study explored the relationship between PPH and postpartum depressive symptoms in the Chinese population. METHODS A retrospective cohort study was conducted at the Baoan Maternal and Child Health Hospital in Shenzhen, China, from January 2016 to June 2020. The Edinburgh Postnatal Depression Scale was used to assess postpartum depressive symptoms. A multivariate logistic regression model was used to estimate the odds ratios (ORs) with 95% confidence intervals (95% CIs) between PPH and risk of postpartum depressive symptoms. RESULTS Of the 7734 respondents, 293 (3.8%) and 7441 were in the PPH and control groups, respectively. Puerperal women with PPH were more likely to screen positive for postpartum depressive symptoms than those without PPH (16.4% vs. 11.7%, p = .016). Adjusting for other covariates, women with PPH still had higher risk of postpartum depressive symptoms (OR = 1.68, 95% CI: 1.16-2.42). Stratification analyses revealed no interaction between PPH and maternal age, prepregnancy body mass index, mode of delivery, and fetal sex in developing depressive symptoms (p for interaction > .05). CONCLUSIONS PPH may increase the risk of postpartum depressive symptoms. Therefore, women with PPH should be actively screened for depressive symptoms in the immediate postpartum period.
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Affiliation(s)
- Kewei Wang
- Department of Children's Intensive Research Center, Hunan Children's Hospital, Changsha, China
| | - Jun Qiu
- Department of Children's Intensive Research Center, Hunan Children's Hospital, Changsha, China
| | - Liping Meng
- Department of Public Health, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, China
| | - Xin Lai
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhenzhen Yao
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Songxu Peng
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
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Jiang Q, Guo Y, Zhang E, Cohen N, Ohtori M, Sun A, Dill SE, Singh MK, She X, Medina A, Rozelle SD. Perinatal Mental Health Problems in Rural China: The Role of Social Factors. Front Psychiatry 2021; 12:636875. [PMID: 34950062 PMCID: PMC8688533 DOI: 10.3389/fpsyt.2021.636875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 11/08/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Perinatal mental health is important for the well-being of the mother and child, so the relatively high prevalence of perinatal mental health problems in developing settings poses a pressing concern. However, most studies in these settings focus on the demographic factors associated with mental health problems, with very few examing social factors. Hence, this study examines the prevalence of the depressive, anxiety and stress symptoms among pregnant women and new mothers in rural China, and the associations between these mental health problems and social factors, including decision-making power, family conflicts, and social support. Methods: Cross-sectional data were collected from 1,027 women in their second trimester of pregnancy to 6 months postpartum in four low-income rural counties in Sichuan Province, China. Women were surveyed on symptoms of mental health problems using the Depression, Anxiety, and Stress Scale (DASS-21) and social risk factors. Multivariate logistic regression analyses were conducted to examine social risk factors associated with maternal mental health problems, with results reported as odds ratios (OR) and 95% confidence intervals (CI). Results: Among all respondents, 13% showed symptoms of depression, 18% showed symptoms of anxiety, 9% showed symptoms of stress, and 23% showed symptoms of any mental health problem. Decision-making power was negatively associated with showing symptoms of depression (OR = 0.71, CI: 0.60-0.83, p < 0.001) and stress (OR = 0.76, CI: 0.63-0.90, p = 0.002). Family conflict was positively associated with depression (OR = 1.53, CI: 1.30-1.81, p < 0.001), anxiety (OR = 1.34, CI: 1.15-1.56, p < 0.001), and stress (OR = 1.68, CI: 1.41-2.00, p < 0.001). In addition, social support was negatively associated with depression (OR = 0.56, CI: 0.46-0.69, p < 0.001), anxiety (OR = 0.76, CI: 0.63-0.91, p = 0.002), and stress (OR = 0.66, CI: 0.53-0.84, p < 0.001). Subgroup analyses revealed that more social risk factors were associated with symptoms of anxiety and stress among new mothers compared to pregnant women. Conclusion: Perinatal mental health problems are relatively prevalent among rural women in China and are strongly associated with social risk factors. Policies and programs should therefore promote individual coping methods, as well as target family and community members to improve the social conditions contributing to mental health problems among rural women.
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Affiliation(s)
- Qi Jiang
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Yian Guo
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Evelyn Zhang
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Nourya Cohen
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Mika Ohtori
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Adrian Sun
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Sarah-Eve Dill
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Manpreet Kaur Singh
- Stanford Pediatric Mood Disorders Program, Stanford University, Stanford, CA, United States
| | - Xinshu She
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Alexis Medina
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Scott D. Rozelle
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
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Ruohomäki A, Toffol E, Airaksinen V, Backman K, Voutilainen R, Hantunen S, Tuomainen TP, Lampi J, Kokki H, Luoma I, Kumpulainen K, Heinonen S, Keski-Nisula L, Pekkanen J, Pasanen M, Lehto SM. The impact of postpartum depressive symptoms on self-reported infant health and analgesic consumption at the age of 12 months: A prospective cohort study. J Psychiatr Res 2021; 136:388-397. [PMID: 33640540 DOI: 10.1016/j.jpsychires.2021.02.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/14/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/26/2022]
Abstract
The infants of mothers with elevated depressive symptoms (EDS) postpartum appear to be at increased risk of somatic health problems during their first 12 months of life in low- and lower-middle-income countries. However, in higher-income countries, knowledge of this association is scarce. We sought to examine whether maternal reports of infant health problems, adherence to vaccination schedules and analgesic supply to the infant during the first 12 months of life differ between mothers with and without postpartum EDS. Altogether, 969 women who were enrolled in the Kuopio Birth Cohort study (www.kubico.fi) during 2012-2017 were included in this investigation. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale during pregnancy (1st and/or 3rd trimester) and at eight weeks postpartum. Infant health data were collected as a part of a 12-month online follow-up questionnaire for mothers and were based on self-reports of either maternal observations or physician-determined diagnoses. Postpartum EDS were associated with a 2- to 5-fold increased likelihood of abnormal crying and paroxysmal wheezing (based on parental observations), as well as gastroesophageal reflux and food allergy (based on physician-determined diagnoses). Mothers with postpartum EDS also supplied their infants with analgesic medication for longer periods. Adherence to vaccination schedules was similar between the examined groups. In conclusion, infants of mothers with postpartum EDS may be more likely to experience health problems or to be perceived by their mother as having health problems, and thus receive more medications.
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Affiliation(s)
- Aleksi Ruohomäki
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland.
| | - Elena Toffol
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, P.O. Box 20, FI, 00014, Helsinki, Finland
| | - Ville Airaksinen
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Katri Backman
- Institute of Clinical Medicine / Pediatrics, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Raimo Voutilainen
- Institute of Clinical Medicine / Pediatrics, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Jussi Lampi
- Department of Health Security, National Institute for Health and Welfare, P.O. Box 95, FI, 70701, Kuopio, Finland
| | - Hannu Kokki
- Institute of Clinical Medicine / Anaesthesiology, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Ilona Luoma
- Institute of Clinical Medicine / Child Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland; Department of Child Psychiatry, Kuopio University Hospital, P.O. Box 100, FI, 70029, Kuopio, Finland
| | - Kirsti Kumpulainen
- Institute of Clinical Medicine / Child Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynaecology, University of Helsinki, P.O. Box 22, FI, 00014, Helsinki, Finland; Department of Obstetrics and Gynaecology, Helsinki University Hospital, P.O. Box 140, FI, 00029, Helsinki, Finland
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynaecology, Kuopio University Hospital, P.O. Box 100, FI, 70029, Kuopio, Finland; Institute of Clinical Medicine / Obstetrics and Gynaecology, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Juha Pekkanen
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, P.O. Box 20, FI, 00014, Helsinki, Finland; Department of Health Security, National Institute for Health and Welfare, P.O. Box 95, FI, 70701, Kuopio, Finland
| | - Markku Pasanen
- Faculty of Health Sciences, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland; Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, FI, 00014, Helsinki, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, FI, 00014, Helsinki, Finland
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11
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Peng S, Lai X, Du Y, Meng L, Gan Y, Zhang X. Prevalence and risk factors of postpartum depression in China: A hospital-based cross-sectional study. J Affect Disord 2021; 282:1096-1100. [PMID: 33601683 DOI: 10.1016/j.jad.2021.01.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 12/05/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is a major public health problem worldwide, which adversely affects maternal and infant health. The purpose of this study was to determine the prevalence and related factors of postpartum depression in Chinese puerperium women. METHODS A cross-sectional study was conducted in Baoan Maternal and Child Health Hospital located in the west of Shenzhen, China. The Chinese version of the Edinburgh Postpartum Depression Scale (EPDS) was used to screen PPD. A score of ≥10 was used as the threshold of postpartum depression. RESULTS A total of 4813 puerperal women were included in this study, 11.5% of whom were considered to have PPD. Multivariate logistic regression analysis found that family history of mental illness (OR = 1.94; 95% CI, 1.05-3.57; P = 0.033), living with parents-in-law (OR = 1.41; 95% CI, 1.16-1.72; P < 0.001), anxiety during pregnancy (OR = 3.66; 95% CI, 2.97-4. 52; P < 0.001), depression during pregnancy (OR = 4.25; 95% CI, 3.28-5.50; P < 0.001), and stressful life events (OR = 1.50; 95% CI, 1.03-2.20; P = 0.036) were associated with the high prevalence of PPD. LIMITATIONS The cross-sectional survey cannot assess direct causality. EPDS is just a screening tool and not a diagnostic one. CONCLUSION Postpartum depression is a common disease in Chinese puerperal population. High-risk pregnant women with postpartum depression need routine screening and targeted intervention for PPD.
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Affiliation(s)
- Songxu Peng
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Xin Lai
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Yukai Du
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Liping Meng
- Department of Public Health, Baoan Maternal and Child Health Hospital, Jinan University, 21 Yu'an second Road, Baoan District, Shenzhen, 518101, China.
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan 430030, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China.
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12
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El Sayed S, Aljehani Y, Alanzi M, Aljehani S, Saleem A, Alraddadi SR, Alblowi R, Aly H. Impact of pregnancy outcomes on postpartum depression among women attending primary health-care centers in Al-Madina Al-Munawarah, Saudi Arabia. Saudi J Health Sci 2021. [DOI: 10.4103/sjhs.sjhs_247_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Soghier LM, Kritikos KI, Carty CL, Glass P, Tuchman LK, Streisand R, Fratantoni KR. Parental Depression Symptoms at Neonatal Intensive Care Unit Discharge and Associated Risk Factors. J Pediatr 2020; 227:163-169.e1. [PMID: 32681990 DOI: 10.1016/j.jpeds.2020.07.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 10/11/2019] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To investigate the prevalence and risk factors associated with parental depressive symptoms at neonatal intensive care unit (NICU) discharge and determine the relationships among depressive symptoms, stress, and social support. STUDY DESIGN Parents participating in the Giving Parents Support trial (n = 300) were surveyed before NICU discharge. Depressive symptoms, stress, and social support were assessed using the Center for Epidemiological Studies Depression Scale (CESD-10), Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU), Perceived Stress Scale (PSS-10), and Multidimensional Scale of Perceived Social Support (MSPSS). Regression analyses examined relationships among depressive symptoms, stress, social support, and parent/infant factors. RESULTS At NICU discharge, 45% of parents reported depressive symptoms and 43% reported elevated perceived stress. Increased odds of elevated depressive symptoms were associated with older gestational age (P = .02), female infant (P = .02), and longer length of stay (P = .045). Odds of depression were 7.87 (95% CI, 2.15-28.75) for parents of infants with gestational age ≥37 weeks compared with gestational age <28 weeks. Parental NICU stress was higher in younger parents (P < .01). Depressive symptoms were positively associated with parental stress. Each 1-point increase in PSS:NICU score was associated with a 2.1-point (95% CI, 1.6-2.9; P < .001) increase in CESD-10 score. Social support was inversely associated with depressive symptoms. CONCLUSION The prevalence of depressive symptoms in parents at NICU discharge was high, even among parents of term infants. Older gestational age, greater parental stress, and lower levels of social support were strong correlates of depressive symptoms. Strategies to support parents, including depression screening, stress reduction strategies, and mental health referrals, are needed.
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Affiliation(s)
- Lamia M Soghier
- Department of Neonatology, Children's National Hospital, Washington, DC; Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC.
| | - Katherine I Kritikos
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC
| | - Cara L Carty
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC
| | - Penny Glass
- Department of Neonatology, Children's National Hospital, Washington, DC; Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC
| | - Lisa K Tuchman
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Adolescent and Young Adult Medicine, Children's National Hospital, Washington, DC
| | - Randi Streisand
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC
| | - Karen R Fratantoni
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Division of General and Community Pediatrics, Children's National Hospital, Washington, DC
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14
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Nisar A, Yin J, Waqas A, Bai X, Wang D, Rahman A, Li X. Prevalence of perinatal depression and its determinants in Mainland China: A systematic review and meta-analysis. J Affect Disord 2020; 277:1022-1037. [PMID: 33065811 DOI: 10.1016/j.jad.2020.07.046] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [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: 12/24/2019] [Revised: 05/16/2020] [Accepted: 07/05/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Perinatal depression is a maternal mental health condition that is associated with various adverse health outcomes both for the mothers and the babies. The study aim was to estimate the prevalence of perinatal depression and its risks and determinants in Mainland China. METHODS Systematic searches were conducted in 10 major databases and random effect meta-analysis was performed to achieve the pooled variance of perinatal depression. Subgroup analyses were conducted based on region, scale, methods of diagnosis and study design. Meta-regression was performed with the variables such as age, quality assessment score and gross domestic product (GDP) of the province. RESULTS Pooled prevalence of perinatal depression was 16.3% (CI=95%; 14.7% to 18.2%, P < 0.001), with antenatal depression 19.7% (CI=95%; 15.8% to 24.2%, P < 0.001) and postnatal depression 14.8% (CI=95%; 13.1% to 16.6%, P < 0.001). Significant publication bias was found and heterogeneity was I2= 98.13%. Lower socioeconomic status, poor physical health, anxiety about pregnancy and reduced social support were major risk factors while better living conditions and higher level of education were protective factors. The prevalence of perinatal depression showed a significant increasing trend in the last decade. LIMITATIONS The review does not include studies with small sample size (n <250). Moreover a narrative review of risk and protective factors was done, these were not included in meta-analysis. CONCLUSION The prevalence of perinatal depression in China is similar to low and middle-income countries. Urgent attention is needed to address this public health priority in China.
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Affiliation(s)
| | - Juan Yin
- Xi'an Jiaotong University, Xi'an, China
| | - Ahmed Waqas
- University of Liverpool, Liverpool, United Kingdom; Human Development Research Foundation, Islamabad, Pakistan
| | - Xue Bai
- Xi'an Jiaotong University, Xi'an, China
| | - Duolao Wang
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Atif Rahman
- University of Liverpool, Liverpool, United Kingdom
| | - Xiaomei Li
- Xi'an Jiaotong University, Xi'an, China.
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Zejnullahu VA, Ukella-Lleshi D, Zejnullahu VA, Miftari E, Govori V. Prevalence of postpartum depression at the clinic for obstetrics and gynecology in Kosovo teaching hospital: Demographic, obstetric and psychosocial risk factors. Eur J Obstet Gynecol Reprod Biol 2020; 256:215-220. [PMID: 33248376 DOI: 10.1016/j.ejogrb.2020.11.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Postpartum depression affects 10 up to 15 % of women of childbearing age in industrialized countries and presents significant public health problem which leads to short and long-term consequences for mother, child and her family. However, social determinants, including poverty, gender stereotypes, domestic violence, gender discrimination and cultural differences make this medical issue more problematic in less developed countries. The aim of this study was to examine the prevalence and risk factors of postpartum depression at the Clinic for Obstetrics and Gynecology in Pristina, Kosovo (a tertiary referral center). MATERIAL AND METHODS A prospective observational cohort study was conducted from June 2019 to October 2019 at the Clinic for Obstetrics and Gynecology in Pristina, Kosovo. A total of 247 delivery women were screened for postpartum depression at 6 weeks following delivery using the Edinburg Postnatal Depression Scale (EPDS). Socio-demographic, obstetric and psychologic factors were tested as predictors of PPD using bivariate or multivariate logistic regression analysis (Logit model). Odds ratio (OR) with 95 % confidence intervals were calculated for each risk factor. The p values < 0.05 were considered statistically significant. RESULTS The prevalence of PPD at the Clinic for Obstetrics and Gynecology in Kosovo teaching hospital was 21 % at 6 weeks following childbirth. The bivariate and multivariate logistic regression analysis identified four predictor variables for postpartum depression: pregnancy complications (OR 1.057; 95 % CI; 1.002-1.114 and P = 0.040); fear of childbirth (OR 1.121; 95 % CI; 1.057-1.190 and P = 0.00016); prenatal depression or anxiety (OR 1.088; 95 % CI; 1.032-1.147 and P = 0.0018); poor marital relation (OR 1.085, 95 % CI; 1.002-1.174 and P = 0.044). No statistically significant association was found between the postpartum depression (PPD) and maternal age, education, employment, family type, smoking, previous abortion, parity, household income, social support, child gender, birthweight, and breast feeding. CONCLUSIONS The high prevalence of postpartum depression in our setting and its known adverse effects on woman, infant and her family implies an urgent need for evidence-based interventions. Such interventions are needed to promote knowledge of perinatal mental illness and improve maternal mental health in particular in less developed countries. Future efforts should address early identification of high-risk women, assessment of risk factor during the antenatal period, early postpartum depression screening and timely therapeutic approaches, to improve social and psychological functioning of the woman.
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Affiliation(s)
- Vjosa A Zejnullahu
- Department of Obstetrics and Gynecology, University Clinical Center of Kosovo, Pristina, Kosovo, Albania
| | - Dardane Ukella-Lleshi
- Department of Obstetrics and Gynecology, University Clinical Center of Kosovo, Pristina, Kosovo, Albania
| | - Valon A Zejnullahu
- Department of Abdominal Surgery, University Clinical Center of Kosovo, Pristina, Kosovo, Albania
| | - Ermira Miftari
- Department of Obstetrics and Gynecology, University Clinical Center of Kosovo, Pristina, Kosovo, Albania
| | - Valbona Govori
- Department of Neuropsychiatry, University Clinical Center of Kosovo, Pristina, Kosovo, Albania.
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Yao J, Song T, Zhang Y, Guo N, Zhao P. Intraoperative ketamine for reduction in postpartum depressive symptoms after cesarean delivery: A double-blind, randomized clinical trial. Brain Behav 2020; 10:e01715. [PMID: 32812388 PMCID: PMC7507540 DOI: 10.1002/brb3.1715] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 05/10/2020] [Accepted: 05/19/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a common mental disease happens in perinatal period. Ketamine as an anesthesia and analgesia drug has been used for a long time. In recent years, ketamine is proved to have an antidepression effect with a single administration. We hypothesized that intraoperative ketamine can reduce postpartum depressive symptoms after cesarean delivery. METHODS In a randomized, double-blind, placebo-controlled study trail, healthy women scheduled for cesarean delivery were randomly assigned to receive intravenous ketamine (0.25 mg/kg diluted to 5 ml with 0.9% saline) or placebo (5 ml of 0.9% saline) within 5 min following clamping of the neonatal umbilical cord. The primary outcome was the degree of postpartum depressive symptoms, which was evaluated by Edinburgh Postnatal Depression Scale (EPDS, a threshold of 9/10 was used) at 1 week, 2 weeks, and 1 month after delivery. The secondary outcome was the numerical rating scale (NRS) score of pain at 2 days postpartum. This trail is registered in the Chinese Clinical Trial Registry, number ChiCTR1900022464. RESULTS Between 26 January 2019 and 15 July 2019, 502 subjects were screened and 330 were randomly allocated: 165 (50%) to the ketamine group and 165 (50%) to the placebo group. There were significant differences in the degree of postpartum depressive symptoms between subjects in the ketamine group and the placebo group at 1 week postpartum (13.1% vs. 22.6%, respectively; p = .029). However, no difference was found between subjects in the two groups at 2 weeks (11.8% vs. 16.8%, respectively; p = .209) and 1 month postpartum (10.5% vs. 14.2%, respectively; p = .319). The NRS score of wound pain (3.0 ± 0.9 vs. 4.0 ± 1.0, respectively; p < .001) and uterine contraction pain (3.0 ± 0.9 vs. 4.1 ± 0.9, respectively; p < .001) was lower in the ketamine group at 2 days postpartum compared with placebo group. The prevalence of headache, hallucination, and dizziness was higher in the ketamine group than the placebo group during the operation. CONCLUSIONS Operative intravenous ketamine (0.25 mg/kg) can reduce the postpartum depressive symptoms for 1 week. The long-time effect is remained to be seen.
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Affiliation(s)
- Jiaxin Yao
- The Second Department of AnesthesiaShengjing Hospital of China Medical UniversityShenyangChina
| | - Tingting Song
- The Second Department of AnesthesiaShengjing Hospital of China Medical UniversityShenyangChina
| | - Yue Zhang
- The Second Department of AnesthesiaShengjing Hospital of China Medical UniversityShenyangChina
| | - Nan Guo
- The Second Department of AnesthesiaShengjing Hospital of China Medical UniversityShenyangChina
| | - Ping Zhao
- The Second Department of AnesthesiaShengjing Hospital of China Medical UniversityShenyangChina
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Ye Z, Wang L, Yang T, Chen LZ, Wang T, Chen L, Zhao L, Zhang S, Luo L, Qin J. Gender of infant and risk of postpartum depression: a meta-analysis based on cohort and case-control studies. J Matern Fetal Neonatal Med 2020; 35:2581-2590. [PMID: 32635787 DOI: 10.1080/14767058.2020.1786809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/24/2022]
Abstract
BACKGROUND It is inconclusive nowadays for the association between infant's gender and their mothers' risk of developing postpartum depression (PPD). In addition, a complete overview is missing. A meta-analysis of cohort and case-control studies was performed to address the question of whether women who gave birth to a female infant were at an increased risk of developing PPD, compared with those giving birth to a male infant. METHODS Unrestricted searches were conducted, with an end date parameter of 31 January 2018, of PubMed, Embase, Google Scholar, Cochrane Libraries, and Chinese databases, to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. RESULTS Twenty-three studies involving 119,736 women were included for analysis. Overall, mothers who gave birth to a female infant experienced a significantly increased risk of developing PPD compared with the reference group (OR = 1.15, 95%CI: 1.01-1.31; p = .03). However, substantial heterogeneity (p < .00001; I2 = 75%) was observed across studies. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed. CONCLUSIONS Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, the present study suggests women giving birth to a girl are associated with a higher risk of developing PPD when compared with those giving birth to a boy. Improving family and social communication and reducing gender preference should be important components of any such interventions.Statement of significanceProblem or issue Interestingly, the known risk factors leading to PPD are basically the same in different regions and cultures, but the gender of the infant seems to be an exception.What is already known Some studies conducted in traditional western countries indicated that there is a weak or null association between infant's gender and risk of PPD, while others suggested a positive association. In contrast, studies conducted in Nigeria, India, Turkey and China showed that mothers giving birth to a female infant were at a higher risk of developing PPD.What this paper adds Today, the association between infant's gender and risk of developing postpartum depression (PPD) is still uncertain; additionally, a complete overview is missing. Our study represents the first meta-analysis of risk of PPD associated with infant's gender.
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Affiliation(s)
- Ziwei Ye
- Central South University, Changsha, China
| | - Lesan Wang
- Central South University, Changsha, China
| | - Tubao Yang
- Central South University, Changsha, China
| | | | | | - Letao Chen
- Central South University, Changsha, China
| | | | | | - Liu Luo
- Central South University, Changsha, China
| | - Jiabi Qin
- Central South University, Changsha, China
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Sun J, Xiao Y, Zou L, Liu D, Huang T, Zheng Z, Yan X, Yuan A, Li Y, Huang X. Epidural Labor Analgesia Is Associated with a Decreased Risk of the Edinburgh Postnatal Depression Scale in Trial of Labor after Cesarean: A Multicenter, Prospective Cohort Study. Biomed Res Int 2020; 2020:2408063. [PMID: 32025517 DOI: 10.1155/2020/2408063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/13/2019] [Indexed: 02/02/2023]
Abstract
Postpartum depression is a disabling mental disorder commonly seen in parturients under trial of labor after cesarean, which causes serious harm to the parturients. The etiology is unclear. We hypothesized that epidural labor analgesia can reduce the incidence rate of postpartum depression. Enrolled multiparas were divided into the epidural labor analgesia group (n = 263) or nonanalgesia group (n = 160) according to their own request. Edinburgh Postnatal Depression Scale was used to assess their mental status at 48 hours and 42 days after delivery. Relative perinatal variables were collected and further analyzed using univariate analysis and multivariate logistic regression analysis to assess the relation of epidural analgesia with the occurrence of postpartum depression under trial of labor after cesarean. The Edinburgh Postnatal Depression Scale score 48 hours ≥ 10 in the no epidural analgesia group was 26.42% while the epidural analgesia group was 8.49% (OR, 0.209; 95% CI, 0.096–0.429; P < 0.001). The Edinburgh Postnatal Depression Scale score 42 day ≥ 10 in the no epidural analgesia group was 25.16% while the epidural analgesia group was 6.59% (OR, 0.235; 95% CI, 0.113–0.469; P < 0.001). The incidence of postpartum depression was significantly lower in the epidural labor analgesia group at 48 hours and 42 days. There was also a significant relation between the Edinburgh Postnatal Depression Scale scores at 48 hours and 42 days after delivery. Epidural analgesia, discomfort within 42 days, and self-rating anxiety scale are independent predictors of postpartum depression for trial of labor after cesarean in 42 days. Epidural labor analgesia is associated with a decreased risk of postpartum depression. Further study with a large sample size and more centers is needed to evaluate the impact of epidural analgesia on the occurrence of postpartum depression. Chinese Clinical Trial Register, ChiCTR-ONC-17010654.
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Wang YY, Li X, Duan Z, Wilkinson MR, Yu R, Li S, Huang L, Guo Y, Ma L, Dong Q, Sun J, Yang X, Tao Y, Lv Y, Yang Y, Chen R. Screening for postpartum hypomania among Chinese women after childbirth. Psychiatry Res 2019; 282:112591. [PMID: 31703981 DOI: 10.1016/j.psychres.2019.112591] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 04/26/2019] [Revised: 09/27/2019] [Accepted: 09/29/2019] [Indexed: 12/12/2022]
Abstract
This study examines the prevalence and risk factors for postpartum hypomania in women after childbirth as well as examining the potential influence of personality traits in relation to experiencing symptoms of postpartum hypomania. A total of 1022 women no later than 1 month post-birth were recruited in Suzhou, China, between March 2017 and December 2018. Hypomanic symptoms were assessed with the Hypomania Checklist-32 (HCL-32), and a total score of 14 or higher was defined as having hypomanic symptoms. We found 43.6% of the women in our sample had hypomanic symptoms. The results of multiple logistic regression showed that rural residence [p = 0.01, odds ratio (OR) = 0.7, 95% confidence interval (CI) = 0.5-0.9], education background (p = 0.005, OR = 0.6, 95% CI = 0.5-0.9), marriage satisfaction (p = 0.048, OR = 0.9, 95% CI =0.8-1.0), Pittsburgh Sleep Quality Index (PSQI) (p = 0.001, OR = 0.9, 95% CI = 0.9-1.0), Eysenck Personality Questionnaire-Extraversion (p < 0.001, OR = 1.2, 95% CI = 1.1-1.2), Eysenck Personality Questionnaire-Lie (p = 0.01, OR = 0.9, 95% CI = 0.9-1.0), and General Anxiety Disorder-7 (p = 0.02, OR = 1.1, 95% CI = 1.0-1.1) were independently associated with exhibiting hypomanic symptoms. The current study provided insights into hypomanic symptoms in Chinese postpartum women. We also found that extraversion and lie personality were significantly associated with an increased risk of hypomanic symptoms in postpartum women. It is urgent to arrange screening for women at risk of developing postpartum hypomania as soon as possible after giving birth and at regular intervals in the first 6 months to prevent the women developing psychological disorders such as depression and bipolar disorder later on.
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Affiliation(s)
- Yuan-Yuan Wang
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Xiaohong Li
- Suzhou Science & Technology Town Hospital, Jiangsu Province, PR China
| | - Zhizhou Duan
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders & Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing 100088, PR China; School of Health Sciences, Wuhan University, Wuhan, Hubei Province, PR China
| | - Meredith R Wilkinson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Renjie Yu
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, Jiangsu Province 215137, PR China
| | - Shun Li
- Gusu District Wumenqiao Street Canglang Xincheng Community Health Service Center, Jiangsu Province, PR China
| | - Liming Huang
- Suzhou Science & Technology Town Hospital, Jiangsu Province, PR China
| | - Yan Guo
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, Jiangsu Province 215137, PR China
| | - Ling Ma
- Suzhou Science & Technology Town Hospital, Jiangsu Province, PR China
| | - Qin Dong
- Suzhou Science & Technology Town Hospital, Jiangsu Province, PR China
| | - Jue Sun
- Gusu District Wumenqiao Street Canglang Xincheng Community Health Service Center, Jiangsu Province, PR China
| | - Xiaonan Yang
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, Jiangsu Province 215137, PR China
| | - Ye Tao
- Suzhou Science & Technology Town Hospital, Jiangsu Province, PR China
| | - Yongliang Lv
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, Jiangsu Province 215137, PR China
| | - Yong Yang
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, Jiangsu Province 215137, PR China.
| | - Runsen Chen
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders & Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing 100088, PR China; Department of Psychiatry, University of Oxford, Oxford, UK.
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20
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Abstract
Despite people emphasizing their luck of having healthy baby, many secretly mourn for not having a baby which they preferred leading to gender disappointment. Hence, it is critical to explore factors contributing to gender disappointment particularly girl child which is pervasive in Asian countries. The study analyzes the variation in gender disappointment among different genders and age groups using percentage analysis and also employs structural equation modeling (SEM) to determine the direct factors and moderators contributing to gender disappointment. The findings reveal that societal pressure, cultural factors, economic expectancy, and safety expectancy significantly explain the gender disappointment with girl child. Neuroticism, conscientiousness, extraversion, and intellect were found to be the most significant personality bias moderators. The findings of the study give an insight for the government in designing awareness programs and free counseling programs to persuade people with different personalities to suppress gender disappointment, thereby enhancing women's mental health. Focusing on exploring the factors causing gender disappointment with girl babies, the role of personality in explaining gender disappointment and variation in gender disappointment between different genders and age groups makes the study unique from other research contributions. It also gives an insight for the government to create awareness programs and free counseling programs among people to eradicate these issues for the well-being of the society.
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Affiliation(s)
- P Theerthaana
- MBA Department, College of Engineering, Guindy, Anna University, Chennai, Tamil Nadu, India.
| | - A K Sheik Manzoor
- MBA Department, College of Engineering, Guindy, Anna University, Chennai, Tamil Nadu, India
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21
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Ding G, Niu L, Vinturache A, Zhang J, Lu M, Gao Y, Pan S, Tian Y. "Doing the month" and postpartum depression among Chinese women: A Shanghai prospective cohort study. Women Birth 2019; 33:e151-e158. [PMID: 31060983 DOI: 10.1016/j.wombi.2019.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND The Chinese postpartum custom of "doing the month" characterized by generous social support available through the traditional cultural practices was considered to protect women from postpartum depression in early puerperium. METHODS This study used data from the Shanghai Birth Cohort, a study of 2615 postpartum women from Shanghai, China, that was conducted between 2013 and 2016. Detailed information on the traditional "doing the month" practices and the on the Edinburgh Postnatal Depression Scale scores was collected from questionnaires administered on the 42nd day after childbirth. Logistic regression models were used to examine the association between the adopting traditional puerperium practices and postpartum depression. RESULTS The estimated prevalence of postpartum depression in women from the Shanghai area in China was 11.8% (n = 308) at six weeks postpartum. Women who went outside their homes during the first month postpartum showed higher risks of postpartum depression compared with those who never left the house (1-2 times: OR = 1.9, 95% CI = 1.4-2.4; 3-5 times: OR = 2.3, 95% CI = 1.5-3.5; ≥6 times: OR = 2.5, 95% CI = 1.2-5.1). Women with average sleep of 6 h or less per night were more likely to suffer from postpartum depression compared with those who slept 8 h (6 h: OR = 1.7, 95% CI = 1.2-2.4; less than 6 h : OR = 3.3, 95% CI = 2.2-5.0). Women who opened the house windows most of the time exhibited decreased risks of postpartum depression compared to those who never or rarely opened the windows (often: OR = 0.6, 95% CI = 0.4-0.9; always: OR = 0.4, 95% CI = 0.3-0.7). CONCLUSIONS Our results suggested that not all the activities of "doing the month" provided protection against developing PPD. This study emphasized the need for flexibility to fit and adjust the ritual into the modern life to enhance the positive effects of traditional practices on maternal health.
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Affiliation(s)
- Guodong Ding
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
| | - Lei Niu
- Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Angela Vinturache
- Department Obstetrics & Gynecology, St. George's Hospital, St. George's University Hospitals NHS Foundation Trust, London, UK.
| | - Jun Zhang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Lu
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
| | - Yu Gao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Shuming Pan
- Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ying Tian
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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22
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Pampaka D, Papatheodorou SI, AlSeaidan M, Al Wotayan R, Wright RJ, Buring JE, Dockery DW, Christophi CA. Postnatal depressive symptoms in women with and without antenatal depressive symptoms: results from a prospective cohort study. Arch Womens Ment Health 2019; 22:93-103. [PMID: 29971553 DOI: 10.1007/s00737-018-0880-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 12/13/2017] [Accepted: 06/22/2018] [Indexed: 01/01/2023]
Abstract
Evidence exists that the risk factors for depression in the antenatal and postnatal period may differ, but only a handful of studies looked at depression longitudinally. The aims of this study were (1) to estimate the prevalence of postnatal depressive symptoms in Kuwait where data about postnatal depression are scarce and identify its determinants and (2) to compare these risk factors between women who had experienced antenatal depressive symptoms and those that did not. Data collected in the TRansgenerational Assessment of Children's Environmental Risk (TRACER) Study in Kuwait were used in this analysis. The sample was restricted to the 1348 women who answered the Edinburgh Postnatal Depression Scale (EPDS) both antenatally and postnatally. The prevalence of postnatal depressive symptoms, defined by an EPDS score ≥ 10, was 11.7%. Overall, antenatal depressive symptoms were the strongest determinant of postnatal depressive symptoms. Multivariable logistic regression analysis showed that in women with depressive symptoms in pregnancy, having a lower household income was the most significant risk factor for postnatal depressive symptoms. Among women without antenatal depressive symptoms, those who had lower income, were Kuwaitis, experienced other problems in pregnancy such as perceived stress, PTSD symptoms and social isolation, and those who delivered a boy had higher odds of postnatal depressive symptoms. Antenatal depressive symptoms and other psychosocial characteristics can predict postnatal depressive symptoms. Therefore, maternal mental health issues should be detected during the antenatal period and support should be provided in order to lower the risk of postnatal depression and its sequelae.
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Affiliation(s)
- Despina Pampaka
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.
| | - Stefania I Papatheodorou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus
| | | | | | - Rosalind J Wright
- Department of Pediatrics and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Douglas W Dockery
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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23
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Myers S, Johns SE. Male infants and birth complications are associated with increased incidence of postnatal depression. Soc Sci Med 2019; 220:56-64. [DOI: 10.1016/j.socscimed.2018.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/18/2018] [Accepted: 10/14/2018] [Indexed: 12/13/2022]
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24
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Mori E, Iwata H, Maehara K, Sakajo A, Tamakoshi K. Relationship between the mode of conception and depressive symptoms during the first 6 months post-partum in Japan. Reprod Med Biol 2018; 17:275-282. [PMID: 30013429 PMCID: PMC6046529 DOI: 10.1002/rmb2.12101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 03/08/2018] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To determine whether conventional treatment and assisted reproductive technology for infertility are associated with depressive symptoms and to identify the predictors of depressive symptoms during the first 6 months' post-partum. METHODS A prospective cohort design was used, with the participants being recruited from 13 Japanese hospitals. Using self-report questionnaires, a total of 2709 women (response rate: 71.9%) provided longitudinal data at five time points: during their hospital stay and at 1, 2, 4, and 6 months' post-partum. The depressive symptoms were measured by using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS). A logistic regression analysis was used to examine the association between the mode of conception and depressive symptoms and to identify the predictors of the depressive symptoms. RESULTS There was no significant association between the mode of conception and the depressive symptoms at any time point. Six factors that were associated with the EPDS score were first-time childbirth, emergency cesarean delivery, infant feeding, financial burden, having a male infant, and dissatisfaction with social support. CONCLUSION There was no significant relationship between the mode of conception and depressive symptoms. Nursing care should be based on individual assessments that focus on parity, the delivery method, infant feeding method, financial burden, the infant's sex, and social support, rather than on the mode of conception.
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Affiliation(s)
- Emi Mori
- Department of Health Promotion NursingGraduate School of NursingChiba UniversityChibaJapan
| | - Hiroko Iwata
- Department of Health Promotion NursingGraduate School of NursingChiba UniversityChibaJapan
| | - Kunie Maehara
- Department of Health Promotion NursingGraduate School of NursingChiba UniversityChibaJapan
| | - Akiko Sakajo
- Department of Health Promotion NursingGraduate School of NursingChiba UniversityChibaJapan
| | - Koji Tamakoshi
- Department of NursingGraduate School of MedicineNagoya UniversityNagoyaJapan
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25
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Shi P, Ren H, Li H, Dai Q. Maternal depression and suicide at immediate prenatal and early postpartum periods and psychosocial risk factors. Psychiatry Res 2018; 261:298-306. [PMID: 29331710 DOI: 10.1016/j.psychres.2017.12.085] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [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: 11/07/2016] [Revised: 07/01/2017] [Accepted: 12/31/2017] [Indexed: 01/27/2023]
Abstract
Maternal depression has been intensively explored; however, less attention has been paid to maternal suicide. No studies to date have observed maternal depression and suicide at immediate prenatal and early postpartum stages. In total, 213 Chinese women were recruited in hospitals after they were admitted for childbirth. All completed a short-term longitudinal survey at perinatal stages. Women reported lower depression scores (6.65) and higher suicidal ideation incidence (11.74%) after childbirth. Prenatal depression raised the possibility of prenatal suicidal ideation, while prenatal depression and suicidal ideation increased postpartum depression and suicidal ideation. At immediate prenatal stage, marital satisfaction protected women from depression, while miscarriage experiences and self-esteem increased the risk. At early postpartum stage, in contrast, being first-time mother, marital satisfaction, and harmony with mother-in-law prevented them from depression. Our study is among the first to confirm that women have decreased depression but increased suicidal ideation at early postpartum, and a causal relationship between them, which are worthy of public attention. Potential protective (marital satisfaction, being first-time mother, and harmony with mother-in-law) or risk factors (miscarriage experiences and self-esteem) of maternal depression and suicidal ideation are identified at perinatal stages. This offers reliable guidance for clinical practice of health care.
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Affiliation(s)
- Peixia Shi
- Department of nursing psychology, the Third Military Medical University, Chong qing 400038, China
| | - Hui Ren
- Department of nursing, the Third Military Medical University, Chong qing 400038, China
| | - Hong Li
- Psychology & Social College, Shenzhen University, Shenzhen 518060, China
| | - Qin Dai
- Department of nursing psychology, the Third Military Medical University, Chong qing 400038, China; Psychology & Social College, Shenzhen University, Shenzhen 518060, China.
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26
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Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries. Front Psychiatry 2018; 8:248. [PMID: 29449816 PMCID: PMC5799244 DOI: 10.3389/fpsyt.2017.00248] [Citation(s) in RCA: 288] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/07/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD and a meta-regression to identify economic, health, social, or policy factors associated with national PPD prevalence. METHODS We conducted a systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To test for country level predictors, we drew on data from UNICEF, WHO, and the World Bank. Random effects meta-regression was used to test national predictors of PPD prevalence. FINDINGS 291 studies of 296284 women from 56 countries were identified. The global pooled prevalence of PPD was 17.7% (95% confidence interval: 16.6-18.8%), with significant heterogeneity across nations (Q = 16,823, p = 0.000, I2 = 98%), ranging from 3% (2-5%) in Singapore to 38% (35-41%) in Chile. Nations with significantly higher rates of income inequality (R2 = 41%), maternal mortality (R2 = 19%), infant mortality (R2 = 16%), or women of childbearing age working ≥40 h a week (R2 = 31%) have higher rates of PPD. Together, these factors explain 73% of the national variation in PPD prevalence. INTERPRETATION The global prevalence of PPD is greater than previously thought and varies dramatically by nation. Disparities in wealth inequality and maternal-child-health factors explain much of the national variation in PPD prevalence.
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Affiliation(s)
- Jennifer Hahn-Holbrook
- Department of Psychology, University of California, Merced, Merced, CA, United States
- Center for Excellence in Biopsychosocial Approaches to Health, Chapman University, Orange, CA, United States
| | | | - Itzel Anaya
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
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27
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Park KT. Is the Moderating Effect of Social Support on New Korean Mothers' Psychological Distress Contingent on Levels of Marital Quality? Asia Pac J Public Health 2018; 30:167-177. [PMID: 29359599 DOI: 10.1177/1010539517753735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 11/16/2022]
Abstract
This study examines how levels of marital quality change the effect of social support on postpartum psychological distress among new Korean mothers using the Panel Study on Korean Children (N = 1585). In accord with findings from previous studies, this study shows that low marital quality negatively affects new mothers' mental health, but that social support alleviates psychological distress independent of marital quality. The main finding of this research is that the moderating effect of social support is contingent on levels of marital quality. Aggregated social support moderates the effects of marital quality on new mothers' mental health only when the level of marital quality is low. Furthermore, each dimension of social support (emotional, informational, and instrumental) only has a moderating effect when marital quality is low. The findings highlight the fact that the moderating effect of social support varies with the individual context and so customized social support that fits individual needs matters for the mental health of new mothers.
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Affiliation(s)
- Ki Tae Park
- 1 University of Hawaii at Manoa, Honolulu, HI, USA
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28
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Yan J, Liu Y, Cao L, Zheng Y, Li W, Huang G. Association between Duration of Folic Acid Supplementation during Pregnancy and Risk of Postpartum Depression. Nutrients 2017; 9:E1206. [PMID: 29099069 DOI: 10.3390/nu9111206] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 10/28/2017] [Accepted: 10/30/2017] [Indexed: 11/17/2022] Open
Abstract
Postpartum depression (PPD), as a common complication of childbearing, could have adverse consequences on mothers, children, and families. This cohort study aimed to assess the association between duration of folic acid (FA) supplementation during pregnancy and the onset of PPD in Chinese women. A total of 1592 participants were recruited, and data collected between July 2015 and March 2017 in Tianjin, China. Participants’ baseline data were collected regarding socio-demographic and lifestyle characteristics, obstetric history, and FA supplementation during pregnancy. The Chinese version of the self-rating depression scale was used to assess depressive symptoms at 6–12 weeks postpartum, and the prevalence of PPD in participants was 29.4%. Pregnant women who took FA supplements for >6 months had a lower prevalence of PPD, compared to those who took FA for ≤6 months. After using the 1:1 ratio propensity score matching, 601 FA-users ≤ 6 months and 601 FA-users > 6 months were included in the further analyses; this also yielded similar results (P < 0.05). Logistic regression analysis showed that FA intake for >6 months was an independent determinant of PPD (odds ratio = 0.76; 95% confidence interval: 0.59–0.98; P < 0.05). Thus, prolonged FA supplementation during pregnancy was associated with a decreased risk of PPD in Chinese women.
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29
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Gondwe KW, White-Traut R, Brandon D, Pan W, Holditch-Davis D. The role of sociodemographic factors in maternal psychological distress and mother-preterm infant interactions. Res Nurs Health 2017; 40:528-540. [PMID: 28877554 DOI: 10.1002/nur.21816] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 08/04/2017] [Indexed: 11/05/2022]
Abstract
Preterm birth has been associated with greater psychological distress and less positive mother infant interactions than were experienced by mothers of full-term infants. Maternal and infant sociodemographic factors have also shown a strong association with psychological distress and the mother-infant relationship. However, findings on their effects over time are limited. In this longitudinal analysis, we explored the relationship of maternal and infant sociodemographic variables (maternal age, maternal education, marital status, being on social assistance, maternal race, infant birth weight, and infant gender) to maternal psychological distress (depressive, posttraumatic stress, anxiety, parenting stress symptoms, and maternal worry about child's health) through 12 months corrected age for prematurity, and on the home environment, and mother-infant interactions through 6 months corrected age for prematurity. We also explored differences related to maternal obstetrical characteristics (gestational age at birth, parity, mode of delivery, and multiple birth) and severity of infant conditions (Apgar scores, need for mechanical ventilation, and infant medical complications). Although the relationship of maternal and infant characteristics with these outcomes did not change over time, psychological distress differed based on marital status, maternal education, infant gender, and infant medical complications. Older mothers provided more a positive home environment. Mother-infant interactions differed by maternal age, being on public assistance, maternal race, infant gender, and infant medical complications. More longitudinal research is needed to better understand these effects over time in order to identify and support at-risk mothers.
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Affiliation(s)
- Kaboni W Gondwe
- Duke University School of Nursing, Durham, North Carolina.,University of Malawi Kamuzu College of Nursing, Lilongwe, Central Region, Malawi
| | - Rosemary White-Traut
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois.,Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Debra Brandon
- Duke University School of Nursing, Durham, North Carolina
| | - Wei Pan
- Duke University School of Nursing and Department of Biostatistics, Durham, North Carolina
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Wang YY, Li H, Wang YJ, Wang H, Zhang YR, Gong L, Ma J, Wang Y, Wang MZ, Qiu SX, Yuan SX. Living with parents or with parents-in-law and postpartum depression: A preliminary investigation in China. J Affect Disord 2017; 218:335-338. [PMID: 28494391 DOI: 10.1016/j.jad.2017.04.052] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 08/23/2016] [Revised: 04/04/2017] [Accepted: 04/24/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies have investigated the association between puerperal women's living situation and postpartum depression. The aim of this study was to examine the association between living with parents or with parents-in-law and postpartum depression among Chinese puerperal women. METHODS A total of 1126 participants who completed questionnaire were included in our analysis. Postpartum depression status was assessed using the Edinburgh Postnatal Depression Scale. Logistic regression models were used to estimate the association between living with puerperal women's parents or with parents-in-law and risk of postpartum depression after adjustment for potential confounders. RESULTS The prevalence of postpartum depression among participants was 11.8%. Of the 1126 participants, 524 (46.5%) lived only with their husbands, 387 (34.4%) lived with their parents-in-law, and 215 (19.1%) lived with their parents. Compared with those living only with their husbands, puerperal women living with their parents-in-law had higher risk of postpartum depression after adjustment for potential confounders (OR=2.48; 95% CI: 1.20, 5.15). No association between living with puerperal women's parents and postpartum depression was found after adjustment for confounders (OR=1.05; 95%CI: 0.42, 2.65). LIMITATIONS Although we adjusted for a wide range of potential confounders, we cannot rule out the possibility of residual confounding by other unmeasured factors, such as breastfeeding, intimate partner violence, and marital relationship. CONCLUSIONS Our findings suggest that living with parents-in-law may be a risk factor for postpartum depression among Chinese puerperal women. Future preventive interventions should include strategies that target the puerperal women who lived with parents-in-law.
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Affiliation(s)
- Yue-Yun Wang
- Shenzhen Maternity and Child Health Hospital, Guangdong, China
| | - Hui Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - You-Jie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Wang
- Shenzhen Maternity and Child Health Hospital, Guangdong, China
| | - Yan-Ru Zhang
- Shenzhen Maternity and Child Health Hospital, Guangdong, China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Gong
- Shenzhen Maternity and Child Health Hospital, Guangdong, China
| | - Jian Ma
- Futian District Maternity and Child Health Hospital, Guangdong, China
| | - Yan Wang
- Longgang District Maternity and Child Health Hospital, Guangdong, China
| | - Ming-Zhen Wang
- Yantian District Maternity and Child Health Hospital, Guangdong, China
| | - Shi-Xian Qiu
- Shenzhen Maternity and Child Health Hospital, Guangdong, China
| | - Shi-Xin Yuan
- Shenzhen Maternity and Child Health Hospital, Guangdong, China.
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Xu H, Ding Y, Ma Y, Xin X, Zhang D. Cesarean section and risk of postpartum depression: A meta-analysis. J Psychosom Res 2017; 97:118-126. [PMID: 28606491 DOI: 10.1016/j.jpsychores.2017.04.016] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [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: 01/16/2017] [Revised: 04/22/2017] [Accepted: 04/22/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The association of cesarean section (CS) with the risk of postpartum depression (PPD) remains controversial. Therefore, we conducted a meta-analysis to explore the association between CS and the risk of PPD. METHODS A systematic literature search was performed in PubMed, Web of Science and Embase databases for relevant articles up to November 2016. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with fixed-effects model or random-effects model. RESULTS A total of 28 studies from 27 articles involving 532,630 participants were included in this meta-analysis. The pooled OR of the association between CS and PPD risk was 1.26 (95% CI: 1.16-1.36). In subgroup analyses stratified by study design [cohort studies: (1.25, 95% CI: 1.10-1.41); case-control studies: (1.25, 95% CI: 1.00-1.56); cross-sectional studies: (1.44, 95% CI: 1.14-1.82)] and adjustment status of complications during pregnancy [adjusted for: (1.29, 95% CI: 1.12-1.48); not-adjusted for: (1.24, 95% CI: 1.13-1.36)], the above-mentioned associations remained consistent. The pooled ORs of PPD were 1.15 (95% CI: 0.92-1.43) for elective cesarean section (ElCS) and 1.47 (95% CI: 1.33-1.62) for emergency cesarean section (EmCS). CONCLUSION This meta-analysis suggests that CS and EmCS increase the risk of PPD. Further evidence is needed to explore the associations between the specific types of CS and the risk of PPD.
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Affiliation(s)
- Hui Xu
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Yu Ding
- Department of Reproduction, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Yue Ma
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Xueling Xin
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong Province, People's Republic of China.
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Senturk Cankorur V, Duman B, Taylor C, Stewart R. Gender preference and perinatal depression in Turkey: A cohort study. PLoS One 2017; 12:e0174558. [PMID: 28355286 DOI: 10.1371/journal.pone.0174558] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 03/11/2017] [Indexed: 01/08/2023] Open
Abstract
Background Child gender preference is important in some cultures and has been found to modify risk for antenatal and postnatal depression. We investigated discrepancies in the child gender preference between participating women and other key family members and the extent to which these predicted perinatal depression. Methods In a large cohort study of perinatal depression in urban and rural Turkey, participants had been asked about child gender preferences: their own, and those of their husband, parents, and parents in-law. Of 730 participants recruited in their third trimester (94.6% participation), 578 (79.2%) were reassessed at a mean (SD) 4.1 (3.3) months after childbirth, and 488 (66.8%) were reassessed at 13.7 (2.9) months. Results No associations were found between any gender preference reported in the antenatal period and depression at any examination. On the other hand, we found associations of antenatal depression with differences in participant-reported gender preference and that reported for their mother-in-law (OR 1.81, 1.08–3.04). This non-agreement also predicted depression at the 4 month (OR 2.24, 1.24–4.03) and 14 month (OR 2.07, 1.05–4.04) post-natal examinations. These associations with postnatal depression persisted after adjustment for a range of covariates (ORs 3.19 (1.54–6.59) and 3.30 (1.49–7.33) respectively). Conclusions Reported disagreement in child gender preferences between a woman and her mother-in-law was a predictor of post-natal depression and may reflect wider family disharmony as an underlying factor.
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Fiala A, Švancara J, Klánová J, Kašpárek T. Sociodemographic and delivery risk factors for developing postpartum depression in a sample of 3233 mothers from the Czech ELSPAC study. BMC Psychiatry 2017; 17:104. [PMID: 28327118 PMCID: PMC5361789 DOI: 10.1186/s12888-017-1261-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 03/09/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In the postpartum period, certain groups of women are at a higher risk for developing depressive episodes. Several studies have described risk factors for developing postpartum depression (PPD). However, these studies have used limited numbers of participants, and therefore the estimated prevalence of PPD varies greatly. METHODS The objective of this study is to identify the main risk factors for developing PPD by using data collected via the Czech version of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC). This database provides a representative sample (n = 7589) observed prospectively and a large amount of data on depressive symptoms and on biological, socioeconomic, and environmental factors. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for incidence of PPD. The affective pathology was examined at three time points: before delivery, 6 weeks after delivery, and 6 months after delivery. RESULTS The prevalence of depressive symptoms before delivery was 12.8%, 6 weeks after delivery 11.8%, and 6 months after delivery 10.1%. The prevalence rates are based on women who completed questionnaires at all three time-points (N = 3233). At all three time points, the main risk factors for developing PPD identified as significant by both univariate and multivariate analysis were personal history of depressive episodes and mothers experiencing psychosocial stressors. Other risk factors occurring in both types of analysis were: family history of depression from expectant mother's paternal side (prenatal), mothers living without partners (6 weeks postpartum) and feelings of unhappiness about being pregnant (6 months postpartum). Several protective factors were also observed: male child gender (prenatal), primiparous mothers (6 months postpartum), and secondary education (prenatal, only by multivariate analysis). Significant risk factors found solely by univariate analysis were family history of depression in both parents of the expectant mother (prenatal and 6 weeks postpartum), family history of depression from subject's maternal side (6 months postpartum), unintentional pregnancy (prenatal and 6 weeks postpartum), feelings of unhappiness about being pregnant (prenatal and 6 weeks postpartum), primary education (prenatal and 6 weeks postpartum), mothers who opted not to breastfeed (6 months postpartum) and mothers living without partners (prenatal and 6 months postpartum). Family savings were identified as protective factor (prenatal and 6 months postpartum). CONCLUSIONS We identified significant predictors of PPD. These predictors can be easily detected in clinical practice, and systematic screening can lead to identifying potentially at risk mothers. Since the risk is linked with experience of psychosocial stressors it seems that they might benefit from increased psychosocial support to prevent affective pathology.
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Affiliation(s)
- Adam Fiala
- Department of Psychiatry, Masaryk University, Brno, Czech Republic.
| | - Jan Švancara
- 0000 0001 2194 0956grid.10267.32Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic ,0000 0001 2194 0956grid.10267.32Institute of Biostatistics and Analyses, Faculty of Medicine and Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Jana Klánová
- 0000 0001 2194 0956grid.10267.32Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Tomáš Kašpárek
- 0000 0001 2194 0956grid.10267.32Department of Psychiatry, Masaryk University, Brno, Czech Republic
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Chi X, Zhang P, Wu H, Wang J. Screening for Postpartum Depression and Associated Factors Among Women in China: A Cross-Sectional Study. Front Psychol 2016; 7:1668. [PMID: 27847483 PMCID: PMC5088192 DOI: 10.3389/fpsyg.2016.01668] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 10/11/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study examined what percentage of Chinese mothers during a three-year postpartum period were screened for postpartum depression and explored the correlation between postpartum depression and various socio-demographic, psychological, and cultural factors. Study design: Cross-sectional survey. Methods: A total of 506 mothers 23 years of age and older who were within three years postpartum completed the online survey. The survey collected information such as family economic status, a history of depression, preparation for pregnancy, relationships with husbands, and family members, adult attachment types (Adult Attachment Scale, AAS), and depression (The Center for Epidemiologic Studies Depression Scale, CESD). Results: Approximately 30% of mothers 1-3 years postpartum reported symptoms above the CESD cut-off score (≥16 scores) associated with the risk for depression (28.0% in the first year, 30.8% in the second year, and 31.8% in the third year). Factors significantly associated with depression in participants in the correlation analysis were education level; family income; preparation for pregnancy; a history of depression; amount of time spent with their husbands; relationships with husbands, parents, and parents-in-law; and a close, dependent, and/or anxious attachment style. Multiple regression analyses revealed that a history of depression; less preparation for pregnancy; poorer relationships with husbands, parents, and parents-in-law; and a more anxious attachment style were strongly related to a higher risk of postpartum depression. Conclusion: The overall percentage of mothers after delivery who were vulnerable to depression in China remains high. Various factors were significant predictors of postpartum depression. The research findings have several valuable implications for intervention practices. For example, attachment styles and depression history in the assessments of perinatal depression could improve screenings and the design of interventions. Additionally, improving the family relationships and family environments of women post-delivery may be promising approach for postpartum depression prevention or intervention.
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Affiliation(s)
- Xinli Chi
- College of Psychology and Sociology, Shenzhen University, Shenzhen China
| | - Peichao Zhang
- Research Center of Modern Psychology, Wuhan University, Wuhan China
| | - Haiyan Wu
- State Grid Anhui Maintenance Company, Hefei China
| | - Jian Wang
- College of politics and law, Anhui Jianzhu University, Hefei China
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Abstract
OBJECTIVES The majority of Chinese families were under either one-child or two-child birth control policy status from 2001 to 2015. We explore the association between an infant's sex and the mother's postpartum well-being, which may be moderated by birth control policy status in China. SETTING AND PARTICIPANTS We conducted a prospective cohort study in Shanghai City, one of the largest cities in China. A total number of 1730 childbearing women from eight obstetric hospitals across Shanghai were included in the study at baseline, with 1503 women completing the survey 7 days postpartum in 2013. MEASURES The General Well-Being Schedule (GWBS) was used to assess maternal well-being at baseline and follow-up investigation in the study. The women's demographic, clinical characteristics, and well-being were measured at baseline. Maternal satisfaction and postpartum well-being were assessed in the follow-up survey. RESULTS Multivariable linear regression analyses showed that women who gave birth to male infants were positively associated with the total score of maternal well-being, when the participating hospitals, maternal well-being at baseline, sociodemographic characteristics, and maternal and infant health outcomes were added to the adjustments (β=1.462, p<0.05). The association disappeared when the two-child policy status was added to the adjustments (p>0.05). The results of a multiple logistic regression model showed that having a male infant was a risk factor of 'severe distress' (OR=1.607, p<0.05), which was moderated by the two-child policy status (p>0.05). CONCLUSIONS Our results emphasise the importance of conducting interventions to increase maternal general well-being, especially for those with a female infant in a society such as China where preference is for a son, and enhance the necessity of sustainability of a newly relaxed two-child policy which allows more couples to have a second child in China.
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Affiliation(s)
- Jing Hua
- Department of Shanghai First Maternity and Infant Hospital, The Women and Children's Health Care, Tongji University School of Medicine, Shanghai, China
| | - Liping Zhu
- The Research Office of Shanghai Maternity and Child Health Care Center, Shanghai, China
| | - Wenchong Du
- Psychology Division, Nottingham Trent University, Nottingham, UK
| | - Li Du
- The Research Office of Shanghai Maternity and Child Health Care Center, Shanghai, China
| | - Ting Luo
- Department of Public health School, Health Statistics and Social Medicine, Fudan University, Shanghai, China
| | - Zhuochun Wu
- Department of Public health School, Health Statistics and Social Medicine, Fudan University, Shanghai, China
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Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry 2016; 3:973-982. [PMID: 27650773 PMCID: PMC5155709 DOI: 10.1016/s2215-0366(16)30284-x] [Citation(s) in RCA: 581] [Impact Index Per Article: 72.6] [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: 06/20/2016] [Revised: 08/19/2016] [Accepted: 08/22/2016] [Indexed: 12/11/2022]
Abstract
Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries.
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Affiliation(s)
- Bizu Gelaye
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Marta B Rondon
- Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru
| | - Ricardo Araya
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Michelle A Williams
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
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Weng SC, Huang JP, Huang YL, Lee TSH, Chen YH. Effects of tobacco exposure on perinatal suicidal ideation, depression, and anxiety. BMC Public Health 2016; 16:623. [PMID: 27448804 PMCID: PMC4957348 DOI: 10.1186/s12889-016-3254-z] [Citation(s) in RCA: 22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 06/30/2016] [Indexed: 12/16/2022] Open
Abstract
Background Previous studies have stressed the importance of tobacco exposure for the mood disorders of depression and anxiety. Although a few studies have focused on perinatal women, none have specifically considered the effects of smoking and secondhand smoke exposure on perinatal suicidal ideation. Thus, this study aimed to investigate the relationships of smoking/secondhand smoke exposure status with suicidal ideation, depression, and anxiety from the first trimester to the first month post partum. Methods This cross-sectional study based on self-reported data was conducted at five hospitals in Taipei, Taiwan from July 2011 to June 2014. The questionnaire inquired about women’s pregnancy history, sociodemographic information, and pre-pregnancy smoking and secondhand smoke exposure status, and assessed their suicidal ideation, depression, and anxiety symptoms. Logistic regression models were used for analysis. Results In the 3867 women in the study, secondhand smoke exposure was positively associated with perinatal depression and suicidal ideation. Compared with women without perinatal secondhand smoke exposure, women exposed to secondhand smoke independently exhibited higher risks for suicidal ideation during the second trimester (odds ratio (OR) = 7.63; 95 % confidence interval (CI) = 3.25–17.93) and third trimester (OR = 4.03; 95 % CI = 1.76–9.23). Women exposed to secondhand smoke had an increased risk of depression, especially those aged 26–35 years (OR = 1.71; 95 % CI = 1.27–2.29). Conclusions Secondhand smoke exposure also considerably contributes to adverse mental health for women in perinatal periods, especially for the severe outcome of suicidal ideation. Our results strongly support the importance of propagating smoke-free environments to protect the health of perinatal women. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3254-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shu-Chuan Weng
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.,Mackay Memorial Hospital, New Taipei, Taiwan.,MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Ya-Li Huang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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Satyanarayana VA, Chandra PS, Sharma MK, Sowmya H, Kandavel T. Three sides of a triangle: gender disadvantage, resilience and psychological distress in a sample of adolescent girls from India. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/17542863.2016.1206949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Usuda K, Nishi D, Makino M, Tachimori H, Matsuoka Y, Sano Y, Konishi T, Takeshima T. Prevalence and related factors of common mental disorders during pregnancy in Japan: a cross-sectional study. Biopsychosoc Med 2016; 10:17. [PMID: 27213012 PMCID: PMC4874014 DOI: 10.1186/s13030-016-0069-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/02/2016] [Indexed: 11/10/2022] Open
Abstract
Background Common mental disorders (CMD) during pregnancy can have a clearly harmful influence on both mothers and children. Some studies have reported related factors for mental disorders, such as region-specific background. This study examined the prevalence of CMD and its related factors in mid-pregnancy in Japan. Methods Pregnant women between 12 and 24 weeks gestation and aged ≥20 years were consecutively recruited at a maternity hospital in Japan between May 2014 and September 2014. CMD were diagnosed using the Mini-International Neuropsychiatric Interview (MINI), self-rated depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale, and interpersonal traumatic experience was measured using the Life Events Checklist. Results Among 297 eligible pregnant women, 177 participated in the study. Two participants (1.1 %) met the criteria for major depressive disorder. The most frequent diagnosis was agoraphobia (n = 7; 3.9 %). Eleven participants (6.2 %) met the criteria for one or more diagnoses, with 2 participants having two mental disorders and 3 having three mental disorders. Six participants developed CMD after gestation. Logistic regression analysis revealed history of psychiatric disorder, past interpersonal traumatic experience, and feeling pressure to have a child were associated with CMD. Conclusion These findings indicate a lower prevalence of CMD in mid-pregnancy in Japan than reported in most other countries. Besides the related factors reported previously, feeling pressure to have a child might increase risk for CMD among pregnant women in Japan. Asian cultural background might be related to the lower CMD prevalence and risk factors identified in this study.
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Affiliation(s)
- Kentaro Usuda
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan ; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan ; Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553 Japan
| | - Daisuke Nishi
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan ; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan ; Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553 Japan
| | - Miyuki Makino
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan ; National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553 Japan
| | - Hisateru Tachimori
- Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553 Japan
| | - Yutaka Matsuoka
- Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukizi, Chuo-ku, Tokyo, 104-0045 Japan
| | - Yo Sano
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan
| | - Takako Konishi
- Musashino University, 3-3-3 Ariake, Koto-ku, Tokyo, 135-8181 Japan
| | - Tadashi Takeshima
- Health and Social Welfare Bureau, Kawasaki City Office, 3-16-1 Ida, Nakahara-ku, Kawasaki, Kanagawa 211-0035 Japan
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Kang YT, Yao Y, Dou J, Guo X, Li SY, Zhao CN, Han HZ, Li B. Prevalence and Risk Factors of Maternal Anxiety in Late Pregnancy in China. Int J Environ Res Public Health. 2016;13. [PMID: 27153080 PMCID: PMC4881093 DOI: 10.3390/ijerph13050468] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/22/2016] [Accepted: 04/23/2016] [Indexed: 12/23/2022]
Abstract
Objective: A large number of studies have shown the adverse neonatal outcomes of maternal psychological ill health. Given the potentially high prevalence of antenatal anxiety and few studies performed among Chinese people, the authors wanted to investigate the prevalence of antenatal anxiety and associated factors among pregnant women and to provide scientific basis to reduce prenatal anxiety effectively. Methods: A cross-sectional study was carried out at the Changchun Gynecology and Obstetrics Hospital from January 2015 to march 2015, with 467 participants of at least 38 weeks’ gestation enrolled. Antenatal anxiety was measured using the Self-Rating Anxiety Scale (SAS). χ2 test and logistic regression analysis were performed to evaluate the association of related factors of antenatal anxiety. Results: Among the 467 participants, the prevalence of antenatal anxiety was 20.6% (96 of 467). After adjustment for women’s socio-demographic characteristics (e.g., area, age, household income), multivariate logistical regression analysis revealed that antenatal anxiety showed significant relationship with education level lower than middle school (years ≤ 9), expected natural delivery, anemia during pregnancy, pregnancy-induced hypertension syndrome, disharmony in family relationship and life satisfaction. Conclusions: It is important to prevent or reduce antenatal anxiety from occurring by improving the health status of pregnant women and strengthening prenatal-related education and mental intervention.
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Khalifa DS, Glavin K, Bjertness E, Lien L. Determinants of postnatal depression in Sudanese women at 3 months postpartum: a cross-sectional study. BMJ Open 2016; 6:e009443. [PMID: 26966055 PMCID: PMC4800153 DOI: 10.1136/bmjopen-2015-009443] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [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] [Received: 07/21/2015] [Revised: 12/11/2015] [Accepted: 01/19/2016] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Maternal mental health is a neglected issue in Sudanese healthcare. The aim of this study was to explore the factors associated with postnatal depression (PND) at 3 months postpartum in a sample of Sudanese women in Khartoum state. SETTING Recruitment was from two major public antenatal care (ANC) clinics in two maternity teaching hospitals in Khartoum state. The study participants were recruited during their pregnancy and were followed up and screened for PND at 3 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). PARTICIPANTS A sample of 300 pregnant Sudanese women in their second or third trimester was included in the study. The inclusion criteria were Sudanese nationality, pregnancy in the second or third trimester and satisfactory contact information. OUTCOME MEASURES PND was assessed using the EPDS at a cut-off score of ≥ 12. Maternal and sociodemographic factors of interest were illustrated in a directed acyclic graph (DAG) to identify which variables to adjust for in multivariate analyses and to show their type of effect on PND. A forward logistic regression model was built to assess the factors that are independently associated with PND. RESULTS History of violence increased the odds of PND sevenfold, OR=7.4 (95% CI 1.9 to 27.6). Older age of mothers decreased the odds of PND by almost 20%, OR=0.82 (95% CI 0.73 to 0.92). Exclusive breast feeding and regular prenatal vitamins during pregnancy are associated with an 80% decrease in odds of PND, OR=0.2 (95% CI 0.06 to 0.70) and 0.17 (95% CI 0.06 to 0.5), respectively. CONCLUSIONS Factors associated with PND in this study are comparable to factors from other developing countries, although findings should be judged with caution owing to the high number of women who refused recruitment into the study.
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Affiliation(s)
- Dina Sami Khalifa
- Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Faculty of Health Sciences, Ahfad University for Women, Khartoum, Sudan
| | | | - Espen Bjertness
- Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lars Lien
- National Advisory Board on Dual Diagnosis, Innlandet Hospital Trust, Hamar, Norway
- Department of Public Health, Hedmark University College, Elverum, Norway
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Abdollahi F, Etemadinezhad S, Lye MS. Postpartum mental health in relation to sociocultural practices. Taiwan J Obstet Gynecol 2016; 55:76-80. [DOI: 10.1016/j.tjog.2015.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2014] [Indexed: 11/16/2022] Open
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Murray L, Dunne MP, Van Vo T, Anh PNT, Khawaja NG, Cao TN. Postnatal depressive symptoms amongst women in Central Vietnam: a cross-sectional study investigating prevalence and associations with social, cultural and infant factors. BMC Pregnancy Childbirth 2015; 15:234. [PMID: 26423807 PMCID: PMC4590693 DOI: 10.1186/s12884-015-0662-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 09/16/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This study investigated the prevalence and socio-cultural correlates of postnatal mood disturbance amongst women 18-45 years old in Central Vietnam. Son preference and traditional confinement practices were explored as well as factors such as poverty, parity, family and intimate partner relationships and infant health. METHODS A cross-sectional study was conducted in twelve randomly selected Commune Health Centres from urban and rural districts of Thua Thien Hue Province, Vietnam. Mother-infant dyads one to six months postpartum were invited to participate. Questionnaires from 431 mothers (urban n = 216; rural n = 215) assessed demographic and family characteristics, traditional confinement practices, son preference, infant health and social capital. The Edinburgh Postnatal Depression Scale (EPDS) and WHO5 Wellbeing Index indicated depressive symptoms and emotional wellbeing. Data were analysed using general linear models. RESULTS Using an EPDS cut-off of 12/13, 18.1% (n = 78, 95% CI 14.6-22.1) of women had depressive symptoms (20.4% urban; 15.8% rural). Contrary to predictions, infant gender and traditional confinement were unrelated to depressive symptoms. Poverty, food insecurity, being frightened of family members, and intimate partner violence increased both depressive symptoms and lowered wellbeing. The first model accounted for 30.2% of the variance in EPDS score and found being frightened of one's husband, husband's unemployment, breastfeeding difficulties, infant diarrhoea, and cognitive social capital were associated with higher EPDS scores. The second model had accounted for 22% of the variance in WHO5 score. Living in Hue city, low education, poor maternal competence and a negative family response to the baby lowered maternal wellbeing. CONCLUSIONS Traditional confinement practices and son preference were not linked to depressive symptoms among mothers, but were correlates of family relationships and wellbeing. Poverty, food insecurity, violence, infant ill health, and discordant intimate and family relationships were linked with depressive symptoms in Central Vietnam.
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Affiliation(s)
- Linda Murray
- School of Public Health and Social Work, Queensland University of Technology (QUT), Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.
- School of Medicine, University of Tasmania, 1/17 Liverpool St, Hobart, Tasmania, 7000, Australia.
| | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology (QUT), Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.
- Institute of Community Health Research, Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
| | - Thang Van Vo
- Institute of Community Health Research, Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
- Faculty of Public Health Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
| | - Phuong Nguyen Thi Anh
- Institute of Community Health Research, Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
- Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
| | - Nigar G Khawaja
- School of Psychology and Counseling, Queensland University of Technology (QUT), Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.
| | - Thanh Ngoc Cao
- Institute of Community Health Research, Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
- Hue University of Medicine and Pharmacy, 06 Ngo Quyen St, Hue City, Vietnam.
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Norhayati MN, Hazlina NHN, Asrenee AR, Emilin WMAW. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord 2015; 175:34-52. [PMID: 25590764 DOI: 10.1016/j.jad.2014.12.041] [Citation(s) in RCA: 440] [Impact Index Per Article: 48.9] [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: 07/08/2014] [Revised: 12/15/2014] [Accepted: 12/15/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND The prevalence of postpartum depression worldwide varies from 0.5% to 60.8% in the first 12 months postpartum using self-reported questionnaire. This review aims to update the current magnitude of postpartum depression based on self-reported questionnaire and clinical interview and explore its associated factors in developed and developing countries. METHODS A literature search conducted between 2005 and 2014 identified 203 studies, of which 191 used self-reported questionnaire in 42 countries and 21 used structured clinical interview in 15 countries. Nine studies used a combination of self-reported questionnaire and clinical interview. RESULT The prevalence of postpartum depression varies from 1.9% to 82.1% in developing countries and from 5.2% to 74.0% in developed countries using self-reported questionnaire. Structured clinical interview shows a much lower prevalence range from 0.1% in Finland to 26.3% in India. Antenatal depression and anxiety, previous psychiatric illness, poor marital relationship, stressful life events, negative attitude towards pregnancy, and lack of social support are significant contributors to postpartum depression. LIMITATION All studies are included irrespective of the methodological quality, such as small sample size and their inclusion could affect the generalizability of the results. CONCLUSION The current prevalence of postpartum depression is much higher than that previously reported, and similar risk factors are documented. A culturally sensitive cut-off score with adequate psychometric properties of the screening instruments should be available. In future studies, examining the physical, biological, and cultural factors in qualitative studies and in those with adequate methodological qualities is recommended.
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Affiliation(s)
- M N Norhayati
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
| | - N H Nik Hazlina
- Women Health Development Unit, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - A R Asrenee
- Department of Psychiatry, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - W M A Wan Emilin
- Perpustakaan Hamdan Tahir, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
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Yan X, Lu J, Shi S, Wang X, Zhao R, Yan Y, Chen G. Development and psychometric testing of the Chinese Postnatal Risk Factors Questionnaire (CPRFQ) for postpartum depression. Arch Womens Ment Health 2015; 18:229-37. [PMID: 25142052 DOI: 10.1007/s00737-014-0451-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022]
Abstract
This article describes the development and psychometric assessment of the Chinese Postnatal Risk Factors Questionnaire (CPRFQ). There were four phases in this process: (1) the items were generated using a literature review and a focus group, (2) content validity was evaluated by an expert panel, (3) a pilot study was conducted with 45 postpartum women to refine the scale, and (4) a convenience sample of 256 postpartum women in China was recruited to complete the questionnaire. Construct validity was established by exploratory factor analysis; a four-factor structure of the scale was accepted (social and family, personality and relationship, mother and infant, maternal feelings and 'doing the month'). These factors explained 47.46 % of the variance. Pearson's correlation coefficient was conducted to test convergent validity with the Edinburgh Postnatal Depression Scale (EPDS) (r = 0.54; p < 0.001). The Cronbach's alpha coefficient of the four subscales ranged from 0.58 to 0.71. The final 18-item version of the questionnaire is potentially a valuable tool for assessing postnatal risk factors in Chinese postpartum mothers.
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Mohamad Yusuff AS, Tang L, Binns CW, Lee AH. Prevalence and risk factors for postnatal depression in Sabah, Malaysia: A cohort study. Women Birth 2015; 28:25-9. [DOI: 10.1016/j.wombi.2014.11.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 11/03/2014] [Accepted: 11/04/2014] [Indexed: 01/12/2023]
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Weobong B, Ten Asbroek AH, Soremekun S, Danso S, Owusu-Agyei S, Prince M, Kirkwood BR. Determinants of postnatal depression in rural ghana: findings from the don population based cohort study. Depress Anxiety 2015; 32:108-19. [PMID: 24272979 DOI: 10.1002/da.22218] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [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: 06/17/2013] [Revised: 10/27/2013] [Accepted: 10/28/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Risk factors for postnatal depression (PND), one of the most pervasive complications of child bearing, are poorly understood in Africa. A recent systematic review of 31 studies found that the strongest predictors are social and economic disadvantage and gender-based factors; only six of these studies were community based, and almost all were in South Asia. METHODS Cohort study nested within 4 weekly surveillance of all women of reproductive age to identify pregnancies and collect data on births and deaths in the Kintampo Health Research Centre study area of Ghana. Women were screened for depression during pregnancy and after birth using the Patient Health Questionnaire to ascertain DSM-IV major or minor depression. Information was collected on determinants relating to the mother, birth, and baby, which were examined using logistic regression; effect sizes reported as relative risks with 95% confidence intervals. RESULTS Thirteen thousand nine hundred and twenty nine women were screened both during pregnancy and after birth, of whom 13,360 (95.9%) had complete data on potential determinants. Two hundred and fifty five (3.8%, 95% CI: 3.5%, 4.1%) had PND. Antenatal depression (AND) was the strongest determinant accounting for 34.4% of PND cases. Other determinants were season of delivery, peripartum/postpartum complications, newborn ill health, still birth, or neonatal death. Common determinants were observed for onset and persistent depression. CONCLUSIONS Although most AND resolves in this setting, more than a third of women with PND also had AND. Adverse birth- and baby-related outcomes are the other main determinants. We recommend that programs detect and treat depression during pregnancy and provide support to women with adverse birth outcomes.
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Hou L, Wang X, Li G, Zou L, Chen Y, Zhang W. Cross sectional study in China: fetal gender has adverse perinatal outcomes in mainland China. BMC Pregnancy Childbirth 2014; 14:372. [PMID: 25344636 PMCID: PMC4218998 DOI: 10.1186/s12884-014-0372-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 10/15/2014] [Indexed: 01/21/2023] Open
Abstract
Background The association between fetal gender and pregnancy outcomes has been thoroughly demonstrated in western populations. However, this association has not been thoroughly documented in China. The primary objective of the present study is to determine whether the association of adverse pregnancy and labour outcomes with male fetuses applies to the Chinese population. Methods This cross-sectional hospital-based retrospective survey collected data from thirty-nine hospitals in 2011 in mainland China. A total of 109,722 women with singleton pregnancy who delivered after 28 weeks of gestation were included. Results Of these pregnancies, the male-to-female sex ratio was 1.2. The rates of preterm birth (7.3% for males, 6.5% for females) and fetal macrosomia (8.3% for males, 5.1% for females) were higher for male newborns, whereas fetal growth restriction (8.0% for females, 5.4% for males) and malpresentation (4.3% for females, 3.6% for males) were more frequent among female-bearing mothers. A male fetus was associated with an increased incidence of operative vaginal delivery (1.3% for males, 1.1% for females), caesarean delivery (55.0% for males, 52.9% for females), and cephalopelvic disproportion/failure to progress (10.0% for males, 9.2% for female). Male gender was also significantly associated with lower Apgar scores (<7 at 5 min, adjusted odds ratio 1.3, 95% CI 1.0-1.6), as well as a neonatal intensive care unit admission and neonatal death, even after adjustments for confounders (adjusted odds ratio 1.3, 95% CI 1.1-1.5, adjusted odds ratio 1.4, 95% CI 1.1-1.8). Conclusion We confirm the existence of obvious neonatal gender bias and adverse outcomes for male fetuses during pregnancy and labour in our population. Further research is required to understand the mechanisms and clinical implications of this phenomenon. Electronic supplementary material The online version of this article (doi:10.1186/s12884-014-0372-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lei Hou
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
| | - Xin Wang
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
| | - Guanghui Li
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
| | - Liying Zou
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
| | - Yi Chen
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
| | - Weiyuan Zhang
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
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El-Hachem C, Rohayem J, Bou Khalil R, Richa S, Kesrouani A, Gemayel R, Aouad N, Hatab N, Zaccak E, Yaghi N, Salameh S, Attieh E. Early identification of women at risk of postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) in a sample of Lebanese women. BMC Psychiatry 2014; 14:242. [PMID: 25193322 PMCID: PMC4172818 DOI: 10.1186/s12888-014-0242-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 08/18/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND During the postpartum period, women are vulnerable to depression affecting about 10 to 20% of mothers during the first year after delivery. However, only 50% of women with prominent symptoms are diagnosed with postpartum depression (PPD). The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening instrument for PPD . The main objectives of this study are to assess whether an EPDS score of 9 or more on day 2 (D2) postpartum is predictive of a depressive episode between days 30 and 40 postpartum (D30-40), to determine the risk factors as well as the prevalence of PPD in a sample of Lebanese women and to determine a threshold score of EPDS predictive of PPD. METHODS A sample of 228 women were administered the EPDS on D2. An assessment for PPD was done on D30-40 during a telephone interview. RESULTS On D2, the average score on EPDS was 7.1 (SD = 5.2) and 33.3% of women had an EPDS score ≥ 9. On D30-40 postpartum, the average score was 6.5 (SD = 4.7) and 19 women (12.8%) presented with PPD. A positive correlation was shown between scores on EPDS on D2 and D30-40 (r = 0.5091, p < 0.0001). A stepwise regression shows that an EPDS score ≥9 on D2 (p < 0.001) and a personal history of depression (p = 0.008) are significantly associated with the diagnosis of PPD on D30-40. CONCLUSION The EPDS may be considered as a reliable screening tool on as early as D2 after delivery. Women with EPDS score ≥ 9 and/or a positive personal history of major depressive disorder should benefit from a closer follow-up during the rest of the post-partum period.
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Affiliation(s)
- Charline El-Hachem
- Department of psychiatry, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon
| | - Jihane Rohayem
- Department of psychiatry, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon ,Saint Joseph University, Beirut, Lebanon
| | - Rami Bou Khalil
- Department of psychiatry, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon ,Saint Joseph University, Beirut, Lebanon
| | - Sami Richa
- Department of psychiatry, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon ,Saint Joseph University, Beirut, Lebanon
| | - Assaad Kesrouani
- Department of obstetrics and gynecology, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon ,Saint Joseph University, Beirut, Lebanon
| | - Rima Gemayel
- Department of psychiatry, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon
| | - Norma Aouad
- Department of obstetrics and gynecology, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon
| | - Najat Hatab
- Research Unit, department of Nursing, Hotel Dieu de France, Beirut, Lebanon
| | - Eliane Zaccak
- Department of obstetrics and gynecology, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon
| | - Nancy Yaghi
- Department of obstetrics and gynecology, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon
| | - Salimé Salameh
- Department of obstetrics and gynecology, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon
| | - Elie Attieh
- Department of obstetrics and gynecology, Hotel Dieu de France- Saint Joseph University, Beirut, Lebanon ,Saint Joseph University, Beirut, Lebanon
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Ding T, Wang DX, Qu Y, Chen Q, Zhu SN. Epidural Labor Analgesia Is Associated with a Decreased Risk of Postpartum Depression. Anesth Analg 2014; 119:383-392. [DOI: 10.1213/ane.0000000000000107] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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