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Barat S, Ghanbarpour A, Mirtabar SM, Kheirkhah F, Basirat Z, Shirafkan H, Hamidia A, Khorshidian F, Hosseini Talari D, Pahlavan Z, Esmaelzadeh S, Buzari Z, Zeynalzadeh M, Charati SY, Shafizade F, Adnani M, Amirkhanloo F, Mollaalipour M, Kani AC, Amiri M, Khazaei R, Mehdinia SS, Basirat F, Asadollahi S, Khodami A, Azizi A, Nasiri-Amiri F, Fatery N, Shahrokhi S, Zarinkamar B, Aligoltabar S, Faramarzi M. Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry. BMC Pregnancy Childbirth 2023; 23:793. [PMID: 37964209 PMCID: PMC10648632 DOI: 10.1186/s12884-023-06024-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/23/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum. METHODS A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions. RESULTS The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P < 0.001), as well as its three subscales: somatization (β = 1.355, P = 0.019), anxiety symptoms (β = 2.249, P < 0.001), and depressive symptoms (β = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (β = 1.344, P = 0.038) and the somatization subscale (β = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (β = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (β = 1.998, P = 0.012) and depressive symptoms (β = 1.949, P = 0.020). CONCLUSION The high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.
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Affiliation(s)
- Shahnaz Barat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Azita Ghanbarpour
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Seyyedeh Mahboubeh Mirtabar
- Research Clinical Psychology, Student Research Committee, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Basirat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hoda Shirafkan
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Angela Hamidia
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Faezeh Khorshidian
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Davood Hosseini Talari
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zeynab Pahlavan
- Department of Midwifery, School of Nursing and Midwifery,Infertility and Reproductive Health Research Center, Reproductive Health, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sedigheh Esmaelzadeh
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zinatosadat Buzari
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahtab Zeynalzadeh
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shahla Yazdani Charati
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Shafizade
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mahsima Adnani
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Amirkhanloo
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Maedeh Mollaalipour
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Atieh Chale Kani
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mania Amiri
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Razieh Khazaei
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Seyedeh Shabnam Mehdinia
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Basirat
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Simin Asadollahi
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Asieh Khodami
- Department of Obstetrics and Gynecology, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Alireza Azizi
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Nasiri-Amiri
- Department of Midwifery, School of Nursing and Midwifery,Infertility and Reproductive Health Research Center, Reproductive Health, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Nooshin Fatery
- Midwifery, Clinical Research Development Unit of Rohani Hospital, Health Research, Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shirin Shahrokhi
- Clinical Psychology, Student Reasearch Committee, Behshahr Azad University, Behshahr, Iran.
| | - Banafshe Zarinkamar
- Clinical Psychology, Clinical Research Development Unit of Shahid Yahya Nejad, Health Research Institute, Babol University of Medical Sciences, HospitalBabol, Iran
| | - Sajedeh Aligoltabar
- Midwifery, Student Reasearch Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of General Courses, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Galera C, Barbosa S, Collet O, Khalfallah O, Aouizerate B, Sutter-Dalley AL, Koehl M, Capuron L, Van der Waerden J, Melchior M, Côté S, Heude B, Glaichenhaus N, Davidovic L. Cord Serum Cytokines at Birth and Children's Anxiety-Depression Trajectories From 3 to 8 Years: The EDEN Mother-Child Cohort. Biol Psychiatry 2021; 89:541-549. [PMID: 33349450 DOI: 10.1016/j.biopsych.2020.10.009] [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: 06/18/2020] [Revised: 09/23/2020] [Accepted: 10/12/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Recent research suggests that immune dysregulation in pregnancy could be a risk factor for anxiety and depression symptoms in offspring. Whereas animal studies have demonstrated the importance of the link between perinatal cytokines and abnormal behaviors in offspring, human epidemiological studies in this area remain limited. The objectives of the study were to describe the network of cord serum cytokines at birth and test whether they are associated with subsequent anxiety and depression symptom trajectories in offspring. METHODS We used data and biological samples from 871 mother-child pairs followed up from pregnancy to 8 years of age and participating in the French mother-child cohort EDEN (a study on the pre- and early postnatal determinants of child health and development). Cord serum cytokines were measured at birth. Children's symptoms of anxiety and depression were assessed with the emotional difficulties subscore of the Strength and Difficulties Questionnaire at ages 3, 5, and 8 years, from which trajectories of anxiety-depression symptoms were derived. RESULTS Results showed a significant association between cord serum interleukin-7 at birth and the trajectories of children's anxiety-depression symptoms between ages 3 to 8 years (adjusted odds ratio, 0.73; 95% confidence interval, 0.57-0.93). The associations considered relevant confounders, including prenatal maternal depressive symptoms. CONCLUSIONS Early immune changes may contribute to subsequent anxiety and depression symptoms in childhood. Beyond the understanding of mechanisms underlying the occurrence of emotional difficulties in children, our findings open avenues for future research in human and animals.
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Affiliation(s)
- Cédric Galera
- Departments of Public Health and Neurocampus, University of Bordeaux, Bordeaux, France; Institut National de la Santé et de la Recherche Médicale, Bordeaux Population Health Center, Bordeaux, France; Centre Hospitalier Perrens, Bordeaux, France; Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada.
| | - Susana Barbosa
- Université Côte d'Azur, Nice, France; Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
| | - Ophélie Collet
- Departments of Public Health and Neurocampus, University of Bordeaux, Bordeaux, France; Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada
| | - Olfa Khalfallah
- Université Côte d'Azur, Nice, France; Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
| | - Bruno Aouizerate
- Departments of Public Health and Neurocampus, University of Bordeaux, Bordeaux, France; Centre Hospitalier Perrens, Bordeaux, France; Bordeaux INP, NutriNeuro UMR 1286, Bordeaux, France
| | - Anne-Laure Sutter-Dalley
- Institut National de la Santé et de la Recherche Médicale, Bordeaux Population Health Center, Bordeaux, France; Centre Hospitalier Perrens, Bordeaux, France
| | - Muriel Koehl
- Departments of Public Health and Neurocampus, University of Bordeaux, Bordeaux, France; Institut national de recherche pour l'agriculture, l'alimentation et l'environnement, Neurocentre Magendie U1215, and Institut National de la Santé et de la Recherche Médicale, Bordeaux, France
| | - Lucile Capuron
- Departments of Public Health and Neurocampus, University of Bordeaux, Bordeaux, France; Bordeaux INP, NutriNeuro UMR 1286, Bordeaux, France
| | - Judith Van der Waerden
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Maria Melchior
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Sylvana Côté
- Departments of Public Health and Neurocampus, University of Bordeaux, Bordeaux, France; Institut National de la Santé et de la Recherche Médicale, Bordeaux Population Health Center, Bordeaux, France; Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Barbara Heude
- Institut National de la Santé et de la Recherche Médicale, INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, ORCHAD Team, Paris, France; Institut National de la Santé et de la Recherche Médicale, Paris, France; Paris University, Paris, France
| | - Nicolas Glaichenhaus
- Université Côte d'Azur, Nice, France; Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
| | - Laetitia Davidovic
- Université Côte d'Azur, Nice, France; Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
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