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Cheng J, Ren Z, Rehman S, Zhou Z, Wang X, Wang Y, Peng Y, Xiong J, Qin X, Peng Z, Mao W, Chen M, Zeng Y, Wang M, Zhang L, Ju Y, Liu J, Yu Y, Liu B, Zhang Y. Comparative assessment of Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale for screening antenatal depression among Chinese pregnant women. J Affect Disord 2025; 376:104-112. [PMID: 39909161 DOI: 10.1016/j.jad.2025.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2025] [Revised: 01/20/2025] [Accepted: 02/01/2025] [Indexed: 02/07/2025]
Abstract
BACKGROUND The Patient Health Questionnaire-9 (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS) are commonly used for assessing antenatal depression in China. However, clear guidelines for their application are lacking in China, leading to inconsistencies in prenatal mental health care. This study compares the psychometric properties of these scales to improve early detection and intervention strategies for antenatal depression. METHODS The cross-sectional study included 44,220 women receiving prenatal care from January 1, 2020, to January 31, 2024. All the participants underwent a psychological screening during their maternity check-ups at the Shenzhen Baoan Women's and Children's Hospital, China. We evaluated the reliability, construct validity, and concurrent validity of the two scales using internal consistency indices, factor structures, correlations, and Cohen's kappa. RESULTS Both the PHQ-9 (Cronbach's α = 0.800) and EPDS (α = 0.783) demonstrated good internal consistency. The correlation between PHQ-9 and EPDS scores was moderate (ρ = 0.61). Exploratory factor analysis (EFA) revealed a two-factor structure for each scale. When combining all items from both scales, EFA identified four factors: "somatic symptoms," "negative cognitive bias and suicidal ideation," "anxiety and depression," and "anhedonia." The agreement was generally fair across various cutoff scores, with the highest Cohen's kappa being 0.493. CONCLUSIONS Both the EPDS and PHQ-9 exhibit strong internal consistency in screening for antenatal depression in China. While the EPDS emphasizes "depression and anxiety," the PHQ-9 focuses on "somatic symptoms," suggesting that combining the two may improve detection. Adjusting EPDS cutoff scores and incorporating the PHQ-9 could further enhance screening accuracy.
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Affiliation(s)
- Junzhe Cheng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China; Clinical Medicine Eight-Year Program, Xiangya School of Medicine, Central South University, Changsha, Hunan 41008, China
| | - Zhixuan Ren
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Shazia Rehman
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Zhiruo Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Xinyi Wang
- Clinical Medicine Eight-Year Program, Xiangya School of Medicine, Central South University, Changsha, Hunan 41008, China
| | - Yubo Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China; Clinical Medicine Eight-Year Program, Xiangya School of Medicine, Central South University, Changsha, Hunan 41008, China
| | - Yilin Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Jintao Xiong
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Xuemei Qin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Zhuo Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Weiguo Mao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Mingfang Chen
- Department of Obstetrics, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, Guangdong 518100, China
| | - Yundi Zeng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Mi Wang
- Department of Mental Health Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Li Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Yumeng Ju
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Jin Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Yan Yu
- Department of Obstetrics, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, Guangdong 518100, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China.
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China.
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He ZP, Cheng JZ, Yu Y, Wang YB, Wu CK, Ren ZX, Peng YL, Xiong JT, Qin XM, Peng Z, Mao WG, Chen MF, Zhang L, Ju YM, Liu J, Liu BS, Wang M, Zhang Y. Social and obstetric risk factors of antenatal depression: A cross-sectional study in China. World J Psychiatry 2025; 15:100650. [PMID: 40309581 PMCID: PMC12038661 DOI: 10.5498/wjp.v15.i4.100650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 01/01/2025] [Accepted: 02/07/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring. Early identification and intervention of antenatal depression can help to prevent adverse outcomes. However, there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China. AIM To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population. METHODS The cross-sectional survey was conducted in Shenzhen, China from 2020 to 2024. Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), with a score of ≥ 13 indicating the presence of probable antenatal depression. The χ 2 test and binary logistic regression were used to identify the factors associated with antenatal depression. Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels. RESULTS Among the 44220 pregnant women, the prevalence of probable antenatal depression was 4.4%. An age ≤ 24 years, a lower level of education (≤ 12 years), low or moderate economic status, having a history of mental disorders, being in the first trimester, being a primipara, unplanned pregnancy, and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression (all P < 0.05). Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms. EPDS8 ("sad or miserable") and EPDS4 ("anxious or worried") showed the highest nodal strength across groups with different risk levels. CONCLUSION This study suggested that the prevalence of antenatal depression was 4.4%. Several social and obstetric factors were identified as risk factors for antenatal depression. EPDS8 ("sad or miserable") and EPDS4 ("anxious or worried") are pivotal targets for clinical intervention to alleviate the burden of antenatal depression. Early identification of high-risk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.
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Affiliation(s)
- Zi-Ping He
- Department of Mental Health Center, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
- Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
| | - Jun-Zhe Cheng
- Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Yan Yu
- Department of Obstetrics, Baoan Maternal and Child Health Care Hospital, Shenzhen 518100, Guangdong Province, China
| | - Yu-Bo Wang
- Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Chen-Kun Wu
- Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
| | - Zhi-Xuan Ren
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Yi-Lin Peng
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Jin-Tao Xiong
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Xue-Mei Qin
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Zhuo Peng
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Wei-Guo Mao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Ming-Fang Chen
- Department of Obstetrics, Baoan Maternal and Child Health Care Hospital, Shenzhen 518100, Guangdong Province, China
| | - Li Zhang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Yu-Meng Ju
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Jin Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Bang-Shan Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Mi Wang
- Department of Mental Health Center, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
| | - Yan Zhang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
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Zhou C, Tan F, Li X, Chen J, Huang Q, Lin X, Zhao F, Yuan Q. Trend of Antenatal Depression and Its Risk Factors Among Pregnant Women in China From 2016 to 2021: A Repeated Cross-Sectional Study Under Multiple Fertility Policy Adjustments and Economic Development. Depress Anxiety 2025; 2025:6823160. [PMID: 40264858 PMCID: PMC12014251 DOI: 10.1155/da/6823160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/18/2025] [Accepted: 03/18/2025] [Indexed: 04/24/2025] Open
Abstract
Background: The objective of the current study was to evaluate the trend and risk factors of antenatal depression (AD) among Chinese women in the third trimester of pregnancy, taking into account the impact of multiple fertility policy adjustments and economic development in China. Method: A repeated cross-sectional study design was used. A total of 3404 pregnant women at 30-42 weeks' gestation were recruited from the two largest maternity hospitals in Zhejiang Province, China, between 2016 and 2021. Results: The prevalence of AD among women in their third trimester of pregnancy had significantly increased from 31.8% to 60.6% (p < 0.001) from 2016 to 2021. Pregnant women aged between 18 and 24 years reported the highest prevalence of AD. Those aged between 25 and 34 years (odds ratio [OR], 0.788; 95% confidence interval [CI]: 0.630-0.985), with a better self-reported health status (OR, 0.929; 95% CI: 0.922-0.936) and higher perceived social support (OR, 0.948; 95% CI: 0.940-0.955), reported a lower prevalence of AD. Pregnant women who were housewives (OR, 1.399; 95% CI: 1.078-1.817), had an introverted personality (OR, 1.324; 95% CI: 1.119-1.568), and had experienced an unplanned pregnancy (OR, 1.303; 95% CI: 1.098-1.547) reported a higher prevalence of AD. Conclusions: The significant increase in the prevalence of AD from 2016 to 2021 has caused concern in society. To improve the aforementioned situation, it is imperative to implement further initiatives to address the challenges faced by pregnant women, especially those who are housewives, have introverted personalities, and have experienced unplanned pregnancies.
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Affiliation(s)
- Chi Zhou
- School of Public Administration, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Fang Tan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Xu Li
- School of Public Administration, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Jingchun Chen
- School of Health Medicine, Guangzhou Huashang College, Guangzhou 511300, Guangdong, China
| | - Qunfang Huang
- School of Public Administration, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Xiaoling Lin
- School of Public Administration, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Falin Zhao
- School of Public Administration, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Qi Yuan
- Research Division, Institute of Mental Health, Singapore 539747, Singapore
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Hong H, Chen Q, Lin Y, Li Y, Zheng J, Gao P, Lei Y, Huang F. Effects of psychosocial factors on postpartum depression: a half-longitudinal mediation analysis of cognitive reactivity. BMC Pregnancy Childbirth 2025; 25:296. [PMID: 40089721 PMCID: PMC11910840 DOI: 10.1186/s12884-025-07364-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Accepted: 02/24/2025] [Indexed: 03/17/2025] Open
Abstract
BACKGROUND The prevention and treatment of perinatal depression are currently the focus of perinatal health care, with cognitive reactivity confirmed to be an important predictor. However, how cognitive reactivity mediates the relationship between psychosocial factors (e.g. family function, perceived stress, mindfulness, and insomnia) and perinatal depression remains unclear. This study aims to investigate the mediating role of cognitive reactivity between psychosocial factors and perinatal depression. METHODS Based on a half-longitudinal design, this study investigated 368 perinatal women from China in the third trimester (T1) and three months postpartum (T2) using the Perceived Stress Scale, Cognitive and Affective Mindfulness Scale, Athens Insomnia Scale, Family Adaptation Partnership Growth Affection and Resolve Index, Leiden Index of Depression Sensitivity, and Edinburgh Postnatal Depression Scale. Data were analysed using structural equation modelling. RESULTS The overall fit of the hypothetical structural model is acceptable. The analysis confirmed a direct relationship between family function, perceived stress, mindfulness, and insomnia at T1, and cognitive reactivity at T2. Factors other than mindfulness at T1 had a direct effect on perinatal depression at T2. Furthermore, cognitive reactivity at T2 mediated the influences of family function, perceived stress, mindfulness, and insomnia at T1 on perinatal depression at T2. CONCLUSIONS Cognitive reactivity levels in the third trimester were stable predictors and mediators of postpartum depression. Effective strategies to reduce cognitive reactivity in perinatal women should focus on enhancing family function, mindfulness, and sleep quality and in guiding women toward adopting positive coping styles to alleviate stress levels, ultimately reducing postpartum depression.
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Affiliation(s)
- Huilan Hong
- School of Nursing, Fujian Medical University, No 1 Xueyuan Road, Minhou county, Fuzhou, Fujian, 350122, China
- Department of Obstetrics, The Second Attached Hospital of Fujian Medical University, Quanzhou, China
| | - Qiuhong Chen
- School of Nursing, Fujian Medical University, No 1 Xueyuan Road, Minhou county, Fuzhou, Fujian, 350122, China
| | - Yiyang Lin
- School of Nursing, Fujian Medical University, No 1 Xueyuan Road, Minhou county, Fuzhou, Fujian, 350122, China
| | - Yonglin Li
- School of Nursing, Fujian Medical University, No 1 Xueyuan Road, Minhou county, Fuzhou, Fujian, 350122, China
| | - Jianqing Zheng
- Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Ping Gao
- Department of Obstetrics and Gynecology, Quanzhou Women's and Children's Hospital, Quanzhou, China
| | - Yang Lei
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, P.R. China.
| | - Feifei Huang
- School of Nursing, Fujian Medical University, No 1 Xueyuan Road, Minhou county, Fuzhou, Fujian, 350122, China.
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Aziz HA, Yahya HDB, Ang WW, Lau Y. Global prevalence of depression, anxiety, and stress symptoms in different trimesters of pregnancy: A meta-analysis and meta-regression. J Psychiatr Res 2025; 181:528-546. [PMID: 39700731 DOI: 10.1016/j.jpsychires.2024.11.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 07/02/2024] [Accepted: 11/27/2024] [Indexed: 12/21/2024]
Abstract
The global prevalence of psychological problems in different trimesters is unclear due to methodological constraints in previous reviews. A precise estimate would be a key first step in raising awareness and allocating resources. This review aims to (1) calculate the global prevalence of depression, anxiety, and stress symptoms during different trimesters and (2) determine the factors influencing their prevalence estimates. A comprehensive search across eight databases was conducted. The meta packages in R software were used to perform meta-analysis, subgroup analysis, and meta-regression analysis. The Newcastle Ottawa Scale was used to assess the study quality, while the Grading of Recommendations, Assessment, Development, and Evaluation method was utilized to assess the certainty of the evidence. A total of 88 studies with 61,719 participants across 48 countries were included. The prevalences of depression, anxiety, and stress symptoms during all trimesters were 27% (95% CI: 23-31), 37% (95% CI: 31-42), and 26% (95% CI: 9-49), respectively. The second trimester had the highest prevalence of depression (30%) and anxiety (28%) symptoms, whereas the third trimester had the highest prevalence of stress symptoms (52%). A series of subgroup and meta-regression analyses revealed that regions, economic levels of the country, setting, the COVID-19 pandemic, and quality of study were significant factors. Most studies were high quality, but the certainty of the evidence was very low. Findings can contribute as evidence to raising awareness about specific psychological problems during different trimesters. Implementing effective policies and launching targeted interventions can help minimize the prevalence.
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Affiliation(s)
- Halimatusaadiyah Abdul Aziz
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Huda Dianah Binte Yahya
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Wen Wei Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ying Lau
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
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Ren F, Zhu X, Liu J, Zhai Q, Wang J, Gao Y, Zhang Y, Guan L, Guo Y, Chang L, Li X, Liu G, Chen J, Wang S. Associations of multiple risk factors with prenatal depression and anxiety: Evidence from the Tianjin Birth Cohort (TJBC) study. J Affect Disord 2024; 366:411-422. [PMID: 39216646 DOI: 10.1016/j.jad.2024.08.122] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/17/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Antenatal mental disorders are associated with maternal and fetal adverse events. Previous studies have been focused on the postpartum period, rather than pregnancy, yet the association of risk factors with prenatal depression and anxiety through pregnancy has been rarely reported. This study aimed to identify the risk factors of prenatal depression and anxiety, and access their potential roles in developing mental disorders during pregnancy. METHODS This is a prospective study in 6470 participants from the Tianjin Birth Cohort in China (TJBC). The degree of prenatal depression and anxiety was evaluated using a questionnaire of Self-Rating Depression scale (SDS) and Self-Rating Anxiety Scale (SAS), which was given to pregnant women at 15-27 (Stage-2), and 28-41 (Stage-3) gestational weeks. The questionnaire also collected demographic, personal, and lifestyle information. The association of different factors with SDS/SAS score was examined by logistic regression analysis. RESULTS We observed an overall depression rate of 12.4 % and an overall anxiety rate of 7.7 % during pregnancy in the TJBC. In the Stage-2, the depression rate was 14.5 % and the anxiety rate was 9.5 %. In the Stage-3, the depression rate dropped to 9.7 % while the anxiety rate dropped to 5.3 %. With univariate analysis, we found that age, education, social support, marriage satisfaction, secondhand smoke (SHS), sleeping time and stress were common factors of prenatal mental health. Working status, family income, gravidity, smoking, electronic using, recreational activities were associated with depression risk, whereas BMI, disease history, changing eating habits, and feeding animal were associated with anxiety risk. Using logistic regression, we found that low education level, low social support, low marriage satisfaction, thyroid disfunction, Stage-2(second trimester), and stress were related to prenatal mental health. CONCLUSION The prevalence anxiety and depression in Tianjin is normal as national level. Age appropriateness, a good education level, sufficient social support, marital satisfaction, normal thyroid function, and absence of stress are associated with relieving depression and anxiety during gestation. However, due to individual difference, expectant mothers should seek professional support and guidance to address their mental health needs during gestation.
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Affiliation(s)
- Fangyi Ren
- BGI Research, Shenzhen, 518083, China; China National GeneBank, BGI-Shenzhen, Shenzhen, 518210, China
| | - Xiaowei Zhu
- BGI Research, Shenzhen, 518083, China; China National GeneBank, BGI-Shenzhen, Shenzhen, 518210, China
| | - Jinnan Liu
- Tianjin Women's and Children's Health Center, Tianjin, 300070, China
| | | | - Jing Wang
- Tianjin Women's and Children's Health Center, Tianjin, 300070, China
| | - Ya Gao
- BGI Research, Shenzhen, 518083, China
| | - Yu Zhang
- Tianjin Women's and Children's Health Center, Tianjin, 300070, China
| | - Lingyao Guan
- BGI Research, Shenzhen, 518083, China; China National GeneBank, BGI-Shenzhen, Shenzhen, 518210, China
| | - Yuanyuan Guo
- Tianjin Women's and Children's Health Center, Tianjin, 300070, China
| | - Lulin Chang
- BGI Research, Shenzhen, 518083, China; China National GeneBank, BGI-Shenzhen, Shenzhen, 518210, China
| | - Xi Li
- BGI Research, Shenzhen, 518083, China; BGI Research, Wuhan, 430074, China
| | - Gongshu Liu
- Tianjin Women's and Children's Health Center, Tianjin, 300070, China
| | - Jiayu Chen
- BGI Research, Shenzhen, 518083, China; China National GeneBank, BGI-Shenzhen, Shenzhen, 518210, China.
| | - Shuo Wang
- Tianjin Women's and Children's Health Center, Tianjin, 300070, China.
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Correia RH, Greyson D, Kirkwood D, Darling EK, Pahwa M, Bayrampour H, Jones A, Kuyvenhoven C, Liauw J, Vanstone M. New perinatal mental health conditions diagnosed during COVID-19: a population-based, retrospective cohort study of birthing people in Ontario. Arch Womens Ment Health 2024:10.1007/s00737-024-01534-1. [PMID: 39560777 DOI: 10.1007/s00737-024-01534-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 11/04/2024] [Indexed: 11/20/2024]
Abstract
PURPOSE We aimed to determine the incidence of mental health diagnoses and associated health and social risk factors among perinatal people in three different COVID-19 phases. METHODS We conducted a population-based, retrospective cohort study using linked administrative datasets. We included persons with live, in-hospital births in Ontario, Canada from January 1 to March 31 in 2019, 2021, or 2022 (three phases relative to COVID-19 with different public health policy measures). We excluded people with prior mental health diagnoses. We used diagnostic codes to identify new onset of depression, anxiety, or adjustment disorder in the antenatal and postpartum period. We developed multivariable, modified Poisson models to examine associations between sociodemographic and clinical factors and new mental health diagnoses in each phase. RESULTS There were 72,242 people in our cohort. Antenatal mental health diagnoses were significantly higher in 2021 (aRR = 1.32; CI = 1.20-1.46) and 2022 (aRR = 1.22; CI = 1.11-1.35) versus 2019. Postpartum diagnoses were significantly greater in 2021 (aRR = 1.16; CI = 1.08-1.25) versus 2019. Antenatal diagnoses were associated with birth year, previous stillbirth, pre-existing hypertension, multiparity, residential instability, and ethnocultural diversity. Postpartum diagnoses were associated with birth year, maternal age, multiparity, care provider profession, assisted reproductive technology, birthing mode, pre-existing hypertension, intensive care admission, hospital readmission, residential instability, and ethnocultural diversity. Family physicians increasingly made mental health diagnoses in 2021 and 2022. CONCLUSION Increased incidence of perinatal mental health diagnoses during COVID-19 suggests complex dynamics involving pandemic and health and social risk factors. REGISTRATION This study was registered with Clinicaltrials.gov (NCT05663762) on December 21, 2022.
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Affiliation(s)
- Rebecca H Correia
- Health Research Methodology graduate program, McMaster University, Hamilton, ON, Canada
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - Elizabeth K Darling
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - Manisha Pahwa
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Hamideh Bayrampour
- Department of Family Practice, Midwifery Program, University of British Columbia, University Endowment Lands, Vancouver, Canada
| | - Aaron Jones
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | | | - Jessica Liauw
- Department of Obstetrics and Gynecology, University of British Columbia, University Endowment Lands, Vancouver, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
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8
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Sergi MR, Saggino A, Balsamo M, Picconi L, Anchora L, Tommasi M. Risk factors of the antenatal depression in a sample of Italian pregnant women: a preliminary study. BMC Pregnancy Childbirth 2024; 24:689. [PMID: 39433991 PMCID: PMC11494958 DOI: 10.1186/s12884-024-06704-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 07/16/2024] [Indexed: 10/23/2024] Open
Abstract
BACKGROUND Antenatal depression is characterized by low mood, insomnia, disorganised behaviour, irritability, and agitation during the pregnancy. If underestimated, antenatal depression is untreated during the pregnancy. It is associated to higher levels of suicide, higher risk of depression after childbirth, preeclampsia, preterm birth, low birth weight, poor interactions between child and mother and severe obstetric outcomes. New data underlined the importance to prevent the risk of depression during the pregnancy. This study examines the predictive validity of potential risk factors, such as socio-demographic and psychological factors, in developing the antenatal depression. METHODS The sample was composed by Italian pregnant women (N = 247, mean age of 33.77, SD = 4.78 years). This sample completed the Edinburg Postnatal Depression Scale (EPDS), the Teate Depression Inventory (TDI) and questionnaires about demographic variables. To study associations among variables examined bivariate correlations were computed. To analyse the role of socio-demographic factors and the psychological dimension to predict the severity of the antenatal depression a logistic regression was performed. RESULTS Results showed significantly positive correlations between the EPDS and the TDI, and no associations among the EPDS and all socio-demographic factors. Therefore, only the psychological factors were significant predictive risk factors of antenatal period. Finally, higher score of the depression measured via TDI predicted higher score of the EPDS. CONCLUSIONS Our results had implications in clinical field. Indeed, the early diagnosis of depression during the pregnancy can help operators in the gynaecological field to prevent the depression in the post-partum period.
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Affiliation(s)
- Maria Rita Sergi
- Department of Psychology, University of Chieti-Pescara, Chieti, Italy.
| | - Aristide Saggino
- Department of Psychology, University of Chieti-Pescara, Chieti, Italy
| | - Michela Balsamo
- Department of Psychology, University of Chieti-Pescara, Chieti, Italy
| | - Laura Picconi
- Department of Psychology, University of Chieti-Pescara, Chieti, Italy
| | | | - Marco Tommasi
- Department of Psychology, University of Chieti-Pescara, Chieti, Italy
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9
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Cheng J, Peng Y, Xiong J, Qin X, Peng Z, Mao W, Li H, Wang M, Zhang L, Ju Y, Liu J, Yu Y, Liu B, Zhang Y. Prevalence and risk factors of antenatal depression in the first trimester: A real-world cross-sectional study in a developed district in South China. J Affect Disord 2024; 362:853-858. [PMID: 39029675 DOI: 10.1016/j.jad.2024.07.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/28/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Antenatal depression may result in adverse outcomes for both the mother and the offspring. However, few studies have focused on the screening of pregnant women at a higher risk for antenatal depression in the first trimester. The present study aimed to assess the effect of lifestyle and family relationships on antenatal depression in the first trimester in a large Chinese population. METHODS Cross-sectional population data were obtained from a real-world cross-sectional survey conducted in Shenzhen, China from 2020 to 2024. The data on sociodemographic characteristics, lifestyle, and family relationships were obtained using self-reported questionnaires. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a score of ≥13 indicating the presence of probable antenatal depression. A binary logistic regression model was used to identify the risk factors of antenatal depression. RESULTS A total of 42,363 pregnant women in the first trimester were recruited in the cross-sectional survey, among whom 3107 (7.3 %) had probable antenatal depression. We found (1) age < 25 years, (2) low or moderate economic status, (3) smoking, (4) partner smoking, (5) alcohol use, (6) lack of physical exercise, (7) poor or moderate living environment, (8) low or moderate marital happiness, and (9) never talking about problems were associated with antenatal depression. However, level of education, employment status, partner alcohol use, and living alone were not significantly related to antenatal depression in the first trimester. LIMITATIONS The cross-sectional design and the use of self-report measures must be considered while interpreting the results. CONCLUSIONS This study suggested that the prevalence of antenatal depression in the first trimester was 7.3 %. Public health prevention efforts aimed at reducing the prevalence of antenatal depression are recommended. Early identification of women at a higher risk in early pregnancy is necessary for preventing antenatal depression and improving quality of life.
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Affiliation(s)
- Junzhe Cheng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China; Clinical Medicine Eight-Year Program, Xiangya School of Medicine, Central South University, Changsha, Hunan 41008, China
| | - Yilin Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Jintao Xiong
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Xuemei Qin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Zhuo Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Weiguo Mao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Huiqin Li
- Department of Obstetrics, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, Guangdong 518100, China
| | - Mi Wang
- Department of Mental Health Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Li Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Yumeng Ju
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Jin Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Yan Yu
- Department of Obstetrics, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, Guangdong 518100, China.
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China.
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China.
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Wu D, Chen S, Zhong X, Zhang J, Zhao G, Jiang L. Prevalence and factors associated with antenatal depressive symptoms across trimesters: a study of 110,584 pregnant women covered by a mobile app-based screening programme in Shenzhen, China. BMC Pregnancy Childbirth 2024; 24:480. [PMID: 39014317 PMCID: PMC11251361 DOI: 10.1186/s12884-024-06680-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/04/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Antenatal depression is a significant public health issue affecting pregnant women both globally and in China. Using data from a mobile app-based screening programme, this study explored the prevalence and factors associated with antenatal depressive symptoms across different trimesters in Shenzhen. METHODS A retrospective cross-sectional study was conducted on pregnant women who gave birth in any hospital in Shenzhen between July 2021 and May 2022 and underwent depression screening using an official maternal and infant health mobile app at least once during pregnancy. Depressive symptoms were evaluated using the 9-item Patient Health Questionnaire (PHQ-9), with cut-off scores of 5 and 10 for mild and high level of symptoms, respectively. The prevalence for each trimester was determined by calculating the proportion of women scoring 5 or higher. A variety of sociodemographic, obstetric, psychological, and lifestyle factors were assessed for their association with depressive symptoms. Chi-square test and multivariate logistic regression were performed to identify significant predictors. RESULTS A total of 110,584 pregnant women were included in the study, with an overall prevalence of depressive symptoms of 18.0% and a prevalence of high-level symptoms of 4.2%. Depressive symptoms were most prevalent in the first trimester (10.9%) and decreased in the second (6.2%) and third trimesters (6.3%). Only a small proportion (0.4%) of women showed persistent depressive symptoms across all trimesters. Anxiety symptoms in early pregnancy emerged as the most significant predictor of depressive symptoms. Other factors linked to an increased risk throughout pregnancy include lower marital satisfaction, living with parents-in-law, experience of negative life events, as well as drinking before and during pregnancy. Factors associated with a reduced risk throughout pregnancy include multiparity and daily physical activity. CONCLUSIONS This large-scale study provides valuable insights into the prevalence and factors associated with antenatal depressive symptoms in Shenzhen. The findings underscore the need for targeted interventions for high-risk groups and the integration of mental health care into routine antenatal services. Continuous, dynamic monitoring of depressive symptoms for pregnant women and ensuring at-risk women receive comprehensive follow-up and appropriate psychological or psychiatric care are crucial for effectively addressing antenatal depression and improving maternal and infant health outcomes.
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Affiliation(s)
- Dadong Wu
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518000, Guangdong Province, China
- Shenzhen Key Laboratory of Maternal and Child Health and Diseases, Shenzhen, 518000, Guangdong Province, China
| | - Siqi Chen
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Xiaoqi Zhong
- The Second School of Clinical Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong Province, China
| | - Jiayi Zhang
- School of Health Management, Southern Medical University, Guangzhou, 510515, Guangdong Province, China
| | - Guanglin Zhao
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Lei Jiang
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518000, Guangdong Province, China.
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11
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Albertini JGL, Benute GRG, Francisco RPV, Galletta MAK. Factors associated with depression during pregnancy in women receiving high- and low-risk prenatal care: a predictive model. Front Psychiatry 2024; 15:1326151. [PMID: 39045551 PMCID: PMC11263013 DOI: 10.3389/fpsyt.2024.1326151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 06/12/2024] [Indexed: 07/25/2024] Open
Abstract
Introduction Depression during pregnancy can put strain on pregnant women's interpersonal relationships, the formation of emotional bonds with the fetus, and the adaptation to the new routine and social role post-pregnancy. Some studies have associated socioeconomic factors, emotional factors, interpersonal relationships, perceived social support, gestational risk, and the occurrence of certain diseases during pregnancy with higher risk of depression. Objectives This study aimed to investigate the prevalence of depression during pregnancy and associated factors in low- and high-risk prenatal patients at a Brazilian university hospital. Methods This study presents a retrospective and prospective cross-sectional design. A total of 684 prenatal psychological analysis records from a Brazilian tertiary university service were retrospectively evaluated to assess depression through the PRIME-MD questionnaire between 2002-2017. Between 2017 and 2018, 76 patients treated at the same service were prospectively evaluated with the aforementioned instrument. Medical records were accessed to obtain labor and birth data. Multivariate analyses assessed the association between sociodemographic, gestational or obstetric, and health variables and the presence of depression during pregnancy. Results A total of 760 pregnant women were included in the study, with a depression prevalence of 20.66% (n = 157). At the time of assessment, 48 (21.05%) women from the low-risk pregnancy group and 109 (20.49%) from the high-risk pregnancy group were depressed. The mean age was 30.01 ± 6.55 years in the group with depression and 29.81 ± 6.50 years in the group without depression. In the univariate analysis, there was an association of risk for depression with absence of paid work, absence of a partner, low family income and diagnosis of epilepsy, being a protective factor the presence of diabetes during pregnancy. However, in the multivariate analysis, a lower family income, not having a partner at the time of the assessment, and the prevalence of epilepsy were independently associated with an increased risk of depression during pregnancy. Conclusion This study showed that 1 in 5 women had depression during pregnancy, with no association with obstetric risk, but those women living in unfavorable economic conditions, without a partner, and having epilepsy were at increased risk of depression.
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Affiliation(s)
- Jessica Gorrão Lopes Albertini
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia da Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Rossana Pulcineli Vieira Francisco
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia da Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Marco Aurélio Knippel Galletta
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia da Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
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12
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Kim ME, Jung HN. Prevalence and associated factors of prenatal depression in pregnant Korean women during the COVID-19 pandemic: a cross-sectional study. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2023; 29:274-290. [PMID: 38204388 PMCID: PMC10788393 DOI: 10.4069/kjwhn.2023.11.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 06/22/2023] [Accepted: 11/22/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE This study investigated the effects of prenatal education characteristics, pandemic-related pregnancy stress, and health behaviors during pregnancy on prenatal depression in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. METHODS The participants were 180 pregnant Korean women, recruited from internet communities for pregnancy preparation, childbirth, and childcare, from July 5 to 15, 2022. The collected data were analyzed using the t-test, analysis of variance, the Mann-Whitney U-test, the Kruskal-Wallis test, and multiple regression analysis. RESULTS The scores for pandemic-related pregnancy stress (24.50±6.37) and health behaviors during pregnancy (67.07±9.20) were high. Nearly half of the participants (n=89, 49.4%) presented with prenatal depression, with scores of 10 or greater. Prenatal depression had a positive correlation with gestational age (r=.18, p=.019) and pandemic-related pregnancy stress (r=.27, p<.001), and a negative correlation with health behaviors during pregnancy (r=-.42, p<.001). The factors associated with prenatal depression were pandemic-related pregnancy stress (t=4.70, p<.001), marital satisfaction (dissatisfied) (t=3.66, p<.001), pregnancy healthcare practice behaviors (t=-3.31, p=.001), family type (weekend couple) (t=2.84, p=.005), and gestational age (t=2.32, p=.022). The explanatory power of these variables was 38.2%. CONCLUSION Since participants had a high level of prenatal depression during the pandemic, and infectious diseases such as COVID-19 may recur, strategies should be developed to improve pregnant women's mental health with consideration of the unique variables that are relevant in a pandemic. It is also necessary to develop efficient online prenatal education programs that can be implemented even in special circumstances such as social distancing, and to evaluate their effectiveness.
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Affiliation(s)
- Mi-Eun Kim
- Department of Nursing Science, Jeonju University, Jeonju, Korea
| | - Ha-Neul Jung
- Department of Nursing Science, Jeonju University, Jeonju, Korea
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13
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Warmelink JC, Marissink L, Kroes L, Ranjbar F, Henrichs J. What are antenatal maternity care needs of women who conceived through fertility treatment?: a mixed methods systematic review. J Psychosom Obstet Gynaecol 2023; 44:2148099. [PMID: 36508566 DOI: 10.1080/0167482x.2022.2148099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Existing research indicates that pregnant women who conceived through fertility treatment might experience more stress and anxiety compared to women who conceived spontaneously. Therefore, these women might have additional antenatal care needs. METHODS A search for both quantitative and qualitative studies was performed in PubMed, PsycINFO, CINAHL and MEDLINE through May 2021, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. 21 articles met the inclusion criteria. After methodological quality appraisal using the Mixed Methods Appraising Tool, 15 studies were included in the review. RESULTS Analysis of the studies identified behavioral, relational/social, emotional, and cognitive needs and women's preference about maternity care. Women who conceived through fertility treatment reported lower social and physical functioning scores and elevated levels of anxiety and depression compared to women who conceived spontaneously. They reported difficulties adjusting to pregnancy and experienced a care gap between discharge from the fertility clinic and going to local maternity care services for their first consultation, and a care gap postpartum. CONCLUSIONS Women who conceived through fertility treatment have additional antenatal care needs. We recommend to offer these women more frequent check-ins, and to pay attention to the impact of their infertility and treatment on their pregnancy.
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Affiliation(s)
- J Catja Warmelink
- Department of General Practice and Elderly Care Medicine, Section Midwifery Science AVAG, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Midwifery Science, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Midwifery Academy Amsterdam/Groningen, Groningen, The Netherlands
| | - Lisa Marissink
- Midwifery Academy Amsterdam/Groningen, Groningen, The Netherlands.,Midwifery Practice Liberis Libenter, Enschede, The Netherlands
| | - Linda Kroes
- Midwifery Academy Amsterdam/Groningen, Groningen, The Netherlands.,Midwifery Practice De vroedschap, Oosterwolde, The Netherlands.,Midwifery Practice De morgen, Dalfsen, The Netherlands
| | - Fahimeh Ranjbar
- Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jens Henrichs
- Department of Midwifery Science, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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14
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Yu J, Zhang Z, Deng Y, Zhang L, He C, Wu Y, Xu X, Yang J. Risk factors for the development of postpartum depression in individuals who screened positive for antenatal depression. BMC Psychiatry 2023; 23:557. [PMID: 37528383 PMCID: PMC10394808 DOI: 10.1186/s12888-023-05030-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/15/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Women with antenatal depression often have a higher risk of developing postpartum depression (PPD) after delivery. A number of factors associated with the PDD in those previously reporting antenatal depression have been suggested, but further research is needed. This study aimed to investigate factors associated with developing subsequent postnatal depression in women who had screened positive for antenatal depression. METHODS This study was carried out in Hangzhou women's Hospital. 578 women who experienced antenatal depression from this cohort were enrolled in this study. The sociodemographic and clinical characteristics of the participants were collected and tabulated against the incidence of postnatal depression. Binary logistic regression was used to estimate the effects of the principal underlying variables. The Chinese-version Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PPD. Antenatal screening for depression was conducted at 28-34 weeks during pregnancy and postpartum depressive symptoms were assessed at 6 weeks after childbirth in the women. Path Analysis of Structural Equation Model (SEM) was employed to explore the direct, indirect, and total effects of risk factors of PPD. RESULTS 57.6% (n = 333) of the participants subsequently developed PPD in our study. The results of the logistic analysis indicated that ages ≤ 35 years old (OR = 1.852; 95%CI: 1.002-3.423), non-one-child families (OR = 1.518; 95%CI: 1.047-2.200), and rare care from partner during pregnancy (OR = 2.801; 95%CI: 1.038-7.562), the antenatal EPDS score (OR = 1.128; 95%CI: 1.052-1.209), pyrexia during pregnancy (OR = 2.43; 95%CI: 1.358-4.345), fairly good (OR = 1.836; 95%CI: 1.009-3.340), fairly bad (OR = 3.919; 95%CI:2.072-7.414) and very bad postpartum sleep quality (OR = 9.18; 95%CI: 2.335-36.241) were associated with increased risk of PPD (compared to very good postpartum sleep quality). In path analysis model, antenatal EPDS score (standardized total β = 0.173) and pyrexia during pregnancy (standardized total β = 0.132) had both direct and indirect effects (the impact on outcome variables needs to be determined through other variables) on PPD. Sleep quality after delivery (standardized β = 0.226) and one-child family (standardized β = 0.088) had direct effects only on PPD. CONCLUSION The results from our study indicated that more than 50% of the women who experienced antepartum depression would subsequently develop PPD. Depressive symptoms and pyrexia during pregnancy increase PPD scores, and these effects were in part mediated via poor sleep quality during the postpartum period.
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Affiliation(s)
- Jingjing Yu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China
| | - Zhiyin Zhang
- Department of Obstetrics, The Affiliated Hangzhou Women's Hospital, Hangzhou Normal University, Hangzhou, China
| | - Yuanyuan Deng
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China
| | - Lijun Zhang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China
| | - Chuncao He
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China
| | - Yinyin Wu
- Department of Epidemiology and Biostatistics, Hangzhou Normal University School of Public Health, Hangzhou, China
| | - Xianrong Xu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China.
| | - Jun Yang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, 2318 Yuhangtang Rd, Hangzhou, 311121, Zhejiang, China.
- Zhejiang Provincial Research Center for the Diagnosis and Treatment of Uterine Cancer, The Affiliated Women's Hospital, Zhejiang University, Hangzhou, China.
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Kundarti FI, Titisari I, Rahayu DE, Kiswati, Jamhariyah. Mindfulness improves the mental health of infertile women: A systematic review. J Public Health Res 2023; 12:22799036231196693. [PMID: 37711728 PMCID: PMC10498716 DOI: 10.1177/22799036231196693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/04/2023] [Indexed: 09/16/2023] Open
Abstract
Infertility in women causes mental health problems, the bad ones. Women with infertility need psychological treatment using mindfulness interventions. This study's purpose was to analyze mindfulness's effect on the mental health of women with infertility through a systematic review. The method used in this systematic review was by searching through the following databases; ProQuest database, Wiley Library, Pubmed, Scopus, Science Direct, Sage Journal, Cochrane Library, and Cambridge Core from January 2011 to December 2021. Nine articles met the inclusion criteria. Results show that the use of mindfulness was found to be effective in reducing mental disorders in women with infertility. Nine articles that meet the criteria for inclusion. According to a study on the effects of mindfulness on infertile women, affect increasing mental health levels by reducing mental health disorder scores. Mindfulness has been proven to be an effective intervention for women undergoing infertility-related mental disorders such as stress, anxiety, and depression. However, different types of mindfulness-based interventions are used to target different mental health issues. For example, Mindfulness-Based Stress Reduction (MBSR) targets stress and anxiety while Mindfulness-Based Cognitive Therapy (MBCT) targets depression. Additionally, specific mindfulness for example, for the midwifery profession can be developed to improve the quality and treatment outcomes of healthcare for women struggling with infertility problems.
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Affiliation(s)
- Finta Isti Kundarti
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Ira Titisari
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Dwi Estuning Rahayu
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Kiswati
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Jamhariyah
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
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16
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Răchită AIC, Strete GE, Sălcudean A, Ghiga DV, Rădulescu F, Călinescu M, Nan AG, Sasu AB, Suciu LM, Mărginean C. Prevalence and Risk Factors of Depression and Anxiety among Women in the Last Trimester of Pregnancy: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1009. [PMID: 37374213 DOI: 10.3390/medicina59061009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
Pregnancy represents a psychologically and emotionally vulnerable period, and research indicates that pregnant women have a higher prevalence of symptoms of anxiety and depression, debunking the myth that hormonal changes associated with pregnancy protect the mother. In recent years, several researchers have focused on the study of prenatal anxiety/depression-emotional disorders manifested by mood lability and low interest in activities-with a high prevalence. The main objective of this research was to conduct an antenatal screening in a cohort of pregnant women hospitalized for delivery in order to assess the prevalence of anxiety and depression. The secondary objective was to identify the risk factors associated with depression and anxiety in women in the third trimester of pregnancy. We carried out a prospective study in which we evaluated 215 pregnant women in the third trimester of pregnancy hospitalized for childbirth at the Obstetrics and Gynecology Clinic of the Târgu-Mureș County Clinical Hospital. The research was carried out between December 2019 and December 2021. The results showed that age and the environment of origin are the strongest predictors of mental health during pregnancy (OR = 0.904, 95%CI: 0.826-0.991; p = 0.029). For women from urban areas, there is an increased probability of falling at a higher level on the dependent variable (moderate depression) (OR = 2.454, 95%CI: 1.086-5.545; p = 0.032). In terms of health behaviors, none of the variables were statistically significant predictors of the outcome variable. The study highlights the importance of monitoring mental health during pregnancy and identifying relevant risk factors to provide appropriate care to pregnant women and the need for interventions to support the mental health of pregnant women. Especially in Romania, where there is no antenatal or postnatal screening for depression or other mental health conditions, these results could be used to encourage the implementation of such screening programs and appropriate interventions.
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Affiliation(s)
- Anca Ioana Cristea Răchită
- Doctoral School, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540139 Târgu Mureș, Romania
| | - Gabriela Elena Strete
- Department of Psychiatry, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
- Mental Health Center, Mureș County Clinical Hospital, 540072 Târgu Mureș, Romania
| | - Andreea Sălcudean
- Department of Ethics and Social Sciences, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
| | - Dana Valentina Ghiga
- Department of Medical Scientific Research Methodology, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
| | - Flavia Rădulescu
- Department of Endocrinology, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
| | - Mihai Călinescu
- Graduate of Cluj School of Public Health, Babes-Bolyai University Cluj Napoca, 400347 Cluj-Napoca, Romania
| | - Andreea Georgiana Nan
- First Department of Psychiatry, Clinical County Hospital, 540139 Târgu Mureș, Romania
| | - Andreea Bianca Sasu
- First Department of Psychiatry, Clinical County Hospital, 540139 Târgu Mureș, Romania
| | - Laura Mihaela Suciu
- Department of Obstetrics and Gynecology Clinic II, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
| | - Claudiu Mărginean
- Department of Obstetrics and Gynecology Clinic II, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, 540136 Târgu Mureș, Romania
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17
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Anxiety and Depression Levels in Parents after Counselling for Fetal Heart Disease. J Clin Med 2023; 12:jcm12010394. [PMID: 36615193 PMCID: PMC9821259 DOI: 10.3390/jcm12010394] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023] Open
Abstract
The progress in fetal cardiology allows for the early diagnosis of congenital heart defects, but there is still a lack of data on the psychological situation of parents expecting a child with a congenital heart defect. In this cross-sectional study, 77 parents (45 women and 32 men) expecting a child with a heart defect were interviewed with different questionnaires. The standardized Hospital Anxiety and Depression Scale (HADS) questionnaire was used to assess the psychological state of the parents. Various statistical procedures were performed to determine the prevalence, risk factors, and predictors of anxiety and depression. The prevalence for prenatal anxiety was 11.8% and for depressed mood 6.6%, whereas the postnatal prevalence was 25% for anxiety and 16.7% for depressed mood. The mother is influential in protecting against depression as a contact person (p = 0.035). Women were more affected by anxiety and depression than men (p = 0.036). A significant and positive correlation was observed between anxiety and depression before birth (ρ = 0.649, p < 0.001) and after birth (ρ = 0.808, p < 0.001). The level of education correlated negatively with depression (p = 0.016) and anxiety (p = 0.017) before birth. Significantly higher anxiety and depression scores were not observed among health and social workers (p = 0.084), first-time mothers (p = 0.190), and parents whose pregnancies were due to medical assistance (p = 0.051). Close collaboration between maternal-fetal care units, pediatric cardiologists and psychiatric/psychosomatic disciplines is a possible strategy to reduce stress in parents. Therefore, an expert team of professionals, educating with understandable terms and sufficient knowledge about fetal heart disease in parenting counseling, is required. The support of affected parents can positively impact the treatment of the child and should be integrated into the daily routine of the clinic.
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18
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Jiang L, Wu D, Chen S, Zhao G, Wang Y, Duan W, Liu H. Towards Universal Screening for Postpartum Depression in China: Lessons Learned from a Comprehensive Prevention Programme in Shenzhen. Matern Child Health J 2022; 26:2109-2117. [PMID: 35947274 DOI: 10.1007/s10995-022-03482-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 05/09/2022] [Accepted: 07/19/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE This study was conducted to assess the real-world efficacy of a universal programme for the prevention of postpartum depression (PPD) in Shenzhen. Given the lack of evidence on routine PPD screening and intervention in China, it sought to provide insights for programme planning and implementation, particularly in relation to achievement of the targets set by the first national guidelines for PPD prevention and treatment. METHODS Using routine health information system data, the PPD screening, referral and intervention rates for 2015-2019 were calculated and compared to the programmes targets. Trends of variables were tested by using trend χ2. RESULTS The programme screened 137,761 to 178,857 women for PPD every year with the coverage among all postpartum women increased steadily from 71.1% to 82. 5% (χ2 = 10145.251, p < 0.001). The PPD-positive rate maintained between 4.06% and 4.89%. However, although referral messages were given to an increased percentage of PPD-positive women (χ2 = 1090.908, p < 0.001), the intervention rate (i.e., referral uptake) were far lower than the programme target of 80%. CONCLUSIONS This study demonstrated high efficacy of Shenzhen's comprehensive PPD prevention programme initiated in 2013. The resultant rise in the screening rate among all postpartum women, together with a high referral rate of those screened positive, have contributed to the city's relatively low PPD prevalence. PPD screening and intervention should be included as part of basic public health services to ensure universal coverage and specific strategies should be adopted to ensure referral uptake.
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Affiliation(s)
- Lei Jiang
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 2004, Hongli Road, 518000, Shenzhen, Guangdong Province, China
| | - Dadong Wu
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 2004, Hongli Road, 518000, Shenzhen, Guangdong Province, China.
| | - Siqi Chen
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 2004, Hongli Road, 518000, Shenzhen, Guangdong Province, China
| | - Guanglin Zhao
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 2004, Hongli Road, 518000, Shenzhen, Guangdong Province, China
| | - Yueyun Wang
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 2004, Hongli Road, 518000, Shenzhen, Guangdong Province, China
| | - Weidong Duan
- Shenzhen Kangning Psychiatric Hospital, No. 1080, Cuizhu Road, 518000, Shenzhen, Guangdong Province, China
| | - Honglei Liu
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 2004, Hongli Road, 518000, Shenzhen, Guangdong Province, China
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19
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Buehler C, Girod SA, Leerkes EM, Bailes L, Shriver LH, Wideman L. Women's Social Well-Being During Pregnancy: Adverse Childhood Experiences and Recent Life Events. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:582-592. [PMID: 35814611 PMCID: PMC9258794 DOI: 10.1089/whr.2022.0023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse experiences during childhood and recent stressful life events are each associated with women's reduced well-being and poorer health during pregnancy. Few studies, however, have focused upon pregnant women's social well-being, and inclusion of both independent variables in the same analysis is rare. This study focuses upon adverse experiences during childhood as well as recent life events in relationship to four aspects of social well-being: social support, couple aggression for partnered women, neighborhood safety, and food insecurity. MATERIALS AND METHODS A diverse community sample of 176 pregnant women completed questionnaires during their third trimester. A cross-sectional design was used that included retrospective reports of childhood experiences, as well as reports of recent life events and current well-being. RESULTS Adverse experiences during childhood were uniquely associated with couple aggression (β = 0.206, p = 0.026) and lower neighborhood safety (β = -0.185, p = 0.021). Recent stressful life events were uniquely associated with lower social support (β = -0.247, p = 0.001) and greater food insecurity (β = 0.494, p = 0.000). For social support and food insecurity, there was a significant indirect pathway from adverse childhood experiences through recent stressful life events. Adverse child experiences and recent stressful life events did not interact. CONCLUSIONS A life-course perspective that considers women's experiences across their life span is critical for use by both researchers and health practitioners. Adverse childhood experiences and recent stressful life events are important for understanding social features of pregnant women's daily lives.
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Affiliation(s)
- Cheryl Buehler
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Savannah A. Girod
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Esther M. Leerkes
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
- School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Lauren Bailes
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Lenka H. Shriver
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, North Carolina, USA
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20
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Li L, Yue SW, Xu J, Qiao J, Redding SR, Ouyang YQ. Effectiveness of Internet-based psychological interventions for treating perinatal depression: A systematic review and meta-analysis. J Clin Nurs 2022. [PMID: 35697972 DOI: 10.1111/jocn.16399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 02/18/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Perinatal depression can result in short- and long-term adverse effects for women and their children if untreated. Psychological interventions, the preferred treatment for most women with perinatal depression, can also be provided online. AIMS This study aimed to provide a comprehensive and systematic review of Internet-based psychological interventions and to evaluate their effectiveness in the treatment of perinatal depression. DESIGN Systematic review and meta-analysis. METHODS A systematic literature search was conducted of six databases, including CINAHL, PubMed, Embase, Web of Science, the Cochrane Library and PsycINFO. Depression and anxiety, which were the primary and secondary results of this search, were presented as standardised mean differences (SMD) and 95% confidence intervals (CIs). This review was conducted according to the PRISMA checklist. RESULTS Thirteen studies involving 2158 perinatal women were included. Content, method, duration and frequency of Internet-based psychological interventions were varied. Participants indicated a high rate of satisfaction with these interventions; participants' dropout rates ranged from 2.6% to 60.8%. Meta-analysis demonstrated that Internet-based psychological interventions improved perinatal depression (SMD = -0.72, CI = [-1.02, -0.42], p < .01) and anxiety symptoms (SMD = -0.52, CI = [-0.73, -0.30], p < .01), with heterogeneity of 86% and 59%, respectively. CONCLUSIONS Internet-based psychological interventions are considered as convenient and effective alternative treatment for perinatal depression and anxiety. In the future, additional studies are needed to investigate the long-term effects of these interventions on the mental health of perinatal women and the effects on the growth and development of infants while controlling for the dropout rate. RELEVANCE TO CLINICAL PRACTICE Internet-based psychological interventions are innovative approaches to improving perinatal depressive symptoms that can leverage mental health resources and improve accessibility while promoting multidisciplinary integration. The approach, content, frequency and duration of intervention should be considered comprehensively to achieve the objectives of the intervention while maintaining compliance of women with perinatal depression.
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Affiliation(s)
- Lu Li
- School of Nursing, Wuhan University, Wuhan, China
| | - Shu-Wen Yue
- School of Nursing, Wuhan University, Wuhan, China
| | - Jing Xu
- School of Nursing, Wuhan University, Wuhan, China
| | - Jia Qiao
- School of Nursing, Wuhan University, Wuhan, China
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21
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Huang S, Wischik DL, Whittemore R, Jeon S, Qing L, Guo J. Determinants of elevated depressive symptoms in Chinese women with gestational diabetes mellitus. Birth 2022; 49:289-297. [PMID: 34927281 DOI: 10.1111/birt.12605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/19/2021] [Accepted: 12/08/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Pregnant women with gestational diabetes mellitus (GDM) have a higher risk of developing elevated depressive symptoms than women without GDM. The aim of this study was to investigate the sociodemographic (eg, location), clinical (eg, health care-seeking behaviors), and psychological (eg, active coping skills) factors associated with elevated depressive symptoms in Chinese women with GDM. METHODS This was a secondary data analysis of a cross-sectional study among Chinese women with GDM. Data (n = 323) were collected in 2018 from two hospitals in Hunan Province in China. The Center for Epidemiological Survey Depression Scale was used, with a criterion score ≥20 indicative of clinically elevated depressive symptoms. Descriptive, bivariate, and multiple logistic regression analyses were completed. FINDINGS The women had a mean age of 32.71 (SD = 5.17), and the majority were married (84.2%), college-educated (65.6%), and with Han ethnicity (89.8%). About 68% of women had elevated depressive symptoms. Women with higher active coping scores were less likely (OR = 0.19, 95% CI: 0.10-0.38) to have elevated depressive symptoms. Women from one geographical location (Changde) who had more emergency room visits had higher odds (OR = 3.10, 95% CI: 1.88-5.10) of elevated depressive symptoms. DISCUSSION There was a high co-occurrence of GDM and elevated depressive symptoms among pregnant women in our sample. Assessment for depressive symptoms in women with GDM is warranted. More research about increasing active coping skills may improve health outcomes in women with GDM.
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Affiliation(s)
| | | | | | | | - Long Qing
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, China
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22
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Pathways from Neuroticism, Social Support, and Sleep Quality to Antenatal Depression during the Third Trimester of Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095602. [PMID: 35565028 PMCID: PMC9100278 DOI: 10.3390/ijerph19095602] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 02/04/2023]
Abstract
Background: Antenatal depression is a severe public health problem. Many studies support the concept that neuroticism, social support, and sleep quality are closely related to antenatal depression. However, there is little evidence concerning the influencing pathways of these variables on antenatal depression. The aim of this study is to investigate the pathways from neuroticism, social support, and sleep quality to antenatal depression during the third trimester of pregnancy. Methods: A cross-sectional study design was used. A total of 773 eligible women in the third trimester of pregnancy submitted valid questionnaires from June 2016 to April 2017. Instruments with good reliability and validity were used to measure neuroticism, social support, sleep quality, and antenatal depression. Structural equation modeling was used to explore the pathways from neuroticism, social support, and sleep quality to antenatal depression during the third trimester of pregnancy. Results: Antenatal depression is shown to be positively correlated with neuroticism and negatively correlated with social support and sleep quality. Neuroticism is shown to have a direct effect and indirect effects through social support and sleep quality on antenatal depression. Conclusions: Neuroticism influences antenatal depression directly and indirectly. Social support and sleep quality are the mediators of the indirect relationship between neuroticism and antenatal depression. Our results suggest that a personality test offered to all pregnant women could help detect a vulnerability to depression, whereupon intervention in the domains of sleep and social support could prove preventive.
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23
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Oh J, Ahn S. Predictors of Antenatal Depression in Pregnant Couples. Clin Nurs Res 2021; 31:881-890. [PMID: 34961355 DOI: 10.1177/10547738211065238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pregnant women and their partners are at an increased risk of antenatal depression. Therefore, this cross-sectional study of data from 116 couples investigated predictors of maternal and paternal antenatal depression using sociodemographic data, women's risk factors for depression during the antenatal period, women's perceived stress, and antenatal depression in the other partner. Pregnant women had higher depression scores (7.4 ± 4.7) and a higher frequency of being at high risk for depression (25.9%) than their spouses (4.6 ± 3.5, 9.5%). Multiple linear regression analysis revealed that the statistically significant predictors of antenatal depression in pregnant women were perceived stress (β = .45, p < .001) and antenatal depression risk factors (β = .30, p = .002) and in spouses, women's antenatal depression risk factors (β = .29, p = .013). The present findings suggest that nurses should intervene to mitigate the risk of maternal antenatal depression and perceived stress to prevent depression in pregnant couples.
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Affiliation(s)
- Jiwon Oh
- Chungnam National University, Daejeon, Republic of Korea
| | - Sukhee Ahn
- Chungnam National University, Daejeon, Republic of Korea
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24
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Li P, Wang H, Feng J, Chen G, Zhou Z, Gou X, Ye S, Fan D, Liu Z, Guo X. Association Between Perceived Stress and Prenatal Depressive Symptoms: Moderating Effect of Social Support. J Multidiscip Healthc 2021; 14:3195-3204. [PMID: 34819730 PMCID: PMC8606966 DOI: 10.2147/jmdh.s341090] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/04/2021] [Indexed: 12/19/2022] Open
Abstract
Purpose Prenatal depressive symptoms are an important mental health problem during pregnancy. We aimed to explore the moderating role of social support on the association between perceived stress and prenatal depressive symptoms. Materials and Methods A cross-sectional study was conducted at an obstetrics clinic. A total of 1846 women completed a self-administered questionnaire, with a response rate of 91.8%. Results Of the 1846 participants, 28.2% reported prenatal depressive symptoms (Edinburgh postnatal depression scale score ≥ 9). After adjusting for demographic characteristics, gestational age, exercise, and passive smoking, both perceived stress (adjusted odds ratio (AOR): 1.210, 95% confidence interval (CI): 1.178–1.242) and social support (AOR: 0.950, 95% CI: 0.932–0.968) were associated with prenatal depressive symptoms. Moreover, social support had a moderating effect on the association between perceived stress and prenatal depressive symptoms (p < 0.001), and pregnant women with low social support were more likely to be affected by stress and experience prenatal depressive symptoms. Conclusion Our study suggests that higher social support reduces the impact of stress on pregnant women, which in turn, decreases the risk of prenatal depressive symptoms. Therefore, interventions aimed at improving social support should be considered for the prevention and treatment of prenatal depressive symptoms.
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Affiliation(s)
- Pengsheng Li
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Haiyan Wang
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Biobank, Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Jinping Feng
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Gengdong Chen
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Zixing Zhou
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Xiaoyan Gou
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Biobank, Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Shaoxin Ye
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Dazhi Fan
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Zhengping Liu
- Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Xiaoling Guo
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
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25
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Guo J, Zheng A, He J, Ai M, Gan Y, Zhang Q, Chen L, Liang S, Yu X, Kuang L. The prevalence of and factors associated with antenatal depression among all pregnant women first attending antenatal care: a cross-sectional study in a comprehensive teaching hospital. BMC Pregnancy Childbirth 2021; 21:713. [PMID: 34702205 PMCID: PMC8545620 DOI: 10.1186/s12884-021-04090-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/29/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Antenatal depression has become a common and serious problem, significantly affecting maternal and fetal health. However, evaluation and intervention methods for pregnant women in obstetric clinics are inadequate. This study aimed to determine the prevalence of and risk factors for depression among all pregnant women at their first attending antenatal care in the obstetrics clinic, a comprehensive teaching hospital, southwest of China. METHODS From June to December 2019, 5780 pregnant women completed online psychological assessments, and data from 5728 of the women were analyzed. The women were categorized into two groups according to the presence or absence of depression. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9), with a cutoff point of 10 for depression. Anxiety and somatic symptoms were measured by the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-15 (PHQ-15), respectively. Univariate analysis and binary logistic regression analysis were used to determine the association among antenatal depression, anxiety, somatic symptoms and participants' characteristics. RESULTS The prevalence of antenatal depression among all the pregnant women at their first attending antenatal care was 16.3%, higher in the first trimester (18.1%). Anxiety symptoms (Mild anxiety AOR = 2.937; 95% CI: 2.448-3.524) and somatic symptoms (Mild somatic symptoms AOR = 3.938; 95% CI: 2.888-3.368) were major risk factors for antenatal depression among women and the risk increased more with the anxiety level or somatic symptoms level. Gestational weeks (second trimester AOR = 0.611; 95% CI: 0.483-0.773; third trimester AOR = 0.337; 95% CI: 0.228-0.498) and urban residence (AOR = 0.786; 95% CI: 0.652-0.947) were protective factors for antenatal depression among women. CONCLUSIONS About one in six pregnant women would experience depression, and special attention should be paid to some risk factors (i.e., early pregnancy, anxiety symptoms, somatic symptoms, rural residence). Online psychological assessments might be a time-saving and convenient screening method for pregnant women in obstetric clinics.
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Affiliation(s)
- Jiamei Guo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Anhai Zheng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Jinglan He
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Yao Gan
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Qi Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Lulu Chen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Sisi Liang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Xiaoyu Yu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
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Míguez MC, Vázquez MB. Risk factors for antenatal depression: A review. World J Psychiatry 2021; 11:325-336. [PMID: 34327125 PMCID: PMC8311510 DOI: 10.5498/wjp.v11.i7.325] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/20/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
Depression is the most prevalent mental disorder in pregnancy, and yet it is less studied than postpartum depression despite the consequences it may have on both the pregnant woman and her offspring. Therefore, it would be important to know which risk factors may favour the appearance of antenatal depression in order to carry out appropriate prevention interventions. The aim of the present review was to identify the main risk factors of antenatal depression. We searched in databases PubMed and PsycINFO for articles published about the factors associated with antenatal depression from January 2010 through December 2020. The literature review identified three main groups of antenatal depression risk factors: sociodemographic, obstetric, and psychological. First, among the sociodemographic variables, the low level of studies and the economic income clearly stood out from the rest. Then, not having planned the pregnancy was the main obstetric variable, and finally, the main psychological risk factors were having a history of psychological disorders and/or depression as well as presenting anxiety, stress, and/or low social support during pregnancy. This review shows that the antenatal depression is affected by multiple factors. Most can be identified at the beginning of the pregnancy, and some are risk factors potentially modifiable through appropriate interventions, such as psychological factors. For this reason, it is important to carry out a good screening for depression during pregnancy and consequently, be able to prevent its appearance or treat it if necessary.
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Affiliation(s)
- M Carmen Míguez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - M Belén Vázquez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela 15782, Spain
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Guan Z, Wang Y, Hu X, Chen J, Qin C, Tang S, Sun M. Postpartum depression and family function in Chinese women within 1 year after childbirth: A cross-sectional study. Res Nurs Health 2021; 44:633-642. [PMID: 34101868 DOI: 10.1002/nur.22159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 05/03/2021] [Accepted: 05/15/2021] [Indexed: 01/13/2023]
Abstract
Family-related factors are reported to influence the development of postpartum depression (PPD), but limited studies have considered the role of family function in this condition. This study aimed to describe the proportion of people with probable or suspected PPD and to determine the relationships among PPD, family function, and obstetric factors. A cross-sectional study was conducted with 630 women who attended six integrated teaching and scientific research communities in Changsha, China. Instruments included the Edinburgh Postpartum Depression Scale and the Family Assessment Device (FAD). A multivariate logistic regression model was used to determine the risk factors of PPD. The prevalence of probable or suspected PPD was 37% in this sample. We found communication (odds ratio [OR] = 3.795, 95% confidence interval [CI] = 1.619-8.897), affective responsiveness (OR = 2.685, 95% CI = 1.642-4.301), role (OR = 2.483, 95% CI = 1.041-5.922), and general functioning (OR = 5.704，95% CI = 2.233-14.569) dimensions of FAD, and type of feeding (OR = 2.700, 95% CI = 1.285-5.671) influenced PPD in the context of Chinese culture. To decrease the prevalence of PPD, interventions such as health education programs and cognitive behavior therapy to strengthen family function are recommended among couples during and after pregnancy.
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Affiliation(s)
- Ziyao Guan
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Yuwei Wang
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Xin Hu
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Jiarui Chen
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Chunxiang Qin
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China.,Department of Obstetrical, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Siyuan Tang
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China
| | - Mei Sun
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha, China.,Hunan Women's Research Association, Changsha, China
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Toscano M, Royzer R, Castillo D, Li D, Poleshuck E. Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications: A Systematic Review and Meta-analysis. Obstet Gynecol 2021; 137:881-891. [PMID: 33831928 PMCID: PMC8087456 DOI: 10.1097/aog.0000000000004335] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To systematically review the prevalence of antenatal depression and anxiety in women hospitalized in an antepartum unit for obstetric complications. DATA SOURCES We searched PubMed, EMBASE, CINAHL, PsycINFO, and ClinicalTrials.gov for English-language articles published from database inception through March 2020. METHODS OF STUDY SELECTION We included cross-sectional, cohort, case-control, quasi-experimental, and randomized controlled studies from any country that reported the proportion of pregnant women with an elevated depression or anxiety screening scale or diagnostic interview during antepartum hospitalization of any duration and at any gestational age. TABULATION, INTEGRATION, AND RESULTS We identified 8,799 articles and reviewed 79, 39 of which were included in a systematic review and 18 in meta-analysis of the primary outcome. Two raters independently assessed quality of individual studies using a 14-question tool. A random effects meta-analysis model was used to estimate prevalence and 95% CI of depression or anxiety. Heterogeneity was examined with the I2 test, and funnel plots were used to assess publication bias. After meta-analysis, the estimated prevalence of depression was 34% (95% CI 27-41%) and of anxiety 29% (95% CI 16-43%). There was expected substantial clinical and methodologic heterogeneity between studies that persisted even after planned a priori subgroup analyses and meta-regression. Even so, the direction of effect was consistent across studies. No publication bias was found. CONCLUSION The current meta-analysis suggests that one in three women hospitalized during pregnancy for obstetric complications report clinical levels of depression or anxiety symptoms, twice the reported prevalence of antenatal depression or anxiety in the general obstetric population. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42020172111.
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Affiliation(s)
- Marika Toscano
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, the Edward G. Miner Library, Institute for Innovative Education, the Department of Public Health Sciences, the Department of Obstetrics & Gynecology, and the Department of Psychiatry, University of Rochester Medical Center, and the School of Medicine and Dentistry, University of Rochester, Rochester, New York
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29
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Huang Y, Liu Y, Wang Y, Liu D. Family function fully mediates the relationship between social support and perinatal depression in rural Southwest China. BMC Psychiatry 2021; 21:151. [PMID: 33711987 PMCID: PMC7953569 DOI: 10.1186/s12888-021-03155-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 03/08/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Perinatal depression is the most common complication of gestation and childbearing affecting women and their families, and good social support and family function are considered protective and modifiable factors. This study aimed to investigate depression status and explore inter-relationships between social support and perinatal depression considering the influence of family function in rural areas of Southwest China. METHODS This is a cross-sectional study. The following instruments were used: the Edinburgh Postpartum Depression Scale, the APGAR Family Care Index Scale, and the Social Support Rate Scale. A structural equation modelling was used to test the hypothesis relationships among the variables. RESULTS A total of 490 rural antenatal (N = 249) and postpartum (N = 241) women (mean age (standard deviation), 28.17 ± 5.12) participated. We found that the prevalence of depression symptoms was 10.4%. Path analysis showed that family function had a direct negative correlation with depression (β = - 0.251, 95%CI: - 0.382 to - 0.118). Social support had a direct positive correlation with family function (β =0.293, 95%CI: 0.147 to 0.434) and had an indirect negative correlation with depression (β = - 0.074, 95%CI: - 0.139 to - 0.032), family function fully mediated the relationship between social support and depression. CONCLUSIONS Findings of this study highlight that family function should be considered as the key target for interventions aiming to lower the prevalence of perinatal depression. Family members interventions are critical to reduce depression among antenatal and postpartum women.
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Affiliation(s)
- Yilin Huang
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Yan Liu
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Yu Wang
- grid.506261.60000 0001 0706 7839Department of Radiation Oncology, National Cancer Center and Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
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30
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Zhang L, Wang L, Cui S, Yuan Q, Huang C, Zhou X. Prenatal Depression in Women in the Third Trimester: Prevalence, Predictive Factors, and Relationship With Maternal-Fetal Attachment. Front Public Health 2021; 8:602005. [PMID: 33575242 PMCID: PMC7870992 DOI: 10.3389/fpubh.2020.602005] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/23/2020] [Indexed: 12/11/2022] Open
Abstract
Objective: The prevalence of prenatal depression in pregnant women has found to be high, which may adversely affect the intimacy of a mother to her fetus. Few studies have investigated the relationship between prenatal depression and maternal-fetal attachment in pregnant Chinese women. This study is thus designed to evaluate the prevalence rate, predictive factors of prenatal depression in Chinese pregnant women in the third trimester of pregnancy, and the effect of prenatal depression on maternal-fetal attachment. Methods: A total of 340 pregnant women in the third trimester of pregnancy were recruited from a hospital in Anhui Province. The Edinburgh Postpartum Depression Scale (EPDS) was rated to assess the prenatal depression; the Pittsburgh Sleep Quality Index (PSQI) and Zung Self-Rating Anxiety Scale (SAS) were used to assess sleep quality and anxiety level for all participants. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal-fetal attachment. Results: The prevalence of prenatal depression in the participants was high (19.1%) in our study. The scores of prenatal anxiety and sleep disorders were higher with prenatal depression than in those without prenatal depression (47.6 ± 9.5 vs. 38.9 ± 6.9; 8.3 ± 3.3 vs. 6.1 ± 2.7, all p < 0.01). MAAS quality was lower in prenatal depression women than those in non-prenatal depression women (43.8 ± 5.6 vs. 46.4 ± 4.5, p < 0.01). Correlation analysis showed that prenatal depression was associated with parity, prenatal education, education level, marital satisfaction, anxiety and sleep disorders (all p < 0.05). Furthermore, binary logistic regression results showed that anxiety and sleep disorders were risk factors for prenatal depression. Prenatal education, higher marriage satisfaction were protective factors for prenatal depression. In addition, correlation analysis also showed that prenatal depression was positively correlated with MAAS intensity, but negatively correlated with MAAS quality. Conclusions: Our results indicated a high prevalence of prenatal depression in women in the third trimester. Prenatal education and higher marital satisfaction were protective factors for prenatal depression; antenatal anxiety and sleep disorders during pregnancy were risk factors for prenatal depression. Prenatal depression was negatively correlated with MAAS quality, but positively correlated with MAAS intensity.
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Affiliation(s)
- Ling Zhang
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Lei Wang
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Shu Cui
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Qiuyu Yuan
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Cui Huang
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Xiaoqin Zhou
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China.,Chaohu Hospital, Anhui Medical University, Hefei, China
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31
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Nadorff DK, Scott RK, Fitchie TM. Depressive Symptoms and Suicidality of Those Raised in Kincare: A Peer Comparison Study. OMEGA-JOURNAL OF DEATH AND DYING 2020; 86:298-311. [PMID: 33103572 DOI: 10.1177/0030222820966245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The rate at which children are raised in kincare has steadily been on the rise. Prior research indicates that this group of individuals are at an increased risk of mental health problems. The current study examined the suicidality and depressive symptoms of adults who were raised in kincare compared to those raised by their parents. There were a total of 1,486 participants, 171 of whom were adults raised in kincare, and 1,315 who were raised by one or both of their parents. Participants completed a measure of suicide risk and reported symptoms of depression and anhedonia.Those raised in kincare scored significantly higher on the measures of anhedonia and suicide risk. However, there were no differences in general depressive symptoms. Further analyses found that more frequent attendance of religious activities and higher levels of household income acted as protective factors. These findings suggest kincare is associated with adverse mental health outcomes.
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Affiliation(s)
- Danielle K Nadorff
- Mississippi State University, Mississippi State, Mississippi, United States
| | - Rachel K Scott
- Mississippi State University, Mississippi State, Mississippi, United States
| | - Theresa M Fitchie
- Mississippi State University, Mississippi State, Mississippi, United States
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