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Dooley RL, McAloon J. The efficacy of antenatal Cognitive Behavioural Therapy for antenatal and postnatal depression: A PRISMA based systematic review and meta-analysis. J Affect Disord 2025; 376:225-240. [PMID: 39914752 DOI: 10.1016/j.jad.2025.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 01/01/2025] [Accepted: 02/02/2025] [Indexed: 02/13/2025]
Abstract
BACKGROUND Considerable research has assessed the effectiveness of Cognitive Behavioural Therapy (CBT) for perinatal depression, however limited attention has been paid to its effectiveness when delivered during pregnancy. The primary aim of this review was to review evidence of the efficacy of CBT interventions delivered antenatally to treat symptoms of depression in women during the antenatal and postnatal periods. The review's secondary aim was to evaluate potential moderators of treatment outcome. METHODS Electronic Databases; CINAHL, PsycINFO, Medline, Scopus, and Web of Science were searched for studies that employed CBT in response to symptoms of depression in pregnant women. Randomized control trials were included if they compared outcomes for pregnant women with outcomes of inactive controls. A systematic review and meta-analysis was conducted on n = 12 eligible studies. RESULTS CBT yielded statistically significant, within and between groups' effects on depressive symptoms during the antenatal period. CBT delivered at that time also yielded smaller yet statistically significant within and between groups' effects on depressive symptoms experienced postnatally. CBT was found to be more effective for women of greater age, higher number of weeks gestation, or who were multiparous. The facilitator of treatment, delivery mode, the assessment measures used to evaluate treatment outcome, and symptom severity also moderated treatment outcome. LIMITATIONS Significant publication bias and heterogeneity were evident across studies indicating a need to focus future research. CONCLUSIONS Overall, findings support the use of CBT delivered antenatally to reduce depression experienced during, and following, pregnancy.
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Affiliation(s)
- Rebecca L Dooley
- UTS Family Child Behaviour Clinic, Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Sydney, NSW, Australia
| | - John McAloon
- UTS Family Child Behaviour Clinic, Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Sydney, NSW, Australia.
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2
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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. [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 χ2 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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Laughlin HM, Khan K, Rashid F, Scarbrough A, Bick JR. Social and Economic Correlates of Prenatal Depression in Rural Bangladeshi Women. Matern Child Health J 2025:10.1007/s10995-025-04087-6. [PMID: 40148712 DOI: 10.1007/s10995-025-04087-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2025] [Indexed: 03/29/2025]
Abstract
OBJECTIVE Prevalence rates of perinatal depression are especially high among women living in lower-middle-income countries (LMICs) when compared to higher-income countries. This is especially true for women living in Bangladesh, an LMIC in South Asia, a country that has limited mental health infrastructure and high rates of poverty. Women living in rural, impoverished communities in Bangladesh have been identified as being at high risk for prenatal depression. However, there is limited understanding of variability of prevalence rates across rural communities. To address this gap in understanding, we examined prevalence rates and correlates of prenatal depression among women living in two rural Bangladesh communities, Matlab and Ariahizar. METHODS During a prenatal health care visit, 60 women in two rural communities in Bangladesh, completed a survey battery asking about household income, education, depression symptoms, autonomy over household technology, and financial decision-making ability. RESULTS On average, prenatal depression was experienced by 31.6%, of women enrolled in this study, although rates varied significantly across communities. Around 50% of all women in the higher-risk, more underserved, Arihaizar community experienced clinically significant symptoms of prenatal depression in comparison with only 13.3% of women who experienced clinically significant levels of prenatal depression in Matlab, a higher resourced rural community. Across both communities, perceived autonomy and independence (based on reports of having control over resources in the home) were associated with lower depression symptoms. CONCLUSIONS FOR PRACTICE Prevalence of prenatal depression is highest in the most underserved communities. Additionally, we found preliminary associations between women's autonomy and depression during pregnancy.
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Affiliation(s)
- H M Laughlin
- Department of T.I.M.E.S/Psychology, University of Houston, Houston, TX, USA
| | - K Khan
- Department of Public Health, Sam Houston State University, Huntsville, TX, USA
| | - F Rashid
- Department of Public Health, Sam Houston State University, Huntsville, TX, USA
| | - A Scarbrough
- Department of Public Health, Sam Houston State University, Huntsville, TX, USA
| | - J R Bick
- Department of T.I.M.E.S/Psychology, University of Houston, Houston, TX, USA.
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Rae C, McRae R, Holliday E, Chojenta C. Interventions to Prevent Relapse or Recurrence of Preconception Anxiety and/or Depression in Perinatal Women: A Systematic Review. Matern Child Health J 2025; 29:294-303. [PMID: 39847257 PMCID: PMC11926042 DOI: 10.1007/s10995-025-04054-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2025] [Indexed: 01/24/2025]
Abstract
OBJECTIVES Women with preconception anxiety and/or depression experience high rates of relapse or recurrence of the disorders in the perinatal period. This review aimed to identify perinatal interventions that were designed to prevent relapse or recurrence in women with a history of anxiety and/or depression. METHODS The review was conducted based on the PRISMA guidelines. Six medical databases were searched with specific search strategies for each. The reference lists of literature reviews retrieved in this search were also screened, as well as the reference lists of reviews identified within these reviews. Additionally, the publications of the first authors of included studies were reviewed for relevant articles. RESULTS There were 10 articles eligible for inclusion. These articles described pharmacological or dietary supplement interventions, as well as psychological and/or behavioural interventions. All identified studies focused on the prevention of recurrent depression, comprising four antenatal interventions and six postnatal interventions. No studies reporting interventions for the prevention of recurrent anxiety were identified. CONCLUSIONS FOR PRACTICE Several published studies provided evidence supporting the use of prophylactic antidepressants and progesterone to prevent relapse or recurrence of depression, although studies were limited by small sample sizes and the potential for study bias. More recent and higher quality evidence exists for the role of mindfulness and cognitive behavioural therapy in the prevention of depressive relapse. Further exploration of relapse prevention strategies for women with preconception anxiety and/or depression is required, particularly for recurrent anxiety.
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Affiliation(s)
- Celia Rae
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
| | - Rebecca McRae
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Elizabeth Holliday
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Catherine Chojenta
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
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Nombela E, Marchena C, Duque A, Chaves C. The efficacy of psychological interventions on well-being during the perinatal period: A systematic review. Gen Hosp Psychiatry 2025; 93:40-51. [PMID: 39824062 DOI: 10.1016/j.genhosppsych.2025.01.006] [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: 09/17/2024] [Revised: 01/09/2025] [Accepted: 01/09/2025] [Indexed: 01/20/2025]
Abstract
Although research has already shown the importance of promoting well-being during pregnancy and after birth, previous meta-analyses on the effectiveness of psychological interventions do not include wellbeing as a primary outcome measure, focusing instead on assessing the effectiveness in reducing symptoms. This study aimed at conducting a systematic review of the effects of psychological interventions on well-being during the perinatal period. A search was conducted in Psycinfo, PubMed, Web of Science (WOS) and Scopus for articles published from 2014 to 2024. A review of 16 randomized clinical trials revealed that most interventions were effective in both improving well-being and reducing clinical symptoms. Face-to-face, therapist-led, and group-based approaches showed better adherence. Positive changes in well-being were maintained over time, although the postpartum transition may have influenced the maintenance of results. This study highlights the importance of including well-being measures in clinical trials during the perinatal period and advocates for a shift toward promoting well-being alongside symptom management.
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Affiliation(s)
- Elisa Nombela
- School of Psychology, Complutense University of Madrid, Madrid, Spain
| | | | | | - Covadonga Chaves
- School of Psychology, Complutense University of Madrid, Madrid, Spain.
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Pekarsky C, Skiffington J, Chaput K, Slater D, Leijser LM, Metcalfe A. The impact of relationship factors on antenatal depression in the context of the COVID-19 pandemic. Birth 2025; 52:78-88. [PMID: 39133551 PMCID: PMC11829261 DOI: 10.1111/birt.12862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/25/2024] [Accepted: 07/24/2024] [Indexed: 02/16/2025]
Abstract
BACKGROUND Antenatal depression is the most prevalent pregnancy-associated mental health disorder. Previous studies have identified several risk factors for antenatal depression, including partner support. However, during the COVID-19 pandemic, many relationship dynamics changed. This study examined the extent to which relationship factors had an impact on antenatal depression in comparison with other well-researched factors in the context of the pandemic. METHODS A secondary analysis was conducted using data from the P3 Cohort in Calgary, a longitudinal cohort study based in Alberta, Canada. Pregnant people (n = 872) completed self-report questionnaires and validated scales about sociodemographic, psychological, and relationship characteristics. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression was used to assess the impact of reported characteristics on antenatal depression. Tests of model fit were used to examine whether the inclusion of variables related to relationship quality improved model fit after accounting for other known risk factors. RESULTS Overall, 18.23% of participants experienced antenatal depression. Relationship factors including relationship unhappiness (OR = 1.98 [95% CI: 1.06-3.69]), having an upsetting partner (OR = 2.00 [95% CI: 1.17-3.40]), and having a lower quality of relationships with close friends and family (OR = 1.76 [95% CI: 1.14-2.73]) were associated with antenatal depression; however, inclusion of these relationship factors did not improve model fit after accounting for other known predictors. CONCLUSION Overall, relationship factors were not associated with antenatal depression during the pandemic after accounting for other known risk factors. Stress and anxiety caused by the pandemic may have overshadowed the impact of relationship factors, or relationship factors may have contributed to higher levels of stress and anxiety more generally within our sample.
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Affiliation(s)
- Chloe Pekarsky
- Department of Obstetrics & GynecologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Janice Skiffington
- Department of Obstetrics & GynecologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Kathleen Chaput
- Department of Obstetrics & GynecologyUniversity of CalgaryCalgaryAlbertaCanada
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Donna Slater
- Department of Obstetrics & GynecologyUniversity of CalgaryCalgaryAlbertaCanada
- Department of Physiology & PharmacologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Lara M. Leijser
- Department of Pediatrics, Section of NeonatologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Amy Metcalfe
- Department of Obstetrics & GynecologyUniversity of CalgaryCalgaryAlbertaCanada
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
- Department of MedicineUniversity of CalgaryCalgaryAlbertaCanada
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Mulupi S, Abubakar A, Nyongesa MK, Angwenyi V, Kabue M, Mwangi PM, Odhiambo R, Marangu J, Njoroge E, Mokaya MM, Obulemire EK, Ombech E, Ssewanyana D, Moran G, Martin MC, Proulx K, Marfo K, Lye S. Prevalence and correlates of depressive and anxiety symptoms among pregnant women from an urban informal settlement in Nairobi, Kenya: a community-based cross-sectional study. BMC Pregnancy Childbirth 2025; 25:213. [PMID: 40011816 DOI: 10.1186/s12884-025-07339-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Accepted: 02/17/2025] [Indexed: 02/28/2025] Open
Abstract
PURPOSE Previous research, largely from the Global North, reports high rates of common mental health disorders among women in the antenatal period, but there is paucity of such data in contexts like Kenya. This study investigated the prevalence and correlates of depressive and anxiety symptoms among pregnant women in an urban informal settlement in Kenya's capital - Nairobi. METHODS An analysis of baseline cross-sectional data from a pilot cluster randomized trial of an integrated early childhood development programme. Participants were pregnant women in their third pregnancy trimester (N = 249), residing in an urban informal settlement in Nairobi County. Mental health measures [(Patient health questionnaire (PHQ-9) and generalized anxiety disorder scale (GAD-7)] were administered alongside other sociodemographic, pregnancy, and health-related questionnaires. Linear regression analysis was performed to investigate correlates of antenatal depressive and anxiety symptoms. RESULTS Participant's mean age was 27.5 years (SD = 5.6). The prevalence of antenatal depressive and anxiety symptoms was 26.9% (95%CI: 21.4-32.4) and 6.4% (95%CI: 3.4-9.4), based on the PHQ-9 and GAD-7 cut-off scores of ≥ 10 respectively. Being married was a significant correlate for decreased depressive and anxiety symptoms. Higher levels of education (secondary or tertiary), history of three or more previous pregnancies, and an experience of moderate-to-extreme pain were significant correlates for elevated depressive symptoms. Similarly, tertiary level of education, history of four or more previous pregnancies, and experiencing pain were significant correlates for elevated anxiety symptoms for the pregnant women. Participants reporting feeling unwell had significantly higher anxiety symptom scores. CONCLUSION In this setting, correlates of antenatal depressive and anxiety symptoms cut across demographic, pregnancy and health-related factors with implications for targeted interventions. Findings point to the need for screening of depression and anxiety as part of routine antenatal care. Further research is needed to understand these contextual correlates. TRIAL REGISTRATION This study was part of the integrated early childhood development pilot cluster randomised control trial, retrospectively registered in the Pan African Clinical Trial Registry on 26/03/2021, registration number PACTR202103514565914.
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Affiliation(s)
- Stephen Mulupi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya.
- Neuroassement group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research, Kilifi, Kenya.
| | - Moses Kachama Nyongesa
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- Medical School, Havard University, Boston, MA, USA
| | - Vibian Angwenyi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Margaret Kabue
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | | | - Rachel Odhiambo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Joyce Marangu
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Eunice Njoroge
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | | | | | - Eunice Ombech
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Derrick Ssewanyana
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Greg Moran
- Department of Psychology, Western University, London, ON, Canada
| | - Marie-Claude Martin
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Kerrie Proulx
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Kofi Marfo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Stephen Lye
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
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Zuo H, Chen X, Huang X, Benny C, Fu D, Xiu Q, Cui X, Lyu Y. Using inflammatory biomarkers in early pregnancy to predict subsequent antenatal depression. J Affect Disord 2025; 371:156-163. [PMID: 39233249 DOI: 10.1016/j.jad.2024.08.220] [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: 11/28/2023] [Revised: 08/24/2024] [Accepted: 08/31/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Antenatal depression (AD) is one of the most common pregnancy complications. Recent studies indicated that immune responses during pregnancy may contribute to development of AD. OBJECTIVES This study aimed to identify possible inflammatory biomarkers in early pregnancy to predict maternal depressive symptoms before delivery. METHODS This case-control study was conducted within the Maternal and Infant Health (MI-Health) birth cohort (Beijing, China) and depressive symptoms were assessed by Zung Self-rating Depression Scale (SDS) in both second and third trimesters. By using immune multi-factors kits, we tested 26 inflammatory factors in the serum of 38 cases with antenatal depression symptoms in both trimesters (SDS ≥ 53) and 38 controls. Logistic regression was used to identify candidate biomarkers, and the predictive capabilities were evaluated by using Receiver Operator Characteristics (ROC) analysis. RESULTS The concentrations of ln(CCL24) (p = 0.020), IL-7 (p = 0.006) and IL-10 (p = 0.014) were higher in early pregnancy among women with depressive symptoms comparing to healthy controls. The difference remained statistically significant after adjusting for maternal age, education level, gestational diabetes mellitus, pre-pregnancy BMI and gestational weeks of blood sampling (OR(ln(CCL24)) = 4.625, OR(IL-7) = 1.414, OR(IL-10) = 1.151). In ROC analysis, ln(CCL24), IL-7, and IL-10 achieved discrimination for depressive symptoms antepartum, with the values of AUC estimated at 0.75. LIMITATIONS The sample size is limited, and the infectious disease infection records were not collected for control. CONCLUSION Higher levels of CCL24, IL-7 and IL-10 may indicate the higher risk of antenatal depression and are potential biomarkers indicating pathogenesis of antenatal depression.
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Affiliation(s)
- Hanxiao Zuo
- Experiment Center, Capital Institute of Pediatrics, Beijing, China; School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Xiaoli Chen
- Department of Genetics, Capital Institute of Pediatrics, Beijing, China
| | - Xiaolan Huang
- Experiment Center, Capital Institute of Pediatrics, Beijing, China
| | | | - Dongmei Fu
- Department of Obstetrics, Beijing Daxing Maternal and Child Care Hospital, Beijing, China
| | - Qingyong Xiu
- Department of Pediatrics, Beijing Daxing Maternal and Child Care Hospital, Beijing, China
| | - Xiaodai Cui
- Experiment Center, Capital Institute of Pediatrics, Beijing, China
| | - Yanyu Lyu
- Experiment Center, Capital Institute of Pediatrics, Beijing, China.
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Girchenko P, Lahti-Pulkkinen M, Laivuori H, Kajantie E, Räikkönen K. Maternal Antenatal Depression Is Associated With Metabolic Alterations That Predict Birth Outcomes and Child Neurodevelopment and Mental Health. Biol Psychiatry 2025; 97:269-278. [PMID: 39127233 DOI: 10.1016/j.biopsych.2024.07.023] [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: 03/07/2024] [Revised: 07/04/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Evidence regarding metabolic alterations associated with maternal antenatal depression (AD) is limited, and their role as potential biomarkers that improve the prediction of AD and adverse childbirth, neurodevelopmental, and mental health outcomes remains unexplored. METHODS In a cohort of 331 mother-child dyads, we studied associations between AD (a history of medical register diagnoses and/or a Center for Epidemiological Studies Depression Scale score during pregnancy ≥ 20) and 95 metabolic measures analyzed 3 times during pregnancy. We tested whether the AD-related metabolic measures increased variance explained in AD over its risk factors and in childbirth, neurodevelopmental, and mental health outcomes over AD. We replicated the findings in a cohort of 416 mother-child dyads. RESULTS Elastic net regression identified 15 metabolic measures that collectively explained 25% (p < .0001) of the variance in AD, including amino and fatty acids, glucose, inflammation, and lipids. These metabolic measures increased the variance explained in AD over its risk factors (32.3%, p < .0001 vs. 12.6%, p = .004) and in child gestational age (9.0%, p < .0001 vs. 0.7%, p = .34), birth weight (9.0%, p = .03 vs. 0.7%, p = .33), developmental milestones at the age of 2.3 to 5.7 years (21.0%, p = .002 vs. 11.6%, p < .001), and any mental or behavioral disorder by the age of 13.1 to 16.8 years (25.2%, p = .03 vs. 5.0%, p = .11) over AD, child sex, and age. These findings were replicated in the independent cohort. CONCLUSIONS AD was associated with alterations in 15 metabolic measures, which collectively improved the prediction of AD over its risk factors and birth, neurodevelopmental, and mental health outcomes in children over AD. These metabolic measures may become biomarkers that can be used to identify at-risk mothers and children for personalized interventions.
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Affiliation(s)
- Polina Girchenko
- Clinical Medicine Research Unit, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Department of Psychology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Marius Lahti-Pulkkinen
- Department of Psychology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Finnish Institute for Health and Welfare, Helsinki, Finland; Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Hannele Laivuori
- Department of Obstetrics and Gynecology, Tampere University Hospital, The Wellbeing Services County of Pirkanmaa, Tammerfors, Finland; Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Clinical Medicine Research Unit, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Katri Räikkönen
- Department of Psychology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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10
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Behl R. Perinatal mental health within the contours of the Indian MTP Act framework: From the lens of the Indian judiciary. Asian J Psychiatr 2025; 104:104355. [PMID: 39793477 DOI: 10.1016/j.ajp.2024.104355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Revised: 12/27/2024] [Accepted: 12/29/2024] [Indexed: 01/13/2025]
Affiliation(s)
- Ritika Behl
- Assistant Professor, Alliance School of Law, Alliance University, Bengaluru, India; Symbiosis International (Deemed University), Pune, India.
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Abebe M, Asgedom YS, Gebrekidan AY, Tebeje TM. Antenatal depression among pregnant women in Ethiopia: An umbrella review. PLoS One 2025; 20:e0315994. [PMID: 39836614 PMCID: PMC11750105 DOI: 10.1371/journal.pone.0315994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 12/03/2024] [Indexed: 01/23/2025] Open
Abstract
INTRODUCTION Antenatal depression, ranging from mild to severe, is influenced by hormonal changes during pregnancy and childbearing years, making it a significant public health issue. Antenatal depression, with its far-reaching effects on mothers, infants, and children, continues to be a significant public health issue in developing countries such as Ethiopia. Research on antenatal depression in Ethiopia has produced varied results. Although previous systematic reviews and meta-analyses studies have addressed this topic, a comprehensive summary of existing reviews has not been available. Therefore, this umbrella review aims to consolidate the findings on antenatal depression and associated factors among pregnant women in Ethiopia. METHODS This review included five systematic reviews and meta-analyses from various databases, including PubMed, PsycINFO, Research4life, CINHALE and Science Direct. Only reviews published between January 1, 2010, and July 30, 2024, were considered. The search, conducted from August 5 to 15, 2024, used CoCoPop questions and included only English-language reviews. Study quality was assessed with the AMSTAR tool, and data extraction and analysis were performed using Microsoft Excel 2016 and STATA 14.0. The I2 and Cochran's Q tests were used to assess heterogeneity. Pooled effect sizes were calculated based on the pooled prevalence of antenatal depression and odds ratios for associated factors, with a 95% confidence interval indicating statistical significance. RESULTS This umbrella review encompassed 50 primary studies from five systematic reviews and meta-analyses, involving a total of 25,233 pregnant women. The pooled prevalence of antenatal depression in Ethiopia was found to be 24.60% (95% CI: 22.46-26.73). Significant associations were identified between antenatal depression and several factors: unplanned pregnancy (POR = 2.29; 95% CI: 1.75, 2.82), poor social support (POR = 2.10; 95% CI: 1.37, 2.84), history of abortion (POR = 2.49; 95% CI: 1.64, 3.34), history of depression (POR = 3.57; 95% CI: 2.43, 4.71), and history of obstetric complications (POR = 2.94; 95% CI: 1.61, 4.28). CONCLUSIONS The significant prevalence of antenatal depression (24.60%) among pregnant women in Ethiopia is closely linked to factors such as unplanned pregnancy, poor social support, history of abortion, previous depression, and obstetric complications. To tackle this issue, it is recommended to enhance social support networks, increase access to family planning services to minimize unplanned pregnancies, conduct regular mental health screenings, and incorporate mental health services into antenatal care.
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Affiliation(s)
- Mesfin Abebe
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla Ethiopia
| | - Yordanos Sisay Asgedom
- Department of Epidemiology and Biostatistics, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amanuel Yosef Gebrekidan
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tsion Mulat Tebeje
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla Ethiopia
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12
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Vitte L, Nakić Radoš S, Lambregtse-van den Berg M, Devouche E, Apter G. Peripartum Depression: What's New? Curr Psychiatry Rep 2025; 27:31-40. [PMID: 39625603 DOI: 10.1007/s11920-024-01573-6] [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] [Accepted: 11/25/2024] [Indexed: 01/12/2025]
Abstract
PURPOSE OF THE REVIEW Peripartum depression (PPD), including both depression during pregnancy and postpartum, is the most frequent health disorder during the perinatal period. It is a significant public health issue in many countries due to its prevalence and its impact on women, as well as on their partners and offspring. Here, we will attempt to untangle the most recent studies and publications, considering what it is essential to know in 2024 about PPD as a specific perinatal issue. RECENT FINDINGS PPD appears to be a very heterogeneous disorder in which a complex interplay between different factors contributes to its pathophysiology. Thus, the need to enhance diagnosis and referral through a better understanding of its severity and co-morbidities has emerged as a major public health issue. Indeed, research has consistently shown that PPD negatively impacts parent-infant interactions and infants' cognitive, social, and emotional development. Evidence underlining its global risk has accumulated over the past three decades, but many questions remain, including how these vulnerable offspring developmental trajectories unfold.
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Affiliation(s)
- Lisa Vitte
- Service Universitaire de Pédopsychiatrie, Hospital Group Du Havre, University Rouen Normandy, Le Havre, France
- Laboratoire de Psychopathologie et Processus de Santé (LPPS UR 4057), Université Paris Cité, Paris, France
| | - Sandra Nakić Radoš
- University Department of Psychology, Catholic University of Croatia, Ilica 244, 10000, Zagreb, Croatia
| | - Mijke Lambregtse-van den Berg
- Departments of Psychiatry and Child & Adolescent Psychiatry, Erasmus University Medical Center, 3015 GD, Rotterdam, The Netherlands
| | - Emmanuel Devouche
- Service Universitaire de Pédopsychiatrie, Hospital Group Du Havre, University Rouen Normandy, Le Havre, France.
- Laboratoire de Psychopathologie et Processus de Santé (LPPS UR 4057), Université Paris Cité, Paris, France.
| | - Gisèle Apter
- Service Universitaire de Pédopsychiatrie, Hospital Group Du Havre, University Rouen Normandy, Le Havre, France
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13
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Worrall S, Christiansen P, Carlisle N, Fallon V, Khalil A, Shennan AH, Tribe RM, Carter J, Silverio SA. Anxiety, depression, and perceived wellbeing in antenatal women at risk of preterm birth: a retrospective cohort study. Front Glob Womens Health 2024; 5:1511352. [PMID: 39713064 PMCID: PMC11659212 DOI: 10.3389/fgwh.2024.1511352] [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: 10/14/2024] [Accepted: 11/25/2024] [Indexed: 12/24/2024] Open
Abstract
Introduction Women identified at risk for preterm may be vulnerable to developing mental health difficulties due to the increased likelihood of poor pregnancy outcome and uncertainty surrounding their delivery. Formal assessment of mental wellbeing in specialist preterm birth clinics is not routinely offered, but may offer the opportunity for early intervention. Methods We aimed to investigate if demographic characteristics and obstetric risk factors were associated with psychological wellbeing in women at risk of preterm birth. We explored associations between mental wellbeing and risk factors for preterm birth using hierarchical regression analyses. Results When demographic variables were considered alone, high body mass index (BMI) was significantly associated with anxiety (p = .026), however became non-significant when obstetric risk factors were also considered. Previous late miscarriage was associated with high anxiety (p = .049). Lower maternal age at estimated date of delivery (p = .019) and non-European ethnic heritage (p = .029) were significantly associated with depression. High maternal BMI (p < .001), being of any other non-European ethnic heritage (p = .043), currently smoking (p = .002), and previous spontaneous preterm birth (p = .017) were associated with lower perceived wellbeing. Discussion The results of this study highlight the importance of routinely monitoring mental health in women with relevant risk factors, particularly if they are already at risk of preterm birth.
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Affiliation(s)
- Semra Worrall
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Paul Christiansen
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Naomi Carlisle
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Asma Khalil
- Fetal Medicine Unit, Liverpool Women’s NHS Foundation Trust, Liverpool, United Kingdom
- Fetal Medicine Unit, St. George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Andrew H. Shennan
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
| | - Rachel M. Tribe
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
| | - Jenny Carter
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
| | - Sergio A. Silverio
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
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14
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López DP, Serna LG, Arnáiz MCS, Ruiz MO, Viladegut JS, Sol J, Salinas-Roca B. Outcomes of antenatal depression in women and the new-born: a retrospective cohort study. Fam Pract 2024; 41:925-931. [PMID: 39428585 DOI: 10.1093/fampra/cmae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2024] Open
Abstract
OBJECTIVE To determine what effect maternal antenatal depression has on pregnancy and infant outcomes in the Lleida health region. METHODS Retrospective observational cohort study in pregnant women between 2012 and 2018 in the Lleida health region. Variables included age, body mass index, caesarean section, pre-eclampsia, birth weight, and Apgar score. We performed multivariate analysis, with linear regression coefficients and 95% confidence interval (CI). RESULTS Antenatal depression was diagnosed in 2.54% pregnant women from a total sample of 17 177. Depression is significantly associated with a higher risk pregnancy and low birth weight. Pre-eclampsia, 1-minute Apgar score, and caesarean section were not significantly associated with depression. CONCLUSIONS Antenatal depression increases the risk of pregnancy complications. In addition, depression in the mother increases the probability of low birth weight.
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Affiliation(s)
| | - Laura Gascó Serna
- Primary Care Center 11 de Setembre, Institut Català de la Salut, Lleida, 25005, Spain
| | - María Catalina Serna Arnáiz
- Departament of Familial Medicine, University of Lleida, Lleida, 25002, Spain
- Primary Care Center Eixample, Institut Català de la Salut, Lleida, 25003, Spain
| | - Miriam Orós Ruiz
- Primary Care Center Eixample, Institut Català de la Salut, Lleida, 25003, Spain
| | | | - Joaquim Sol
- Delegació de la Conselleria de Salut, Gerent del Servei Català de la Salut (Health región of Lleida), Lleida, 25007, Spain
| | - Blanca Salinas-Roca
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity Diabetes and Metabolism (ODIM) Research Group, IRBLleida, Lleida, 25298, Spain
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326-332, 08025 Barcelona, Spain
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15
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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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16
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Faro EZ, Jones D, Adeagbo M, Cho H, Swartzendruber G, Tabb KM, Tandon SD, Ryckman K. Can an evidence-based mental health intervention be implemented into preexisting home visiting programs using implementation facilitation? Study protocol for a three variable implementation effectiveness context hybrid trial. Implement Sci 2024; 19:76. [PMID: 39529089 PMCID: PMC11556184 DOI: 10.1186/s13012-024-01402-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Accepted: 10/15/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Perinatal mental health conditions are the most common complication of pregnancy and childbirth (1 in 8 women). When left untreated, perinatal depression and anxiety adversely affects the entire family with pregnancy complications and negative outcomes including preterm birth, impaired mother-infant bonding, impaired lactation, substance abuse, divorce, suicide, and infanticide. Significant disparities persist in the diagnosis and treatment of perinatal depression and anxiety and these inequities are often intersectional. Preliminary research with stakeholders including community advisory boards, underrepresented and minority birthing people, and state departments of health, demonstrates the importance of social support as a mechanism for reducing disparities in perinatal depression, particularly in rural geographies. Home visiting programs (HVPs) can provide the social support needed to improve mental health outcomes in pregnant and postpartum women. Our project aims to explore the impact of context on the implementation of a mental health intervention, focusing on the lived experiences of diverse populations served by HVPs to reduce disparities in adverse maternal outcomes. METHODS Using implementation facilitation, our study will engage multilevel stakeholders (e.g., policymakers, front-line implementers, and intervention recipients) to adapt facilitation to integrate a maternal mental health intervention (i.e., Mothers and Babies) across two midwestern, rural states (Iowa and Indiana) with multiple HVP models. Given the complexity and heterogeneity of the contexts in which Mothers and Babies will be integrated, a three variable hybrid implementation-effectiveness-context trial will test the adapted facilitation strategy compared with implementation as usual (i.e., standard education) and will assess contextual factors related to the outcomes. Using an evidence-based implementation strategy that tailors implementation delivery to the needs of the specific populations and context may improve fidelity and adoption, particularly in rural states where residents have limited access to care. DISCUSSION The immediate impact of this research will be to show whether adapted facilitation can improve the uptake and fidelity of Mothers and Babies across multiple HVP models and thus positively affect depressive symptoms and perceived stress of recipients. Our implementation protocol may be used by researchers, practitioners, and policy makers to better integrate evidence-based interventions into diverse contexts, leading to more equitable implementation and improved health outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT06575894, registered on August 29, 2024 https://clinicaltrials.gov/study/NCT06575894?id=NCT06575894&rank=1 .
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Affiliation(s)
- Elissa Z Faro
- Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA, 52242, USA.
| | - DeShauna Jones
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA
| | - Morolake Adeagbo
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA
| | - Hyunkeun Cho
- Department of Biostatistics, University of Iowa College of Public Health, Iowa CIty, USA
| | - Grace Swartzendruber
- Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Karen M Tabb
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - S Darius Tandon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kelli Ryckman
- Indiana University School of Public Health, Bloomington, IN, USA
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Kukora SK, Branche T, Miller ER, Henner N, Kapadia V, Haward MF. Supporting parents' emotional and mental health in the antenatal consultation. J Perinatol 2024:10.1038/s41372-024-02156-2. [PMID: 39462056 DOI: 10.1038/s41372-024-02156-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 10/15/2024] [Accepted: 10/17/2024] [Indexed: 10/28/2024]
Abstract
Supporting parents' emotional and mental health is crucial during antenatal consultations, in which expectant parents often receive serious news about their infant and sometimes face complex antenatal or postnatal decision-making. Being considerate of the circumstances to mitigate barriers and stressors, utilizing clear and sensitive language, and personalizing counseling and decision-making to support parents' pluralistic values are strategies that individual neonatologists can use to promote parents' mental wellness in these encounters. Partnership with clinicians of other disciplines and professions in antenatal consultations can help in providing additional medical information and parent support; however, care must be coordinated within the team to ensure that confusing or conflicting counseling is avoided. In addition to improving communication skills for these encounters as individuals and teams, opportunities also exist to enhance support of parents' mental health at the institutional and national level.
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Affiliation(s)
- S K Kukora
- Bioethics Center and Division of Neonatology, Children's Mercy Hospital, Kansas City, MO, USA.
| | - T Branche
- Division of Neonatology, Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - E R Miller
- Division of Neonatology, Cincinnati Children's Hospital, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - N Henner
- Division of Neonatology, Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
- Division of Palliative Care, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - V Kapadia
- Palliative Care at Landmark Health, Optum Home and Community, Irving, TX, USA
| | - M F Haward
- Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
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18
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Verhelst P, Sels L, Lemmens G, Verhofstadt L. The role of emotion regulation in perinatal depression and anxiety: a systematic review. BMC Psychol 2024; 12:529. [PMID: 39358735 PMCID: PMC11448051 DOI: 10.1186/s40359-024-02033-9] [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: 09/24/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Major depressive disorder and anxiety disorders are highly prevalent and comorbid during the perinatal period. Although research and clinicians agree that emotion regulation (ER) is an important transdiagnostic factor underlying both disorders in the general population, ER during the perinatal period has received less research attention. The aim of this systematic review was to assess the literature regarding the role of ten commonly studied ER strategies in the onset and maintenance of perinatal depression and anxiety in pregnant women and young mothers, using the Process Model of Gross (1998) as a theoretical framework. METHODS We searched four electronic databases with variations of the following key words: women; emotion regulation (i.e., behavioral approach, behavioral avoidance, problem solving, support seeking, distraction, rumination, reappraisal, acceptance, expressive suppression, and expressive engagement); perinatal period; and psychopathology. The aim was to identify peer-reviewed, and quantitative studies published between January 1999 and January 2023. Six articles were selected for analysis. RESULTS Similar ER strategies emerged as risk and protective factors in perinatal depression and anxiety. Overall, behavioral avoidance, distraction, rumination, and expressive engagement appeared as risk factors, while problem solving, emotional and instrumental support seeking, cognitive reappraisal, and acceptance, emerged as protective factors in the onset and maintenance of perinatal depression and anxiety. These findings align with previous research in perinatal community samples, as well as in non-perinatal clinical samples. CONCLUSIONS Our results support the role of ER as a transdiagnostic factor underlying both perinatal depression and anxiety. Clinicians are encouraged to implement ER strategies into the screening, prevention, and treatment of perinatal depression and anxiety. Further research is needed to strengthen these findings and to examine the role of emotion regulation during antenatal depression and anxiety more closely.
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Affiliation(s)
- Pauline Verhelst
- Faculty of Psychology and Educational Sciences, UGent, Ghent, Belgium.
| | - Laura Sels
- Faculty of Psychology and Educational Sciences, UGent, Ghent, Belgium
| | - Gilbert Lemmens
- Faculty of Medicine and Health Sciences, UGent, Ghent, Belgium
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19
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Hansen K, Kukora SK, Sherman A, Feldman K. Mental health in pregnancy complicated by fetal anomaly: depression screening and referrals in a single fetal care center. J Perinatol 2024:10.1038/s41372-024-02118-8. [PMID: 39289556 DOI: 10.1038/s41372-024-02118-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 08/28/2024] [Accepted: 09/06/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVE To quantify depression screening rates in a fetal care center, identify characteristics associated with screenings and identify mental health referral uptake rates STUDY DESIGN: This retrospective cohort study of 166 patients in a single fetal care center investigated patients screened during pregnancy with the Edinburgh Postnatal Depression Scale RESULTS: Patients screened positive for depression at a rate of 31.9% using 10 as the cut-off score at their first mental health consult following diagnosis. Patients with a prior mental health diagnosis and lacked insurance or had state insurance were more likely to screen positive. Additionally, patients were more likely to screen positive with a severe fetal diagnosis or uncertain fetal prognosis. Patients were likely to accept a referral for therapy; fewer accepted a referral for pharmacotherapy CONCLUSION: Fetal care center patients are at risk of depressed mood and may be identified through universal screening. Particular attention should be provided to patients with an uncertain fetal prognosis and other identified characteristics.
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Affiliation(s)
- Kara Hansen
- Fetal Health Center, Children's Mercy Kansas City, Kansas City, MO, USA.
| | - Stephanie K Kukora
- Bioethics Center and Division of Neonatology, Children's Mercy Kansas City, Kansas City MO; University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, MO, USA
| | - Ashley Sherman
- Biostatistics and Epidemiology Core and Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Keith Feldman
- Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, MO; University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, MO, USA
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20
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Kong L, Hu J, Yue M, Xin X, Lin F, Hu Y, Wang X. Visual analysis of research hotspots and trends of external therapies in traditional Chinese medicine for depression. Heliyon 2024; 10:e36918. [PMID: 39286159 PMCID: PMC11402998 DOI: 10.1016/j.heliyon.2024.e36918] [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: 04/28/2024] [Revised: 07/05/2024] [Accepted: 08/23/2024] [Indexed: 09/19/2024] Open
Abstract
Objective Based on the visualization and analysis of the CiteSpace software, we aimed to explore the current research status and development trend of depression caused by external therapies in traditional Chinese medicine (TCM) and to provide a reference for further research in this field. Methods In the China National Knowledge Infrastructure, Wanfang, Web of Science, and PubMed databases, relevant articles on external therapies in TCM for depression were selected as the research objects, and CiteSpace performed the bibliometric analysis. Results In total, 1672 Chinese and 441 English articles were included after CiteSpace was used to remove duplicate articles and perform manual screening. The Chinese articles were analyzed, and the overall issuance showed an upward trend; the core author was Tu Ya, and the institution with the highest article production was Heilongjiang University of Traditional Chinese Medicine. The English articles were analyzed, and the overall issuance showed an upward trend; the core author was Macpherson, Hugh, and the institution with the highest article production was Guangzhou University of Traditional Chinese Medicine. China ranked first in terms of number and centrality of publications, followed by the United States. The keywords of Chinese and English articles were analyzed to conclude that the research trends in this field were an exploration of therapeutic mechanisms, acupoint application therapy, and assessment of sleep quality, and the research hotspots were the clinical application of external therapies in TCM and the types of underlying diseases. Conclusion This study comprehensively and objectively summarized the relevant literature on external therapies in TCM for depression. It highlights the direction for further exploration by revealing and analyzing the research hotspots and trends in this field.
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Affiliation(s)
- Lingzu Kong
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Jinglin Hu
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Ming Yue
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Xiaoqi Xin
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Fengbei Lin
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Yinghua Hu
- Teaching and Research Office of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
| | - Xichen Wang
- School of Medical Information, Changchun University of Chinese Medicine, Changchun, Jilin, 130117, China
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21
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Wasti P, Panta PP, Gc VS, Ghimire B, Sapkota P, Wasti SP. Prevalence of Perinatal Depression and Its Associated Risk Factors among Nepalese Women in Kathmandu, Nepal. Healthcare (Basel) 2024; 12:1773. [PMID: 39273797 PMCID: PMC11395621 DOI: 10.3390/healthcare12171773] [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: 07/08/2024] [Revised: 08/28/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
Perinatal mental health is a major public health issue that arises during pregnancy and/or after birth, with substantial implications for social, parental, and maternal functioning, as well as overall quality of life. The study aimed to determine the prevalence of perinatal depression and its associated risk factors among women who visited a maternity hospital in Kathmandu, Nepal. A cross-sectional study was conducted at the Paropakar Maternity and Women's Hospital in Kathmandu. A total of 300 women in their perinatal period were interviewed. The Edinburgh Perinatal Depression Scale (EPDS) was used to measure perinatal depression. The Poisson regression model was used to determine risk factors associated with perinatal depression. The mean age of respondents was 25.5 (SD 4.5) years; average age during their first pregnancy was 23.5 (SD 3.7) years; and 53.7% of respondents were in the antenatal period. The prevalence of depressive symptoms (EPDS ≥ 10) was 40% (95% CI 31.4% to 45.8%). Unsupportive family members (adjusted prevalence ratio [aPR] 2.23; 95% CI 1.75-2.86), postnatal period (aPR 2.64; 95% CI 1.97-3.53), complications faced during delivery (aPR 1.76; 95%CI 1.30-2.39), history of intimate partner violence (aPR 0.48; 95% CI 0.36-0.64), and first pregnancy at the age of ≤25 years (aPR 0.61; 95% CI 0.42-0.88) were identified as key risk factors of perinatal depression. Strong family support and the active involvement of partners in counselling can contribute to alleviating perinatal depression symptoms. Targeted interventions in health and well-being services should be implemented to address mental health burden during both pregnancy and postpartum periods.
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Affiliation(s)
- Pratikshya Wasti
- Department of Public Health, Nobel College, Kathmandu 44600, Nepal
| | | | - Vijay S Gc
- School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Biwash Ghimire
- College of Pharmacy, Idaho State University, Pocatello, ID 83209, USA
| | - Pooja Sapkota
- College of Pharmacy, Idaho State University, Pocatello, ID 83209, USA
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Biete C, Gonçalves VSS, Carmo AS, Pizato N. The Happy Child Program's Intersectionality: Prenatal Home Visit Frequency, Food Insecurity Risk, Symptoms of Depression, and Parental Practices in Brazilian Women Assisted during Pregnancy. Nutrients 2024; 16:2990. [PMID: 39275305 PMCID: PMC11396776 DOI: 10.3390/nu16172990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 08/31/2024] [Accepted: 09/03/2024] [Indexed: 09/16/2024] Open
Abstract
Food insecurity (FI) is a critical issue in developing countries, particularly in low-resource settings, where it can worsen women's mental health. Psychosocial factors such as low household income, limited education, multiparity, and vulnerability are linked to depressive symptoms during pregnancy. Additionally, the family environment influences parental practices, which may impact mental health. This study evaluates the association of socioeconomic factors, parental practices, FI risk, and home visit frequency with depressive symptoms in pregnant women enrolled in the Happy Child Program (Programa Criança Feliz-PCF) in the Federal District, Brazil. In this cross-sectional study, 132 pregnant women monitored by PCF from May to July 2023 were assessed using a self-administered questionnaire for socioeconomic data, the two-item Triage for Food Insecurity (TRIA) instrument for FI risk, the Scale of Parental Beliefs and Early Childhood Care Practices, and the Beck Depression Inventory-II for depressive symptoms. Most participants were multiparous (87.9%), had low income (under 200 USD/month; 80.8%), presented depressive symptoms (67.4%) and were at risk of FI (81.8%). About half demonstrated adequate parental practices (50.8%) and received four home visits per month during pregnancy (54.5%). Women who received four PCF home visits had a lower prevalence of depressive symptoms compared to those with fewer visits (PR 0.76, 95% CI 0.59-0.98). No significant association was found between FI or parental practices and depressive symptoms. These findings suggest that the PCF home-visiting program may strengthen vulnerable families, support social networks, and improve mental health during pregnancy. Additionally, the results of this study highlight the need for targeted interventions aimed at reducing food insecurity and promoting mental health during pregnancy, particularly among socially vulnerable populations. Furthermore, they reinforce the importance of expanding access to home-visiting programs as an effective strategy to improve maternal mental health and well-being, while fostering healthier prenatal environments for both mothers and their children.
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Affiliation(s)
- Camila Biete
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil
| | - Vivian S S Gonçalves
- Graduate Program in Public Health, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil
| | - Ariene S Carmo
- Graduate Program in Public Health, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Nathalia Pizato
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil
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23
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Desaunay P, Eslier M, Alexandre J, Dreyfus M, Chrétien B, Guénolé F. Antidepressants and fetal death: A systematic review and disproportionality analysis in the WHO safety database (VigiBase Ⓡ). Psychiatry Res 2024; 339:116048. [PMID: 38959577 DOI: 10.1016/j.psychres.2024.116048] [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: 11/05/2023] [Revised: 04/03/2024] [Accepted: 06/16/2024] [Indexed: 07/05/2024]
Abstract
Recent research suggests that fetal exposure to antidepressants (ADs) is significantly associated with fetal death, including stillbirth. However, there has been limited investigation into the timing of AD exposure during pregnancy, the specific effect of each drug, and the possibility of indication bias. To address these gaps in knowledge, we conducted a systematic review of literature and disproportionality analyses using the WHO Safety Database (VigiBaseⓇ). The systematic review provided evidence for increased risks of fetal death with exposure to any selective serotonin reuptake inhibitor (SSRI) at any time of pregnancy, stillbirth with exposure to any AD during the first trimester, and stillbirth with exposure to any SSRI during the first trimester. Disproportionality analyses revealed significant associations with citalopram, clomipramine, paroxetine, sertraline, and venlafaxine. Combining both sets of results, we conclude that exposure to ADs, especially during the first trimester of pregnancy, seems to be associated with fetal mortality, and that ADs with highest placental transfer may be particularly involved. Further research should investigate the links between ADs during early pregnancy and fetal mortality.
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Affiliation(s)
- Pierre Desaunay
- Centre Hospitalier Universitaire de Caen Normandie, service de psychiatrie de l'enfant et de l'adolescent, Avenue de la côte de nacre, 14000, Caen, France
| | - Maxime Eslier
- Polyclinique du Parc, service de gynécologie et d'obstétrique, 20 Avenue du Capitaine Georges Guynemer, 14000, Caen, France; Center for Research on Epidemiology and Statistics Sorbonne Paris Cité, Obstetrical Perinatal and Pediatric Epidemiology Research Team, 10 Avenue de Verdun, 75010, Paris, France
| | - Joachim Alexandre
- Centre Hospitalier Universitaire de Caen Normandie, service de pharmacologie, Avenue de la côte de nacre, 14000, Caen, France
| | - Michel Dreyfus
- Centre Hospitalier Universitaire de Caen Normandie, service de gynécologie-obstétrique et de médecine de la reproduction, Avenue de la côte de nacre, 14000, Caen, France
| | - Basile Chrétien
- Centre Hospitalier Universitaire de Caen Normandie, service de pharmacologie, Avenue de la côte de nacre, 14000, Caen, France
| | - Fabian Guénolé
- Centre Hospitalier Universitaire de Caen Normandie, service de psychiatrie de l'enfant et de l'adolescent, Avenue de la côte de nacre, 14000, Caen, France.
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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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25
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Martínez-Borba V, Suso-Ribera C, Osma J. Current state and practical recommendations on reproductive mental health: a narrative review. Women Health 2024; 64:451-470. [PMID: 38812266 DOI: 10.1080/03630242.2024.2360419] [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: 11/24/2023] [Accepted: 05/21/2024] [Indexed: 05/31/2024]
Abstract
Emotional disorders (EDs) are highly prevalent during the reproductive period, including pregnancy, postpartum, and women undergoing fertility treatments. International guidelines are increasingly suggesting the need to evaluate, prevent, and treat EDs in those women. The main aim of this narrative review is to summarize current practice in the field of EDs management during fertility treatments, pregnancy, and the postpartum and to propose a new technology-based model of care that helps to provide psychological care to all women who are in these periods. Four different databases (Pubmed, Scopus, Science Direct, Web of Science) were consulted. Selected keywords were related with infertility, pregnancy, postpartum, EDs, assessment, prevention, treatment, and technologies. We identified 1603 studies and 43 were included in this review. According to these studies, different face-to-face protocols already exist to manage EDs in women undergoing fertility treatments, pregnant or at the postpartum. We noticed an increased interest in developing technology-based solutions to overcome the limitations of traditional mental healthcare services. However, we also detected some issues in the use of technologies (i.e. increased attention to the postpartum or the lack of transdiagnostic approaches). Our results evidenced that there is still a need to develop modern, well-designed, and conceptually-relevant ICT-based programs to be used in women undergoing fertility treatments, pregnant or at the postpartum.
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Affiliation(s)
- V Martínez-Borba
- Departament of Psychology and Sociology, University of Zaragoza, Teruel, Spain
- Health Research Institute of Aragon, Zaragoza, Spain
| | - C Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón de la Plana, Spain
| | - J Osma
- Departament of Psychology and Sociology, University of Zaragoza, Teruel, Spain
- Health Research Institute of Aragon, Zaragoza, Spain
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26
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Yan S, Fan W, Ma Y, Xie S, Li R, Lan Y, Xie L, Jing J. Pregnant Women's Dyadic Coping and Associated Factors: A Cross-Sectional Study Utilizing Latent Profile Analysis. Int J Womens Health 2024; 16:1009-1022. [PMID: 38835832 PMCID: PMC11149646 DOI: 10.2147/ijwh.s458763] [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: 01/09/2024] [Accepted: 05/11/2024] [Indexed: 06/06/2024] Open
Abstract
Background The problem of maternal mental health is a priority issue of global concern. Dyadic coping refers to the co-managing and making decisions between two parties in response to a joint stressful event. At present, china has limited focus on dyadic coping for pregnant women during pregnancy. This study aimed to investigate different categories and characteristics of dyadic coping in pregnant women throughout pregnancy and to analyze the factors that influence these categories. Methods This study was a cross-sectional, and 376 pregnant women who visited the obstetric clinic at a tertiary hospital in Sichuan province from June to September 2023 were interviewed face-to-face using convenience sampling. Data were collected using a sociodemographic questionnaire, dyadic coping scale, and family adaptability and cohesion evaluation scale. The data were imported into excel and exported to spss 27.0 to analyze the potential characteristics of pregnant women's dyadic coping during pregnancy and to explore the effects of this using univariate analysis and multifactorial logistic regression. Results A total of 376 valid questionnaires were collected. The results of the potential profile analysis showed that the dyadic coping of pregnant women during pregnancy could be categorized into three different groups: the "low coping group" (21.3%), the "general coping group" (67.5%), and the "high coping group" (11.2%). Multiple logistic regression analyses revealed that low monthly family income, early pregnancy, primipara, family adaptability and cohesion were the factors influencing the dyadic coping of pregnant women during pregnancy. Conclusion During pregnancy, pregnant women exhibit moderate levels of dyadic coping. Three different categories of dyadic coping patterns were exhibited: low coping group, general coping group, and high coping group, with significant heterogeneity. Therefore, there is a need to focus on the dyadic coping status of various categories of pregnant women and implement targeted couple and family-wide interventions.
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Affiliation(s)
- Shiqiong Yan
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People's Republic of China
| | - Wenzhuo Fan
- Department of Nursing, Chengdu Women and Children's Central Hospital, Chengdu, Sichuan Province, People's Republic of China
| | - Yonghong Ma
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Sijia Xie
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People's Republic of China
| | - Rong Li
- Department of Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People's Republic of China
| | - Yao Lan
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People's Republic of China
| | - Linli Xie
- Department of Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People's Republic of China
| | - Jie Jing
- Department of Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People's Republic of China
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Ayrout RA, Kookash MH, Kalalib Al Ashabi K, Safiah MH, Latifeh Y. Exploring prenatal depression and postpartum depression: Findings from a prospective cohort study at University Hospital Obstetrics in Damascus. Medicine (Baltimore) 2024; 103:e38170. [PMID: 38758898 PMCID: PMC11098259 DOI: 10.1097/md.0000000000038170] [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: 11/22/2023] [Accepted: 04/17/2024] [Indexed: 05/19/2024] Open
Abstract
The perinatal period is crucial for both mother and newborn, and mental health, including prenatal and postpartum depression (PPD), is a significant aspect. Screening for these disorders allows for early treatment and helps prevent risks to both mother and child. This prospective cohort study was carried out at University Hospital Obstetrics in Damascus City. The first phase was during the third trimester of pregnancy and the second phase involved a follow-up assessment after 6 weeks of delivery. The Arabic-validated version of the Edinburgh Postnatal Depression Scale questionnaire (EPDS) was used. A cutoff of 13 or higher was used to determine the presence of probable depression in both assessments. Of 347 pregnant women, 38.6% had prenatal depression (PND). 295 patients have achieved the second assessment, of which 30.2% had PPD. Furthermore, 42.6% who had PND developed PPD on follow-up. Binary logistic regression indicated that PND was predicted by non-Syrian nationality, paternal absence, poor financial status, number of previous pregnancies, and a history of depression independent of pregnancy. PPD was predicted by a history of PPD, and work status. Findings underscore potential value of early screening for depressive symptoms as a predictive measure. It is recommended that women with a history of depression receive heightened attention and care, irrespective of the timing of their depressive episodes.
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Affiliation(s)
- Ramah Abdo Ayrout
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Majd Hatem Kookash
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | | | - Mhd Homam Safiah
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Youssef Latifeh
- Department of Psychiatry, Damascus University, Damascus, Syrian Arab Republic
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28
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Broberg L, Bendix JM, Røhder K, Løkkegaard E, Væver M, Grew JC, Johnsen H, Juhl M, de Lichtenberg V, Schiøtz M. Combining the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale in Early Pregnancy in Danish Antenatal Care-A Qualitative Descriptive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:454. [PMID: 38673365 PMCID: PMC11050197 DOI: 10.3390/ijerph21040454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/04/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Pregnant women with a history of mental disorders, neglect, or low social support are at increased risk of mental health problems. It is crucial to identify psychosocial risk factors in early pregnancy to reduce the risk of short- and long-term health consequences for mother and child. The Antenatal Risk Questionnaire has been found acceptable as a psychosocial screening tool among pregnant women in Australia, but it has not been tested in a Scandinavian context. The aim of this study was to explore the experiences of pregnant women when using the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale as part of a model to identify psychosocial vulnerabilities in pregnancy in Denmark. We conducted individual interviews (n = 18) and used thematic analysis. We identified two main themes: (1) Feeling heard and (2) An occasion for self-reflection. Overall, the pregnant women deemed the online ANRQ/EPDS acceptable as a screening tool. The screening model provided a feeling of being heard and provided an occasion for self-reflection about mental health challenges related to pregnancy and motherhood. However, some women expressed that the screening raised concerns and fear of the consequences of answering honestly. A non-judgmental, open, emphatic, and reassuring approach by clinicians may help reduce stigma.
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Affiliation(s)
- Lotte Broberg
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark; (J.C.G.); (M.S.)
- Department of Gynecology and Obstetrics, Slagelse Hospital, Fælledvej 14, 4200 Slagelse, Denmark
| | - Jane M. Bendix
- Department of Gynecology and Obstetrics, Copenhagen University Hospital—North Zealand, Dyrehavevej 29, 3400 Hillerød, Denmark; (J.M.B.); (E.L.)
| | - Katrine Røhder
- Center for Early Intervention and Family Research, Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen, Denmark; (K.R.); (M.V.)
| | - Ellen Løkkegaard
- Department of Gynecology and Obstetrics, Copenhagen University Hospital—North Zealand, Dyrehavevej 29, 3400 Hillerød, Denmark; (J.M.B.); (E.L.)
| | - Mette Væver
- Center for Early Intervention and Family Research, Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen, Denmark; (K.R.); (M.V.)
| | - Julie C. Grew
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark; (J.C.G.); (M.S.)
| | - Helle Johnsen
- Department of Midwifery and Therapeutic Science, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark; (H.J.); (M.J.); (V.d.L.)
| | - Mette Juhl
- Department of Midwifery and Therapeutic Science, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark; (H.J.); (M.J.); (V.d.L.)
| | - Vibeke de Lichtenberg
- Department of Midwifery and Therapeutic Science, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark; (H.J.); (M.J.); (V.d.L.)
| | - Michaela Schiøtz
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark; (J.C.G.); (M.S.)
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29
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Radoš SN, Akik BK, Žutić M, Rodriguez-Muñoz MF, Uriko K, Motrico E, Moreno-Peral P, Apter G, den Berg MLV. Diagnosis of peripartum depression disorder: A state-of-the-art approach from the COST Action Riseup-PPD. Compr Psychiatry 2024; 130:152456. [PMID: 38306851 DOI: 10.1016/j.comppsych.2024.152456] [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: 10/16/2023] [Revised: 12/26/2023] [Accepted: 01/28/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Peripartum depression (PPD) is a major depression disorder (MDD) episode with onset during pregnancy or within four weeks after childbirth, as defined in DSM-5. However, research suggests that PPD may be a distinct diagnosis. The goal of this study was to summarize the similarities and differences between PPD and MDD by synthesizing the current research on PPD diagnosis concerning different clinical features and give directions for improving diagnosis of PPD in clinical practice. METHODS To lay the groundwork for this narrative review, several databases were searched using general search phrases on PPD and its components of clinical diagnosis. RESULTS When compared to MDD, peripartum depression exhibits several distinct characteristics. PPD manifests with a variety of symptoms, i.e., more anxiety, psychomotor symptoms, obsessive thoughts, impaired concentration, fatigue and loss of energy, but less sad mood and suicidal ideation, compared to MDD. Although PPD and MDD prevalence rates are comparable, there are greater cross-cultural variances for PPD. Additionally, PPD has some distinct risk factors and mechanisms such as distinct ovarian tissue expression, premenstrual syndrome, unintended pregnancy, and obstetric complications. CONCLUSION There is a need for more in-depth research comparing MDD with depression during pregnancy and the entire postpartum year. The diagnostic criteria should be modified, particularly with (i) addition of specific symptoms (i.e., anxiety), (ii) onset specifier extending to the first year following childbirth, (iii) and change the peripartum onset specifier to either "pregnancy onset" or "postpartum onset". Diagnostic criteria for PPD are further discussed.
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Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | | | - Maja Žutić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Maria F Rodriguez-Muñoz
- Department of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Kristiina Uriko
- Department of Psychology and Behavioural Sciences, Tallinn University, Tallinn, Estonia
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
| | - Patricia Moreno-Peral
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA), Málaga, Spain
| | - Gisèle Apter
- Child and Perinatal Psychiatric Department, Le Havre University Hospital, University Rouen Normandie, Le Havre, France
| | - Mijke Lambregtse-van den Berg
- Departments of Psychiatry and Child & Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
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30
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Pouranayatihosseinabad M, Taylor M, Hawrelak JA, Peterson GM, Veal F, Ling T, Williams M, Whatley M, Ahdieh K, Mirkazemi C. Maternal Antibiotic Exposure and the Risk of Developing Antenatal Depressive Symptoms. J Clin Med 2024; 13:1434. [PMID: 38592691 PMCID: PMC10932309 DOI: 10.3390/jcm13051434] [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: 01/05/2024] [Revised: 02/25/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Antenatal depression is common and has significant consequences. The literature suggests that antibiotic exposure may be associated with depression. Many individuals are exposed to antibiotics during pregnancy. Further investigation of the association between antenatal antibiotic use and the development of depression during pregnancy is needed. Methods: A national prospective observational cohort study of pregnant individuals was undertaken using an online survey, completed during the third trimester. Antenatal depressive symptoms (ADSs) were defined as having an Edinburgh Postnatal Depression Scale score of ≥13 and/or receiving a clinical diagnosis of depression. Results: One in six individuals (16.5%, n = 977) experienced ADSs during their pregnancy, of whom 37.9% received a depression diagnosis. There was no relationship between antibiotic use and the development of ADSs. Four factors were identified as significant independent predictors of ADSs: personal history of depression, severe nausea and vomiting causing an inability to eat, emotional abuse from an intimate partner within the prior 12 months, and not having a university degree. Conclusions: Antenatal antibiotic use was not associated with the development of ADSs. Given the high incidence of undiagnosed depression, new strategies and models of care that prioritise individuals with risk factors may be required to optimise antenatal care.
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Affiliation(s)
- Mahsa Pouranayatihosseinabad
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia (G.M.P.); (C.M.)
| | - Maggie Taylor
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia (G.M.P.); (C.M.)
| | - Jason A. Hawrelak
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia (G.M.P.); (C.M.)
- Human Nutrition and Functional Medicine, University of Western States, Portland, OR 97213, USA
| | - Gregory M. Peterson
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia (G.M.P.); (C.M.)
| | - Felicity Veal
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia (G.M.P.); (C.M.)
| | - Tristan Ling
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia (G.M.P.); (C.M.)
| | - Mackenzie Williams
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia (G.M.P.); (C.M.)
| | - Megan Whatley
- Department of Obstetrics and Gynaecology, Mater Mothers’ Hospital, Brisbane, QLD 4101, Australia
| | - Kyan Ahdieh
- Launceston Medical Centre, Health Hub, Launceston, TAS 7250, Australia
| | - Corinne Mirkazemi
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia (G.M.P.); (C.M.)
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Wang Y, Gu J, Zhang F, Xu X. Path analysis of influencing factors for maternal antenatal depression in the third trimester. Sci Rep 2024; 14:4742. [PMID: 38413698 PMCID: PMC10899182 DOI: 10.1038/s41598-024-55355-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/22/2024] [Indexed: 02/29/2024] Open
Abstract
Maternal antenatal depression (AD) is a nonpsychotic depressive episode during pregnancy that can harm both the pregnant woman and the fetus. This study aimed to investigate the intrinsic interrelationships between AD and its influencing factors by constructing a path model. This survey-based cross-sectional study included 1071 pregnant women who underwent pregnancy examinations in three hospitals in Nantong City, China, between February and June 2023. General information and information regarding maternal AD, pregnancy stress, prenatal anxiety, social support, marital satisfaction, sleep quality, and resilience were collected. Multiple linear regression analysis using SPSS 25.0 was employed to determine the factors influencing pregnancy depression, and Amos25.0 was used to construct a structural equation model. AD incidence was 19.4% (208/1071). The independent risk factors affecting AD in pregnant women have been integrated into the established path analysis model. The model demonstrated a good fit (χ2/DF = 1.238, comparative fit index = 0.999, goodness-of-fit index = 0.998, normed fit index = 0.996, adjusted goodness-of-fit index = 0.990, incremental fit index = 0.999, and root mean square error of approximation = 0.015). While prenatal anxiety (0.230) and hyperthyroidism (0.048) only had direct effects on AD, mental resilience was the biggest factor affecting AD, followed by pregnancy stress, marital satisfaction, prenatal anxiety, sleep quality, social support, and hyperthyroidism. Improved mental resilience, social support, sleep quality, and marital satisfaction; reduced pregnancy stress and prenatal anxiety; and effective hyperthyroidism treatment might reduce AD. This study underscored the significance of delivering actionable strategies and tangible assistance to pregnant women to reduce AD.
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Affiliation(s)
- Yanchi Wang
- Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), Nantong, Jiangsu, China
- Medical School of Nantong University, Nantong, Jiangsu, China
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Jian Gu
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Feng Zhang
- Medical School of Nantong University, Nantong, Jiangsu, China.
- Medical School (School of Nursing), Nantong University, Nantong, 226001, Jiangsu, China.
| | - Xujuan Xu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
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Matijasevich A, Faisal-Cury A, Giacomini I, Rodrigues JDS, Castro MC, Cardoso MA. Maternal depression and offspring mental health at age 5: MINA-Brazil cohort study. Rev Saude Publica 2024; 57Suppl 2:5s. [PMID: 38422334 PMCID: PMC10897964 DOI: 10.11606/s1518-8787.2023057005560] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/24/2023] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE To identify longitudinal patterns of maternal depression between three months and five years after child's birth, to examine predictor variables for these trajectories, and to evaluate whether distinct depression trajectories predict offspring mental health problems at age 5 years. METHODS We used data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3 and 6-8 months, and 1 and 2 years after delivery. Mental health problems in 5-year-old children were evaluated with the Strengths and Difficulties Questionnaire (SDQ) reported by parents. Trajectories of maternal depression were calculated using a group-based modelling approach. RESULTS We identified four trajectories of maternal depressive symptoms: "low" (67.1%), "increasing" (11.5%), "decreasing" (17.4%), and "high-chronic" (4.0%). Women in the "high/chronic" trajectory were the poorest, least educated, and oldest compared with women in the other trajectory groups. Also, they were more frequently multiparous and reported smoking and having attended fewer prenatal consultations during pregnancy. In the adjusted analyses, the odds ratio of any SDQ disorder was 3.23 (95%CI: 2.00-5.22) and 2.87 (95%CI: 1.09-7.57) times higher among children of mothers belonging to the "increasing" and "high-chronic" trajectory groups, respectively, compared with those of mothers in the "low" depressive symptoms group. These differences were not explained by maternal and child characteristics included in multivariate analyses. CONCLUSIONS We identified poorer mental health outcomes for children of mothers assigned to the "chronic/severe" and "increasing" depressive symptoms trajectories. Prevention and treatment initiatives to avoid the adverse short, medium, and long-term effects of maternal depression on offspring development should focus on women belonging to these groups.
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Affiliation(s)
- Alicia Matijasevich
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil
| | - Alexandre Faisal-Cury
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil
| | - Isabel Giacomini
- Universidade de São PauloFaculdade de Saúde PúblicaPrograma de Pós-Graduação em Nutrição em Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação em Nutrição em Saúde Pública. São Paulo, SP, Brasil
| | - Julia de Souza Rodrigues
- Universidade de São PauloFaculdade de MedicinaPrograma de Pós-Graduação em Saúde ColetivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Programa de Pós-Graduação em Saúde Coletiva. São Paulo, SP, Brasil
| | - Marcia C. Castro
- Harvard T.H. Chan School of Public HealthDepartment of Global Health and PopulationBostonMAUnited States of AmericaHarvard T.H. Chan School of Public Health. Department of Global Health and Population. Boston, MA, United States of America
| | - Marly A. Cardoso
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
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Drzymalla E, Crider KS, Wang A, Marta G, Khoury MJ, Rasooly D. Epigenome-wide association studies of prenatal maternal mental health and infant epigenetic profiles: a systematic review. Transl Psychiatry 2023; 13:377. [PMID: 38062042 PMCID: PMC10703876 DOI: 10.1038/s41398-023-02620-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 10/01/2023] [Accepted: 10/06/2023] [Indexed: 12/18/2023] Open
Abstract
Prenatal stress and poor maternal mental health are associated with adverse offspring outcomes; however, the biological mechanisms are unknown. Epigenetic modification has linked maternal health with offspring development. Epigenome-wide association studies (EWAS) have examined offspring DNA methylation profiles for association with prenatal maternal mental health to elucidate mechanisms of these complex relationships. The objective of this study is to provide a comprehensive, systematic review of EWASs of infant epigenetic profiles and prenatal maternal anxiety, depression, or depression treatment. We conducted a systematic literature search following PRISMA guidelines for EWAS studies between prenatal maternal mental health and infant epigenetics through May 22, 2023. Of 645 identified articles, 20 fulfilled inclusion criteria. We assessed replication of CpG sites among studies, conducted gene enrichment analysis, and evaluated the articles for quality and risk of bias. We found one repeated CpG site among the maternal depression studies; however, nine pairs of overlapping differentially methylatd regions were reported in at least two maternal depression studies. Gene enrichment analysis found significant pathways for maternal depression but not for any other maternal mental health category. We found evidence that these EWAS present a medium to high risk of bias. Exposure to prenatal maternal depression and anxiety or treatment for such was not consistently associated with epigenetic changes in infants in this systematic review and meta-analysis. Small sample size, potential bias due to exposure misclassification and statistical challenges are critical to address in future efforts to explore epigenetic modification as a potential mechanism by which prenatal exposure to maternal mental health disorders leads to adverse infant outcomes.
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Affiliation(s)
- Emily Drzymalla
- Division of Blood Disorders and Public Health Genomics, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Krista S Crider
- Infant Outcomes Research and Prevention Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Arick Wang
- Infant Outcomes Research and Prevention Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Muin J Khoury
- Division of Blood Disorders and Public Health Genomics, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Danielle Rasooly
- Division of Blood Disorders and Public Health Genomics, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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34
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Camacho EM, Shields GE, Eisner E, Littlewood E, Watson K, Chew-Graham CA, McMillan D, Ali S, Gilbody S. An economic evaluation of universal and targeted case-finding strategies for identifying antenatal depression: a model-based analysis comparing common case-finding instruments. Arch Womens Ment Health 2023:10.1007/s00737-023-01377-2. [PMID: 37851079 DOI: 10.1007/s00737-023-01377-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023]
Abstract
Half of women with depression in the perinatal period are not identified in routine care, and missed cases reflect inequalities in other areas of maternity care. Case finding (screening) for depression in pregnant women may be a cost-effective strategy to improve identification, and targeted case finding directs finite resources towards the greatest need. We compared the cost-effectiveness of three case-finding strategies: no case finding, universal (all pregnant women), and targeted (only pregnant women with risk factors for antenatal depression, i.e. history of anxiety/depression, age < 20 years, and adverse life events). A decision tree model was developed to represent case finding (at around 20 weeks gestation) and subsequent treatment for antenatal depression (up to 40 weeks gestation). Costs include case finding and treatment. Health benefits are measured as quality-adjusted life years (QALYs). The sensitivity and specificity of case-finding instruments and prevalence and severity of antenatal depression were estimated from a cohort study of pregnant women. Other model parameters were derived from published literature and expert consultation. The most cost-effective case-finding strategy was a two-stage strategy comprising the Whooley questions followed by the PHQ-9. The mean costs were £52 (universal), £61 (no case finding), and £62 (targeted case finding). Both case-finding strategies improve health compared with no case finding. Universal case finding is cost-saving. Costs associated with targeted case finding are similar to no case finding, with greater health gains, although targeted case finding is not cost-effective compared with universal case finding. Universal case finding for antenatal depression is cost-saving compared to no case finding and more cost-effective than targeted case finding.
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Affiliation(s)
- Elizabeth M Camacho
- School of Health Sciences, University of Manchester, Manchester, UK.
- Institute of Population Health, University of Liverpool, Liverpool, UK.
| | - Gemma E Shields
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Emily Eisner
- School of Health Sciences, University of Manchester, Manchester, UK
- Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Kylie Watson
- Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Dean McMillan
- Hull York Medical School and Department of Health Sciences, University of York, York, UK
| | - Shehzad Ali
- Hull York Medical School and Department of Health Sciences, University of York, York, UK
- Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Simon Gilbody
- Hull York Medical School and Department of Health Sciences, University of York, York, UK
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35
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Aguilar M, Contreras C, Raviola G, Sepúlveda A, Espinoza M, Moran L, Ramos L, Peinado J, Lecca L, Pedersen GA, Kohrt BA, Galea JT. Perinatal depression and implementation of the "Thinking Healthy program" support intervention in an impoverished setting of Lima, Peru: Assessment before and during the COVID-19 pandemic. Glob Ment Health (Camb) 2023; 10:e64. [PMID: 37854394 PMCID: PMC10579694 DOI: 10.1017/gmh.2023.45] [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: 03/16/2023] [Revised: 07/10/2023] [Accepted: 08/10/2023] [Indexed: 10/20/2023] Open
Abstract
Socios En Salud (SES) implemented the Thinking Healthy program (THP) to support women with perinatal depression before and during the COVID-19 pandemic in Lima Norte. We carried out an analysis of the in-person (5 modules) and remote (1 module) THP intervention. Depression was detected using PHQ-9, and THP sessions were delivered in women with a score (PHQ-9 ≥ 5). Depression was reassessed and pre- and post-scores were compared. In the pre-pandemic cohort, perinatal depression was 25.4% (47/185), 47 women received THP and 27 were reassessed (57.4%), and the PHQ-9 score median decreased from 8 to 2, p < 0.001. In the pandemic cohort, perinatal depression was 47.5% (117/247), 117 women received THP and 89 were reassessed (76.1%), and the PHQ-9 score median decreased from 7 to 2, p < 0.001. THP's modalities helped to reduce perinatal depression. Pregnant women who received a module remotely also reduced depression.
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Affiliation(s)
| | - Carmen Contreras
- Socios En Salud, Lima, Peru
- Harvard Global Health Institute, Harvard University, Cambridge, MA, USA
| | - Giuseppe Raviola
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Partners in Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | | | | | - Lourdes Ramos
- Socios En Salud, Lima, Peru
- Escuela Profesional de Tecnología Médica, Universidad Privada San Juan Bautista, Lima, Peru
| | - Jesús Peinado
- Socios En Salud, Lima, Peru
- School of Medicine, Faculty of Health Sciences, Peruvian University of Applied Sciences – UPC, Lima, Peru
| | - Leonid Lecca
- Socios En Salud, Lima, Peru
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Partners in Health, Boston, MA, USA
| | - Gloria A. Pedersen
- Department of Psychiatry and Behavioral Sciences, George Washington University, WashingtonDC, USA
| | - Brandon A. Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, WashingtonDC, USA
| | - Jerome T. Galea
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- School of Social Work, University of South Florida, FL, USA
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36
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Wittenberg MF, Fitzgerald S, Pluhar E. Depressive symptomatology in pregnant adolescents: considerations for care. Curr Opin Pediatr 2023; 35:415-422. [PMID: 36988280 DOI: 10.1097/mop.0000000000001250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
PURPOSE OF REVIEW Adolescents who are pregnant experience higher levels of depressive symptoms than nonpregnant peers and pregnant adults. Clinicians caring for youth are often the first point of clinical contact for pregnant adolescents but report low confidence in assessing and treating reproductive health concerns. In the current review, we outline risk factors for depressive symptoms among pregnant adolescents and provide guidance on best practices in assessment and treatment of depressive symptoms in this pediatric sub-population. RECENT FINDINGS Depressive symptoms are persistent across pregnancy. In adolescents, they are linked to greater risk of suicidal ideation, suicidal behavior, and nonsuicidal self-injury. Risk factors for prenatal depressive symptoms among adolescents include lower levels of income, history of depression, exposure to childhood maltreatment and/or recent abuse, and/or lifetime exposure to racial/ethnic discrimination. These risk factors likely interact with each other. SUMMARY Clinicians should assess carefully for depressive symptoms in all pregnant adolescents using a standardized, validated measure supplemented by thoughtful clinical interviewing. Clinicians can educate adolescents on the distinction between symptoms of pregnancy versus symptoms of depression. We encourage clinicians to increase their comfort in providing psychopharmacological treatment, consulting with colleagues in psychiatry, and referring adolescents for psychopharmacological treatment and therapy as needed.
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Affiliation(s)
| | - Shannon Fitzgerald
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
- Department of Pediatrics, Harvard Medical School
| | - Emily Pluhar
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
- Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
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37
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Silva MMDJ, Serrano TBDM, Porcel GDS, Monteiro BB, Clapis MJ. Risk of depression during pregnancy in usual risk antenatal care. Rev Lat Am Enfermagem 2023; 31:e3962. [PMID: 37493727 PMCID: PMC10370154 DOI: 10.1590/1518-8345.6463.3962] [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: 08/31/2022] [Accepted: 05/08/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE to identify the risk of depression during pregnancy among pregnant women receiving routine prenatal care and the associated factors. METHOD a cross-sectional study, carried out with 201 pregnant women, in a routine prenatal clinic of a university maternity hospital. Data were collected using an electronic form containing a characterization instrument and the Escala de Risco de Depressão na Gravidez (Depression during Pregnancy Scale). The dependent variable was the risk of depression during pregnancy. Statistical analysis was performed by calculating the Odds Ratio and using the Chi-square and Fischer's Exact tests. RESULTS among the participants, 68.2% had a higher risk of depression during pregnancy. There was a statistically significant association between a higher risk of depression during pregnancy and occupation (p=0.04), that is, unemployment (OR=2.00) doubled the risk of depression. CONCLUSION the high prevalence of the risk of depression during pregnancy indicates the necessity of planning, prioritizing, and integrating mental health into prenatal health services, especially in the primary healthcare environment, by health managers and policymakers.
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Affiliation(s)
- Mônica Maria de Jesus Silva
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Tainah Barbosa de Moraes Serrano
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Giovanna da Silva Porcel
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Bruna Borlina Monteiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Maria José Clapis
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
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Wang P, Yim IS, Lindsay KL. Maternal Diet Quality and Prenatal Depressive Symptoms: The Moderating Role of Economic Well-Being. Nutrients 2023; 15:2809. [PMID: 37375713 PMCID: PMC10303235 DOI: 10.3390/nu15122809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Prenatal depression is prevalent and adversely impacts maternal and infant health. This study addresses a critical literature gap and investigates the association between maternal diet quality and prenatal depressive symptoms, as well as the moderating effect of economic well-being on this link. A cross-sectional design was used, including 43 healthy pregnant women in the second trimester aggregated from two research projects. Prenatal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Dietary quality was evaluated using two non-consecutive 24 h dietary recalls, from which the Adapted Dietary Inflammatory Index (ADII) and the Healthy Eating Index (HEI)-2015 were derived. Economic well-being was indicated by the income-to-poverty ratio. A higher HEI-2015 (adherence to dietary guidelines; β = -0.53, p = 0.01) and negative ADII (anti-inflammatory diet; β = 0.40, p = 0.06) were associated with fewer prenatal depressive symp-toms. Among pregnant women with worse economic well-being, a pro-inflammatory diet was as-sociated with more prenatal depressive symptoms (b = 1.69, p = 0.004), but among those with better economic well-being, the association was not significant (b = 0.51, p = 0.09). Dietary interventions aimed at reducing dietary inflammation might hold some promise for improving mental health among pregnant women who are economically vulnerable.
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Affiliation(s)
- Peiyi Wang
- Department of Psychological Science, University of California, Irvine, CA 92617, USA; (P.W.); (I.S.Y.)
| | - Ilona S. Yim
- Department of Psychological Science, University of California, Irvine, CA 92617, USA; (P.W.); (I.S.Y.)
| | - Karen L. Lindsay
- Department of Pediatrics, School of Medicine, University of California, Irvine, CA 92617, USA
- UCI Susan Samueli Integrative Health Institute, College of Health Sciences, Irvine, CA 92617, USA
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Mazza M, Avallone C, Kotzalidis GD, Marano G, Moccia L, Serio AM, Balocchi M, Sessa I, Janiri D, De Luca I, Brisi C, Spera MC, Monti L, Gonsalez del Castillo A, Angeletti G, Chieffo D, Rinaldi L, Janiri L, Lanzone A, Scambia G, Mercuri EM, Sani G. Depressive Symptoms during Pregnancy: Prevalence and Correlates with Affective Temperaments and Psychosocial Factors. J Pers Med 2023; 13:jpm13020211. [PMID: 36836445 PMCID: PMC9967878 DOI: 10.3390/jpm13020211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
Pregnancy is a unique experience in women's life, requiring a great ability of adaptation and self-reorganization; vulnerable women may be at increased risk of developing depressive symptoms. This study aimed to examine the incidence of depressive symptomatology during pregnancy and to evaluate the role of affective temperament traits and psychosocial risk factors in predicting them. We recruited 193 pregnant women, collected data regarding sociodemographic, family and personal clinical variables, social support and stressful life events and administered the Mood Disorder Questionnaire (MDQ), the Patient Health Questionnaire-9 (PHQ-9), and the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A). In our sample, prevalence of depressive symptomatology was 41.45% and prevalence of depression was 9.85% (6.75% mild and 3.10% moderate depression). We have chosen a cutoff >4 on PHQ-9 to identify mild depressive symptoms which may predict subsequent depression. Statistically significant differences between the two groups were found in the following factors: gestational age, occupation, partner, medical conditions, psychiatric disorders, family psychiatric history, stressful life events, and TEMPS-A mean scores. In our sample mean scores on all affective temperaments but the hyperthymic, were significantly lower in the control group. Only depressive and hyperthymic temperaments were found to be, respectively, risk and protective factors for depressive symptomatology. The current study confirms the high prevalence and complex aetiology of depressive symptomatology during pregnancy and suggests that affective temperament assessment seems to be a useful adjunctive instrument to predict depressive symptomatology during pregnancy and postpartum.
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Affiliation(s)
- Marianna Mazza
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Carla Avallone
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Georgios Demetrios Kotzalidis
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
- Correspondence:
| | - Giuseppe Marano
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Lorenzo Moccia
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Anna Maria Serio
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marta Balocchi
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilenia Sessa
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Delfina Janiri
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilaria De Luca
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Caterina Brisi
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Chiara Spera
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Laura Monti
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Angela Gonsalez del Castillo
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gloria Angeletti
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Daniela Chieffo
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Lucio Rinaldi
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Lanzone
- Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanni Scambia
- Division of Gynecologic Oncology, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Eugenio Maria Mercuri
- Paediatric Neurology Unit, Fondazione Policlinico Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gabriele Sani
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Liu L, Zhou M, Xiao G, Zhang T, Li X, Owusua T, He W, Qin C. The impact of antenatal depressive symptoms on exclusive breastfeeding intention: A moderating effect analysis. Midwifery 2023; 116:103551. [PMID: 36413906 DOI: 10.1016/j.midw.2022.103551] [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: 07/22/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Exclusive breastfeeding intention is an important predictor of exclusive breastfeeding behavior. Antenatal depressive symptoms are a potentially modifiable risk factor for exclusive breastfeeding intention. However, studies of the impact of antenatal depressive symptoms on exclusive breastfeeding intention are sparse and contradictory. Therefore, explorations that evaluate the effects of identical factors of exclusive breastfeeding intention and antenatal depressive symptoms in their relationship are urgently needed. This study aims to (1) investigate the impact of antenatal depressive symptoms on exclusive breastfeeding intention based on confounders related either to antenatal depressive symptoms and/or exclusive breastfeeding intention and (2) explore whether or not identical factors moderate the relationship between antenatal depressive symptoms and exclusive breastfeeding intention. DESIGN AND SETTING A cross-sectional survey was conducted at a tertiary hospital in Hunan, China. PARTICIPANTS A total of 393 pregnant women completed a self-administered questionnaire, a question on their breastfeeding intention, the Edinburgh Postnatal Depression Scale, and the Perceived Social Support Scale during their first-trimester hospital visit. Logistic regression was used to evaluate the impact of antenatal depressive symptoms on exclusive breastfeeding intention. Moderate analysis was employed to explore whether identical factors moderate the relationship between antenatal depressive symptoms and exclusive breastfeeding intention. RESULTS Antenatal depressive symptoms negatively affect the exclusive breastfeeding intention after controlling as fully as possible for confounders (adjusted OR = 2.88, 95% CI: [1.06, 7.82]) and it was moderated by one of the identical factors (i.e., social support). The results of the simple slope test showed a negative relationship between antenatal depressive symptoms and exclusive breastfeeding intention among pregnant women with low levels of social support (b =-0.011, p < 0.05). CONCLUSION AND IMPLICATION FOR PRACTICE Social support moderates the negative effects of depressive symptoms on exclusive breastfeeding intention. Clinical care practices and future intervention research that focus on improving antenatal depressive symptoms and exclusive breastfeeding intention should consider the moderator.
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Affiliation(s)
- Li Liu
- Department of Health Management, Department of Nursing, The Third XiangYa Hospital, Central South University, Changsha, China; Xiangya School of Nursing, Central South University, Changsha, China
| | - Mengjia Zhou
- Department of Health Management, Department of Nursing, The Third XiangYa Hospital, Central South University, Changsha, China; Xiangya School of Nursing, Central South University, Changsha, China
| | - Gui Xiao
- Department of Health Management, Department of Nursing, The Third XiangYa Hospital, Central South University, Changsha, China; Xiangya School of Nursing, Central South University, Changsha, China
| | - Tingting Zhang
- Department of Health Management, Department of Nursing, The Third XiangYa Hospital, Central South University, Changsha, China; Xiangya School of Nursing, Central South University, Changsha, China
| | - Xingxing Li
- School of Medicine, Jishou University, Jishou, China
| | | | - Wei He
- Catholic University College of Ghana, Sunyani, Ghana
| | - Chunxiang Qin
- Catholic University College of Ghana, Sunyani, Ghana.
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Kodama T, Takaki S. Association Between Smartphone Applications for Pregnant Women and Psychological Distress in Japan. J Psychosoc Nurs Ment Health Serv 2023; 61:32-38. [PMID: 35858202 DOI: 10.3928/02793695-20220705-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The current study investigated pregnant women's use of pregnancy applications (apps) and how these apps affect their mental health. A questionnaire was administered in the outpatient obstetrics and gynecology department at a university hospital. Of 110 pregnant women included in the analysis, 97 had downloaded and used pregnancy apps and believed that these were either helpful or a little helpful. Among the 110 respondents, 20 (18.2%) women were identified as having psychological distress. Thus, the percentage of women with psychological distress who downloaded pregnancy apps was significantly lower than women in the mentally healthy group. Non-use of pregnancy apps was strongly associated with psychological distress, indicating that pregnancy apps improve pregnant women's mental health. Alternatively, non-use of apps could arise from deteriorated mental health, causing reduced energy or inclination to use these apps. Screening for good mental health among pregnant women is important; non-use of pregnancy apps may indicate risk of mental health deterioration among pregnant women. [Journal of Psychosocial Nursing and Mental Health Services, 61(1), 32-38.].
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Jiang T, Tuxunjiang X, Wumaier G, Li X, Li L. Path analysis of influencing factors for prenatal depressive symptoms in pregnant women. J Affect Disord 2022; 317:397-402. [PMID: 36029871 DOI: 10.1016/j.jad.2022.08.076] [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] [Received: 11/10/2021] [Revised: 05/20/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To explore the influencing factors and relationships associated with prenatal depressive symptoms in pregnant women. METHODS This study was a survey based cross-sectional investigation conducted on 750 pregnant women who underwent pregnancy and delivery examinations in a third class hospital in Urumqi City, and their general information was collected and a patient health questionnaire using a depression scale (Patients' Health Questionnaire Depression Scale - 9 item, PHQ - 9). Spss25.0 was used to compare the differences between the maternal depressive symptoms group and the non-depressed group, and Amos23.0 was used to construct a structural equation model to explore the influencing factors. RESULTS The incidence of depressive symptoms in 750 pregnant women was 13.6 % (102/750) and maternal prenatal depressive symptoms was related to occupation, total monthly income, physical exercise, psychological preparation for pregnancy, residence status, couple relationship, knowledge about pregnancy and other factors (P < 0.05). Binary logistic regression analysis showed that the independent risk factors for prenatal depressive symptoms in pregnant women included occupation (OR = 2.492), monthly gross income (OR = 1.293), psychological preparation for pregnancy (OR = 1.882), residential status (OR = 1.831), knowledge about pregnancy (OR = 2.028), prenatal anxiety (OR = 1.415), and pregnancy stress (OR = 4.590). The constructed path analysis model had good a fit (x2/DF = 3.805, GFI = 0.976, AGFI = 0.946, NFI = 0.902, CFI = 0.924, RMSEA = 0.061) and the path analysis showed that pregnancy stress had only a direct effect on prenatal depressive symptoms (effect value 0.169). DISCUSSION The binary logistic regression model showed that knowledge about pregnancy had the greatest influence on prenatal depressive symptoms, and the popularization of pregnancy knowledge reduced prenatal depressive symptoms.
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Affiliation(s)
- Ting Jiang
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | | | | | - Xue Li
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | - Ling Li
- Obstetrics Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China.
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Liu S, Lin Q, Feng Y, Zhong D, Jiang C, Zhang L. The protective role of social support on prenatal depression among pregnant women of advanced maternal age: a Three-Trimester follow-up study in China. J OBSTET GYNAECOL 2022; 42:3456-3463. [PMID: 36308734 DOI: 10.1080/01443615.2022.2135986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The aim of this study was to compare the depressive symptoms during pregnancy between pregnant women aged over 35 years and those aged less than 35 years and to evaluate the protective effect of social support in early pregnancy against prenatal depressive symptoms. One hundred and seventy one women aged over 35 years and 342 trimester-matched women aged less than 35 years were included from a level III hospital in Shenzhen, China. The self-report Edinburgh Postnatal Depression Scale (EPDS) and Social Support Rating Scale (SSRS) were used to evaluate prenatal depression and social support in early pregnancy. The proportions of women aged over 35 years who screened positive for prenatal depression were 22.8%, 23.4%, and 24.0% in the first, second and third trimesters, respectively. Advanced maternal age (≥35 years) was a positive predictor of prenatal depressive symptoms (β = 0.747, P = 0,008). Social support, especially objective support (β = -0.030, P = 0.002) and subjective support (β = -0.028, P = 0.006) in early pregnancy, had stronger protective effects against prenatal depressive symptoms for women aged over 35 years than younger women. Our findings support that older pregnant women experience more depressive symptoms than younger pregnant women, and social support could serve as a targeted intervention to decrease prenatal depressive symptoms.Impact statementWhat is already known on this subject? Depressive symptoms, which are strongly associated with adverse psychosocial and birth outcomes, appear to be prevalent and change in nature. Social support is an important protective factor against prenatal depression.What the results of this study add? Pregnant women of advanced maternal age experienced more depressive symptoms than younger women during the prenatal period. Social support, especially objective support and subjective support, had stronger protective effects against prenatal depression for women aged over 35 years than women aged less than 35 years.What the implications of these findings are for clinical practice? Screening of prenatal depression should be strengthened, especially for women aged over 35 years, and improving subjective support could improve their emotional experience.
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Affiliation(s)
- Shaofei Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Qiaoxuan Lin
- Nursing Department, Baoan People’s Hospital, Shenzhen, China
| | - Yonghsen Feng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Dongmei Zhong
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Cuiting Jiang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lifeng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Bahri Khomami M, Teede HJ, Joham AE, Moran LJ, Piltonen TT, Boyle JA. Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion. Clin Endocrinol (Oxf) 2022; 97:227-236. [PMID: 35383999 PMCID: PMC9544149 DOI: 10.1111/cen.14723] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/28/2022] [Accepted: 03/06/2022] [Indexed: 12/16/2022]
Abstract
Polycystic ovary syndrome (PCOS) is associated with a higher risk for pregnancy and birth complications according to the specific features associated with PCOS. The features include obesity before and during pregnancy, hyperandrogenism, insulin resistance, infertility, cardiometabolic risk factors, and poor mental health. PCOS is not often recognized as a risk factor for poor pregnancy and birth outcomes in pregnancy care guidelines, while its associated features are. Pregnancy-related risk profile should ideally be assessed for modifiable risk factors (e.g., lifestyle and weight management) at preconception in women with PCOS. Hyperglycaemia should be screened using a 75-g oral glucose tolerance test at preconception or within the first 20 weeks of pregnancy if it has not been performed at preconception and should be repeated at 24-28 weeks of pregnancy. In the absence of evidence of benefit for strategies specific to women with PCOS, the international evidence-based guidelines for the assessment and management of PCOS recommend screening, optimizing, and monitoring risk profile in women with PCOS (at preconception, during and postpregnancy) consistent with the recommendations for the general population. Recommended factors include blood glucose, weight, blood pressure, smoking, alcohol, diet, exercise, sleep and mental health, emotional, and sexual health among women with PCOS. The guidelines recommend Metformin in addition to lifestyle for assisting with weight management and improving cardiometabolic risk factors, particularly in those with overweight or obesity. Letrozole is considered the first-line pharmacological treatment for anovulatory infertility in PCOS. Individualized approach should be considered in the management of pregnancy in PCOS.
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Affiliation(s)
- Mahnaz Bahri Khomami
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
- Monash HealthMelbourneAustralia
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
- Monash HealthMelbourneAustralia
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
| | - Terhi T. Piltonen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University HospitalUniversity of OuluOuluFinland
| | - Jacqueline A. Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
- Monash HealthMelbourneAustralia
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Nisarga V, Anupama M, Madhu KN. Social and obstetric risk factors of antenatal depression: A cross-sectional study from South-India. Asian J Psychiatr 2022; 72:103063. [PMID: 35334285 DOI: 10.1016/j.ajp.2022.103063] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/09/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE Antenatal depression is as prevalent as postpartum depression and studies on it are very few. It has been relatively neglected leading to adverse effects on the growing child as well as the mother. Hence screening of depression in high risk individuals, planning and adopting important strategies for prevention needs to be undertaken. Our study aimed to assess the modifiable social and obstetric risk factors of antenatal depression. METHODS Third trimester pregnant women of 18-40 years attending obstetric out-patient department and admitted in tertiary hospitals who had no past psychiatric illness were screened using Edinburgh postnatal depression scale after obtaining written consent, socio-demographic and obstetric details. Statistical analysis was calculated using IBM version SPSS 23. RESULTS Among 222 women recruited, 25.6% had antenatal depression. Significant associations were found between lower level of education (p = 0.02,O.R=1.87), urban population (p = 0.04,O.R=5.139), intimate partner violence (p = 0.01,O.R=15.769), daily alcohol use by husband (p < 0.00,O.R=15.281), poor relationship with in-laws (p < 0.000,O.R=21.733) and parents (p < 0.000,O.R=15.281), number of previous pregnancies (p = 0.026,O.R=5.545), parity (p = 0.04,O.R=4.187), previous abortions (p = 0.007,O.R=2.834), fear of labour (p < 0.000,O.R=5.77) and complications during pregnancy (p < 0.000,O.R=3.017) with antenatal depression. Living in urban area (p = 0.023, A.O.R=3.132), fear of labour (p < 0.000, A.O.R=7.398), intimate partner violence (p = 0.026, A.O.R=36.655), poor relationship with in-laws (p = 0.001, A.O.R=36.855) and parents (p = 0.042, A.O.R=8.377) were found to be predictors of antenatal depression. CONCLUSION Antenatal depression is multifactorial in origin and requires a multifactorial approach in prevention and treatment. Routine antenatal screening for depression must be conducted with efforts to build strong family, peer and social support at community level.
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Affiliation(s)
- Vinyas Nisarga
- Department of Psychiatry, J.J.M Medical College, Davangere, Karnataka, India.
| | - M Anupama
- Department of Psychiatry, J.J.M Medical College, Davangere, Karnataka, India.
| | - K N Madhu
- Department of Obstetrics and Gynaecology, J.J.M Medical College, Davangere, Karnataka, India.
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Adeoye IA, Sogbesan A, Esan O. Prevalence, associated factors and perinatal outcomes of antepartum depression in Ibadan Nigeria. BMC Pregnancy Childbirth 2022; 22:219. [PMID: 35303804 PMCID: PMC8933907 DOI: 10.1186/s12884-022-04549-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/07/2022] [Indexed: 12/01/2022] Open
Abstract
Background Antepartum depression is the most common mental health disorder in pregnancy and it is also a risk factor for adverse perinatal outcomes. Low and middle income countries like Nigeria bear a higher burden of antepartum depression compared with high income countries. Prioritizing mental health issues among pregnant women is crucial to achieving the Sustainable Development Goals. We determined the prevalence, associated factors and perinatal outcomes of antepartum depression among pregnant women in Ibadan, Nigeria. Methods A prospective cohort study was conducted among 1745 pregnant women enrolled early in pregnancy (≤ 20 weeks) at four comprehensive obstetric facilities within Ibadan metropolis. Antepartum depression was ascertained during the third trimester using the Edinburg Postpartum Depression Scale ≥ 12. The primary exposure was antepartum depression and the outcome variables were the perinatal outcomes. The associated factors assessed included sociodemographic, obstetric, psychological, and lifestyle characteristics. Bi-variate logistic and Poisson regression analyses were used to assess the factors and relative risk for perinatal outcomes of antepartum depression. Results The prevalence of antepartum depression was 14.1%. The significant factors associated with APD after adjusting for confounders were: high income (≥ 20, 000) which was protective (AOR) = 0.59; 95% CI: (0.40 – 0.88); p-value: 0.010] and perceived stress increased the odds of APD in a monotonic fashion: moderate stress [AOR = 2.39; 95% CI: (1.01 – 5.7); p-value: 0.047], high stress [AOR = 6.43; 95% CI: (2.28 – 18.2); p-value: < 0.001]. Preterm delivery was the only significant perinatal outcome [Relative Risk (RR) = 1.66; 95% CI (1.14 – 2.39); p-value = 0.007]. Depression did not increase the risk of having low birth weight babies (p = 0.513), macrosomia (p = 0.894), birth asphyxia (p = 0.317), and caesarean section (p = 0.298). Conclusions APD was prevalent among our study population. The significant factors identified in this study can be targeted to reduce the occurrence of APD among pregnant women in Nigeria through appropriate social and public health interventions which include APD screening, counselling, and the provision of emotional support for pregnant women during antenatal care.
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Affiliation(s)
- Ikeola A Adeoye
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria. .,Consortium for Advanced Research in Africa (CARTA), Nairobi, Kenya.
| | - Abiodun Sogbesan
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oluyomi Esan
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Umuziga MP, Gishoma D, Hynie M, Nyirazinyoye L. Antenatal depressive symptoms in rwanda: rates, risk factors, and social support. BMC Pregnancy Childbirth 2022; 22:193. [PMID: 35260093 PMCID: PMC8905742 DOI: 10.1186/s12884-022-04522-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 02/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background Prevalence of perinatal depression is high in Rwanda and has been found to be associated with the quality of relationship with partner. This study extends this work to examine the relationship between antenatal depressive symptoms and social support across several relationships among women attending antenatal care services. Methods Structured survey interviews were conducted with 396 women attending antenatal care services in 4 health centres in the Southern Province of Rwanda. The Edinburgh Postnatal Depression Scale (EPDS) and Maternity Social Support Scale (MSSS) were used to assess antenatal depressive symptoms and the level of support respectively. Socio-demographic and gestational information, pregnancy intentions, perceived general health status, and experience of violence were also collected. Univariate, bivariate analyses and a multivariate logistic regression model were performed to determine the relationship between social support and risk factors for antenatal depressive symptoms. Results More than half of respondents were married (55.1%) or living with a partner in a common-law relationship (28.5%). About a third (35.9%) were in their 6th month of pregnancy; the rest were in their third term. The prevalence of antenatal depressive symptoms was 26.6% (EPDS ≥ 12). Bivariate analyses suggested that partner and friend support negatively predict depression level symptoms. Adjusting for confounding variables such as unwanted pregnancy (AOR: 0.415, CI: 0.221- 0.778), parity (AOR: 0.336, CI: 0.113–1.000) and exposure to extremely stressful life events (AOR: 2.300, CI: 1.263- 4.189), partner support (AOR: 4.458, CI: 1.833- 10.842) was strongly significantly associated with antenatal depressive symptoms; women reporting good support were less likely to report depressive symptoms than those reporting poor support or those with no partner. Friend support was no longer significant. Conclusion The study revealed that social support may be a strong protector against antenatal depressive symptoms but only support from the partner. This suggests that strengthening support to pregnant women may be a successful strategy for reducing the incidence or severity of maternal mental health problems, but more work is required to assess whether support from the broader social network can compensate for absent or unsupportive partners.
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Affiliation(s)
- Marie Providence Umuziga
- School of Nursing, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda.
| | - Darius Gishoma
- School of Nursing, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Michaela Hynie
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Laetitia Nyirazinyoye
- School of Nursing, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
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Luciano M, Di Vincenzo M, Brandi C, Tretola L, Toricco R, Perris F, Volpicelli A, Torella M, La Verde M, Fiorillo A, Sampogna G. Does antenatal depression predict post-partum depression and obstetric complications? Results from a longitudinal, long-term, real-world study. Front Psychiatry 2022; 13:1082762. [PMID: 36590632 PMCID: PMC9795022 DOI: 10.3389/fpsyt.2022.1082762] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Main aims of the present paper are to: (1) assess the prevalence of antenatal depression (AD) and identify its predictors; (2) analyse the impact of AD on obstetric outcomes and on the incidence of post-partum depression. METHODS All pregnant women referring to the Gynecology and Obstetrics inpatients unit of the University of Campania "Luigi Vanvitelli" were invited to participate. Upon acceptance, women completed the Italian version of the Edinburgh Postnatal Depression Scale and an ad-hoc questionnaire on the women's sociodemographic, gynecological and peripartum characteristics as well as their psychiatric history. Women were assessed at each trimester of pregnancy, immediately after the childbirth and after one, three, 6 and 11 months. RESULTS 268 pregnant women were recruited, with a mean of 32.2 (±5.81) years. Ninety-seven women (36.2%) reported the presence of depressive symptoms during pregnancy. Predictors of AD were personal history of depression, a family history for depressive disorders and problematic relationships with the partner. The presence of AD was associated to a reduced gestational age at the time of delivery, a lower APGAR score at 1 and 5 min, labor induction and admission of the new-born into neonatal intensive care unit. Mothers with antenatal depression are less likely to natural breastfeed. Lastly, antenatal depression was a risk factor for higher EPDS scores at follow-ups. CONCLUSIONS Our results support the idea that women should be screened during pregnancy and post-partum for the presence of depressive and anxiety symptoms. Health professionals should be adequately trained to detect psychiatric symptoms during pregnancy.
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Affiliation(s)
- Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Carlotta Brandi
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Lucia Tretola
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Rita Toricco
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Francesco Perris
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Antonio Volpicelli
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Marco Torella
- Obstetrics and Gynaecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco La Verde
- Obstetrics and Gynaecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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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: 1] [Impact Index Per Article: 0.3] [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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Bombana M, Wittek M, Müller G, Heinzel-Gutenbrunner M, Wensing M. Women's Media Use and Preferences of Media-Based Interventions on Lifestyle-Related Risk Factors in Gynecological and Obstetric Care: A Cross-Sectional Multi-Center Study in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189840. [PMID: 34574762 PMCID: PMC8466324 DOI: 10.3390/ijerph18189840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate factors affecting (1) women’s media use regarding health-related behaviors during pregnancy and lactation, (2) women’s preferences for media format, and (3) the content of media-based interventions on lifestyle-related risk factors during pregnancy and lactation. A cross-sectional observational multi-center study of pregnant and lactating women and women of childbearing age was carried out in 14 randomly selected obstetric and gynecologic care settings in the 12 most populated cities in Baden-Wuerttemberg, South-West Germany. Data from 219 surveyed women showed that older women, pregnant women, and lactating women have a higher probability of using media during pregnancy and lactation, respectively. The majority of women preferred a combination of analog and digital media-based interventions in gynecological (46.9%) and obstetric (47.1%) care settings and at home (73.0%). Women would like to see information brochures and flyers on health-related behaviors during pregnancy and lactation for use in gynecological and obstetric care settings, and for media use at home, they would like to have books. The probability of preferring the favored media formats in gynecological and obstetric care settings and at home were associated with pregnancy status, relationship status, socioeconomic status (SES), ethnicity, and health insurance status. About 80% of the surveyed women preferred media content regarding recommendations for a healthy lifestyle and healthy behavior during pregnancy and lactation. All of the independent variables were associated with the probability of preferring a specific media content. The SES was found to play a major role in the probability of preferring a specific media content, followed by pregnancy status, ethnicity, and health insurance status. The results from our study provide a basis for tailored preventive interventions in gynecological and obstetric care settings and for use at home. The results imply that a woman can be reached before conception, during pregnancy, or during lactation with preventive measures tailored to their requirements; however, acceptance may vary across personal attributes, such as SES, ethnicity, and others.
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Affiliation(s)
- Manuela Bombana
- Department of General Practice and Health Service Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.W.); (M.W.)
- Department of Health Promotion, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany;
- Correspondence: ; Tel.: +49-711-2593-7945
| | - Maren Wittek
- Department of General Practice and Health Service Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.W.); (M.W.)
| | - Gerhard Müller
- Department of Health Promotion, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany;
| | | | - Michel Wensing
- Department of General Practice and Health Service Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.W.); (M.W.)
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