The Postpartum Depressive State in Relation to Perceived Rearing: A Prospective Cohort Study

Norika Hayakawa,Satomi Murase,Norio Ozaki,Kaori Furumura,Atsuko Kanai,Setsuko Goto,Tomoko Masuda,Branko Aleksic,Harue Ohoka,Yukako Nakamura,Takayoshi Koide,Ai Tamaji,Takashi Okada,Naoko Ishikawa,Hinako Usui,Naomi Banno,Tokiko Morita,Tomoko Shiino,Gabriel Alejandro De Erausquin

doi:10.1371/journal.pone.0050220

Abstract

BackgroundThe relationship between perceived rearing and the postpartum depressive state remains unclear. We aimed to examine whether perceived rearing is a risk factor for postpartum depression as measured by the Edinburgh Postnatal Depression Scale (EPDS), and whether the score of perceived rearing is affected by depressive mood (the state dependency of perceived rearing).MethodsPregnant women (n = 448, mean age 31.8±4.2 years) completed the EPDS as a measure of depressive state in early pregnancy (T1), late pregnancy (around 36 weeks), and at 1 month postpartum (T2), and the Parental Bonding Instrument (PBI) at T1 as a measure of perceived rearing. Changes in the EPDS and the PBI scores from T1 to T2 were compared between the non depressive (ND) group and the postpartum depressive (PD) group.ResultsThere were no significant differences in any PBI category for perceived rearing between the ND and PD groups at T1. EPDS scores did not change significantly from T1 to T2 in the ND group but increased significantly in the PD group. The PBI maternal care score increased significantly in the ND group (p<0.01), while decreasing in the PD group (p<0.05). Additionally, in both the ND and PD groups, significant negative correlation was observed regarding change in the EPDS and PBI maternal care scores from T1 to T2 (r = −0.28, p = 0.013).ConclusionsThe present study suggests that perceived rearing is not a strong risk factor for postpartum depression as measured by the EPDS. Furthermore, the results indicated the state dependency of the PBI maternal care score.

Highlights

Postpartum depression, which is observed in about 13% of postpartum women, is defined as a depressive disorder occurring within four weeks after delivery [1]
The results indicated that the clinical course of postpartum depressive state could be classified into four patterns based on scores of the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy, late pregnancy, and at 1 month postpartum [16,17]
There were no significant differences in any Parental Bonding Instrument (PBI) category between the non depressive (ND) group and postpartum depressive (PD) group at T1 (Table 2)

Summary

Introduction

Postpartum depression, which is observed in about 13% of postpartum women, is defined as a depressive disorder occurring within four weeks after delivery [1]. There have been recent studies attempting to establish the relationship between postpartum depression and perceived rearing (own memories of being raised) in women. Boyce et al [6] have reported that the onset of postpartum depression is associated with parental rearing styles manifested in the form of low care or high overprotection, as well as high interpersonal sensitivity regarding the relationship with the husband. Similar findings by Matthey et al [7] revealed that the onset of postpartum depression 4 months after delivery in patients showing no signs of depression during pregnancy depended on the relationship with their partners, the high interpersonal sensitivity, and quality of early parent-child relationships characterized by low care and high overprotection. We aimed to examine whether perceived rearing is a risk factor for postpartum depression as measured by the Edinburgh Postnatal Depression Scale (EPDS), and whether the score of perceived rearing is affected by depressive mood (the state dependency of perceived rearing)

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Discussion

Conclusion