Abstract
Postpartum depression (PPD) is one of most common postnatal complications, affecting approximately 10%–15% of women after childbirth annually. Traditional Chinese medicine (TCM) has been gaining popularity as the choice of treatment for PPD in Taiwan. Hence, our aim was to analyze the utilization of TCM among PPD patients in Taiwan. A cross-sectional study was conducted using a random sample of one million beneficiaries selected from the Taiwanese National Health Insurance Research Database. We identified patients with PPD who had received either TCM treatment or non-TCM treatment from the database during 2000–2012. Multivariate logistic regression analysis was used to identify the factors associated with the use of TCM. A total of 653 patients with PPD were enrolled. The majority of patients with PPD were 26–30 years old, lived in a highly urbanized area of Taipei, had a monthly income <20,000 NT$, and were private enterprise employees. Around 52.7% of PPD patients had the motivation to seek TCM services. Younger women, who resided in central and southern Taiwan and who had used TCM one year before PPD diagnosis, were more likely to use TCM services. PPD patients who underwent TCM treatment had a lower overall medical expenditure than non-TCM users. Most TCM users chose simple Chinese herbal medicine. The coexisting factors that made PPD patients to seek TCM services were respiratory or oral infections. We demonstrated the characteristics of those that seek TCM for PPD, which may provide useful insights to health care providers towards resource allocation.
Highlights
Childbirth is usually a unique and unforgettable experience for most women of childbearing age
Characteristics of the Traditional Chinese medicine (TCM) user and non-TCM user cohorts of patients with Postpartum depression (PPD) are presented in Table 1. e mean duration between the delivery dates and initial diagnosis of PPD was approximately 0.44 years. e mean age of PPD patients was 31.2 years. e highest proportion of PPD patients in both cohorts were in the 26-30-year age group, followed by the 31–35-year-old and 20–25-year-old groups. ere were no substantial differences in the insured amounts, urbanization levels, or insured units between the two groups. e difference between the number of patients with PPD was not significantly different among spring, summer, autumn, and winter. e most common baseline comorbidity was cirrhosis, followed by hypertension and coronary artery disease. e prevalence of all baseline comorbidities was similar in both groups
Using a multivariate-adjusted analysis, we observed that patients with PPD who were in the 20-35-year age group, TCM users one year prior to the PPD diagnosis, who resided in the central and southern area, were more likely to use TCM services
Summary
Childbirth is usually a unique and unforgettable experience for most women of childbearing age. Some factors interfere with the positive aspects of mother-child interactions of new mothers, including the exhausting process of childbirth, postpartum physical uncomfortable conditions, breastfeeding stress, lifestyle changes, and relationship dynamic changes [1, 2]. Postpartum depression (PPD) is a depressive disorder often occurring within one year of delivery [3]. It is one of the most common postnatal complications, during which the person with PPD can experience sadness, worthlessness, or hopelessness, which could potentially result in maternal and familial negative consequences, disabilities, or life-threatening situations [4, 5]. PPD affects about 10%–15% of new, adult mothers annually, which often leads to a substantial humanistic burden on affected mothers, their partners, and their other children [6, 7]
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