Antepartum Depression Research Articles

Perinatal depression and adverse child growth outcomes in low-income and middle-income countries (LMICs): A systematic review and meta-analysis.

Perinatal depression (PND), which encompasses the antepartum and postpartum depression (APD and PPD), is a neglected crisis in low-income and middle-income countries (LMICs). We aimed to systematically search and meta-analyze existing evidence to determine whether a mother's PND affects adverse growth outcomes in children in LMICs (PROSPERO protocol: CRD42021246803). We conducted searches, including nine databases (PubMed, EMBASE, Web of Science, CINAHL Plus, Global Health Database, Google Scholar, WHO Regional Databases, PsycINFO, and LILACS) from January 2000 to September 2023. We restricted studies that assessed PND using validated screening tools or clinical interviews during pregnancy or within 12 months postpartum. We included studies that reported four types of adverse child growth outcomes (stunting, wasting, underweight, and overweight/obesity) in children younger than 5 years. We assessed the quality using the Newcastle Ottawa Scale and pooled risk ratios (RRs) and odds ratios (ORs) between PND and each adverse growth outcome using random-effects models. In total, 27 studies met the inclusion criteria for systematic review, with 24 eligible for meta-analysis, spanning data from 15 countries and 26,261 mother-baby pairs. Based on the studies that reported ORs, children below the age of 3 years with mothers experiencing PND had higher odds for stunting (OR 1.63, 95% CI 1.32, 2.02, I2 = 56.0%) and underweight (OR 2.65, 95% CI 1.90, 3.68, I2 = 34.5%) compared to children of mothers without PND. The pooled RRs for stunting and underweight did not show significant differences between mothers with and without PND. Studies on wasting (n = 5) and overweight/obesity (n = 2) were limited, demonstrating inconsistent results across studies. The association between PND and adverse growth outcomes varied according to the measure of association, region, country, PND type, outcome timepoint, and study design. There were limited studies in diverse LMICs, particularly on wasting, or overweight/obesity as an outcome.

Association between inflammatory biomarkers before pregnancy and risk of perinatal depression: A prospective cohort study of 4483 women in Sweden

AimPerinatal depression (PND) is a global health concern, affecting millions of childbearing women. Emerging data suggest that inflammation may play a role in the development of PND. Peripheral blood inflammatory biomarkers before pregnancy are widely tested in clinical practice at minimum cost, yet their potential role in PND risk remains unknown. MethodsWe conducted a prospective cohort study of 4483 birthing women during 2009–2021 within the LifeGene study with linkage to Swedish registers. Peripheral blood inflammatory biomarkers were profiled at baseline. Cases of PND were identified using validated tools or clinical diagnosis from subsequent pregnancies and postpartum periods. Logistic regression models were employed to assess the associations of each inflammatory biomarker (z scored) with PND. ResultsWe identified 495 (11.0 %) PND cases with an average age of 29.2 years. Pre-pregnancy platelet-to-lymphocyte ratio (PLR) was positively associated [OR, 95 % CI:1.14(1.01,1.27)], while lymphocyte count was inversely associated [OR, 95 % CI: 0.89(0.80,0.98)] with PND. A dose-response relationship was indicated for both PLR and lymphocytes when analyzed in categories based on tertile distribution. These associations appeared more pronounced for postpartum depression than antepartum depression and were independent of psychiatric comorbidities. ConclusionWith implications for future mechanistic research, these findings suggest that blood levels of lymphocytes and PLR before pregnancy are associated with subsequent risk of PND in a dose-response manner.

Bidirectional associations between perinatal allopregnanolone and depression severity with postpartum gray matter volume in adult women.

Perinatal depression (PND) is a debilitating condition affecting maternal well-being and child development. Allopregnanolone (ALLO) is important to perinatal neuroplasticity, however its relationship with depression severity and postpartum structural brain volume is unknown. We examined perinatal temporal dynamics and bidirectional associations between ALLO and depression severity and the association between these variables and postpartum gray matter volume, using a random intercept cross-lagged panel model. We identified a unidirectional predictive relationship between PND severity and ALLO concentration, suggesting greater depression severity early in the perinatal period may contribute to subsequent changes in ALLO concentration (β = 0.26, p = 0.009), while variations in ALLO levels during the perinatal period influences the development and severity of depressive symptoms later in the postpartum period (β = 0.38, p = 0.007). Antepartum depression severity (Visit 2, β = 0.35, p = 0.004), ALLO concentration (Visit 2, β = 0.37, p = 0.001), and postpartum depression severity (Visit 3, β = 0.39, p = 0.031), each predicted the right anterior cingulate volume. Antepartum ALLO concentration (Visit 2, β = 0.29, p = 0.001) predicted left suborbital sulcus volume. Antepartum depression severity (Visit 1, β = 0.39, p = 0.006 and Visit 2, β = 0.48, p < 0.001) predicted the right straight gyrus volume. Postpartum depression severity (Visit 3, β = 0.36, p = 0.001) predicted left middle-posterior cingulate volume. These results provide the first evidence of bidirectional associations between perinatal ALLO and depression severity with postpartum gray matter volume.

Prevalence and factors associated with antepartum depression among adolescent women in the assin north district of Ghana: a cross-sectional study

BackgroundGlobally, depression is a leading cause of disease-related disability among women. In low-and-middle-income countries (LMICs), the prevalence rate of antepartum depression is estimated to range between 15% and 57% and even higher in adolescent antepartum women. Although a number of studies have shown that depression is common in adolescent pregnancies and has a prevalence rate between 28% and 67% among adolescent mothers, there currently exists no literature on depression among adolescent pregnant women in Ghana. The study aimed to determine the prevalence of antepartum depression and identify the factors associated with it among pregnant adolescent women.MethodsA quantitative cross-sectional study design was adopted by randomly recruiting 220 adolescent pregnant women visiting antenatal clinics in five selected health facilities in five communities in the Assin North District of Ghana. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS). Data analysis was performed using Stata version 14. Both descriptive and inferential analyses were performed. A chi-square analysis was conducted to identify the association between independent and dependent variables. A multivariate logistic regression analysis was carried out to identify the independent variables that were significantly associated with the dependent variable. In all analyses, p-values ≤ 0.05 were deemed statistically significant at a 95% confidence interval.ResultsThe results indicated prevalence of depression was 38.6% using the EPDS cut-off ≥ 13. Respondents who were cohabiting were less likely to experiencing antepartum depression compared to those who were single (AOR = 0.36, 95% CI: 0.20–0.64, p = 0.001). Also, Respondents who had completed Junior High School had a lower likelihood of experiencing antepartum depression compared to those who had no formal education (AOR = 0.19, 95% CI: 0.05–0.76, p = 0.019). Respondents who perceived pregnancy-related items to be costly had higher odds of experiencing antepartum depression (AOR = 2.05, 95% CI: 1.02–4.12, p = 0.042). Lastly, adolescent pregnant women who reported that pregnancy-related items are costly were likely to experience antepartum depression compared to those who did not report such costs (AOR = 2.12, 95% CI: 1.20–3.75, p < 0.001).ConclusionThe results of this study highlight the importance of a multi-pronged strategy for combating antepartum depression in adolescents and improving the overall health and well-being of pregnant adolescents. Considering that adolescence is a transitional period occasioned by several bio-psycho-social challenges, setting up systems to ensure that young girls are motivated and supported to stay in school will enhance their economic prospects and improve their standards of life while providing psycho-social support will benefit their health and general well-being.

The Impact of Social Determinants of Maternal Mental Health in Marginalized Mothers.

Background: A deeper understanding of the key determinants of maternal mental health is important for improving care for women, especially women who are at an economic disadvantage. Objectives: To explore the associations of select social determinants: access, social support, and stress, with the onset of antepartum depression in low-income mothers. Participants: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing, population-based surveillance system with selected data from 2016 to 2019, establishing a randomly selected sample of women with a recent live birth at most 4 months postdelivery, between 1,300 and 3,400 women per state (n ∼ 162,558). Methods: In this cross-sectional study, the phase 8 PRAMS was adapted to measure social support, access, stress, and their relationships with the onset of antepartum depression in low-income mothers. To assess low-income marginalization, a threshold was established based on income levels within 130% of the federal poverty level; antepartum (n ∼ 41,289). Results: The defined access, social support, and stress factors showed a statistically significant association with the onset of antepartum depression among low-income mothers. Of women in this sample, 22.6% indicated antepartum depression (p < 0.001; R2 = 0.066). Negative social support indicators were associated with an increased likelihood of antepartum depression; 3.71 increased odds of depression for abuse during pregnancy, and 0.79 decreased odds with positive acknowledgment of paternity. Access indicator terms showed an association with the decreased likelihood of antepartum depression through breastfeeding information support (Info from Baby Doc, odds ratio [OR] = 0.86), prenatal care utilization (12+ visits, OR = 0.82), and specific insurance type (insurance by job, OR = 0.82). All instances of stressful life events showed an increased likelihood of depression during pregnancy (for majority of stressful life events: OR >1.12). Conclusions: Economically marginalized mothers face unmet social and health care needs leading to poorer outcomes during pregnancy. These findings provide additional support for improved policy and public health efforts, such as assessment, education, and interventions, to decrease prevalence and improve treatment for antepartum depression among marginalized mothers.

Patterns of peripartum depression and anxiety during the pre-vaccine COVID-19 pandemic

BackgroundPregnant people are vulnerable to new or worsening mental health conditions. This study aims to describe prevalence and course of depression and anxiety symptoms in pregnancy during the pre-vaccine COVID-19 pandemic.MethodsThis is a prospective cohort study of pregnant individuals with known or suspected COVID-19. Participants completed Edinburgh Postnatal Depression Scale (EPDS) and Generalized-Anxiety Disorder-7 (GAD-7) questionnaires, screening tools for depression and anxiety, at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum. Prevalence of elevated depressive and anxiety symptoms at each visit was described. Univariable logistic regression analysis was used to determine the association between demographic and clinical factors and those with elevated depression or anxiety symptoms.Results317 participants were included. The prevalence of elevated antepartum depression symptoms was 14.6%, 10.3%, and 20.6% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. The rate of elevated anxiety symptoms was 15.1%, 10.0%, and 17.3% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. A prior history of depression and/or anxiety (p’s < 0.03), as well as higher EPDS and GAD-7 scores at enrollment (p’s < 0.04) associated with elevated depression and anxiety symptoms throughout pregnancy and the postpartum period. Quarantining during pregnancy was associated with elevated anxiety symptoms at 34weeks gestational age in univariate (P = 0.027) analyses. COVID-19 diagnosis and hospitalization were not associated with elevated depression or anxiety symptoms.ConclusionsElevated depression and anxiety symptoms were prevalent throughout pregnancy and the postpartum period, particularly in those with prior depression and/or anxiety and who quarantined. Strategies that target social isolation may mitigate potential adverse consequences for pregnant people, and continued vigilance in recognition of depression and anxiety in pregnancy should be considered.

Persistent depression in pregnant refugee and migrant women living along the Thai-Myanmar Border: a secondary qualitative analysis.

Antepartum depression affects around 15% of pregnant women worldwide, and may negatively impact their infants' physical, cognitive and social development, and confer a greater risk of emotional dysregulation in their children. Risk factors for antepartum depression disproportionately affect women from resource-sparse settings. In particular, pregnant refugee and migrant women face many barriers to diagnosis and care of mental health conditions, yet this group is under-represented in the literature. This study explores what refugee and migrant women living along the Thai-Myanmar border perceive as being contributory and protective factors to their antepartum depression, through secondary qualitative analysis of responses to clinical interviews for depression. Previous research investigating perinatal depression in pregnant refugee and migrant women on the Thai-Myanmar border involved assessing 568 women for depression, using the Structured Clinical Interview for the diagnosis of DSM-IV Disorders (SCID). This study analyses a subsample of 32 women, diagnosed with persistent depression during the antepartum period. Thematic analysis of responses to the SCID and social and demographic surveys was undertaken to investigate factors which contribute towards, or protect against, persistent antepartum depression. Major themes which women described as contributing towards persistent antepartum depression were financial problems, interpersonal violence, substance misuse among partners, social problems and poor health. Factors women considered as protecting mental wellbeing included social support, accessible healthcare and distractions, highlighting the need for focus on these elements within refugee and migrant settings. Commonly expressed phrases in local Karen and Burmese languages were summarised. Knowledge of factors affecting mental wellbeing in the study population and how these are phrased, may equip stakeholders to better support women in the study area. This study highlighted the limitations of contextually generic diagnostic tools, and recommends the development of tools better suited to marginalised and non-English speaking groups.

Perinatal depression and risk of mortality: nationwide, register based study in Sweden

ObjectiveTo determine whether women with perinatal depression are at an increased risk of death compared with women who did not develop the disorder, and compared with full sisters.DesignNationwide, register based...

Bidirectional association between autoimmune disease and perinatal depression: a nationwide study with sibling comparison

Although major depression, characterized by a pro-inflammatory profile, genetically overlap with autoimmune disease (AD) and the perinatal period involve immune system adaptations and AD symptom alterations, the bidirectional link between perinatal depression (PND) and AD is largely unexplored. Hence, the objective of this study was to investigate the bidirectional association between PND and AD. Using nationwide Swedish population and health registers, we conducted a nested case-control study and a matched cohort study. From 1,347,901 pregnancies during 2001–2013, we included 55,299 incident PND, their unaffected full sisters, and 10 unaffected matched women per PND case. We identified 41 subtypes of AD diagnoses recorded in the registers and compared PND with unaffected population-matched women and full sisters, using multivariable regressions. Women with an AD had a 30% higher risk of subsequent PND (95% CI 1.2–1.5) and women exposed to PND had a 30% higher risk of a subsequent AD (95% CI 1.3–1.4). Comparable associations were found when comparing exposed women with their unaffected sisters (nested case-control OR: 1.3, 95% CI 1.2–1.5, matched cohort HR: 1.3, 95% CI 1.1–1.6), and when studying antepartum and postpartum depression. The bidirectional association was more pronounced among women without psychiatric comorbidities (nested case-control OR: 1.5, 95% CI 1.4–1.6, matched cohort HR: 1.4, 95% CI 1.4–1.5) and strongest for multiple sclerosis (nested case-control OR: 2.0, 95% CI 1.6–2.3, matched cohort HR: 1.8, 95% CI 1.0–3.1). These findings demonstrate a bidirectional association between AD and PND independent of psychiatric comorbidities, suggesting possibly shared biological mechanisms. If future translational science confirms the underlying mechanisms, healthcare providers need to be aware of the increased risk of PND among women with ADs and vice versa.

Dose-response associations of maternal prenatal noise exposure duration with antepartum depression status

BackgroundAntepartum depression has been reported to be associated with the intensity of maternal prenatal noise exposure; however, the association between noise exposure duration and the development of antepartum depression has not been established. This study aimed to determine the total and trimester-specific association of prenatal noise exposure duration with the development of antepartum depression.MethodsFrom May 2018 to June 2021, we recruited 2,166 pregnant women from Shengjing Hospital, northeast China. We used a standardized questionnaire to assess women’s prenatal noise exposure and used the Edinburgh Postnatal Depression Scale to assess pregnant women’s antepartum depression during the 1st -, 2nd -, and 3rd - trimesters. We calculated a cumulative noise exposure score ranging from 0 to 3, with a higher score reflecting higher frequency and longer duration of noise exposure during pregnancy.ResultsWomen who were exposed to noise for ≥ 15 min per day had an increased risk of antepartum depression compared with women who were not exposed to noise during pregnancy [odds ratio (OR) = 1.83, 95%CI:1.18, 2.83]. Noise exposure in a specific trimester was associated with higher risk of depression in the same trimester and subsequent trimesters. We observed increases in antepartum depression risk with increasing cumulative noise exposure scores (P for trend < 0.05 for all). Pregnant women with the highest scores had the highest risk of antepartum depression during the first (OR = 1.30, 95%CI:1.02, 1.65), second (OR = 1.75, 95%CI:1.23, 2.50) trimesters. Women with a cumulative noise exposure score of 2 had the highest risk of antepartum depression during the third trimester (OR = 1.79, 95%CI:1.14, 2.80), as well as during the whole pregnancy (OR = 1.94, 95%CI:1.14, 3.30).ConclusionsMaternal prenatal noise exposure duration was positively associated with antepartum depression risk in a dose-response manner. It is necessary to develop strategies by which pregnant women can avoid excessive exposure to noise to prevent antepartum depression.

A prospective cohort study to assess the prevalence and risk factors of antepartum depression and its effect on maternal and fetal outcome

Antepartum depression (APD) is a public health issue has negative repercussions on the health of the mother, child, and family. Early screening for APD will help in early detection and further prevention of postpartum depression and adverse maternal and fetal outcomes. This study was designed to determine i) the prevalence rate of APD in the Indian population and its associated risk factors, ii) the impact of APD on maternal and fetal outcomes. A retrospective cohort study was conducted among antenatal women in the third trimester and screened for antepartum depression between October 2021 and March 2022 by adopting the Edinburgh Postnatal Depression Scale (EPDS). In the study population, 36.6 % had mild to moderate level of depressive symptoms (EPDS score of 8–12) and 28 % had high levels of depressive symptoms (EPDS score of ≥13). An unplanned pregnancy, a history of abortion, and a history of any pregnancy complications were the likely maternal risk factors for developing antepartum depression. The APD risk was also likely to be increased by sociodemographic and personal factors such as insufficient family support, a history of domestic violence, marital dissatisfaction, and a partner with a poor level of education (P < 0.05). Women screened with antepartum depression had 58.34 times the likelihood of developing postpartum depression and a threefold greater risk of having premature delivery. These findings may help to improve pregnancy outcomes by early identification, referral for early treatment of antepartum depression, also inform maternal mental health service development and utilization for boosting women's mental wellbeing.

Trends in Risk Factors for Peripartum Depression in Socio-economically Disadvantaged Childbearing Community

Introduction: Perinatal depression is defined as a depressive episode(s) during the pregnancy and/or postpartum period up to one year. Studies have shown that childbearing people in urban settings experience a higher burden of social factors, such as low socioeconomic status, which may influence the likelihood of developing perinatal depression. Of note, episodes of perinatal depression have been shown to negatively impact child development. Our study has identified population trends in Center for Epidemiological Studies Depression Scale (CES-D) scores &gt;10 during perinatal periods alongside significant social risk factors for people served by LSA Family Health Service providing skilled home-based nursing visits to reduce adverse outcomes. Methods: A retrospective chart review of nursing notes from 2009-2017 was conducted for this cross-sectional study. Outcome measures included antepartum (AP) and postpartum (PP) Center for Epidemiological Studies Depression Scale (CES-D) scores, with a score of &gt; 10, suggesting a positive risk for developing depression. Data were grouped and analyzed using Microsoft Excel and SPSS software (SPSS version 23). Data have been presented as yearly population percentages scoring &gt;10 on their CES-D screen. Results: The maternal outreach program (MOP) enrolled 1,183 birthing individuals from 2009-2017. The mean parental age was 27 years. 70% were Latinx (n=829) and 20.88% (n=247) were Black. Spanish was the primary language for 43.62% (n=516) of participants. Among CES-D screens completed in the antepartum period, 4.5% to 24.6% of the population met criteria over the 9-year study period for risk of developing depression. Positive CES-D screens completed postpartum ranging from 11.9% to 27.2% during the study period. Significant risk factors for positive postpartum CES-D screens were postpartum risk assessment score (p=0.03), increased gestational age (p=0.05), low income (p=0.03), teen/inexperienced parents (p=0.003), and low education levels (p=0.04). Conclusion: Trends of positive antepartum and postpartum depression screens in this population have fluctuated over the study period; however, we have identified significant risk factors for positive postpartum screens. Screening for postpartum depression risk factors is important to identify birthing parents who may most benefit from mental health interventions.

Brain-derived neurotrophic factor levels in perinatal depression: A systematic review and meta-analysis.

This systematic review and meta-analysis aim to synthesize the available evidence and determine the overall brain-derived neurotrophic factor (BDNF) levels in individuals diagnosed with perinatal depression (PND). We performed a thorough search of electronic databases, including PubMed, Embase, PsycINFO, and Web of Science, from their start until April 30, 2023. Our search strategy involved using specific keywords and medical subject headings (MeSH) terms related to BDNF, perinatal, post-partum, and antepartum depression. In the meta-analysis, we employed a random-effects model, and subgroup analyses were conducted to investigate any variations in the results. A total of 15 studies met the inclusion criteria, of which 10 were used in the quantitative analysis. The meta-analysis demonstrated a significant decrease in BDNF levels in both individuals with antepartum depression (SMD: -0.31; 95% CI: -0.48 to -0.13; p-value = 0.0008; I2 = 71%), and post-partum depression (SMD: -0.61; 95% CI: -0.99 to -0.22; p-value = 0.0002 I2 = 77%). Furthermore, a significantly higher rate of PND among individuals in the lowest BDNF quartile (OR: 2.64; 95% CI: 1.01 to 6.89; p-value = 0.05; I2 = 90%) was seen. The results of subgroup analyses showed a statistically significant effect of the depression assessment tool on overall heterogeneity between studies. This systematic review and meta-analysis provide evidence of lower BDNF protein levels in individuals diagnosed with PND. The results indicate that BDNF dysregulation may play a part in the development of PND. More research is needed to understand the mechanisms behind this and explore potential therapeutic applications.

Antepartum Depression and Its Clinico-Social Correlates: A Cross Sectional Study in a Tertiary Hospital of North India.

Maternal depression, the second leading cause of disease burden in women worldwide is often under-diagnosed and untreated. It can have consequences for pregnancy outcomes and child health. (1) To estimate the prevalence of antepartum depression among females attending antenatal clinic of a tertiary hospital. (2) To determine its obstetric and clinico-social correlates. A cross-sectional study was conducted in antenatal clinic by consecutive sampling of 300 pregnant women. We included those in third trimester, aged 18-40years and giving informed consent and excluded those with pre-diagnosed mental disorders. Pre-tested structured questionnaire and Edinburgh postnatal depression scale used. Score ≥ 10 indicated possible antepartum depression (APD). Chi-square test and logistic regression analysis applied using IBM SPSS version 22.0. P < 0.05 was considered statistically significant. Prevalence of possible APD was 23.3%. It was higher among urban females (25.3%) than rural (17.7%) but the difference was not statistically significant. APD increased with increasing maternal age. Other socio-demographic and obstetric factors were not associated significantly with APD. History of recent stressful life event, domestic violence, marital conflict, lack of support from husband, and preference of male child were found to be the significant correlates. More than one out of five antenatal females had possible antepartum depression, but none had sought treatment for the same. Antenatal women of higher age and those afflicted with social pathologies are more at risk. Screening for APD should be included in the maternal and child health care programme to address this hidden 'iceberg' disease.

Antepartum depression: The prevalence, associated factors and perinatal outcomes: A cross-sectional study

Objective: The current study aimed to track the prevalence of APD, its associated factors and perinatal outcomes among Egyptian pregnant women.&#x0D; Methodology: The current work included 122 pregnant women, with singleton normal pregnancy. They were evaluated for antepartum depression and perceived stress. In addition, demographics and obstetric data were collected and documented. The psychiatric status was assessed in the third trimester (preferably at 35 to 37 week of gestation). Then, the feto-maternal outcome was recorded. The primary outcome was the prevalence of APD and perceived stress. Neonatal outcome was document especially preterm birth and neonatal weight.&#x0D; Results: APD was recognized among 28 women (23.0%). The APD was significantly associated with employment (82.1% and 57.4%, in those with and without APD respectively). The unplanned pregnancy was significantly increase in women with than those without APD (35.7% vs 9.6%). Maternal obesity, low birth weight and preterm delivery were associated with APD. Finally, the perceived stress score was significantly higher among women with APD than those without APD (18.92±7.30 vs 14.75±9.07).&#x0D; Conclusion: APD was reported in nearly one of four women and significantly associated with maternal obesity, unplanned pregnancy and employment. In addition, preterm birth and low birth weight significantly increased with APD.

The impact of socio-demographic and obstetric characteristics on the prevalence of major depression in the antenatal population in the core Niger delta

Background: Antepartum depression (APD) is also of immense concern because of its grave consequences on the mother, pregnancy outcomes, child development and the family. Its prevalence is under the influence of several factors. Aim: To determine the impact of patients’ socio-demographic and obstetric characteristics on the prevalence of major antenatal depression in Rivers State University Teaching hospital, Nigeria. Methods: This was a cross-sectional study of 163 pregnant women who were recruited via systematic random sampling in the antenatal clinic of Rivers State University Teaching Hospital over a period of 4 months. Data on socio-demographic and obstetrics characteristics of the patients were obtained with the aid of semi-structured interviewer-administered questionnaire. Screening for and diagnosis of depression was done using the Edinburgh Postnatal Depression Scale (EPDS). Data collected was analyzed using the Statistical Package for Social Sciences (SPSS) version 20 statistical software. Descriptive analysis of all the variables in the study was carried out using frequency tables and bar charts. The associations between depression during pregnancy and the independent variables (socio-demographic, gestational and obstetric characteristics) were assessed using Chi-square test or a Fisher’s exact test when the expected cell count was less than five in at least twenty percent of the cells. Level of significance was set at p&lt;0.05. Results: The mean age of the participants was 29.1±4.53 years with an age range of 20-40 years. Majority of the participants were married (87.1%) from monogamous families (73.6%) and had tertiary level of education (67.5%), Majority were within high social class (56.4%), and did not experience intimate partner violence (92.6%). The prevalence of depression was 44.8%. Educational level showed significant statistical relationship with antepartum depression (X2=9.773, p&lt;0.009). APD was not shown to have significant association with the age of the mothers (X2=4.60, P&lt;0.203) and marital status (X2=0.847, p &lt;0.738). Furthermore, there were no statistically significant differences in the prevalence of major depression among women in the three different trimesters of pregnancy. Conclusion: The prevalence of antepartum major depression at the RSUTH, Port Harcourt in Nigeria was high. There was statistically significant differences in the prevalence of major depression among different educational categories.

Trajectories of antepartum depressive symptoms and birthweight: a multicenter and prospective cohort study.

Antepartum depression is a prevalent unhealthy mental health problem worldwide, particularly in low-income countries. It is a major contributor to adverse birth outcomes. Previous studies linking antepartum depression to birthweight have yielded conflicting results, which may be reason that the depressive symptoms were only measured once during pregnancy. This study aimed to explore the associations between trajectories of antepartum depressive symptoms and birthweight. Depressive symptoms were assessed prospectively at each trimester in 3699 pregnant women from 24 hospitals across 15 provinces in China, using the Edinburgh Postpartum Depression Scale (EPDS). Higher scores of EPDS indicated higher levels of depressive symptoms. Associations between trajectories of depressive symptoms and birthweight were examined using group-based trajectory modeling (GBTM), propensity score-based inverse probability of treatment weighting (IPTW), and logistic regression. GBTM identified five trajectories. Compared with the low-stable trajectory of depressive symptoms, only high-stable (OR = 1.35, 95% CI: 1.15-2.52) and moderate-rising (OR = 1.18, 95% CI: 1.12-1.85) had an increased risk of low birthweight (LBW) in the adjusted longitudinal analysis of IPTW. There was no significant increase in the risk of LBW in moderate-stable and high-falling trajectories. However, trajectories of depressive symptoms were not associated with the risk of macrosomia. Antepartum depressive symptoms were not constant. Trajectories of depressive symptoms were associated with the risk of LBW. It is important to optimize and implement screening, tracking, and intervention protocols for antepartum depression, especially for high-risk pregnant women, to prevent LBW. This article is protected by copyright. All rights reserved.

Overall maternal morbidity during pregnancy using the WHO-WOICE tools.

The objective of this study is to evaluate the prevalence of nonsevere maternal morbidities (including overall health, domestic and sexual violence, functionality, and mental health) in women during antenatal care in rural versus urban areas. This study aimed to describe the factors that affect women's health during pregnancy by administration of the WHO's WOICE 2.0 instrument. This was a cross sectional study conducted at perinatal care health centers in Morocco (5 in rural and 5 in urban). We recruited n = 257 women in the third trimester of their pregnancy using a questionnaire developed by the WHO to assess maternal morbidity, which includes various instruments that measure different aspects of maternal health. This tool evaluates the functionality and ability to perform daily tasks includes a tool that evaluates mental health, the General Anxiety Disorder 7-item test (GAD-7), and the 9-item Patient Health Questionnaire (PHQ-9), to assess depression. Data on health conditions and socio-demographic characteristics were collected through structured interview, medical record review, and clinical examination. This paper presents descriptive data on the distribution of functioning status among antepartum women. In all, 257 women at a mean age of 30 years were included, and the majority had a partner (98%) and primary education (68.48%). Over one third of the population cannot read. Exposure to violence occurred in 12.23%. Sexual dissatisfaction was reported by 28.20% of antepartum women. Overall, women reported very good and good health (39.69%), and more than third had a medical condition (39.69%). There was an overall rate of anxiety in 83.65%, depression in 43.57%. Based on the χ2 test, Fisher exact test, or Kruskal-Wallis test, there was a significant relationship between the distribution of depression (p<0.001) and sexual satisfaction (p<0.01) between urban and rural women. Considering these results, antepartum depression and anxiety were highly prevalent in our sample and contributed substantially to perceived disability. These serious threats to health must be further investigated and more data are needed to comprehensively quantify the problem in Morocco.

Effects of domestic violence on antenatal depression: meta-analysis

Antenatal depression or depression in pregnant women is influenced by various factors, one of which is the stressor of the social life of the household life, such as domestic violence. Domestic abuse during pregnancy has a negative impact on the mother's health as well as the newborn's and the child's development. The purpose of this study is to determine how much domestic violence affects antenatal depression. This study uses a meta-analytic study design from articles published from 2008 to 2022 using the Google Scholar, PubMed, Springer Link, and ScienceDirect databases. Articles are collected for 2 months by keywords (“Intimate Partner Violence” OR “IPV” OR “Domestic Violence”) AND “Antenatal Depression” OR “Antepartum Depression” AND (“adjusted odds ratio” OR “multivariable”). The articles used are articles that meet the inclusion and exclusion criteria. There were 14 articles from 3 continents namely Asia, Africa, and North America with cross sectional and cohort study designs. Cross-sectional meta-analysis shows that domestic violence can increase the incidence of antenatal depression by 3.97 times compared by not experiencing domestic violence (aOR= 3.97; 95% CI= 2.44 to 6.47; p&lt;0.001). Meanwhile, the cohort study showed that domestic violence can increase the incidence of antenatal depression by 2.58 times compared to not experiencing domestic violence (aOR= 2.58; 95% CI= 2.06 to 3.23; p&lt;0.001). Total heterogeneity shows I2 = 81%, such that it can be said that the data distribution is heterogeneous (random effect model). Domestic violence can increase the incidence of antenatal depression.

Literature review: Vitamin D Levels and Perinatal Depression Association

Background: Vitamin D levels have been linked to psychological symptoms such as anxiety, depression, and impaired cognitive performance. It is found that lower vitamin D levels in early pregnancy are associated with depressive symptoms in perinatal.This study examines the association between vitamin D levels and perinatal depression. This article based on literature source from Pubmed/MEDLINE and Science Direct with keywords: vitamin D levels including 25(OH)D levels or vitamin D deficiency, prenatal, antenatal, and postpartum depression. The discussion of this study will assist readers and health professionals analyze how vitamin D levels in the body affect the incidence of antepartum depression. Results: these are five filtered literature, the journal discusses the relationship between vitamin D levels and antepartum depression. This literature review shows that pregnant women with less than 20 ng/mL vitamin D levels are 3.3 times more at risk than pregnant women with more than 20 ng/mL. Vitamin D plays a role in the process of increasing serotonin synthesis and increasing anti-inflammatory so that it can suppress the increase in pro-inflammatory cytokines that play a role in the incidence of depression. Conclusion: There is a correlation between vitamin D levels and the occurrence of depression during the perinatal period. It can be suggested that pregnant women check their vitamin D levels regularly.