Edinburgh Postnatal Depression Scale Scores Research Articles

Impact of covid-19 pandemic over depressive symptoms among mothers from a population-based birth cohort in southern brazil.

Our aim was to assess the impact of COVID-19 on depressive symptoms among mothers from a population-based birth cohort in Pelotas, Southern Brazil. A subgroup of mothers from the Pelotas 2004 Birth Cohort was assessed pre-pandemic (November,2019 to March,2020) and mid-pandemic (August-December,2021). In both follow-ups, depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Pre-pandemic (T1) and pandemic-related predictors (T2) were analyzed. Prevalence of depression (EPDS score ≥ 13) at T1 and T2 were compared with chi-square test. Changes in EPDS from T1 to T2 were estimated by multivariate latent change score modelling. 1,550 women were assessed. Prevalence of depression increased 38.1% (from 18.9% at T1 to 26.1% at T2) (p < 0.001). At T1, higher schooling, higher family income and being employed or working were related to lower EPDS, whereas being beneficiary of a cash transfer program and a larger number of people living in the household predicted higher EPDS. The deterioration of ones' own perception of quality of overall health (β = 0.191; SE = 0.028; p < 0.001) and worst family financial situation due to the pandemic (β = 0.083; SE = 0.024; p = 0.001) predicted the increase in EPDS from T1 to T2. Almost two years after the beginning of the pandemic, the prevalence of depressive symptoms among the women was higher than before the pandemic. The deterioration of ones' own perception of quality of overall health and worst family financial situation due to the pandemic are proxies for the effect of COVID-19 pandemic (the true exposure of interest) in the women mental health.

Antepartum depressive symptoms are associated with significant postpartum opioid use

Antepartum depression is common, and outside of childbirth preoperative anxiety and depression have been associated with heightened postoperative pain. In light of the national opioid epidemic, the relationship between antepartum depressive symptoms and postpartum opioid use is particularly relevant. This study evaluated the association between antepartum depressive symptoms and significant postpartum opioid use during birth hospitalization. This retrospective cohort study at an urban academic medical center from 2017 to 2019 included patients who received prenatal care at the medical center and linked pharmacy and billing data with electronic medical records. The exposure was antepartum depressive symptoms, defined as Edinburgh Postnatal Depression Scale ≥10 during the antepartum period. The outcome was significant opioid use, defined as: (1) any opioid use following vaginal birth and (2) the top quartile of total opioid use following cesarean delivery. Postpartum opioid use was quantified using standard conversions for opioids dispensed on postpartum days 1 to 4 to calculate morphine milligram equivalents. Poisson regression was used to calculate risk ratios and 95% confidence intervals, stratified by mode of delivery and adjusted for suspected confounders. Mean postpartum pain score was a secondary outcome. The cohort included 6094 births; 2351 births (38.6%) had an antepartum Edinburgh Postnatal Depression Scale score. Of these, 11.5% had a maximum score ≥10. Significant opioid use was observed in 10.6% of births. We found that individuals with antepartum depressive symptoms were more likely to have significant postpartum opioid use, with an adjusted risk ratio of 1.5 (95% confidence interval, 1.1-2.0). When stratified by mode of delivery, this association was more pronounced for cesarean births, with an adjusted risk ratio of 1.8 (95% confidence interval, 1.1-2.7), and was no longer significant for vaginal births. Mean pain scores after cesarean delivery were significantly higher in parturients with antepartum depressive symptoms. Antepartum depressive symptoms were associated with significant postpartum inpatient opioid use, especially following cesarean delivery. Whether identifying and treating depressive symptoms in pregnancy may impact the pain experience and opioid use postpartum warrants further investigation.

Treatment options and their uptake among women with symptoms of perinatal depression: exploratory study in Norway and Portugal.

Perinatal depression is the most undertreated clinical condition during the perinatal period. Knowledge about women's decision-making in seeking and receiving treatment is scarce. To investigate and compare treatment option uptake in perinatal women with depressive symptoms in Portugal and Norway, and to identify sociodemographic and health-related factors associated with treatment uptake. Participants were women resident in Portugal or Norway (≥18 years) who were pregnant or had given birth in the past 12 months, who presented with active depressive symptoms (Edinburgh Postnatal Depression Scale score ≥10). In an electronic questionnaire, women reported treatment received and sociodemographic and health-related factors. The sample included 416 women from Portugal and 169 from Norway, of which 79.8% and 53.9%, respectively, were not receiving any treatment. Most Portuguese women were receiving psychological treatment, either alone (45.2%) or combined with pharmacological treatment (21.4%). Most Norwegian participants were receiving only pharmacological (36.5%) or combined treatment (35.4%). Compared with the Portuguese sample, a higher proportion of Norwegian women started treatment before pregnancy (P < 0.001). In Portugal, lower depressive symptoms and self-reported psychopathology were significantly associated with higher likelihood of receiving treatment. We found that, in both Norway and Portugal, a substantial number of perinatal women with depressive symptoms do not receive any treatment. Differences exist regarding the chosen treatment option and timing of treatment initiation in the two countries. Only mental health-related factors were associated with treatment uptake for perinatal depression in Portugal. Our results highlight the importance of implementing strategies aimed to improve help-seeking behaviours.

Should Severe Preeclampsia Be Considered a Risk Factor for Postpartum Depression and Anxiety? [ID: 1376999

INTRODUCTION: Postpartum mood disorders are common and seen in approximately 20% of women. It is important to understand risk factors associated with this diagnosis so that earlier interventions can be initiated. To date, the effect of preeclampsia on postpartum mood disorders has not been thoroughly investigated. The purpose of this study was to investigate whether severe preeclampsia (SPE) acts as a risk factor for postpartum depression (PPD) or postpartum anxiety (PPA). METHODS: A retrospective chart review of participants who delivered between January 1, 2015, and April 1, 2022, was conducted after IRB approval. Inclusion criteria required: 1) at least one prenatal visit, 2) a postpartum visit, 3) an Edinburgh Postnatal Depression Scale (EPDS) score, 4) a SPE diagnosis, and 5) no other significant perinatal complications. Control records met #1–3 and #5 criteria. Data analysis was conducted using an independent-samples t test. RESULTS: Of 216 SPE participants and 253 control participants queried, 150 and 200 participants respectively met inclusion criteria. An independent-samples t test comparing EPDS scores of SPE and control participants found no significant difference, t(299)=0.40, P=.693. Comparing EPDS anxiety scores (EPDS-3A) likewise found no significant difference between the two groups, t(240)=.85, P=.397. CONCLUSION: Results indicate that SPE is not a risk factor for PPD or PPA diagnosis. Despite null findings, those with and without preeclampsia must be screened for PPD because of its prevalence and detrimental effect if left untreated. Future studies should examine PPD and PPA diagnoses within 12 months postpartum instead of the immediate postpartum period.

Generating EQ-5D-3L health utility scores from the Edinburgh Postnatal Depression Scale: a perinatal mapping study

BackgroundPerinatal depression (PND) describes depression experienced by parents during pregnancy or in the first year after a baby is born. The EQ-5D instrument (a generic measure of health status) is not often collected in perinatal research, however disease-specific measures, such as the Edinburgh Postnatal Depression Scale (EPDS) are widely used. Mapping can be used to estimate generic health utility index values from disease-specific measures like the EPDS.ObjectiveTo develop a mapping algorithm to estimate EQ-5D utility index values from the EPDS.MethodsPatient-level data from the BaBY PaNDA study (English observational cohort study) provided 1068 observations with paired EPDS and EQ-5D (3-level version; EQ-5D-3L) responses. We compared the performance of six alternative regression model types, each with four specifications of covariates (EPDS score and age: base, squared, and cubed). Model performance (ability to predict utility values) was assessed by ranking mean error, mean absolute error, and root mean square error. Algorithm performance in 3 external datasets was also evaluated.ResultsThere was moderate correlation between EPDS score and utility values (coefficient: – 0.42). The best performing model type was a two-part model, followed by ordinary least squared. Inclusion of squared and cubed covariates improved model performance. Based on graphs of observed and predicted utility values, the algorithm performed better when utility was above 0.6.ConclusionsThis direct mapping algorithm allows the estimation of health utility values from EPDS scores. The algorithm has good external validity but is likely to perform better in samples with higher health status.

Impact of a postpartum care rehabilitation program to prevent postpartum depression at a secondary municipal hospital in Qingdao China: a cross-sectional study

BackgroundThe emerging postpartum rehabilitation (PPR) program in Chinese hospitals characterized by applying ongoing medical care through traditional cultural practices shows a protective effect in early puerperium in China. This study explores the benefit of PPR program practices to postpartum depression (PPD) and the influencing factors for PPD among Chinese women during the first postnatal six weeks.MethodsThe cross-sectional study included 403 participants and was conducted in a Secondary Municipal Hospital in Qingdao, China, from 01 to 2018 to 31 December 2021. Information on this PPR program was collected during the six-weeks postpartum consultation, including the Edinburgh postnatal depression scale (EPDS) scores, the measurement results for diastasis recti abdominis, and the international physical activity questionnaire (long form) (IPAQ-L) scores. Logistic regression models were used to examine the effect of the PPR program on PPD among the local population. The secondary aim of this study was to investigate possible influencing factors for PPD, such as coronavirus disease 2019 (COVID-19), physical exercises, etc.ResultsPPR program has shown a positive effect in preventing PPD (p < 0.001) and diastasis recti prevalence (p < 0.001) during the six-weeks postnatal control in Qingdao, China. Better post-pregnancy weight reduction (p = 0.04) and higher metabolic equivalent of task (MET) value (p < 0.001) were noticed in the non-PPR group. Furthermore, lower PPD risk was associated with factors such as longer relationship duration years (2–5 years) (p = 0.04) and exercising one to three times a week (p = 0.01). A higher PPD risk was related to factors such as urinary incontinence during the postpartum period (p = 0.04) and subjective insomnia (p < 0.001). No significant effect was shown between COVID-19 and the EPDS score in this study (p = 0.50).ConclusionOur results suggested that the PPR program provided protection against PPD and diastasis recti during the first six weeks after delivery. Urinary incontinence and subjective insomnia were the main risk factors for PPD, while longer relationship duration years and exercising one to three times a week gave protective effects to PPD. This study emphasized that a comprehensive ongoing medical care program, such as the PPR program, effectively improves women’s mental and physical health in the early postpartum in China.

Relationships between postpartum depression, sleep, and infant feeding in the early postpartum: An exploratory analysis.

The study objectives were to determine the relationships between postpartum depression and maternal and infant sleep parameters and to examine the impact of infant feeding method on infant and maternal sleep and postpartum depression symptomatology. Participants were 61 new mothers aged 18 to 45 years old, and their full-term, normal birth-weight, singleton infants. Participants were recruited from a large teaching hospital in northeast England. Data collection took place in participants' homes. The study used a prospective longitudinal design, with data collected at six, 12 and 18 weeks postpartum. We collected data on total sleep time, longest sleep period, wake after sleep onset, and night waking for mothers and infants objectively from actigraphic records and subjectively from maternal sleep logs. Participants reported on sleep disturbances using the General Sleep Disturbances Scale, on maternal sleepiness, and on depression symptomatology using the Edinburgh Postnatal Depression Scale. Scores on the Edinburgh Postnatal Depression Scale and General Sleep Disturbances Scale were consistently correlated with each other (6 weeks r = 0.452, p < 0.01; 12 weeks r = 0.317, p < 0.05; 18 weeks r = 0.493, p < 0.01), and did not correlate with objective measures or subjective reports of maternal or infant sleep. Edinburgh Postnatal Depression Scale scores at six, 12 and 18 weeks were predicted by General Sleep Disturbances Scale, prior Edinburgh Postnatal Depression Scale score, or both, but not by sleep parameters. With regard to infant feeding method, EPDS score was not higher among exclusively breastfeeding than among exclusively formula-feeding participants at any time point (6 weeks t = 0.306, p = 0.762; 12 weeks t = 0.343, p = 0.733; 18 weeks t = 0.426; p = 0.673). Different pathways emerged to predict Edinburgh Postnatal Depression Scale score for exclusively breastfeeding and exclusively formula-feeding women. Postpartum depression may be associated with disturbed sleep due to negative perception of sleep among depressed women, rather than disrupted sleep causing postpartum depression. With regard to infant feeding method, exclusively breastfeeding women are not more likely to suffer from postpartum depression, and different pathways may predict development of postpartum depression symptoms in exclusively breastfeeding and exclusively formula feeding women.

In-person 1-day cognitive behavioral therapy-based workshops for postpartum depression: a randomized controlled trial.

Postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet as few as 10% access evidence-based treatment. One-day cognitive behavioral therapy (CBT)-based workshops for PPD have the potential to reach large numbers of sufferers and be integrated into stepped models of care. This randomized controlled trial of 461 mothers and birthing parents in Ontario, Canada with Edinburgh Postnatal Depression Scale (EPDS) scores ⩾10, age ⩾18 years, and an infant <12 months of age compared the effects of a 1-day CBT-based workshop plus treatment as usual (TAU; i.e. care from any provider(s) they wished) to TAU alone at 12-weeks post-intervention on PPD, anxiety, the mother-infant relationship, offspring behavior, health-related quality of life, and cost-effectiveness. Data were collected via REDCap. Workshops led to meaningful reductions in EPDS scores (m = 15.77 to 11.22; b = -4.6, p < 0.01) and were associated with three times higher odds of a clinically significant decrease in PPD [odds ratio (OR) 3.00, 95% confidence interval (CI) 1.93-4.67]. Anxiety also decreased and participants had three times the odds of clinically significant improvement (OR 3.20, 95% CI 2.03-5.04). Participants reported improvements in mother-infant bonding, infant-focused rejection and anger, and effortful control in their toddlers. The workshop plus TAU achieved similar quality-adjusted life-years at lower costs than TAU alone. One-day CBT-based workshops for PPD can lead to improvements in depression, anxiety, and the mother-infant relationship and are cost-saving. This intervention could represent a perinatal-specific option that can treat larger numbers of individuals and be integrated into stepped care approaches at reasonable cost.

Relationship between postpartum depression and plasma vasopressin level at 6–8 weeks postpartum: a cross-sectional study

Postpartum depression (PPD) is the most important postpartum mood disorder due to its significant effect on both the infant and family health. Arginine vasopressin (AVP) has been suggested as a hormonal agent involved in the development of depression. The purpose of this study was to investigate the relationship between the plasma concentrations of AVP and the score of Edinburgh Postnatal Depression Scale (EPDS). This cross-sectional study was conducted in 2016–2017 in Darehshahr Township, Ilam Province, Iran. In the first phase, 303 pregnant women, who were at 38 weeks, met the inclusion criteria, and were not depressed (according to their EPDS scores) were included in the study. In the 6–8 week postpartum follow-up, using the EPDS, 31 depressed individuals were diagnosed and referred to a psychiatrist for confirmation. The maternal venous blood samples of 24 depressed individuals still meeting the inclusion criteria and 66 randomly selected non-depressed subjects were obtained to measure their AVP plasma concentrations with ELISA assay. There was a significant positive relationship between plasma AVP levels and the EPDS score (P = 0.000, r = 0.658). Also the mean plasma concentration of AVP was significantly higher in the depressed group (41.35 ± 13.75 ng/ml) than in the non-depressed group (26.01 ± 7.83 ng/ml) (P < 0.001). In a multiple logistic regression model for various parameters, increased vasopressin levels were associated with increased odds of PPD (OR = 1.15, 95% CI = 1.07–1.24, P = 0.000). Furthermore, multiparity (OR = 5.45, 95% CI = 1.21–24.43, P = 0.027) and non-exclusive breastfeeding (OR = 13.06, 95% CI = 1.36–125, P = 0.026) were associated with increased odds of PPD. Maternal gender preference (having a baby of desired and desired sex) decreased the odds of PPD (OR = 0.13, 95% CI = 0.02–0.79, P = 0.027 and OR = 0.08, 95% CI = 0.01–0.5, P = 0.007). AVP seems to be a contributor to clinical PPD by affecting the hypothalamic–pituitary–adrenal (HPA) axis activity. Furthermore, primiparous women had significantly lower EPDS scores.

Perinatal Depressive Symptoms among Pregnant Employees in Taiwan.

This was a longitudinal study of perinatal depressive symptoms among females employed in a large electronics manufacturer in Taiwan, conducted from August 2015 through October 2016. We used questionnaires to collect data on perceived job strain, social support, and the Edinburgh Postnatal Depression Scale (EPDS) scores at three perinatal time-points (pregnancy, delivery, and return to the workplace). Of the 153 employees who agreed to participate, 82 completed the three stages. The prevalence of perinatal depressive symptoms for the three stages was 13.7%, 16.8%, and 15.9%, respectively. The incidence at 3 weeks after childbirth and 1 month after returning to the workplace was 11.0% and 6.8%, respectively. During the third trimester of pregnancy, sleep problems (odds ratio [OR] = 6.2, 95% confidence Interval [95% CI] = 2.1-19.3), perceived job strain (OR = 4.4, 95% CI = 1.5-14.3), and lack of support from family or friends (OR = 7.0, 95% CI = 1.3-40.8) were significant risk factors. Sleep problems (OR = 6.0, 95% CI = 1.7-23.5) and lack of support from family or friends (OR = 27.6, 95% CI = 4.1-322.3) were associated with an increased risk of perinatal depressive symptoms at 3 weeks after childbirth. After returning to the workplace, perceived job strain (OR = 18.2, 95% CI = 2.2-435.7) was a significant risk factor. These findings could provide insight about early symptom detection, and more studies to clarify the association would be worthwhile.

A randomized trial assessing the impact of educational podcasts on personal control and satisfaction during childbirth

Childbirth education can help pregnant individuals feel in control, relieve anxiety and fear, and decrease pain perception. However, many barriers exist that impede patients from obtaining adequate childbirth education, especially in the era of the COVID-19 pandemic. Advances in technology, such as podcasts, can allow for asynchronous patient education. This study aimed to assess the effect of a labor education podcast on personal perception of control and patient satisfaction during childbirth. This was a randomized controlled trial that included nulliparous, low-risk women with singleton gestations who reached 36 weeks' gestation at 2 academic hospitals in Philadelphia, Pennsylvania. Participants were randomized at 28 weeks and 0 days of gestation to usual education (control) or podcast education (intervention), which included links to 7 labor-related podcast episodes on patient-suggested topics that were available on widely-used podcatchers. Primary outcomes were assessed with a 3-question birth satisfaction survey and the Labour Agentry Scale to evaluate personal perception of control during childbirth. Secondary outcomes included the Edinburgh Postnatal Depression Scale score. Analyses were performed as intention-to-treat. Parametric and nonparametric data were compared using the Student t-test or Wilcoxon rank-sum test, as appropriate. A total of 201 women were randomized, and 153 were included in the final analysis (78 in podcast and 75 in control group). There were no significant differences in maternal demographics. Patients in the podcast group had higher median birth satisfaction scores compared with the control group (20 [18-21] vs 18 [16-21]; P=.002), without a significant difference in median Labour Agentry Scale scores (57 [50-63] vs 54 [47-62]; P=.12). When restricting analysis to patients who underwent induction, Labour Agentry Scale scores were significantly higher in the podcast group (58 [53-64] vs 54 [47-61]; P=.045), representing an increased perception of control. However, birth satisfaction score was not different between the groups (P=.06). The most downloaded podcasts were on induction and labor anesthesia. More than 95% of participants would recommend the podcasts to family and friends. An educational podcast on labor topics was well-received, increased patient satisfaction overall, and increased labor agentry among those who were induced. Podcasts are a promising educational modality to improve patient experience during childbirth, and warrant further exploration.

Association between Edinburgh Postnatal Depression Scale and Serum Levels of Ketone Bodies and Vitamin D, Thyroid Function, and Iron Metabolism.

Suicide due to postpartum depression is the most common perinatal-related death and is a social concern in Japan. Nutritional deficiencies during pregnancy may contribute to postpartum depression; therefore, we investigated the relationship between postpartum depression and nutritional status during pregnancy and postpartum. We focused specifically on ketone bodies because they are known to protect brain cells. The relationship between the Edinburgh Postnatal Depression Scale (EPDS) scores and the serum levels of ketone bodies and vitamin D, thyroid function, and iron metabolism was examined. Overall, 126 pregnant women were identified for the study, and 99 were eventually included in the analysis. We defined an EPDS score of ≥9 as being positive for postpartum depression, and serum ketone levels were found to be higher in the group with an EPDS score of ≥9 during the second trimester; however, there were no other significant findings. We may be able to predict postpartum depression from a pregnant woman's serum ketone levels in the second trimester. There was a positive correlation between the EPDS scores at 3 days and 1 month postpartum (r = 0.534, p < 0.001). EPDS scores assessed in the early postpartum period may be useful for the timely detection of postpartum depression.

Selected Factors of Experiencing Pregnancy and Birth in Association with Postpartum Depression.

The aim of the study is to analyse the risk of postpartum depression using dimensions of perceived support (information, emotional, and physical), antenatal education (satisfaction and attitude), and attitude toward pregnancy (wanted or unwanted). A cross-sectional study was carried out among 584 postpartum women in two university birth centres in Slovakia. The Edinburgh Postnatal Depression Scale (EPDS) score was used. Descriptive statistics and analysis of variance, as well as logistic regression, were employed in the study. Found associations were adjusted for education level, type of birth, psychiatric history, and age. As many as 95.1% of women reported their pregnancy as being wanted. Antenatal education, particularly satisfaction with it, showed a negative association with the EPDS score level. No significant differences in depression levels were found considering attitude toward pregnancy and perceived support. The study pointed out the significance of antenatal education to lower the risk of the postpartum depression. One of the important criteria of effective education is a woman's subjective satisfaction with it.

Associations between maternal postpartum depression and infant temperament in treatment-seeking mothers prior to and during the COVID-19 pandemic.

It remains unclear how the COVID-19 pandemic has affected the mother-infant relationship and associations between maternal postpartum depression (PPD) and offspring temperament. This study examined the impact of the pandemic on these links and how maternal ratings of the mother-infant relationship mediated associations between PPD and infant temperament in a sample of treatment-seeking mothers in Ontario, Canada before and during the COVID-19 pandemic. Mothers with infants <12 months of age and Edinburgh Postnatal Depression Scale scores ≥10 enrolled in two separate randomized controlled trials of 1-day cognitive behavioral therapy-based workshops for PPD conducted before COVID-19 (n = 392) and during the pandemic (n = 403). Mothers reported on depressive symptomatology, infant temperament, and the mother-infant relationship. Maternal PPD was associated with more infant negative affectivity and mother-infant relationship difficulties. While associations between PPD and infant-focused anxiety were stronger during COVID-19, the pandemic did not otherwise affect associations between PPD and infant temperament. Mediation analyses suggested that aspects of the mother-infant relationship mediated associations between PPD and infant negative affectivity. Findings highlight the importance of detecting PPD and intervening to potentially improve outcomes for mothers and their children.

Effects of massage therapy on depression in post partum mothers

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: A mental illness known as postpartum depression can develop following the delivery of a child. It is a primary focus in midwifery care since postpartum depression still occurs at a high rate in Indonesia, between 11% and 30%. The lack of social support from the mother's closest friends and family, the mother's continued discomfort after giving birth, the pain in her perineal wound, and her psychological unpreparedness for parenthood, according to several studies, are support factors that contribute to postpartum depression. The health of the mother, the baby, and the family are all negatively impacted by postpartum depression. Postpartum mothers who have postpartum depression will have a reduced capacity to care for children, less interest in their infants, and will not react well or favorably to infants. Mothers will also become sluggish.&lt;strong&gt;&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Objective&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: To determine the effect of massage therapy on the level of depression in postpartum women.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Methods&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: This research is a Quasy Experiment with Pre-Posttest Design With nonequivalent Control Group with 58 postpartum mothers as respondents. Respondents were divided into the intervention group and the control group. The intervention group will be given massage therapy once a week for 4 weeks, while the control group will be given postnatal general care. Both groups were measured for post partum depression by pretest-posttest using the Edinburgh Postnatal Depression Scale (EPDS) questionnaire. Data were analyzed using a computer program. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: The results of the statistical test showed that there was a significant difference in the decrease in the EPDS score in the two groups (p-value 0.000).&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Conclusions&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: This study shows that massage therapy is effective in reducing depression in postpartum women at the Mengwi I Health Center, Badung Regency.&lt;/em&gt;&lt;/p&gt;

Higher n-3 polyunsaturated fatty acid status during early pregnancy is associated with lower risk for depression at 12 months postpartum: The NuPED study

Perinatal depression can negatively affect the health of the mother and her offspring. N-3 polyunsaturated fatty acids (PUFA) may play a role in the aetiology of depression. Therefore, we investigated the association of n-3 PUFA status during early pregnancy with perinatal depression among women living in urban Johannesburg, South Africa. For this prospective analysis, we analysed red blood cell (RBC) total phospholipid fatty acid (FA) composition (% of total FA) of 242 pregnant women at <18 weeks’ gestation. We used the Edinburgh Postnatal Depression Scale (EPDS) to identify women at risk for depression (EPDS score ≥9) at <18, 22 and 36 weeks’ gestation, and at 6 and 12 months postpartum. RBC EPA status was negatively (β=-0.22, p<0.05), and the AA/EPA ratio positively (β=0.24, p<0.05) associated with EPDS scores at 12 months postpartum. Higher RBC DHA and n-3 index were further associated with lower odds (OR=0.56 [95% CI: 0.32-0.91]; OR=0.63 [95% CI: 0.39-0.94]), while higher n-6/n-3 PUFA and AA/EPA ratios early in pregnancy were associated with higher odds for depression at 12 months postpartum ((OR=2.34 [95% CI: 1.12-4.97]; OR=1.02 [95% CI: 1.00-1.05]). Our results suggest that women with a higher RBC n-3 PUFA status during early pregnancy may be at lower risk for depression at 12 months postpartum.

The relationship between fatigue, sleep quality, resilience, and the risk of postpartum depression: an emphasis on maternal mental health

BackgroundSeveral factors can contribute to the development of postpartum depression (PPD) and negatively affect mothers’ mental and physical well-being. The objective of this study was to determine the relationship between fatigue, sleep quality, resilience, and the risk of PPD development.MethodsA cross-sectional study was conducted using an online questionnaire distributed to mothers during their postpartum period. The risk of PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS), postpartum fatigue (PPF) was assessed using the Fatigue Severity Scale (FSS), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and resilience was assessed using the Brief Resilience Scale (BRS). The Pearson correlation coefficient was calculated to determine the relationship between the study variables. Simple and multiple linear regression analyses were performed to explain the contributions of PPF, sleep quality, and resilience as independent predictors of PPD development.ResultsA total of 1409 postpartum women were included in the analysis, with 75% of the participants reporting a risk of PPD, 61% reporting PPF, 97% reporting having sleep problems, and 36% being in the “low resilience level” category. In terms of correlations, the scores of FSS and the PSQI showed moderate positive relationships with the EPDS scores (r = 0.344 and r = 0.447, respectively, p = .000). The BRS scores were negatively associated with the EPDS scores (r = −0.530, p = 0.000). Fatigue, sleep quality, and resilience were predictors of depressive symptoms (β = 0.127, β = 0.262, and β = −0.393, respectively, R2 = 0.37, p = 0.000). The association remained significant in the regression model after adjusting for mother’s age, mother’s BMI, child’s age, smoking status, full-term pregnancy, having a chronic disease, and taking anti-depressant.ConclusionsMothers with higher levels of fatigue, poor sleep quality, and low resilience levels were at high risk of developing PPD. Healthcare providers should identify these factors and thus set better rehabilitation goals to improve overall maternal health.

Maternal fear, loss and hope in Melbourne’s COVID-19 lockdown: Women-mothers performing lived maternity, using self-report in words and pictures, within the context of the CONNECT-from-HOME art therapy Zoom group

This article offers a window onto the authoring and performing of lived maternity experiences by new mothers who met virtually and participated in group art therapy during the time of COVID-19 lockdown in Melbourne, Australia, between July and December 2020. The eight-week, face-to-face art therapy programme CONNECT for distressed mothers and babies was delivered for the first time via Zoom to participant mothers, each provisioned with a printed booklet and a pack of art materials. In weekly Zoom sessions, women-mothers were encouraged to contemplate and revisit their motherhood journeys through engagement in a series of art-based exercises facilitated by two experienced therapists. Through words and picture-making, mothers authored and represented their lived maternity experiences and, in turn, took to the Zoom stage to ‘show and tell’ the group audience just how maternity had played out for them, with the added anxiety of that uninvited guest at the party – COVID. A lived maternity group culture arose that permitted a redefinition of maternity; understanding and wisdom flourished as group members decided for themselves what the ‘new normal’ was for lived maternity in the time of COVID. Edinburgh Postnatal Depression Scale scores showed a reduction in distress over the course for the participants. Post-group written feedback from participants about the CONNECT-from-HOME Zoom group revealed benefits including feeling less alone, feeling affirmed in a sense of struggle, wisdom gained in understanding past life experiences through reflection and group discussion, enjoying the process of art expression to give visual form to emotions/experiences and gaining understanding/wisdom from hearing other mothers tell about their motherhood journeys in words/pictures. Whilst several mothers were able to identify a positive impact on their mothering from the COVID pandemic, with their partner able to share in the early life of the baby, the vast majority of mothers performed fear and loss. Written feedback revealed largely negative impacts from the COVID pandemic and lockdown, specifically anxiety about health and reduced access to medical care and support. Lockdown elicited a sense of crisis, feelings of being ‘cheated’ (out of anticipated/wished-for motherhood experiences) and anger, anxiety, isolation, profound loss and disappointment alongside impact on energy, well-being, stress levels, mental health, self-esteem and relationships with baby, partner and extended family.

Dads in Distress: symptoms of depression and traumatic stress in fathers following poor fetal, neonatal, and maternal outcomes

BackgroundThis study aims to explore the prevalence of symptoms of depression and traumatic stress in fathers in the setting of poor fetal, neonatal, and maternal outcomes.MethodsA prospective mixed-methods study was conducted at an outer metropolitan public teaching hospital in Brisbane, Australia, with quantitative results presented here. Subjects included 28 fathers whose partners had experienced pregnancy or childbirth complicated by a significant congenital abnormality or aneuploidy, termination of pregnancy, fetal death in-utero, stillbirth, admission to the neonatal intensive care unit or special care nursery or significant maternal morbidity, such as a postpartum haemorrhage or an emergency postpartum hysterectomy. These experiences were classified into two groups: anticipatory (time to prepare) and sudden (no warning). The fathers were screened using the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Events Scale-Revised (IES-R) to assess subjective distress at 2-3 weeks (timepoint 1) and 3-4 months (timepoint 2) after the event.ResultsData for both the EPDS and IES-R scales was available for 26 fathers (92.9%) at timepoint 1 and for 15 fathers (53.6%) at timepoint 2. High overall EPDS scores (≥10) were noted in 16/27 (59.3%) fathers at timepoint 1 and 6/15 fathers (40.0%) at timepoint 2. High overall IES-R scores ≥33 were noted in 12/26 (46.2%) fathers at timepoint 1 and 4/15 fathers (26.7%) at timepoint 2. A higher percentage of fathers who experienced anticipatory events had EPDS and IES-R score above these cut-offs at timepoint 1 (8/13 or 61.5%) compared to those experiencing sudden events (8/14 or 57.1%), however, percentages were similar between groups at time point 2 (2/7 or 28.6%% and 4/8 or 50.0%, respectively). More fathers who experienced anticipatory events had IES-R scores ≥33 at timepoint 1 (7/13 or 53.8%) compared to those experiencing sudden events (5/14 or 38.0%).ConclusionOur study indicates high rates of distress in fathers exposed to poor fetal, neonatal, and maternal outcomes, which can persist for months after the event. Increased support for fathers in this setting may be required to prevent poor mental health. Further research on the long-term effects of these adverse events is warranted.

Comparison of response options and actual symptom frequency in the Japanese version of the Edinburgh Postnatal Depression Scale in women in early pregnancy and non-pregnant women

BackgroundThe positive predictive rate of the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS) is lower than those of other versions. This study aimed to confirm whether the EPDS Japanese version reflects actual symptom frequency and to examine the possibility of improving the positive predictive rate.MethodsThis is a methodological study aimed at improving the positive predictive value of EPDS. The participants were 63 non-pregnant and 382 pregnant women. They answered the 10 questions of the Japanese version of the EPDS and reported the specific number of days as the frequency. The EPDS score (EPDS-S) and the frequency score (FREQ-S) were calculated for three factors of emotion: anhedonia, anxiety, and depression.ResultsThe positive rates of the EPDS-S and FREQ-S in pregnant women were 6% and 8%, respectively, which were lower than those in non-pregnant women (17%). On comparing the EPDS-S with the FREQ-S, a significant underestimation of frequency was observed in approximately 3% of pregnant women. The FREQ-S showed better internal consistency than the EPDS-S. Among the factors of emotion, women tended to rate anhedonia lower in the EPDS-S than in the frequency scale.ConclusionPregnant women tended to report a lower frequency on the Japanese version of the EPDS than their actual symptom frequency, which was especially true for those with a desire to self-harm. The combined use of the FREQ-S and EPDS-S can prevent underestimation and help improve the detection rate of depression.