Edinburgh Postpartum Depression Scale Score Research Articles

Therapeutic effect of manual massage on early postpartum rectus abdominis separation and postpartum depression.

Rectus abdominis separation (DRA) affects pelvic stability and body image. No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression. To analyze the curative effect of massage on early postpartum DRA and its impact on postpartum depression and thus its ability promote the overall psychosomatic rehabilitation of postpartum women. Data were retrospectively collected on 70 primiparous women with postpartum DRA who underwent rehabilitation at the Postpartum Rehabilitation Center of Huzhou Maternal and Child Health Hospital from October 2022 to September 2023. The patients were divided into the Group S (35 cases, biomimetic electrical stimulation treatment) and Group L (35 cases, biomimetic electrical stimulation combined with manual massage treatment). Baseline data, the edinburgh postpartum depression scale (EPDS) score, and the visual analog scale (VAS) scores for rectus abdominis distance, waist circumference, and lower back pain before and after treatment were compared. No significant differences were found in the baseline data, rectus abdominis distance, waist circumference, and VAS and EPDS scores between the two groups before treatment (P > 0.05). After treatment, the distance between rectus abdominis and waist circumference in Group L were significantly smaller than those in Group S (P < 0.05). Furthermore, lower back pain (VAS score) and the EPDS score in Group L were significantly lower than those in Group S (P < 0.05). Manual massage can significantly reduce early postpartum DRA, waist circumference, and back pain and improve the patient's mental state and postpartum depression.

Impact of the Fetal Echocardiogram on Maternal Depression and Well-Being.

Fetal echocardiography allows for prenatal diagnosis of congenital heart disease (CHD). The objective of this study is to assess for the impact of fetal echocardiogram on levels of well-being and depression in pregnant women. Adult pregnant women carrying a fetus < 31-week gestational age were enrolled in the prospective observational study from February 2022 to June 2022. These subjects were split into two cohorts: those with CHD and those without CHD. Surveys were distributed prior to the fetal echocardiogram, six weeks later and six weeks after delivery. These surveys consisted of the Edinburgh Postpartum Depression Scale (EPDS) and questions about topics, such as anxiety and social support. Of the 152 subjects enrolled, 14 women had a fetus with CHD and 138 women had a fetus without CHD. Initial EPDS scores were elevated for the study population compared to the general population. Six weeks later, EPDS scores remained elevated. For the post-partum surveys, the EPDS scores were decreased below the rate of the general population for the group without CHD and similar to the general population rate for the CHD group. Anxiety, worry, and guilt remained low for both groups after the initial survey. Counseling from the pediatric cardiologist may help decrease anxiety and worry. Social support, like support groups, may be helpful for women carrying a fetus with CHD.

Factors associated with postpartum depression among high-risk women during the COVID-19 pandemic

ABSTRACT The purpose of this study was to investigate the impacts of the COVID-19 pandemic on multi-level factors associated with depression among a high-risk sample of postpartum women using longitudinal data collected at two timepoints. High-risk postpartum participants in the United States were recruited to participate in a parent study focused on mitigating risk of cardiometabolic disease in postpartum women. Individuals completed a baseline survey which included the Edinburgh Postpartum Depression Scale (EPDS) at 6-weeks postpartum between 2017 through 2019. A modified survey with the inclusion of selected questions from the Coronavirus Health Impact Survey (CRISIS) questionnaire was administered again during the first 6-months of the COVID-19 pandemic and individuals who completed both the baseline assessment and the COVID-19 assessment were included for analyses (n = 46). Multivariate models were run to investigate the impacts of individual-, interpersonal-, and structural-level factors on change in EPDS scores across the postpartum period. Findings suggest that losing contact with social supports (β = 4.5, SE = 1.9, p = .02) and individuals who reported a total household income of less than $75,000 (β = 3.4, SE = 1.7, p = .05) were more likely to report significantly worsening postpartum depression scores compared to others. Recommendations to mitigate the stressors that have been amplified by the COVID-19 pandemic and resulting mental health disparities include screening all high-risk postpartum women for depression and anxiety during both postpartum and pediatric healthcare visits, providing informational flyers with tips related to healthy coping behaviors and free/affordable community resources, and linking individuals to peer-led support groups.

Peripartum Mood Clinic Referral Rates Pre- and Post-COVID

Background: Peripartum depression is a common complication of pregnancy with the potential for dangerous consequences to maternal and infant health if left untreated. The COVID-19 pandemic increased the incidence of mental health disorders globally with an even greater effect on peripartum mothers. Disparities in access to mental health services may further exacerbate health care outcomes for affected individuals. Aims: The aim of this study is to evaluate Edinburgh Postpartum Depression Scale (EPDS) scores pre- and post-COVID-19 to determine if mental health worsened post-COVID and assess how certain demographics were affected compared to others. Methods: This is a retrospective cohort study of all pregnant patients referred to the Perinatal Mood Disorder Program at a large academic hospital in Indianapolis between March 1, 2019 to March 1, 2021. March 1, 2020 was the date used to determine our pre- and post-COVID groups, as it was near this time an official coronavirus outbreak was declared. Referral criteria were based on EPDS score and clinical gestalt. A convenience The sample of the population was assessed with EPDS score as the primary outcome. Demographic information including zip code of residence, psychiatric history, obstetric and newborn outcomes were also captured. Descriptive analysis, t-test and χ2 test were performed with statistical significance determined as p&lt;0.05. Results: There were 1,487 total pregnant patients referred with 733 referred pre-COVID and 754 post-COVID. Six hundred patients were sampled for analysis – 288 pre-COVID and 312 post-COVID. There were no statistically significant differences in age, ethnicity and race between groups. The mean EPDS score was not statistically significant between the groups (9.71 and 9.81, p 0.84). The four zip codes with the highest referral rates to the mood clinical also corresponded to areas within Indianapolis with the highest levels of poverty. Conclusion: Edinburgh Postpartum Depression Scale scores were not different between pregnant patients pre- and post-COVID. There was also no difference in demographic characteristics between groups. The pandemic exacerbated existing barriers to treatment of peripartum mood disorders, highlighting the responsibility of clinicians and policymakers to support, identify, and facilitate treatment for this vulnerable population to prevent both short and long-term repercussions.

Assessment of eating disorders and depression in postpartum women.

To determine the prevalence of eating disorders and orthorexia in postpartum women and examine the relationship with postpartum depression. Included in this study were 227 postpartum women. The Eating Attitude Test-26 (EAT-26) was used to determine the risk of eating disorders in the women, followed by the Orthorexia 11 Scale (ORTO-11) to identify orthorexia, and the Edinburgh Postpartum Depression Scale (EPDS) to identify postpartum depression. 63 of the women (27.8%) exhibited an orthorexic tendency, which was also related to eating disorders and postpartum depression. Each one-point increase in the EAT-26 score led to a decrease of 0.32 points in the ORTO-11 score. Similarly, each one-point increase in the EPDS score caused a reduction of 0.18 points in the ORTO-11 score. The ORTO-11 score increased by 0.26 points per each live birth. An obsessive focus on healthful nutrition may result in the impairment of health and numerous adverse psychological and physiological outcomes in the future. Healthy eating habits should be maintained to improve the quality of life without causing an obsession with healthy eating.

Postpartum Depression Among Mothers of Infants Hospitalized in the Neonatal Intensive Care Unit During the COVID-19 Pandemic.

Background Neonatal intensive care unit (NICU) hospitalization of newborn babies has been shown to have a negative impact on the mental health of postpartum women. The mental health of new mothers may be further burdened by the effects of the coronavirus disease 2019 (COVID-19) pandemic on social, economic, and psychological dimensions. This study aimed to evaluate postpartum depression and related factors in mothers of infants hospitalized in NICU during two distinct COVID-19 pandemic periods and examine anyadditional effects of the pandemic on the mental health of postpartum women. Methodology The Edinburgh Postpartum Depression Scale (EPDS) was applied to 250 NICU mothers during the COVID-19 pandemic. The first 125 women's children were hospitalized during a period of high number of cases and deaths when restrictions were in place for NICU parental visits (November 2021 to February 2022, the early group). The remaining 125 women completed the scale when there was a lower number of cases and restrictions had been eased (March to June 2022, the late group). Results In the early group, the EPDS scores were statistically higher(7.53.9 vs. 5.63.4; p < 0.001), smoking and NICU stay duration were significantly higher (p = 0.01), whereas the duration ofmarriagewas significantly lower (p = 0.01). Women in the late group with EPDS scores ≥13 were statistically less educated (p = 0.01). EPDS scores ≥13 were significantly associated with depression during pregnancy and with a history of abortion/stillbirth/neonatal death (odds ratio (OR) = 5.240, 95% confidence interval (CI) 1.114 to 27.967, p = 0.03 and OR = 1.641, 95% CI = 1.009 to 2.669, p = 0.04, respectively). Conclusions NICU admission is a significant maternal risk factor for postpartum depression due to the disruption of maternal-infant bonding, and this risk may be exacerbated during times of global public health crises such as the COVID-19 pandemic. Depression during pregnancy and the presence of a perinatal loss may also contribute to worse postpartum mental outcomes in NICU mothers.

Association between maternal postpartum depression and children's physical growth in early childhood: a birth cohort study.

Untreated maternal postpartum depression (PPD) has consequences for children's physical growth, but no published study has evaluated changes in this effect over time. Here we therefore aimed to evaluate the dynamic effects of PPD on the physical growth of children in a prospective birth cohort. Between 2015 and 2019, 960 mother-child pairs in Changsha, China were followed up when the child was aged 1-48 months. Data were obtained through household surveys. The mothers' depressive symptoms were measured using the Edinburgh Postpartum Depression Scale (EPDS) at 1 month postpartum. Linear mixed models were used to examine the changes in the association of PPD and EPDS scores with physical growth in six different age groups of children between 1 and 48 months. A total of 604 mother-child pairs completed the follow-up, and 3.3% of mothers reported PPD. No associations were found between PPD and weight or height growth at any age. While EPDS scores were associated with weight gain (β = -0.014, 95% CI (-0.025, -0.002), P = 0.024) and height growth (β = -0.044, 95% CI (-0.084, -0.004), P = 0.030) rates at 1-3 months, no associations were found in older children. The number of mothers who reported PPD was relatively small, and the measurement of PPD was not continuously taken. After adjustments for confounders, no dynamic association was found between PPD and children's weight and height growth. EPDS scores, in contrast, did negatively affect children's weight and height growth at age 1-3 months, but this effect was not long-lasting.

Anxiety and depression among perinatal women during the long-term normal prevention of COVID-19 pandemic period in China: a cross-sectional study

BackgroundCOVID-19 has increased the probability of occurrence of maternal anxiety and depression in pregnant women. However, there is limited research on anxiety and depression among pregnant women during the long-term normal prevention of COVID-19 pandemic period. This study aimed to examine the anxiety and depression and influencing factors among perinatal women during the long-term normal prevention of COVID-19 pandemic period in China.MethodsA cross-sectional survey was designed. A total of 1338 pregnant women were studied. The prenatal anxiety and depression were assessed by the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS), respectively. Postnatal depression was assessed by the Edinburgh Postpartum Depression Scale (EPDS) in 10–14 days after delivery. The data analysis was processed by SPSS9.0. Descriptive analysis was expressed by mean and standard deviation. The counting data were expressed by percentage, χ2 test, multiple linear regression and binary logistic regression.ResultsThe incidence of prenatal anxiety (SAS score ≥ 50) was 27.95% (374 cases), prenatal depression (SDS score ≥ 0.5) was 34.01% (455 cases), and postpartum depression (EPDS score ≥ 0.5) was 25.04% (335 cases). Both the prenatal SAS score (r = 0.635, P < 0.001) and prenatal SDS score (r = 0.738, P < 0.001) were related to postpartum depression. Pregnant women who were younger than 35 years, in middle household income, lower education level, underweight before pregnancy, primiparous, and fear of being infected were at increased risk for developing anxiety and depression during the long-term normal prevention of COVID-19 pandemic.ConclusionsThe incidences of postpartum depression among perinatal women during the long-term normal prevention of COVID-19 pandemic period were a little lower than those during the COVID-19 outbreak period, but still higher than those before the COVID-19.

The effectiveness of kangaroo mother care in lowering postpartum depression in mothers of preterm and low birth weight babies: a systematic review and meta-analysis.

Kangaroo mother care (KMC) intervention involves skin-to-skin contact between mother and infant. Some studies have shown a decrease in postpartum depression (PPD) in mothers of preterm and low birth weight (LBW) infants. However, the literature is scattered and of variable quality. To conduct a systematic review of available literature and provide a comprehensive picture of the effect of KMC on PPD among mothers of preterm and LBW infants. The study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. After PROSPERO registration, a systematic search was conducted using PubMed, Cochrane Central Library, and Google Scholar from the inception of the databases till 14 June 2021. Of the 2944 studies assessed for titles and abstracts, nine studies with 2042 participants were included in the review. Included articles targeted mothers with LBW (<2500g) or preterm infants (<37 weeks), used an authentic PPD tool, and had standard care or an incubator as the control group. Studies not published in English and in which mothers had a previous psychiatric illness were excluded. The risk of bias was assessed using the Cochrane Risk of Bias Tool for randomized control trials and the Newcastle-Ottawa Scale for observational studies. All the results were converted to standard mean deviation and pooled together using a random-effects model with a 95% CI. A P-value of less than 0.05 is considered significant. KMC Intervention was significantly associated with a lower depression score than control groups. The reduction in depression in the intervention (KMC) group was moderate: SMD=-0.38 (-0.68 to -0.08; 95% CI; I 2=86%; P=0.013). No significant difference was found between the PPD scores of both groups using the Edinburgh Postpartum Depression Scale score. The authors conclude that the negative effects of LBW and preterm birth experience on maternal mental health can be avoided to a moderate degree by KMC. Due to a lack of methodological uniformity, different scales for outcome measurement, and discrepancies in intervention features, significantly high heterogeneity was detected. The authors need further larger-scale studies with a uniform study design to better predict the efficacy of KMC better.

Study on the effect of intervention on postpartum psychological improvement and body recovery of caesarean section women based on information-motivation-behavioural skills model.

To explore the effect of information-motivation-behavioural skills (IMB) model on psychological and emotional state of caesarean section (CS) women. Control-group patients got routine nursing during the preoperative, intraoperative and postoperative periods. Observation-group patients received routine nursing combined with the IMB model that included specific informational, motivational and behavioural interventions. Pregnant women (n= 102) who underwent CS in Hangzhou Women's Hospital were randomly divided into Control and Observation-groups (n= 51 each). Self-rating anxiety scale (SAS), self-rating depression scale (SDS) and general self-efficacy scale (GSES) scores, complication rate, fatigue severity scale (FSS) and Edinburgh postpartum depression scale (EPDS) scores were compared. Interventions lowered SAS and SDS scores, significantly lower in the Observation-group (p< 0.05), and increased GSES scores, significantly higher in the Observation-group (p< 0.05). Observation-group had less complications (4.08% vs. 17.39% in the Control-group; p< 0.05), and decreased FSS and EPDS scores (p< 0.05).

The Factors Affecting the Postnatal Bonding of Mothers Whose Babies were Admitted to the Neonatal Intensive Care Unit During the COVID-19 Pandemic.

COVID-19 pandemic has created challenges for sick preterm babies and their parents. This study aimed to explore the factors affecting the postnatal bonding of mothers who were not permitted to visit and touch their babies who were in the neonatal intensive care unit during the COVID-19 pandemic. This is a cohort study conducted in a tertiary neonatal intensive care unit in Turkey. The participants consisted of mothers who were offered full rooming in with their baby (group 1, n = 32) and mothers whose newborns had been admitted to the neonatal intensive care unit immediately after delivery and were hospitalized for at least 7 days (group 2, n = 44). The Turkish versions of Beck Anxiety Inventory, Edinburgh Postpartum Depression Scale, Adjustment Disorder-New Module 8, and Postpartum Bonding Questionnaire were applied to mothers. Tests were performed once in group 1 at the end of the first postpartum week (test1) and twice in group 2 before the baby was discharged from the neonatal intensive care unit (test1) and 2 weeks after the discharge (test2). None of the Beck Anxiety Inventory, Edinburgh Postpartum Depression Scale, Adjustment Disorder-New Module 8, and Postpartum Bonding Questionnaire scores was abnormal. Although the scales were within normal ranges, Postpartum Bonding Questionnaire 1 and Postpartum Bonding Questionnaire 2 had statistically significant correlation with gestational week (r = -0.230, P = .046; r = -0.298, P = .009), Edinburgh Postpartum Depression Scale score (r = 0.256, P = .025; r = 0.331, P = .004), hospitalization (r = 0.280, P = .014; r = 0.501, P < .001), and neonatal intensive care unit anxiety (r = 0.266, P = .02; r = 0.54, P < .001). Postpartum Bonding Questionnaire 2 had statistically significant correlation with birth weight (r = -0.261, P = .023). Low gestational week and birth weight, increased maternal age, maternal anxiety, high Edinburgh Postpartum Depression Scale scores and hospitalization negatively affected maternal bonding. Although all self-reporting scale scores were low, being in the neonatal intensive care unit and not being able to visit (touch) the baby is a major stressor.

Anxiety and Depression of Neonatal Intensive Care Unit Mothers During the COVID-19 Pandemic

Background: To determine the prevalence of anxiety and depression of the mothers whose babies were admitted to neonatal intensive care unit (NICU) for any reason other than COVID-19 during the pandemic, and the effect of duration of NICU stay on mothers' anxiety and depression. Materials and Methods: The NICU mothers were divided into three groups according to duration of hospitalization of their babies. The duration of hospitalization of the babies was &amp;lt; 7 days for the first group of the mothers (G1), ≥ 7- &amp;lt;14 days for the second group (G2), and ≥ 14- &amp;lt; 30 days for the third group (G3). The anxiety level of the mothers was assessed with "State Trait Anxiety Inventory (STAI)", and a cut-off score above 40 was used to define probable clinical levels of anxiety. Depression was evaluated with “Edinburgh Postpartum Depression Scale (EPDS)”, and a cut-off score above 12 was considered as probable risk for presence of postpartum depression. Results: Among 150 mothers (in each group n=50), the STAI-State scores of all mothers were &amp;gt; 40, indicating clinical levels of anxiety. Seventy three (48.7%) of the mothers had a EPDS score &amp;gt; 12. The STAI-State scores of the mothers in G3 were higher than the mothers in G2 (p=0.029). Depression scores did not differ between the three groups. Conclusions: All the NICU mothers were found to be anxious and nearly half of them were depressive. Mean state anxiety levels were higher in mothers of babies who stayed longer in NICU.

Obstetric anesthesia clinic childbirth course combined with labor epidural analgesia is associated with a decreased risk of postpartum depression : a prospective cohort study

BackgroundPostpartum depression (PPD) is a serious complication commonly seen in postnatal women. In this paper, an investigation was conducted to see if obstetric anesthesia clinic childbirth course combined with labor epidural analgesia (LEA) was associated with a decreased risk of PPD.MethodsSix hundred fifty-five nulliparous women were enrolled in this prospective cohort study. The parturients were divided into 4 groups, with Group C being the control group, Group AC received the obstetric anesthesia clinic childbirth course only, Group LEA received LEA only, and Group AC + LEA received both the obstetric anesthesia clinic childbirth course and LEA. Maternal and neonatal variables in the perinatal period were recorded. PPD at 6 weeks was assessed using the Chinese version of the Edinburgh Postpartum Depression Scale (EPDS), where a score ≥ 10 is the threshold for PPD. Multivariate logistic regression analysis was performed to assess the association between obstetric anesthesia clinic childbirth course combined with LEA and postpartum depression.ResultsA total of 124 maternities had EPDS ≥10 points, the incidence of PPD was 18.9%。The incidence of PPD and EPDS scores were significantly lower in Group AC + LEA than in Group C (12.1% vs 26.8%, P < 0.05; 6 (5, 7) vs 7 (5, 11), P < 0.05). Received an anesthesia clinic childbirth course combined with LEA was associated with a decreased risk of PPD (OR 0.273, 95% CI, 0.100–0.743, P = 0.013). Multivariate logistic regression analysis identified 5 other independent factors for PPD, including maternal SAS score in the delivery room, W-DEQ score in the delivery room, living in a confinement center, EPDS score at 1st week postpartum and perinatal care satisfaction .ConclusionsReceived an obstetrics anesthesia clinic childbirth course combined with LEA for nulliparous women with a single term cephalic pregnancy was associated with a decreased risk of PPD at 6 weeks.Trial registrationChinese Clinical Trial Registry, ChiCTR2000039163. Registered on 20/10/2020.

Exploring associations between postpartum depression and oxytocin levels in cerebrospinal fluid, plasma and saliva

BackgroundPostpartum depression (PPD) is a serious mental health concern affecting approximately 17.22 % of new mothers worldwide. In addition to its obstetric effects, oxytocin (OXT) has also been considered to play a role in PPD. However, most previous studies exploring associations between PPD and OXT levels focus on easier accessible compartments such as blood or saliva. Study aimTo explore the possible association between PPD and OXT levels, and to assess the interaction between peripheral secretion and central release of OXT. MethodsIn this study, we prospectively measured OXT concentrations in cerebrospinal fluid (CSF), plasma and saliva of 94 women with elective cesarean section by enzyme-linked immunosorbent assay (ELISA) kits. The participants were divided into the PPD group if the score of Edinburgh Postpartum Depression Scale (EPDS) ≥ 10 at 3 months postpartum, otherwise into the non-PPD (nPPD) group. ResultsThe incidence of PPD was 30.85 %. OXT concentrations in CSF (r = −0.518, p < 0.001), plasma (r = −0.240, p = 0.020) and saliva (r = −0.263, p = 0.010) were negatively correlated with EPDS score, and were valuable for the prediction of PPD, with AUC and 95%CI of 0.890 (0.809–0.945), 0.683 (0.579–0.775) and 0.699 (0.596–0.790), respectively. Moreover, OXT concentrations in plasma (r = 0.407, p < 0.001) and saliva (r = 0.624, p < 0.001) were positively correlated with CSF OXT concentrations. LimitationsOnly full-term pregnant women undergoing elective cesarean section were included in this study, which may affect study generalizability. ConclusionsThe central and peripheral release of OXT is coordinated, and OXT level measured prenatally in CSF, plasma, or saliva is valuable for the prediction of PPD.

Is COVID-19 Associated With an Increase in Edinburgh Postpartum Depression Scale Scores Among Postpartum Women? [A307

INTRODUCTION: Postpartum depression affects approximately 10% to 20% of pregnancies. Recent studies suggest an increased incidence of postpartum depression during the COVID-19 pandemic. The purpose of this study was to investigate the incidence of postpartum depression in a cohort of patients cared for within a tertiary care center before and after the COVID-19 pandemic using the Edinburgh Postpartum Depression Scale (EPDS). METHODS: A retrospective chart review of randomly selected patients seen for postpartum care and who completed an EPDS between April 2019–February 2020 (pre–COVID-19 cohort, 448 patients) and April 2020–February 2021 (post–COVID-19 cohort, 468 patients) was conducted with Institutional review board approval. The EPDS scores categorized four levels: &lt;9, 9–11, 12–14, and ≥15, corresponding to negative, mild, moderate, and severe total scores. One-way analysis of variance (ANOVA) compared these associations. RESULTS: Percentages of pre–COVID-19 cohort patients within each EPDS category above were 64.9%, 17%, 11.6%, and 6.5%, respectively, and for the post–COVID-19 cohort were 36.8%, 31.8%, 18.6%, and 12.8%, respectively. In the post–COVID-19 cohort, ANOVA showed a significant increase in the number of patients with positive total EPDS scores (F(1,895.22)=30.66, P&lt;.001, η2=0.032), in mild EPDS levels (F(1,843.65)=12.24, P&lt;.001, η2=0.013) and severe EPDS levels, (F(1,860.72)=12.26, P&lt;.001, η2=0.013). ANOVA showed no significant difference in the number of patients with moderate EPDS levels. CONCLUSION: This study demonstrates a statistically significant increase in EPDS scores in postpartum patients during the COVID-19 pandemic. Further research should be conducted to determine which factors impacted the increase in EPDS scores after the onset of the COVID-19 pandemic.

Fear of childbirth: Validation study of the Chinese version of Wijma delivery expectancy / experience questionnaire version B

IntroductionFear of childbirth has a significant impact on women's well-being post-birth. It can affect the women's relationships, future reproductive choices, and their decision on their future mode of birth. The Wijma Delivery Expectancy/Experience Questionnaire (Version B) is a comprehensive instrument for the assessment of postnatal fear of childbirth. MethodsHong Kong Chinese women at a postnatal ward of a tertiary hospital completed the translated questionnaire, Edinburgh Postpartum Depression Scale, and State-trait Anxiety Inventory. Exploratory factor analysis was performed. Pearson's correlation between the Wijma Delivery Expectancy/Experience Questionnaire (Version B) and the State-trait Anxiety Inventory or Edinburgh Postpartum Depression Scale scores were used to determine the convergent validity. Cronbach's alpha coefficient and intraclass correlation coefficient were used to determine the reliability of the translated Wijma Delivery Expectancy/Experience Questionnaire (Version B). Results136 postnatal mothers completed the study. 21.3% of women experienced fear of childbirth using the standard cut-off of 85/165. The Cronbach's alpha coefficient and test-retest reliability of the Chinese version were 0.910 and 0.741 respectively. Convergent validity was demonstrated with other psychological measures at expected moderate levels. Exploratory factor analysis revealed 4 factors. ConclusionThe Chinese version of the Wijma Delivery Expectancy/Experience Questionnaire (Version B) is a valid and reliable instrument to measure fear of childbirth amongst Chinese postpartum women. The questionnaire can be used to assess the severity of women's fear throughout their postpartum period, and to monitor the response of any medical or psychological interventions for women experiencing postnatal fear of childbirth.

Fear of childbirth: Validation study of the Chinese version of Wijma delivery expectancy/experience questionnaire version A

Introduction: Fear of childbirth causes significant distress and impact on women's wellbeing. It contributed to the rising trend of non-medically indicated Caesarean births worldwide. The objective of this study was to translate and validate the Chinese version of the Wijma Delivery Expectancy/Experience Questionnaire (Version A) (W-DEQ-A), which is a comprehensive instrument for the assessment of fear of childbirth among antenatal women.Methods: The translated questionnaire was finalised after back-translation and review by an expert panel. Hong Kong Chinese women at an antenatal clinic completed the translated questionnaire, Edinburgh Postpartum Depression Scale (EPDS), and State-trait Anxiety Inventory (STAI). The reliability of the translated questionnaire was analysed using Cronbach's alpha coefficient and intraclass correlation coefficient. Convergent validity was measured by Pearson's correlation between the W-DEQ-A and STAI or EPDS scores. The subscales of the questionnaire were determined using exploratory factor analysis.Results: One hundred and fifty women completed the study. The Cronbach's alpha coefficient and test-retest reliability of the Chinese version were 0.907 and 0.867, respectively. Convergent validity was demonstrated by the moderate correlation between the translated W-DEQ-A and STAI or EPDS. Exploratory factor analysis of the W-DEQ-A revealed a multi-dimensional structure with four factors: sense of isolation, moment of birth, negative emotion, and lack of positive self-evaluation. Using a standard cut-off of 85, 11.3% of women were found to suffer from fear of childbirth.Conclusion: The Chinese version of the Wijma Delivery Expectancy/Experience Questionnaire (Version A) is a reliable and valid instrument to measure antenatal fear of childbirth among Chinese women.

Effects of COVID-19 Pandemic on Mental Health Status of COVID-positive Pregnant Women in a COVID Care Center: A Prospective Observational Study

Background: The global pandemic of the novel coronavirus disease 2019 (COVID-19) has created a public health emergency straining the entire human race. The population of antenatal and postnatal women is subjected to additional anxiety and psychological stress due to issues related to the pandemic like the public health measures, such as quarantine, and anxiety about the health of the fetus. Aim: To study the prevalence of depression and anxiety in antenatal and postnatal women during the COVID-19 pandemic. Materials and methods: We have screened 300 women in a COVID-19 care center for psychological depression and anxiety. The Edinburgh postpartum depression scale (EPDS) and also a self-reported questionnaire with COVID-specific anxiety questionnaire with eight items related to the COVID-9 pandemic were answered in graded response scale from 1 to 5. The clinical records identifying high-risk factors along with EPDS score and anxiety response were analyzed. EPDS greater than 13 was suggestive of probable depression. Anxiety questions were analyzed according to the percentage of questions that have been marked as ’much’ and ’very much' responses. Results: Among 300 women, the prevalence of depression was 43.3%. The anxiety question marked by 39% of women was about worries of the health of fetus graded as “very much” followed by that regarding the worries about delivery marked by 25.3% of women as very much. Conclusion: The increased psychological distress among pregnant women irrespective of COVID-19 status is significant. The preventive mental health strategies should be integrated with antenatal and postnatal care of women during the pandemic. © Jaypee Brothers Medical Publishers. 2021.

Trajectories of antenatal depression and adverse pregnancy outcomes

Antenatal depression affects approximately 1 of 7 pregnancies, with an increasing prevalence across gestation. Data regarding the associations between antenatal depression and adverse pregnancy outcomes yielded conflicting results. However, previous studies evaluated the cross-sectional prevalence of depression at various time points and not the depressive symptom trajectory across gestation. This study aimed to identify whether the trajectory of antenatal depressive symptoms is associated with different risks of adverse pregnancy outcomes. This was a secondary analysis of a large multisite prospective cohort of nulliparous women across the United States. The Edinburgh Postpartum Depression Scale was administered at 2 study visits: between 6 and 14 weeks' gestation and between 22 and 30 weeks' gestation. The Edinburgh Postpartum Depression Scale score trajectories were categorized as improved, stable, or worsened based on whether the scores changed by at least 1 standard deviation between the 2 visits. The frequencies of adverse pregnancy outcomes (hypertensive disorders of pregnancy, abruption, cesarean delivery, preterm birth [ie, <37 weeks' gestation], small for gestational age neonates, neonatal intensive care unit admission, and maternal readmission) were compared with depression trajectories across gestation in bivariable and multivariable analyses. Secondary analyses evaluated the frequencies of spontaneous and medically indicated preterm births and frequencies of spontaneous and medically indicated preterm births before 35, 32, and 28 weeks' gestation. Of the 8784 women who completed the 2 antenatal Edinburgh Postpartum Depression Scale screens, 1141 (13.0%) had improved, 6663 (75.9%) had stable, and 980 (11.2%) had worsened depressive symptom trajectories across gestation. Compared with women with improved or stable depressive symptoms, those with worsened symptoms were more likely to experience preterm birth (8.3% vs 7.4% vs 9.9%, respectively; P=.018). After controlling for potential confounders, worsened depressive symptoms remained associated with more frequent preterm birth (adjusted odds ratio, 1.68; 95% confidence interval, 1.10-2.57). Women with depression symptoms that worsen as pregnancy progresses have increased odds of preterm birth. Future research is warranted to optimize and implement effective prevention, screening, and treatment protocols for antenatal depressive symptoms as a strategy to prevent preterm birth.

Genetic Polymorphism of rs13306146 Affects α2AAR Expression and Associated With Postpartum Depressive Symptoms in Chinese Women Who Received Cesarean Section.

Postpartum depressive symptom (PDS) is a common psychological and mental disorder after giving birth. Our previous studies showing the application of dexmedetomidine, an α2-AR agonist, can significantly improve maternal sleep, as well as relieve and reduce the incidence of PDS. This study investigated the association between α2AAR gene polymorphisms and PDS. A total of 568 cesarean section patients were enrolled; the incidence of PDS is 18.13% (103 with PDS, 465 with non-PDS). The Edinburgh Postpartum Depression Scale score ≥10 was used to diagnose PDS at 42 days after delivery. The single-nucleotide polymorphisms of α2AR were sequenced by pyrosequencing. The effect of rs13306146 A > G polymorphism on α2AR transcription and the regulation of miR-646 on α2AR expression were assessed by dual luciferase reporter assays or gene transfection. Increased stress during pregnancy, poor relationship between mother-in-law and daughter-in-law, spousal relationship, domestic violence, antenatal depression, self-harm ideation, and stressful life events were all associated with increased PDS incidence (p < 0.05). The logistic regression analysis found that the α2AAR rs13306146 polymorphism was associated with PDS after adjusting confounding variables. The transcriptional function of the α2AAR rs13306146 A allele was decreased compared with the G allele, and the α2AAR expression level was correspondingly decreased (p < 0.05), as the strongest binding ability of miR-646 to the α2AAR rs13306146 AA genotype. The effect of α2AAR rs13306146 A > G polymorphism may change the binding ability of miR-646 at the 3′UTR of the α2AAR gene, affecting the expression of α2AAR. This study supports the involvement of the norepinephrine system in the pathogenesis of PDS. Genotypes of α2AAR may be novel and useful biomarkers for PDS.