Edinburgh Postpartum Depression Scale Research Articles

India’s Silent Struggle: A Scoping Review on Postpartum Depression in the Land of a Billion Mothers

Background: Postpartum emotional issues, including postpartum blues, postpartum psychosis, and postpartum depression (PPD), affect many mothers worldwide. The prevalence of postpartum blues ranges from 300 to 750 per 1,000 mothers, while postpartum psychosis has a prevalence of 0.89–2.6 cases per 1,000 births. PPD affects 100–150 new mothers per 1,000 births, and its prevalence can go above 25% globally. Depression in mothers can have long-lasting impacts on children and the next generation, affecting their growth, development, and relationships. However, the condition of PPD is frequently misdiagnosed, and women who suffer from it do not receive treatment. There is a lack of solid systematic evidence that looks at the overall burden of PPD and the risk factors that are associated with it in India. The awareness of PPD is critical in managing the symptoms and seeking professional support, and studies are needed to evaluate and assess the situation in India. Methodology: This study is a systematic literature review with a scoping review approach aimed at providing existing evidence on the awareness and prevalence of PPD in India. The search strategy for the electronic bibliographic search included a list of related terms and factors of awareness and prevalence of PPD. The search encompassed six prominent databases. The assessment tools used in studies from 2012 to 2023 study the factors using the Postpartum Depression Literacy Scale (PoDLiS) and the Edinburgh Postpartum Depression Scale, which measure the awareness and prevalence of PPD. Results: The study found a significantly low volume of studies conducted in India to determine the prevalence of PPD. The materials or studies accessible are hospital-based research with a minimal number of samples. The reported prevalence rate of postpartum depression (PPD) in India varies across different studies, ranging from 4% to 48.5%. Among mothers who gave birth either naturally or by cesarean section in a hospital setting, one study reported the lowest prevalence rate (4%). The prevalence of PPD among women in India is estimated to be 18% based on the average score across all research. A study that evaluated the moms in the community found that PPD was prevalent in new mothers at a rate of 21.5%. There are three studies, in particular, that focus on how aware people are of PPD. Two studies found that 54% of the family members of postpartum moms and women undergoing tertiary pediatric care are aware of PPD. Discussion: Many studies point to the lack of social support as a significant risk factor for mental health complications after delivery. History of depression, anxiety, adverse life events, partner abuse, low economic status, complications at childbirth, and a traumatic childbirth experience are some of the associated factors identified in the studies. Studies have also shown that women who undergo a cesarean section have a higher risk of developing PPD than those with a vaginal delivery.

Implementation and evaluation of the WHO maternity care model: a convergent parallel mixed-methods study protocol.

According to the World Health Organization (WHO), intrapartum care is considered a platform for providing respectful, personalized, and women-centered services to women. This study aims to investigate the intrapartum care model proposed by WHO. This convergent parallel mixed-methods study will be carried out in qualitative and quantitative phases. In the quantitative phase (a quasi-experimental study), 108 pregnant women admitted to the maternity ward will be randomized to intervention (receiving intrapartum care based on the WHO model) and control group (receiving routine hospital care) before the beginning of the active stage of labor (cervix dilatation equal to 5 cm) and Wijma's delivery fear scale (DFS) will be completed for them and again at 7-8 cm dilatation. The participants of both groups will be followed up for 6 weeks after labor and then they will be invited to a relatively quiet place to complete the Childbirth Experience Questionnaire (CEQ 2.0), the Edinburgh Postpartum Depression Scale (EPDS), the Post-Traumatic Stress Disorder (PTSD) Symptom Scale (PSS-I), the Pregnancy and Childbirth Questionnaire (PCQ), exclusive breastfeeding and a checklist on willingness to give birth to another child. The qualitative phase will employ content analysis to explain mothers' views about the effects of this model especially subjective components of this model on their labor process after 4-6 weeks. The two phase's results will be discussed in combination. The implementation of such care models is expected to prevent mental disorders caused by negative experiences of childbirth, and also, prevent uncontrolled increases in cesarean sections. https://fa.irct.ir/user/trial/68313/view, identifier (IRCT20120718010324N69).

The effect of music played to new birth mothers on postpartum blues: A randomized controlled trial

BackgroundPostpartum blues/postpartum maternal blues is a psychological disorder experienced by mothers with symptoms of postpartum sadness, easy crying, easy anxiety, sensitivity, indecisiveness. The study aimed to examine the effect of music played on newly delivered mothers on postpartum blues. MethodsA prospective, two-arm, randomized controlled study was conducted on n = 82 (41 = control, 41 = music group) mothers who gave birth at term in Trakya University Health Research and Application Center Maternity Service between May and December 2023. The research data were collected through the Personal Information Form, Stein Blues Scale (SBS), and Edinburgh Postpartum Depression Scale (EPDS). The scales used in the study were evaluated four times: postoperative 0–3 h, 12th, 24th, and 36th hours. ResultsThe postoperative 0–3 h SBS test median of the new mothers in the music group was 19.00, and the 36th hours test median was 2.00, while the postoperative 0–3 h SBS test median of the control group was 21.00, and the 36th hour test median was 13.00. The postoperative 0–3 h EPDS test median of the new mothers in the music group was 22.00, and the 36th hours test median was 0.00, while the postoperative 0–3 h EPDS test median of the control group was 26.00, and the 36th hours test median was 10.00. A significant difference was found in the 12th, 24th, and 36th hours (p < .001). A statistically significant high positive correlation was found between EPDS and SBS in the 12th, 24th, and 36th hours (p < .001). ConclusionsIn the study, it was found that music played to newly delivered mothers reduced postpartum blues and depression levels. RegistrationThe submission date for a clinical trial protocol is prior to completing participant recruitment and for a systematic review, prior to completing full paper screening. NCT06252155

Analysis of the correlation between general postpartum well-being and depression in primiparas: A cross-sectional study.

To investigate the status quo and influencing factors of general postpartum well-being in primiparas, analyze its correlation with postpartum depression, and provide a theoretical foundation for enhancing the postpartum well-being of primiparas. From the start of November 2021 to the end of December 2021, the General Information Questionnaire, General Well-Being Scale, and the Edinburgh Postpartum Depression Scale were used to survey primiparas in a tertiary hospital, and the correlation between general well-being and postpartum depression was analyzed. We surveyed a total of 225 primiparas. The average score for general well-being in primiparas was 77.84 ± 6.83, and the total score for postpartum depression was 9.11 ± 2.51. Confinement location, planned pregnancy, pregnancy complications, neonatal sex, medical expenses, etc, had statistically significant effects on the general well-being scores (P < .05), whereas per capita monthly income, pregnancy complications, maternal and infant care skills, and medical expenses had statistically significant effects on postpartum depression scores (P < .05). Postpartum depression scores were negatively correlated with general well-being, health anxiety, energy, sad or happy mood, relaxation, and tension. There is a negative correlation between the general well-being of primiparas and postpartum depression, suggesting that in clinical care, the focus should be on primiparas with pregnancy complications, and psychological counseling should be provided in advance to prevent postpartum depression and the resulting decrease in well-being.

Depression in pregnant Hispanic women: Risk factors, pregnancy outcomes and plasma cytokines

BackgroundMaternal depression is considered a major contributor to morbidity and mortality in pregnancy. A population at risk are U.S. born or immigrant Hispanic women, and few prenatal depression or immune studies have focused on this population. ObjectiveThe research questions for the study were 1) What are the occurrences, risk factors and outcomes associated with depression in Hispanic pregnant women in the United States and 2) What are the associations of plasma immune cytokines and prenatal depression in this population. Study designWomen of self-reported Hispanic ethnicity were born in the continental United States or foreign-born. Screening of potential participants (n = 690) at a first prenatal clinic visit consisted of antibody testing for Toxoplasma gondii antibodies in a larger grant, and only the women with antibody levels below the cutoff for T. gondii positivity (N = 536) were included in the present study. All participants completed a health and demographic questionnaire, the Edinburgh Postpartum Depression (EPDS) scale, the Perceived Stress Scale (PSS), and the Medical Outcomes Study Social Support (MOS) scale. We surveyed electronic health records (EHR) for risk factors and adverse pregnancy outcomes in the sample. We further measured physical and mental health and seven plasma immune cytokines at four study visits during pregnancy in a longitudinal subsample (N = 128). ResultsThe frequency of EPDS scores of 10 (depression risk) or above was 18.6 % at the time of enrollment. Socioeconomic factors such as less education, greater unemployment, and U.S. born nativity were associated with greater depression risk, but these relationships became insignificant when we corrected for false discovery rate. Depression scores were not associated with adverse birth and pregnancy outcomes. The inflammatory cytokine TNF-α was significantly higher across pregnancy in women with depression risk (p < 0.03). Other inflammatory cytokines were higher in depressed women, but only at one time point in mid-pregnancy. ConclusionsPrenatal depression occurs in early pregnancy and then declines in Hispanic women. The frequency of depression and stress were higher in U.S. born compared to immigrant Hispanic women. There was an elevation in plasma levels of TNF-α through the pregnancy in depressed women, and elevations in other cytokines, at midpregnancy. The adverse pregnancy outcomes, including preterm delivery, known to be associated with prenatal depression were not present in this cohort.

GAMBARAN KEJADIAN BABY BLUES PADA IBU POSTPARTUM DI KOTA MEDAN

Postpartum depression in postpartum mothers usually begins with the postpartum blues or baby blues. Baby blues syndrome is often considered not very important and is arely considered, because even if many experience it, it is often only seen as a side effect of fatigue after giving birth. But basically abby blues are very dangerous for the healt of postpartum mothers and also dangerous for their babies. The purpose of this research is to find out how the prevalence of abbay blues in the city of Medan, North Sumatera. The samples taken in this study were 80 postpartum mothers. The method used is descriptive quantitative research with primary data collection through questionnaire interviews according to the Edinburgh Postpartum Depression Scale. The result of study can be stated that many mothers experience baby blues as much as 92,5% of respondents. Mothers who experienced the incidence of baby blues from the age of &lt;20 were 56,25%. As well as the incidence of postpartum blues in primipadra mothers as much as 72,52%. Symptoms of postpartum blues are characterized by the presence of disturbances such as reaction of depression or sadbess, crying,irritability, anxiety, feeling unstable, tending to blame oneself, impaired appetite.

The Effect of Spousal Support on Postpartum Depression and Quality of Life

Objective: The study was conducted to determine the effect of spousal support on postpartum depression and quality of life.&#x0D; Methods: The descriptive and correlational study was conducted with 201 mothers between the 4th and 12th week postpartum in a Lokman Hekim Hospital of Ankara. The data were collected with the Personal Information Form, the Spouse Support Scale, the Edinburg Postpartum Depression Scale, and the World Health Organization Quality of Life Scale-Short Form. The data were evaluated using the SPSS 22.0 program, parametric methods, correlation and regression analyses and descriptive statistics. &#x0D; Results: The mean scores of the participants were 66.23±18.19 on the Spouse Support Scale, 6.14±7.90 on the Edinburg Postpartum Depression Scale and 15.09±3.72 on the World Health Organization Quality of Life Scale. The postpartum depression rate was 25.4%. There was a negative and high correlation between the Spouse Support Scale and the Edinburgh Postpartum Depression Scale (r=-.84, p

Influencing factors of sleep quality in pregnant: a structural equation model approach

BackgroundTo describe the changes in the level of sleep quality during pregnancy among pregnant women in Urumqi; also to construct a structural equation model of the factors influencing the sleep quality of pregnant women, to analyze the path relationship between the influencing factors, and to take reasonable interventions to prevent and reduce the occurrence of sleep disorders among pregnant women.Methods986 pregnant women who gave birth in Urumqi Maternal and Child Health Hospital and Urumqi Youai Hospital between August 2021 and May 2023 were selected. The Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Edinburgh Postpartum Depression Scale (EPDS) were used to assess the sleep, anxiety, and depression of pregnant women, Building a structural equation model based on AMOS 23.0 Tools.ResultsThe results of structural equation modeling showed that: basic characteristics, obstetrical characteristics, tocolysis, lifestyle, psychological had a direct effect on the PSQI, with path coefficients of 0.243, 0.106, 0.140, 0.174, 0.658, the corresponding T-values for each path are 4.585, 2.677, 2.578, 2.297, and 9.036. The indirect effect of basic characteristics, obstetric characteristics and lifestyle on PSQI was 0.123, 0.020, 0.027.ConclusionsThe high incidence of sleep disorders in pregnant women and their close association with psychological symptoms in pregnant women should focus on screening and counseling regarding psychological disorders in pregnant women, thus improving the quality of sleep in pregnant women.

The effect of antepartum depressive and anxiety symptoms on mother-infant interaction: The mediating role of antepartum maternal emotional stress

Anxiety disorders, depression, and emotional stress during the antepartum period are interlinked with adverse child development. The quality of the dyadic interaction seems to play a crucial role in the transmission of these effects. In this study, we explored the mediating effect of antepartum maternal emotional stress (assessed via the Prenatal Emotional Stress Index) regarding the relationship of antepartum maternal depressive (assessed via the Edinburgh Postpartum Depression Scale), anxiety symptoms (assessed via the Stat-Trait-Anxiety-Inventory), and depressive and anxiety disorders (assessed according to the DSM-IV-TR) in the antepartum period on postpartum interactive quality in a longitudinal design. The Face-to-Face-Still-Face Paradigm (FFSF) and the Infant and Caregiver Engagement Phases (ICEP-R) coding system were used to assess the postpartum interactive qualities of the mother-infant dyads. The sample consisted of 59 women, 38 in the clinical and 21 in the control group. We found significant indirect effects of antepartum depressive symptoms and maternal diagnostic status on the mother’s neutral engagement and on the latency to the first social positive interactive match during the interaction – effects that were mediated by antepartum stress. Moreover, there was an indirect effect of state anxiety on neutral engagement – mediated by antepartum stress. Therapeutic intervention studies focusing on maternal antepartum regulation of emotional stress and postpartum interactive patterns might be crucial to encounter maladaptive developmental trajectories.

Social support during pregnancy and the risk of postpartum depression in Polish women: A prospective study

Social support has been proposed as an important determinant of women's physical and emotional well-being during pregnancy and after childbirth. Our study aimed to examine the association between the risk of postpartum depression (PPD) and perceived social support during pregnancy. A web-based prospective study survey was conducted among Polish women. The level of social support was measured with the Berlin Social Support Scales during pregnancy. Four weeks after the birth the risk of PPD was assessed using the Edinburgh Postpartum Depression Scale. Data from 932 mothers aged 19–43 (mean 30.95; SD 3.83) were analyzed using multinomial logistic regression. Higher perceived available support (emotional and instrumental), currently received support (emotional, instrumental and informational), satisfaction with the support, and sum of score were all associated with lower risk of PPD, after controlling for selected covariates (woman's age, socioeconomic status, parity status, place of residency, education, child's Apgar score, type of delivery, complications during birth, kin assisting the labor, breastfeeding). Our results suggest that the more social support the pregnant woman receives, the lower is her risk of PPD. Since humans evolved as cooperative breeders, they are inherently reliant on social support to raise children and such allomaternal help could improve maternal well-being.

Placental corticotrophin-releasing hormone trajectories in pregnancy: Associations with postpartum depressive symptoms

ObjectiveDepressive symptoms following birth are common and can have adverse effects for mothers, children, and families. Changes in hypothalamic-pituitary-adrenal (HPA) axis regulation during pregnancy may be implicated in the development of postpartum depressive symptoms, particularly changes in placental corticotropinreleasing hormone (pCRH). However, few studies have tested how dynamic pCRH changes over pregnancy relate to postpartum depressive symptoms. This preregistered investigation tests associations of both pCRH levels and changes from early to late pregnancy with postpartum depressive symptoms. Methods: The sample consists of 173 women studied in early, mid, and late pregnancy who later reported on depressive symptoms with the Edinburgh Postpartum Depression Scale during interviews at 1, 6 and 12 months postpartum. Blood samples were collected at each prenatal timepoint and assayed for pCRH using radioimmunoassay. Latent growth curve analysis was employed to identify distinct trajectories of pCRH during pregnancy.Results: We identified three prenatal pCRH trajectories labeled as typical, flat, and accelerated. Each trajectory showed exponential increases in pCRH levels over the course of gestation but differed in overall levels and rates of change. pCRH levels were not associated with postpartum depressive symptoms. However, women with accelerated pCRH trajectories reported marginally higher depressive symptoms one month postpartum. Primary analysis models adjusted for marital status, income, prepregnancy BMI, parity, prenatal depressive symptoms, and gestational age.Conclusions: These findings add to our understanding of dynamic changes to maternal HPA axis regulation during pregnancy and contribute to growing evidence on how pCRH changes relate to the development of postpartum depressive symptoms

The Effect of Information Motivation Behavioural Skills (IMB) Model Based Postpartum Sexual Counselling on Sexual Health of Women

Aim: The aim of this study was to determine the effect of postpartum sexual counseling provided using the Information-Motivation-Behavior (IMB) model on women's sexual health.&#x0D; Materials and Method: This semi-experimental study was completed with 105 people, including 55 postpartum women in the experimental group and 50 people in the control group. Postpartum sexual counseling based on Information-Motivation-Behavioral skills was given to the women in the experimental group.The Female Sexual Function Questionnaire Index (IFSF), Edinburgh Postpartum Depression Scale (EPDS), and Body Image Scale (BCS) were used to obtain the data.&#x0D; Results: In the repeated measurements of the experimental group made in the 2nd and 4th months postpartum; It was determined that the IFSF total score and Sexual Satisfaction subscale scores were higher than the control group and the difference between them was statistically significant. In the 4th month postpartum, the EPDS scores of the experimental group were significantly lower. BCS scores were found to be lower in the experimental group than the control group at the 2nd and 4th months.&#x0D; Conclusion: It was determined that postpartum sexual counseling using the IMB model positively affected women's sexual health.

Association of Postpartum Depression with Maternal Serum Magnesium Levels, Infant Growth, and Neurodevelopmental Indices.

Postpartum depression (PPD) can exert both short-term and long-term effects on a child's health. Offspring born to mothers who suffer from PPD face an elevated susceptibility to encountering psychological disturbances and developmental delays. Moreover, there has been conjecture surrounding a plausible connection between maternal magnesium (Mg) levels and psychiatric manifestations. This study aims to investigate the relationship between maternal Mg levels and PPD and the correlation between PPD and an infant's growth and neurodevelopment at 6 and 12 months. This longitudinal study is a sub-study derived from the "PERSIAN Birth Cohort Study," encompassing 224 mother-infant pairs randomly enlisted during 2019-2020 in Isfahan. Maternal serum magnesium (Mg) levels were measured at 38 weeks of gestation. PPD was evaluated employing the Edinburgh Postpartum Depression Scale (EPDS) four weeks postpartum. Measurements of birth size were undertaken, adhering to standardized protocols at birth, 6 months, and 12 months. Anthropometric parameters and the Persian version of the validated Ages and Stages Questionnaires (ASQ) were employed to assess infant neurodevelopmental status at 6 and 12 months. Overall, 22.3% of mothers grappled with PPD. The mean (standard deviation) maternal magnesium levels (Mg) were 1.95 ± 0.23 mg/dL. No statistically significant association was detected between maternal serum magnesium (Mg) levels and the incidence of PPD. Correspondingly, no significant association emerged between PPD and indices of growth. However, a noteworthy distinction materialized in the communication scores of offspring born to depressed and non-depressed mothers following adjustments for confounding variables at 12 months (β = 1.81; 95% confidence interval: 0.32-3.30). Furthermore, a substantial regression in communication skills became apparent between 6 and 12 months. This study failed to establish a significant association between maternal serum magnesium (Mg) levels and PPD. Nevertheless, research lends credence to an inverse correlation between maternal depression and subsequent behavioral difficulties in offspring, such as communication skills. Thus, the imperative nature of screening for PPD should be underscored to facilitate its early detection and intervention, thereby enhancing infant well-being.

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.

The relationship between postpartum negative life events and postpartum depression: a moderated mediation model of neuroticism and psychological flexibility

BackgroundPostpartum depression (PPD) is a major public health problem worldwide. Previous studies have shown that postpartum negative life events and neuroticism are both important risk factors for PPD. However, few studies have considered the role of protective factors in the influence of postpartum negative life events and neuroticism on PPD. Based on the diathesis–stress model and Acceptance and Commitment Therapy (ACT), a moderated mediating model was established to examine the mediating role of neuroticism between postpartum negative life events and PPD, as well as the moderating role of psychological flexibility in this mediating effect.MethodsA sample of 776 parturients from three different Grade A hospitals in China were assessed using the Edinburgh Postpartum Depression Scale, the Postpartum Negative Life Events Scale, the Neuroticism Subscale of the Big Five Personality Scale, and the Acceptance and Action Questionnaire– II.ResultsPPD, postpartum negative life events, neuroticism, and experiential avoidance were significantly positively correlated with one another. Neuroticism partially mediated the relationship between postpartum negative life events and PPD. In this mediation model, the direct path and the second half of the mediation path were moderated by psychological flexibility. Specifically, the links between postpartum negative life events and PPD, as well as between neuroticism and PPD, were stronger when psychological flexibility was low, but weaker when psychological flexibility was high.ConclusionsThe results show that psychological flexibility plays an important role in buffering the negative effects of postpartum negative life events and neuroticism on PPD. These findings provide implications for the prevention and intervention of PPD using an ACT approach.

Self-harm thoughts among postpartum women - associated factors

ABSTRACT Background Even though in many countries suicide is the leading cause of maternal deaths during the postpartum period, the prevalence of thoughts of self-harm (SHTs), an important risk factor for suicide attempts, is still not well documented. Aim We aimed to investigate the prevalence of SHTs in a Polish cohort of postpartum women and identify socio-demographic and maternal mental health factors associated with experiencing SHTs. Method 1545 women took part in a midwife-led postpartum depression (PPD) screening. 337 of them reported SHTs. The Edinburgh Postpartum Depression Scale (EPDS) was administered. Specifically, we used an abbreviated 5-item version to assess depression symptoms, item 10 to assess SHTs, a composite score of items 1 and 2 - anhedonia, and a composite score of items 3, 4, and 5 - anxiety. Logistic regression analyses were performed to examine associations between variables. Results Approximately 2% (n = 337) of women self-reported experiencingSHTs. Within the group of postpartum mothers who self-reported SHTs, 65.60% (n = 221) manifested the symptoms of PPD, and 56.40% (n = 190) - of anxiety. The symptoms of PPD, a mood disorder diagnosed in the past, and younger age were predictors of SHTs. Conclusion The results of this study can contribute to the development of prevention strategies: analysing separately items from PPD screening questionnaires focusing on SHTs can be an important part of prevention. The lack of the symptoms of PPD and anxiety risk does notexclude experiencing SHTs.

Postpartum depression: combining a mobile application with recititations from the Holy Quran in Indonesia

Background/Aims The incidence of postpartum depression in Indonesia is greater than the global average, and has detrimental effects on mothers, families, society and the country. Mobile applications are widely used to treat postpartum depression, but combining this with readings from the Holy Quran is uncommon in Indonesia. This study aimed to investigate the effect of combining mobile applications with the Holy Quran on postpartum depression symptoms. Methods A randomised controlled pre-post-test time series was conducted from June to December 2020, involving 128 pregnant women in their third trimester. The ‘app’ group (64 participants) received the intervention until 2 months postpartum, while the control group (64 participants) received no intervention. The Edinburgh postpartum depression scale, state-trait anxiety inventor, and the Rosenberg self-esteem scale were used to gather data. Results Postpartum depression scores in the app group were significantly lower than in the control group. There were no differences in the anxiety or self-esteem scores between the app and control groups. The proportion of depression scores of 10 and above decreased by 25% in the app group and 7.8% in the control group. Conclusions Use of a mobile application in combination with the Holy Quran voice may help reduce postpartum depressive symptoms in Indonesia. Maternity nurses and midwives may wish to recommend use of this app to the women they care for, if appropriate.

Pre-pregnancy BMI Association with Maternal Phenotype and Offspring Neurobehavioral Outcomes

BackgroundAllostatic load due to chronic exposure to physiological or psychological stressors lead to compromised capacity of the body to maintain homeostasis. Obesity as a metabolic stressor is associated with a suboptimal physiological milieu including an inflammatory state and a dysregulated stress axis. Perinatal maternal body mass index (BMI) impacts pregnancy, birth outcomes, and child metabolic and neurodevelopmental health. We examine the impacts of pre-pregnancy BMI on maternal phenotype characteristics throughout pregnancy and fetal heart rate measurements as an early marker of programming effects of altered autonomic nervous system and infant neurobehavioral outcomes with a focus on sex-dimorphic effects. MethodsPregnant women (n=176) attended sessions at gestation weeks 12-22, 23-28, and 34-36, where blood was collected for cytokine analysis and DNA methylation, and Edinburgh post-partum depression scale was administered. On the latter two visits, heart rate assessment was carried out for mothers and fetuses. ResultsMaternal high BMI was associated with higher perinatal depression, increased inflammation, and reduced heart rate variability. DNA methylation of maternal blood indicated enrichment in immune related biological processes. Moreover, we observed a decrease in fetal heart rate variability in female fetuses of women of high BMI, indicating alteration in the neurobehavioral development of the fetus. In infancy, female infants of high BMI mothers had reduced behavioral regulation and orientation to stimulus. ConclusionThis work highlights that the metabolic stress associated with BMI could leave a molecular fingerprint that could explain other maternal physiological and psychological outcomes, which in turn program the fetal neurodevelopmental outcomes.

Effect of online health training/counseling and progressive muscle relaxation exercise on postpartum depression and maternal attachment: A randomized controlled trial.

To evaluate the effect of online health training/counseling and a progressive muscle relaxation exercise (PMRE) program on postpartum depression and maternal attachment. The present study was a randomized, controlled, experimental trial. Participants were asked to complete the Prenatal Attachment Inventory (PAI) and the Edinburgh Postpartum Depression Scale (EPDS) at 35 weeks of pregnancy. Group assignment was done by stratified block randomization according to EPDS score (0-9, 10-30) and parity. Women in the experimental group received training in progressive muscle relaxation, postpartum depression, and maternal attachment via online video calls twice a week starting at 36-37 weeks of pregnancy. They were asked to complete the PMRE program from 36 weeks of pregnancy until 6 months postpartum, and online counseling was provided throughout this period. Participants completed the Maternal Postpartum Attachment Scale (MPAS) and the EPDS at 6 weeks postpartum. Mean PAI score was 64.24 ± 9.61 in the experimental group before the intervention and 62.14 ± 10.13 in the control group. The mean EPDS score of the experimental group was 9.12 ± 5.05 and the mean score of the control group was 9.77 ± 6.30 (P > 0.05). The mean MPAS score after the intervention was 13.92 ± 5.54 in the experimental group and 17.51 ± 6.12 in the control group. The mean EPDS score of the experimental group was 3.40 ± 3.00 and the mean score of the control group was 11.40 ± 5.91 (P < 0.05). Online health training/counseling and PMRE reduce the risk of postpartum depression and increase maternal attachment.

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.