Edinburgh Postpartum Depression Research Articles

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.

The Effect of Psychological Support Intervention Based on Structure-Process-Result Three-Dimensional Quality Assessment on Maternal Role Adaptation and Pelvic Floor Rehabilitation Exercise Compliance of Women in Spontaneous Labor.

Objective A case-control study was conducted to explore the effect of psychological support intervention based on structure-process-result three-dimensional quality assessment on maternal role adaptation and pelvic floor rehabilitation exercise compliance. Methods 110 parturients who delivered naturally in our hospital from January 2019 to October 2021 were randomly divided into the control group and the study group. Patients in the former group received routine nursing measures, while patients in the latter group received psychological support intervention based on structure-process-outcome three-dimensional quality assessment (intervention group). Psychological intervention measures include health education, cognitive therapy, behavioral therapy, collective psychological intervention, and happiness therapy. The Edinburgh postpartum depression (PPD) scale and general self-efficacy scale were adopted before intervention, on the day of discharge, and 42 days after delivery. Meanwhile, the mother's role adaptation questionnaire was adopted 42 days after delivery. The PPD, the change of self-efficacy, the function of the pelvic floor, the role adaptation of mothers, and the compliance of pelvic floor rehabilitation exercise in the control group and the intervention group were analyzed. Results There was a significant difference in the EPDS score between the two groups at 42 days after delivery. There was a significant difference in the incidence of depression 42 days after delivery between the two groups (P < 0.05). The score of pelvic floor function in the two groups after intervention was higher than that before intervention, and that in the intervention group was higher than that in the control group (P < 0.05). The score of self-efficacy in the two groups after intervention was higher than that before intervention, and that in the intervention group was higher than that in the control group (P < 0.05). The role adaptation of mothers in the intervention group was better than that in the control group (P < 0.05). The compliance rate of pelvic floor rehabilitation exercise in the intervention group was higher than that in the control group (P < 0.05). Conclusion Psychological support intervention based on structure-process-result three-dimensional quality assessment can effectively enhance the sense of self-efficacy, pelvic floor function, maternal role adaptation, and pelvic floor rehabilitation exercise compliance of parturients and can effectively reduce the incidence of PPD and play a positive role in the prevention of PPD.

The impact of maternal obesity on newborn and maternal health status

BACKGROUND: Obesity and overweight are more common, especially among women of reproductive age. Therefore, the approach to maternal obesity requires a multidisciplinary approach, especially health professionals working in primary care preventive health services.AIM: The aim of the study is to determine the effect of maternal obesity on maternal and newborn health in Al Khansaa Teaching Hospial, City of Mosul, Iraq.MATERIALS AND METHODS: The study, which was planned as à case-control study, was conducted in the Al Khansa Teaching Hospital City of Mosul, Iraq.The inclusion criteria included women in postnatal period in the same Hospital, speaking and understanding Arabic, knowing her pre-pregnancy weight, not having any chronic disease (diabetes, hypertension, trioid diseases, etc.) before pregnancy, pre-pregnancy body mass index (BMI) 18.5–25, those with a BMI &gt;29.9, and those with primary school or higher education were included. The exclusion criteria included multiple pregnancies, without any formal education, physical disability (that prevented the completion of the data collection forms), and mental health problems. Data were collected with the data collection form and Edinburgh Postpartum Depression Scale.RESULTS. The study was completed with 286 women, 142 cases and 144 control groups. There was no statistical difference between the case and control groups in terms of family type and employment status (p&gt;0.050). While the mean age, pregnancy and number of living children of the women in the case group were statistically higher, their educational status was found to be lower (p&lt;0.050). It was found that women with obesity experienced health problems such as urinary tract infection, anemia, gestational diabetes, psychological problems, and preeclampsia/gestational hypertension at a higher rate than women in the control group (p&lt;0.010), and women in the control group gained 13.94±5.29 kg (p=0.001).CONCLUSION In conclusion, it was found that women in the case group experienced pregnancy, early and late postpartum complications at a higher rate than the control group, while there was no difference between the groups in terms of depression at the end of the sixth week postpartum.

Influences of family-centered maternity care nursing on puerperal depression of delivery women during puerperal period

Objective: Discuss the preventive effects of family-centered maternity care nursing on puerperal depression of delivery women during puerperal period and relieve burden of natural delivery women and decrease the possibility of delivery women’s postpartum depression. Methods: 120 natural delivery women in the obstetrics of Yuhuangding Hospital from July 2015 to 2016 were randomly divided into two groups: the control group (n=60) was endowed with the conventional nursing. Delivery women accepted examination of prepartum, instruction of delivery, and conventional nursing of puerperium. The experimental group (n=60) accepted the family-centered maternity care nursing based on the control group. There was no statistical significance on age, cycle of gestation, education level, personal incomes and frequency of gestation (P>0.05) in both group, showing comparability. Before nursing and after one month of postpartum, Self-Rating Anxiety Scale (SAS) and Edinburgh Postpartum Depression (EPDS) were applied to do effect evaluation. Incidence of puerperal depression of delivery women in both groups were observed and compared. Results: By making a comparison on SAS and EPDS between two groups, there was no statistical significance at pre-care nursing in both groups, but scores after birthplace in both groups were slightly reduced by comparing with pre-care nursing. Moreover, significance of the experimental group was less than the control group (P<0.05). The depression rate in the control group was up to 53%, while the experimental group was only 37%. The number of the depression in the experimental group was obviously less than the control group. The difference between them had statistical significance (χ2=9.6, P<0.05). Conclusions: Family-centered maternity care nursing has the important role on relieving puerperal depression and improving life quality of delivery women, thus delivery women will pass through delivery period and puerperium without pressure.

Randomized trial of psychological interventions to preventing postpartum depression among Iranian first-time mothers

Background:The current study was conducted to examine the effect of cognitive behavior therapy on the reduction postpartum mood disorder and increasing the self-esteem of at-risk Iranian mothers.Methods:In this quasi-experimental study, 135 at-risk mothers were selected from the population by means of cluster sampling and randomly assigned into one of two groups: Intervention (n = 64), or control (n = 71). The control group received usual medical care, and the intervention group received an eight sessions’ cognitive behavior program during pregnancy. Assessments were administered at two time points (pretest at the beginning of the third trimester and posttest at 2 weeks postpartum). Beck anxiety, beck depression, Edinburgh postpartum depression, (PPD) Coopersmith self-esteem, and religious attitude questionnaire were used to collect data.Results:The mean age of participants was 25.8 ± 3.7 years. One-third of them had either bachelor or higher degrees in education (33%). About two-third of participants were unemployment with similar distribution in both the groups (intervention = 80%, control = 83%). The majority (70%) of the participants had cesarean section deliveries. There were no statistically significant differences respects to sociodemographic characteristics between the control and intervention groups (P > 0.05). The multivariate analysis of covariance results showed that the average scores of PPD were reduced significantly in the intervention group (P < 0.001). Also while the mean score of anxiety in the intervention group decreased from 23.31 (standard error [SE] =12.11) to 16.64 (SE = 8.33) and self-esteem increased from 29.09 (SE = 3.51) to 31.81 (SE = 2.76), no change was statistically significant in comparison to the control group.Conclusions:According to the findings of the present study, cognitive behavior intervention is effective in reducing PPD in at-risk mothers.

Intimate Partner Violence as a Risk Factor for Postpartum Depression Among Canadian Women in the Maternity Experience Survey

Intimate partner violence is a worldwide public health concern that predominantly affects women of reproductive age. The purpose of this study was to evaluate the effect of exposure to intimate partner violence before, during, or after pregnancy on postpartum depression in a nationally representative sample of Canadian women. A cross-sectional analysis was performed with the use of data from the Maternity Experience Survey conducted by Statistics Canada in 2006. A population-based sample of 8542 women 15 years and older who delivered singleton live births was selected from all Canadian provinces and territories; of those, 6421 completed a computer-assisted telephone interview. Recent experiences with and threats of physical or sexual violence by an intimate partner were examined in relation to postpartum depression assessed through the Edinburgh Postpartum Depression Scale. The prevalence of postpartum depression was 7.5% (95% confidence interval, 6.8-8.2). Controlling for confounders, odds of postpartum depression were significantly greater among women who reported partner violence in the past two years as opposed to those who did not (adjusted odds ratio, 1.61; 95% confidence interval, 1.06-2.45). Intimate partner violence is positively associated with postpartum depression among Canadian women. Implications for healthcare practice are discussed.

Maternal psychological problems associated with neonatal intensive care admission.

Background. Mothers of infants admitted to a neonatal intensive care unit (NICU) are believed to have heightened distress. The purpose of this paper was to determine depression and anxiety symptoms and attachment style in NICU mothers. Methods. The NICU group consisted of mothers whose infants were admitted to the NICU and the control group consisted of mothers of healthy term infants. The psychosocial assessments were done at the first month. Results. The mean Edinburgh Postpartum Depression (EPDS) score of NICU mothers was significantly higher than that of the control group mothers (9.6 ± 5.6 versus 7.3 ± 4.9, P = .005). NICU mothers who had high EPDS (≥13) scores had significantly higher anxiety scores and insecure attachment style in comparison to the subgroup of NICU mothers who had low EPDS scores. Conclusion. Mothers of NICU babies had higher EPDS scores. Mothers who had higher EPDS scores had higher anxiety scores as well. These NICU mothers should receive appropriate counseling during the hospitalization of their babies.