Higher Rates Of Postpartum Depression Research Articles

Feasibility and acceptability of a community health worker administered behavioral activation intervention for postpartum depression: a single arm pilot study from India.

Women in India experience high rates of postpartum depression (PPD), with minimal availability of screening or treatment. India has an extensive network of community health workers, known as accredited social health activists (ASHAs). While they are knowledgeable about most maternal-child health problems, they have minimal knowledge about PPD. We trained ASHAs to deliver a simple home-based intervention, behavioral activation (BA), which involves individuals in activities that are sources of positive reinforcement to counter depression. The research questions guiding this study were as follows: 1) What are the feasibility and acceptability of ASHAs screening for and delivering a brief behavioral activation intervention addressing PPD among women in Belagavi, South India? 2) What impact did the brief behavioral activation intervention have on PPD? The mixed methods evaluation used interviews with participants and interventionists, and depression scores were assessed before and after the evaluation. After a 2-day training with 17 ASHAs that focused on understanding PPD, screening using the Edinburgh Postnatal Depression Scale (EPDS), and implementing the BA protocol, ASHAs and researcher supervisors screened the mothers 6-12 weeks postpartum presenting at pediatric immunization clinics. Mothers who screened positive were invited to participate in an ASHA-led 5-week BA intervention, with ASHAs visiting the mothers' homes. We assessed post-intervention EPDS scores and conducted satisfaction assessments and individual interviews. All 26 women who screened positive on the EPDS agreed to be enrolled in the study. All participants had a significant reduction (p < 0.001) in PPD scores. Both ASHAs and mothers had high enthusiasm for the intervention methods and activities. This ASHA-delivered BA intervention was found to be feasible, acceptable, and effective in treating PPD in rural Indian mothers. This corroborates literature that demonstrates the efficacy of a BA intervention among individuals with generalized depression in South Asia. In communities with minimal mental health resources, interventions led by trained community workers have the potential to address PPD.

Home Visits for Postpartum Depression Intervention among Low-Income Latinas: Results from the PST4PPD Project

ABSTRACT Research shows that U.S. Latinas are at risk for high rates of postpartum depression (PPD) but have low rates of treatment compared to non-Hispanic White mothers. This study examined the feasibility of a multi-site home-visiting intervention (PST4PPD) conducted by bilingual community health workers (CHW) among low-income Latina mothers. A one-group, pre/posttest design and paired sample’s t-test were used to measure changes in depressive symptoms and self-efficacy for participants (n = 76) across five sites. The Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) were used to assess depression; the New General Self-Efficacy Scale and the Maternal Efficacy Questionnaire measured general self-efficacy and parenting self-efficacy. Depression scores decreased significantly from pretest to posttest. Participants’ general self-efficacy, maternal self-efficacy, and PPD knowledge increased. With a 76% completion rate, demonstrable improvements were seen in participants’ depression and self-efficacy. Implications for addressing modifiable factors such as self-efficacy and stress management are discussed.

Land allotment, transportation access, and indigenous maternal mental health

American Indian/Native Alaskan (AI/AN) mothers experience higher rates of postpartum depression than any other racial group in the United States. In addition, historical forced relocation and decimation of ancestral lands limit AI/AN mothers' access to quality personal or public transportation to access perinatal health care. This study used story inquiry, a decolonizing qualitative approach, to understand the impact of transportation on perinatal care and maternal mental health care access for Keetoowah mothers in Tahlequah, Oklahoma (N = 8). This study includes three themes: (1) transportation access and historical trauma; (2) perinatal health care and transportation, and (3) transportation access and affordability solutions.

Pregnancy in Medical Training: A Survey of Physician Moms on Their Experiences During Residency and Fellowship

Resident physicians undergo physically and emotionally rigorous training; this is particularly difficult for the pregnant resident and affects their unborn child. This study aims to elucidate pregnant residents' perspectives regarding their prenatal and postnatal experiences, across all specialties, with a focus on pregnancy complications, postpartum health, and policy execution. This is a nationwide cross-sectional survey study developed to characterize resident and fellow perceptions about work schedules while pregnant, perceived discrimination, complications during pregnancy, lactation and lactation support, marital distress, parental leave policy, and overall satisfaction with the parental leave period. Descriptive statistics were used to characterize survey responses. The experiences of physician mothers in online Facebook support groups: Physician Mom Group, Surgeon Mom Group, and Dr Mothers Interested in Lactation Knowledge, were queried by an electronic survey distributed using Qualtrics XM. Physicians who had children during their U.S. residency training were eligible to participate and 1,690 physician mothers from all specialties completed the survey. One thousand six hundred and ninety responses from members of the Facebook support groups were analyzed. Most surveyed physicians (1353/1519, 89.1%) were required to work until delivery and 63.6% (993/1561) of women took in-house calls during the last month of pregnancy. Half (820/1560, 52.6%) thought that the physical demands of their jobs compromised their own health and safety, or that of their child, and 1259 complications were reported among 1690 respondents, an average of three complications for every four respondents. Twenty-nine percent (442/1519, 29.1%) of physician mothers suffered from postpartum depression. Ninety-two percent (1479/1602, 92.3%) of respondents breastfed, but only one-third (483/1456, 33.2%) breastfed for more than 12 months and 52.7% (769/1458) would have liked to breastfeed longer. Marital distress was reported by nearly half (756/1650, 45.8%) of respondents during pregnancy and/or the first year of their child's life due to parental leave policies. The majority (957/1688, 56.7%) did not have a parental leave policy at their institution. Nearly two-thirds (946/1518, 62.3%) of respondents took 6 or fewer weeks off, and 79.7% (1211/1520) felt their duration of time off was inadequate. Nearly 30% (457/1593, 28.7%) stated they would recommend against a female medical student going into their field of medicine based upon their own experiences during pregnancy. Many mothers experienced discrimination from colleagues and worked until delivery despite concerns about the health and safety of themselves or their unborn children, and many reported experiencing a pregnancy-related complication. Most did not have a parental leave policy, which likely contributed to the disproportionately higher rates of postpartum depression among physician mothers compared to the general public. Residency training parental leave policies should be more accommodating to improve mental health, career satisfaction, and retention of the next generation of physician mothers.

Husband-wife Relationship, Neonatal Health, Breast Milk Volume and Postpartum Depression: A Prospective Cohort Study

ABSTRACT Postpartum depression (PPD) is a major public health problem that has negative effects on mothers, infants, and society. This study was aimed at investigating the prevalence of PPD and elucidating the delivery factors implicated in PPD so as take more targeted measures for reducing the potential risk factors. A prospective cohort study was conducted. Following the criterion, 151 pregnant women were included in the study. The Edinburgh Postpartum Depression Scale (EPDS) and the general questionnaire were filled out 2–3 days after delivery. At weeks 2 and 6 postpartum, the EPDS was reassessed either online or via telephone. Also, electronic medical records based on relevant information during the delivery period were collected. Statistical significance was defined as p < 0.05. A high rate of PPD (31.13%) was reported. Univariate correlation analysis showed statistically significant differences in the husband-wife relationship (χ2 = 18.497, p < 0.001), neonatal health (χ2 = 14.710, p < 0.001), and breast milk volume (χ2 = 5.712, p = 0.017) between PPD and normal control groups. Adjusting for other covariates, multivariate logistic regression analysis showed that satisfactory conjugal relation could reduce the risk of PPD (OR, 0.053; p = 0.022); Neonatal health problems significantly increase the risk of PPD (OR, 6.497; p = 0.001); Adequate breast milk could alleviate the risk of PPD (OR, 0.351; P = 0.045). Data analysis suggests that marital discord and unhealthy new-born are independent risk factors; nevertheless, sufficient breast milk is a protective factor against PPD. Healthcare workers such as hospital and community doctors and social workers should pay attention to PPD. Furthermore, perinatal emotional support, health education, and EPDS assessment need to be incorporated into maternity care. Screening and personalized psychological counselling should be carried out for high-risk pregnant women with PPD.

Postpartum Depression and Its Contributing Factors among Mothers during the COVID-19 Pandemic in North Jakarta, Indonesia

Background: Postpartum depression is a common psychological problem that occurs after birth. It has become especially prevalent in the era of the COVID-19 pandemic. Several factors contribute to postpartum depression. However, a limited study evaluated factors contributing postpartum depression among mothers during the COVID-19 pandemic, particularly in Indonesia.Purpose: This study aimed to explore postpartum depression among mothers and its contributing factors during the COVID-19 pandemic.Methods: This study adopted a cross-sectional design. A total of 110 postpartum mothers were recruited by accidental sampling with the following inclusion criteria: mothers between one month and one year after birth, married, a singleton birth and the baby alive, and the mother is healthy with no complications. The Edinburgh Postnatal Depression Scale was used to measure postpartum depression. Descriptive statistics, t-test, Fisher exact test, one-way ANOVA, and logistic regression were performed to analyze the data.Results: The prevalence of postpartum depression during the pandemic period was 31.82%. Factors contributing to postpartum depression were the mother’s age (p=0.011), childcare stress (p=0.001), stressful life events (p=0.003), and pregnancy status (p=0.0001). A logistic regression showed that pregnant status (Unplanned/unwanted pregnancy) was the most contributor to postpartum depression (β=0.377, t=5.138, p=0.0001).Conclusion: This study identified a high rate of postpartum depression with related factors, including mother’s age, childcare stress, life stress, and unplanned/ unwanted pregnancy. Screening for postpartum depression is required to ensure early detection among postpartum mothers.

Postpartum Depression Symptoms in Various Sects of Ultra-Orthodox Society in Israel.

Ultra-Orthodox society in Israel is characterized by a higher birth rate than Israeli Jewish society. This study investigated the association of reproductive experiences among different sects of 254 ultra-Orthodox women with symptoms of postpartum depression (PPD) and general depression, controlling for demographic features. PPD symptoms were found among 22% of the participants, with Sephardic women with higher rates of symptoms (34%) than women from the Lithuanian sect (16%) and Hasidic women (14%), and those who were formerly secular also had higher rates of PPD (33%) compared to 19% among those born ultra-Orthodox. Implications for health care practitioners are discussed.

Gestational hemodilution as a putative risk factor for postpartum depression: A large-scale nationwide longitudinal cohort study

BackgroundWhile anemia during pregnancy has been linked to increased postpartum depression (PPD) risk, longitudinal studies on the association between gestational hemodilution, represented by decreased hematocrit (Hct) during the transition from the 1st to 2nd trimester, and PPD risk, are scarce. The current study aimed to investigate this association in a nationwide cohort over the perinatal period. MethodsThis retrospective cohort study included 104,715 women who gave birth between January 2008 and December 2015. The cohort was followed up for new-onset PPD during the year post birth and gestational hemodilution was assessed by the change in Hct levels (Δ: 2nd-1st trimester). The cohort was divided into three hemodilution groupings: maximal and minimal 10 % of mothers and intermediate 80 %. Multivariable regression analyses were performed to estimate the association between gestational hemodilution and PPD, adjusting for confounders. ResultsAmong the full cohort, 2.2 % (n = 2263) met the definition of new-onset PPD. Mothers with greater hemodilution had higher rates of PPD: 2.7 % (n = 269) in the maximal hemodilution group, 2.1 % (n = 1783) in the intermediate and 1.9 % (n = 211) in the minimal hemodilution group (p < 0.001). The maximal hemodilution group had higher rates of pre-gestational psychiatric disorders (p < 0.001) and higher adjusted risk for PPD [OR = 1.18, 95 % CI (1.04, 1.35)]. LimitationsData on iron levels and supplementation were unavailable, thus it could not be adjusted for in the analysis. ConclusionsWomen in the top 10th percentile of gestational hemodilution may be at risk for PPD, justifying monitoring of gestational Hct as a biomarker for PPD.

Postpartum Depression in a Community Sample of American Indian Mothers.

American Indian (AI) mothers experience high rates of postpartum depression (PPD). We evaluated the factor structure of the Edinburgh Postnatal Depression Scale (EPDS) among AI mothers from a rural AI serving health system. We also investigated potential associations between EPDS scores and selected psychosocial factors (n = 315). Exploratory Factor Analysis (n = 157) showed that a one-factor structure best fits the data. A Confirmatory Factor Analysis was then conducted to examine the fit of the one-factor model (n = 158). Goodness-of-fit statistics showed overall poor model fit (RMSEA = .13) which may be suggestive of an indicator of depression among Natives not detected by the EPDS. Results of the multiple regression analysis were non-significant. The findings demonstrated that while the EPDS measured aspects of PPD, there may be additional aspects of depression specific to the AI women in our sample not captured by the EPDS. Limitations and directions for future research are discussed.

Prospective Cohort Study of Depression During Pregnancy and the Postpartum Period in Women With Epilepsy vs Control Groups.

Assess the incidence and factors associated with major depressive episodes (MDEs) and symptoms of depression and anxiety during pregnancy and postpartum periods in pregnant women with epilepsy (PWWE) compared with healthy pregnant women (HPW) and nonpregnant women with epilepsy (NPWWE) in comparable timeframes. Previous studies have reported higher rates of postpartum depression in women with epilepsy compared with women without epilepsy. However, the incidence of MDE using a structured interview during pregnancy and postpartum has not been directly compared with control groups, and the comparison of depression and anxiety symptoms and the role of associated factors remain ambiguous. The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational parallel group cohort study of PWWE and their children. This report examines mood disorders. Unlike previous epilepsy pregnancy studies, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (SCID) provided lifetime diagnoses, and repeated SCID mood modules assessed for MDE, the a priori primary outcome. Symptoms of depression (Beck Depression Inventory [BDI] and Edinburg Postnatal Depression Scale [EPDS]) and anxiety (Beck Anxiety Inventory [BAI]) were also assessed along with multiple clinical factors. This study included PWWE (n = 331) and HPW (n = 102) during pregnancy and postpartum and NPWWE (n = 102) at comparable times. No difference in SCID-diagnosed MDE incidence was found across groups, but BDI depressive symptoms were worse during pregnancy in PWWE vs NPWWE and during postpartum vs HPW and NPWWE. BAI anxiety symptoms were worse during pregnancy in PWWE vs HPW and NPWWE and during postpartum vs HPW. Factors associated with MDE during pregnancy/postpartum for PWWE included >1 seizure/90 days, anticonvulsant polytherapy, unplanned pregnancy, and lifetime history of mood disorder. Suicidal ideation from BDI or EPDS was related to BAI anxiety symptoms. Although SCID-based MDE did not differ across groups, this prospective study confirms higher rates of psychiatric symptoms in patients with epilepsy during pregnancy and postpartum, provides new data on associated factors, and underscores the importance of anxiety in risk for depression and thoughts of death/dying or suicide. Given the risks, PWWE should be routinely assessed and symptomatic patients should be offered treatment. This study is registered at ClinicalTrials.gov as NCT01730170.

The Current Role of General Anesthesia for Cesarean Delivery

Purpose of the ReviewThe use of general anesthesia for cesarean delivery has declined in the last decades due to the widespread utilization of neuraxial techniques and the understanding that neuraxial anesthesia can be provided even in urgent circumstances. In fact, the role of general anesthesia for cesarean delivery has been revisited, because despite recent devices facilitating endotracheal intubation and clinical algorithms, guiding anesthesiologists facing challenging scenarios, risks, and complications of general anesthesia at the time of delivery for both mother and neonate(s) remain significant. In this review, we will discuss clinical scenarios and risk factors associated with general anesthesia for cesarean delivery and address reasons why anesthesiologists should apply strategies to minimize its use.Recent FindingsUnnecessary general anesthesia for cesarean delivery is associated with maternal complications, including serious anesthesia-related complications, surgical site infection, and venous thromboembolic events. Racial and socioeconomic disparities and low-resource settings are major contributing factors in the use of general anesthesia for cesarean delivery, with both maternal and perinatal mortality increasing when general anesthesia is provided. In addition, more significant maternal pain and higher rates of postpartum depression requiring hospitalization are associated with general anesthesia for cesarean delivery.SummaryRates of general anesthesia for cesarean delivery have overall decreased, and while general anesthesia no longer is a contributing factor to anesthesia-related maternal deaths, further opportunities to reduce its use should be emphasized. Raising awareness in identifying situations and patients at risk to help avoid unnecessary general anesthesia remains crucial.

223 Pregnancy outcomes of women with cerebral palsy: an international observational study

Our current knowledge about reproductive health and pregnancy in women with Cerebral Palsy (CP) is limited. The lack of rigorous studies in this area may shape discussions with physicians about pre-pregnancy counseling, antepartum and postpartum management, attitudes, and care received. The goal of this study was to examine the reproductive health and pregnancy outcomes of women with CP. This is part of an international observational questionnaire examining pregnancy outcomes of women with CP. Multiple recruitment techniques were employed including partnering with cerebral palsy and disability organizations to distribute information regarding the study, as well as snowball and peer recruitment. A total of 158 participants from 15 countries participated in this study. Most participants (93/140, 66.4%) reported having spastic CP, 27/140 (19.3%) ataxia CP, 15/140 (10.7%) dyskinesia CP and 19/140 (13.6%) mixed CP. 50 births were included in this analysis. 16/50 (32.0%) reported anemia and 10/50 (20.0%) reported hyperemesis. 30/50 participants delivered vaginally (60.0%) and 18/50 delivered via caesarean section (36.0%). Preterm birth <37 weeks occurred in 20.0% of pregnancies (10/50). 8/50 (16.0%) developed preeclampsia, 6/50 (12.0%) developed gestational hypertension and 7/50 (14.0%) developed gestational diabetes. 5/50 (10.0%) of participants were admitted to a high-risk pregnancy unit. 15/50 (30.0%) participants reported experiencing postpartum depression. Women with cerebral palsy appear to be at increased risk of hyperemesis, anemia, preterm birth, gestational diabetes, hypertensive disorders of pregnancy, and admission to high risk pregnancy units during pregnancy. Following pregnancy, women with CP report high rates of postpartum depression. This information may assist in preconception counselling, pregnancy, and postpartum management. Further evaluation regarding identification of risk factors, such as pre-pregnancy health status may aid in better understanding of the etiology of these risks.

Ethnic disparities in receiving benefits for disability following postpartum mental illness during first two years after delivery: an Israeli nationwide study

BackgroundDespite relatively high rates of Postpartum Depression (PPD), little is known about the granting of social security benefits to women who are disabled as a result of PPD or of other postpartum mood and anxiety disorders (PMAD). This study aims to identify populations at risk for underutilization of social security benefits due to PMAD among Israeli women, with a focus on ethnic minorities.MethodsThis retrospective cohort study is based on the National Insurance Institute (NII) database. The study population included a simple 10% random sample of 79,391 female Israeli citizens who gave birth during 2008–2016 (these women delivered a total of 143,871 infants during the study period), and who had not been eligible for NII mental health disability benefits before 2008.The dependent variable was receipt of Benefit Entitlement (BE) due to mental illness within 2 years following childbirth. Maternal age at delivery, population group, Socio-Economic Status (SES), family status, employment status of the mother and her spouse, and infant mortality were the independent variables. Left truncation COX proportional hazard model with time-dependent variables was used, and birth number served as a time discrete variable.ResultsBedouin and Arab women had significantly lower likelihood of BE (2.6 times lower and twice lower) compared with other ethnic groups (HR = 0.38; 95% CI: 0.26–0.56; HR = 0.47; 95% CI: 0.37–0.60 respectively). The probability of divorced or widowed women for BE was significantly higher compared to those living with a spouse (HR = 3.64; 95% CI: 2.49–5.33). Lack of employment was associated with higher likelihood of BE (HR = 1.54; 95% CI: 1.30–1.82). Income had a dose-response relationship with BE in multivariable analysis: lower income was associated with the nearly four-fold greater probability compared to the highest income quartile (HR = 3.83; 95% CI: 2.89–5.07).ConclusionsDespite the exceptionally high prevalence of PMAD among ethnic minorities, Bedouins and Arabs had lowest likelihood of Benefit Entitlement. In addition to developing programs for early identification of postpartum emotional disorders among unprivileged ethnic groups, awareness regarding entitlement to a mental health disability allowance among ethnic minorities should be improved.

"Everything Is Greyscaled": Immigrant Women's Experiences of Postpartum Distress.

Postpartum distress increases the risk of developing mental disorders over a woman's lifespan. Although immigrant women experience a high rate of postpartum depression, we know very little about the psychosocial experiences of postpartum distress in immigrant populations. No theories have been developed to account for the intersection of cultural and maternal transitions or the relationship of this dual transition to postpartum distress. Therefore, this study aims to generate a conceptual model for describing immigrant women's experience of and social-psychological responses to postpartum distress. This study uses grounded theory to conduct and analyze interviews with 22 Chinese immigrant women who experienced postpartum distress. During their dual transitions, participants encountered many losses significant to their psychological self. The conceptual model of greyscaling and reviving the psychological self provides pathways to respond to these losses, assesses the pathways' impact on experiencing distress, and offers strategies that resolve distress.

Impact of maternal stressors and neonatal clinical factors on post-partum depression screening scores

Background Higher rates of postpartum depression (PPD) are reported in mothers of neonatal intensive care unit (NICU) hospitalized infants. The relationship of neonatal clinical risk factors and self-reported maternal stress levels to positive PPD screening is not well characterized. Objective To determine the feasibility of postpartum depression screening in a regional perinatal center, and assess the association of NICU-specific comorbidities and maternal stress levels with PPD screening scores. Design/Methods Prospective study of mothers of NICU-hospitalized infants conducted between 21and 30 days of their infant’s life. Mothers completed the Edinburgh Postpartum Depression scale (EPDS) and the Parental Stressor Scale: NICU (PSS: NICU) in the environmental, infant behavior and parental domains. Total EPDS scores and positive PPD screening were correlated with NICU comorbidities, demographic factors and PSS: NICU scores. Results The incidence of positive PPD screening was 19% (25/135). In bivariate analysis, positive PPD screen was associated with exclusive breastfeeding (67% vs, 35%, p < .05) and maternal age <35 years (32% vs. 12%, p < .05). No observed differences in maternal and infant demographic factors or neonatal comorbidities were seen in mothers with positive PPD screening. Mean PPD screening scores were higher in infants with intraventricular hemorrhage of any grade and necrotizing enterocolitis. In adjusted analysis, overall and domain-specific PSS: NICU scores were associated with positive PPD screening. Conclusion Cumulatively and within each PSS: NICU domain, parental stress correlated with positive PPD screening but was unrelated to NICU comorbidities. Reducing modifiable factors which exacerbate parental stress may impact the incidence of positive PPD screening among NICU mothers.

Postpartum Depression in a Cohort of Post-9/11 Women Veterans: The Role of Military Stress and Trauma

Introduction This study aimed to investigate the relationship between military-related traumatic experiences and postpartum depression in a cohort of post-9/11 women veterans. We hypothesized that women veterans would report high rates of postpartum depression, and that military-related traumas would constitute unique risk factors for postpartum depression. Methods: This cross-sectional study was based on survey data from post-9/11veterans who were discharged and gave birth between October, 2001 and September, 2015. Bivariate and multivariate analyses included military-related trauma variables, demographics, and factors that have been previously associated with postpartum depression in other populations. Results: Based on multivariate analyses of 151 respondents, 41% of women reported a definite or possible history of postpartum depression. Military exposures, namely multiple deployments (OR = 2.41, CI = 1.06-5.50), and combat exposure (OR= 1.05, CI = 1.01-1.10), were predictive of postpartum depression following the most recent, post-deployment pregnancy. Discussion: These findings suggest that military-related factors may increase the risk for postpartum depression among women veterans. Clinicians should be vigilant in screening for military service and exposures to provide early referral and additional support as needed.

The relationship between neonatal encephalopathy and maternal postpartum depression

Purpose: Neonatal hypoxic–ischemic encephalopathy (HIE) is a type of brain injury resulting from insufficient oxygen and blood supply. The standard treatment for HIE is therapeutic hypothermia (TH), which involves a 72-h period of hypothermia, during which time the infant is isolated from his/her parents. The primary objective of this study was to assess the effects of the diagnosis of neonatal encephalopathy and subsequent separation on rates of maternal postpartum depression (PPD) as compared to other hospitalized infants.Materials and methods: Case-control analysis of newborns admitted to the neonatal intensive care unit from 2015 to 2018 was carried out. Maternal PPD symptoms were determined by the Edinburgh Postnatal Depression Scale (EPDS). Demographics, diagnoses, and outcomes were abstracted from clinical records. Associations between EPDS scores and HIE diagnosis and severity, insurance type, marital status, markers of overall illness severity, and the need for neonatal transport were evaluated. Student’s t-test and Fisher’s exact test were used to compare differences in continuous and categorical variables, respectively. A multiple regression model was used to adjust for markers of illness severity.Results: The study found no association between EPDS scores and marital status, overall illness severity, or the need for transport. A trend toward higher EPDS scores was noted in mothers of infants with HIE versus other admission diagnoses (21 versus 10%, p = .09). A similar trend was seen in mothers of infants with severe versus moderate encephalopathy (30 versus 7%, p = .12). Mothers of infants with no insurance (20%) or Medicaid (16%) had higher rates of PPD than those with private (6%) or military insurance (6%) (p = .02).Conclusions: Mothers of infants with HIE are at high risk for PPD, which may be in part related to TH interfering with maternal–infant bonding. These findings support the need for continued universal depression screening with investigation of new methods to reduce stress and improve the bonding experience during and after TH.

Prediction of postpartum depression based on women’s quality of life

Background. Postpartum depression is the most common problem after childbirth. Objectives. To determine the level postpartum depression, quality of life and predict postpartum depression based on the quality of life of women. Material and methods. This was a descriptive cross-sectional study. The research population consisted of women who were reporting to health care centres in Hamadan, Iran, 2 to 4 weeks after delivery. A total of 300 eligible women were selected using the cluster sampling method. The data gathering tool was a questionnaire that consisted of three sections: demographic characteristics, Short Form Health Survey (SF-36) and Edinburgh depression questionnaire. SF-36 was used to measure quality of life, which includes eights dimension. Data was analysed using SPSS version 21. Descriptive statistics, Pearson’ correlation and linear multiple regression analysis were used. Results. The mean age was 28.6 ± 5.2 years. The average quality of life scores in individuals were within a moderate level, the highest score was related to physical function, and the lowest score was related to role impairment due to physical health. Postpartum depression was determined in 25 of women, of which 7 had severe depression. Physical functioning (p = 0.32), role impairment due to emotional health (p = 002), energy/fatigue (p = 0.010), emotional well-being (p = 002) and social function (p = 0.002) were significant predictors of postpartum depression. Conclusions. Considering the high rate of postpartum depression, improving quality of life aspects, early diagnosis of postpartum depression and appropriate care for women after childbirth, especially those of a low socio-economic status, are suggested. © Copyright by Wydawnictwo Continuo.

Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries.

Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD and a meta-regression to identify economic, health, social, or policy factors associated with national PPD prevalence. We conducted a systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To test for country level predictors, we drew on data from UNICEF, WHO, and the World Bank. Random effects meta-regression was used to test national predictors of PPD prevalence. 291 studies of 296284 women from 56 countries were identified. The global pooled prevalence of PPD was 17.7% (95% confidence interval: 16.6-18.8%), with significant heterogeneity across nations (Q = 16,823, p = 0.000, I2 = 98%), ranging from 3% (2-5%) in Singapore to 38% (35-41%) in Chile. Nations with significantly higher rates of income inequality (R2 = 41%), maternal mortality (R2 = 19%), infant mortality (R2 = 16%), or women of childbearing age working ≥40 h a week (R2 = 31%) have higher rates of PPD. Together, these factors explain 73% of the national variation in PPD prevalence. The global prevalence of PPD is greater than previously thought and varies dramatically by nation. Disparities in wealth inequality and maternal-child-health factors explain much of the national variation in PPD prevalence.

The Rate and Risk Factors of Pospartum Depression in Sana’a Yemen

This cross – sectional study was done to assess the rate and risk factors of postpartum depression among women who had given birth between 4 – 6 weeks prior to interview in four public medical centers of Sana’a city over a period from February to July 2016. We administered the Edinburgh postnatal Depression Scale to 642 women. Among these, 97 women had scored ≥ 12, giving the rate of 15.1% of postpartum depression. Mothers with this condition were more likely to have unwanted pregnancy, recent conflict with husbands / family, financial hardship, anxiety and health problems during pregnancy, and difficulties in breastfeeding. The study revealed a high rate of postpartum depression. Although it is recognized that timing and ideal interval for screening is unknown such screening would increase detection, treatment and improve health outcomes of women and their children.