History Of Postpartum Depression Research Articles

Postpartum depression in relation to chronic diseases and multimorbidity in women’s mid-late life: a prospective cohort study of UK Biobank

BackgroundMaternal short-term outcomes of postpartum depression (PPD) were widely examined, but little is known about its long-term association with multiple chronic diseases (multimorbidity) in women’s later life. This study aims to assess the association of PPD with chronic diseases and multimorbidity in women’s mid-late life.MethodsThis prospective cohort study included female participants in UK Biobank who attended online follow-up assessment and reported their history of PPD. A total of 36 chronic diseases were assessed and multimorbidity was defined as the co-existence of two or more of these diseases. Participants were followed from the baseline recruitment to the onset of two or more chronic diseases, death, or the end of follow-up (2023). Logistic regression models, Cox proportional hazard models, quasi-Poisson mixed effects models, and linear mixed models were conducted to examine the association of PPD with chronic diseases and multimorbidity at baseline and during follow-up.ResultsAmong all 54,885 participants, 5106 (9.3%) participants experienced PPD, 13,928 (25.4%) participants had multimorbidity at baseline, and 14,135 (25.8%) participants developed two or more diseases during a median follow-up of 15 years. Women with a PPD history had higher odds of having multimorbidity at baseline (odds ratio = 1.35, 95% confidence interval [CI] = 1.27–1.44) and higher risk of developing multimorbidity during follow-up (hazard ratio = 1.13, 95% CI = 1.08–1.20). PPD was associated with increased number of chronic diseases, with the relatively new-onset number of diseases during follow-up being 8% higher for those with PPD (relative risk = 1.08, 95% CI = 1.05–1.12). Chronic diseases also accumulated at a faster annual rate for women with a history of PPD (b = 0.009, 95% CI = 0.007–0.011), compared to those without. We observed no interaction or mediation effects of physical activity, smoking, alcohol drinking, and dietary factors on the association between PPD and multimorbidity; however, women’s body mass index at baseline contributed to the association, with the mediation proportion of 6.38% (2.56–10.20%).ConclusionsPPD was associated with higher risks of chronic diseases and multimorbidity in women’s mid-late life. This finding supports the importance of perinatal and postpartum mental health care, and its role in the prevention of chronic diseases and multimorbidity throughout women’s life course.

Associations between lifetime reproductive events among postmenopausal women with bipolar disorder.

The premenstrual phase of the menstrual cycle, childbirth and perimenopause often coincide with a worsening of mood symptoms in women with bipolar disorder (BD). To date, findings from the limited number of studies investigating associations between these events among women with BD have been inconsistent. This study aimed to investigate associations between episodes in relation to the perimenopause and (i) premenstrual symptoms and (ii) postpartum mood episodes in a large sample of postmenopausal women with BD. Among 567 postmenopausal women with BD, recruited as part of the UK Bipolar Disorder Research Network, relationships between reproductive event-associated mood symptoms/episodes were examined. Multivariate binary analyses were carried out to identify if history of premenstrual symptoms and/or postpartum episodes predicted the occurrence of mood episodes in relation to the perimenopause, controlling for potential confounders including number of mood episodes per illness year. History of premenstrual symptoms was associated with experiencing any type of mood episode, and depression specifically, during the perimenopause (OR 6.189, p < 0.001 and OR 2.709, p = 0.019 respectively). History of postpartum depression within 6 weeks of delivery was associated with depressive episodes during the perimenopause (OR 2.635, p = 0.027). Postpartum mania was not a significant predictor. Our findings suggest that women with BD with a history of premenstrual symptoms and postpartum depression are potentially at increased risk of experiencing episodes of depression in relation to the perimenopause. There are clinical and self-management implications in identifying a subgroup of women with BD who may be particularly vulnerable to episodes of mood disturbance during reproductive events.

Increased risks of Maternal Mental Health Conditions Following the COVID-19 Pandemic.

Women are at an increased risk of developing psychiatric conditions such as anxiety and depression during pregnancy. Psychiatric conditions during pregnancy can put mothers and fetuses at risk of worse physical and mental health before, during, and after the completion of a pregnancy. Previous research indicates that women pregnant during COVID-19 were at a greater risk of developing mental health conditions and being exposed to stressors. While most of the research in the field focuses solely on maternal mental health or interactions between stressors and maternal mental health, little research has been done comparing maternal mental health, demographic variables, and socioeconomic variables across pre-, during-, and post-COVID-19 time periods. We conducted an observational cohort study of 703 mothers divided into pre-, during-, and post-COVID-19 groups based on time of enrollment. Rates of maternal anxiety (p < 0.001), medication use for anxiety (p < 0.001), depression (p < 0.001), medication use for depression (p < 0.001), history of postpartum depression (p < 0.001), and medication use for other psychiatric conditions (p < 0.001) significantly increased during COVID-19 and remained at elevated levels post-COVID-19 compared with pre-COVID-19. Income >150% of the poverty level (p = 0.003), food security level (p = 0.010), marital status (p = 0.001), and private insurance type (p < 0.001) were significantly increased during COVID-19 compared with pre-COVID-19 levels. Future work should focus on stratifying the effects of the COVID-19 pandemic on maternal mental health by race and ethnicity and establishing guidelines to support maternal mental health during epidemics and pandemics.

Postpartum depression and its relationship with the positive and negative perfectionism.

Depression is a common mental disorder after childbirth, which has serious consequences for the mother, baby, and family. A wide range of causes, including some personality traits of mothers, are involved in its etiology. Therefore, this study was conducted aiming to determine the factors related to postpartum depression (PPD) and its relationship with positive and negative perfectionism in Qom, Iran. This cross-sectional analytical study was conducted on 162 mothers who had been referred to health centers in Qom during 6-8 weeks after normal vaginal delivery (NVD) in 2020. After randomly classifying the health centers, the convenience sampling method was carried out. Data collection tools included social-individual information form, Edinburg Postnatal Depression Scale (EPDS), and Positive and Negative Perfectionism Questionnaire of Terry-Short. The data were analyzed using the Chi-square and Pearson correlation tests and multivariate logistic regression analysis. The prevalence of PPD in this study was 29.6%. The results showed that with the increase in the negative dimension of perfectionism, the chance of PPD in people increases by 14% (OR = 1.14, CI = 1.06-1.21), while there was no significant correlation between the positive dimension of perfectionism and PPD (r = 0.006, P > 0.05). Furthermore, the chance of PPD was higher in student mothers, mothers who had a history of PPD, and unintended pregnancy. Moreover, some factors such as multigravidity, breastfeeding, and not worrying about body image reduce the chance of occurrence. Since mothers' negative perfectionism is associated with PPD, it is recommended to identify perfectionist individuals during pregnancy and after delivery and provide counseling service to them.

Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study.

This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents' cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers. The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children's Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews. Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents' and mothers' perspectives as associated with adolescents' MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility. This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence.

Obstetric and psychiatric history as predictors for psychosomatic symptoms among Korean perimenopausal women.

Menopause presents various physical and psychological disturbances for women and comes at a high financial cost. Therefore, this study aimed to identify factors influencing menopause symptoms. Data of Korean perimenopausal women aged 40-60 (n=1060; mean age, 46.03±4.08) were collected by a research company. Participants were classified into a "functional" group (n=716) or a "dysfunctional" group (n=344) according to the severity of their perimenopausal psychosomatic symptoms. To investigate the association of obstetric and psychiatric history with membership of the "dysfunctional" group, a hierarchical logistic regression analysis was conducted. The outcomes of all three hierarchical logistic regression models presented significant overall model fit. Among the independent variables, family history of menopausal symptoms, menarcheal age, number of pregnancies, history of postpartum depression, postpartum psychosis, and other psychiatric disorders were positively associated with being in the "dysfunctional" group, whereas age and number of deliveries were negatively associated with being in the "dysfunctional" group. A short reproductive period and short exposure to estrogen due to late menarche and early menopausal transition may be related to severe perimenopausal symptoms. The relationship between the history of postpartum mental illness and severe perimenopausal symptoms may be associated with heightened sensitivity to hormonal triggers when a woman is exposed to fluctuating ovarian sex steroid levels. The relationship between parity or gravidity and the severity of menopausal symptoms in Korean women differed from that in studies conducted in other countries, possibly due to the low birth rate in Korea.

The association between labour epidural analgesia and postpartum depression in primiparous patients: a historical cohort study.

Peripartum pain has been associated with postpartum depression (PPD), and labour epidural analgesia (LEA) may be able to modify this risk. The objective of this historical cohort study was to examine the association between LEA and PPD among primiparous patients. With institutional research ethics board approval, a provincial perinatal database was searched for primiparous patients who delivered a liveborn singleton infant between 2004 and 2018. Those patients who experienced PPD following their first delivery were identified by a history of PPD in the perinatal records of their second pregnancy. We used logistic regression to compute odds ratios (ORs) for the association between LEA and PPD and performed an adjusted analysis to control for confounding variables. A total of 35,437 primiparous patients were identified, 67% (n = 23,599) of whom received LEA. In the cohort, 3.7% (n = 1,296) of patients developed PPD. Patients who received LEA had increased odds of developing PPD compared with patients who did not receive LEA (adjusted OR, 1.29; 95% confidence interval [CI], 1.12 to 1.48). In a multivariable regression model, LEA remained a significant predictor for PPD, as did body mass index, pre-existing anxiety, and maternal antidepressant use. This historical cohort study found an association between LEA and PPD among primiparous patients who subsequently had a second pregnancy in the same province. The findings call into question the hypothesis that LEA decreases the risk for PPD and further illustrates the complexities of PPD.

Temporal dynamics of neurobehavioral hormone sensitivity in a scaled-down experimental model of early pregnancy and parturition.

The hormonal changes of pregnancy and parturition can trigger robust changes in affective state, particularly among patients with a history of postpartum depression. However, more work is needed to elucidate the temporal dynamics of symptom emergence. The current study explored how quickly hormone-sensitive (HS+) individuals can be differentiated from hormone-insensitive (HS-) controls in the context of a tightly controlled experimental hormone manipulation, and which symptoms demonstrate the most rapid, consistent, and largest response during this protocol. Participants were female, non-pregnant, and euthymic, with a history of DSM-5 major depressive episode with peripartum onset (n = 15) or parous healthy controls with no psychiatric history (n = 15). Perinatal hormonal changes were simulated by inducing hypogonadism, adding back estradiol (E2) and progesterone (P4) to reach first-trimester levels for 8 weeks, and then subsequently withdrawing both hormones. Those reporting a 30% or greater increase during addback or withdrawal on select subscales of the Inventory of Depression and Anxiety Symptoms (IDAS) were identified as HS+. Participants provided daily ratings of symptoms throughout the study via the Daily Record of Severity of Problems. Results indicated that HS+ participants could be differentiated from HS- participants early in the hormone protocol, with many symptoms showing significantly greater change from baseline within the first week of addback. Notably, the most rapid symptom increases were observed for Anger/Irritability, Mood Swings, Overwhelm, Lethargy, Increased Appetite, Joint and Muscle Pain, and Breast Tenderness, reaching 50% of peak group contrast within the first week of hormone addback. The largest group effects were observed for Anger/Irritability, followed by Fatigue and Anxiety, and the most consistent group effects were observed for Anger/Irritability, Interpersonal Conflict, Overwhelm, and Hopelessness. Findings support the role of reproductive hormones in the onset of perinatal affective disorders. The rapid emergence of anger and irritability in HS+ participants suggests that these symptoms may be early indicators of perinatal hormone sensitivity.

Effects of Sex Steroid Manipulation on Irritability in Women with a History of Postpartum Depression

Sex steroid changes interact with antecedent vulnerability to trigger irritability in women. Here we present data from three pharmaco-fMRI studies investigating the effects of experimentally controlled reproductive steroid exposure on irritability. In Study 1, the hormone states of pregnancy and parturition were simulated in women with a history of postpartum depression (PPD; n=15) and controls (n=15) by inducing hypogonadism, adding back supraphysiologic doses of estradiol (E2) and progesterone (P4) for 8 weeks, and then withdrawing both steroids. fMRI was conducted during baseline and withdrawal. In Study 2, the same hormone protocol was employed in PPD (n=10) and controls (n=12) with a truncated addback period of 2 weeks. In Study 3, women who participated in Study 1 were treated with E2 and P4 for 1 week in double-blind, placebo-controlled crossover design. In Study 1, 11/15 of PPD participants were “hormone sensitive” (HS+) (i.e., showed 30% increased mood symptoms during addback or withdrawal). HS+ experienced irritability within one week of starting addback (p<.001). During withdrawal, irritability was associated with reduced activity in supramarginal gyrus (r=-.536, p<.005). In Study 2, 8/10 of PPD participants were HS+, which was characterized by increased irritability during hormone addback (p<.05). In Study 3, the 1-week hormone protocol provoked irritability in the same individuals as the extended protocol used in Study 1 (p<.001). Findings support the role of sex steroids in perinatal-onset irritability, which may be mediated by reduced activity in the supramarginal gyrus.

221. The Effects of Sex Steroid Manipulation on Anhedonia in Women With a History of Postpartum Depression

221. The Effects of Sex Steroid Manipulation on Anhedonia in Women With a History of Postpartum Depression

Latent Profile Analysis for Classification of Psychosomatic Symptoms in Perimenopausal Women.

Over 80% of perimenopausal women experience various physical and neuropsychiatric symptoms due to changes in hormones. However, accurate evaluation and treatment of menopausal symptoms are lacking due to limited evidence regarding customized treatment for each symptom type. This study aimed to identify and cluster psychosomatic symptoms in Korean perimenopausal women and to investigate the characteristics of each cluster type. This Web-based survey assessed 1060 Korean perimenopausal women recruited from nationally representative panels available from a commercial research company. Menopausal symptoms were evaluated using the Menopause Rating Scale, Patient Health Questionnaire-15, Patient Health Questionnaire-9, Insomnia Severity Index, Subjective Memory Complaints Questionnaire, and Overactive Bladder Symptom Score. Data were analyzed using latent profile analysis and multinomial logistic regression. Latent profile analysis identified 4 latent classes: "all unimpaired (class 1)," "impaired sexual function, while others are unimpaired (class 2)," "unimpaired sexual function, while others are impaired (class 3)," and "all impaired (class 4)." Classes 3 and 4 were significantly more likely to have a family history of perimenopausal syndrome and a history of other mental disorders, postpartum depression, and postpartum psychosis than classes 1 and2. Psychosomatic symptoms appear during perimenopause along with depression, somatic symptoms, insomnia, impaired memory, and overactive bladder symptoms. Individuals with these symptoms are more likely to have a history of postpartum depression, psychosis, and other psychiatric disorders. Therefore, sexual dysfunction must be independently treated. Further studies are needed to develop and verify individualized treatments according to symptom class.

Intrinsically dysregulated cellular stress signaling genes and gene networks in postpartum depression.

Postpartum depression (PPD) is a leading cause of morbidity and mortality among women. Clinically, the administration and withdrawal of supraphysiologic estradiol and progesterone (E2 + P) can cause affective symptom reoccurrence in women with a history of PPD, but not matched controls. To investigate the cellular basis underlying this differential affective response, lymphoblastoid cell lines (LCLs) were derived from women with and without past PPD and compared transcriptomically in hormone conditions mimicking pregnancy and parturition: supraphysiologic E2 + P-addback; supraphysiologic E2 + P-withdrawal; and no added E2 + P (Baseline). RNA-sequencing identified unique differentially expressed genes (DEGs) in all hormone conditions, but the majority tended to be downregulated in PPD and observed in E2 + P-addback. Two of these DEGs were evolutionarily conserved cellular stress regulators: IMPACT, an integrative response protein maintaining translational homeostasis, and WWTR1, a transcriptional coactivator in the 'Hippo' pathway mediating cell proliferation and survival. Correspondingly, significant gene network modules were linked to cell cycle progression, estrogen response, and immune dysregulation, suggesting innate differences in intracellular signaling in PPD. In certain hormone conditions, PPD LCLs displayed increased GATA3 expression (an upstream regulator of IMPACT and WWTR1) and differentially phosphorylated eiF2α (the ultimate downstream target of IMPACT). Taken together, these transcriptomic data primarily implicate innately dysregulated cellular responses as potentially influencing mood and/or escalating PPD risk. Furthermore, the intrinsic downregulation of IMPACT's translation and WWTR1's transcription networks may suggest a novel link between PPD and a compromised ability to maintain homeostasis in the context of cellular stress occurring during pregnancy and parturition.

Endocrine disease history and the risk of postpartum depression.

Previous research has suggested that some women are at increased risk of postpartum depression (PPD) because of an extra sensitivity to fluctuating hormones before and after parturition. This may particularly apply to women with endocrine disease, characterised by a less than optimal capability to self-regulate the hormonal feedback system. To investigate if women with endocrine disease history are at increased risk of developing PPD. Based on information from Danish national registers, this nationwide cohort study included 888 989 deliveries (1995-2018). Endocrine disease history was defined as thyroid disease, pre-pregnancy diabetes, polycystic ovary syndrome and/or previous gestational diabetes within 10 years before pregnancy start. PPD was defined as use of antidepressants and/or hospital contact for depression within 6 months after childbirth. Among 888 989 deliveries, 4.1% had a history of endocrine disease and 0.5% had a PPD episode. Overall, women with an endocrine disease history had a 42% (risk ratio 1.42, 95% CI 1.24-1.62) higher risk of PPD when compared with women with no endocrine disease. However, we also found the reverse association, whereby women with a PPD history had a 50% (hazard ratio 1.5, 95% CI 1.4-1.6) higher risk of endocrine disease when compared with women with no PPD history. Women with endocrine disease history had a 40% higher risk of PPD compared with women with no endocrine disease. More attention should be given to pregnant women with endocrine disease history to increase awareness of early signs of PPD. The bi-directionality of the association points to a common underlying factor.

Familial risk of postpartum depression.

Many psychiatric diseases have a strong familial aggregation, but it is unknown whether postpartum depression (PPD) without prior psychiatric history aggregates in families. Based on Danish national registers, we constructed a cohort with information on 848,544 singleton deliveries (1996-2017). Women with an episode of PPD were defined as having used antidepressant medication and/or had a hospital contact for depression within 6months after delivery. Those with psychiatric history prior to the delivery were excluded. We estimated relative risk (RR) of PPD, comparing women with female relatives with and without PPD history, respectively. Overall, women with a PPD history in female blood relatives had themselves a higher risk of PPD (RR=1.64, 95% CI 1.16-2.34). Having the first-degree female relative with PPD history was associated with a more than 2.5 times (RR=2.65, 95% CI 1.79-3.91) increased risk of PPD. However, having the second/third-degree female relative and/or a female non-blood relative with PPD history did not increase the woman's own risk of PPD (RR=0.58, 95% CI 0.26-1.28, RR=1.09, 95% CI 0.83-1.44). Postpartum depression aggregates in families with no other psychiatric history, but the findings do not support a strong genetic trait as a major cause. Other possible mechanisms are shared environment and/or health-seeking behavior in close relationships.

Spitting on my sources: Depression, DNA, and the ambivalent historian.

While writing a book on the history of postpartum depression in the United States, I became interested in an ongoing study about possible genetic markers of postpartum mental illness. I participated in the first step, an online survey. When I qualified for the next step, saliva collection, I was torn over whether or not to continue. Making this decision required reflecting on some overlapping issues: gender, medicalization, genetic research, and the political functions of DNA donation. In this perspectives essay, I explore tensions around situating myself in my historical research project.

Effects of gonadal steroids on reward circuitry function and anhedonia in women with a history of postpartum depression

BackgroundReward system dysfunction is evident across neuropsychiatric conditions. Here we present data from a double-blinded pharmaco-fMRI study investigating the triggering of anhedonia and reward circuit activity in women. MethodsThe hormonal states of pregnancy and parturition were simulated in euthymic women with a history of postpartum depression (PPD+; n = 15) and those without such a history (PPD−; n = 15) by inducing hypogonadism, adding back estradiol and progesterone for 8 weeks (“addback”), and then withdrawing both steroids (“withdrawal”). Anhedonia was assessed using the Inventory of Depression and Anxiety Symptoms (IDAS) during each hormone phase. Those who reported a 30 % or greater increase in IDAS anhedonia, dysphoria, or ill temper during addback or withdrawal, compared with pre-treatment, were identified as hormone sensitive (HS+) and all others were identified as non-hormone sensitive (HS−). The monetary incentive delay (MID) task was administered during fMRI sessions at pre-treatment and during hormone withdrawal to assess brain activation during reward anticipation and feedback. ResultsOn average, anhedonia increased during addback and withdrawal in PPD+ but not PPD−. During reward feedback, both HS+ (n = 10) and HS− (n = 18) showed decreased activation in clusters in the right putamen (p < .031, FWE-corrected) and left postcentral and supramarginal gyri (p < .014, FWE-corrected) at the withdrawal scans, relative to pre-treatment scans. LimitationsA modest sample size, stringent exclusion criteria, and relative lack of diversity in study participants limit the generalizability of results. ConclusionAlthough results do not explain differential hormone sensitivity in depression, they demonstrate significant effects of reproductive hormones on reward-related brain function in women.

Is Emotion recognition processing across menstrual cycle and a history of Postpartum Depression potential risk factors for Premenstrual Dysphonic Disorder?

IntroductionMany women during the different phases of the menstrual cycle experience significant emotional and cognitive changes; for some, these changes can affect their everyday living. Premenstrual Dysphonic Disorder (PMDD) is a health problem that affects up to 5% of women of childbearing age. The exact cause is unknown; still, hormonal changes throughout the menstrual cycle may play a role. Women with a family history of Postpartum Depression (PPD) may be at increased risk.ObjectivesThe purpose was to examine if Emotion recognition processing across menstrual cycle and a history of PPD are potential risk factors for PMDD.MethodsWe identified 34 women with a history of PPD and contacted their daughters to explain the purpose of our study. Of those meeting the criteria to participate, 38 volunteered (aged 18-30 y.o., right handed, educational level &gt;9 y., regular cycle duration). The Emotion Recognition Task (ERT) was administered in the luteal and the follicular phase. Women found to present significant differences in emotion recognition depending on the estradiol and progesterone levels were clinically interviewed (DSM-V).ResultsOf the 16 women who have showed significant differences across the two phases of the menstrual cycle, 7 were diagnosed with PMDD (43,7%). Among the ones who have not presented differences (22), only 2 received a diagnosis of PMDD (9%).ConclusionsThis study shows that Emotion recognition processing across menstrual cycle and a history of PPD may predict which women could be at risk for PMDD, playing, therefore a key role in PMDD early diagnosis.DisclosureNo significant relationships.

Assessment of the Relationship between Vitamin D Levels and Common Complications of Pregnancy with the Incidence of Postpartum Depression in Mothers Covered by Health Centers in Isfahan City in 2020

Introduction: Physiological and psychological changes during pregnancy are the cause of many psychological disorders including depression. The aim of this study was to determine the relationship between vitamin D levels and common complications of pregnancy with the incidence of postpartum depression in mothers. Methods: The present study is a prospective cohort that was performed in two stages on 300 pregnant women who were in the third trimester of pregnancy. The sample selection method was done in several steps using demographic characteristics questionnaire, Sherborne and Stewart social support questionnaire and Edinburgh depression questionnaire. Data were analyzed using SPSS software version 16 and descriptive statistics, independent t-test, paired t-test, one-way ANOVA and Chi-square. A p value of less than 0.5 was considered significant. Results: The results of the study showed that gestational complications such as urinary tract infection (P = 0.139), diabetes (P = 0.587) and gestational hypertension (P = 0.080) were not significantly associated with postpartum depression. There is also no significant relationship between vitamin D levels during pregnancy in people with postpartum depression and non-patients. (P&gt; 0/05). Also, low level of social support was associated with a 3.2-fold increase in the risk of postpartum depression (P = 0.001) Conclusion: Postpartum depression is associated with devastating consequences for both mother and fetus. Therefore, pregnant women, especially those with risk factors and a history of postpartum depression, should be supported by various sources and at the head of the family.

Prevalence of Post-partum Depression among Sudanese Women Using Edinburgh Postnatal Depression Scale (EPDS) in Two Major Delivery Hospitals in Khartoum State

Background: Postpartum depression is a mood disorder that can affect women after childbirth; it can occur at any time during the first year after delivery. Mothers experience depressive symptoms that may make it difficult for them to complete daily care activities. The aim of this study was to find out the prevalence of postpartum depression among Sudanese women as well as determining the association between postpartum depression (PPD), socio-demographic, and obstetric characteristics. Method: In this cross-sectional study, 129 women selected through convenient sampling technique were interviewed; the participants were recruited from the postnatal and child welfare clinics at the Saad Abueleella and the Dream International Hospitals. To assess any possible depression, information was collected at six weeks postpartum using a structured questionnaire in addition to a screening tool. Results: At a cutoff score of ≥12, the prevalence of PPD was found to be 10.9% (Confidence Interval 6.5–17.3%); while 79.1% of mothers revealed no signs of PPD and scored &lt;9 points, 10.1% scored 9–11, indicating a need for extra visits. Interestingly, 59.7% of the respondents were aged between 25 and 35 years, 76% were university graduates, 64.3% housewives, 20.9% had obstetric complications, 3.1% reported a history of PPD, and almost 97.7% breastfed their babies. Moreover, PPD was found to be associated with occupational status (p = 0.01) and a previous history of PPD (p = 0.01). Conclusion: The prevalence of postpartum depression was 10.9% among the studied sample. Interventions to address its risk factors should be implemented, physicians and health personnel should be qualified on screening and referring depressed mothers for further clinical assessment. Keywords: Postpartum depression, Prevalence, Screening, Sudanese

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.