Mean Edinburgh Postnatal Depression Scale Score Research Articles

Risk factors of positive depression screening during the third trimester of pregnancy in a Chinese tertiary hospital: a cross-sectional study

ObjectivePregnant women experience enormous psychological pressure, particularly during the late trimester. Symptoms of depression in late pregnancy may persist postpartum, increasing the incidence of postpartum depression. This study is aimed to investigate the factors influencing depressive symptoms among pregnant women in their third trimester at a Chinese tertiary hospital and provide information for effective intervention.MethodsPregnant women in their third trimester who visited the Ningbo Women and Children’s Hospital between January 1, 2020 and June 30, 2022 participated in this study. A score of ≥ 13 on the Edinburgh Postnatal Depression Scale (EPDS) was considered as positive for depressive symptom. Potential influencing factors were examined by using an online questionnaire and analyzed using multivariate logistic regression.ResultsA total of 1196 participants were recruited. The mean EPDS score was 7.12 ± 4.22. The positive screening rate for depressive symptom was 9.9%. Univariate analysis showed that living with partner, annual family income, planned pregnancy, sleep quality, and partner’s drinking habits were related to positive screening for depression(P < 0.05). Furthermore, multivariate logistic regression analysis showed that living away from the partner (odds ratio [OR]: 2.054, 95% confidence interval [CI]: 1.094–3.696, P = 0.02), annual family income < 150,000 Chinese Yuan (CNY; OR: 1.762, 95% CI: 1.170–2.678, P = 0.007), poor sleep quality (OR: 4.123, 95% CI: 2.764–6.163, P < 0.001), and partner’s frequent drinking habit (OR: 2.227, 95% CI: 1.129–4.323, P = 0.019) were independent influencing factors for positive depression screening (P < 0.05).ConclusionFamily’s economic condition, sleep quality, living with partner, and partner's drinking habits were related to positive depression screening in late pregnancy. Pregnant women with these risk factors should be given more attention and supported to avoid developing depression.

Group antenatal care compared with standard antenatal care for Somali-Swedish women: a historically controlled evaluation of the Hooyo Project

ObjectivesComparing language-supported group antenatal care (gANC) and standard antenatal care (sANC) for Somali-born women in Sweden, measuring overall ratings of care and emotional well-being, and testing the feasibility of the...

Impact on Maternal Postpartum Depressive Symptoms of a Primary Care Intervention Promoting Early Language: A Pilot Study.

Maternal depressive symptoms are an important risk factor for adverse child outcomes, especially in the perinatal period. We studied whether introducing finger puppets in the primary care setting to promote infant language improves maternal postpartum depressive symptoms. An intervention cohort was enrolled and given a finger puppet at the 2-month infant well visit. Two usual care cohorts were enrolled at either the 6- or 12-month well visit as part of a larger study. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), which was administered by clinic providers as part of routine screening done at both the 2- and 4-month well visits. EPDS scores were obtained retrospectively through the electronic medical record. Included mothers (n = 127) completed the EPDS at 2 and 4 months postpartum. Most children (83%) were on government-sponsored insurance. Mean EPDS scores and scores classified as possible depression (≥ 10) did not differ between cohorts. However, the change in scores between visits was significantly different for intervention (n = 46) compared to usual care (n = 81) participants (-1.1 vs. +0.4, p = 0.001). More intervention scores improved (n = 17, 37%) compared to usual care (n = 14, 17%), while more usual care scores worsened (n = 28, 35%) compared to intervention (n = 6, 13%) (p = 0.008). Finger puppets introduced during infant primary care visits to support language-rich maternal-infant interactions may provide a simple, low-cost way to improve maternal postpartum depressive symptoms. Larger studies with more diverse populations are needed to determine if effects are replicable, generalizable, and translate into better clinical outcomes.

Prevalence and Associated Risk Factors of Antenatal Depression among Pregnant Women Attending Tertiary Care Hospitals in South India.

Antenatal depression (AND) is a common mood disorder that affects both the mother and the child. The current study is aimed at identifying the prevalence of antenatal depression and the risk factors associated with it in South Indian pregnant women. The current study was carried out in a tertiary care teaching hospital where pregnancy and postnatal care are offered. In the study, 314 pregnant women who visited the antenatal clinic for their prenatal checkups were included. To diagnose possible depression, Edinburgh Postnatal Depression Scale (EPDS) was used. The chi-square test was applied to determine the association between antenatal depression and various socioeconomic, obstetric, and medical factors. A logistic regression analysis was performed to identify significant confounding variables. Of the total 314 women, 69 (21.98%) were suffering from possible depression with the mean EPDS score being 10.61 ± 7.48. Women of younger age had greater risks for depression than older women (AOR = 2.01; 95% CI: 0.56-7.20). Maternal age (χ 2 = 0.013, p = 0.009) and the presence of health issues during the current pregnancy (χ 2 = 5.18, p = 0.023) were the factors significantly associated with antenatal depression. Clinical efforts should focus on screening antenatal depression, early identification, and effective care, thus preventing progression to postpartum depression and its detrimental effects.

Fear and anxiety related to COVID-19 pandemic may predispose to perinatal depression in Italy.

The COVID-19 pandemic situation significantly affected the mental health of the general and clinical population. However, few studies investigated which COVID-19-related psychopathological determinants may predispose to perinatal depression. We evaluated the impact of COVID-19 related anxiety and fear on perinatal depression in Italy. We retrospectively screened 184 perinatal outpatients afferent to Perinatal Mental Health outpatient service, during March 2020-March 2021, by administering the Edinburgh Postnatal Depression Scale (EPDS), the Fear of COVID-19 (FCV-19-S) and the Coronavirus Anxiety Scale (CAS). Among these, 85 patients agreed to be recruited in the present study. The mean EPDS score was 9.0, experiencing a clinically relevant perinatal depression in 45.7% of the sample. The mean FCV-19-S score was 15.0 and CAS was 1.7. Linear regression analyses demonstrated that FCV-19-S and CAS scores statistically significantly predicted EPDS total scores. A positive significant correlation was reported between FCV-19-S and EPDS and between CAS and EPDS. During the COVID-19 pandemic, women in their perinatal period, independently of previous psychiatric history, experienced increased levels of anxiety, fear and psychological distress, due to subsequent isolation, quarantine, lockdown and deprivation of their normal social support. Further preventive and screening strategies should be implemented in order to early identify at-risk pregnant and puerperal women during the COVID-19 pandemic.

Parent-infant closeness after preterm birth and depressive symptoms: A longitudinal study.

BackgroundPreterm birth increases the risk for postpartum depression in both mothers and fathers, calling for strategies to alleviate and prevent depressive symptoms in parents of preterm infants. The aim of this study was to assess the association between early parent-infant closeness and later depressive symptoms among parents of preterm infants. We hypothesized that longer duration of closeness associate with fewer depressive symptoms in both parents.MethodsThis prospective cohort study included 23 neonatal intensive care units (NICUs) from 15 countries in 2018 to 2020. Each unit recruited families with preterm infants aiming to 30 families. The total duration of parents’ presence in the NICU, and separately parent-infant skin-to-skin contact and holding, were measured using a Closeness Diary up to 14 days. The Edinburgh Postnatal Depression Scale (EPDS) was used at discharge and at 4 months corrected age of the infant.ResultsThe study included 684 mothers and 574 fathers. The median presence was 469 min (Q1 258 and Q3 1,087) per 24 h for the mothers and 259 min (Q1 100 and Q3 540) for the fathers; mean EPDS scores were 9.2 (SD 5.0) and 6.3 (SD 4.4) at discharge and 6.6 (4.7) and 4.3 (4.2) at 4 months, respectively. Parents’ presence and depressive symptoms varied greatly between the units. Parents’ presence as the total measure, or skin-to-skin contact and holding separately, did not associate with depressive symptoms in either mothers or fathers at either time point (adjusted).ConclusionNo association was found between the duration of parent-infant closeness in the neonatal unit and parents’ depressive symptoms. The beneficial effects of family-centered care on parents’ depression seem to be mediated by other elements than parent-infant physical closeness. More research is needed to identify the critical elements which are needed to alleviate parents’ depression after NICU stay.

Postnatal health and care following hypertensive disorders in pregnancy: a prospective cohort study (BPiPP study)

IntroductionOne in 10 women have hypertensive disorders in pregnancy (HDP) and are at risk of adverse short- and long-term health outcomes, yet there is limited information on their postnatal health and care needs. This study aimed to look at postnatal physical and psychological morbidity in women with HDP, compared to women without HDP, and the postnatal care received in both groups.MethodsWithin a prospective cohort study, women with and without HDP were identified and recruited on the postnatal ward of 17 maternity units across England and invited to complete a short baseline questionnaire. At 3 months postpartum, women were sent a follow-up questionnaire, with reminders. The principal outcomes were the mean score at 3 months for the Edinburgh Postnatal Depression Scale (EPDS) and the EuroQol Group 5-dimension (EQ-5D) scale.ResultsOne thousand eight hundred twenty-nine women agreed to participate. Of these, 1757 (96%) completed the baseline questionnaire: 769 (44%) women had HDP and 988 (56%) women did not. Despite a difference in health-related quality of life and symptoms of depression at baseline between the two groups, at 3 months postnatal, within the 653 women who completed their follow-up questionnaire (37.2% of those who completed the baseline questionnaire) there were no significant differences between the groups (median EQ-5D VAS: 85 in women with HDP, 85 in women without HDP, p = 0.99 and mean EPDS score 5.5 in women with HDP, 5.0 in women without HDP, p = 0.80). Overall levels of physical postnatal morbidity were high, with 89% reporting one or more morbidities. Approximately 9% of women were re-admitted within 3 months after birth, higher in the HDP group (13.1%) higher compared to women without HDP (5.5%; RR 2.41; 95% CI 1.44–4.05).ConclusionOverall levels of physical and psychological morbidity were high in this postnatal population. Although there were increased needs of women with HDP in the immediate postnatal period (compared to other women), their health assessments were similar at 3 months. This study highlights the unmet needs of women in the postnatal period, in addition to a missed opportunity to influence future pregnancies and improve the longer-term health of women and their babies.

A case-control study on the severity postpartum depression among COVID19 positive mother

BackgroundCOVID19 pandemic has caused a variety of psychological problems including panic disorder, anxiety and depression. It is also associated with adverse psychological outcomes in pregnant women. The aim of this study was to compare the severity of postpartum depression in pregnant women with and without COVID-19 during the coronavirus epidemic. MethodsThis case-control study was performed on 102 pregnant women referred to the hospitals of (XXX). Using questionnaire, consisting of demographic and maternal data (age, number of pregnancies, type of delivery, history of any disease, history of drug use, breastfeeding experience, separation of mother from infant due to coronavirus) and score from Edinburgh postnatal depression scale (EPDS) score data from all the participants obtained and analyzed statistically using SPSSv23. ResultsThe results showed that the mean EPDS score in COVID-positive mothers was 26.64 and in COVID-negative mothers was 24.76, which was statistically significant, p < 0.001. The score did not vary among the two group with respect to age group and type of delivery method. The score was significantly higher among the women with 3–4 pregnancies. ConclusionCOVID-positive status is associated with increased postnatal depression among women. Perinatal and postnatal psychological consultancy is required in such patients along with monitoring of maternal and neonate physical and mental health.

Relationship between paternal postnatal depression and its predictors factors among Iranian fathers

ABSTRACT Background: Paternal postnatal depression (PPND) is widely overlooked despite being the most common mental health disorder among fathers in the postpartum period, and it affects all aspects of family life, particularly the relationship with the spouse and children. Objective: To determine the predictor factors of PPND. Methods: A descriptive-analytical study was performed on 400 fathers of children aged six weeks to one-year referring to the healthcare centers. Data were collected using a demographic characteristics form and the Edinburgh Postnatal Depression Scale (EPDS). Data analysis was performed using SPSS software version 22. Results: The mean EPDS score was 6/54± 4.3, the mean age of the studied fathers was 35 ± 5.4, and 57.7% had experienced more than one pregnancy with their spouses. There was a significant relationship (P>0.05) between the education level and the EPDS score. According to linear regression, the most influential factors on EPDS score included satisfaction with life and general health, as well as an unwanted pregnancy amongst maternal fertility characteristics. Conclusion: Determining the predictor/related factors with paternal postnatal depression helped us to identify at-risk fathers promptly, to manage earlier, and to prevent the adverse effects of PPND on family health and relationship.

Does Walking Reduce Postpartum Depressive Symptoms? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Rising demands for traditional postpartum depression (PPD) treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. Our objective is to determine the impact of walking on PPD severity. Methods: A structured search of seven electronic databases for randomized controlled trials published between 2000 and July 29, 2021 was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Results: Five studies involving 242 participants were included (mean age = ∼28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n = 4) and 24 (n = 1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS), and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled mean difference = -4.01; 95% CI: -7.18 to -0.84, I2 = 86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes per week of moderate-intensity walking, may produce greater EPDS reductions. Conclusions: While limited by a relatively small number of included studies, pooled effect estimates suggest that walking may help mothers manage PPD. This is the first-time walking as treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers, has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020.

Effectiveness of psychosocial support provided by midwives and family on preventing postpartum depression among first-time adolescent mothers at 3-month follow-up: A randomised controlled trial.

To evaluate the effectiveness of a midwife-family provided social support programme (MFPSS programme) for first-time adolescent mothers on preventing postpartum depression (PPD) at 3-month postpartum. Adolescent mothers with lack of social support are a high-risk group for increasing the development of PPD. Interventions designed to promote social support and provided to mothers following childbirth have a more effective role in preventing PPD. The Consolidated Standards of Reporting Trials (CONSORT) guidelines for a single-blinded randomised controlled trial were conducted. Forty-two adolescent mothers were randomly assigned to 4-week MFPSS programme plus routine care (n=21) and routine care only (n=21). PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS), rates and severity at baseline, post-test, 6-week and 3-month postpartum follow-ups. Repeated measures ANOVA and Cohen's d were used to analyse the data. At the last follow-up, 20 (95.24%) participants remained in each group. Data were analysed based on 40 adolescent mothers. After the intervention, the mean EPDS scores in the intervention group were significantly lower than the same scores in the control group at post-test, 6-week and 3-month postpartum follow-ups. Similarly, the rates and severity of PPD in the intervention group were also lower than the control group at post-test, 6-week and 3-month postpartum follow-ups. Psychosocial support interventions designed to incorporate support from midwives and family members is an effective intervention for preventing PPD in first-time adolescent mothers and the preventive effect is sustained for up to 3-month postpartum. Midwives or nurses could apply the MFPSS programme to nursing care for adolescent mothers and family members by adding health information about PPD and promoting social support. The trial was registered with Thai Clinical Trials Registry (TCTR). The trial registration number is TCTR 20190206004.

The Impact of Prenatal Depression in Patients of High Risk Pregnancy Clinic on Obstetric Outcomes.

Prenatal depression is common and has been associated with risky maternal behavior, postpartum depression, and atypical child development. Still, its association with adverse perinatal outcomes is complex. The aim of our study was to look for this potential association in our region. The medical charts of women who were treated at our High-Risk Pregnancy Clinic and gave birth at our hospital were reviewed. The Edinburgh Postnatal Depression Scale (EPDS) was used to discover prenatal depression. Patients who reported past or current mental illness were excluded. We enrolled 202 women at a mean age of 32.81. Twin pregnancy was the most common reason for referral to the clinic (17.3%). The mean EPDS score was 4.63 (±4.66), with 15.3% scoring 10 or more. A significant correlation was found between the EPDS score and intrapartum fetal heart rate abnormalities, as well as with low birth weight. There were significant associations between the EPDS score and the maternal status of genetic disorder carrier, and the number of previous pregnancies, miscarriages, and elective termination of pregnancy. This study demonstrates a significant impact of the maternal psychological state on the obstetric outcome. In addition, we observed a significant association between maternal obstetric history, genetic data, and the risk of prenatal depression. Our study shows that completing the EPDS questionnaire is a very important part of the pregnancy follow-up, as it illuminates risk factors for prenatal depression and adverse perinatal outcomes.

Associations of Tryptophan, Docosahexaenoic Acid (DHA), and Vitamin D With Sleep Quality and Depression During Pregnancy

ObjectivesDuring pregnancy women are at increased risk of poor sleep quality and depression. Serotonin and melatonin are compounds that are involved in regulation of sleep and mood. Several nutrients are involved in the synthesis of these compounds, including tryptophan, docosahexaenoic acid (DHA), and vitamin D. Studies exploring associations between these nutrients and sleep, as well as mood, have been largely limited to the general population, showing mixed results. The aim of this study was to assess the associations of dietary intake of these nutrients with sleep quality and depression in pregnant women. MethodsParticipants enrolled in the Understanding Pregnancy Signals and Infant Development (UPSIDE) Study (n = 253) were included in this analysis if they completed dietary, sleep and depression assessments during the 2nd trimester. Dietary and supplement intake were measured using 24-hour dietary recalls. The NCI method was used to estimate usual intake. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear regression was conducted to estimate the associations between nutrients and sleep/depression, adjusting for age, race/ethnicity, parity, education, early pregnancy body mass index, smoking status, energy and macronutrient intake. ResultsThe NCI adjusted mean intakes of tryptophan, DHA, and vitamin D were 1.02 ± 0.11 g/day, 0.13 ± 0.11g/day, and 19.74 ± 21.80 mcg/day, respectively. Mean PSQI score was 6.15 ± 3.39, where higher scores indicated worse sleep quality, and mean EPDS score was 5.84 ± 4.77, where higher scores indicated increased severity of depressive symptoms. Tryptophan intake was inversely associated with EPDS scores (b = –15.23, 95%CI: –26.75, –3.72). The associations between DHA, vitamin D, and depression were not significant. The selected nutrients were not associated with PSQI scores. ConclusionsIn this study, higher tryptophan intake was associated with lower depressive symptoms among pregnant women during the second trimester. Additional research on the relationship between tryptophan intake and maternal mental health during pregnancy is warranted. Funding SourcesNIH, Mae Stone Goode Foundation, Wynne Family Foundation.

The role of gestational weight gain disorders in symptoms of maternal postpartum depression.

To examine the association of gestational weight gain (GWG), categorized according to 2009 IOM guidelines as adequate, inadequate, and excessive, with symptoms of mental disorders perceived by mothers after childbearing as anhedonia, anxiety, and depression, defined by the Edinburgh Postnatal Depression Scale (EPDS). Previous studies indicated that disorders related to GWG are associated with an increased risk of postpartum psychological distress. A prospective cohort study took place at the Policlinico Abano Terme, Italy, from May 2016 to November 2018. The sample included 1268 healthy at term puerperae, 557 (43.9%) with adequate, 388 (30.6%) with inadequate, and 323 (25.5%) with excessive GWG. Mean EPDS scores were comparable among inadequate, adequate, and excessive GWG groups. However, mean factor scores for anhedonia and anxiety were significantly higher (P=0.041 and P=0.001, ANOVA) in mothers with excessive GWG. Conversely, factor scores for depression were significantly higher (P=0.008, ANOVA) in mothers with inadequate GWG. It was found that excessive GWG across an uncomplicated pregnancy is a warning sign of symptoms of anhedonia and anxiety, whereas inadequate GWG is a significant indicator of symptoms of depression. These relationships highlight the potential for interventions directed toward psychosocial support to have beneficial effects upon GWG.

Effect of Aromatherapy Using Bergamot and Lavender Oils on Postpartum Blues

Postpartum adaptation failure can cause a mild psychological disorder in the type of postpartum blues. Various aromatherapy has been tested to treat postpartum blues. This study aimed to compare the effectiveness of aromatherapy using bergamot with lavender oils in postpartum blues. This non-randomized quasi-experimental controlled trial study with a pretest and posttest design was performed on 40 women after cesarean section (C-section) using consecutive sampling. The Edinburgh Postnatal Depression Scale (EPDS) questionnaire was used for the diagnosis of postpartum blues. The participants were given seven drops of aromatherapy oils via a handkerchief inhaled with ten deep breaths for 14 days and then placed next to a pillow. The EPDS scores were measured twice (at the baseline and after 7 days). The data were analyzed using SPSS software (version 21) and the Mann-Whitney U and Wilcoxon tests. The mean EPDS scores before the intervention were 11.4±0.9 and 11.1±1.2 in the bergamot and lavender groups, respectively. The mean EPDS scores on the 7th day of the intervention were 8.8±3.1 and 5.3±2.2 in the bergamot and lavender groups, respectively (P=0.003). Aromatherapy is recommended within the 3rd to 5th day following C-section.

The Relationship between psychosocial health status and risk of depression among pregnant women in Turkey

Background & aim: Pregnancy involves physiological, psychological, and social changes, in which women are expected to adapt to the biopsychosocial changes. Failure to make such an adaptation would be accompanied by an increased risk of prenatal depression in pregnant women. This study was conducted to determine the relationship between psychosocial health status and the risk of depression in pregnant women. Methods: This descriptive-analytic study was carried out on 792 pregnant women (i.e., 73, 369, and 350 cases in the first, second, and third trimesters, respectively) referring to the Outpatient Clinic of the Meram Medical Faculty Hospital, Necmettin Erbakan University, Turkey, from 22 March to 30 June 2016. The pregnant women who attended the outpatient clinic and met the inclusion criteria were selected using haphazard sampling, as a non-probability sampling method. The data were collected through a researcher-made questionnaire, the Pregnancy Psychosocial Health Assessment Scale (PPHAS), and the Edinburgh Postnatal Depression Scale (EPDS). Data analysis was performed in SPSS software (version 22) using descriptive statistics, Mann-Whitney U test, and Kruskal Wallis test. Results: The pregnant women had the depression risk of 28.2% and mean depression score of 9.41±4.8. The total mean score of PPHAS was obtained as 4.05±0.45. The risk of depression showed a statistically negative relationship with the total and sub-dimension mean scores of PPHAS, as well as the mean EPDS score (P˂0.001). Conclusion: Pregnant women with lower psychosocial health status were more likely to have the risk of depression. In other words, the risk of depression in pregnant women was influenced by factors that determine their psychosocial health.

A Comparison of Postpartum Depression in Mothers Conceived by Assisted Reproductive Technology and Those Naturally Conceived.

BackgroundIt is thought that mothers who conceive via assisted reproductive technology (ART) may be at greater risk of postpartum depression (PPD) because of the problems and psychological stresses associated with ART treat- ment. The aim of the present study is to determine the occurrence of PPD among mothers who conceive by ART in comparison with mothers who naturally conceive. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD.Materials and MethodsThis historical cohort study investigated 406 mothers with infants aged 3-9 months. Three hundred and eight women with natural pregnancies were selected as the control group from mothers who referred to Tehran healthcare centres for infant vaccinations. The ART group consisted of 98 women who conceived via ART at Royan Institute. Participants completed a general questionnaire that asked about education, occupation, number of children, delivery method, history of infant hospitalization, breastfeeding, mothers’ and infants’ ages, cause of infertil- ity (ART group), and history of depression. A validated Persian version of the EPDS was used to measure depressive symptoms.ResultsThe mean EPDS score in mothers who naturally conceived was 8.38 ± 0.35 in comparison with mothers who conceived via ART (7.59 ± 0.63). The proportions of women who reported PPD were 26.0% for the control group and 20.4% for the ART group. There was no statistically significant difference in PPD between the control and ART groups (P=0.26).ConclusionThe occurrence of PPD in mothers who conceived via ART was similar to those who conceived naturally.

Physical activity during early pregnancy and antenatal depression: A prospective cohort study

BackgroundDespite the known health benefits of physical activity, its impact on depression during pregnancy remains inconclusive, especially in Asian populations. A large prospective cohort study was conducted to ascertain the association between total and domain-specific physical activity during early pregnancy and antenatal depression in Chinese women. MethodsInformation was collected prospectively from a cohort of 1440 pregnant women in Chengdu, Western China. Habitual physical activities (total, domain-specific and intensity level) were measured by the validated Chinese version of the Pregnancy Physical Activity Questionnaire during the first trimester. Antenatal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 32–37 weeks of gestation. Multivariable linear and logistic regression analyses were undertaken, modelling EPDS as both continuous score and binary variable, respectively. ResultsOverall, the mean EPDS score was 9.3 (SD 3.7) and the prevalence of antenatal depression (EPDS ≥13) was 17.5% (n = 252). The mean total physical activity was 149.1 (SD 84.2) MET-hours/week. A high level of occupational activity (>73 MET-hours/week) was associated with a reduced risk of antenatal depression (odds ratio 0.57; 95% CI 0.37 to 0.94). A similar inverse association was evident for the continuous EPDS score. However, no apparent associations with EPDS were observed for total, other domains and intensities of physical activity exposures. LimitationsLack of information on history of major depression. Use of self-reported questionnaires instead of objective measures of physical activity and clinical diagnosis of antenatal depression. ConclusionsBeing active at work during early pregnancy may reduce antenatal depressive symptoms for Chinese women.

The role of elective and emergency cesarean delivery in maternal postpartum anhedonia, anxiety, and depression.

To compare levels of anhedonia, anxiety, and depression in women following elective and emergency cesarean delivery. An observational study was conducted between January 1, 2015, and May 31, 2017, among Italian women who delivered healthy neonates at term at the Policlinico Abano Terme, Italy, by vaginal, elective cesarean delivery (ElCD) or emergency cesarean (EmCD) delivery. The women completed the Edinburgh Postnatal Depression Scale (EPDS), including specific factors within each category, 2days post-delivery to measure postpartum depressive symptomatology. Of the 2234 women enrolled in the study, 1702 (76.2%) had a vaginal delivery and 532 (23.8%) a cesarean delivery, of which 264 (11.8%) were emergency and 268 (12.0%) were elective. Mean EPDS scores (P=0.075) and the number of women with EPDS scores >12 (P=0.718) were comparable among the delivery groups. However, mean anxiety factor scores were significantly higher in the ElCD group (P=0.031), and conversely, mean anhedonia factor scores were significantly higher in the EmCD group (P=0.001). Postpartum depressive symptomatology of women who have had a cesarean delivery was characterized by higher levels of anxiety after ElCD and by higher levels of anhedonia after EmCD.

Perinatal mental health and psychosocial risk screening in a community maternal and child health setting: evaluation of a digital platform

Abstract Background Screening women for depression and psychosocial risk during the perinatal period is recognised best practice. Screening by current pen and paper methods can be time consuming, and prone to scorer error. The lack of readily available translated versions of screening tools also excludes many women from different cultures. Aim To evaluate a perinatal mental health digital screening platform, iCOPE. The trial was conducted in a community maternal and child health setting in Melbourne, Australia. Method A descriptive, cohort design was used. All women attending the urban clinic were invited to complete their routine perinatal screening on the digital platform, designed to automate score calculations and produce instant clinical and client reports whilst collecting data in real time. Screening included the Edinburgh Postnatal Depression Scale (EPDS) and psychosocial risk questions in line with current national clinical guidelines. Functionality of iCOPE was assessed according to duration of screening, completion rates, accuracy of reporting and level of engagement by women. Results During the trial, 144 screens were performed. The mean screening time was 6.7 min (SD=3.78). Most (65.7% n=94) women took between 3 and 6 min. Mean EPDS score was 7.2 with 16% (n=23) scoring 13 or more. The accuracy of reports was 100% and screening completion rate was 99.3%. Many women (81.3%) requested a copy of their personal report. Discussion The iCOPE platform was efficient in terms of screening time, scoring accuracy, and engagement of women. The automated production of tailored client and clinical reports enabled screening outcomes to be instantly communicated to women and health professionals. The collection of data in real time facilitated the monitoring of screening rates and evaluation of outcomes by clinicians and service managers.