Occurrence Of Postpartum Depression Research Articles

The Effect of an Educational program about COVID-19 for Pregnant Women on the Occurrence of Postpartum Depression

The Effect of an Educational program about COVID-19 for Pregnant Women on the Occurrence of Postpartum Depression

Effect of esketamine on postpartum depression after labor analgesia and potential mechanisms: a randomized, double-blinded controlled trial

BackgroundTo evaluate the effect of esketamine combined with ropivacaine hydrochloride on the occurrence of postpartum depression (PPD) after labor analgesia under epidural analgesia pump and explore the possible mechanisms.MethodsA total of 120 women aged 24 to 36 years old who underwent labor analgesia by epidural analgesia pump, with American Society of Anesthesiologists (ASA) physical status II were enrolled. According to the formula of epidural analgesia pump, all participants were randomly divided into two groups: esketamine group (Group E) and control group (Group C). Epidural anaesthesia were operated in all women between L2 and L3 after cervical dilation up to 2 ~ 3 cm. After successful puncture, the epidural catheter was placed 3.5 cm toward the head and 1% lidocaine was injected for 3 ml. The epidural analgesia pump was connected. Esketamine (0.2 mg/kg) combined with 0.75% ropivacaine hydrochloride (20 ml) were diluted by normal saline up to 100 ml in Group E, when only the equal dose of ropivacaine hydrochloride was used in Group C. The visual analogue scale (VAS) before analgesia (T1), 5 (T2), 10 (T3) and 20 (T4) minutes after analgesia were measured. The duration of the first and second stage of labor, the Apgar score of fetus at delivery, postpartum hemorrhage, consumption of esketamine and ropivacaine were recorded. The incidence of PPD was recorded at 1 week and 6 weeks after delivering. The occurrence of side effects such as nausea and vomiting, dizziness, and nightmares were also recorded for 48 h after delivering. The levels of leptin, norepinephrine(NE), and epinephrine(E) in the peripheral venous blood were measured before labor analgesia and at 24 h, 1 week, and 6 weeks after delivering.ResultsCompared with Group C, the VAS score at T2, T3 and T4 were significantly lower in Group E (P < 0.01). Compared with Group C, the incidence of PPD was significantly lower at 1 week and 6 weeks after delivering in Group E (P < 0.01). Compared with Group C, the levels of leptin were significantly higher at 24 h and 1 week after delivering in Group E (P < 0.01), while NE and E (P < 0.01) were lower at the same time (P < 0.01). There were no significant difference of the duration of the first and second stage of labor, the Apgar score of fetus at delivery, postpartum hemorrhage, consumption of ropivacaine and the side effects for 48 h after delivering between the two groups.ConclusionEsketamine combined with ropivacaine hydrochloride used in labor analgesia can significantly reduce the incidence of postpartum depression after delivering without increasing related side effects, which may be related to the regulation of leptin, norepinephrine, and epinephrine in the serum.Trial registrationThe trial was registered at the Chinese Clinical Trial Registry on 30/05/2022 (CTRI registration number—ChiCTR2200060387). URL of registry: https://www.chictr.org.cn/bin/home.

Effect of single intravenous injection of esketamine on postpartum depression after labor analgesia and potential mechanisms: a randomized, double-blinded controlled trial

BackgroundThe study was designed to investigate effects of single intravenous injection of esketamine on the incidence of postpartum depression (PPD) after labor analgesia and explore the potential mechanisms.MethodsA total of 120 women who underwent labor analgesia by epidural analgesia pump were enrolled and divided into two groups randomly. Esketamine at a dose of 0.2 mg/kg was intravenously injected after fetal disengagement in the test group and placebo was administered in the control group. The occurrence of PPD and side effects after delivery were recorded. Some indicators related to stress and inflammation were measured before labor analgesia and at 24 h, 1 week, and 6 weeks after delivery in this study. Data were analyzed by independent t-test, repeated measures analysis of variance and Chi-square test in SPSS software (version 25.0). It was considered statistically significant since a p value less than 0.05.ResultsThe incidence of PPD was significantly decreased both for one week and six weeks after delivery by using of esketamine (3.4% vs. 15.3%, p = 0.004 and 5.2% vs. 18.6%, p = 0.006, respectively). There were also significant differences between the stress and inflammation-related indicators in different time points in this study, while the side effects for 48 h after delivery were similar between the two groups.ConclusionsSingle intravenous injection of esketamine after delivery in participants underwent labor analgesia can decrease the occurrence of postpartum depression for one week and six weeks after delivery, while the side effects were not increased. The antidepressant effects of esketamine may be related to the reduction of stress response and inflammation.Trial registrationThe trial was registered at the Chinese Clinical Trial Registry on 5/30/2022 (CTRI registration number—ChiCTR2200060387). URL of registry: https://www.chictr.org.cn/bin/home.

Postpartum Depression Among Malaysian Mothers During the COVID-19 Pandemic and Its Relationship With Breastfeeding Practices and Perceived Social Support

Introduction: Breastfeeding practice aids babies in acquiring nutrients they need but it could be impeded when women are struggling from postpartum depression (PPD). The prevalence of PPD varied across countries and certain sociodemographic traits along with breastfeeding practices have influenced PPD rates differently. The aim of this research was to study the prevalence of PPD among Malaysian mothers during the COVID-19 pandemic and to study the overall relationship between breastfeeding ractice with PPD and perceived social support. Methods: Through an online questionnaire, 109 mothers have participated, and the collected data were analysed based on the sociodemographic information, Edinburgh Postnatal Depression Scale (EPDS) and Multidimensional Scale of Perceived Social Support (MSPSS). Results: The prevalence of PPD was 48.6%. Sociodemographic characteristics like working status, ethnicity, living region and household income had no association with PPD. No statistically significant differences in working status with PPD and perceived social support levels respectively, although the occurrence of PPD was higher among working-class mothers. A significant negative correlation was found between PPD level with perceived social support (P=0.040, rs=-0.197) and paid maternity leave (P=0.015, rs=-0.333). Perceived social support was positively correlated with education level (P=0.044, rs=0.194) and paid maternity leave (P=0.023, rs=0.218). Conclusion: The social support and paid maternity leave may reduce the PPD, yet further studies involving a larger and more diverse subjects may warrant a more conclusive finding.

Effect of pre-administration of esketamine intraoperatively on postpartum depression after cesarean section: A randomized, double-blinded controlled trial.

To evaluate the effect of pre-administration of esketamine intraoperatively on the occurrence of postpartum depression after cesarean section under combined spinal-epidural anesthesia. A total of 120 women aged 24 to 36 years undergoing cesarean section by spinal-epidural anesthesia with American Society of Anesthesiologists physical status II were enrolled. According to the intraoperative use of esketamine, all participants were randomly divided into 2 groups: test group (group E) and control group (group C). Esketamine was administered intravenously at a dose of 0.2 mg/kg after the infant was delivered in group E and equal volume of normal saline was given in group C. The incidence of postpartum depression was recorded at 1 week and 6 weeks after the operation. The occurrence of adverse reactions such as postpartum bleeding, nausea and vomiting, drowsiness, and nightmares were also recorded at 48 hours after surgery. Compared with group C, the incidence of postpartum depression was significantly lower at 1 week and 6 weeks after surgery in group E (P < .01). There was no significant difference of the adverse effects at 48 hours after the operation between the 2 groups. Intravenous infusion of 0.2 mg/kg esketamine in women during cesarean section can significantly reduce the incidence of postpartum depression at 1 week and 6 weeks after surgery without increasing related adverse effects.

Desrespeito e abuso durante o parto e depressão pós-parto: uma revisão de escopo

This study aims to map, within the scientific literature, the relationship between disrespect and abuse during childbirth and the occurrence of postpartum depression. This is a scoping review designed in accordance with the recommendations of the Joanna Briggs Institute. The search was performed in Embase, LILACS, MEDLINE, PsycINFO, Web of Science, and in the CAPES Portal of Theses and Dissertations. We included studies that investigated the relationship between disrespect and abuse during childbirth with postpartum depression, considering cases diagnosed by physicians and by self-reports via validated scales, without restrictions regarding the year of publication and language. A total of 3,399 publications were identified and, after removing the duplicates and reading the title, abstracts, and the full-texts, seven articles were selected to integrate this review. Studies were published from 2017 onward, in four countries. Women who had experienced disrespect and abuse during childbirth were more likely to experience symptoms of postpartum depression. A standard terminology is necessary for disrespectful and abusive care during childbirth, as well as the elaboration of a measurement instrument that is universally accepted.

Screening of Postpartum Depression among postnatal mother at a selected Tertiary Care Hospital, Chengalpattu district, Tamil Nadu, India

Background of the study: Postpartum depression a form of severe depression after delivery that may be interferes withday-to-day activities and it also requires treatment. The occurrence of postpartum depression may be a few days, weeksor even months after childbirth. A woman with postpartum depression may have feeling of low level of mood, anxiety,irritability to severe degree.it could also associated with the antenatal depression, young maternal age, hyperemesis,marital status, and previous affective disorders. Postpartum depression having the most common complications ofchildbearing and is usually associated with impairments in mother–infant interactions that can lead to severe consequencesfor the infant such as illness, poor growth and development. These mothers’ infants had more commonly symptoms andillnesses, especially infantile colic, and they were less likely to be breastfed. Similarly, among depressed mothers low levelof support from spouse and significant others and physical family violence were more common, likewise poor basic andprofessional education, poor economic and housing situation can also cause postpartum depression, As it is alarming theresearchers conducted a study on screening of postpartum depression among postnatal mothers.Methods and Materials: Quantitative research approach, descriptive research design was carried out. The sample of56 postnatal mothers were selected by using purposive sampling technique. The study was conducted at tertiary carehospital, Kelambakkam, Chengalpet district. Phone number of postnatal mother who delivered from 2-6 weeks after delivery was obtained earlier from MRD. Telephonic interview was carried out to collect the data by using modifiedEdinburg postnatal depression scale. Data was analysed by using descriptive and inferential statistics.Results: This study showed that 21.4% of postnatal mothers having postpartum depression whereas, 78.6% were notdepressive. The findings implies that P value is more than 0.05 so there is no significant association between prevalenceof postpartum depression with demographic and obstetrical variables.

Association of General Anesthesia and Neuraxial Anesthesia in Caesarean Section with Maternal Postpartum Depression: A Retrospective Nationwide Population-Based Cohort Study

Although cesarean section (CS) has become a common method of child delivery in recent decades, the choice between general anesthesia (GA) and neuraxial anesthesia (NA) for CS must be carefully considered. Depending on the type of anesthesia used in CS, a major outcome observed is the occurrence of postpartum depression (PPD). This study investigated the association between PPD risk and the anesthesia method used in CS by using data from three linked nationwide databases in Taiwan, namely, the National Health Insurance Research Database, the National Birth Reporting Database, and the National Death Index Database. After propensity score matching by baseline depressive disorders, maternal demographics, status at delivery, infant’s health, maternal diseases during pregnancy, and age of partner, we included women who had natural births (n = 15,706), cesarean sections with GA (n = 15,706), and cesarean sections with NA (n = 15,706). A conditional logistic regression was used to estimate the odds ratios and 95% confidence intervals (CIs) of PPDs, including depression, sleep disorder, and medication with hypnotics or antidepressants, under anesthesia during CS. The prevalence rates of combined PPDs were 26.66%, 43.87%, and 36.30% in natural births, CS with GA, and CS with NA, respectively. In particular, the proportions of postpartum use of hypnotic drugs or antidepressants were 21.70%, 39.77%, and 31.84%, which were significantly different. The aORs (95% CIs) were 2.15 (2.05–2.25) for the included depressive disorders, 1.10 (1.00–1.21) for depression, 1.03 (0.96–1.11) for sleep disorder, and 2.38 (2.27–2.50) for medication with hypnotics or antidepressants in CS with GA compared with natural births. Women who underwent CS with GA had a significantly higher risk of depressive disorders and a higher need for antidepressants for sleep problems than those who underwent CS with NA. The risks of PPD were significantly associated with the anesthesia method, especially GA. Our results can assist physicians in carefully considering the appropriate anesthesia method for CS delivery, particularly with regard to postpartum drug abuse and drug safety.

Prevalence and Associated Factors of Postpartum Depression among Women in Central Region of Saudi Arabia

Introduction: Postpartum depression is one of the most common psychological problems in women worldwide. Globally, it was estimated that 10% of women have a mental illness, mainly depression, during pregnancy, whereas 13% after giving birth. This study aims to identify the prevalence and associated factors of postpartum depression among married women in the central region of Saudi Arabia. Material and Methods: A community-based cross-sectional study was conducted from October 2020 to June 2021 in Ar-Riyadh province, located in the center part of the country. The information in this study was collected using online web media, which incorporated Edinburgh postnatal depression scale to assess postpartum depression. This study followed a simple random sampling method where the sample was selected based on the response that meets the required age group and has at least one pregnancy experience in their lifetime. A total of 1067 sample was taken for the study, among which 907 were reached. The collected information was entered and analyzed using SPSS version 21, where the required analysis was performed to present the information. Results: In this study, among 907 respondents, most (34%) of the respondents were from the age group 31-40, and the majority of them were married, 90%. Likewise, Two-third of the respondent (66.6%) reported that they got a lot of social support from the child's father, while one-third (33.4%) did not receive much support. The study also indicated that more than 50% reported being on postpartum depression and that which majority of respondents (92.6%) did not have a history of depression. In comparison, 7.4% reported a history of depression. Here, a significant association was seen between the number of children and PPD (P=&lt;0.001). Also, a significant association was seen between mothers' history of depression and the occurrence of postpartum depression (P=&lt;0.001). Conclusion: The study concluded that there is a high prevalence of PPD among women in the Central region of Saudi Arabia, which is an alarming issue. Therefore, there is an increased need of often screening and preventive treatment as the support for managing the mental issues of the mothers. Keywords: Postpartum depression, Prevalence, Saudi Arabia

The association between postpartum depression and air pollution during pregnancy and postpartum period: a national population study in Taiwan

Epidemiological evidence shows the association between air pollutants and several mental health outcomes, including depression, sleep disturbance, dementia, childhood neurodevelopment and suicide. Pregnant women are believed to be more susceptible and vulnerable to environmental pollutants, and postpartum depression (PPD) is a prevalent debilitating mental disorder. However, data on the effects of exposure to air pollution during pregnancy and postpartum period on the risk of PPD remain limited. This study aimed to evaluate the association between exposure to ambient air pollution during pregnancy and postpartum period and the incidence of PPD. The Taiwan Birth Cohort Study recruited representative 12% of all newborn in 2005 and their mothers by two-stage stratified sampling, including 21 248 mother–infant pairs. The occurrence of PPD was assessed by a self-reported questionnaire. Exposure to air pollutants during pregnancy and postpartum period was estimated using hybrid kriging/land-use regression (LUR) and integrated LUR-machine learning model based on data from the air monitoring stations. Logistic regression was then conducted to determine adjusted odds ratios (aORs) of PPD in relation to air pollutants. A total of 21 188 women were included in the final analysis, among whom 3,648 (17.2%) developed PPD within 6 months postpartum. The occurrence of PPD was significantly related to exposure to ambient concentrations of nitrogen dioxide (NO2) during first trimester after adjustment [aOR: 1.081 per interquartile range (10.67 ppb), 95% confidence interval: 1.003, 1.165], but not to particulate matter ⩽2.5 µm in diameter or carbon monoxide. Exposure to ambient NO2 during early pregnancy was significantly related to the occurrence of PPD among the women investigated in this population-based study.

DIFFERENCES IN POSTPARTUM MATERNAL DEPRESSION LEVELS BASED ON CHARACTERISTICS OF MATERNAL AGE AND HUSBAND SUPPORT

The International Statistical Classification of Disease (ICD-10) defines postpartum depression as a mental and behavioral disorder that occurs after six-week labor. The number of postpartum blues in Asia is high and varies between 26-85%. In Indonesia, especially Jakarta, Yogyakarta, and Surabaya, the prevalence of postpartum depression is 11-20%. In Surabaya, 22% mothers had postnatal depression in 2003. The occurrence of postpartum depression is influenced by several factors namely biological and characteristic. This study aimed to analyze differences in postpartum maternal depression levels based on characteristics of maternal age and husband support. This study used quantitative with cross sectional study design. The population of this study was 209 mothers with postpartum depression in the timeframe of 6 weeks to 1 year. The sample size was 70 samples selected through simple random sampling. The retrieval of data was through surveys and questionnaires. The results of the study showed most respondents aged 26-30 years had high husband support and were not at risk of depression. There was a significant difference between postpartum maternal depression levels based on maternal age (p = 0.014) as well as on husband support (p = 0.000). Based on the results, researchers suggest to establish continuous husband support, conduct early detection, and educate mothers.Keywords: depression level, husband support, mother's age, postpartum depression

The risk of eating disorder relapse during pregnancy and after delivery and postpartum depression among women recovered from eating disorders

BackgroundStudies have shown that women of reproductive age develop eating disorders (EDs). Few studies have examined EDs in women by performing long-term follow-ups during pregnancy and after delivery. Our study aimed to identify relapse of EDs during pregnancy and after delivery as well as postpartum depression in women who had complete remission of EDs.MethodsOf the 1008 patients with EDs who visited our outpatient clinic between 1994 and 2004, 55 experienced ED remission and pregnancy. Of these, 25 (21 with BN and 4 with AN) consented to participate in this study. Finally, 24 patients were included in this study after 1 patient was excluded owing to a miscarriage. They were interviewed every 2 weeks both during pregnancy and after giving birth. We used the Eating Attitudes Test-26 (EAT-26) and Edinburgh Postnatal Depression Scale (EPDS) as reference scales for diagnosing the EDs and the postpartum depression, respectively. We used a two-sided unpaired test for the statistical analysis.ResultsSixteen participants (67%) experienced ED relapse during pregnancy and twelve (50%) relapsed after birth. Twelve (50%) had postpartum depression, four of whom (33%) had low-birth-weight infants. Among the participants who did not have postpartum depression, there were no low-body-weight infants. There was no significant difference (p = 0.065) in birth weight between the postpartum depression and non-depression groups.ConclusionsOur study revealed that recurrence of EDs and the occurrence of postpartum depression were higher in this population, indicating the need to closely monitor EDs both during pregnancy and after birth.

Exposure to General Anesthesia for Cesarean Delivery and Odds of Severe Postpartum Depression Requiring Hospitalization.

Previous research suggests that, compared with regional anesthesia, general anesthesia is associated with increased odds of postoperative depressive disorders. No study has specifically evaluated the possible protective effect of neuraxial anesthesia for cesarean delivery on maternal mental health compared with general anesthesia. This exploratory study was designed to test the hypothesis that general anesthesia for cesarean delivery is associated with increased odds of severe postpartum depression (PPD) requiring hospitalization compared with neuraxial anesthesia. This retrospective cohort study included cesarean delivery cases performed in New York State hospitals between January 2006 and December 2013. Exclusion criteria were as follows: (1) having >1 cesarean delivery during the study period; (2) residing outside of New York State; (3) having a general anesthetic for other surgery or delivery in the previous year or in the year after the index case. The primary outcome was the occurrence of PPD, and the secondary outcomes were: (1) the composite of suicidal ideation or self-inflicted injury (ie, suicidality); (2) anxiety disorders; and (3) posttraumatic stress disorders (PTSD). Primary and secondary outcomes were identified during the delivery hospitalization and up to 1 year after delivery. Adjusted odds ratios (aORs) and 95% confidence interval (CI) of adverse psychiatric outcomes associated with general anesthesia were estimated using propensity score matching. Of the 428,204 cesarean delivery cases included, 34,356 had general anesthesia (8.0%). Severe PPD requiring hospitalization was recorded in 1158 women (2.7/1000; 95% CI, 2.5-2.9); of them, 60% were identified during readmission, with a median of 164 days after discharge. Relative to neuraxial anesthesia, general anesthesia in cesarean delivery was associated with a 54% increased odds of PPD (aOR, 1.54; 95% CI, 1.21-1.95) and a 91% increased odds of suicidal ideation or self-inflicted injury (aOR, 1.91; 95% CI, 1.12-3.25). There was insufficient evidence in these data that general anesthesia was associated with anxiety disorders (aOR, 1.37; 95% CI, 0.97-1.95) or PTSD (aOR, 1.50; 95% CI, 0.50-4.47). General anesthesia for cesarean delivery is associated with increased odds of severe PPD requiring hospitalization, suicidal ideation, and self-inflicted injury. If confirmed, these preliminary findings underscore the need to avoid the use of general anesthesia for cesarean delivery whenever possible, and to provide mental health screening, counseling, and other follow-up services to obstetric patients exposed to general anesthesia.

Epidural Labor Analgesia Is Associated with a Decreased Risk of the Edinburgh Postnatal Depression Scale in Trial of Labor after Cesarean: A Multicenter, Prospective Cohort Study.

Postpartum depression is a disabling mental disorder commonly seen in parturients under trial of labor after cesarean, which causes serious harm to the parturients. The etiology is unclear. We hypothesized that epidural labor analgesia can reduce the incidence rate of postpartum depression. Enrolled multiparas were divided into the epidural labor analgesia group (n = 263) or nonanalgesia group (n = 160) according to their own request. Edinburgh Postnatal Depression Scale was used to assess their mental status at 48 hours and 42 days after delivery. Relative perinatal variables were collected and further analyzed using univariate analysis and multivariate logistic regression analysis to assess the relation of epidural analgesia with the occurrence of postpartum depression under trial of labor after cesarean. The Edinburgh Postnatal Depression Scale score 48 hours ≥ 10 in the no epidural analgesia group was 26.42% while the epidural analgesia group was 8.49% (OR, 0.209; 95% CI, 0.096–0.429; P < 0.001). The Edinburgh Postnatal Depression Scale score 42 day ≥ 10 in the no epidural analgesia group was 25.16% while the epidural analgesia group was 6.59% (OR, 0.235; 95% CI, 0.113–0.469; P < 0.001). The incidence of postpartum depression was significantly lower in the epidural labor analgesia group at 48 hours and 42 days. There was also a significant relation between the Edinburgh Postnatal Depression Scale scores at 48 hours and 42 days after delivery. Epidural analgesia, discomfort within 42 days, and self-rating anxiety scale are independent predictors of postpartum depression for trial of labor after cesarean in 42 days. Epidural labor analgesia is associated with a decreased risk of postpartum depression. Further study with a large sample size and more centers is needed to evaluate the impact of epidural analgesia on the occurrence of postpartum depression. Chinese Clinical Trial Register, ChiCTR-ONC-17010654.

The effect of social support to postpartum depression in postpartum mother in 2018

The Effect Of Social Support To Postpartum Depression in Postpartum Mother. Post-partum mother have the potential of depression. Their new role as mother gives a higher burden on their mental health. According to the American of Pedriatrics, a retrospective study conducted by nursing found that one of seven women was hospitalized for depression during pregnancies up to one year after childbirth. The prevalence of maternal depression in 2 weeks after delivery was 80-85% and more than 8-15% will develop into postpartum depression. Pregnant mother who did not receive social support were associated with the incidence of postpartum depression with an OR of 2.12 to 3.38 as well as postpartum mothers who received less social support associated with postpartum depression with OR values of 2.06 to 9.64.The study was conducted by literature studies on 10 previous studies about social support variables and the occurrence of postpartum depression. It was found that social support is essential for post-partum mothers in order to keep their confidence to take care their babies and adapt to new things. The social supports were expected from husbands, families, health professionals and environment. Several factors such as culture, education level, demography, and birth experience have the effects on the potential of post-partum depression. Low level of social support increased maternal depression and reduce maternal mental health within four weeks after delivery. High levels of depression can lead to self-harming, acute depression symptoms such as sadness, crying, irritability, anxiety, concentration difficulty, lability of feelings and sleep and appetite disorders, even at an advanced level, it can lead to suicide. In order to minimize and overcome postpartum depression, midwives are expected to provide promotive preventive care on mental health both in prenatal and antenatal periods.

The interaction between estradiol change and the serotonin transporter gene (5-HTTLPR) polymorphism is associated with postpartum depressive symptoms.

Although estrogenic fluctuation is considered a major risk factor for postpartum depression (PPD), the effects of the interactions between the genetic background and estradiol (E2) change on PPD are not well understood. Here, a cohort study with 437 postpartum women was carried out to evaluate the role of a serotonin transporter gene polymorphism (5-HTTLPR) and E2 change on the risk of PPD symptoms. The participants were assessed using the Edinburgh Postnatal Depression Scale and the Self-Rating Depression Scale at 1 and 6 weeks after delivery. The PCR-based restriction fragment length polymorphism method was utilized to examine the genotype distribution of the 5-HTTLPR polymorphism, and the serum levels of E2 were determined in individuals in the third trimester of pregnancy and at 1 week postpartum. A significant association was observed between E2 change and PPD susceptibility in the late postpartum period (6 weeks) [P = 0.002, odds ratio (OR) = 2.341, 95% confidence interval (CI) = 1.361-4.027], but it was not observed in the early postpartum period (1 week). There was no significant association between the 5-HTTLPR genotype and PPD risk at both the early and late postpartum periods (P > 0.05). However, the interaction between E2 change and the 5-HTTLPR polymorphism could reasonably influence PPD risk. The women who carried the SS genotype with large decreases in E2 showed a significantly higher risk for PPD at both the early (P = 0.002, OR = 2.525, 95% CI = 1.384-4.059) and late postpartum periods (P < 0.001, OR = 3.108, 95% CI = 1.562-4.436) compared with those who carried the SL/LL genotype. This study suggests that there is an association between E2 change in the perinatal period with the 5-HTTLPR genotype and the occurrence of PPD.

Postpartum depression: association with genetic polymorphisms of noradrenaline metabolic enzymes and the risk factors

To investigate the association of genetic polymorphisms of norepinephrine metabolizing enzymes with postpartum depression and analyze the risk factors for postpartum depression in women following cesarean section. A total of 591 Chinese woman of Han Nationality undergoing caesarean section were enrolled in this study. The diagnosis of postpartum depression was established for an Edinburgh Postnatal Depression Scale (EPDS) score ≥9. For all the women without antepartum depression, the genotypes of catechol-O-methyltransferase (COMT; at 5 sites including rs2020917 and rs737865) and monoamine oxidase A (rs6323) were determined using Sequenom? Mass Array single nucleotide polymorphism (SNP) analysis. We analyzed the contribution of the genetic factors (SNPs, linkage disequilibrium and haplotype) to postpartum depression and performed logistic regression analysis to identify all the potential risk factors for postpartum depression and define the interactions between the genetic and environmental factors. The incidence of postpartum depression was 18.1% in this cohort. Univariate analysis suggested that COMT polymorphism at rs2020917 (TT genotype) and rs737865 (GG genotype) were significantly correlated with the occurrence of postpartum depression (P &lt; 0.05). Logistic regression analysis showed that COMT polymorphism at rs2020917 (TT genotype) and rs737865 (GG genotype), severe stress during pregnancy, and domestic violence were the risk factors for postpartum depression (P &lt; 0.05); no obvious interaction was found between the genetic polymorphisms and the environmental factors in the occurrence of postpartum depression. The rs2020917TT and rs737865GG genotypes of COMT, stress in pregnancy, and domestic violence are the risk factors for postpartum depression.

The relationship between mode of delivery and postpartum depression.

PURPOSE:Postpartum period is a critical interval in which the woman is under risk for psychiatric disorders including postpartum depression (PD). This study was performed to investigate the impact of the mode of delivery on the occurrence of PD in primiparous mothers.MATERIALS AND METHODS:This correlational study was performed on 244 primiparous women (aged 15–49 years) in 17 primary health-care centers. Sociodemographic, obstetric, and PD-related data were gathered using questionnaires and the Edinburgh Postnatal Depression Scale (EPDS) on the 1st and 3rd months after delivery. The questionnaires were administered to all primiparous mothers who were registered to the relevant health-care center. Questionnaires were administered by the researcher for 25–30 min with face-to-face interview technique.RESULTS:Comparison of EPDS scores on the 1st and 3rd months indicated that there was a remarkable decline over time (Z = 11.112, P = 0.001). There was an inverse association between educational level and EPDS scores on the 3rd month (P = 0.037). On the other hand, no significant relationship was detected between age groups, occupation, income, place of accommodation, and EPDS scores. Evaluation of the relationship between obstetric features and EPDS scores revealed that desired and performed modes of delivery, induction, episiotomy, and spinal anesthesia were not linked with EPDS scores. The postpartum behavior (χ2 = 10.315; P = 0.035) and feeding method of infants (χ2 = 6.109; P = 0.013) were associated with EPDS scores on the 1st month, but not with EPDS scores on the 3rd month.CONCLUSION:Effective measures must be established for early recognition of factors affecting the occurrence of PD. Health planners and policymakers must spend their efforts for promotion of the knowledge and attitudes of mothers during pregnancy. Identification of factors for PD necessitates implementation of multicentric, controlled trials on larger series.

Postpartum depression and breastfeeding in primary care in Krakow, Poland

Purpose of Investigation: The aim of this study was to examine the risk of postpartum depression (PPD) and its relationship with confidence in breastfeeding (BF) in women under the care of general practitioners in Krakow. Materials and Methods: The study among Polish women was performed in seven primary care out-patient clinics in Krakow in 2015. Each participant completed a personal questionnaire which included the Edinburgh Postnatal Depression Scale (EPDS) and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Results: The authors examined 273 women of which 13% of participants were at risk of developing PPD. Women who are more likely to develop PPD are less satisfied with their BF or do not feed their children naturally at all. There was a statistically significant correlation between the risk of developing PPD and mothers’ chronic diseases and occurrence of PPD after previous labours. Conclusion: After childbirth in women living in Krakow, the prevalence of the risk of PPD did not differ from other European countries and was higher in those with low BF self-efficacy scores.

The influence of mistreatment during childbirth on postpartum depression: Findings from the 2015 Pelotas (Brazil) birth cohort study

Background Women worldwide face diverse forms of mistreatment during childbirth that puts their lives and well-being at-risk. Minimal research has focused on the impact of mistreatment experiences during childbirth on adverse maternal and perinatal health outcomes. Aims To determine whether there is an association between mistreatment of women during facility-based childbirth and postpartum depression occurrence. Methods We used data from the 2015 Pelotas (Brazil) Birth Cohort Study. Women who had given birth in a local medical hospital facility (either public or private) under the supervision of a skilled birth attendant in the year 2015 were considered eligible to take part in the study, as well as their newborns (cohort members). Self-report mistreatment experiences during childbirth (disrespect and abuse) and postpartum depressive symptoms were assessed by household interviews three months after delivery. Mistreatment included information on physical abuse, verbal abuse, denial of care, and undesired procedures. Binary variables were created to indicate the occurrence of at least one, and at least two mistreatment experiences. The Edinburgh Postnatal Depression Scale to assess postpartum depression. A positive screening was defined as EPDS ≥ 15. We used multivariable logistic regression to determine the odds of having a positive screening for postpartum depression between women who experienced mistreatment during childbirth and those who did not. We adjusted for potential confounders including family income, maternal education, age, skin color, parity, marital status, desire for pregnancy, fathers’ reaction when discovering the pregnancy, previous depression, pregnancy morbidities, and deliver type (C-section or vaginal). We tested for interaction between antenatal depression (EPDS ≥ 10) and mistreatment experiences on the occurrence of postpartum depression. Results A total of 4275 cohort members took part in the perinatal follow-up. The three-month follow-up interviewed 4087 biological mothers; 18.3% and 5.1% reported having experienced at least one and at least two types of mistreatment forms during childbirth, respectively; 6.8% screened positive for postpartum depression (EPDS ≥ 15). Women reported having experienced at least one type of mistreatment presented higher odds for postpartum depression (OR: 1.53; 95% CI: 1.07–2.20) as well as the women who reported at least two mistreatment forms (OR: 1.85; 95% CI: 1.06–3.24). We observed an interaction between antenatal depression and mistreatment during childbirth on postpartum depression. We found higher odds of postpartum depression among women who did not experienced antenatal depression (OR: 2.32; 95% CI: 1.05–5.14) when compared those who did (OR: 1.26; 95% CI: 0.81–1.90) for at least one mistreatment experience. The odds of postpartum depression among women reporting both antenatal depression and mistreatment during childbirth was 15.5 (95% CI: 9.6–25.0). Conclusions Mistreatment during childbirth higher the odds of postpartum depression three months after birth. The independent effect of having experienced mistreatment during childbirth on postpartum depression is greater for women not presenting depression during pregnancy. Strategies to promote high-quality and respectful maternal healthcare are essential to prevent mother–child adverse outcomes. Women presenting antenatal depression are a priority group for interventions.