Incidence Of Postpartum Depression Research Articles

Impact of air pollution and climate change on mental health outcomes: an umbrella review of global evidence.

The impact of air pollution and climate change on mental health has recently raised strong concerns. However, a comprehensive overview analyzing the existing evidence while addressing relevant biases is lacking. This umbrella review systematically searched the PubMed/Medline, Scopus and PsycINFO databases (up to June 26, 2023) for any systematic review with meta-analysis investigating the association of air pollution or climate change with mental health outcomes. We used the R metaumbrella package to calculate and stratify the credibility of the evidence according to criteria (i.e., convincing, highly suggestive, suggestive, or weak) that address several biases, complemented by sensitivity analyses. We included 32 systematic reviews with meta-analysis that examined 284 individual studies and 237 associations of exposures to air pollution or climate change hazards and mental health outcomes. Most associations (n=195, 82.3%) involved air pollution, while the rest (n=42, 17.7%) regarded climate change hazards (mostly focusing on temperature: n=35, 14.8%). Mental health outcomes in most associations (n=185, 78.1%) involved mental disorders, followed by suicidal behavior (n=29, 12.4%), access to mental health care services (n=9, 3.7%), mental disorders-related symptomatology (n=8, 3.3%), and multiple categories together (n=6, 2.5%). Twelve associations (5.0%) achieved convincing (class I) or highly suggestive (class II) evidence. Regarding exposures to air pollution, there was convincing (class I) evidence for the association between long-term exposure to solvents and a higher incidence of dementia or cognitive impairment (odds ratio, OR=1.139), and highly suggestive (class II) evidence for the association between long-term exposure to some pollutants and higher risk for cognitive disorders (higher incidence of dementia with high vs. low levels of carbon monoxide, CO: OR=1.587; higher incidence of vascular dementia per 1 μg/m3 increase of nitrogen oxides, NOx: hazard ratio, HR=1.004). There was also highly suggestive (class II) evidence for the association between exposure to airborne particulate matter with diameter ≤10μm (PM10) during the second trimester of pregnancy and the incidence of post-partum depression (OR=1.023 per 1 μg/m3 increase); and for the association between short-term exposure to sulfur dioxide (SO2) and schizophrenia relapse (risk ratio, RR=1.005 and 1.004 per 1 μg/m3 increase, respectively 5 and 7 days after exposure). Regarding climate change hazards, there was highly suggestive (class II) evidence for the association between short-term exposure to increased temperature and suicide- or mental disorders-related mortality (RR=1.024), suicidal behavior (RR=1.012), and hospital access (i.e., hospitalization or emergency department visits) due to suicidal behavior or mental disorders (RR=1.011) or mental disorders only (RR=1.009) (RR values per 1°C increase). There was also highly suggestive (class II) evidence for the association between short-term exposure to increased apparent temperature (i.e., the temperature equivalent perceived by humans) and suicidal behavior (RR=1.01 per 1°C increase). Finally, there was highly suggestive (class II) evidence for the association between the temporal proximity of cyclone exposure and severity of symptoms of post-traumatic stress disorder (r=0.275). Although most of the above associations were small in magnitude, they extend to the entire world population, and are therefore likely to have a substantial impact. This umbrella review classifies and quantifies for the first time the global negative impacts that air pollution and climate change can exert on mental health, identifying evidence-based targets that can inform future research and population health actions.

Associations between Unplanned Pregnancy, Low Social Support, Domestic Violence, and Intrapartum Complication, with Postpartum Depression: Meta Analysis

Background: The postpartum period is a period where the risk of depression and other mental disorders generally increases due to the physiological and psychosocial changes that occur. The aim of this study was to measure the relationship using the meta-analysis method of unplanned pregnancy, poor social support, domestic violence, complications during childbirth with the incidence of postpartum depression..
 Subjects and Method: This research is a systematic review and meta-analysis. Article searches were carried out using PICO. Population: Postpartum women. Interventions: unplanned pregnancy, poor social support, domestic violence, and complications during childbirth. Comparison: planned pregnancy, good social support, no domestic violence, and no complications during childbirth. Outcome: Postpartum depression. The keywords used in the article search were "postpartum depression" AND "unplanned pregnancy" AND "poor social support" AND "intimate partner violence" AND “delivery complications”. Articles were obtained from several databases including Google Scholar, Pubmed, Science Direct from 2015-2023. Data is processed using the Review Manager Application (RevMan 5.3)
 Results: Meta-analysis of 11 cross-sectional studies showed that unplanned pregnancy increased the risk of postpartum depression (aOR= 2.69; 95% CI= 2.30 to 3.16; p= 0.001). Meta-analysis of 11 cross-sectional studies showed that low social support increased the risk of postpartum depression (aOR= 2.35; 95% CI= 1.46 - 3.79; p= 0.004). Meta-analysis of 7 cross-sectional studies showed that partner violence increased the risk of postpartum depression (aOR= 2.82; 95% CI= 1.81 - 4.40; p= 0.001). Meta-analysis of 6 cross-sectional studies showed that complications during delivery increased the risk of postpartum depression (aOR= 2.20; 95% CI= 1.75 to 2.77; p= 0.001).
 Conclusion: Unplanned pregnancies, poor social support, partner violence, and complications during childbirth increase the risk of postnatal depression.
 Keywords: Unplanned pregnancy, social support, partner violence, postpartum depression.
 Correspondence: Wulan Adis Aranti. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: wulanaranti@gmail.com.

Support-Seeking Strategies, Family Communication Patterns, and Received Support Among Chinese Women with Postpartum Depression: A Content Analysis of Zhihu Posts

ABSTRACT The incidence of postpartum depression (PPD) among Chinese women surpasses the global average, and this disparity is closely associated with the level of social support they receive. Using Sensitive Interaction Systems Theory and Family Communication Patterns Theory as guiding frameworks, we conducted a content analysis of 705 posts gathered from the hashtag #PPD (chanhou yiyu) on Zhihu, a popular Chinese social media platform. Our findings reveal that postpartum women primarily seek social support from their husbands and mothers-in-law through indirect nonverbal and direct verbal communication strategies. They tend to receive more problem-focused support than emotion-focused solace. Moreover, the use of direct verbal communication strategies promotes potential support providers’ problem-solving behaviors, while the use of indirect nonverbal strategies elicits their avoidance behaviors. In addition, the conversation-oriented family communication pattern strengthens the positive association between direct verbal communication and support-providing behaviors, whereas the conformity-oriented family communication pattern weakens this relationship. This study contributes to the applicability of the abovementioned theories in the Chinese context and provides insights for future interventions aimed at addressing PPD among women.

Association of Postpartum Depression with Maternal Serum Magnesium Levels, Infant Growth, and Neurodevelopmental Indices.

Postpartum depression (PPD) can exert both short-term and long-term effects on a child's health. Offspring born to mothers who suffer from PPD face an elevated susceptibility to encountering psychological disturbances and developmental delays. Moreover, there has been conjecture surrounding a plausible connection between maternal magnesium (Mg) levels and psychiatric manifestations. This study aims to investigate the relationship between maternal Mg levels and PPD and the correlation between PPD and an infant's growth and neurodevelopment at 6 and 12 months. This longitudinal study is a sub-study derived from the "PERSIAN Birth Cohort Study," encompassing 224 mother-infant pairs randomly enlisted during 2019-2020 in Isfahan. Maternal serum magnesium (Mg) levels were measured at 38 weeks of gestation. PPD was evaluated employing the Edinburgh Postpartum Depression Scale (EPDS) four weeks postpartum. Measurements of birth size were undertaken, adhering to standardized protocols at birth, 6 months, and 12 months. Anthropometric parameters and the Persian version of the validated Ages and Stages Questionnaires (ASQ) were employed to assess infant neurodevelopmental status at 6 and 12 months. Overall, 22.3% of mothers grappled with PPD. The mean (standard deviation) maternal magnesium levels (Mg) were 1.95 ± 0.23 mg/dL. No statistically significant association was detected between maternal serum magnesium (Mg) levels and the incidence of PPD. Correspondingly, no significant association emerged between PPD and indices of growth. However, a noteworthy distinction materialized in the communication scores of offspring born to depressed and non-depressed mothers following adjustments for confounding variables at 12 months (β = 1.81; 95% confidence interval: 0.32-3.30). Furthermore, a substantial regression in communication skills became apparent between 6 and 12 months. This study failed to establish a significant association between maternal serum magnesium (Mg) levels and PPD. Nevertheless, research lends credence to an inverse correlation between maternal depression and subsequent behavioral difficulties in offspring, such as communication skills. Thus, the imperative nature of screening for PPD should be underscored to facilitate its early detection and intervention, thereby enhancing infant well-being.

The Relationship between Age and Husband's Support for Pregnant Women on the Prevention of Baby Blues in PMB Azimah, Jambi City

According to data from the Center for Diseases Control from 2004-2021, the prevalence of postpartum depression was 11.5% from 27 countries (Rockhill et al, 2017). The incidence of postpartum depression in Asia is quite high and varies between 3.5% to 63.3% (Yusuff ASM et al, 2015). According to the Ministry of Health (2019), it explains that Baby blues syndrome or postpartum stress, is a very mild form of depression which usually occurs in the first 14 days after giving birth and tends to get worse around the third or fourth day after giving birth. Almost all mothers who have just given birth experience baby blues. This study aims to determine the relationship between age and husband's support for pregnant women on the prevention of baby blues in PMB Azimah, Jambi City. This research uses a quantitative type of research with a cross sectional research design. The population in this study was 354 pregnant women who checked for pregnancy from January to March 2023 at PMB Azimah, Jambi City. The sampling technique was simple random sampling technique with a total sample of 35 pregnant women. Data analysis used the Chi-Square test. The research results showed that most of the known ages of pregnant women in PMB Azimah, Jambi City who were at risk were categorized as 20 years 35 years with good knowledge of 4 people (11.4%) and poor knowledge of 28 people (80.0%). Most of the known husband's support for pregnant women in PMB Azimah, Jambi City who are at risk is categorized as negative, with 6 people (17.1%) having good knowledge and 16 people (45.7%) with poor knowledge. The Chi-Square test results obtained a value of p = 0.017 for mother's age, p = 0.039 for husband's support. The conclusion of this research is that there is a relationship between age and husband's support for pregnant women on the prevention of baby blues in PMB Azimah, Jambi City. It is recommended as reference material and as a reference in further research on the same topic, but with different variables and research locations.

Incidence of Postpartum Depression and Associated Risk Factors in Antenatal Women: A Cohort Study

Abstract Background: The incidence of postpartum depression (PPD) varies across cultures, regions, and communities, and there are very few studies addressing this issue, henceforth making it difficult to estimate the actual burden of the disease. Aims: The aim of this study was to evaluate the incidence and identify potential risk factors for PPD in a cohort of antenatal women. Methods: This study conducted in a tertiary hospital included 105 participants in their second or third trimester of pregnancy. Relationship with and support from the family were assessed. The scales applied were the Perceived Stress Scale, Ardell Wellness Stress Scale, State-Trait Anxiety Inventory, and Pittsburgh Sleep Quality Index. Participants were followed up 4 weeks postnatally. They were asked about the gender of their baby, and the Edinburgh Postnatal Depression Scale (EPDS) was applied. PPD was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria and International Classification of Diseases-10 criteria. Results: Of the 105 participants, 6 were lost to follow-up. Among the 99 women, an EPDS score of ≥10 was identified in 17 women who were diagnosed with PPD. The risk factors according to our study were sleep disturbances, state anxiety, stress, and obstetrical complications antenatally and female sex of the newborn. These risk factors are likely to be interactive as well as multiplicative in effect. Conclusion: The study shows a high prevalence of PPD in Indian mothers. There is enough evidence suggesting that intervention for PPD is crucial for the care of the mother as well as for the well-being of the infant, hence an integrated approach is required for its screening.

Efficacy of esketamine for the treatment of postpartum depression and pain control following cesarean section: a randomized, double-blind, controlled clinical trial

BackgroundPostpartum depression (PPD) following a cesarean delivery is a frequently seen complication. Despite the prophylactic effects of ketamine, the impact of esketamine on PPD in women undergoing cesarean section remains uncertain. This study aimed to assess the effectiveness of esketamine as an adjunct to patient-controlled intravenous analgesia (PCIA) in preventing PPD in women undergoing caesarean section.MethodsA total of 275 parturients undergoing caesarean section and subsequent patient-controlled intravenous analgesia (PCIA) were randomly assigned to receive either the control treatment (sufentanil 2 µg/kg + tropisetron 10 mg) or the experimental treatment with additional esketamine (1.5 mg/kg). The primary outcome measured was the incidence of postpartum depression (PPD), classified by Edinburgh Postnatal Depression Scale (EPDS) scores equal to or greater than 13 indicating PPD. Secondary outcomes included cumulative sufentanil consumption during specific time periods (0–24 h, 24–48 h, and 0–48 h) after the surgical procedure and numerical rating scale (NRS) scores at rest and during movements.ResultsThe final analysis included a total of 246 postpartum women who had undergone caesarean delivery. On postoperative day 42, the incidence of depression among the control group was 17.6%, which was significantly higher compared to the esketamine group with a rate of 8.2% (P = 0.02). The EPDS scores also showed a significant difference between the two groups, with a mean score of 9.02 ± 2.21 in the control group and 6.87 ± 2.14 in the esketamine group (p < 0.0001). In terms of pain management, the esketamine group showed lower sufentanil consumption in the 0–24 h (42.5 ± 4.58 µg vs. 50.15 ± 5.47 µg, P = 0.04) and 0–48 h (87.40 ± 9.51 µg vs. 95.10 ± 9.36 µg, P = 0.04) postoperative periods compared to the control group. Differences in movement were also observed between the two groups at 24 and 48 h after the cesarean Sect. (3.39 ± 1.57 vs. 4.50 ± 0.80, P = 0.02; 2.43 ± 0.87 vs. 3.56 ± 0.76, P = 0.02). It is worth noting that the frequency of side effects observed in both groups was comparable.ConclusionsEsketamine at a dose of 1.5 mg/kg, when used as a supplement in PCIA, has been shown to significantly reduce the occurrence of PPD within 42 days. Additionally, it has been found to decrease cumulative consumption of sufentanil over a 48-hour period following cesarean operation, all without increasing the rate of adverse effects.Trial registrationRegistered in the Chinese Clinical Trial Registry (ChiCTR2200067054) on December 26, 2022.

Postpartum depression: combining a mobile application with recititations from the Holy Quran in Indonesia

Background/Aims The incidence of postpartum depression in Indonesia is greater than the global average, and has detrimental effects on mothers, families, society and the country. Mobile applications are widely used to treat postpartum depression, but combining this with readings from the Holy Quran is uncommon in Indonesia. This study aimed to investigate the effect of combining mobile applications with the Holy Quran on postpartum depression symptoms. Methods A randomised controlled pre-post-test time series was conducted from June to December 2020, involving 128 pregnant women in their third trimester. The ‘app’ group (64 participants) received the intervention until 2 months postpartum, while the control group (64 participants) received no intervention. The Edinburgh postpartum depression scale, state-trait anxiety inventor, and the Rosenberg self-esteem scale were used to gather data. Results Postpartum depression scores in the app group were significantly lower than in the control group. There were no differences in the anxiety or self-esteem scores between the app and control groups. The proportion of depression scores of 10 and above decreased by 25% in the app group and 7.8% in the control group. Conclusions Use of a mobile application in combination with the Holy Quran voice may help reduce postpartum depressive symptoms in Indonesia. Maternity nurses and midwives may wish to recommend use of this app to the women they care for, if appropriate.

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.

Causal effects of potential risk factors on postpartum depression: a Mendelian randomization study.

Postpartum depression (PPD) is a type of depressive episode related to parents after childbirth, which causes a variety of symptoms not only for parents but also affects the development of children. The causal relationship between potential risk factors and PPD remains comprehensively elucidated. Linkage disequilibrium score regression (LDSC) analysis was conducted to screen the heritability of each instrumental variant (IV) and to calculate the genetic correlations between effective causal factors and PPD. To search for the causal effect of multiple potential risk factors on the incidence of PPD, random effects of the inverse variance weighted (IVW) method were applied. Sensitivity analyses, including weighted median, MR-Egger regression, Cochrane's Q test, and MR Pleiotropy Residual Sum and Outlier (MR-PRESSO), were performed to detect potential Mendelian randomization (MR) assumption violations. Multivariable MR (MVMR) was conducted to control potential multicollinearity. A total of 40 potential risk factors were investigated in this study. LDSC regression analysis reported a significant genetic correlation of potential traits with PPD. MR analysis showed that higher body mass index (BMI) (Benjamini and Hochberg (BH) corrected p = 0.05), major depression (MD) (BH corrected p = 5.04E-19), and schizophrenia (SCZ) (BH corrected p = 1.64E-05) were associated with the increased risk of PPD, whereas increased age at first birth (BH corrected p = 2.11E-04), older age at first sexual intercourse (BH corrected p = 3.02E-15), increased average total household income before tax (BH corrected p = 4.57E-02), and increased years of schooling (BH corrected p = 1.47E-11) led to a decreased probability of PPD. MVMR analysis suggested that MD (p = 3.25E-08) and older age at first birth (p = 8.18E-04) were still associated with an increased risk of PPD. In our MR study, we found multiple risk factors, including MD and younger age at first birth, to be deleterious causal risk factors for PPD.

Improving the Management of Maternal Mental Health with Digital Health Care.

Digital health solutions have the potential to improve maternal mental health care. The objective of this study is to determine if utilization of a digital health platform, Maven, is associated with improved management of mental health among peripartum people with a history of mental health disorders and determine which components of utilization associate with maternal mental health outcomes. Participants in this retrospective cohort analysis (n=1561) accessed Maven as an employer-sponsored health benefit and enrolled during their pregnancy and delivered from January 2020 through September 2022. Participants completed health surveys at enrollment, including history of a mood disorder, and post-delivery. Maven includes online articles, asynchronous and synchronous virtual classes, app-based mental health screenings, access to allied health professional and maternity care providers via messaging and telehealth appointments. Quantile g-computation was used to estimate the effects of multi-utilization exposures on reports of postpartum depression (PPD) and management of mental health. Multi-utilization exposure mixture models demonstrated that increasing use of digital resources by one quartile is associated with an increased odds of reporting that Maven helped users manage their mental health (aOR: 12.58 [95% CI: 6.74, 23.48]) and was not associated with self-reported incidence of PPD (aOR: 1.30 [95% CI: 0.52, 3.27]). Care advocate appointments, provider messages, and article reads were positively associated with improved mental health management. Digital health platforms, such as Maven, may play an important role in managing maternal mental health conditions among pregnant and postpartum people at high risk for PPD.

Investigating the relationship between hepatitis B virus infection and postpartum depression in Chinese women: a retrospective cohort study.

Postpartum depression (PPD) is associated with several psychological and obstetric factors. Hepatitis B virus (HBV) infection has been linked with a high risk of depression, but little is known about the relationship between maternal HBV infection and PPD. We aimed to investigate the association between HBV infection and PPD. This retrospective cohort study included 3,808 mothers who gave birth in a hospital in southern China. Self-reported Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Multivariate logistic regression was used to determine whether maternal HBV infection was associated with PPD risk. Of the 3,808 participants, 11.9% of mothers had PPD at 6 weeks postpartum. Two hundred and seventy-eight (7.3%) and 3,530 (92.7%) were in the HBV and control groups, respectively. Women with HBV infection were more likely to test positive for PPD (14.7 vs.11.7%). The multivariate logistic regression analysis showed that HBV-infected women did not have a significantly higher incidence of PPD (OR = 1.23; 95% CI, 0.82-1.84) than those without HBV infection in the study cohort. Parity and postpartum hemorrhage were found to be associated with PPD. In addition, our study showed that e antigen positivity was not associated with PPD risk (OR = 0.56, 95% CI 0.19-1.63). To our knowledge, this is the first investigation of the relationship between maternal HBV infection and PPD. In a cohort of women without prior history or family history of mental illness, having HBV infection was not significantly associated with self-reporting of PPD compared to not having HBV infection.

Treatment of postpartum depression with integrated traditional Chinese and Western medicine nursing and electrical stimulation

Treatment of postpartum depression with integrated traditional Chinese and Western medicine nursing and electrical stimulation

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.

Predictor of Postpartum Depression: Literature Review

The incidence of postpartum depression is quite high. The largest percentage occurs when they have their first child, and have a family history of mood disorders. The incidence of postpartum depression is 50 - 60% in mothers when they have their first child, and around 20% in mothers who give birth to subsequent children. This study aims at reviewing and synthesizing the determinants factor of depression among adolescent in rural area. This study design was a systematic review using the PICO framework. This data was carried out from various journal databases 2012-2022, including Scopus, ScienceDirect, PubMed. 16 articles meet the inclusion criteria and meet the qualifications for review. A systematic procedure is used to collect articles, as well as a critical appraisal and data synthesis with qualitative synthesis. The analysis of the literature review found that aspects of findings related to predictors of postpartum depression are as follows: socio-demographic factors (age, socio-economic status, education, risk age group), maternal factors (pregnancy spacing, parity, pregnancy condition, birth experience, postpartum complications), biological factors (hypothalamus function, prolactin, CRH, inflammatory process), psychosocial factors (negative mood, anxiety, unpreparedness, history of depression), cultural factors (children care stress, wisdom), support system (support husband, family support, decision-making patterns). Healthcare professionals should be aware of this phenomenon and strategies such as primary, secondary, and tertiary prevention interventions may be applied. Women should be screened for potential risk factors and depressive symptoms during pregnancy and postpartum periods so that appropriate interventions if needed, can be initiated in a timely fashion.

Incidence of postpartum depression in low-income cannabis users with and without a history of depression.

While past research has linked cannabis use in pregnancy with a history of depression, sparse literature exists on cannabis use during pregnancy and postpartum depression (PPD). In this study, we aimed to better understand the association between PPD and cannabis use during pregnancy in those with and without a history of depression. This was a retrospective cohort study of patients who received prenatal care at a single institution between January 2017 and December 2019. Patient demographics, obstetric history, depression history, substance use history, and Edinburgh Postnatal Depression Scale (EPDS) scores were extracted from patients' medical records. Modified Poisson Regression with robust standard errors was used to estimate the relative risk (RR) of screening positive for PPD, adjusting for age at delivery, race/ethnicity, insurance type, marital status, and smoking history. Among the 799 subjects meeting inclusion criteria, 15.9% used cannabis during pregnancy. There was an increased risk of screening positive for PPD among prenatal cannabis users compared to non-users (aRR = 1.60, 95% CI: (1.05, 2.45)). Among individuals with a history of depression, the adjusted relative risk of screening positive for symptoms of PPD at the postpartum visit was 1.62 times greater in cannabis users compared to non-users (95% CI: (1.02, 2.58)). Prenatal cannabis use is associated with screening positive for PPD, particularly in those individuals with a history of depression. These results should discourage women with depression from self-medicating with cannabis in pregnancy and provide additional support to the existing recommendations to abstain from prenatal cannabis use.

Thyroid Predictors of Postpartum Mood Disorders.

Postpartum mood disorders (PMD) are currently among the leading causes of maternal postpartum morbidity and mortality. PMD includethe conditions of postpartum blues (PB), postpartum depression (PPD), and postpartum psychosis. The pathogenesis of PMDs are ambiguous, and there are no reliable prenatal predictive markers despite current research efforts. Even though reliable indicators have not been found, leading ideas suggest an etiology of hormonal fluctuations. Although thyroid markers have long been linked to psychiatric disorders such as major depressive disorder (MDD), how they correlate with PMDs is still unclear. This study aimed to evaluate the pathophysiological link between thyroid function, PMDs, and the usefulness of thyroid markers as indicators of their occurrence and severity. The methodology consisted of a narrative literature review. Several inclusion and exclusion criteria were used to filter the results of literature searches in PubMed. Studies were included if they discussed any marker related to thyroid endocrinology in relation to the incidence or pathophysiology of any PMD. Both primary and secondary analyses were included. The permissive inclusion criteria were used due to the relative scarcity of research on the topic and the ambiguous pathophysiology of PMD. The results demonstrated the potential utility of thyroid autoimmunity as a predictor of late-onset PPD. Hypothyroidism, low euthyroid hormone levels, and the presence of thyroid autoantibodies were correlated with increased incidence of PPD and late postpartum depressive symptoms, past the timeline of PB. Most notably a rapid postpartum drop in cortisol level may precipitate thyroid autoimmunity in anti-thyroid peroxidase (TPO) antibody positive women, which could eventually produce a hypothyroid phase associated with depressive symptoms. There was insufficient evidence to suggest a relationship with postpartum psychosis. In conclusion, the exact pathophysiological mechanisms of PMDs remain ambiguous, but TPO-antibodies in the third trimester may be a predictor of late PPD.

Incidence ofPostpartum Depression Decreases After Initial Expansion ofMilitary Maternity Leave.

Postpartum depression impacts 1 in 8 women in the United States. Research has indicated maternity leave duration, and compensation can have an impact on postpartum depression symptoms. The U.S. military increased their maternity leave provision from 6 to 12 weeks in 2016. The aim of this study was to expand upon current literature on the role of maternity leave on postpartum depression by analyzing objective data from 2011 to 2019 utilizing military health records. All deliveries to active duty women in the Military Health System from 2011 to 2019 were considered for analysis. A total of 60,746 women met inclusion criteria. Active duty women were stratified by year of delivery to identify if they had 6 weeks (2011-2015) or 12 weeks (2016-2019) of maternity leave. International Classification of Disease (ICD)-9 and ICD-10 codes were used for the identification of postpartum depression diagnosis. Logistic regression models were used to assess the association between maternity leave provision and postpartum depression diagnosis adjusting for covariates. Overall, 4.8% of the women were diagnosed with postpartum depression. Active duty women who were allotted 12 weeks (2016-2019) of maternity leave had higher odds of postpartum depression diagnosis than those allotted 6 weeks (2011-2015) (12 weeks vs. 6 weeks of leave: odds ratio [OR] = 1.29; 95% confidence interval [CI] = 1.20-1.39, P < 0.0001). However, there was a 50% reduction in odds of postpartum depression during 2016-2017 (the 2 years following the 12-week leave implementation) in comparison to 2011-2015 (OR = 0.50; 95% CI = 0.43-0.57, P < 0.0001). The trends were similar across military branches. Additionally, between 2011 and 2019, the lowest rates of postpartum depression were observed during 2016-2017, but the rates significantly increased starting 2018. Overall, women with lower military ranks had higher postpartum depression rates than those with higher ranks. Our results indicate increasing paid maternity leave in the military from 6 to 12 weeks did initially lower the odds of postpartum depression diagnosis among active duty women from immediately after policy implementation (2016) and prior to the release of the Veterans Affairs and Department of Defense Clinical Practice Guidelines on Pregnancy Management (2018). Later, increased odds of depression (2018-2019) are likely due to increased depression screening protocols at the Military Treatment Facilities in the perinatal period.

COVID-19 Pandemic and the Incidence of Postpartum Depression: a Retrospective Cohort Study

Introduction: To estimate the association between COVID-19 and postpartum depression (PPD) in a retrospective cohort study. Material and methods: Pregnant women who delivered between September 2019-June 2021 at a Mouth Sinai Health System practice in New York City were identified. Baseline information about maternal health, pregnancy outcomes, and postpartum visits were obtained from electronic health records. Edinburgh Postnatal Depression Scores (EPDS) were used as a postpartum depressive symptom marker. Three analyses were performed to compare scores between: (1) women who delivered before and after COVID-19, (2) pregnant women who delivered after the pandemic who did and did not contract COVID-19, and 3) pregnant women eligible for the COVID-19 vaccine who were and were not vaccinated. Results: A total of 1.797 pregnant women were identified. Pregnant women during the pandemic had statistically significant higher rates of pre-existing mental health diagnoses and psychiatric medicine use compared to those who were pregnant before. No difference was observed in EPDS scores of pregnant women who delivered before vs. after the start of COVID-19 nor between COVID-vaccinated and unvaccinated pregnant women. Women who contracted COVID-19 in pregnancy had lower EPDS scores than women who did not. Results remain unchanged after controlling for baseline mental health diagnoses. Conclusions: In our cohort, EPDS scores were not associated with pregnancy during the pandemic, COVID infection while pregnant, or COVID vaccination during pregnancy. However, we did identify a higher incidence of baseline mental health diagnoses during the COVID pandemic, but that did not lead to a higher rate of positive screens for postpartum depression.

Challenges in Accessing Mental Health Care during Pregnancy and Postpartum in Rural Montana.

Postpartum depression is a well-known maternal health care concern. For women using substances or experiencing underlying mental health conditions, incidence of postpartum depression is higher than that of the general population. The purpose of this study was to identify barriers and facilitators associated with seeking mental health care among women with substance use disorder or mental health concerns. Qualitative methods using interviews were conducted via the narrative inquiry approach. Women receiving care at a clinic in rural Montana and reporting substance use or mental health concerns were referred to the research team by the care manager. Participants were at least 18 years of age, English speaking, and pregnant or within 12 months postpartum at time of referral. Twenty-five women met inclusion criteria and were referred for potential study participation. Seven women were interviewed. Four themes on family history, stigmatization, lack of postpartum depression awareness, and isolation were identified. Our findings provide a better understanding of barriers and facilitators to seeking mental health care during pregnancy and postpartum among women living in rural areas with mental health concerns or perinatal substance use. An environment where opportunities for women to receive mental health care in a location that is free of stigma and judgment, while understanding the effects of familial trauma and limited or inconsistent social support, is essential to promote optimal outcomes.