Postpartum Depression Research Articles

Blended CBT Intervention vs. a Guided Web-Based Intervention for Postpartum Depression: Results From a Pilot Randomized Controlled Trial.

This pilot randomized controlled trial evaluated the acceptability and preliminary effectiveness of a blended cognitive behavioural intervention-combination of a web-based program and sessions with a psychologist (intervention group)-compared to a guided web-based intervention (active control group) for the treatment of postpartum depression. Adult Portuguese women in the postpartum period (up to 12 months) presenting clinically relevant depressive symptoms were considered eligible. Participants were randomly assigned to the intervention group (n = 17) or the control group (n = 17) and completed self-report questionnaires at baseline, post-intervention and at 3-month follow-up. In both arms, dropout rates were low, and participants considered the treatment acceptable and useful. Mixed ANOVAs revealed a significant reduction in depressive symptoms and improvements in secondary outcomes (anxiety, negative thoughts, emotion regulation, self-compassion and psychological flexibility) from baseline to post-intervention in both groups. No time × group interactions were found. A significant clinical change in depressive symptoms was observed in more than 80% of the participants in both groups. Significant associations were observed among therapeutic alliance and depressive symptoms. The results of our study support the acceptability, usability and preliminary effects on postpartum depression of both interventions and highlight the important role of therapist support in blended and guided web-based interventions. ClinicalTrials.gov identifier: NCT04441879.

Virtual connection and real community: the qualitative experience of participating in a videoconferencing-based psychotherapy group for postpartum depression and anxiety

BackgroundGroup psychotherapy, an effective treatment for common postpartum mental disorders (e.g. depression, anxiety), has increasingly been delivered virtually since the pandemic. This study aims to understand experiential aspects of participating in videoconferencing-based group psychotherapy in the postpartum period.MethodsOur urban academic ambulatory hospital has delivered group psychotherapy for women (cis and trans) and non-binary individuals of female sex with postpartum depressive and anxiety symptomatology via videoconferencing since 2020. One therapist-facilitator conducts weekly 60-min group therapy sessions with 5-6 participants for eight weeks. Group participants were invited to complete a semi-structured qualitative interview on their experience. Using an interpretive description approach, we conducted reflexive thematic analysis to code anonymized transcripts and construct themes. Facilitator interviews were used for triangulation and additional context.ResultsOf 134 patients in video psychotherapy groups over 11 months, 14 completed an interview, as did all group facilitators (n = 3). Overall, participants felt the experience with videoconferencing group therapy was beneficial for their mental health. Three themes were constructed: (1) “Moving Towards a New Normal”: The group helped participants normalize feelings and experiences around transition to parenthood, and accessing health care virtually was now considered to be normal practice, although some wanted an element of choice. (2) “Virtual Connection, Real Community”: Connections were made virtually, yet participants felt a real sense of community. Facilitators played an important role fostering an environment in which participants could create lasting bonds. Participants noted challenges with feeling comfortable virtually and provided pragmatic and structural suggestions for enhancing the creation of community. (3) “Trade-offs to Virtual Engagement”: Participants made positive and negative trade-offs (e.g. no informal interactions, travel, isolation at home, childcare challenges) to maximize their experience and were able to be more authentic in their self-presentation to the group.ConclusionsPeople with postpartum depression and anxiety who participated in videoconferencing-based group psychotherapy appreciated the sense of community within their groups to normalize their experience transitioning to parenthood. Participants had to make trade-offs to access virtual groups, but felt the experience was worthwhile and helped improve their mental health. Findings will help inform continued delivery of virtual group mental health services.

Transitioning to fatherhood: Prospective effects of wellbeing on future depression symptoms.

Becoming a father is a critical period of life transition. Evidence suggests that lifetime history of mental health disorder/s and elevated depressive symptoms prior to conception increase risk for men's postnatal depression. Less is understood about the role of positive mental health, or wellbeing, as a protective factor for future depressive outcomes during the transition to fatherhood. The present study investigated whether men's post-natal depressive outcomes were associated with pre-conception levels of wellbeing and whether wellbeing during the post-natal period predicted depressive outcomes post-infancy. Secondary analysis of data from a national, longitudinal cohort study of men's health, namely, The Ten to Men Study (TTM), was conducted. Participants in the pre-conception sample were n = 350 men for whom data were available at both a pre-conception baseline and post-natal follow-up. The post-natal sample were n = 427 men with post-natal baseline data and post-infancy follow-up. Multivariate negative binomial regressions and logistic regression models were used to determine pre-conception and post-natal predictors of future depressive outcomes. Men's pre-conception depressive symptoms were the best predictor of post-natal depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) the latter of which was also predicted by a previous mental health diagnosis (IRR = 3.079, p = 0.029). Similarly, post-natal depressive symptoms were the best predictor of post-infancy depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) alongside lifetime prevalence of a mental health disorder (symptoms: IRR = 1.317, p = 0.011; moderate-severe depression: IRR = 2.606, p = 0.023). Preconception levels of wellbeing predicted lower post-natal depressive symptoms (IRR = 0.988, p < 0.001) and reduced risk of moderate-severe depression (IRR = 0.940, p = 0.002) after controlling for baseline symptoms and sociodemographic and behavioural confounds; however, wellbeing during the post-natal period did not predict either depressive outcome post-infancy. Fatherhood-specific risk factors for mental health outcomes (e.g., conception difficulties, maternal postnatal mental health) were not assessed in the present study, and only one aspect of wellbeing was captured. Screening for history of common mental health disorders and current symptoms is recommended to inform preventative approaches to paternal mental health care during early fatherhood. Inclusion of wellbeing in such screening procedures may be beneficial, however, further research is required to elucidate the prospective associations between wellbeing and depressive symptoms during the transition to fatherhood.

Attitudes Towards Parents with a Diagnosis of Borderline Personality Disorder in Child Protection Settings

BackgroundParents diagnosed with borderline personality disorder (BPD) have high rates of child protection involvement. Research has shown that this diagnosis carries a significant amount of stigma. In the absence of standardised procedures for parenting capacity assessments within the child protection sector, the risk of stigma contributing to the decision-making process is high. ObjectiveThis study examined if there were differences in how students and practitioners rated parenting capacity based on parenting scenarios where a parent had a diagnosis of BPD compared to a parent diagnosed with postnatal depression. Participants and settingThe sample included 122 current, past, and prospective child protection workers who were recruited via social media and a local University. MethodsParticipants completed an online survey which included demographic questions and rated parenting capacity based on two vignettes involving two scenarios (one where a parent had a diagnosis of borderline personality disorder and post-natal depression in the other), along with general attitudes towards people with a diagnosis of BPD. ResultsThe parent in the borderline personality disorder vignette was assessed as having poorer parenting capacity compared to the parent in the postnatal depression scenario. Interestingly, there was no significant association between the assessment of parenting capacity and participants general attitudes and skills towards people with a diagnosis of BPD. Differences between the ratings of professionals and students are described. ConclusionsFurther training providing psychoeducation BPD is recommended to reduce the potential impact of stigma on decision-making, particularly for professionals within child protection settings.

Creative art therapy for postpartum depression： A systematic review and meta-analysis

This study aims to ascertain the effectiveness of creative art therapy (CAT) in alleviating symptoms of postpartum depression (PPD). A systematic review of all randomized controlled trials of CAT for PPD was conducted. Eight bibliographic databases, namely, PubMed, The Cochrane Library, Embase, Web of Science, CNKI, Wanfang Database, VIP Database, and China Biomedical Literature Database were searched digitally, while Google Scholar database was searched manually for a comprehensive literature search. The search period is from the establishment of the database to May 2024. Literature screening and data extraction were conducted independently by two researchers, and the risk of bias in the included studies was evaluated. Finally, RevMan5.3 software and STATA 15.1 software were used for meta-analysis. Twelve studies, including 1633 patients, were included in this review. The results of our meta-analysis revealed that the intervention group was significantly better than the control group in depression [SMD=-0.882, 95% CI: -1.256 to -0.508, P ＜ 0.001][WMD=0.680, 95% CI: 0.407-0.953, P ＜ 0.001], anxiety [SMD=-0.712, 95% CI: -1.405 to -0.019, P=0.044], and personal state [WMD=-5.180, 95% CI: -5.869 to -4.491, P ＜ 0.001][SMD=0.388, 95% CI: 0.132-0.643, P=0.003], and the difference was statistically significant. Sensitivity analysis revealed that the above results were stable. CAT (music and creative games) was found to be effective in relieving depression, anxiety, and personal state in patients with PPD. Though CAT appears to be worthy of clinical application, more high-quality and large-sample studies are required to explore various aspects in the current context.

Problematic issues of the impact of microplastics on the human body and the environment: A review

Currently, the widespread use of plastic has become a serious problem for the environment and human health. Microplastics, being an artificial polymer created by man, are highly resistant to external influences and their decomposition requires a significant amount of time. The article provides information on the distribution of microplastics and their impact on the environment and the human body, issues of detecting microplastics in the blood, heart, lungs, placenta and meconium, in breast milk, hypothetical mechanisms by which microplastics penetrate into human tissues and the metabolism of plasticizers in children with autism spectrum disorder and attention deficit hyperactivity disorder. In the modern world, plastic has become an integral part of our daily lives, the presence of microplastics in plastic bags for storing breast milk, in baby formula and polypropylene bottles has been demonstrated, the relationship between microplastics and postpartum depression, the relationship between fecal microplastics and the status of inflammatory bowel diseases has been described. Making the decision to limit the use of plastic products in your home is an important step that can play a key role in reducing environmental pollution and protecting the health of future generations.

Improving psychological and social support needs after traumatic birth: A qualitative study

IntroductionEmergency deliveries increase maternal risk for postpartum depression (PPD) and post-traumatic stress disorder (PTSD). One in three women describe their birth experience as traumatic, but patient-centered support needs are unclear. We conducted a qualitative study of women with traumatic birth to identify patient-centered priorities to optimize mental health support. MethodsSemi-structured interviews were conducted with women who experienced an emergency during birth, and who self-identified as experiencing traumatic birth. The Stanford Acute Stress Reaction Questionnaire and PTSD Checklist were completed. Interviews included open-ended questions about birth events that improved or worsened their delivery experience, perceptions of mental, physical, and emotional support provided by staff, and patient perspectives about psychological and social support referrals after emergent deliveries. ResultsA majority of participants met positive screening criteria for PTSD at the time of interviews. Birth experiences were affected by prenatal expectations, as well as the style and quality of clinical staff communication during and after delivery. There were four key themes central to their experiences and perceptions: (1) Emotional Impact and Intensity, (2) Factors Influencing Birth Experience, (3) Perceived Lack of Emotional Support, and (4) Desire for Post-Birth Follow-Up and Support. Participants almost unanimously desired to be offered psychosocial services after birth trauma. ConclusionThere are significant gaps in emotional support and communication for patients experiencing traumatic births. Offering structured, in-hospital mental health referrals may address immediate psychological needs, aid in trauma recovery, and potentially mitigate long-term mental health consequences. These findings advocate for a more holistic approach to postpartum care that prioritizes both physical and emotional well-being.

Zuranolone: A Rapidly Acting Oral Neuroactive Steroid Antidepressant for the Treatment of Postpartum Depression.

Severe depression, anxiety, and mood dysregulation during pregnancy and postpartum are risk factors for the safety and health of mother and baby. Current best practice guidelines recommend screening for depressive and anxiety symptoms before and during pregnancy, in addition to the postpartum period. Rapid identification and treatment of depression has the potential to be life-saving and prevent deleterious consequences, including impaired mother-infant bonding, emotional dysregulation, and other developmental problems. The current article reviews the neurobiological mechanisms of postpartum depression and a novel rapidly acting oral pharmacotherapeutic neuroactive steroid, zuranolone. [Journal of Psychosocial Nursing and Mental Health Services, 62(11), 7-10.].

Perinatal running training reversed postnatal anxiety and depressive-like behavior and cognitive impairment in mice following prenatal subchronic variable stress.

Pregnancy is a very complex and highly stressful time in women. Despite the high prevalence of postpartum depression, more than 50 % of mothers are undiagnosed or untreated, showing an urgent need to explore an effective preventive strategy. Regular physical activity has been suggested to be associated with an increased quality of life in pregnant and postpartum women. The purpose of this study was to determine whether perinatal running training can affect maternal care stress-related anxiety, depressive-like behavior, and cognitive changes in postpartum dams and to explore the possible underlying mechanism. 40 female C57BL/6J mice were divided into four groups: prenatal control (NC) and running training (EX) group (NC+EX), prenatal control and nonrunning training (RE) group (NC+RE), prenatal subchronic variable stress (SCVS) and running training group (SCVS+EX) and prenatal SCVS and non-running training group (SCVS+RE). Mice in prenatal stress groups were subjected to SCVS after pregnancy confirmed. Mice in running training groups subjected to running training throughout pregnancy and lactation. Then after the delivery, maternal behavior, cognitive changes, anxiety and depressive-like behaviors were tested. Then we measured the serum prolactin (PRL), hypothalamic-pituitary adrenal (HPA) axis activity, and adult hippocampus neurogenesis (AHN) in dams. Compared to NC+RE, prenatal SCVS caused cognitive impairments, the decrease in maternal behavior, and anxiety and depressive-like behavior in SCVS+RE dams, accompanying increase in HPA axis activity and decreased the PRL levels and AHN in postpartum period. Then compared to SCVS+RE, perinatal running training mitigates cognitive impairments, increased maternal behavior, and alleviates anxiety and depressive-like behavior in SCVS+EX dams, accompanying the decreased HPA axis activity, and the increased PRL levels and AHN in postpartum period. Overall, this study suggests that perinatal running training might improve maternal care and reverse prenatal stress-related cognitive impairment and anxiety and depressive-like behavior in postpartum dams.

Web-Based Intervention (SunnysideFlex) to Promote Resilience to Posttraumatic Stress Disorder Symptoms During Pregnancy: Development and Pilot Study.

Approximately 4% to 8% of pregnant individuals meet the criteria for current posttraumatic stress disorder (PTSD), a known risk factor for a multitude of adverse maternal and child health outcomes. However, PTSD is rarely detected or treated in obstetric settings. Moreover, available prenatal PTSD treatments require in-person services that are often inaccessible due to barriers to care. Thus, web-based interventions offer great potential in extending PTSD treatment to high-risk pregnant individuals by providing affordable, accessible care. However, there are currently no web-based interventions designed specifically for the treatment of PTSD symptoms during pregnancy. This study aims to develop and pilot a 6-week, web-based, cognitive behavioral therapy intervention for PTSD, SunnysideFlex, in a sample of 10 pregnant women with current probable PTSD. Consistent with established guidelines for developing and testing novel interventions, the focus of this pilot study was to evaluate the initial feasibility and acceptability of the SunnysideFlex intervention and preintervention to postintervention changes in PTSD and depression symptoms. This approach will allow for early refinement and optimization of the SunnysideFlex intervention to increase the odds of success in a larger-scale clinical trial. The SunnysideFlex intervention adapted an existing web-based platform for postpartum depression, Sunnyside for Moms, to include revised, trauma-focused content. A total of 10 pregnant women in weeks 16 to 28 of their pregnancy who reported lifetime interpersonal trauma exposure (ie, sexual or physical assault) and with current probable PTSD (scores ≥33 per the PTSD checklist for DSM-5) were enrolled in the SunnysideFlex intervention. Assessments took place at baseline and 6 weeks (postintervention). All participants were retained through the postintervention assessment period. Engagement was high; participants on average accessed 90% of their lessons, logged on to the platform at least weekly, and reported a generally positive user experience. Moreover, 80% (8/10) of participants demonstrated clinically meaningful reductions in PTSD symptoms from baseline to postintervention, and 50% (5/10) of participants no longer screened positive for probable PTSD at postintervention. Most (6/10, 60%) of the participants maintained subclinical depression symptoms from baseline to postintervention. Findings from this small pilot study indicate that SunnysideFlex may be a feasible and acceptable mechanism for delivering PTSD intervention to high-risk, trauma-exposed pregnant women who might otherwise not have opportunities for services. Larger-scale trials of the intervention are necessary to better understand the impact of SunnysideFlex on PTSD symptoms during pregnancy and the postpartum period.

Protocol for a randomized controlled trial to evaluate the effectiveness of a telehealth group intervention to reduce perinatal depressive symptoms

BackgroundPerinatal depression and anxiety (PDA) affect approximately 20 % of individuals and are associated with adverse outcomes, including preterm birth, low birth weight, and impaired cognitive development of the child. Telehealth may reduce access barriers to needed mental health services. However, lack of disseminated, standardized study protocols aimed at investigating the role of telehealth in reducing PDA symptoms limits the ability to compare findings across studies. The purpose of this paper is to provide a conceptual framework and a randomized controlled trial protocol (RCT) for use in future studies. Methods and analysisAn RCT was designed to evaluate the effectiveness of a group videoconference intervention (VCI) to reduce PDA symptoms across pregnancy and postpartum period. Participants are randomly assigned to study groups: VCI + standard of care, or attention control (AC) + standard of care. Both groups have weekly one-hour group videoconference sessions for 9 weeks. The VCI groups are facilitated by a mental health professional using a manualized program based on mindfulness-based practices and cognitive behavioral therapy (MBCT). The AC groups are facilitated by a registered nurse using a manualized program for childbirth and parenting education. The primary outcomes are depressive symptoms as measured by the Edinburgh Postnatal Depression Scale (EPDS) and anxiety symptoms as measured by the Generalized Anxiety Disorder (GAD-7). ConclusionThis RCT study protocol can be used as a standard approach to improve the ability to compare findings across studies, applied in any setting (e.g., rural or urban), and adapted to diverse communities.Trial Registration:ClinicalTrials.govNCT03932760

Efficacy of esketamine for perinatal depression: a systematic review and meta-analysis.

Postpartum depression (PPD), now referred to as perinatal depression, is a prevalent and debilitating mood disorder that reduces health-related quality of life (HRQoL) and psychosocial functioning. Esketamine, which is efficacious in adults with treatment-resistant depression and individuals with depression and suicidality, is also analgesic in pain management during childbirth labour. Herein, we investigate the efficacy of prophylactic esketamine in reducing the incidence of PPD. We performed a systematic review (i.e., PubMed, Scopus, and Ovid databases; inception to January 22, 2024) of randomized controlled trials that investigated the use of esketamine for PPD. We delimited our search to studies that prespecified the prevention of PPD with esketamine as the primary outcome. A meta-analysis was performed on PPD incidence rates using a random effects model. Our analysis consisted of seven studies that met our eligibility criteria. We found that esketamine was significantly associated with a decreased incidence of PPD diagnosis within one week of childbirth (OR = 0.30, 95% CI = [0.15, 0.60], p = 0.0047). We also observed that esketamine was significantly associated with a decreased incidence of PPD diagnosis between 4 to 6 weeks post-delivery (OR = 0.33, 95% CI = [0.18, 0.59], p = 0.0034). Our results indicate that esketamine may have preventive antidepressant effects during the postpartum period. The aforementioned points have both mechanistic and clinically meaningful implications for the treatment of PPD.

Effect of Combination of Facial Acupuncture Therapy with Lavender Aromatherapy on Reducing Postpartum Maternal Anxiety Levels in Medan Tuntungan District

Following childbirth, moms will undergo emotional fluctuations characterized by mood swings, anxiety, dizziness, and feelings of despair. Impaired maternal understanding of infant care can lead to psychological issues that impact the mother's physical well-being, including disrupted sleep patterns and reduced appetite. Failure to promptly manage anxiety in postpartum mothers can lead to the development of baby blues syndrome and postpartum depression. This study employs a Quasi Experiment design with a pre-posttest not include a control group to quantitatively investigate the impact of combining facial acupressure therapy with lavender aromatherapy on anxiety reduction in postpartum mothers. The investigation was conducted in Medan Tuntungan District, located in Medan City. One hundred postpartum women constituted the sample in this study. The data collection process involved administering treatment (facial acupressure therapy with lavender aromatherapy), followed by observation and interviews conducted using the HARS instrument. The analysis conducted using the Wilcoxon Signed Ranks Test revealed a negative ranks value of 94. This indicates that out of the 100 postpartum women who participated in the study, 94 mothers reported a reduction in anxiety levels. The positive rankings index is 0, indicating that none of the 100 postpartum moms who participated in the study reported a rise in anxiety levels. The tie value of 6 indicates that among the 100 postpartum moms who participated in the study, 6 mothers did not show any significant difference in anxiety levels before and after undergoing a combination of Facial Acupressure Therapy with Lavender Aromatherapy. Moreover, it is established that the significance value at this stage of analysis is 0.000 or greater than ? (0.05). Therefore, it can be inferred that there is a significant impact of the combination of Facial Acupressure Therapy with Lavender Aromatherapy on the reduction of anxiety levels in postpartum mothers.

Influence of stressful life events in postpartum mothers on the incidence of postpartum depression

The main objective of the study was to explore and document the influence of the stressful life events experienced by postpartum mothers on the incidence of postpartum depression. A systematic review of literature was performed to examine prior research. All major databases including Google Scholar, Scopus, and Web of Science were used. The search is limited to publications from 2018-2023. The results illustrate the diversity of stressful events which include the experience of miscarriage, labour complications, or sudden changes in the baby's health condition. Thematic analysis revealed that these events played significant roles in triggering or exacerbating postpartum depression, amplifying the emotional complexity and psychological well-being of postpartum mothers. We conclude that there is a need for approaches for designing psychological interventions that can provide timely and contextualized support to postpartum women who experience stressful life events

PREDICTIVE ROLE OF MATERNAL DEPRESSIVE SYMPTOMS AND PERCEIVED QUALITY OF LIFE ON POSTNATAL MOTHER-INFANT BONDING

This cross-sectional study was focused on the predictive role of maternal depressive symptoms and perceived quality of life on postnatal mother-infant bonding. Research show that impaired postnatal bonding has a negative long-term effect on child’s development. Relevant literature also acknowledges a scientific gap in the understanding of the relationship between maternal mental health and the quality of postnatal mother-infant bonding. Respondents were 162 women in the first 12 months after childbirth, advising with gynecologist in maternity hospitals in the Republic of North Macedonia. Edinburgh postnatal depression scale, subscales of psychological and environmental domain of the WHO Quality of Life Scale-brief, and Postpartum Bonding Questionnaire were applied to measure study variables. Results from hierarchical binary logistic regression showed that psychological domain of quality of life significantly predicted quality of postnatal bonding in the first and second block. However, its effect was suppressed in the third block when depressive symptoms variable was entered. The presence of depressive symptoms and environmental domain of the perceived quality of life significantly predicted postnatal mother-infant bonding. Findings confirmed the significant predictive relationship of maternal depressive symptoms and of environmental domain of mother’s perceived quality of life on the quality of postnatal boding. This gives reason for increased attention on development of mother–infant dyads during the postnatal period and on the importance of social support.

Relationship between Low Carbohydrate Diet and Postpartum Anxiety and Depression: Iranian Maternal and Child Health Cohort Study

Introduction: Postpartum depression, a form of depression, is a relatively common but serious medical condition that occurs following the birth of a baby. This study aimed to determine the relationship between the carbohydrate diet and the occurrence of anxiety and postpartum depression symptoms in women participating in the initial phase of the Maternal and Child Health Cohort Study, Yazd, Iran. Methods: This study was conducted on the data of 1028 pregnant women from the Yazd Maternal and Child Health Cohort Study. The study tools were food frequency questionnaire (FFQ) and postpartum depression questionnaire. Data related to dietary intake at the beginning of the study were collected in the first visit after pregnancy diagnosis and data related to depression in the second month after delivery. Carbohydrate intake score was calculated for each person according to summing up assigned scores to deciles of percentages of energy from macronutrients. Multivariable logistic regression models were used to estimate the odds ratio (ORs) and 95% confidence interval (CI) of postpartum depression and anxiety across quartiles of low carbohydrate diet scores. Results: Based on the multivariable-adjusted model, there was no significant association between low carbohydrate diet score and odds of postpartum depression (P=0.08). However, multivariable-adjusted model significantly indicated an association between low carbohydrate diet score in second tertile and the odds of postpartum anxiety (P=0.02) (OR: 0.36, 95% CI: 0.15-0.86). Conclusion: After adjusting the confounders, women in the second tertile of low carbohydrate diet score might have 64% lower chance of depression versus those in the first quartile. While low or high carbohydrate intake does not affect postpartum anxiety and depression, moderate carbohydrate intake might be anxiety protective.

Genetical effects of sleep traits on postpartum depression: a bidirectional two-sample Mendelian randomization study

BackgroundPostpartum depression (PPD) is widely recognized as the most prevalent mental health crisis following childbirth and has been linked to sleep disturbances. However, the potential causal relationships between various sleep traits and PPD remain unclear. This study employs a bidirectional two-sample Mendelian randomization (MR) approach to investigate these associations.MethodsThe inverse-variance-weighted method was used to evaluate the causally linked sleep traits on postpartum depression. The weighted median, weighted mode, and MR-Egger were used to estimate the robustness of the inverse-variance-weighted method. The leave-one-out method estimated the sensitivity of the result. Cochran’s Q method was used for the heterogeneous test. The MR-Egger intercept and MR-PRESSO methods detected the horizontal pleiotropy.ResultsWe examined the genetic causal relationships between nine sleep traits and postpartum depression. Sleep apnea syndrome (OR: 1.122; 95%CI: 1.063–1.185; p = 0.000), sleeplessness/insomnia (OR: 1.465; 95%CI: 1.104–1.943; p = 0.008), and frequency of tiredness/lethargy in last 2 weeks (OR: 1.725; 95%CI: 1.345–2.213; p = 0.000) genetically predicted the increased risk of postpartum depression. The reverse Mendelian randomization analysis showed PPD caused sleeplessness/insomnia (β: 0.006; 95%CI: 0.001–0.010; p = 0.016) and frequency of tiredness/lethargy in last 2 weeks (β: 0.007; 95%CI: 0.002–0.011; p = 0.004). The remaining six sleep traits showed no significant association with PPD. There was no heterogeneity or horizontal pleiotropy.ConclusionsGenetic evidence reveals causal relationships between specific sleep traits and PPD, including sleep apnea syndrome, sleeplessness/insomnia, and tiredness. Whether certain sleep health indicators suggest a risk of postpartum depression or sleep issues that are caused by PPD, both may offer insights into the prevention and treatment of PPD.

Association Between Maternal Weight Perception Before and During Pregnancy and Postpartum Depression Status in Southern China.

Postpartum depression (PPD) is a common complication after childbirth. Weight misperception can lead to self-esteem issues and mental health problems, especially in women and adolescents. The aim of this study was to investigate the association between weight perception before and during pregnancy and the status of PPD in Southern China. From October 2021 to November 2023, a multi-stage sampling method was used to recruit 2169 eligible mothers aged 18-49 who had delivered live-born singleton infants within 3 to 180 days postpartum. Anthropometric measurements and face-to-face questionnaire surveys were conducted to collect data. The Kappa test was used to assess the agreement between actual and perceived weight. The generalized linear model incorporating multiplicative interaction analysis was applied to explore the associations among variables. The prevalence of PPD status was 18.0%. Among women, 35.2% perceived their pre-pregnancy weight (PPW) as abnormal, while 33.1% perceived their gestational weight gain (GWG) as inappropriate. There was poor agreement between maternal actual and perceived PPW/GWG (Kappa = 0.366, p < 0.001; Kappa = 0.188, p < 0.001), with 27.8% of women misperceiving their PPW and 52.1% misperceiving their GWG. The results of the general linear model indicated that women who perceived their PPW as underweight (β = 0.70, p = 0.016) or overweight/obese (β = 0.86, p < 0.001), as well as those who perceived their GWG as excessive (β = 0.47, p = 0.028) were more likely to exhibit PPD status. The interaction analysis results showed that those who perceived their PPW as underweight and their GWG as insufficient (β = 1.75, p = 0.020), as well as those who perceived their PPW as overweight/obese and their GWG as excessive (β = 0.90, p = 0.001) had a positive interactive effect on the occurrence of PPD status, while underestimating PPW and GWG may be a protective factor against PPD status (β = -1.03, p = 0.037). These findings support that maternal weight perception plays a role in the development of PPD status. Further improvement is needed in personalized health education for weight management, both prior to and throughout the pregnancy period. This can help women reduce weight anxiety, better understand their body image, and potentially lower the risk of developing PPD.

Prevalence and risk factors for postpartum depression and stress among mothers of preterm and low birthweight infants admitted to a neonatal intensive care unit in Accra, Ghana.

To determine the prevalence of postpartum depression (PPD) and postpartum stress (PPS) and identify associated risk factors among mothers of preterm and low birth weight (LBW) infants. We conducted a secondary analysis of data collected from 255 mothers with preterm and LBW infants admitted to the neonatal intensive care unit (NICU) at Korle-Bu Teaching Hospital, Accra, Ghana. A standardized interviewer-administered questionnaire collected data on maternal, pregnancy, birth, and infant characteristics. The questionnaire also included the Patient Health Questionnaire-9 (PHQ-9) and the Perceived Stress Scale-4 (PSS-4) to assess PPD and PPS, respectively. Simple and multivariable linear regression analyses were performed to identify factors associated with PPD and PPS. The prevalence of moderate to moderately severe PPD was 3.9%, and that of PPS was 43.5%. The multivariable linear regression analysis showed that an increased number of prenatal care visits (β-estimate = 0.26; 95% confidence interval [CI] 0.08-0.43; P < 0.01) was positively associated with higher scores on the PHQ-9, whereas gestational age at birth (β = -0.21; 95% CI -0.40 to -0.03; P = 0.02) was inversely associated with PHQ-9 scores. Moreover, a longer gestational period at the first prenatal care visit (β = 0.25; 95% CI 0.05-0.45; P = 0.01) and following the Islamic religion were associated with elevated scores on the PSS-4 (β = 0.95; 95% CI 0.11-1.80; P = 0.011). Our findings underscore the presence of moderate PPD levels and high PPS levels among mothers. Active screening, diagnosis, and treatment for mothers at risk of mental health disorders during the peripartum period could enhance coping mechanisms for mothers navigating the challenging NICU environment and transitioning to the home environment.

Analysis of the Characteristics and Influencing Factors of Perinatal Obsessive-Compulsive Symptoms in Elderly Parturients.

Aims/Background Perinatal obsessive-compulsive symptoms are significant predictors of increased postpartum anxiety, depression, and bipolar disorder. These symptoms have persistent adverse effects on both mothers and children. Currently, there are few reports in the literature on obsessive-compulsive disorder in elderly parturient women in China. This study primarily discusses the clinical characteristics of perinatal obsessive-compulsive symptoms in elderly parturient women and analyzes their influencing factors, aiming to provide references for clinical prevention and treatment. Methods This research employed a cross-sectional design, utilizing a convenience sampling method to select elderly parturients who delivered at Panjin Central Hospital from September 2022 to August 2023. The assessment instruments included a general data questionnaire, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the self-rating anxiety scale (SAS), the edinburgh postpartum depression scale (EPDS), and the sense of coherence scale (SOC-13). The relationship between the severity of obsessive-compulsive symptoms and negative emotions and psychological burden was examined through Pearson correlation analysis. Additionally, the influencing factors of perinatal obsessive-compulsive symptoms were analyzed using multivariate logistic regression. Results In this study, a total of 124 questionnaires were distributed, and 122 valid questionnaires were recovered, yielding an effective recovery rate of 98.39%. Among the 122 elderly parturients, 37 were positive for perinatal obsessive-compulsive disorder, accounting for 30.33% (37/122). Among the 37 elderly parturients with perinatal obsessive-compulsive symptoms, 64.86% had both obsessive-compulsive thoughts and behaviors, 21.62% had obsessive-compulsive thoughts as the main symptom (8/37), and 13.51% had obsessive-compulsive behaviors (5/37). Multivariate logistic regression analysis showed that pregnancy history, pregnancy complications, fetal health, SOC-13 score, SAS score, and EPDS score were independent risk factors for positive perinatal obsessive-compulsive symptoms (p < 0.05). Conclusion The incidence of perinatal obsessive-compulsive symptoms in elderly parturient women is high. Obsessive-compulsive thoughts primarily involve fears of injury and contamination, while obsessive-compulsive behaviors mainly consist of compulsive checking and cleaning. The occurrence of perinatal obsessive-compulsive disorder is associated with factors such as pregnancy and childbirth history, pregnancy complications, fetal health, negative emotions, and stress resistance.