Postpartum Depressive Symptomatology Research Articles

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.

Risk and timing of postpartum depression in parents of twins compared to parents of singletons.

Parents of twins appear to be at increased risk of postpartum depression (PPD), yet little is known about the magnitude and timing of onset in the postpartum period compared to singleton parents. We conducted a cohort study using the Danish nationwide health registers. We defined a study population of parents that is, mothers and fathers of all twin and singleton livebirths between 1997 and 2019. Postpartum depression was defined as incident depression diagnosis or a redeemed antidepressant prescription from childbirth through 365 days postpartum. We performed a parametric time-to-event analysis based on Poisson regression. The time scale was time since birth, modeled using restricted cubic splines. From this we estimated the hazard ratio (HR) representing the momentary risk, and the cumulative risk ratio (RR) over the first year postpartum, in twin compared to singleton parents. The study population was based on 27,095 twin and 1,350,046 singleton births. In adjusted analyses, the HR of twins compared to singletons was highest around 2 months postpartum (HR 1.28, 95% CI 1.10-1.49) for mothers, and around 6 months (1.20, 95% CI 1.02-1.42) for fathers. The 6 months adjusted cumulative RR of PPD in twins compared to singletons was 1.24 (95% CI 1.10-1.40) for mothers and 1.11 (95% CI 0.95-1.30) for fathers. Twin mothers had increased risk of PPD compared to singleton mothers, which was driven by an immediate increase after childbirth. The risk among twin fathers was not increased immediately after childbirth, but we found slightly elevated risk around 6 months postpartum. This could suggest diverse patterns of PPD symptomatology in twin parents compared to singleton parents and between mothers and fathers. Our findings underline parents of twins as a potentially vulnerable group to PPD and emphasize the need for increased awareness of their mental health.

Longitudinal effects of maternal depressive and anxious symptomatology on child hair cortisol and cortisone from pregnancy to 5-years: The EDEN mother-child cohort

Exposure to maternal depressive and anxious symptomatology in utero and after birth can affect child outcomes. One proposed mechanism is through changes in child stress hormone levels, however current studies present inconsistent findings, and further research is needed to better understand the impact of maternal mental health on child stress response. This study aims to add to the limited literature by analysing longitudinal data ranging from 24 weeks amenorrhea to 5 years postpartum among 281 mother-child pairs from the French EDEN mother-child birth cohort. Hair cortisol and cortisone data were collected from children at four time points: birth, 1, 3, and 5 years. Mothers reported depressive symptomatology via the Center for Epidemiologic Studies Depression Scale (CES‐D) (at 24-weeks amenorrhea, 3-, and 5-year follow-up), and the Edinburgh Postnatal Depression Scale (EPDS) (at 4, 8 and 12 months postpartum). Prenatal anxiety symptomatology was measured via the State Anxiety Inventory (STAI) at 24 weeks amenorrhea. Group-based trajectory modelling indicated a 1-cluster classification of longitudinal child hair cortisol, cortisone and cortisol-to-cortisone ratio, as analyses did not reveal a classification by subgroups representing different child profiles. After inverse probability weighting, small effects showed prenatal depressive symptomatology was significantly associated to higher levels of child hair cortisone at one year. Prenatal anxiety symptomatology was significantly linked to higher levels of child cortisol measured at birth and cortisone at birth and at 1 year. Postpartum depressive symptomatology at 8 months was related to higher levels of cortisone among 3-year-olds. These effects were not moderated by child sex or maternal socio-economic status. Further research is needed to understand why there are associations at some time points and not others to determine any potential buffering factors.

Postpartum Mental Health and Perceptions of Discrimination Among Asian Fathers During the COVID-19 Pandemic.

The purpose of this study was twofold: (1) to examine the prevalence of postpartum depression and anxiety symptomatology among fathers of Asian descent living in North America during the COVID-19 pandemic, and (2) to identify the occurrences of online racial discrimination. Using a cross-sectional design and convenience sampling methods, we recruited fathers online via social media sites (Facebook, Instagram) between March 12 and July 31, 2022. The Edinburgh Postnatal Depression Scale, General Anxiety Scale, and the Online Victimization Scale assessed mental health well-being and discrimination outcomes. Data were analyzed using descriptive statistics, two sample t-test, chi-square test of independence, and Pearson's correlation analysis. Our sample included 61 fathers within 6 months postpartum living in the United States and Canada. Participants were on average 34 years old, married, and represented 17 Asian ethnic groups, including Asian Indian (41%), Filipino (11.3%), and Korean (8.1%). One-third of our participants (31.1%, n = 19) were at high risk of developing postpartum depression and scores of three (4.9%) fathers indicated they had clinically significant anxiety. Overall, 26.3% reported experiencing direct online racial discrimination and 65% reported occurrences of indirect online racial discrimination. There was a high rate of depressive symptoms and occurrences of online racial discrimination among fathers of Asian descent living in North America. These rates are higher than the general perinatal population and further research is warranted to examine risk factors and preventive strategies among this unique paternal ethnic group.

Randomized controlled trial to prevent postpartum depressive symptomatology: An infant carrier intervention

BackgroundThere is a need for effective interventions to reduce symptomatology of postpartum depression. The objective of this study was to test whether providing an ergonomic infant carrier would reduce postpartum depression symptomatology. MethodsA randomized two-arm, parallel-group trial with 100 participants was conducted between February 2018 and June 2019 in a low-income community. At 30-weeks' gestation, 50 participants were randomly assigned to receive an ergonomic infant carrier and instructions on proper use (intervention group), and 50 participants were assigned to a waitlist (control group). Participants tracked the extent of their infant carrier use and completed the Edinburgh Postpartum Depression Scale (EPDS) to assess postpartum depression symptomatology at 6-weeks postpartum. ResultsParticipants in the intervention group reported using an infant carrier significantly more often than the control group (β = 2.69, SE = 0.347, p < .001, 95 % CI = 2.08–3.41). The intervention group reported fewer depressive symptoms at 6-weeks postpartum than the control group (β = −0.541, p = .042). LimitationsThe sample size was relatively small and thus our results may not be generalizable to the general population. ConclusionInfant carrying may be a cost-effective intervention to reduce postpartum depression symptomatology. Large-scale studies are warranted to further examine the efficacy and cost-effectiveness of providing carriers as an intervention to reduce postpartum depression symptomatology. Clinical trial registrationClinicaltrials.gov id: NCT04376021. Data Sharing Statement: Deidentified individual participant data will not be made available because we did not obtain permission to share individual data.Clinical Trial Registration Number: NCT0437602; https://beta.clinicaltrials.gov/study/NCT04376021.

Coping as a Mediator between Attachment and Depressive Symptomatology Either in Pregnancy or in the Early Postpartum Period: A Structural Equation Modelling Approach.

Peripartum depression (PPD) is a major complication of pregnancy, and numerous risk factors have been associated with its onset, including dysfunctional coping strategies and insecure attachment styles, both during pregnancy and postpartum. The aim of our study was to investigate the role of coping strategies in mediating the relationship between women's attachment style and depressive symptomatology in pregnancy and one week after giving birth in a large sample of women (N = 1664). Our hypothesis was that the relationship between anxious and avoidant attachment and depressive symptomatology would be mediated by use of maladaptive coping strategies. The assessment instruments were Edinburgh Postnatal Depression Scale (EPDS), Brief Coping Orientation for Problem Experiences (COPE), and Experiences in Close Relationship Scale (ECR). The results indicated that the effect of insecure attachment styles (anxious and avoidant attachment) on antepartum depressive symptomatology was partially mediated by dysfunctional coping styles. Anxious attachment also has an indirect significant effect on postpartum depressive symptomatology through emotional coping; however, avoidant attachment does not seem to be significantly related to postpartum depressive symptoms. Our findings revealed that not only is it important to consider attachment in understanding peripartum depressive symptomatology, but also that coping plays an important role in these relationships. These findings would help a preventive coping-based intervention strategy to enhance the capacity of women with insecure attachment styles to use more adaptive coping during and after pregnancy.

Health anxiety, death anxiety and coronaphobia: Predictors of postpartum depression symptomatology during the COVID-19 pandemic

ObjectiveTo determine levels of postpartum depression symptoms and possible relevant predictors, such as death anxiety, health anxiety, and coronavirus-related anxiety. DesignCross-sectional web-based survey using quantitative methods. SettingExclusively online recruiting via social media and unpaid cross-posting conducted during the third wave of the COVID-19 pandemic in Romania. ParticipantsWomen were eligible to take part in the study if they were mothers over the age of 18 and had a baby aged between 4 weeks – 12 months of age; 1024 women were included in the final sample. Measurements and findingsHealth anxiety, death anxiety, coronavirus-related anxiety, and postpartum depression symptoms were measured using validated instruments. Current depression symptomatology was 67.6%, 26.7% scored above the cut-off for high health anxiety, 1% for coronavirus-related anxiety, and 62.7% for death anxiety. Significant predictors for depressive symptomatology were breastfeeding, history of depression, family income, number of children, health anxiety, death anxiety, and coronavirus anxiety. Further, hierarchical multiple regression analysis indicated that death anxiety, health anxiety, and coronavirus anxiety predicted postpartum depression symptoms over and above socio-demographic factors. Key conclusionsSupported by previous studies, our results suggest that postpartum depression symptomatology levels during the COVID-19 pandemic are high and that they are predicted by health and death anxiety, which are also increased during the pandemic. Implication for practiceThe findings provide information to identify the risk for depression symptoms in postpartum mothers during acute public health situations.

Mental Health during fatherhoood. Biopsychosocial aspects and questionnaire for depression PHQ9

IntroductionBoth women and men experience potentially stressful events during their reproductive periods and both are at risk of developing peripartum depression. Men have a reproductive period that is difficult to define, and research on their mental health has rarely considered the effects of paternity. A prevalence of postpartum depressive symptomatology of 10.4% has been described worldwide (Paulson J et al. 2010). Paternal depression is also a risk factor for peripartum maternal depression (Escribá et al, 2011; Paulson et al., 2016). Among the risk factors for developing postpartum depression in men are identified: personal history of depression, conflictive relationship, lack of family and social support, unemployment, older age, lower educational level, and the father’s ability to support his new role as a father (Morse et al., 2000).ObjectivesScreening to investigate and identify early objective biomarkers in recent fathers of early depression.MethodsAn anonymous survey is carried out through GoogleForms, to 57 men, fathers, with children born alive under 1 year of age, which includes biopsychosocial aspects and a questionnaire for depression: PHQ9.ResultsOf the total of 57 parents, the average age is 36 years. 4 of them are unemployed, 1 is a student, the rest have active work or parent´s licency. Only 10% refer to present economic problems. 36% reported that their partner had a risky pregnancy and 22% had a peripartum complication. 9% describe an unsatisfactory or very unsatisfactory relationship with the mother of their child(ren). 51% have a personal and/or family history of depression and/or anxiety. 57% are overwhelmed in their role as fathers. 33% feel they have little or no social/emotional support. 5% have increased the consumption of alcohol/psychotropic medication and 94% report that their sleep pattern has been affected. 3.5% refer self-injurious thoughts or that they would be better off dead. 14% have considered requesting/consulting with a psychiatrist/psychologist since the arrival of the baby.In relation to PHQ 9, 5% present moderate/severe depression.ConclusionsIn conclusion, it seems relevant to think about a screening to investigate and identify early objective biomarkers and rapid intervention, not only in mothers but also in fathers and thus take a first step to broaden the view from the mother-child dyad to the triad, thus understanding that mental health does not exist in isolation, it is a contextual and relational phenomenon and also reduce the negative impact of this problem, such as: dysfunction and family well-being, marital satisfaction, growth and development of your child/ren . In this context, primary care health professionals (midwives and primary care doctors) could play a fundamental role in recognizing the importance of incorporating parents as relevant figures in health .Disclosure of InterestNone Declared

Influência da percepção do cuidado e da proteção materna sobre as práticas de aleitamento materno em lactentes no terceiro mês de vida

Abstract Objectives: to evaluate the influence of perception of care and maternal protection on breastfeeding practices on the infants’ third month of life. Methods: longitudinal study with mother-infant pairs distributed in five groupsof gestational clinical conditions. The recruitment occurred in the period 2011 to 2016 at three hospitals in the public health systems in Porto Alegre, Brazil. The Parental Bonding Instrument and the Edinburgh Postpartum Depression Scale were assessed. Exclusive and prolonged breastfeeding were analyzed by questionnaires. Data were analyzed by one-way ANOVA with Tukey’s post-hoc test, Kruskal-Wallis with Dunn’s post-hoc test, or Pearson’s chi-squared test. The significance was set at 5%. Results: 209 mother-infant pairs were investigated. Among those who did not practice breastfeeding, a lower perception of care, a higher perception of maternal protection, and a higher score of postpartum depression were observed (p=0.022, p=0.038, and p&lt;0.001, respectively), when compared to peers who practiced. The control group had a significantly higher perception of care when compared to thediabetes mellitus group (p=0.006), and the perception of maternal protection and postpartum depression had no differences between the intrauterine groups (p&gt;0.05). Conclusions: the perception of care and maternalprotection and the postpartum depressive symptomatology influenced breastfeeding at three months. It is possible to assume a transgenerational effect on breastfeeding, suggesting the existence of a complex model related to mental health in a sample of women who had different backgrounds of gestational clinical conditions

Common mental disorders in pregnancy and postnatal depressive symptoms in the MINA-Brazil study: occurrence and associated factors.

ABSTRACTOBJECTIVE To investigate the occurrence and factors associated with common mental disorders in pregnancy and depressive symptoms in postpartum, as well as the association between both in the Brazilian Western Amazon.METHODS This is a prospective cohort in the MINA-Brazil study with women who received primary health care in the town of Cruzeiro do Sul, Acre State. We performed two clinical evaluations during pregnancy (the first: 16–20 weeks; the second: 28 gestational weeks) and three postpartum evaluations (at 3, 6 and 12 months), in which demographic and socioeconomic, gestational, lifestyle and clinical data were collected. We used the Self-Reported Questionnaire (score ≥ 8) to screen the gestational common mental disorder and the Edinburgh Postnatal Depression Scale (score ≥ 10) to identify postpartum depressive symptoms. We used adjusted ordinal logistic regression to investigate the relationship between the covariates and the occurrence of common mental disorders in pregnancy and postpartum depressive symptomatology.RESULTS A total of 461 women completed the two clinical evaluations in pregnancy; of these, 247 completed the three postpartum evaluations. The occurrence of common mental disorder during pregnancy was 36.2% and 24.5% in the first and second evaluations, respectively, and the cumulative incidence was 9.2%. In addition, 50.3% maintained the disorder between evaluations. During postpartum, approximately 20% of the mothers presented depressive symptoms during the first year of their children’s lives. Parity (≥ 2) was associated with common mental disorders, while low maternal education was associated with postpartum depressive symptoms. Women with a common mental disorder in both evaluations during pregnancy were 5.6 times more likely (95%CI: 2.50–12.60) to develop postpartum depressive symptoms.CONCLUSION The occurrence of common mental disorder at any time assessed during pregnancy, but especially its persistence from the second trimester, was strongly associated with depressive symptoms after childbirth. These findings highlight the need for early screening and monitoring of the mental health of pregnant women at the start of prenatal care in order to reduce possible negative impacts on the health of the mother-child binomial caused by such events.

Depressive Symptoms in Fathers during the First Postpartum Year: The Influence of Severity of Preterm Birth, Parenting Stress and Partners' Depression.

Although preterm birth constitutes a risk factor for postpartum depressive symptomatology, perinatal depression (PND) has not been investigated extensively in fathers of very low (VLBW) and extremely low birth weight (ELBW) infants. This study explored paternal depression levels at 3, 9, and 12 months of infant corrected age, investigating also the predictive role played by the severity of prematurity, maternal and paternal PND levels, and parenting stress. We recruited 153 fathers of 33 ELBW, 42 VLBW, and 78 full-term (FT) infants, respectively. Depression was investigated by the Edinburgh Postnatal Depression Scale (EPDS) and distress by the Parenting Stress Index-Short Form-PSI-SF (Total and subscales: Parental Distress, Parent–Child Dysfunctional Interaction, and Difficult Child). ELBW fathers showed a significant decrease (improvement) in EPDS, total PSI-SF, and Parental Distress mean scores after 3 months. Paternal EPDS scores at 12 months were significantly predicted by VLBW and FT infants’ birth weight categories, fathers’ EPDS scores at 3 and 9 months, Parent–Child Dysfunctional Interaction subscale at 3 months, and Difficult Child subscale at 9 months. This study strengthens the relevance of including early routine screening and parenting support for fathers in perinatal health services, with particular attention to fathers who might be more vulnerable to mental health difficulties due to severely preterm birth.

The Impact of COVID-19 on Anxious and Depressive Symptomatology in the Postpartum Period.

Background: Women in the postpartum period may be particularly vulnerable to the psychological effects of the COVID-19 pandemic. The aim of our study was to evaluate the impact of the coronavirus pandemic on postpartum depression and anxiety levels and the role of the fear of COVID-19 in its development. Methods: Women who delivered at the Bissaya Barreto Maternity Hospital, between 16 March and 16 June 2020 (Group 1: Birth in COVID-19 period, n = 207), recruited in the postpartum period, filled in a set of self-reported validated questionnaires: Perinatal Depression Screening Scale, Perinatal Anxiety Screening Scale, Profile of Mood States, Perseverative Thinking Questionnaire, Dysfunctional Beliefs Towards Maternity Scale, and the Fear of COVID-19 Scale. Levels of depressive and anxious symptomatology, negative affect, negative repetitive thinking, and the dysfunctional beliefs towards motherhood of these women were compared with data from samples of previous studies that included women whose delivery had occurred at the same Maternity Hospital before the COVID-19 pandemic period (Group 2: Birth before the COVID-19 period, n = 212). Results: Based on the cutoff points of the screening scales, the prevalence of clinically relevant depressive and anxious symptoms in Group 1 was 40.1% and 36.2%, respectively. Women in Group 1 had significantly higher levels of anxious and depressive symptoms, negative affect, negative repetitive thinking, and dysfunctional beliefs towards motherhood than women in Group 2 (p < 0.05). Fear of COVID-19 in the postpartum period was a predictor of depressive (ß = 0.262) and anxious (ß = 0.371) symptoms, explaining 6.9% and 13.7% of their variability, respectively (p < 0.001). Conclusion: During the COVID-19 pandemic, women in the postpartum period present greater depressive and anxious symptomatology, as well as increased risk factors.

Social inequalities in maternal depressive symptomatology after childbirth: Comparison across birth cohorts in Brazil

• Depressive symptomatology increased amongst southern women in the postpartum period;. • Depressive symptomatology amongst women residents in the north decreased over time;. • Black/brown women showed higher frequencies of depressive symptomatology;. • Poor mothers showed the highest frequencies of depressive symptomatology;. • Socioeconomic and skin colour inequalities remained stable over the studied period. Approximately 40% of women experience their first depressive episode during the postpartum period. In Brazil, several maternal health outcomes are affected by profound social inequalities. Investigating inequalities in maternal depressive symptomatology in two different regions of the country in the first 24 months after childbirth may help clarify these patterns and appropriate support services. Data from three birth cohorts from two Brazilian cities (Cruzeiro do Sul, North region, and Pelotas, South region) were analysed. The baseline of each cohort consisted of 4,231 (2004 Pelotas), 4,275 (2015 Pelotas), and 1,246 (MINA-Brazil) live births. Depressive symptomatology was repeatedly measured using the Edinburgh Postnatal Depression Scale (EPDS) at 3, 12, and 24 months postpartum. Socioeconomic status and skin colour inequalities in depressive symptomatology were analysed at each point. Between the 3rd and 24th months postpartum, maternal depressive symptomatology increased amongst women from the south, but decreased amongst women in the north. Black/brown women and those belonging to the lowest socioeconomic stratum showed the highest frequency of depressive symptomatology. Absolute and relative inequalities remained stable throughout the study period. Depressive symptomatology was most common amongst women with few years of schooling, multiparae, and amongst those who smoked during pregnancy. There was no information regarding any psychological/psychiatric treatment at the time the EPDS was evaluated, and economic status was assessed differently amongst the cohorts. Marked social inequalities were found in postpartum depressive symptoms. Actions aimed at early detection and reducing social inequalities in maternal postpartum depressive symptomatology are vital.

Étude longitudinale sur le trouble stress post-traumatique du post-partum chez la primipare en Tunisie

ObjectivesThe aims of this study were to estimate the incidence of the post-partum post-traumatic stress disorder (PP-PTSD) in primiparous women, and to determine the profile of women at risk of developing this disorder. MethodsWe conducted a descriptive, prospective and longitudinal study carried out at the maternity department of the Hedi Chaker Hospital, Sfax-Tunisia over a period of 15 months. At the first stage of the study, the Saint-Antoine pain questionnaire, the peri-traumatic dissociative experiences questionnaire and the peri-traumatic distress inventory were used respectively to assess the pain of delivery, the peri-traumatic dissociation and distress. At the second stage of the study, the questionnaires, perinatal post-traumatic stress disorder (PPQ), hospital anxiety and depression scale and the Edinburgh postnatal depression scale were used respectively for the PP-PTSD screening and the assessment of the post-partum anxious and depressive symptomatology. ResultsThe study population consisted of 183 parturients at the first stage of the study and 150 parturients at the second stage of the study. The incidence of the PP-PTSD was 9.3 %. In the multivariate study, some factors studied were significantly associated with the development of PTSD-PP, including a history of therapeutic termination of pregnancy, a history of miscarriage, exposure to a stressful event during pregnancy, prenatal hospitalization of the mother, instrumental delivery, pain intensity especially in the affective component, peri-traumatic dissociation and avoidance of sexual intercourse for fear of a new pregnancy. However the skin to skin contact with the new-born immediately after delivery was a significant protective factor. ConclusionThe psychological consequences associated with the first birth, particularly the PP-PTSD, are common. The Identification of women at risk and a systematic screening of postpartum post-traumatic stress symptoms are desirable.

The prevalence and determinants of postpartum depression (PPD) symptomatology among facility delivered mothers of Dhaka city.

Postpartum depression (PPD) is among the top mental health issues and affects children's health and cognitive development. This study aimed to identify the prevalence of PPD symptomatology and possible determinants among facility delivered mothers of Dhaka city. A cross-sectional study was conducted among 291 mothers within the 12 months of postpartum during January to May 2019. The prevalence of PPD symptomatology was 29.9 % among postpartum mothers. Multiple adjusted odds ratios of stepwise logistic regression analyses revealed, mothers age more than 30 years (AOR = 2.56:95 %CI = 1.21-5.39), being a mother for the first time (AOR = 2.08:95 %CI = 1.09-3.96), lost job or couldn't able to do paid work due to pregnancy (AOR = 2.60:95 %CI = 1.25-5.43), hypertension history (AOR = 2.48:95 %CI = 1.20-5.10), neonatal complication (AOR = 2.04:95 %CI = 1.05-3.95), and rare or no support from husband (AOR = 4.12:95 %CI = 2.14-7.95) were identified as significant predictors of PPD. However, having a household income of more than 50,000 Bangladeshi Taka per month (AOR = 0.36:95 %CI = 0.17-0.76) and passing less sedentary hours (AOR = 0.41:95 % CI = 0.23-0.75) were protective factors for PPD. Our study has revealed a relatively high prevalence of PPD symptomatology; therefore, mental health counseling and proper management of cases are essential for bettering mothers and the next generation.

Effects of COVID-19 Epidemic Lockdown on Postpartum Depressive Symptoms in a Sample of Italian Mothers.

The extraordinary health emergency of the COVID-19 pandemic represents a new challenge for mental health researchers and clinical practitioners. The related containment measures may be a risk factor for psychological distress and mood disorders, especially in at-risk populations. This study aims to explore the impact of COVID-19 on postpartum depressive symptoms in mothers with children below 1 year of age. An online questionnaire survey was therefore conducted in Italy between May and June 2020. The survey consisted of several self-administered questionnaires: besides some ad-hoc questionnaires, the Edinburgh Postnatal Depression Scale (EPDS), the Scale of Perceived Social Support (SPSS) and the Maternity Social Support Scale (MSSS) were used. Two hundred forty-three Italian women were included in the study. The prevalence of postpartum depression symptomatology among mothers was 44%, as measured through the EPDS (cut-off >12). Women who spent the isolation in northern Italy adopted maladaptive coping strategies significantly more than women living in areas at lower risk. The analysis highlighted a significant difference between the group that was not directly affected by the virus and women who have had a direct or indirect contact with it. Besides situational factors specific to the pandemic, the results show that there are some risk factors tied to the personal history of the mother (e.g., having had a previous abortion). These data should inform and enlighten future protocols of intervention.

The complex effects of maternal expectations on postpartum depressive symptoms: when does a protective factor become a risk factor?

Purpose The present study assessed the effects of several prenatal maternal expectations on postpartum depression (PPD), while considering two relevant factors – incongruence between planned and actual birth and the rigidity of the birth plan – that can affect whether maternal expectations act as protective factors or risk factors for PPD. Methods Primiparous women (N = 527) were recruited to a longitudinal study about women’s birth choices and experiences. At time 1, during pregnancy, women completed a questionnaire assessing prenatal depression, preferred birth plan, birth plan flexibility–rigidity and maternal expectations (i.e. Natural-Fulfillment, Infant-Reflects-Mothering, Sacrifice). At time 2, two-months post-partum, they reported their actual birth mode and answered a questionnaire assessing their PPD symptoms. Results Natural-fulfillment maternal expectations were negatively related to PPD symptoms. Yet, the interaction of high natural-fulfillment expectations with an unfulfilled birth plan and the rigidity of the birth plan, served as a risk factor for PPD symptomatology. Conclusions Understanding the conditions under which specific prenatal maternal expectations serve as a risk factor for PPD, can help healthcare providers identify women who are at high risk for developing PPD symptoms and plan preemptive interventions.

A tumultuous transition to motherhood: Altered brain and hormonal responses in mothers with postpartum depression.

Postpartum depression (PPD) is a common but complex condition that is poorly understood and multifactorial in aetiology. It is a condition that can compromise the mother's care for her infant, which may pose challenges to the formation of the mother-infant bond and the infant's overall development. Past research has looked at abnormalities in the brain circuitry and hormonal profiles of mothers with PPD compared to non-depressed mothers. However, abnormalities in PPD that may specifically affect the mother's care of her infant have not been clearly assessed. Thus, the present review aims to synthesise studies of altered brain and hormonal responses in mothers with PPD in relation to their care of their infant. First, we review maternal brain responses and their relation to PPD symptomatology, focusing on the salience/fear network, reward/attachment network and default mode network. Next, we discuss oxytocin and hypothalamic-pituitary-adrenal axis hormones in the context of maternal behaviour and PPD. Finally, we synthesise these findings and propose how future studies may benefit from the combined study of both neural and hormonal activity to better understand the underlying neurobiology of maternal care in PPD.

Associations of postpartum mother-infant bonding with maternal childhood maltreatment and postpartum mental health: a cross-sectional study

BackgroundAfter delivery, some women experience impairment of their mother-infant bonding (MIB), which can lead to long-term disturbances of the mother-child relationship and the child’s social-emotional development. Little is known about the association between early maternal bonding problems and mothers’ own adverse childhood experiences, even though the hypothesis of the intergenerational transmission of caregiving indicates continuity in parenting quality across generations. Therefore, the current study aimed at examining the relationship between maternal childhood maltreatment and postpartum MIB, controlling for the role of postpartum mental health.MethodsFrom February 2014 to March 2015, 725 women completed self-report measures 2 months postpartum. Maternal childhood maltreatment was assessed with the Childhood Trauma Questionnaire, postpartum depression with the Revised Beck Depression Inventory, postpartum anxiety with the Symptom Checklist-90-Revised, and postpartum MIB with the abridged version of the Postpartum Bonding Questionnaire. Data were analysed using a hierarchical regression analysis.ResultsAlmost 46% of the included women reported at least one type of childhood maltreatment with emotional neglect being most prevalent. 13% displayed at least mild postpartum depressive symptomatology and 20% scored above the 75th percentile for postpartum anxiety. In the final regression model, which explained 29% of variance, higher severity of maternal emotional neglect in childhood, higher levels of postpartum depression and higher education were significantly related to more postpartum MIB impairment. In contrast, higher severity of maternal physical neglect was significantly associated with less postpartum MIB impairment.ConclusionsThis study is the first to explore the relationship between diverse types of maternal childhood maltreatment and postpartum MIB, adjusting for postpartum mental health. Maternal experiences of emotional neglect and postpartum depressive symptoms could serve as indicators to identify and support mothers with heightened risk for bonding problems, but results need to be validated in longitudinal studies.

The efficiency of online cognitive-behavioral therapy for postpartum depressive symptomatology: a systematic review and meta-analysis

ABSTRACTPostpartum depression (PD) is a frequently occurring disorder that affects the cognitive, emotional and social development of a mother after childbirth. Online cognitive-behavioral therapy (OCBT) is used as therapy for PD symptomatology, but no clear evidence is available about its effectiveness. The goal of this meta-analysis was to identify, synthesize and analyze the empiric studies regarding the OCBT effectiveness for PD. A search for indexed articles and unpublished theses between 2000 and 2017 was made in Google Scholar, Proquest, ScienceDirect, APA PsycNet, Cochrane, SpringerLink, Medline, PubMed and Dissertations International. Six studies were selected based on the following eligibility criteria: (1) papers published in English, (2) papers about PD, (3) papers that empirically investigated the effectiveness of OCBT for PD, and (4) papers comparing an experimental group with a control group. Exclusion criteria included investigations of PD for: (1) mothers diagnosed with another severe disorder and (2) mothers with deceased children and (3) women with an age below 18 years old. This meta-analytic study identified a moderate significant size-effect (d = – 0.54, 95% CI [−0.716; −0.423]) of the OCBTs in reducing PD, and practical implications and limitations are discussed.