PPD Symptoms Research Articles

Who decides to follow the referral advice after a positive postpartum depression screening result? Reflections about the role of sociodemographic, health, and psychological factors from psychological consultations – a cross-sectional study

Background/objectivePostpartum depression (PPD), a common and severe mental health problem, affects about 13–20 % of new mothers. Despite the psychological intervention's effectiveness, referral uptake rates among affected women are low. In the article, we aim to characterise those new mothers who adhered to referral advice after a positive PPD screening result. Method9161 women had taken part in a midwife-led PPD screening. Those who scored equal to or more than ten points on the Edinburgh Postnatal Depression Scale (EPDS) were referred for psychological consultations (12 %, n = 1109). We used data gathered during the realization of a PPD prevention programme. The following measures were used: EPDS, a sociodemographic and health data survey, and psychological consultation cards. ResultsWe found that only 85 (8 %) of referred mothers later enrolled in psychological consultations. Those mothers who adhered to the referral advice had higher EPDS (total score) and EPDS – 3A anxiety scores than mothers who did not contact a psychologist. Moreover, they had a higher gestational age at birth and, on average, fewer children. More PPD symptoms, C-section experience, self-assessed good financial situation and a postgraduate higher education degree were predictors of seeking help. ConclusionA mother's decision to follow the referral advice is crucial in mental health prevention and should be treated as an addition to a separate step 2: referral in a 3-step PDD management process, with identification constituting a step 1, and intervention - a step 3.

Effect of a targeted health education program on nurses’ awareness about postpartum depression

BackgroundPostpartum depression (PPD) is a prevalent mental health disorder that affects women after giving birth. It seriously harms the mother–child bond. As nurses' expertise can have a significant impact on women after childbirth, this study aimed to compare the knowledge of nurses at the Maternity Hospital of Ain Shams University (ASU) before and after the implementation of an educational program regarding PPD.MethodsA pre-and post-quasi-experimental study was conducted among 63 nurses at ASU Maternity Hospital. A self-administered questionnaire was used to evaluate nurses' knowledge of PPD symptoms, diagnosis, risk factors, treatment, and consequences before and one month following an educational program that comprised PowerPoint, posters, and videos.ResultsThe mean age of nurses was 23.17 ± 1.45. About 76% had previously heard of PPD, and the most frequent sources of their information were nursing studies followed by conferences. After the intervention, there was a significant improvement in the knowledge score regarding PPD symptoms and diagnosis, with a mean score of 7.23 ± 1.32 compared to 6.13 ± 1.97 before the intervention. The knowledge score of PPD risk factors showed a considerable improvement, with a mean score of 11.52 ± 1.49 as compared to 9.69 ± 1.94 previously. There was a significant improvement in the knowledge scores regarding PPD treatment and consequences. Overall, the PPD total knowledge score of nurses improved significantly after the intervention, from 19.56 ± 3.49 to 23.2 ± 2.5 (p-value < 0.001).ConclusionThis study demonstrates the positive impact of a targeted health education program on enhancing nurses’ awareness about PPD. The program effectively increased knowledge levels among participating nurses, empowering them with essential skills to recognize, assess, and respond to PPD in their clinical practice. The improvement in awareness signifies the importance of implementing focused educational interventions to enhance nurses’ ability to identify this critical maternal mental health issue.ImplicationsBeyond the direct effect of this study on nurses' awareness, it has wider implications for patient care, healthcare policies, professional development, interdisciplinary collaboration, and public health awareness related to PPD.Trial registrationIt was registered on clinicaltrials.gov with identifier number NCT06424496.

Engaging husbands in a digital mental health intervention to provide tailored counseling for women experiencing postpartum depression: A mixed methods study in Nepal

BackgroundPostpartum depression (PPD) is a common experience among mothers worldwide. Family members, especially husbands, can play an integral role in supporting and helping mothers recover from PPD. However, husbands are typically not included in interventions to address postpartum depression among women. This study explored husbands’ perspectives on engaging in a counseling intervention augmented with a digital health component for the treatment of PPD. MethodsA convergent mixed methods design was used to evaluate husbands’ attitudes and involvement in a counseling and digital intervention for mothers in a semi-urban region of Nepal.Thematic analysis of semi-structured interviews was used to derive emergent themes. A joint display examined differences in themes for husbands whose wives experienced a significant decline in PPD symptoms as measured by the Patient Health Questionnaire-9 pre and post intervention, as compared to husbands of women whose symptoms stayed the same or worsened. ResultsThirteen husbands were interviewed. Three primary themes emerged: the impact of gender norms and attitudes on engagement in the intervention, involvement and support in the intervention, and suggestions for future interventions for PPD. Among wives who experienced a reduction in depression symptoms, their husbands were more likely to endorse gender-equitable norms and attitudes and the husbands provided emotional support, as well as participating in household chores and childcare. ConclusionWhen husbands are living in the same household, providing support and being involved in their wives’ PPD treatment can help them recover. Husbands describe time at home and work as barriers to being able to help their wives. PPD interventions that involve husbands might need to educate husbands about how they can provide emotional support to their partner.

Marital Satisfaction, Emotion Regulation and Self-Efficacy in Women with Postpartum Depression

The aim of the study is to explore the relationship between marital satisfaction, emotion regulation, and self-efficacy in women experiencing Postpartum Depression. The sample size consisted of N=100 participants which were women with PPD symptoms who visited the OPD of gynecology ward of government hospitals. The selected population age average was 19 to 35 years. Urdu translated scales of Comprehensive Marital Satisfaction Scale, Depression Anxiety Stress Scale, Emotion Regulation Questionnaire and General Self-Efficacy Scale were used for data collection. The information was analyzed using Pearson Product Moment Correlation, Moderation Analysis and Multiple Regression via SPSS 21 version. The conclusion of this research has been demonstrated that there is weak positive correlation between Marital Satisfaction and severity of PPD in women. This study suggests that as Marital Satisfaction increases, the impact of PPD symptoms decreases. It also showed that Self-Efficacy has a strong and significant effect on PPD symptoms as a moderator.

IJCM_23A: Long-Term Maternal and Childhood Outcomes Among Women with Post-Partum Depression in Rural and Urban Areas of Khordha, Odisha.

Background: The prevalence of Postpartum Depression in India varies from 6.8-21.5%. About 5% women reported persistent PPD symptoms even three years after childbirth. PPD increases the suicide risk among mothers. It not only affects the psychological health but also physical health &amp; quality of life of mother. Maternal PPD affects the mother child bonding and also the child growth &amp; development. Objective: To assess the long-term effects of post-partum depression on the mothers and the children at 1 year-5 years. Methodology: We have done a Cohort study with 290 mother-child dyads in both rural and urban area of Khordha, Odisha. Mothers were screened using EPDS for PPD at 6wk to 6 months after delivery. The outcome for mothers and children were assessed at one year to five years after delivery. Chronic depression was assessed with EPDS, confirmed by psychiatric evaluation and suicidality of the mother with SBQ-R; child anthropometric outcomes with WHO growth charts and development with Bayley Scale of Infant and Toddler Neurodevelopment. Results: Among the 62 mothers screened positive for post-partum depression, 18 (29%) were found to have Chronic depression and a significant association was found between post-partum and chronic depression (OR=11.25, CI- 4.60- 27.69, p-value &lt;0.001]. Conclusion: Maternal post-partum depression had significant impact on the maternal and child child-health in the long term.

Efficacy of in-person versus digital mental health interventions for postpartum depression: meta-analysis of randomized controlled trials

ABSTRACT Aim This meta-analysis aimed to compare the efficacy of in-person and digital mental health interventions in addressing Postpartum Depression. Methods Following PRISMA guidelines, the protocol for this meta-analysis was registered at the Open Science Framework (Retrieved from osf.io/wy3s4). This meta analysis included Randomized Controlled Trials (RCTs) conducted between 2013 and 2023. A comprehensive literature search identified 35 eligible RCTs from various electronic databases. Inclusion criteria focused on pregnant women over 18 years old, encompassing antenatal depression and up to two years postpartum. Diagnostic interviews or Edinburgh Postnatal Depression Scale (EPDS) were used to establish PPD. Digital interventions included telephonic, app-based, or internet-based approaches, while in-person interventions involved face-to-face sessions. Results The meta-analysis revealed a moderate overall effect size of −0.69, indicating that psychological interventions are effective for PPD. Digital interventions (g = −0.86) exhibited a higher mean effect size than in-person interventions (g = −0.55). Both types of interventions displayed substantial heterogeneity (digital: I2 = 99%, in-person: I2 = 92%), suggesting variability in intervention content, delivery methods, and participant characteristics. Conclusion Digital mental health interventions show promise in addressing PPD symptoms, with a potentially greater effect size compared to in-person interventions. However, the high heterogeneity observed in both modalities underscores the need for further research to identify key drivers of success and tailor interventions to diverse populations. Additionally, the choice between digital and in-person interventions should consider individual needs and preferences. Ongoing research should further investigate and optimise intervention modalities to better serve pregnant women at risk of PPD.

Potential CSF biomarkers of postpartum depression following delivery via caesarian section

BackgroundPostpartum depression (PPD), the depressive episodes following delivery, is a serious and frequent psychiatric disorder. While numerous screening tools existed for depressive episodes, e.g., the Edinburgh Postnatal Depression Scale (EPDS), there are no objective biological measures for predicting PPD. Despite several studies done to identify biomarkers in PPD, there has been limited exploration into cerebrospinal fluid (CSF) which directly interfaces with the brain. Consequently, novel potential biomarkers of CSF are required to predict PPD, so as to target specific preventive interventions. MethodsSeventy-five parturients undergoing caesarean delivery were enrolled for CSF collection at delivery. Of the twenty-eight subjects who didn't meet any exclusion criteria, the number of the healthy parturients whose score of EPDS 6-weeks postpartum (6-wpp) < 5 and PPD patients whose EPDS 6-wpp ≥ 13 was ten respectively. Gas chromatography–mass spectrometry (GC–MS) analysis of CSF was used for metabolomic assessments. ResultsWe found that capric acid, dodecanoic acid, arachidic acid and behenic acid in CSF were significantly negatively correlated with PPD symptoms, meanwhile L-tryptophan had an obvious positive correlation. Moreover, these five biomarkers can be used as effective predictive biomarkers for PPD. LimitationsThe main limitations are the inclusion of only parturients who underwent caesarean sections and a small sample size. ConclusionsThis study innovatively investigated potential predictive biomarkers of PPD before the onset through intrapartum maternal CSF metabolomics, which offered a more objective approach to predict and diagnose PPD, leading to help identify high-risk parturients for early initiation of secondary prevention to reduce global PPD burden.

Effect of social media-based psychodrama therapy on reduction in symptoms of postpartum depression in women with first birth experience: The contributing role of spousal support

We aimed to examine the impact of social media-based psychodrama therapy in reducing postpartum depression symptoms in first-time mothers. We conducted this study using a quasi-experiment with the use of pretest, posttest and follow-up evaluation after six months. We found a significant main effect of social media-based psychodrama therapy in reducing symptoms of postpartum depression in women F(1,503)= 713.413, p = 0.001, eta squared .441. We also found that this relationship is moderated by spousal support like physical, emotional and social support. Additionally, our results showed that first-time mothers experience PPD symptoms after childbirth more than experienced mothers. We equally found that psychodrama contributed in reducing symptoms of PPD in experienced mothers more than in first-time mothers. The implication of our result is that first-time mothers require more attention to assist them to recover from PPD symptoms than their experienced counterparts.

Postpartum depression in Vietnam: a scoping review of symptoms, consequences, and management

BackgroundPostpartum depression (PPD) is a major health issue that can affect both mothers and their newborn children. In Vietnam, approximately 20% of mothers suffer from PPD. However, there is a lack of synthesized evidence regarding the case management of PPD in the Vietnamese context. A review of early symptoms, consequences, and management strategies of PPD will help to inform best practices to reduce complications and shorten the recovery time after parturition.MethodsThis scoping review aims to analyze and synthesize the findings of studies on PPD examining the symptoms, consequences, and management strategies among Vietnamese women. MEDLINE, CINAHL, PubMed, ScienceDirect, EBSCOHost, Google Scholar, and a networked digital library of projects, theses, and dissertations published between 2010 and 2022 in Vietnam were accessed following search terms including “Vietnam”, “depression”, “postpartum”, “symptom/experience”, “consequence”, and “management”.FindingsThe most-reported symptoms were sadness, tiredness, the feeling of being ignored, lack of interest in the baby, reduced appetite, and sleep disturbance. The recognized consequences were child stunting and slow growth, without mentioning its long-term effects on mothers. Our findings indicated that PPD in Vietnam has not been sufficiently managed; mothers tend to seek help from ‘fortune-tellers’ or ‘word-of-mouth’ practices rather than from evidence-based modern medicine.ConclusionThis scoping review provides an initial stage of PPD symptoms, consequences, and management along with facilitating an interventional program to support this vulnerable group of women. A large survey of Vietnamese mothers' symptoms, effects, and management strategies is needed.

Empirically derived dietary patterns and postpartum depression symptoms in a large sample of Iranian women

BackgroundPostpartum Depression (PPD) is a major depressive disorder that mainly begins within one month after delivery. The present study aimed to determine the relationship between dietary patterns and the occurrence of high PPD symptoms in women participating in the initial phase of the Maternal and Child Health cohort study, Yazd, Iran.MethodsThis cross-sectional study was carried out in the years 2017–2019 included 1028 women after childbirth The Food Frequency Questionnaire (FFQ) and the Edinburgh Postnatal Depression Scale (EPDS) were study tools. The EPDS questionnaire was used to measure postpartum depression symptoms and a cut-off score of 13 was considered to indicate high PPD symptoms. The baseline data related to dietary intake was collected at the beginning of the study at the first visit after pregnancy diagnosis and the data related to depression, were collected in the second month after delivery. Dietary patterns were extracted by exploratory factor analysis (EFA). Frequency (percentage) and mean (SD) were used for description. Chi-square test, Fisher’s exact test, independent sample t-test, and multiple logistic regression (MLR) were used for data analysis.ResultsThe incidence of high PPD symptoms was 24%. Four posterior patterns were extracted including prudent pattern, sweet and dessert pattern, junk food pattern and western pattern. A high adherence to the western pattern was associated with a higher risk of high PPD symptoms than a low adherence (ORT3/T1: 2.67; p < 0.001). A high adherence to the Prudent pattern was associated with a lower risk of high PPD symptoms than a low adherence (ORT3/T1: 0.55; p = 0.001). There are not any significant association between sweet and dessert and junk food patterns and high PPD symptoms risk (p > 0.05).ConclusionHigh adherence to prudent patterns was characterized by high intake of vegetables, fruit and juice, nuts and beans, low-fat dairy products, liquid oil, olive, eggs, fish, whole grains had a protective effect against high PPD symptoms, but the effect of western pattern was characterized by high intake of red and processed meats and organs was reverse. Therefore, it is suggested that health care providers have a particular emphasis on the healthy food patterns such as the prudent pattern.

The Mediating Role of Postpartum Depression and Childbirth-related PTSD in the Relationship Between Attachment Styles and Postpartum Bonding Among Mothers in Ahvaz City, Iran

Objective: Several studies have explored the correlation between postpartum depression and a weak mother-infant bond; however, fewer studies have analyzed how other postpartum mental health conditions, such as childbirth-related post-traumatic stress disorder (PTSD), or important personal characteristics, including adult attachment styles, affect the quality of the mother-infant bond. This study aims to examine the association between attachment styles and postpartum bonding in mothers, considering the mediating influence of postpartum depression and childbirth-related PTSD. Methods: A total of 150 mothers, 4 to 12 weeks postpartum, completed a demographic questionnaire, the Edinburgh postpartum depression questionnaire, the posttraumatic stress questionnaire related to the birth of a child, the mother-child bonding questionnaire, and the attachment style questionnaire. The posttraumatic stress related to the birth of a child questionnaire was translated into Persian for the first time and was used after confirming its validity and reliability. The proposed model was examined by the structural equation modeling method. Results: The conceptual model’s results showed that the direct and standardized effect of anxious attachment style (β=0.49, P=0.001) and avoidant attachment style (β=0.47, P=0.001) on postpartum depression were significant. Also, the direct effect of anxious attachment style (β=0.59, P=0.001) on postpartum PTSD was significant. However, the coefficient of avoidant attachment style (β=-0.04, P=0.581) was not significant for postpartum PTSD. Also, the coefficients were investigated from the direct effect of postpartum depression, postpartum PTSD, anxious attachment style, and avoidant attachment style. The obtained results showed that postpartum depression (β=0.27, P=0.001), postpartum PTSD (β=0.43, P=0.001), and anxious attachment style (β=0.39, P=0.001) could predict the mother-child bond. However, the avoidant attachment style (β=0.00, P=0.946) could not predict the mother-child bond. Conclusion: The findings of the study revealed that insecure attachment styles were linked to challenges in forming a strong mother-infant bond. Anxious attachment was also associated with bonding difficulties, which were influenced by symptoms of postpartum depression and childbirth-related PTSD. In contrast, a higher degree of avoidant attachment style was associated with more significant difficulties in bonding, which were mediated by symptoms of depression. Accordingly, if interventions aim to enhance the mother-infant bond, treatment should focus on addressing childbirth-related PTSD, PPD symptoms, and insecure attachment styles.

The Efficacy of Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Examining Mechanisms of Change in a Randomized Controlled Trial

Postpartum depression (PPD) is treatable and preventable, but most women do not seek professional help for their perinatal depressive symptoms. One increasingly popular approach of improving access to care is the use of web-based intervention programs. The objective of this study was 2-fold: first, to assess the efficacy of Be a Mom, a brief web-based selective or indicated preventive intervention, in reducing depressive and anxiety symptoms of women at high risk for PPD; and second, to examine mechanisms of change linking modifiable self-regulatory skills (ie, emotion regulation, self-compassion, and psychological flexibility) to improved perinatal mental health outcomes. This 2-arm, open-label randomized controlled trial involved a sample of 1053 perinatal women presenting high risk for PPD who were allocated to the Be a Mom intervention group or a waitlist control group and completed self-report measures at baseline and postintervention assessments. Univariate latent change score models were computed to determine changes over time in adjustment processes and outcomes, with a multigroup-model approach to detect differences between the intervention and control groups and a 2-wave latent change score model to examine whether changes in processes were related to changes in outcomes. Be a Mom was found to be effective in reducing depressive (intervention group: µΔ=-3.35; P<.001 vs control group: µΔ=-1.48; P<.001) and anxiety symptoms (intervention group: µΔ=-2.24; P<.001 vs control group: µΔ=-0.43; P=.04) in comparison with the control group, where such changes were inexistent or much smaller. All 3 psychological processes under study improved statistically significantly in posttreatment assessments: emotion regulation ability (Δχ23=12.3; P=.007) and psychological flexibility (Δχ23=34.9; P<.001) improved only in the intervention group, and although self-compassion increased in both groups (Δχ23=65.6; P<.001), these improvements were considerably greater in the intervention group. These results suggest that Be a Mom, a low-intensity cognitive behavioral therapy program, is a promising first-line intervention for helping perinatal women, particularly those with early-onset PPD symptoms. ClinicalTrials.gov NCT03024645; https://clinicaltrials.gov/ct2/show/NCT03024645.

Mediating role of perceived stress on the association between domestic violence and postpartum depression: cross-sectional study in Bangladesh.

Postpartum depression (PPD) is a major depressive disorder developed after childbirth that negatively affects the well-being of both mother and infant. The relationship between domestic violence and the development of PPD symptoms is well documented. However, empirical evidence is lacking on how a person's perception of stress mediates this relationship. To estimate the degree to which perceived stress may explain the association between being the victim of domestic violence and developing PPD symptoms among Bangladeshi mothers. A cross-sectional survey design was employed from October to December 2019 to collect data from 497 postpartum mothers within the first 6 months of giving birth. The associations between domestic violence victimisation and developing PPD symptoms were assessed using multivariable logistic regressions. The Karlson-Holm-Breen method was used for mediation analysis. One-third (34%) of the mothers in this sample reported experiencing PPD within 6 months. A one-item increase in the number of reported experiences ('items') of controlling behaviour, emotional domestic violence and physical domestic violence increased the odds of developing PPD symptoms by 27%, 40% and 31% respectively, after controlling for other variables and mediators. Furthermore, after adjusting for other variables, the mediating effect of perceived stress on the association of controlling behaviour, emotional domestic violence, physical domestic violence and any form of domestic violence with developing PPD symptoms was 45.1%, 43.0%, 31.2% and 37.5% respectively. Findings suggest that perceived stress partially mediates the association between domestic violence victimisation and developing PPD symptoms. Understanding these complex relationships may help policymakers to formulate appropriate intervention strategies and support services.

Postpartum depression crisis since the second lockdown and ‘screening paradox’: many women identified, very few treated

ObjectiveExposure to stressful situations, such as emergencies, infectious diseases, and natural disasters, may lead to a heightened risk of perinatal mental health problems. Declared on March 11th, 2020, the global COVID-19 pandemic triggered an additional burden on women in the perinatal period. Safety recommendations, such as social distancing and isolation, were opposite to the usual advice given to new mothers. Besides fear, changes in financial stability and daily life reorganization contributed to increased depressive symptoms. As the periods of epidemic waves and lockdowns were associated with a more significant burden for young families, we aimed to assess the intensification of depressive and anxiety symptoms during the pandemic concerning the time intervals of the three lockdowns introduced in Poland. Methods: 1588 postpartum women took part in the online self-assessment with the Edinburgh Postnatal Depression Scale (EPDS) and General Anxiety Disorder 2 (GAD-2) questionnaire between January 1, 2020, and March 31, 2021. This self-screening is a part of a prevention program The Next Stop: Mum, implemented in the North of Poland.ResultsThe highest severity of PPD symptoms and anxiety were observed during the second lockdown in Poland: the mean score in the EPDS and anxiety assessment was significantly higher than the mean scores from previous pandemic periods. Since the second lockdown, the average EPDS and GAD-2 scores remained similarly high. Moreover, with the duration of the COVID-19 pandemic, the percentage of women with elevated symptoms of postpartum depression and anxiety began to increase. However, the Polish National Health Fund data indicate that only 0,7% of women giving birth in the northern macro-region of Poland received diagnosis and help from public funds. In The Next Stop: Mum project, 250 women benefited from psychological consultations.ConclusionIncreased severity of depression and anxiety symptoms during the pandemic indicates the need for additional psychological support for postpartum women. However, very few women are diagnosed in health facilities in the first year postpartum and thus are rarely referred for further treatment. The study shows that the availability of services and the focus on social and individual barriers may be critical factors in implementing perinatal mental health programs and practices. This may be especially needed in a country where the screening obligation is new. In case of a further pandemic, policymakers and health care professionals should be aware that the duration of the restrictions and the repetition of lockdowns are associated with the aggravation of symptoms. The online screening without the possibility to discuss the results is only partially effective in increasing referrals for possibly affected women.

The relationship between social capital and postpartum depression symptoms of lactating women in minority areas-A cross-sectional study from Guangxi, China.

Postpartum depression (PPD) is the most common mental illness affecting women during lactation, and good social capital is considered a protective factor. This study aimed to investigate PPD symptoms, and explore the relationships between social capital and PPD symptoms of lactating women in southwest minority areas in China. This cross-sectional study was conducted among 413 lactating women in Guangxi, China. Data were collected using the Edinburgh Postnatal Depression Scale and the Chinese version of the Social Capital Assessment Questionnaire. Hierarchical regression analysis was conducted to explore the factors influencing PPD symptoms, and a structural equation model was used to examine how social participation and cognitive social capital mediated PPD symptoms. The total prevalence of PPD symptoms (score > 12) was 16.46%, and that of mild depression symptoms (9-12 score) was 22.03%. Nine variables predicted PPD symptoms and explained 71.6% of the variance in the regression model: higher age, lack of medical security, fixed occupation, breastfeeding time, self-caregiver, maternity leave, social participation, social trust, and social reciprocity. Furthermore, cognitive social capital mediated the relationship between social participation and PPD symptoms, with a mediation effect rate was 44.00%. The findings of this study highlight that social capital, support from family members, maternity leave, and medical insurance play protective roles in the PPD symptoms of lactating women. It is necessary to improve social capital as a key strategy for interventions for PPD symptoms, and active social participation activities are critical to reducing PPD symptoms among lactating women in minority areas.

Risk factors for postpartum depression in women undergoing elective cesarean section: A prospective cohort study.

BackgroundPostpartum depression (PPD) has adverse effects on maternal and child health. Cesarean section (CS) is suggested to be associated with PPD, but no study has examined the risk factors for PPD in women who underwent CS. Therefore, this study aimed to investigate this association.MethodsA prospective observational study was conducted between December 2020 and September 2021. In total, 590 women who underwent elective CS participated in this study. Data were collected using a questionnaire through a face-to-face interview at three time points: 32nd week of gestation, 2 days postpartum, and 6 weeks postpartum. PPD was defined by an Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 11 at 6 weeks postpartum. Multivariate logistic regression analysis was performed to identify the risk factors for PPD.ResultsAmong the 590 women, 25.4% had PPD (142/590). After adjustment for the confounding factors, high antenatal self-rating anxiety scale score (OR = 1.10, 95% CI = 1.04–1.16), PPD symptoms (EPDS ≥ 11) at 2 days postpartum (OR = 6.17, 95% CI = 1.35–28.31), and pain at 6 weeks postpartum (OR = 2.14, 95% CI = 1.24–3.69) were independently associated with PPD.ConclusionPrenatal anxiety, PPD symptoms occurring at an early postoperative stage, and pain at 6 weeks postpartum may be associated with an increased risk of PPD among women who undergo CS.

Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy for Symptoms of Postpartum Anxiety and Depression: Feasibility Randomized Controlled Trial.

BackgroundPostpartum depression (PPD) and postpartum anxiety (PPA) are often comorbid and are associated with significant personal and economic costs. Fewer than half of the mothers experiencing PPD or PPA symptoms receive face-to-face treatment, suggesting a need for alternative delivery formats such as internet-delivered cognitive behavioral therapy (ICBT).ObjectiveThis pilot study aimed to examine the impact of a therapist-assisted, transdiagnostic ICBT program on symptoms of PPD and PPA, as there is only one previous study on transdiagnostic ICBT with this population, which did not include therapist assistance.MethodsClients endorsing the symptoms of PPD or PPA (N=63) were randomized to an 8-week transdiagnostic ICBT course (Wellbeing Course for New Moms) or to treatment as usual (TAU). Clients completed measures of depression, anxiety, stress, postnatal bonding, and relationship satisfaction, as well as measures of treatment satisfaction and therapeutic alliance, before treatment, after treatment, and at the 1-month follow-up. Outcome measures were also completed at the 6-month follow-up for clients who completed the ICBT course.ResultsBoth the ICBT and TAU groups experienced statistically significant improvements over time. The ICBT group experienced larger improvements after treatment and at the 1-month follow-up on more measures than the TAU group, with medium between-group Cohen d effects on primary outcome measures for anxiety (Cohen d=0.65, 95% CI 0.13-1.17), PPD (Cohen d=0.52, 95% CI 0.01-1.04), and depression (Cohen d=0.56, 95% CI 0.05-1.08), and on secondary outcome measures of overall distress (Cohen d=0.69, 95% CI 0.17-1.21), anxiety (Cohen d=0.59, 95% CI 0.07-1.11), and stress (Cohen d=0.76, 95% CI 0.23-1.28). Time-by-group interactions for proportional reductions between groups over time were only significant after treatment and at the 1-month follow-up for the primary anxiety measure (P=.006). This study was underpowered for detecting small or medium effects. Overall, clients perceived the treatment as credible, and 95% (21/22) of the clients were satisfied with the treatment content and therapist support.ConclusionsFindings from this pilot study provide preliminary support for transdiagnostic ICBT in treating PPD and PPA symptoms to improve access to psychological treatments.Trial RegistrationClinicalTrials.gov NCT04012580; https://clinicaltrials.gov/ct2/show/NCT04012580

Associations between symptoms of maternal postpartum depression, gestational age and infant social withdrawal: A longitudinal study in a community cohort.

Infant social withdrawal is a risk factor for non‐optimal child development; thus, it is important to identify risk factors associated with withdrawal. In a large community sample (N = 19,017), we investigate whether symptoms of maternal and partner postpartum depression (PPD; measured with the Edinburgh Postnatal Depression Scale) and prematurity are predictors of infant social withdrawal (measured with the Alarm Distress Baby Scale). Withdrawal was assessed at 2–3, 4–7 and 8–12 months postpartum. Linear regressions showed that prematurity predicted higher infant social withdrawal at all time points, and maternal symptoms of PPD were positively associated with withdrawal at 2–3 months. Logistic regressions showed that odds for elevated social withdrawal were increased with elevated levels of maternal symptoms of PPD at 2–3 and 8–12 months. Partner's symptoms of PPD were not associated with withdrawal. Future studies should investigate how PPD symptoms and prematurity may impact the individual development of social withdrawal.

Prevalence and accompanying factors for postpartum depression symptoms

Introduction: Postpartum depression [PPD] is a disorder that starts during pregnancy or within the first four weeks postpartum with comorbid major depressive symptoms and is an important cause of morbidity and mortality for both the mother, and the baby. Depression surveys aimed to identify the at-risk population, during pregnancy and postpartum, may prove to be useful in preventing this disorder, which may have serious consequences. The present study aimed to determine the incidence of PPD symptoms in mothers with babies aged 1-18 months and to investigate the parameters affecting the occurrence of PPD.Methods: The study was designed as a descriptive, cross-sectional study including 302 mothers with 1-18-month-old babies registered at Firat 12 Family Health Center (FHC) in Buca, Izmir, between 1 November 2020 and 28 February 2021 The study investigated the sociodemographic characteristics of the cases, marital relations, reproductive health, recent birth history, and development of depression as detected using the Edinburgh Postpartum Depression Scale (EPDS).Results: The mean age of the 302 participants included in the study was 29.49± 5.18 years, where the mean score from the EPDS scale was 6.43± 6.06. As a result of the study, the risk of occurrence of PPD was 14.6%. In the present research, the factors associated with increased risk of PPD included a history of personal and familial psychiatric disorders, poor communication with the partner, partner’s irregular employment status, psychiatric disorders during the previous birth, lack of regular monitoring during pregnancy, and lack of a helper in baby care (p&amp;lt;0.050).Conclusion: In particular, the practices that may reduce the risk of PPD include regular follow-up of the pregnancies of the women with a personal or familial history of psychiatric disorders or with psychiatric problems during their previous birth, questioning their family relationships during this process, referring them to a psychologist, psychiatrist or family counselor if necessary, and offering postpartum family support to mothers in baby care.Keywords: Postpartum period, prevalence, depression, risk factors

Maternal pain during pregnancy dose-dependently predicts postpartum depression: The Japan Environment and Children's Study

BackgroundPostpartum depression (PPD) affects women during the first year after delivery. This study investigated the association between prenatal pain (maternal pain during pregnancy) and PPD. MethodsData were analyzed from the Japan Environment and Children's Study (JECS), a nationwide prospective birth cohort study. Information on prenatal pain was collected twice during pregnancy through self-administered questionnaires. PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale at one month postpartum. Poisson regression analyses were performed to investigate the association between prenatal pain and PPD, with other putative risk factors adjusted in the model. ResultsAmong 84,801 study subjects, 11,535 (13.6%) were screened as positive for PPD. In the present study, the occurrence of prenatal pain was 69.6 and 84.0% at the first trimester and the second/third trimester, respectively. A positive relationship between any degree of pain and PPD in both the first and the second/third trimester was observed. A significant linear dose-dependent association was also found (Ptrend < 0.001) when the subjects were divided by the severity of pain. Using participants without any pain at either point as a reference, those with persistent pain both at the first and the second/third trimesters showed the highest risk for PPD: aRR = 1.95 (95%CI: 1.76–2.15; p < 0.001). LimitationsNo detailed information regarding the type or site of prenatal pain was available in the JECS questionnaires, neither did data concerning delivery and postpartum pain. ConclusionsThe study results suggest that prenatal pain is a dose-dependent risk factor for the development of PPD.