Predictors Of Postpartum Depression Research Articles

Investigating heart rate variability measures during pregnancy as predictors of postpartum depression and anxiety: an exploratory study

Perinatal affective disorders are common, but standard screening measures reliant on subjective self-reports might not be sufficient to identify pregnant women at-risk for developing postpartum depression and anxiety. Lower heart rate variability (HRV) has been shown to be associated with affective disorders. The current exploratory study aimed to evaluate the predictive utility of late pregnancy HRV measurements of postpartum affective symptoms. A subset of participants from the BASIC study (Uppsala, Sweden) took part in a sub-study at pregnancy week 38 where HRV was measured before and after a mild stressor (n = 122). Outcome measures were 6-week postpartum depression and anxiety symptoms as quantified by the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Anxiety Inventory (BAI). In total, 112 women were included in a depression outcome analysis and 106 women were included in an anxiety outcome analysis. Group comparisons indicated that lower pregnancy HRV was associated with depressive or anxious symptomatology at 6 weeks postpartum. Elastic net logistic regression analyses indicated that HRV indices alone were not predictive of postpartum depression or anxiety outcomes, but HRV indices were selected as predictors in a combined model with background and pregnancy variables. ROC curves for the combined models gave an area under the curve (AUC) of 0.93 for the depression outcome and an AUC of 0.83 for the anxiety outcome. HRV indices predictive of postpartum depression generally differed from those predictive of postpartum anxiety. HRV indices did not significantly improve prediction models comprised of psychological measures only in women with pregnancy depression or anxiety.

IJCM_330A: Prevalence and predictors of postpartum depression among females attending tertiary hospital Jammu

Background: Puerperium or Postpartum period is the period of first six weeks postpartum which begin immediately after parturition. During this time woman is adapting to multiple physical, social and psychological changes. Early identification of such symptoms is crucial for its prompt treatment. Many women develop depressive symptoms. Objective: is to find out the prevalence and factors associated with Postpartum Depression especially the social support. Methodology: this cross-sectional study was conducted for a period of one year among mothers who were in the period of 4-7 weeks postpartum. The participants were assessed using the scales -Edinburgh Postnatal Depression scale, Hamilton depression Rating scale and Multidimensional scale of perceived Social Support (MSPSS). Statistical analysis was done using spss version (20.0) info. Appropriate statistical tests were used. A p-value of < 0.05 was considered statistically significant. Results: Out of 750, 16.1% had postpartum depression, (a score of =10 on EPDS). The factors which were significantly associated included marital status, religion, residence, education of mother and her husband, history of domestic violence, history of mental illness in the past, family history of mental illness, duration of pregnancy, time since delivery, any complication during pregnancy, birthweight of baby and planned parenthood. Social support shows negative correlation with PPD which is statistically significant Conclusion: The prevalence of depression in postpartum mothers is high, various sociodemographic and obstetric factors are significantly associated with it. social support emerged to be protective in reducing the postpartum depression.

Prevalence and risk factors of postpartum depression among women attending primary healthcare centers in northern of West Bank/ Palestine: a cross-sectional study, 2022

BackgroundPostpartum depression (PPD) has a huge negative impact on the health of the mother and the family, both physically and mentally. Few postpartum depression studies have been done in Palestine. This study aimed to examine the prevalence and the most probable risk factor of PDD among Palestinian women in the northern West Bank.MethodsThis is a cross-sectional study of 380 mothers, ages 18 and 44 years, visiting vaccination clinics with their infants after 7-12 weeks of delivery between 1 May 2022 and 30 June 2022. Postpartum women seeking care at the seven largest primary health care centers of the Ministry of Health in four cities in the Northern West Bank in Palestine were asked to complete a self-administered questionnaire that included the Edinburgh Postnatal Depression Scale and demographic and birth details. A score of 13 or higher was used to indicate PPD risk. Descriptive and analytical analyses were performed using SPSS version 20. The level of significance was set at 5%.ResultsThe median age of the participants was 27 years with a range of 26 years. A total of 129 women had an EPDS score of 13 or more, giving a prevalence rate of post-partum depression of 33.9%. The predictors of postpartum depression were stressful life events during pregnancy (p-value 0.003, OR: 2.1, 95% CI [1.27-3.4]), vacuum use during delivery p-values 0.002, OR: 4, 95% CI: [1.64-9.91]), low social support (p-value less than 0.001, OR: 2.5, 95%CI: [1.7-4.2]) and husband’s low level of education (p-value less than 0.001, OR: 5.2, 95%CI: [2.7-10]).ConclusionThe study showed a high prevalence of PPD among Palestinian mothers in the northern West Bank. Our study found that PPD risk factors include lack of social support, the husband’s low education, and stressful events during pregnancy. This will emphasize the importance of PPD screening and early intervention, especially among vulnerable women.

Predictor of Postpartum Depression: Literature Review

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

Predictors of postpartum depression in threatened preterm labour: Importance of psychosocial factors

BackgroundPostpartum depression (PPD) is more common in high-risk pregnancies. One of the main causes of high-risk pregnancy is threatened preterm labour (TPL), a stressful event which involves psychological consequences for the mother. The objective of this study was to identify those psychosocial factors that may imply a greater risk of PPD in TPL women. Material and methodsA prospective cohort study was carried out, consisting of a sample of 149 pregnant women who suffered from a TPL during pregnancy, and 61 controls. At the time of inclusion, demographic, obstetric, biological, and psychosocial variables were collected. At 3 months postpartum, depressive symptoms were evaluated along with their predictive factors. ResultsWomen who suffered TPL showed higher scores in depressive symptomatology (F (1, 208)=7.46, p=.007), as well as higher probability of PPD diagnosis than controls (χ2 (1)=8.05, p=005). Higher maternal age (+.335), lower educational level (−2.15), history of trauma (+.28) and higher trait anxiety scores (+.314) were the main predictors of PPD after TPL. ConclusionsExperiencing TPL during pregnancy, carries a higher risk of PPD. This risk is mediated by sociodemographic and psychological factors related to chronic stress. The detection of these potentially modifiable risk factors in pregnant women after experiencing TPL would help prevent PPD and improve the maternal–infant prognosis.

Predictors of postpartum depression and its association with sleep quality among mothers in Qassim, Saudi Arabia: A descriptive cross-sectional study.

This cross-sectional study aims to examine the prevalence of postpartum depression (PPD) and sleep problems, their relationship, and the characteristics associated with depression/insomnia in Qassim, Saudi Arabia. An online survey was administered to a convenience sample of 395 mothers who had given birth within the preceding year. The survey comprised demographic characteristics, pregnancy and childbirth characteristics, depression (via the Edinburgh Postnatal Depression Scale; EPDS), and sleep quality (via the Pittsburgh Sleep Quality Index; PSQI). Nearly two-thirds of respondents (62.3%) had PPD, while 92.2% experienced poor sleep quality. Both scales demonstrated a statistically significant positive correlation. Participants with previous PPD, peripartum depression, a personal or family history of other depression, those bottle-feeding their infants, or who had a change in sleep pattern scored significantly higher on the EPDS and had poorer PSQI scores. Respondents with a history of mental illness, pregnancy or delivery complications, those who lacked support, or gave birth to unhealthy newborns also had significantly higher EPDS scores. PPD and poor sleep quality were highly prevalent among mothers living in the Qassim region of Saudi Arabia. Not surprisingly, PPD was strongly correlated with poor sleep quality. Postpartum counseling for mothers during the first year after delivery is necessary to decrease the risk of developing depressive symptoms and poor sleep quality. Screening for sleep-related difficulties and depression in prenatal and postnatal programs may help prevent the development of depressive disorder among postpartum women in this region of Saudi Arabia (or other areas of the Middle East).

Depression Level and Its Associated Factors among Postpartum Working Women in Kuching, Sarawak-A Cross-Sectional Study.

Postpartum depression (PD) among women, if left untreated, may result in long-term health and social consequences for them and their families. This cross-sectional study aimed to determine the factors contributing to PD among working mothers in Kuching, Sarawak, Malaysia. Systematic sampling was used to recruit working mothers who attended Kuching's maternal and child health clinics. They were interviewed with a validated translated questionnaire to obtain data on sociodemographics, health profiles, and Edinburgh Postnatal Depression Scale (EPDS) and postpartum symptoms. Data were analysed using IBM SPSS version 21.0. Out of the total 281 respondents, 15.3% of respondents had depression symptoms. Fatigue (42.7%), back or neck pain (36.3%), breast discomfort (16.4%), dizziness (13.5%) and nipple irritation (11.0%) were the most common physical symptoms experienced by the mothers. Regression analysis showed that working mothers who exhibited higher scores of physical symptoms were 1.26 times more likely to develop PD (adjusted odd ratio 1.26, P < 0.01; 95% CI: 1.071, 1.487). Physical symptoms were the predictors of PD among working mothers.

How do infant feeding method, sleeping location, and postpartum depression interact with maternal sleep quality?

New mothers generally experience poor and/or disrupted sleep. A range of infant care and mental health factors may impact new mothers' sleep quality. A cross-sectional online survey was completed by a sample of 101 Australian new mothers with children under 12 months (M = 5.52 months, SD = 3.29 months) to examine the relationship between infant feeding method, infant sleeping location, and postpartum depression with maternal sleep quality. Subjective maternal sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and postpartum depression was measured using the Edinburgh Postpartum Depression Scale (EPDS). Overall, new mothers experienced poor subjective sleep quality, with high average PSQI scores, above the cut-off of 5 (M = 9.63, SD = 4.07). The majority of new mothers did not experience postpartum depression, with an average EPDS score below the cut-off of 11 (8.66, SD = 5.20). Mothers who breastfed their infants experienced significantly better subjective sleep quality than mothers who bottle-fed, with a medium effect size (ηp2 = 0.458). Subjective maternal sleep quality did not differ based on infant sleeping location. Poor subjective maternal sleep quality was a significant predictor of postpartum depression. While poor sleep was common in this sample of Australian new mothers, this study demonstrated that new mothers who breastfeed may experience slightly better subjective sleep quality than other feeding methods. Further research into, and better services for the education and advocation of, new mothers’ sleep quality will be beneficial to both new mothers and clinicians.

Predictors of Postpartum Depression Among Women with Low Incomes in the United States.

To evaluate the predictors of postpartum depression and to examine the effects of maternal racial identity on postpartum depression among women with low incomes in the United States. We conducted a secondary data analysis using baseline data from the Baby's First Years study, including postpartum women living below the federal poverty line who were recruited from four diverse communities in the United States. Postpartum depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were performed to identify associations between pre-identified postpartum depression risk factors and postpartum depression among participants, followed by predictive margins analyses to elaborate on probability of postpartum depression across different racial identity groups in the sample. The sample included 1,051 postpartum women. Almost one-half of participants identified as Black (45.9%), followed by White (20.7%), American Indian (1.8%), and Asian (1.3%). Prevalence of postpartum depression in the sample was 24%. Financial insecurity and alcohol use were positively associated with postpartum depression, whereas level of education and reported physical health were negatively associated with postpartum depression. Mothers who identified as Black had an 8.3% higher probability of postpartum depression than that of White mothers in the sample. Nurses working with populations with low income should assess social determinants of health to provide holistic mental health care. Women with low incomes should be referred to resources which account for their financial burden. Racial disparities exist in perinatal care, and birth and postpartum mental health outcomes. It is crucial to address the systemic racism faced by Black mothers experiencing postpartum depression.

Postpartum depression screening in mothers and fathers at well-child visits: a feasibility study within the NASCITA cohort

ObjectiveTo assess the feasibility of the family paediatrician’s (FP) role in identifying the signs of postpartum depression in parents in time to guarantee child well-being.Design, setting and participantsData for this...

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.

0627 Postpartum Insomnia and Poor Sleep Quality are Uniquely Predictive of Postpartum Mood Disorders

Abstract Introduction Many postpartum women experience symptoms of depression (PPD) and anxiety (PPA). Insomnia and poor sleep quality are frequently reported by postpartum women and are risk factors for postpartum mood disorders. This longitudinal study sought to assess whether perinatal insomnia or sleep quality predicted depression and anxiety across each month of the first 6 months postpartum in women with a history of depression. Methods Pregnant women (N = 178) aged 18-45 years with a self-reported prior history of depression were recruited from social media in late pregnancy. None of the women were depressed at enrollment. In late pregnancy and for up to six months postpartum, women completed monthly online questionnaires including the ISQ, PSQI, EPDS, and GAD-7. Repeated-measures multilevel models were performed using the generalized linear mixed model command in the software IBM SPSS 28 to determine predictive associations across the postpartum. Demographics (age, education, race, and sex of baby) were statistically controlled for in these models. Results The rate of depression averaged (15.7%) and anxiety averaged (17.0%) across the postpartum. The prevalence of insomnia was 20.4%, and the prevalence of poor sleep quality was 67.8% across the first 6 months postpartum. Insomnia in the postpartum predicted greater depressive and anxiety symptoms, even after controlling for prenatal insomnia. Likewise, poor sleep quality in the postpartum predicted greater depressive and anxiety symptoms after controlling for prenatal poor sleep quality scores. When considering clinical cutoffs of the EPDS ≥ 12 and GAD ≥ 10, postpartum insomnia and sleep quality uniquely predicted postpartum depression (OR = 5.69, 95% CI 3.33-9.74 and OR = 3.13, 95% CI 1.70 -5.77). Insomnia predicted postpartum anxiety (OR = 11.15, 95% CI 5.99-20.78), with sleep quality trending (OR = 1.76, 95% CI 0.99 -3.12). None of the demographic variables significantly contributed (P’s &amp;gt; 05). Conclusion Both postpartum insomnia and poor sleep quality contributed to clinical postpartum mood. The chronic sleep deprivation of insomnia and the subjective experience of poor sleep quality are uniquely relevant to risk for postpartum mood. The consideration and treatment of both is important as they are uniquely associated with adverse outcomes for mother and child. Support (if any) Happiest Baby, Inc

Levels and predictors of postpartum depression and anxiety during the first year of the COVID-19 pandemic in a confined cross-border city

Pregnancy and/or the puerperium involve social, physiological and psychological changes that make women more vulnerable to mental disorders such as anxiety and depression, even more so if these develop in stressful contexts such as the pandemic. The aim of this study is to identify factors associated with the risk of postpartum anxiety and depression during the COVID-19 pandemic. A cross-sectional study was conducted among postpartum women (n = 69) who gave birth between March 2020 and March 2021 in Melilla, a Spanish cross-border city with Morocco whose borders were closed, making it a confined city. The scales used were the State-Trait Anxiety Inventory and the Edinburgh Postnatal Depression Scale. Results reported an elevated risk of depression (85.5%) and anxiety (63.8%), with severe anxiety reaching 40.6% of cases. Predictors of postpartum depression comprised a personal history of mood disorders (β = 8.421; CI95% = 4.863/11.978) and having been diagnosed with COVID-19 during pregnancy or postpartum (β = 4.488; CI95% = 1.331/7.646). As regards anxiety, it is predicted on the basis of mood antecedents (β = 14.175; CI95% = 7.870/20.479), the fact of having been diagnosed with COVID-19 during pregnancy or postpartum (β = 8.781; CI95% = 2.970/14.592) and the fact of being a multipara (β = 5.513; CI95% = 0.706/10.321). In conclusion, special attention should be paid to women with a history of mood disorders and a positive diagnosis of COVID-19 during pregnancy or postpartum, even more so in the case of multiparous women, because of its impact on mental health during the postpartum period.

Causal effects of opioids on postpartum depression: a bidirectional, two-sample Mendelian randomization study.

Postpartum depression is the most common psychiatric disorder in pregnant women during the postpartum period and requires early detection and treatment. Previous studies have found that opioids use affects depression and anxiety disorders. Although it has long been suspected that opioids may contribute to the development of postpartum depression, observational studies are susceptible to confounding factors and reverse causality, making it difficult to determine the direction of these associations. To examine the causal associations between opioids and non-opioid analgesics with postpartum depression, we utilized large-scale genome-wide association study (GWAS) genetic pooled data from two major databases: opioids, salicylate analgesic, non-steroidal anti-inflammatory drugs (NSAIDs), and aniline analgesics GWAS data from the United Kingdom Biobank database. GWAS data for postpartum depression were obtained from the FinnGen database. The causal analysis methods used random-effects inverse variance weighting (IVW), and complementary sensitivity analyses using weighted median, MR-Egger method, and MR-PRESSO test. In the IVW analysis, Mendelian randomization (MR) analysis showed that opioids increased the risk of postpartum depression (OR, 1.169; 95% CI, 1.050-1.303; p = 0.005). Bidirectional analysis showed a significant causal relationship between genetically predicted postpartum depression and increased risk of opioids and non-opioid analgesics use (opioids OR, 1.118; 95% CI, 1.039-1.203; p = 0.002; NSAIDs OR, 1.071; 95% CI, 1.022-1.121; p = 0.004; salicylates OR, 1.085; 95% CI, 1.026-1.146; p = 0.004; and anilides OR, 1.064; 95% CI, 1.018-1.112; p = 0.006). There was no significant heterogeneity or any significant horizontal pleiotropy bias in the sensitivity analysis. Our study suggests a potential causal relationship between opioids use and the risk of postpartum depression. Additionally, postpartum depression is associated with an increased risk of opioids and non-opioid analgesics use. These findings may provide new insights into prevention and intervention strategies for opioids abuse and postpartum depression.

The Relationship between Postpartum Depression and Postpartum Support : Expatriate and Non-Expatriate Comparisons

Poor social support is a known risk factor in the development of postpartum depression. Expatriate women may be at increased risk of experiencing lower levels of social support due to cultural and language barriers. Currently, research examining postpartum depression and levels of social support in expatriate women is sparse. The aim of this preliminary study was therefore to determine whether postpartum support is a predictor of postpartum depression in expatriate women. Sixty-five women based in the United Kingdom took part in an online cross-sectional survey consisting of a series of questionnaires gathering demographic information and measuring postpartum depression and postpartum social support. Of the total sample, 42 were expatriate and 23 were non-expatriate women, with a mean age of 33 years. Higher levels of depression were reported by the expatriate group. A significant negative correlation was identified between postpartum depression and postpartum support; perceived lack of social support was a significant predictor of postpartum depression. Levels of perceived emotional, material, informational and comparison support were reportedly lower in expatriate women compared to non-expatriate women. This study offers an early understanding of the potential risk factors associated with postpartum depression in expatriate women. Future studies are encouraged to develop interventions that aim to increase social support for expatriate women.

A Prospective Study on the Incidence and Predictors of Postpartum Depression among Pregnant Women Attending an Antenatal Clinic in Kano, Northern Nigeria

A Prospective Study on the Incidence and Predictors of Postpartum Depression among Pregnant Women Attending an Antenatal Clinic in Kano, Northern Nigeria

EPDS screening at delivery discharge as a predictor of postpartum depression

EPDS screening at delivery discharge as a predictor of postpartum depression

Factors Associated with Postpartum Depression among Mothers Visiting a University Hospital in Western Nepal

Background: Postpartum depression (PPD) is a grave problem posing various complications in mothers and their children. We aimed to assess the prevalence and predictors of PPD among women attending a university hospital in western Nepal. Methods: This institution based cross-sectional study enrolled 218 postpartum (&lt; 12 weeks post-delivery) mothers either admitted in the in-patient-units of Obstetrics department or visiting Immunization clinics from February to July 2020. Purposive sampling technique was used. The presence of PPD was assessed by using Nepali version of Edinburgh Post- partum Depression Scale. A face-to-face interview was conducted. Mothers with mental disorders, hearing impairment and migrants were excluded. The predictors of PPD were determined by multivariate analysis. Results: PPD affected 39% of women. Multivariate binary logistic analysis showed that PPD was associated with nuclear family (AOR: 6.74, 95% CI: 3.00-15.12), husband consuming alcohol (AOR: 2.47, 95% CI: 1.18-5.18), and preference of boy child (AOR: 2.93, 95% CI: 1.32-6.50). However, planned pregnancy (AOR: 0.23, 95% CI: 0.11-0.47), vaginal delivery (AOR: 0.37; 95% CI: 0.17-0.81), male baby (AOR: 0.33; 95% CI: 0.16-0.68), and presence of husband throughout pregnancy (AOR: 0.31; 95% CI: 0.10-0.92) were found to be negatively associated with PPD. Conclusion: The prevalence of PPD was common and was positively associated with nuclear family, male child preference and alcohol consuming husband and negatively associated with planned pregnancy, vaginal delivery, male baby, and presence of husband throughout pregnancy.

Prenatal and Childbirth Risk Factors of Postpartum Pain and Depression: A Machine Learning Approach.

About 74.91% of U.S. mothers experience postpartum pain at 6 to 10 weeks postpartum, and one in seven U.S. mothers suffer from postpartum depression. We used machine learning to explore physical, psychological, and social factors during pregnancy and childbirth and identify the most important predictors of postpartum pain and depression. Data were from the Listening To Mothers III survey (2012), a national representative sample of postpartum mothers. We randomly split the dataset into a training set (N = 1467) and a test set (N = 723). The final models included 34 risk factors identified from previous literature. Postpartum pain was measured as "to what extent the pain interferes with mothers' daily life". PHQ2 scores measured depression. We used the random forest model, an aggregate of many regression trees, to accommodate potential nonlinear/interaction effects. In the test data set, our models explained 15.8% of the variance in pain and 27.1% of the variance in depression. The model's strongest predictors for postpartum pain were Cesarean delivery, holding back while communicating with providers, non-use of pain relief medications, and perceived discrimination. For depression scores, the model's strongest predictors included needing help for depression during pregnancy, perceived discrimination, holding back, gestational diabetes, and pain. Mental and physical health are intertwined and should be considered integratively in the perinatal period. Besides, practitioners should also be aware of the importance of patient-provider-relationship, which both independently and interact with other risk factors to predict postpartum health.

Examining psychological inflexibility as a mediator of postpartum depressive symptoms: A longitudinal observational study of perinatal depression

BackgroundDepression is a common, serious complication during the postpartum period. Predictors of postpartum depression characterize who is at-risk for persistent symptoms. This study explored how psychological inflexibility affects depressive symptoms at 4 and 12 weeks postpartum. MethodsParticipants receiving prenatal care at a medical center were recruited during the second trimester. Participants (n = 180) completed online assessments and diagnostic interviews during the third trimester (≥28 weeks gestation), and at 4-, 8-, and 12-weeks postpartum. Online assessments measured psychological inflexibility (PI) and depressive symptoms, while diagnostic interviews measured lifetime history of depression. ResultsMediation analysis examined pathways between 4-weeks postpartum depression, 8-weeks postpartum PI, and 12-weeks postpartum depression. Depressive symptoms at 4-weeks postpartum predicted PI at 8-weeks postpartum (β = 0.31, SE = 0.06, t (177) = 6.06, p < .001). Depressive symptoms at 4-weeks postpartum (β = 0.42, SE = 0.06, t (176) = 7.12, p < .001) and PI at 8-weeks postpartum (β = 0.32, SE = 0.08, t (176) = 4.09, p < .001) predicted depressive symptoms at 12-weeks postpartum. Depressive symptoms at 4-weeks, 8-week PI, and lifetime history of depression accounted for 42% of the variance in 12-week depressive symptoms (R2 = 0.42). The confidence interval of the indirect effect (0.04, 0.18) did not include zero, indicating significant mediation by PI. ConclusionsPI mediated the relation between 4- and 12-weeks postpartum depressive symptoms when controlling for lifetime history of depression. Psychological inflexibility is a transdiagnostic target for future prevention and intervention research during the postpartum period.