Prevalence Of Postpartum Anxiety Research Articles

Effects of perioperative use of esketamine on postpartum depression risk in patients undergoing cesarean section: A randomized controlled trial

BackgroundPostpartum depression (PPD) is a prevalent public health issue. Although ketamine has prophylactic effects on PPD in women undergoing cesarean section, the effects of esketamine on PPD remain unclear. This trial aimed to evaluate the efficacy of perioperative esketamine infusion on PPD risk by assessing Edinburgh Postnatal Depression Scale (EPDS) scores and blood biomarkers. MethodsA total of 150 participants undergoing elective cesarean section were randomly allocated to receive either esketamine or normal saline. Since 27 participants were excluded due to consent withdrawal or loss to follow-up, 123 patients were included. The primary outcome was the prevalence of PPD risk. Secondary outcomes included the prevalence of postpartum anxiety (PPA) risk, levels of biomarkers, postoperative pain intensity, and cumulative sufentanil consumption. ResultsThe prevalence of PPD and PPA risk at 3 days, 42 days, 3 months, and 6 months postpartum did not differ between the two groups. Furthermore, EPDS scores, pain intensity at rest, and during coughing on postoperative days (POD) 1 and 2 did not differ between the two groups. Sufentanil consumption during 0–12 h, 12–24 h, 0–24 h, and 0–48 h postoperatively were significantly lower in the esketamine group compared to the control group. Blood biomarkers did not differ between the two groups on POD 3. LimitationsThe sample size was small. PPD risk was simply screened, not diagnosed. ConclusionsPerioperative administration of esketamine did not decrease the incidence of PPD risk in women after elective cesarean section. However, esketamine reduced opioid consumption.

COVID-19 and Its Effect on the Prevalence of Postpartum Anxiety [A306

COVID-19 and Its Effect on the Prevalence of Postpartum Anxiety [A306

Screening for postpartum anxiety: A quality improvement project to promote the screening of women suffering in silence

BackgroundPostpartum anxiety is a mental health problem that has largely been ignored by maternity care providers despite an estimated incidence as high as 28.9%. Though postpartum anxiety may or may not be accompanied by depression, and while screening for postpartum depression has become more common place, postpartum anxiety is often not assessed or addressed. PurposeThe purpose of this pilot quality improvement project was to implement a screening, treatment and referral program for postpartum anxiety in the birth centre environment. ProceduresMidwives from 10 geographically diverse birth centres, and all members of the American Association of Birth Centres, were recruited to participate in the project. An online video was developed which detailed postpartum anxiety, screening through use of the anxiety subscale of the Edinburgh Postnatal Depression Scale and a toolkit for treatment and/or referral for screen positive patients. Participants entered patient scores into the Perinatal Data Registry of the American Association of Birth Centres. Individual interviews of midwives were conducted following the 10-week pilot period. Main FindingsThere were a total of 387 participants across 9 participating sites. Among all screened participants with follow-up data, (n = 382), 9.69% (n = 37) were lost to follow-up. Among all participants screened with the Edinburgh Postpartum Depression Scale -3A and Edinburgh Postpartum Depression Scale (n = 318), 12.58% (n = 40) had a positive Edinburgh Postpartum Depression Scale -3A score of greater than six. Of all screened participants with an Edinburgh Postpartum Depression Scale score, 15 (6.98%) had a Edinburgh Postpartum Depression Scale score of less than 12 and an Edinburgh Postpartum Depression Scale -3A score greater than six, and would have not received follow up care if only screened for postpartum depression. Midwife participants expressed heightened awareness of the need to screen and felt screening was easy to integrate into clinical practice. ConclusionsThe Edinburgh Postpartum Depression Scale -3A is a valid, easy-to-use tool which should be considered for use in clinical practice. Modification of the electronic health record can serve as an important impetus triggering screening and treatment. It is important that clinicians are educated on the prevalence of postpartum anxiety, its risk factors, symptoms and implications.

Post-partum depression, anxiety and marital satisfaction: A perspective from Southeastern Nigeria.

BackgroundMany studies have noted the high prevalence of post-partum depression (PPD) and anxiety associated with poor marital satisfaction, albeit amidst a dearth of literature on comorbid PPD and anxiety among women in Nigeria.ObjectiveThe study was aimed to assess the prevalence of PPD and anxiety, and to investigate their relationship with marital satisfaction in low-risk women in Enugu, Southeastern Nigeria.MethodA cross-sectional study of 309 randomly selected nursing mothers at two tertiary health institutions. Socio-demographic Questionnaire, Hospital Anxiety and Depression Scale, and Index of Marital Satisfaction (IMS) were used to collect data on demography, anxiety and depression and marital relationship respectively. All statistical tests were performed at a significant level of 0.05.ResultsThe age range of the respondents was 20–46 years; mean and s.d. was 29.65 and ± 4.87, respectively, and most of them were graduates of tertiary educational institutions (74.1%). The prevalence of post-partum anxiety was 31.1% and of PPD was 33.3%. Marital dissatisfaction was observed in 39.5% (122) of the respondents who were mothers. Those with co-morbid depression and anxiety (22.0%) had worse marital dissatisfaction. The strongest correlation with depression and anxiety was item 12 of IMS (‘feel that my partner doesn’t confide in me’).ConclusionThere was a high prevalence of marital dissatisfaction, PPD and anxiety among nursing mothers in Enugu, but with low detection rate. The effects of PPD and anxiety on the mother, her marital relationship and her infant make them essential conditions for early diagnosis, prevention and treatments.

Postpartum Anxiety and Intrapsychic Vulnerability Reflected by Early Maladaptive Schemas

Background: The prevalence of postpartum anxiety is high and its negative consequences are significant. Most research studies have aimed at exploring the demographic and psychosocial risk factors while neglecting factors of intrapsychic vulnerability. The aim of our study is to examine postpartum anxiety from this aspect, that is, uncovering the early relational experiences of mothers, specifically regarding their early maladaptive schemas. Methods: 125 women participated in online data collection in the first year after giving birth. Maternal anxiety was measured with the postpartum version of STAI-S, while early maladaptive schemas were assessed with the Schema Questionnaire. Results: In terms of demographics, most of the mothers in our sample had middle-class characteristics, but 21.6% had clinical, and 34.4% had subclinical levels of anxiety. Our results confirmed a significant, direct effect of maladaptive schemas on postpartum anxiety in case of 13 of the 15 measured schemas. Discussion: This study draws attention to the intrapsychic vulnerability of mothers as a highly neglected etiological aspect of postpartum anxiety. Further research of intrapsychic and, especially, attachment-related vulnerability should be carried out to identify at-risk women and treat postpartum anxiety more adequately. Limitations: The sample consisted of highly educated, married women with planned children, so the results are not representative for mothers in general.

Postpartum Anxiety Prevalence, Predictors and Effects on Child Development: A Review

This narrative review of the literature was derived from a search for 2010-2017 publications on postpartum anxiety and postnatal anxiety on the PubMed and PsycINFO databases. Approximately two thirds of the papers are focused on the prevalence/incidence, onset and course of postnatal anxiety. The other third are almost equally distributed across correlates/risk factors and effects/outcomes, and only a few studies are focused on interventions/treatments. Based on the recent literature, the prevalence of postpartum anxiety has widely ranged from 13 to 40%. The demographic risk factors for postnatal anxiety include being a young mother, having more education and being employed. Childbirth risk factors include being primiparous in one sample and multiparous in another, cesarean delivery, fear of the birth and of death during delivery, lack of control during labor, low self-confidence for the delivery and the delivery staff, and premature delivery. Social support problems include the lack of family support, marital/family conflict, and social health issues. Psychiatric history risk factors include prenatal depression and anxiety. Postnatal anxiety has negative effects on breast-feeding, bonding, mother–infant interactions, and infant temperament, sleep, mental development, health and internalizing behavior and on conduct disorder in adolescents. Unfortunately, only six postnatal anxiety intervention studies could be found including paternal education, music therapy during labor, mothers massaging their infants, cognitive behavior therapy and administering oxytocin.

Prevalence of Postpartum Anxiety and Depression after Intrapartum Oxytocin

Objective: To know the prevalence of postpartum anxiety and depression
 in patients who received intrapartum oxytocin.
 Method: Across-sectional observational study was conducted in Dr.
 Cipto Mangunkusumo hospital. Observation used Edinburgh Postnatal
 Depression scale and Beck Anxiety Inventory before delivery
 day, on the first and fourteenth day of postpartum.
 Result: Of 112 patients, we found the prevalence of mild and moderate
 anxiety were 94.6% and 5.4%. There were no anxiety women
 before delivery and on the first day of postpartum. The prevalence
 of mild and moderate anxiety on the fourteenth day of postpartum
 were 83% and 16.9%. There was no severe anxiety found at those
 time. On the other hand, the prevalence of postpartum depression
 on the first and fourteenth day of postpartum were 31.3% and
 32.1%. There was no association between exogenous oxytocin and
 postpartum anxiety also depression. In multivariate analysis, we
 found that women with low self image were more prone to postpartum
 anxiety (OR 0.16, 95% CI 0.06-0.46). Meanwhile, postpartum
 depression was associated significantly to self image (OR 0.17, 95%
 CI 0.07-0.83), low income (OR 10.35, 95% CI 1.72-62.45) and pregnancy
 plan (OR 0.17, 95% CI 0.06-0.53)
 Conclusion: The patients who received intrapartum oxytocin are
 more prevalent to have mild anxiety. The prevalence of depression
 before delivery day, on the first and fourteenth day of postpartum
 are similar. In statistic, there is no relationship between intrapartum
 oxytocin administration and postpartum anxiety or depression.
 [Indones J Obstet Gynecol 2016; 4-2: 59-63]
 Keywords: anxiety, depression, oxytocin intrapartum, postpartum

Post partum anxiety and depression in peri-urban communities of Karachi, Pakistan: a quasi-experimental study

BackgroundPostpartum anxiety and depression is a major public health concern because of its adverse effects on the cognitive and social development of the infant. Globally postpartum depression has been widely investigated but as anxiety is a more prominent feature of postpartum depression we assessed the prevalence of anxiety and depression and their associated factors in post partum women.MethodsA quasi-experimental study investigating the impact of postpartum anxiety and depression on child growth and development was conducted in two peri-urban, multiethnic, communities of Karachi, a mega city of Pakistan. A house to house questionnaire based survey was done by trained field workers; 420 consenting pregnant women were identified and data for socio-demographic, home environment and family relationship variables was collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother's levels of anxiety and depression were assessed after one month, two months, six months and twelve months of childbirth; this was two step process: initially an indigenous, validated screening instrument Aga Khan University Anxiety and Depression Scale was used and diagnostic confirmation was done through a psychologist's interview based on DSM IV criteria. Women found to be anxious and depressed at least once out of four assessments were considered for the computation of overall prevalence of postpartum anxiety and depression as well as its risk factors. However, point prevalence's of postpartum anxiety and depression were also reported at each assessment time. Two sixty seven women could be followed for one year. Data was analyzed using SPSS. Chi-square test, simple and multiple logistic regression were used to see the association of different factors.ResultsThe overall prevalence of postpartum anxiety and depression was found to be 28.8 percent. Domestic violence, difficulty in breast feeding at birth and unplanned current pregnancy were found to be significantly associated with postpartum anxiety and depression.ConclusionDomestic violence and not having the right to plan pregnancy are related to the patriarchal culture and lack of empowerment of women. The association with difficulties in breast feeding needs to be further explored in future studies