Prevalence Of Postpartum Depressive Symptoms Research Articles

Navigating the landscape of Postpartum Depression: a comprehensive review

Introduction and purpose:
 The joyous occasion of childbirth is often overshadowed by the prevalence of postpartum depression (PPD), a complex mental health condition affecting mothers globally. This paper reviews the current state of knowledge on PPD, exploring its frequency, risk factors, pathogenesis, symptoms, and impact on maternal and child health.
 Description of the State of Knowledge:
 Recent studies indicate an alarming increase in PPD rates, with notable racial and socioeconomic disparities. Symptoms of PPD, ranging from mild to severe include mood disturbances, cognitive impairments, and self-harm ideation. The repercussions extend beyond the postpartum period, affecting long-term child development, breastfeeding practices, and the mother-infant bond. Advancements in screening tools, particularly the Edinburgh Postnatal Depression Scale (EPDS), have facilitated early detection. However, creating an environment conducive to open communication about mental health remains a significant challenge. Interventions for PPD include psychotherapeutic approaches, pharmacological interventions, and complementary therapies. Brexanolone, the first FDA-approved drug for PPD, represents a significant breakthrough. Community-based and peer support programs, alongside a multidisciplinary approach involving healthcare professionals and support networks, have shown promise in alleviating PPD symptoms.
 Summary:
 In conclusion, PPD remains a substantial public health concern. Increased awareness of its multifaceted nature has led to improved screening, diagnosis, and intervention strategies. Ongoing dialogue, supportive environments, and refined treatments are essential for enhancing the well-being of both mothers and their infants in the postpartum period.

Burden of postpartum depression in sub-Saharan Africa: An updated systematic review

Postpartum depression (PPD) is a significant public health concern in resource-constrained sub-Saharan Africa (SSA). Efforts to combat this burden are hampered by the region’s wide variation in reported prevalence. This review aimed to systematically synthesize up-to-date data on PPD in SSA. The review was structured per the Preferred Reporting Item for Systematic Reviews and Meta-analyses. Included in the review were studies that reported the prevalence of PPD in SSA. A search was undertaken of PubMed, Medline, CINAHL, Academic Search Complete, and PsycINFO. A random-effect model was fitted to estimate the pooled burden of postpartum depressive symptoms in SSA. We conducted subgroup analyses to estimate the distribution of postpartum depressive symptoms based on important study characteristics: sample size, the timing of diagnosis, design, study setting/region, instrument, and income/ economy. The prevalence of postpartum depressive symptoms ranged from 3.8% to 69.9%, with a pooled estimate of 22.1% (CI 18.5–26.2; I2 = 98.2; Tau = 0.848; p<0.001). There was a significant variation in postpartum depressive symptoms with sample size (p<0.001). The highest prevalence (25.6% CI 21.5–30.1) was obtained within 12 weeks postpartum. The prevalence estimate was highest (23.3%; CI 20.1–26.8) with the Edinburgh Postnatal Depression Scale (EPDS). South Africa (30.6%; CI 23.6–38.7) and Zimbabwe (29.3%; CI 22.2–37.5) reported the highest prevalence rates, while Tanzania (13.5%; CI 10.1–17.9) reported the lowest prevalence estimates. Upper-middle SSA countries presented the highest prevalence rates (30.6%; CI 23.6–38.7). The prevalence was highest within the period 2010–2015. PPD constitutes a significant health burden in SSA and is fast becoming an epidemic in southern Africa. Significance: Given that PPD is a recurring mental health challenge among women in sub-Saharan Africa, there is an urgent need for strategic policy provisions to ameliorate its burden. An increase in prevalence of PPD from 2005–2010 to 2015–2021 is indicative of the need for national governments to intensify efforts targeted at achieving the UN Sustainable Development Goals 3 and 5 in the region. In SSA, the prevalence of PPD is highest (approximately 30%) in Southern Africa, precisely South Africa and Zimbabwe, where it is fast becoming an epidemic; hence strategies are needed to curtail its growing trend. There is a need to characterise and stratify the risk factors of PPD in sub-Saharan to guide policy development of predictive algorithms and implementation strategies.

Prevalence and risk factors of postpartum depressive symptoms at 42 days among 2462 women in China

BackgroundPostpartum depression is a common and serious mental health problem that is affecting an increasing percentage of the world's population. We aimed to evaluate the prevalence of postpartum depressive symptoms in Beijing, China, during the COVID-19 pandemic and identify several potential risk factors. MethodsThis was a cross-sectional observational study conducted at Peking University First Hospital from 2020 to 2021. Women who delivered and had postpartum reviews at 42 days after delivery were invited to complete the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) under the guidance of trained nurses. A score of ≥10 was used as the threshold of postpartum depression. t-tests, chi-square tests or Mann–Whitney U tests were applied. A multivariate logistic regression analysis was conducted to assess the risk factors for postpartum depressive symptoms. ResultsA total of 2462 mothers were included in this study, 20.2 % of whom were considered to have postpartum depressive symptoms. Multivariate logistic regression analysis showed that formula feeding (OR = 2.219, 95 % CI: 1.300–3.786, P = 0.013), preterm birth (OR = 1.619, 95 % CI: 1.108–2.367, P = 0.013), cervical insufficiency (OR 3.022, 95 % CI: 1.200–7.615, P = 0.019) and history of depression (OR = 6.519, 95 % CI: 1.537–27.659, P = 0.011) were associated with a high prevalence of postpartum depressive symptoms. ConclusionThere is a high prevalence of postpartum depressive symptoms in developed regions of China during the COVID-19 pandemic. More attention should be given to mothers with risk factors for PPD, and follow-up care is needed.

Prevalence of postpartum depression symptoms in high-income, and low- and middle-income countries in the Covid-19 pandemic: a systematic review with meta-analysis.

To perform a meta-analysis and comparison between high-income, and low- and middle-income countries postpartum depression symptoms prevalences. PubMed, Embase, Virtual Health Library, Scopus, Web of Science, PsycINFO and CINAHL databases were searched until October 2022 for studies that collected data from pandemic. The metaprop command was used in the Stata statistical software v.12.0 to run a random-effects meta-analysis. A total of 15 studies with 4,788 postpartum women were included. The overall prevalence of postpartum depression symptoms was 31% (95% CI: 21.85-40.99). The pooled prevalence of postpartum depression symptoms among women from high-income countries [30.5% (95% CI: 16.95-46.02)] did not differ significantly from that among women from low- and middle-income countries [31.5% (95% CI: 19.26-45.15)]. However, studies that analyzed women up to one month after childbirth had a lower prevalence of postpartum depression symptoms [17.5% (95% CI: 9.85-26.62)] compared to those that observed them up to one year after childbirth [38.3% (95% CI: 33.96-42.83)]. The prevalence of postpartum depression symptoms was high regardless of the country's human development index and it must be regularly tracked around the world to assess, discuss, and recommend more assertive steps that may be implemented based on the particular characteristics of each country.

Excessive gestational weight gain and emotional eating are positively associated with postpartum depressive symptoms among taiwanese women

BackgroundExcessive gestational weight gain and emotional eating may be associated with postpartum depression symptoms. This study was designed to identify how gestational weight gain and eating behaviors are related to postpartum depression (PPD) symptoms among women in Taiwan.MethodsA cross-sectional study was conducted from March 2022 to October 2022 with 318 postpartum women recruited in Taipei, Taiwan. Gestational weight gain (GWG) for the total pregnancy period was recorded as inadequate, adequate, or excessive, based on the 2009 Institute of Medicine recommendations (IOM), accounting for pre-pregnancy body mass index category. Eating behavior at one month postpartum was measured on a 16-item 5-point Likert scale with three subscales: uncontrolled, restrained, and emotional. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale with a cutoff score of 13.ResultsThe prevalence of postpartum depression symptoms (Edinburgh Postnatal Depression Scale ≥ 13) was 23.9% at one month postpartum. Logistic regression analysis revealed that excessive gestational weight gain and emotional eating were positively associated with postpartum depression symptoms at that time.ConclusionEvidence presented here suggests that emotional eating and excessive GWG are associated with PPD symptoms in a Taiwanese population. In addition, it should be a public health priority to ensure a particular focus on mental health during the postpartum period. Healthcare providers should discourage pregnant women from unhealthy eating habits by targeting appropriate GWG and focusing on demand eating to reduce PPD in the postpartum period.

Factors associated with postpartum depressive symptoms among women who conceived with infertility treatment

Infertility treatment experiences may accumulate and influence postpartum psychological well-being among women with infertility. However, the association between infertility treatment experiences and postpartum depressive symptoms remained unclear. This cross-sectional survey aimed to describe depressive symptom scores of 180 women, who conceived while undergoing infertility treatment, at 2–6 months after childbirth, and to explore factors, including infertility history and treatment experiences, associated with postpartum depressive symptoms. Data were collected via telephone interviews and patient record reviews. Postpartum depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, with a cutoff score of 10. The prevalence of postpartum depressive symptoms was 34.4 %. Higher perceived stress levels after childbirth than before undergoing infertility treatment, a duration of infertility diagnosis longer than three years, maternal age >35 years, pregnancy conceived through in vitro fertilization (IVF), and experiencing all three lines of infertility treatment, namely ovarian stimulation, intrauterine insemination, and IVF, were associated with a higher risk of postpartum depressive symptoms. Breastfeeding, social support, and baby sex in line with stated preference were negatively associated with postpartum depressive symptoms. There were no significant interactions between the variables. The women's infertility history and treatment experiences were found to have influenced their postpartum depressive symptoms, especially among women who had a long duration of infertility, conceived through IVF, and had received all lines of infertility treatment.

Prevalence of postpartum depression symptoms in developed and developing countries in the COVID-19 pandemic: a systematic review with meta-analysis

Prevalence of postpartum depression symptoms in developed and developing countries in the COVID-19 pandemic: a systematic review with meta-analysis

Pregnant Women's Experiences During and After Hurricanes Irma and Maria, Pregnancy Risk Assessment Monitoring System, Puerto Rico, 2018.

Exposure to natural disasters during and after pregnancy may increase adverse mental health outcomes. Hurricanes Irma and Maria struck Puerto Rico in September 2017. Our objectives were to understand hurricane-related experiences, maternal health concerns, and the impact of hurricane experiences on postpartum depressive symptoms (PDS). We used data from the 2018 Pregnancy Risk Assessment Monitoring System to describe differences in maternal hurricane experiences among women who were pregnant during and after the 2017 hurricanes. We assessed maternal concerns and PDS. We estimated adjusted prevalence ratios (aPRs) and 95% CIs for the associations between hurricane experiences and PDS. The most frequently reported hurricane experiences were losing power for ≥1 week (97%) and feeling unsafe due to lack of order/security (70%). Almost 30% of women who were pregnant during the hurricanes reported missing prenatal care. PDS were reported by 13% of women. Most hurricane experiences were associated with an increased prevalence of PDS. Feeling unsafe (aPR = 2.4; 95% CI, 1.2-4.9) and having difficulty getting food (aPR = 2.1; 95% CI, 1.1-4.1) had the strongest associations. Most women who were pregnant during or after hurricanes Irma and Maria struck Puerto Rico reported negative hurricane experiences, and most experiences were associated with an increased prevalence of PDS. Understanding the experiences of pregnant women during and after disasters and identifying risks for adverse mental health outcomes after pregnancy are important to inform emergency preparedness and prenatal and postpartum care.

The relationship between body dissatisfaction and postpartum depressive symptoms: A cross-sectional study

BackgroundWomen are least satisfied with their bodies during the postpartum period. There is a potential correlation between body dissatisfaction and depressive symptoms post delivery.The aim of this study was to explore the relationship of appearance and body areas satisfaction with depressive symptoms and examine the risk factors of depressive symptoms at 4–6 weeks postpartum. MethodsA total of 330 postpartum women participated in the study. Body dissatisfaction was measured using the Appearance Evaluation (AE) scale and Body Areas Satisfaction Scale (BASS), while depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS), 4–6 weeks postpartum. ResultsThe prevalence of postpartum depressive symptoms among postpartum women was 40 % while 12.1 % of the women had thoughts of self-harm. Those with depressive symptoms or thoughts of self-harm had lower AE and BASS scores. Body dissatisfaction was significantly associated with factors such as postpartum weight retention of >5 kgs, no exercise, lower education level, and cesarean delivery. The three body areas that women were most dissatisfied with were weight, mid-torso, and lower torso. Education level, delivery method, and BASS score significantly predicted postpartum depressive symptoms. LimitationsThe selection bias might have occurred if those with depressive symptoms neglected routine postpartum care visits due to emotional distress. ConclusionsThe results indicate an association between body dissatisfaction and depressive symptoms at 4–6 weeks postpartum. Awareness of this relationship and focus on these risk factors will help healthcare providers plan peripartum programs to decrease the likelihood of postpartum depressive symptoms.

Traumatic experiences of the Great East Japan Earthquake and postpartum depressive symptoms: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

BackgroundNatural disasters can have serious mental health consequences. We aimed to examine the long-term effects of the 2011 Great East Japan Earthquake (GEJE) on postpartum depressive symptoms (PDS). MethodsThe Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study recruited pregnant women in Miyagi Prefecture from 2013 to 2016. Data from 11,403 participants were used in this study. Women were asked about their traumatic experiences of the GEJE with questions addressing threat, witness, and loss. PDS were defined as Edinburgh Postnatal Depression Scale score ≥9 at 1 month after delivery. Multiple logistic regression analyses were conducted to examine the associations of different traumatic experiences of the GEJE and number of traumatic experiences with PDS, after adjustment for age, parity, feelings toward pregnancy, education, income, social isolation, house damage caused by the GEJE, and survey year. ResultsAbout two-fifths of women had at least one traumatic experience of the GEJE. The prevalence of PDS at 1 month after delivery was 13.3 %. Life-threatening experience and witnessing another person's actual or threatened death were associated with PDS: the odds ratios (ORs) were 1.40 (95 % confidence interval [CI], 1.24–1.59) and 1.28 (95 % CI, 1.08–1.53), respectively. Loss of close person was not associated with PDS: the OR was 1.13 (95 % CI, 0.99–1.30). Larger number of traumatic experiences of the GEJE was associated with increased risk of PDS (p for trend <0.001). LimitationsPDS was self-reported. ConclusionsTraumatic experiences of the GEJE prior to pregnancy were associated with increased risks of PDS.

Prevalence and Risk Factors Associated With Postpartum Depressive Symptoms Among Women in Vientiane Capital, Lao PDR.

Postpartum depression (PPD), the onset of depressive episodes after childbirth, is the most common psychological condition following childbirth, and a global public health concern. If undiagnosed and/or untreated, postpartum depression can have negative effects on maternal and child health, however, there are few studies on the prevalence of postpartum depression in low- and middle-income countries. To contribute to filling this gap, this study examined the prevalence and risk factors associated with postpartum depressive symptoms among women after delivery in Vientiane Capital, Lao PDR. The study was a cross-sectional design, with multistage sampling used to identify women between 4 and 24 weeks after giving birth (N = 521). The Edinburgh Postnatal Depression Scale was used to identify women with postpartum depressive symptoms. Univariate and multivariate logistic regressions identified risk factors associated with postpartum depressive symptoms. The prevalence of postpartum depressive symptoms among participants was 21.3%. Associated factors were having at least 2–3 living children (AOR: 1.9, 95% CI: 1.1–3.0), experiencing mental health problems during pregnancy (AOR: 3.3, 95% CI: 1.4–7.6), experiencing conflicts with family members (AOR: 2.5, 95% CI: 1.5–4.0), the experience of intimate partner violence (AOR: 2.6, 95% CI: 1.3–5.5), and receiving moderate social support (AOR: 5.6, 95% CI: 3.2–10.0). In contexts where access to mental health specialists has severely constrained maternal and child healthcare providers at primary health care must be supported to develop the necessary skills to identify risk factors and symptoms and offer basic essential services for postpartum depressive symptom (PDS). The study identified a high proportion of mothers with postnatal depressive symptoms, highlighting the need to screen and treat mothers who present with PDS, as not doing so exposes mother and their children to a range of negative health and social outcomes. Addressing the stigma associated with mental health illness and mental health illness and domestic violence that prevents women from seeking healthcare, must also be developed, implemented, and evaluated.

Risk factors associated with postpartum depressive symptoms: A multinational study

ObjectiveTo evaluate the association between maternal age, parity, gestational number (singleton vs twin), newborn gender and self-reported postpartum depressive symptoms (PDS) in a large multinational sample using survey data from a digital telephone application. MethodsWomen using the Flo app answered a survey (available in 10 languages) from January 2018 to April 2020. A survey question asking about emotional state was used to determine the presence of PDS. Chi-squared statistics were used to compare groups. A weighted mean prevalence was calculated based upon the socioeconomic status and reproductive population of each country in 2020. ResultsOver a million women from 138 countries participated. Of all respondents, 9.4% endorsed PDS. The weighted mean prevalence of PDS was 11%. We found that PDS decreased with advancing age. First-time mothers reported higher rates of PDS. Twin births were associated with a higher symptom burden than singleton births and mothers of twins in the oldest age group reported the greatest burden. We did not find a clinically significant difference in rates of PDS between mothers of singleton girls and boys. ConclusionsTo our knowledge, this study is the first to examine risk factors for postpartum symptoms using the same survey across a large international population. These results can further research and clinical aims to identify and treat maternal depression more effectively. LimitationsData was aggregated, thereby limiting analysis of individual associations. The survey was self-report and not diagnostic for postpartum depression. Generalizability of risks of postpartum depression should be approached with caution.

Perceived social support and postpartum depression symptoms across geographical contexts: Findings from the 2016 Ohio Pregnancy Assessment survey.

The purpose of this study was to examine the association between perceived social support and postpartum depression symptoms (PDS) and to understand how this association may differ for urban, suburban, rural Appalachian, and rural non-Appalachian women in Ohio. Data were obtained via the 2016 Ohio Pregnancy Assessment Survey (n=3382), a representative sample of postpartum women in Ohio. We conducted bivariate analyses to assess the associations between self-perceived social support and PDS, and covariates. Univariate and multivariate logistic regressions were conducted using a modified Poisson distribution to estimate the association between social support and PDS, adjusting for sociodemographic characteristics. We also examined geographical context as an independent predictor of PDS and as an effect modifier for the association between social support and PDS. 15.6% of survey respondents experienced PDS. Women with low levels of social support had slightly higher prevalence (aPR: 1.4, 95% CI: 1.0-2.1) of PDS compared to women with high social support. Geographic context was an independent predictor of PDS; women in rural Appalachia had significantly lower prevalence (aPR: 0.5, 95% CI: 0.2-0.9) of PDS compared to women in urban areas. We did not find that geographical context modified the relationship between social support and PDS (Wald P=.5). Low social support was associated with increased PDS but did not reach statistical significance. Women living in rural Appalachia had a lower prevalence of PDS. Future studies should explore the reasons for lower rates of PDS in rural Appalachia.

Post-partum depression: a cross-sectional study of women enrolled in a conditional cash transfer program in 30 Brazilian cities

ObjectiveInvestigate factors associated with symptoms of postpartum depression in mothers from families in social vulnerability. MethodsInformation was used from the baseline of a randomized trial to assess a child development program that enrolled 3,242 children < 12 months of age from beneficiary families of the Bolsa Família Program residing in 30 municipalities (counties) in six states of Brazil. The Edinburgh Postnatal Depression Scale (EPDS) was applied to the mothers, and depression was defined as score ≥10. Information on the mother (schooling, age, parity, marital status, skin color, smoking, number of prenatal appointments, and planning of the pregnancy), family (paternal schooling, household crowding, support from the child's father and the family during the pregnancy, and number of children under 7 years living in the household), and infant (sex, gestational age, birthweight, Apgar score, and child's age at the time of the interview) was collected. Prevalence rates for depressive symptoms were calculated with crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI), using hierarchical logistic regression, in a multilevel model. ResultsThe analysis included 3,174 mothers with information on EPDS. The interviews were conducted on average 7.9 months (standard deviation= 2.9) after childbirth. Overall prevalence of depressive symptoms was 26.5% (25.0-28.1%). In the adjusted analysis, higher parity was associated with higher odds of postpartum depression (p <0.001). Women with ≥3 previous deliveries showed an odds 84% higher of presenting depressive symptoms (OR= 1.84; 1.43-2.35) than primiparae. Higher maternal and paternal schooling, presence of husband or partner, and having received support from the child's father and the family during the pregnancy were protective factors against postpartum depression. ConclusionThe study showed high prevalence of postpartum depressive symptoms. Promotion of parental education, alongside with the promotion of support to the woman during pregnancy by the child's father and by the family, as well as family planning leading to birth spacing are measures that may help to prevent postpartum depressive symptoms.

Perinatal death triples the prevalence of postpartum depression among women in Northern Uganda: A community-based cross-sectional study.

IntroductionDeaths during the perinatal period remain a big challenge in Africa, with 38 deaths per 1000 pregnancies in Uganda. The consequences of these deaths can be detrimental to the women; some ending up with postpartum depression. We examined the association between perinatal death and postpartum depression among women in Lira district, Northern Uganda.MethodsWe conducted a community-based cross-sectional study of 1,789 women. Trained research assistants screened women for postpartum depressive symptoms on day 50 postpartum using the Edinburgh postpartum depression scale (EPDS). Socio-demographic, economic, birth and survival status of the neonate were collected during pregnancy and within one week postpartum. We used generalized estimating equation for the Poisson family with a log link using Stata to estimate the prevalence ratio of the association between postpartum depressive symptoms (EPDS scores ≥14) and perinatal death. Mothers who lost their babies between 7–49 days postpartum were excluded.ResultsOf the 1,789 participants symptomatically screened for postpartum depression, 377 (21.1%) [95% confidence interval (95%CI): 17.2%, 23.0%] had probable depressive symptoms. The prevalence of postpartum depressive symptoms among the 77 women who had experienced perinatal death (37 stillbirths and 40 early neonatal deaths (≤7 days of life)) was 62.3% [95% CI: 50.8%, 72.6%] compared to 19.2% [95% CI: 17.4%, 21.2%], among 1,712 with live infants at day 50 postpartum. Women who had experienced a perinatal death were three times as likely to have postpartum depressive symptoms as those who had a live birth [adjusted prevalence ratio 3.45 (95% CI: 2.67, 4.48)].ConclusionsThe prevalence of postpartum depressive symptoms, assessed by EPDS, was high among women who had had a perinatal death in Northern Uganda. Women experiencing a perinatal death need to be screened for postpartum depressive symptoms in order to intervene and reduce associated morbidity.

Preventing postpartum depression using an educational video on infant crying

Abstract Background Perception of and reactive behaviors towards infant crying is one of the modifiable risk factors for postpartum depression. The aim of this study was to examine the impact of watching an educational video on infant crying within 1 week of age after delivery at maternity wards to reduce the prevalence of postpartum depressive symptoms at 1 month after giving birth. Methods Study design was a cluster randomized controlled trial (UMIN000015558). The intervention hospitals were randomly assigned, stratified by area and function of the hospital. Participants included 47 obstetrics hospitals or clinics out of 150 hospitals or clinics in Osaka Prefecture, Japan. In total, 44 hospitals or clinics completed the trial and 2,601 (intervention group=1,040, control group=1,561) caregivers responded to the questionnaire on postpartum depression. Mothers in the intervention group watched a 11-minute educational video, within 1 week of age, during hospitalization at maternity wards. Primary outcome in this study was postpartum depression assessed by the Edinburgh Postnatal Depression Scale as 9+, and assessed via questionnaire at a 1-month health checkup. Results In the intervention group, 142 (13.7%) mothers reported postpartum depression compared to 250 (16.0%) in the control group. Intention-to-treat analysis showed no significant difference in the prevalence of postpartum depression between the groups. However, among young mothers (&amp;lt;25 years old), the analysis showed a 67% reduction in postpartum depression (OR:0.33, 95%CI:0.15-0.72). Conclusions Watching an educational video on infant crying did not reduce postpartum depression at 1 month after giving birth, but it was effective for young mothers aged less than 25 years old. It may be easier to introduce our approach to any opportunity for meeting mothers during perinatal period because it does not require specialized manpower and a significant amount of time for the intervention. Key messages The educational video on infant crying, “Baby Doesn't Stop Crying,” had no effect in preventing postpartum depressive symptoms. Among young mothers aged &amp;lt;25 years, the educational video had a protective effect on postpartum depressive symptoms, which was not observed for mothers aged ≥25 years.

Associations of job type, income, and education with postpartum depressive symptoms: The Kyushu Okinawa Maternal and Child Health Study

Epidemiological evidence on the role of socioeconomic status on postpartum depressive symptoms has been inconsistent. The present prospective study investigated the relationship between employment, job type, income, and education and postpartum depressive symptoms. Subjects were 1316 Japanese women. The subjects were asked to complete an Edinburgh Postnatal Depression Scale (EPDS) between three and four months postpartum. Postpartum depressive symptoms were defined as EPDS score ≥ 9. The prevalence of postpartum depressive symptoms was 8.2%. Compared with unemployment, holding a sales job was independently related to a reduced risk of postpartum depressive symptoms: the adjusted odds ratio (OR) was 0.13 (95% CI: 0.01−0.66). Compared with a household income under four million yen per year, a household income of six million yen or more per year was independently inversely associated with postpartum depressive symptoms: the adjusted OR was 0.33 (95% CI: 0.16−0.63). Compared with less than 13 years of education, both 13 or 14 years and 15 years or more were independently inversely related to postpartum depressive symptoms: the adjusted ORs were 0.40 (95% CI: 0.23−0.69) and 0.48 (95% CI: 0.28−0.82), respectively. Holding a sales job, higher household income and higher educational levels may be inversely associated with postpartum depressive symptoms.

Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression - United States, 2018.

IntroductionPerinatal depression is a complication of pregnancy that can result in adverse maternal and infant outcomes. Screening to identify pregnant and postpartum women with depressive symptoms is recommended to provide diagnosis, treatment, and follow-up care to reduce poor outcomes.MethodsCDC analyzed 2018 data from the Pregnancy Risk Assessment Monitoring System to describe postpartum depressive symptoms (PDS) among women with a recent live birth and to assess whether health care providers asked women about depression during prenatal and postpartum health care visits, by site and maternal and infant characteristics.ResultsAmong respondents from 31 sites, the prevalence of PDS was 13.2%, ranging from 9.7% in Illinois to 23.5% in Mississippi. The prevalence of PDS exceeded 20% among women who were aged ≤19 years, were American Indian/Alaska Native, smoked during or after pregnancy, experienced intimate partner violence before or during pregnancy, self-reported depression before or during pregnancy, or whose infant had died since birth. The prevalence of women reporting that a health care provider asked about depression during prenatal care visits was 79.1% overall, ranging from 51.3% in Puerto Rico to 90.7% in Alaska. The prevalence of women reporting that a provider asked about depression during postpartum visits was 87.4% overall, ranging from 50.7% in Puerto Rico to 96.2% in Vermont.Conclusions and Implications for Public Health PracticeThe prevalence of self-reported PDS varied by site and maternal and infant characteristics. Whether providers asked women about perinatal depression was not consistent across sites. Provision of recommended screenings and appropriate referrals for diagnosis, treatment, and follow-up care can ensure early and effective management of depression to reduce adverse maternal and infant outcomes.

Preventing postpartum depressive symptoms using an educational video on infant crying: A cluster randomized controlled trial.

The aim of this study was to examine the impact of watching an educational video on infant crying within 1 week of age after delivery at maternity wards to reduce the prevalence of postpartum depressive symptoms at 1 month after giving birth. The study design was a cluster randomized controlled trial. The intervention hospitals were randomly assigned, stratified by area and function of the hospital. Participants included 47 obstetrics hospitals or clinics out of 150 hospitals or clinics in Osaka Prefecture, Japan. In total, 44 hospitals or clinics completed the trial and 2,601 (intervention group = 1,040, control group = 1,561) caregivers responded to the questionnaire on postpartum depression (response rate: 55.1%). Mothers in the intervention group watched an educational video, within 1 week of age, during hospitalization at maternity wards. Primary outcome in this study was postpartum depression assessed by the Edinburgh Postnatal Depression Scale as 9+ and assessed via questionnaire at a 1-month health checkup. In the intervention group, 142 (13.7%) mothers reported postpartum depression compared to 250 (16.0%) in the control group. Intention-to-treat analysis showed no significant difference in the prevalence of postpartum depression between the groups. However, among young mothers (<25 years), the analysis showed a 67.0% reduction in postpartum depression (odds ratio: 0.33, 95% CI: 0.15-0.72). Watching an educational video on infant crying within 1 week after delivery at maternity wards did not reduce postpartum depression at 1 month after giving birth, but it was effective for young mothers aged <25 years.

The effect of perceived social support during early pregnancy on depressive symptoms at 6 weeks postpartum: a prospective study

BackgroundPostpartum depression was associated with maternal suffering and diminished functioning, increased risk of marital conflict as well as adverse child outcomes. Perceived social support during pregnancy was associated with postpartum depression among women. However, its causal relationship remains unclear. Therefore, we prospectively evaluate the association between perceived social support during early pregnancy and postpartum depressive symptoms.MethodsWe prospectively examined whether perceived social support during early pregnancy affected depressive symptoms at 6 weeks postpartum in a cohort of 3310 women. Perceived social support and postpartum depression were assessed by ENRICHD Social Support Instrument (ESSI) and the postpartum Edinburgh Postpartum Depression Scale (EPDS), respectively. Prevalence of postpartum depressive symptoms was 11.4% (EPDS cutoff≥10). As a test of heterogeneity of association in subpopulations, logistic regression models were performed to analyze the association between social support and postpartum depressive symptoms in strata which were defined by the potential confounder candidates. After multiple imputation, multivariable logistic regression was performed to assess the effect of social support on postpartum symptoms in individual items and total score. Two models were built. Model I adjusted for the variables associated with social support or postpartum depression and changed the association estimates by ≥10%. Model II adjusted for all variables that may be related to social support or postpartum depression.ResultsSignificant associations between low perceived social support and postpartum depressive symptoms was found(Model I odds ratio: 1.63, 95% confidence interval: 1.15, 2.30; Model II odds ratio: 1.77, 95% confidence interval: 1.24–2.52). Stratified analyses showed that there was little evidence of heterogeneity of association in subpopulations by basic characteristics of participants.ConclusionsThese findings suggest that early intervention may be able to help protect against depression symptoms at 6 weeks postpartum.