Prevention Of Postnatal Depression Research Articles

Early Detection of 5 Neurodevelopmental Disorders of Children and Prevention of Postnatal Depression With a Mobile Health App: Observational Cross-Sectional Study.

Delay in the diagnosis of neurodevelopmental disorders (NDDs) in toddlers and postnatal depression (PND) is a major public health issue. In both cases, early intervention is crucial but too rarely implemented in practice. Our goal was to determine if a dedicated mobile app can improve screening of 5 NDDs (autism spectrum disorder [ASD], language delay, dyspraxia, dyslexia, and attention-deficit/hyperactivity disorder [ADHD]) and reduce PND incidence. We performed an observational, cross-sectional, data-based study in a population of young parents in France with at least 1 child aged <10 years at the time of inclusion and regularly using Malo, an "all-in-one" multidomain digital health record electronic patient-reported outcome (PRO) app for smartphones. We included the first 50,000 users matching the criteria and agreeing to participate between May 1, 2022, and February 8, 2024. Parents received periodic questionnaires assessing skills in neurodevelopment domains via the app. Mothers accessed a support program to prevent PND and were requested to answer regular PND questionnaires. When any PROs matched predefined criteria, an in-app recommendation was sent to book an appointment with a family physician or pediatrician. The main outcomes were the median age of the infant at the time of notification for possible NDD and the incidence of PND detection after childbirth. One secondary outcome was the relevance of the NDD notification by consultation as assessed by health professionals. Among 55,618 children median age 4 months (IQR 9), 439 (0.8%) had at least 1 disorder for which consultation was critically necessary. The median ages of notification for probable ASD, language delay, dyspraxia, dyslexia, and ADHD were 32.5 (IQR 12.8), 16 (IQR 13), 36 (IQR 22.5), 80 (IQR 5), and 61 (IQR 15.5) months, respectively. The rate of probable ADHD, ASD, dyslexia, language delay, and dyspraxia in the population of children of the age included between the detection limits of each alert was 1.48%, 0.21%, 1.52%, 0.91%, and 0.37%, respectively. Sensitivity of alert notifications for suspected NDDs as assessed by the physicians was 78.6% and specificity was 98.2%. Among 8243 mothers who completed a PND questionnaire, highly probable PND was detected in 938 (11.4%), corresponding to a reduction of -31% versus our previous study without a support program. Suspected PND was detected a median 96 days (IQR 86) after childbirth. Among 130 users who filled in the satisfaction survey, 99.2% (129/130) found the app easy to use and 70% (91/130) reported that the app improved follow-up of their child. The app was rated 4.8/5 on Apple's App Store. Algorithm-based early alerts suggesting NDDs were highly specific with good sensitivity as assessed by real-life practitioners. Early detection of 5 NDDs and PNDs was efficient and led to a possible 31% reduction in PND incidence. ClinicalTrials.gov NCT06301087; https://www.clinicaltrials.gov/study/NCT06301087.

Health Education on the Prevention of Post Partum Depression at the Bara-Baraya Health Center, Makassar City

Postnatal depression is a disorder that occurs in mothers after giving birth. This disorder occurs in her mood, this condition can cause the mother to be easily sad, tired, irritable, cry for no apparent reason, easily anxious and have difficulty concentrating. The worst condition a mother can experience is when she hurts herself or even her baby. The aim of community service is to increase public knowledge about postnatal depression and how to prevent it. The method for organizing PKM is lectures/counseling, discussions and questions and answers with activities providing material related to postnatal depression and its prevention. This activity was attended by 26 participants who were postpartum mothers. Results: mothers were very enthusiastic and active in asking questions, the level of knowledge of postpartum mothers before being given education about postpartum depression was at sufficient knowledge and after being given education increased to high to good knowledge. Health education regarding the prevention of postnatal depression in postpartum mothers needs to be carried out continuously in order to reduce the incidence of postnatal depression and requires the role and support of husbands to provide special attention to reduce the incidence. from postpartum depression.

Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, Australia

Background and objectivesThe perinatal period presents a high-risk time for development of mood disorders. Australia-wide universal perinatal care, including depression screening, make this stage amenable to population-level preventative approaches. In a large cohort of women receiving public perinatal care in Sydney, Australia, we examined: (1) the psychosocial and obstetric determinants of women who signal distress on EPDS screening (scoring 10–12) compared with women with probable depression (scoring 13 or more on EPDS screening); and (2) the predictive ability of identifying women experiencing distress during pregnancy in classifying women at higher risk of probable postnatal depression.MethodsWe analysed routinely collected perinatal data from all live-births within public health facilities from two health districts in Sydney, Australia (N = 53,032). Perinatal distress was measured using the EPDS (scores of 10–12) and probable perinatal depression was measured using the EPDS (scores of 13 or more). Logistic regression models that adjusted for confounding variables were used to investigate a range of psychosocial and obstetric determinants and perinatal distress and depression.ResultsEight percent of this cohort experienced antenatal distress and about 5 % experienced postnatal distress. Approximately 6 % experienced probable antenatal depression and 3 % experienced probable postnatal depression. Being from a culturally and linguistically diverse background (AOR = 2.0, 95% CI 1.8–2.3, P < 0.001), a lack of partner support (AOR = 2.9, 95% CI 2.3–3.7) and a maternal history of childhood abuse (AOR = 1.9, 95% CI 1.6–2.3) were associated with antenatal distress. These associations were similar in women with probable antenatal depression. Women who scored 10 to12 on antenatal EPDS assessment had a 4.5 times higher odds (95% CI 3.4–5.9, P < 0.001) of experiencing probable postnatal depression compared with women scoring 9 or less.ConclusionAntenatal distress is more common than antenatal depressive symptoms and postnatal distress or depression. Antenatal maternal distress was associated with probable postnatal depression. Scale properties of the EPDS allows risk-stratification of women in the antenatal period, and earlier intervention with preventively focused programs. Prevention of postnatal depression could address a growing burden of illness and long-term complications for mothers and their infants.

Effect of couple-based cognitive behavioural intervention on prevention of postnatal depression: multisite randomised controlled trial.

To compare a couple-based cognitive behavioural intervention (CBI) for postnatal depression with CBI delivered to women alone and control (standard perinatal care). Multisite randomised controlled trial. Antenatal clinics at three regional public hospitals in Hong Kong. 388 low-risk childbearing couples. Childbearing couples were randomly allocated to couple-based CBI (n=134), women-alone CBI (n=124) or control (n=130). The CBI consists of a 3-hour antenatal group session and two 30-minute postnatal telephone follow-up sessions. The primary outcome was depressive symptoms, measured on the Edinburgh Postnatal Depression Scale (EPDS). Assessments were collected at baseline (during pregnancy), 6weeks, 6months, and 12months postpartum. Depressive symptoms were significantly more improved at 6weeks postpartum for mothers in couple-based CBI than in women-alone CBI (difference 1.46, 95% CI 0.11-2.81) or control groups (difference 1.71, 95% CI 0.29-3.13). The proportion of mothers with postnatal depression (EPDS score≥10) was significantly lower at 6weeks postpartum in couple-based CBI than in control (difference 17.8%, 95% CI 3.6-32.0). However, the treatment effect was not maintained at 6 and 12months. There was no significant intervention effect among fathers. Couple-based CBI is more effective than CBI delivered to mothers alone and standard perinatal care in reducing the incidence of postnatal depression among Chinese mothers in the early postpartum period. Couple-based cognitive behavioural intervention is effective in reducing postnatal depression among Chinese mothers in the early postpartum period.

Cost-effectiveness of PoNDER health visitor training for mothers at lower risk of depression: findings on prevention of postnatal depression from a cluster-randomised controlled trial.

There is evidence for the cost-effectiveness of health visitor (HV) training to assess postnatal depression (PND) and deliver psychological approaches to women at risk of depression. Whether this approach is cost-effective for lower-risk women is unknown. There is a need to know the cost of HV-delivered universal provision, and how much it might cost to improve health-related quality of life for postnatal women. A sub-study of a cluster-randomised controlled trial in the former Trent region (England) previously investigated the effectiveness of PoNDER HV training in mothers at lower risk of PND. We conducted a parallel cost-effectiveness analysis at 6-months postnatal for all mothers with lower-risk status attributed to an Edinburgh Postnatal Depression Scale (EPDS) score &lt;12 at 6-weeks postnatal. Intervention HVs were trained in assessment and cognitive behavioural or person-centred psychological support techniques to prevent depression. Outcomes examined: quality-adjusted life-year (QALY) gains over the period between 6 weeks and 6 months derived from SF-6D (from SF-36); risk-of-depression at 6 months (dichotomising 6-month EPDS scores into lower risk (&lt;12) and at-risk (⩾12). In lower-risk women, 1474 intervention (63 clusters) and 767 control participants (37 clusters) had valid 6-week and 6-month EPDS scores. Costs and outcomes data were available for 1459 participants. 6-month adjusted costs were £82 lower in intervention than control groups, with 0.002 additional QALY gained. The probability of cost-effectiveness at £20 000 was very high (99%). PoNDER HV training was highly cost-effective in preventing symptoms of PND in a population of lower-risk women and cost-reducing over 6 months.

S1-8 Midwives' Psychological Group and Individual Support Sessions as Prevention of Postnatal Depression : A Randomised Trial in Japan(ISPOG2007)

S1-8 Midwives' Psychological Group and Individual Support Sessions as Prevention of Postnatal Depression : A Randomised Trial in Japan(ISPOG2007)

Randomised controlled trial of facilitated exercise plus usual care versus usual care only as a treatment for women with a depressive disorder in the first six postnatal months

ABSTRACT FROM: Daley AJ, Blamey RV, Jolly K, et al . A pragmatic randomized controlled trial to evaluate the effectiveness of a facilitated exercise intervention as a treatment for postnatal...

A narrative review of the efficacy of DHA for treatment of major depressive disorder and treatment and prevention of postnatal depression

ObjectiveTo perform a narrative review of the efficacy of docosahexaenoic acid (DHA) supplementation as a treatment for major depressive disorder (MDD) and as prevention and treatment for postnatal depression (PND). MethodElectronic searches of the following databases were preformed: The Cochrane Library and PubMed, published up to September 2014. The search strategy also included cited reference searching. Study results, methodological, potential flaws and study strengths were assessed. ResultsFive studies assessing DHA supplementation in MDD and six for PND were found. Due to heterogeneity of study designs results were difficult to compare. Only one MDD study found a statistically significant decrease in depression severity, although this study had noticeable methodological flaws. None of the studies found significant difference in adverse effects from supplementation between the groups. ConclusionDHA monotherapy does not appear to be beneficial in the treatment of MDD or in the treatment and prevention of PND.

Mind matters: Developing skills and knowledge in postnatal depression

Depression is a condition that affects millions of people worldwide and is the highest cause of disease burden for women. Postnatal depression affects up to 25% of all childbearing women; however, its prevalence is often under-detected and under-diagnosed. Early screening and early intervention are integral in the prevention of postnatal depression. Preventive interventions focus on the efficacy of omega-3 supplements, physical activity and placentophagy practices. However, there is promising evidence regarding the efficacy of antidepressant therapy, increased social support, and technological-based psychological interventions in the prevention of postnatal depression.

Is the Cognitive-Behavioral Therapy an Effective Intervention to Prevent the Postnatal Depression? A Critical Review

The aim of this article is to review and discuss the efficacy of the Cognitive-Behavioral Therapy (CBT), in the prevention of postnatal depression (PD) in pregnant women at risk. PubMed, Medline, PsychInfo, Embase, and the Cochrane Library databases were searched from February 1991 to February 2011. Eight Randomized Controlled Trials (RCT) on the prevention of PD with the CBT were selected and their data were analyzed. The literature analyzed recommends that depression in pregnancy requires an efficient management to provide mother's symptoms relief as well as to prevent the PD. While several studies demonstrated the efficacy of the CBT in the treatment of PD, the efficacy of the CBT in preventing PD in pregnant women at risk has been investigated only by a few studies, presenting a number of methodological flaws. Better designed RCT are needed to support the efficacy of such psychotherapeutic preventive strategy in women at risk for PD.

Effectiveness of Antenatal Emotional Self-Management Training Program in Prevention of Postnatal Depression in Chinese Women

This study aimed to study the effectiveness of an emotional self-management training program to antenatal women in the prevention of postnatal depression. The sample comprised 240 women who were at 32 weeks antenatal. They were randomly assigned into the intervention group and the control group. On completion of the program, the intervention group reported significantly lower mean Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale scores than the control group. Fewer participants from the intervention group were diagnosed as having postnatal depression using the Structured Clinical Interview for DSM-IV. An antenatal emotional self-management training that may lower the risk of developing postnatal depression among Chinese women is recommended.

Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial

Objective To evaluate the effectiveness of telephone based peer support in the prevention of postnatal depression.Design Multisite randomised controlled trial.Setting Seven health regions across Ontario, Canada.Participants 701 women in the...

Antidepressant Prevention of Postnatal Depression

Postnatal depression (PND) occurs in 10 to 15 percent of mothers [1] and is therefore the commonest complication of childbearing. The morbidity of PND for the mother and its potentially negative associations with neonatal and child development and on other family members are well established [2–4]. In theory, the antenatal period and early puerperium are opportune times to implement interventions to prevent PND because mothers are in frequent contact with health professionals. It is also increasingly recognised that some women who are diagnosed with depression postnatally have been depressed during the antenatal period [5,6], so it is important to detect and treat symptoms of depression antenatally to reduce the incidence of PND. We have therefore recently carried out a Cochrane review of antidepressant prevention of postnatal depression (see Text S1).

The prevention of postnatal depression: A narrative systematic review

This systematic review assessed the success of randomized controlled trials of preventative interventions for postnatal depression (PND). Outcomes examined were estimates of PND prevalence. Methodological quality was determined through the examination of key components individually with independent data extraction by all three authors. Data sources included Medline, PsycINFO, Sociofile, CINAHL, COPAC, EMBASE, Cochrane library; hand searches and a newsletter requests for unpublished trials to the Marcé Society and Postpartum Support International. Twenty-one RCTs were included in this review. Nine of these trials demonstrated short-term preventative success (seven psychological and supportive interventions, one unpublished antidepressant trial and a calcium carbonate trial) but none provided any evidence of long-term success. Furthermore, the results of three of the psychological intervention trials should be viewed with caution due to a lack of methodological rigour. There is a need for future research into the prevention of PND to be tightly designed and maybe include an exploration of the experience of postnatal depression for multiparous women.

Prevention of postnatal depression

Postnatal depression is the most frequent psychiatric disorder seen after childbirth, with a prevalence rate of 10% to 15%. The women at risk need to be identified by a valid and reliable method, either using a screening instrument or an interview schedule. The preventive strategies need to have enough power to detect a clinically worthwhile effect to be considered useful in clinical practice. Many of the risk factors for developing postnatal depression are present during the pregnancy and immediate post-partum period. The risk factors for postnatal depression include depression or anxiety during pregnancy, experiencing stressful life events during pregnancy or the early puerperium, maternity blues, low levels of social support, past history of depression and poor marital adjustment. The antenatal and postnatal period provides an ideal opportunity to screen women for these risk factors. The women identified to be at risk can be identified, and preventive interventions can be implemented. Routine clinical practice can be improved to identify some of the women at risk by better communication between health professionals. There are no antenatal screening tools that have been shown to be of benefit in predicting postnatal depression. Edinburgh Postnatal Depression Scale is widely used in the postnatal period to screen for depression. The psychosocial interventions to prevent postnatal depression have not been shown to be beneficial and there is a dearth of psychopharmacological trials to make firm conclusions about their efficacy in preventing postnatal depression. Individualised psychosocial interventions aimed at the at-risk populations and initiated in the postnatal period appear to have some benefit in preventing postnatal depression. The focus of this article will be the risk factors associated with postnatal depression, screening methods and tools to identify those at risk of developing the disorder and the psychosocial, psychological and psychopharmacological interventions to prevent postnatal depression.

Preventing Postnatal Depression: A Review of Research Findings

Postnatal depression is a major source of morbidity among women who have recently delivered a child. Considering its high prevalence and serious negative consequences, prevention should be a high priority. A comprehensive synthesis of current knowledge of prevention strategies is important for clinical practice and future research. Searches of MEDLINE and PsychINFO were performed to identify English-language articles of randomized, controlled trials published from 1990 to 2003 focusing on primary prevention of postnatal depression in both the general and high-risk populations. Nineteen studies meeting these criteria were identified. The main findings and limitations of each study are documented. While the results are mixed, several of the studies provide support for the role of midwife intervention for pregnant and postnatal women. There are also some data that support the efficacy of brief psychotherapy in primary prevention. Unfortunately, many of the studies suffer from shortcomings that may limit their generalizability. Data is also lacking on biological interventions. Directions for future research are discussed, and general recommendations for prevention of postnatal depression in clinical practice are made. The findings of this review indicate that despite the relatively brief history of work in this area, progress is being made in identifying possible prevention interventions.

A trainer's perspective of an innovative programme teaching health visitors about the detection, treatment and prevention of postnatal depression.

Health visitors in North Staffordshire, Edinburgh and Lewisham were given the opportunity to participate in a training programme in the detection, treatment and prevention of postnatal depression, based on previously reported successful intervention strategies. They were trained in the use of the Edinburgh Postnatal Depression Scale (EPDS), and given information about the value and practice of non-directive counselling and about preventative strategies. Knowledge acquisition was evaluation by self-report questionnaires given before and after training. The health visitors were encouraged to screen postnatal women at three specified times using the EPDS and to offer non-directive counselling to women who obtained high scores. A baseline measure of the incidence of postnatal depression was obtained by asking health visitors to give an EPDS form to all women in their caseload with a 6-month-old baby before training commenced. A comparison of the number of women with high EPDS scores at 6 months postnatally, before and after training, showed that participation in the programme enabled health visitors to positively influence the emotional well-being of postnatal women. These results have implications for the role of health visitors which is currently being challenged, as well as for components of their training and continuing professional development.

Prevention and the identification of high risk groups

Prevention of minor psychiatric morbidity in general practice depends on identifying individuals at times of vulnerability. Cross-sectional community studies have shown that psychosocial distress follows closely upon negative life events, and that individuals who lack supportive relationships are at highest risk of poor health outcome. The primary care team is in a good position to identify these undergoing life crises such as bereavement, divorce, childbirth and chronic illness, who appear to lack adequate social support. The theoretical basis of social support interventions is outlined, together with examples of application in primary care. Prevention of postnatal depression and breakdown in carers of demented eldery people are presented as intervention paradigms.