Severity Of Postpartum Depression Symptoms Research Articles

Season of Delivery and Postpartum Depression Symptom Severity

Season of Delivery and Postpartum Depression Symptom Severity

Initial promise of child-parent psychotherapy in reducing stress and postpartum depression among mothers experiencing homelessness: a feasibility and pilot study.

Mothers experiencing homelessness undergo significant stressors in addition to parenting stress, yet the rate and treatment of postpartum depression (PPD) within this population has yet to be explored. We assessed the risk for PPD and examined the changes in PDD and parenting stress following engagement in treatment. Participants included 182 mothers with infants 7 months of age or younger in a shelter setting. After initial assessment of PPD and parenting stress, families participated in Child-Parent Psychotherapy (CPP). Post assessment was then conducted after 16 weeks. CPP was successfully implemented with high levels of procedural and content fidelity (M = 0.99, SD = 0.04; M = 0.95, SD = 0.09, respectively), treatment satisfaction (94%; M = 4.83, SD = 0.52), and relatively moderate levels of intervention completion (53.8%). Following participation in CPP, mothers reported decreases in parenting stress (d = 0.51) and continuous PPD symptom severity (d = 0.43). The proportion of mothers with clinically elevated self-report PPD symptoms also decreased from 15.3 to 6.7% (p = .013). Lastly, improvements in total parenting stress predicted improvements in PPD symptom severity (B = 0.12, p < .001). The findings highlight the relevance of screening for PPD among mothers experiencing homelessness. Most importantly, relationship-based interventions like CPP demonstrate promise in indirectly treating PPD for at-risk populations and within a shelter setting.

The Impact of the COVID-19 Pandemic on Depressive Disorder with Postpartum Onset: A Cross-Sectional Study.

COVID-19 has led to a global health crisis that is defining for our times and one of the greatest challenges to emerge since World War II. The potential impact of the pandemic on mental health should not be overlooked, especially among vulnerable populations such as women who gave birth during the COVID-19 pandemic. The study is a cross-sectional survey conducted from 1 March 2020 to 1 March 2023, during the period of the SARS-CoV-2 (COVID-19) pandemic, based on a retrospective evaluation of 860 postpartum women. The screening tool used to assess symptoms of postpartum depression was the Edinburgh Postnatal Depression Rating Scale (EPDS) questionnaire. The questionnaire was completed both in the Obstetrics and Gynaecology Clinical Sections I and II of the "Pius Brînzeu" County Emergency Hospital in Timisoara, Romania, and online using Google Forms. The highest severity of postpartum depression symptoms was observed during the COVID-19 pandemic. The results of the study conducted during the period of the SARS-CoV-2 pandemic (COVID-19) showed that the prevalence of major postpartum depressive disorder (EPDS ≥ 13) was 54.2% (466 patients), while 15.6% (134) had minor depressive disorder (10 < EPDS ≤ 12) in the first year after delivery. Comparing these results with those obtained in research conducted before the onset of the pandemic period showed an alarming increase in the prevalence of postpartum depression. The risk factors associated with postpartum depression included the type of delivery, level of education, socio-economic conditions, health status, age, background, and personal obstetric history (number of abortions on demand, parity). The effects of the pandemic on mental health are of particular concern for women in the first year after childbirth. Observing these challenges and developing effective measures to prepare our health system early can be of great help for similar situations in the future. This will help and facilitate effective mental health screening for postpartum women, promoting maternal and child health.

The need for additional mental health support for women in the postpartum period in the times of epidemic crisis

BackgroundThis retrospective study aimed to identify possible intensification of mental health difficulties among women seeking support in the postpartum period during the epidemic state in Poland. We assumed that the epidemic crisis, social isolation, and restrictions in hospitals which affect pregnant and postpartum women - lack of family labors, lack of the possibility to be with the newborn when he/she is hospitalized, may increase fear and reduce psychosocial resources of women, hinder their normal process of transition to motherhood and thus contribute to the intensified severity of depressive symptoms.MethodsThe study participants were women seeking support at the on-line platform of the project ‘Next Stop: Mum’, which is a part of the postpartum depression prevention’s program implemented by the Ministry of Health in Poland, and enables remote self-screening for the severity of the postpartum depression symptoms with the Edinburgh Postnatal Depression Scale developed by Cox and collaborators. The analyzed data in this study were obtained from 139 women: 61 filled forms from October 1 - November 10, 2019 (non-epidemic period), and 78 filled forms from February 20–March 30 (beginning of the COVID-19 epidemic), 2020.ResultsA statistically significant difference in the severity of postpartum depression symptoms were observed among women making a self-assessment with EPDS scale at the beginning of the COVID-19 epidemic in Poland (M = 15.71; SD = 6.23), compared to the pre-epidemic neutral period (M = 13.56; SD = 6.46).ConclusionsThe results of this study indicate that the epidemic crisis may be associated with an increased need for additional caution and support of women’s mental health in the postpartum period. We believe that recommendations for medical staff, policy, and families of women struggling with postpartum depression symptoms during crisis should be widespread as the second wave of COVID-19 disease may develop in the autumn-winter 2020 and spring 2021.

Assessment of the risk of postpartum depression and the support expected and received by women within a year of giving birth

Abstract Introduction. Postpartum depression (post-natal depression, pure postpartum depression, PPD) is one of three types of post-natal mood disorders. The degree (severity) of this disorder may be defined as moderate or severe. A milder form of depression is postpartum sadness (baby blues), while the untreated depression can develop into a very severe form of depression called postpartum psychosis Aim. The aim of the work was to analyse the incidence and severity of postpartum depression symptoms in women in the first year after giving birth, evaluated by the Edinburgh Postnatal Depression Scale, and the social support received and expected by them. Material and methods. This paper presents the severity of depressive symptoms in 150 women measured by the Edinburgh Postnatal Depression Scale in the first year after their giving birth as well as the support received by them and the demand for it. Results. More than half of the women filling in the Edinburgh Postnatal Depression Scale achieved a result indicating a high risk of postpartum depression (more than 12 points). The severity of postpartum depression symptoms depended on the place of residence of women, was related to attendance antenatal classes, breastfeeding and the support received. Conclusions. It would be advisable to initially assess the risk of postpartum depression in women immediately after childbirth and the social support available to them.

Postpartum depression and social support in a racially and ethnically diverse population of women.

Lack of social support is an important risk factor for postpartum depression (PPD), whereas the presence of social support can buffer against PPD. However, the relationship between social support and PPD in racial/ethnic minority women is still largely unknown. Our purpose was to examine the role of social support in a large, diverse population of PPD cases and controls. Participants (N= 1517) were recruited at the routine 6-week postpartum visit (± 1-2weeks) from four different outpatient clinics in North Carolina. Case status was determined using the MINI International Neuropsychiatric Interview. Social support was measured using the Medical Outcomes Social (MOS) Support survey and the Baby's Father Support Scale (DAD). We found that higher levels of social support had a strong protective association against PPD (MOS total score OR, 0.23; 95% CI, 0.19-0.27; p = 6.92E-90; DAD total score OR, 0.89; 95% CI, 0.88-0.92; p = 1.69E-29), and the effects of social support did not differ when accounting for race/ethnicity. Additionally, PPD symptom severity is significantly and negatively correlated with the degree of social support. Our findings suggest that multi-dimensional aspects of social support may be protective for racial/ethnic minority women. We believe this study is currently the largest and most robust characterizing PPD case status and its association with social support in a diverse cohort of mothers. Future work is required to understand how best to implement culturally sensitive interventions to increase social support in minority perinatal women.

Incidence of postpartum depression and couple relationship quality.

The childbirth constitutes a significant event in a woman's life and in the marital/ couple dyad. The changes which follow childbirth require re-organization of previous coping styles and development of new methods of adaptation, which proves difficult. The current study evaluated to what extent the development of postpartum depression symptoms in new mothers was associated with their level of satisfaction in marital relationship. The study included 100 women in their first month after delivery. The women completed questionnaires regarding postpartum depression (Postpartum Depression Screening Scale) and marital relationship quality (Marital Compatibility Questionnaire). There was a significant correlation between the level of postpartum depression and relationship quality. A greater severity of postpartum depression symptoms (sleeping/ eating disturbances, anxiety/insecurity, emotional lability, mental confusion, loss of self, guilt/ shame, suicidal thoughts) occurred in women who were less satisfied with their relationship, i.e., those who experienced a decreased level of intimacy, self-fulfillment and partner similarity, as well as a deeper sense of disillusionment. Women who declared deeper satisfaction with their relationship displayed a greater sense of mental well-being. No correlation was found between the occurrence of postpartum depression and socio-demographic factors (age, education level, place of residence) and factors associated with the subjects' childbearing history (number of children, number of pregnancies, history of miscarriage, family planning, prior diagnosis of depression, type of delivery, newborn's condition following birth, infant feeding method). Patients dissatisfied with the quality of their marital relationship experienced an increased severity of postpartum depression symptoms. Greater satisfaction with relationship quality was expressed by women in formalized relationships.

Interaction of oxytocin level and past depression may predict postpartum depressive symptom severity.

We examined plasma oxytocin concentration and postpartum depression (PPD) symptom severity in women who were not depressed during pregnancy and whether this differed by major depressive disorder (MDD) history. We assessed psychiatric history and plasma oxytocin in 66 healthy pregnant women in the third trimester (M = 35 ± 3weeks) and depressive symptoms at 6weeks postpartum (M = 5.9 ± 0.8weeks). Linear regression analysis was used to examine oxytocin and PPD symptom severity and moderation of oxytocin and PPD by past MDD. Women with (n = 13) and without (n = 53) past MDD differed in third trimester depressive symptom severity, but not oxytocin level, demographic factors, or birth outcomes. Controlling for third trimester depressive symptoms, oxytocin level was unrelated to PPD symptom severity [B(SE) = -.019 (.084); β = -.025; t = -.227; p = .821]. However, oxytocin level interacted with past MDD to predict PPD symptom severity [B(SE) = 7.489 (2.429); β = .328; t = 3.084; p = .003]. Higher oxytocin predicted greater PPD symptom severity in women with past MDD (p = .019), but not in women without (p = .216). Replication in a larger sample and methodologic challenges are discussed.

Incidence and determinants of postpartum depression among healthy pregnant women and high-risk pregnant women

Not every woman associates pregnancy, childbirth and puerperium with experiencing moments of joy. In the first 3 months following childbirth, approximately 15–20% of mothers all over the world suffer from postpartum depression. The aim of this study was to answer the question of whether postpartum depression is more common among high-risk pregnant women in comparison to healthy pregnant women, and whether there are differences in the severity of symptoms as well as in correlates and predictors within the studied groups of women. A total sample of 284 healthy (N = 172) and high-risk pregnant women (N = 112) were examined. Participants were recruited at the maternity hospitals and gynaecology clinics, pregnancy classes as well as via web pages and Internet fora for birth and pregnancy. Participants completed a set of self-report questionnaires twice: during the 37th and 42nd week of pregnancy and between the 2nd and 4th week postnatally. The following methods have been used in the study: Beck Depression Inventory, Postpartum Depression Screening Scale, The Perceived Stress Scale, Social Support Scale, Coping Orientation to Problems Experienced Scale, Marital Bond Scale and Breastfeeding Self-Efficacy Scale-Short Form and demographic survey. Postpartum depression symptoms are more common (85.7%) and more intense (p < 0.001) in high-risk pregnant women in comparison to healthy pregnancies (46.5%). High-risk pregnant women achieve higher mean scores in Beck Depression Inventory (p < 0.001). The regression analysis in a group of healthy pregnant women showed that the efficacy of breastfeeding, depression in pregnancy and the type of feeding explain 46.7% of the variance of the independent variable, which is postpartum depression. Among high-risk pregnant women, 67.1% of the variance reported subsequently the efficacy of breastfeeding, depression during pregnancy, childbirth complications, type of feeding and focusing attention away from the problem. Postpartum depression symptoms occur more frequently in high-risk than healthy pregnant women. The severity of postpartum depression symptoms is also higher among high-risk pregnancy group of women. The analysis of risk factors indicates that women exposed to symptoms of postpartum depression are those who suffered from depression during pregnancy, who had difficulty in coping and experienced negative emotions after childbirth as well as had a low self-efficacy in breastfeeding. They also chose less active ways of coping and focused on experiencing emotions and restrain coping. The results emphasise the need to pay more attention to the mental state of women whose pregnancy is high risk.