Significant Predictors Of Postpartum Depression Research Articles

Role of Intrapartum Social Support in Preventing Postpartum Depression.

A cross-sectional, multicenter study examined the role of intrapartum social support (SS) on postpartum depression (PPD), using survey data that covered eight of the 25 PPD risk factors identified by a recent umbrella review. A total of 204 women participated at an average of 1.26 months after birth. An existing U.S. Listening to Mothers-II/Postpartum survey questionnaire was translated, culturally adapted, and validated. Multiple linear regression found four statistically significant independent variables. A path analysis determined that prenatal depression, pregnancy and childbirth complications, intrapartum SS from healthcare providers and partners, and postpartum SS from husbands and others were significant predictors of PPD, while intrapartum and postpartum SS were intercorrelated. In conclusion, intrapartum companionship is as important as postpartum SS in preventing PPD.

The effect of perceived stress and postpartum partner support on postpartum depression

Aim: The aim of our study was to examine the impact of partner support and perceived stress on the level of depressive symptoms in the postpartum period. Design: Cross-sectional observational study. Methods: A total of 206 women were included in the study. The mean age of respondents was 30.9 years (SD = 4.8; range: 20–44 years.). The Edinburgh Postnatal Depression Scale, Postpartum Partner Support Scale, and Perceived Stress Scale were used to measure the main observed variables. The questionnaire was supplemented with socio-demographic, health-related, and obstetric data. Results: The linear regression model showed that significant predictors of postpartum depression were: lack of support person during labor [β = -0.105; 95% CI = (-0.754; -0.030)]; lower education [β = -0.139; 95% CI = (-2.256; -0.407)]; lower partner support [β = -0.154; 95% CI = (-0.115; -0.025)]; and higher perceived stress [β = 0.755; 95% CI = (0.470; 0.615)]. Perceived stress was deemed to be the most significant predictor of increased depressive symptoms. Conclusion: Identifying mothers who perceive low support from their partner, or who experience high levels of stress and depression, and, subsequently, offering effective psychological support is important in helping to maintain the psychological and mental wellbeing of mothers.

Predictors of Postpartum Depression among Italian Women: A Longitudinal Study.

Introduction: Postpartum depression is commonly experienced by mothers worldwide and is associated with anxiety disorders, parenting stress, and other forms of distress, which may lead to a complex illness condition. Several studies have investigated the risk factors for this disorder, including biological and socio-demographic variables, medical and obstetric factors, and psychological and relational dimensions. The present study aimed to describe the psychological status of mothers up to 12 months postpartum, and to investigate the predictors of depressive symptoms at 12 months postpartum, considering obstetric factors along with psychological and relational variables. Methods: A sample of 137 women completed a questionnaire composed of a sheet on anamnestic and obstetric information and the following scales: Wijma Delivery Experience Questionnaire; State-Trait Anxiety Inventory; Edinburgh Postnatal Depression Scale; Parenting Stress Index (Short Form); Dyadic Adjustment Scale; and Multidimensional Scale of Perceived Social Support. Data were collected at four assessment times: 2–3 days, 3 months, 6 months, and 12 months postpartum. Results: Findings showed that the highest percentage of women with clinically significant symptoms of anxiety (state and trait) and depression was found at 12 months postpartum, which indicated that this was the most critical time. The quality of childbirth experience and trait anxiety at three months postpartum emerged as significant predictors of postpartum depression at 12 months. Conclusion: Our findings highlight the importance of providing stable programs (such as educational programs) to mothers in the first year postpartum. Furthermore, because the quality of the childbirth experience is one of the most important predictors of PPD at 12 months postpartum, effort should be made by healthcare professionals to guarantee a positive experience to all women to reduce possible negative long-term consequences of this experience.

The prevalence and determinants of postpartum depression (PPD) symptomatology among facility delivered mothers of Dhaka city.

Postpartum depression (PPD) is among the top mental health issues and affects children's health and cognitive development. This study aimed to identify the prevalence of PPD symptomatology and possible determinants among facility delivered mothers of Dhaka city. A cross-sectional study was conducted among 291 mothers within the 12 months of postpartum during January to May 2019. The prevalence of PPD symptomatology was 29.9 % among postpartum mothers. Multiple adjusted odds ratios of stepwise logistic regression analyses revealed, mothers age more than 30 years (AOR = 2.56:95 %CI = 1.21-5.39), being a mother for the first time (AOR = 2.08:95 %CI = 1.09-3.96), lost job or couldn't able to do paid work due to pregnancy (AOR = 2.60:95 %CI = 1.25-5.43), hypertension history (AOR = 2.48:95 %CI = 1.20-5.10), neonatal complication (AOR = 2.04:95 %CI = 1.05-3.95), and rare or no support from husband (AOR = 4.12:95 %CI = 2.14-7.95) were identified as significant predictors of PPD. However, having a household income of more than 50,000 Bangladeshi Taka per month (AOR = 0.36:95 %CI = 0.17-0.76) and passing less sedentary hours (AOR = 0.41:95 % CI = 0.23-0.75) were protective factors for PPD. Our study has revealed a relatively high prevalence of PPD symptomatology; therefore, mental health counseling and proper management of cases are essential for bettering mothers and the next generation.

An Assessment of the Risk Factors and Concerns of Postpartum Depression among Mothers Seeking Health Care in North Central Trinidad.

Background:Postpartum depression (PPD) is a debilitating mental disorder which affects mainly females usually after giving birth.Objectives:We aimed to study the risk factors and concerns of PPD among mothers seeking health care at regional health authority hospitals in Trinidad.Materials and Methods:The cross-sectional study consisted of 360 mothers from the postnatal and neonatal clinics of the North Central Regional Health Authority, Trinidad. Data were collected via a questionnaire using convenience sampling to study the risk factors and concerns of PPD among mothers. Participants were asked to sign a consent form before filling out the questionnaire. The questions were geared toward obtaining mother's perspective on predisposing factors of PPD, identifying if they are at risk for perinatal depression, the outcomes of having PPD, and determining if they were screened and treated for it.Results:This study comprised 360 postnatal women among which 4.7% were diagnosed with postpartum while 40% scored ≥10 in the Edinburgh Postnatal Depression Scale which indicated a risk for PPD. This research revealed seven significant predictors of PPD: family history of mental illness, baby blues, mood swings during period, use of oral contraceptives, emotional support, life stress, and being diagnosed with depression (P < 0.05). Other characteristics like sociodemographics were not remarkably correlated but marginally indicative of depressive signs.Conclusion:The study shows that many risk factors of PPD exist, and screening and treatment should be used to avoid the consequences of PPD.

Effects of Breast-Feeding Adaptation and Quality of Sleep on Postpartum Depression in Puerperal Women

Purpose This study aimed to provide preliminary data for a nursing intervention plan for puerperal women to reduce postpartum depression by investigating factors that affect depressive disorder during the puerperal period. Methods A total of 153 pregnant women were recruited from a university hospital in Gimhae city in Korea. Data were collected using self-report questionnaires. Results Mothers’ quality of sleep, breast-feeding confidence, discomfort with breastfeeding, depressive feeling during pregnancy, and baby’s feeding capability and growth were significant predictors of postpartum depression. These variables explained 36.1% of the variance in postpartum depression in puerperal women. Conclusion The aforementioned results indicate that puerperal women are less likely to experience postpartum depression when their quality of sleep is higher, breast-feeding confidence is higher, discomfort with breast-feeding is lower, when they did not feel depressed during pregnancy, and when baby’s feeding capability and growth is better. Therefore, to decrease puerperal women’s depression, a nursing intervention program and a research study to verify the effects of the program are necessary to increase mother’s sleep quality and breast-feeding adaptation and prevent depression during pregnancy. Key Words: Puerperium period, Postpartum depression, Breast feeding, Sleep

SU36 - ADVERSE LIFE EVENTS, PSYCHIATRIC COMORBIDITY, AND BIOLOGICAL PREDICTORS OF POSTPARTUM DEPRESSION IN AN ETHNICALLY DIVERSE SAMPLE OF POSTPARTUM WOMEN

Background Race, psychiatric history, and adverse life events have all been independently associated with Postpartum Depression (PPD). However, the role these play together in Black and Latina women remains inadequately studied. Therefore, we performed a case-control study of PPD, including comprehensive assessments of symptoms and biomarkers, while examining the effects of genetic ancestry. Methods We recruited our sample (549 cases, 968 controls) at six weeks postpartum from obstetrical clinics in North Carolina. PPD status was determined using the MINI-plus. Psychiatric history was extracted from medical records. Participants were administered self-report instruments to assess depression (Edinburgh Postnatal Depression Scale) and adverse life events. Levels of estradiol, progesterone, Brain-Derived Neurotrophic Factor (BDNF), oxytocin, and allopregnanalone were assayed. Principal components from genotype data were used to estimate genetic ancestry and logistic regression was used to identify predictors of PPD. Results This population was racially diverse (68% Black, 13% Latina, 18% European). Case status was predicted by a history of major depression (p=4.01E-14), lifetime anxiety disorder diagnosis (p=1.25E-34), and adverse life events (p=6.06E-06). Genetic ancestry was not a predictor of PPD. There were no significant differences between groups in any hormones or neurosteroids. Discussion Psychiatric comorbidity and multiple exposures to adverse life events were significant predictors of PPD in a population of minority and low-income women. Genetic ancestry and hormone levels were not predictive of case status. Increased genetic vulnerability in conjunction with risk factors may predict the onset of PPD, whereas genetic ancestry does not appear predictive.

Prediction of postpartum depression based on women’s quality of life

Background. Postpartum depression is the most common problem after childbirth. Objectives. To determine the level postpartum depression, quality of life and predict postpartum depression based on the quality of life of women. Material and methods. This was a descriptive cross-sectional study. The research population consisted of women who were reporting to health care centres in Hamadan, Iran, 2 to 4 weeks after delivery. A total of 300 eligible women were selected using the cluster sampling method. The data gathering tool was a questionnaire that consisted of three sections: demographic characteristics, Short Form Health Survey (SF-36) and Edinburgh depression questionnaire. SF-36 was used to measure quality of life, which includes eights dimension. Data was analysed using SPSS version 21. Descriptive statistics, Pearson’ correlation and linear multiple regression analysis were used. Results. The mean age was 28.6 ± 5.2 years. The average quality of life scores in individuals were within a moderate level, the highest score was related to physical function, and the lowest score was related to role impairment due to physical health. Postpartum depression was determined in 25 of women, of which 7 had severe depression. Physical functioning (p = 0.32), role impairment due to emotional health (p = 002), energy/fatigue (p = 0.010), emotional well-being (p = 002) and social function (p = 0.002) were significant predictors of postpartum depression. Conclusions. Considering the high rate of postpartum depression, improving quality of life aspects, early diagnosis of postpartum depression and appropriate care for women after childbirth, especially those of a low socio-economic status, are suggested. © Copyright by Wydawnictwo Continuo.

Adverse life events, psychiatric history, and biological predictors of postpartum depression in an ethnically diverse sample of postpartum women.

Race, psychiatric history, and adverse life events have all been independently associated with postpartum depression (PPD). However, the role these play together in Black and Latina women remains inadequately studied. Therefore, we performed a case-control study of PPD, including comprehensive assessments of symptoms and biomarkers, while examining the effects of genetic ancestry. We recruited our sample (549 cases, 968 controls) at 6 weeks postpartum from obstetrical clinics in North Carolina. PPD status was determined using the MINI-plus. Psychiatric history was extracted from medical records. Participants were administered self-report instruments to assess depression (Edinburgh Postnatal Depression Scale) and adverse life events. Levels of estradiol, progesterone, brain-derived neurotrophic factor, oxytocin, and allopregnanalone were assayed. Principal components from genotype data were used to estimate genetic ancestry and logistic regression was used to identify predictors of PPD. This population was racially diverse (68% Black, 13% Latina, 18% European). Genetic ancestry was not a predictor of PPD. Case status was predicted by a history of major depression (p = 4.01E-14), lifetime anxiety disorder diagnosis (p = 1.25E-34), and adverse life events (p = 6.06E-06). There were no significant differences between groups in any hormones or neurosteroids. Psychiatric history and multiple exposures to adverse life events were significant predictors of PPD in a population of minority and low-income women. Genetic ancestry and hormone levels were not predictive of case status. Increased genetic vulnerability in conjunction with risk factors may predict the onset of PPD, whereas genetic ancestry does not appear predictive.

Screening for Postpartum Depression and Associated Factors Among Women in China: A Cross-Sectional Study.

Objectives: This study examined what percentage of Chinese mothers during a three-year postpartum period were screened for postpartum depression and explored the correlation between postpartum depression and various socio-demographic, psychological, and cultural factors.Study design: Cross-sectional survey.Methods: A total of 506 mothers 23 years of age and older who were within three years postpartum completed the online survey. The survey collected information such as family economic status, a history of depression, preparation for pregnancy, relationships with husbands, and family members, adult attachment types (Adult Attachment Scale, AAS), and depression (The Center for Epidemiologic Studies Depression Scale, CESD).Results: Approximately 30% of mothers 1–3 years postpartum reported symptoms above the CESD cut-off score (≥16 scores) associated with the risk for depression (28.0% in the first year, 30.8% in the second year, and 31.8% in the third year). Factors significantly associated with depression in participants in the correlation analysis were education level; family income; preparation for pregnancy; a history of depression; amount of time spent with their husbands; relationships with husbands, parents, and parents-in-law; and a close, dependent, and/or anxious attachment style. Multiple regression analyses revealed that a history of depression; less preparation for pregnancy; poorer relationships with husbands, parents, and parents-in-law; and a more anxious attachment style were strongly related to a higher risk of postpartum depression.Conclusion: The overall percentage of mothers after delivery who were vulnerable to depression in China remains high. Various factors were significant predictors of postpartum depression. The research findings have several valuable implications for intervention practices. For example, attachment styles and depression history in the assessments of perinatal depression could improve screenings and the design of interventions. Additionally, improving the family relationships and family environments of women post-delivery may be promising approach for postpartum depression prevention or intervention.

산욕초기 산모의 산후우울에 자기효능감, 신체상, 가족지지가 미치는 영향

The purpose of this study was to determine the self efficacy, body image and family support affect on postpartum depression in early postpartum mothers. The data was collected 306 mothers on the first week after delivery from one hospital located in B city. The instruments were a survey of general characteristics, obstetrical characteristics, the Edinburgh Postnatal Depression Scale(EPDS), self-efficacy, body image and family support. Data was analysed using descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression. The results revealed that the average item score of the EPDS was 6.09. The significant predictors of postpartum depression were body image, emotional state in pregnancy, and family support. These variables had a 38.4% explainability. The results indicate that the postpartum mothers should be screened for postpartum depression early in the postpartum period and it's necessary to implement nursing intervention focused on to enhance the body image and family support, especially the weak emotional state mothers in pregnancy.

Predictors of Early Postpartum Depression in Mothers of Preterm Infants in Neonatal Intensive Care Units.

PURPOSE: This study was done to investigate the point prevalence of postpartum depression and its predictors during early postpartum in mother of preterm infants.METHODS: Participants were 101 women, 2-3 weeks after delivery whose preterm babies were hospitalized in a neonatal intensive care unit. Data were collected from June 2010 to January 2011. The instruments included 'Edinburgh Postnatal Depression Scale', 'Prenatal depression', 'Subjective health status of infant', 'Medical staff support', and 'Husband support'. Collected data were analyzed using t-test, chi2-test, and multiple logistic regression with SPSS/WIN version 18.0.RESULTS: The point prevalence was 86.1% that postpartum depression occurred during the early postpartum period in mothers of preterm infants. Three significant predictors of postpartum depression in mothers of preterm infants were identified; 'Type of delivery (OR, 5.57; 95% CI, 1.25-24.77)', 'Subjective health status of infant (OR, 0.34; 95% CI, 0.16-0.70)', and 'Medical staff support (OR, 0.52; 95% CI, 0.28-0.97)'.CONCLUSION: The results indicate that postpartum mothers should be screened for postpartum depression early in the postpartum period and that, medical personnel should pay particular attention to mothers with a caesarean section and should help mothers of preterm babies to develop positive perceptions of their babies.

Clinically Identified Postpartum Depression in Asian American Mothers

To identify the clinical diagnosis rate of postpartum depression (PPD) in Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) compared to non-Hispanic Whites. Cross-sectional study using electronic health records (EHR). A large, outpatient, multiservice clinic in Northern California. A diverse clinical population of non-Hispanic White (N = 4582), Asian Indian (N = 1264), Chinese (N = 1160), Filipino (N = 347), Japanese (N = 124), Korean (N = 183), and Vietnamese (N = 147) mothers. Cases of PPD were identified from EHRs using physician diagnosis codes, medication usage, and age standardized for comparison. The relationship between PPD and other demographic variables (race/ethnicity, maternal age, delivery type, marital status, and infant gender) were examined in a multivariate logistic regression model. The PPD diagnosis rate for all Asian American mothers in aggregate was significantly lower than the diagnosis rate in non-Hispanic White mothers. Moreover, of the six Asian American subgroups, PPD diagnosis rates for Asian Indian, Chinese, and Filipino mothers were significantly lower than non-Hispanic White mothers. In multivariate analyses, race/ethnicity, age, and cesarean were significant predictors of PPD. In this insured population, PPD diagnosis rates were lower among Asian Americans, with variability in rates across the individual Asian American subgroups. It is unclear whether these lower rates are due to underreporting, underdiagnosis, or underutilization of mental health care in this setting.

The prevalence of postpartum depression

Little is known about the prevalence of clinically significant postpartum depression in women of varying social status. The purpose of the present study was to examine the prevalence of postpartum depression as a function of three indices of social status: income, education and occupational prestige. A sample of 4,332 postpartum women completed a demographic interview and the Inventory to Diagnose Depression, a self-report scale developed to identify a major depressive episode in accordance with DSM diagnostic criteria. Logistic regression was used to assess the relative significance of the three social status variables as risk factors for postpartum depression controlling for the effects of correlated demographic variables. In the logistic regression, income, occupational prestige, marital status, and number of children were significant predictors of postpartum depression controlling for the effects of other related demographic characteristics. The Wald Chi Square value for each of these significant predictors indicates that income was the strongest predictor. The prevalence of postpartum depression was significantly higher in financially poor relative to financially affluent women. Maternal depression screening programs targeting women who are financially poor are well placed. Future research is needed to replicate the present findings in a more ethnically diverse sample that includes the full age range of teenage mothers.

The Predictors of Postpartum Depression

This study was designed to determine the predictors of postpartum depression. One hundred- sixty one women within one year after delivery from one public health center located in the northern area of Seoul were used in this study. The instruments were a survey of general characteristics, the Edinburgh Postnatal Depression Scale, recent life events index, perceived social support from family, Quality of marriage index, parenting stress index, and Rosenberg's self-esteem inventory. Data was analysed using descriptive statistics, Pearson correlation coefficients, and logistic regression. The average item score of the EPDS was 6.67. 12.4% of respondents, who scored above a threshold 12, were likely to be suffering from a depression of varying severity. The fitness of the model for explaining postpartum depression from six variables, plan for pregnancy, family support, quality of marital relation, perceived social support, life events, childcare stress, and self-esteem, was statistically significant and the predictive power of these variables was 90.9%. The significant predictors of postpartum depression were family support and child care stress. Further research is needed to identify the prevalence rate of postpartum depression using more reliable sampling methods from a large general population. Nursing interventions need to be developed for promoting family support and reducing childcare stress.

A comparative study of postnatal depression and its predictors in Taiwan and mainland China

Objective The purpose of this study was to compare the prevalence and risk factors of postpartum depression in Taiwan and mainland China. Study design A total of 512 mothers during the 6th postpartum week were recruited by means of convenience sampling from Kaohsiung City and Pingtung County aboriginal tribes in Taiwan and Fuzhou City in China. Five self-report instruments were used to collect data. Results Significant differences of stress, social support, self-esteem, depression, and health-promoting lifestyles were found among the three groups. Stress, social support, and self-esteem were the significant predictors of postpartum depression for women living in Kaohsiung, Taiwan. Stress and self-esteem were the significant predictors of postpartum depression for female aborigines living in Pingtung County, Taiwan. Education, social support, and self-esteem were the significant predictors of postpartum depression for women living in Fuzhou, China. Conclusion These findings serve as a reminder that when considering postpartum depression mechanisms, one should not disregard cultural mediators. Also, there is evidence that the new mother's self-esteem is transculturally important with regard to the susceptibility to postpartum depression.

Predictors of postpartum depression: an update.

Approximately 13% of women experience postpartum depression. Early recognition is one of the most difficult challenges with this mood disorder because of how covertly it is suffered. The purpose of this meta-analysis was to update the findings of an earlier meta-analysis of postpartum depression predictors that had synthesized the results of studies conducted mostly in the 1980s. A meta-analysis of 84 studies published in the decade of the 1990s was conducted to determine the magnitude of the relationships between postpartum depression and various risk factors. Using the software system Advanced Basic Meta-Analysis, effect sizes were calculated three ways: unweighted, weighted by sample size, and weighted by quality index score. Thirteen significant predictors of postpartum depression were revealed. Ten of the 13 risk factors had moderate effect sizes while three predictors had small effect sizes. The mean effect size indicator ranges for each risk factor were as follows: prenatal depression (.44 to .46), self esteem (.45 to. 47), childcare stress (.45 to .46), prenatal anxiety (.41 to .45), life stress (.38 to .40), social support (.36 to .41), marital relationship (.38 to .39), history of previous depression (.38 to .39), infant temperament (.33 to .34), maternity blues (.25 to .31), marital status (.21 to .35), socioeconomic status (.19 to .22), and unplanned/unwanted pregnancy (.14 to .17). Results confirmed findings of an earlier meta-analysis and in addition revealed four new predictors of postpartum depression: self-esteem, marital status, socioeconomic status, and unplanned/unwanted pregnancy.