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1.
Zhen Ci Yan Jiu ; 46(3): 231-4, 2021 Mar 25.
Artículo en Chino | MEDLINE | ID: mdl-33798297

RESUMEN

OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS)combined with epidural analgesia on postpartum depression and to explore its underlying mechanism. METHODS: One hundred and twenty cases of full-term primiparous women with singleton pregnancy were selected from May 2018 to November 2018 in Jinzhong Maternal and Child Health Hospital. The parturients with labor analgesia requirement were randomly divided into the epidural group and the combination group, and the parturients without labor analgesia requirement were used as the control group, with 40 cases in each group. Patients in the control group did not receive labor analgesia and were treated according to the routine procedures of natural delivery; patients in the epidural group received epidural labor analgesia; patients in the combination group received TEAS at bilateral Hegu(LI4), Sanyinjiao(SP6) and Zusanli(ST36) (2 Hz/100 Hz, the current intensity is gradually increased from 15 mA, and the treatment was performed every 2 h, 20 min each time) combined with epidural labor analgesia. The visual analogue scale (VAS) scores were recorded when the uterine orifice opened to 3, 6, 8, 10 cm. Plasma glutamate was measured using high-performance liquid chromatography before analgesia, at the end of the third stage of labor and 42 days after delivery, and Edinburgh postnatal depression scale (EPDS) score was measured at 42 days after delivery. RESULTS: In comparison with the control group, the VAS score, EPDS score and the incidence of postpartum depression of the epidural group and the combination group were significantly lower(P<0.05), and the combination group had significant decrease than those in epidural group (P<0.05). Immediately before analgesia, there was no statistically significant difference in glutamate levels among the 3 groups (P>0.05). Compared with the control group, at the end of the third stage of labor and 42 days postpartum, the glutamate levels of the epidural group and the combination group were significantly reduced(P<0.05), and the combination group decreased more significantly than the epidural group (P<0.05). CONCLUSION: TEAS combined with epidural analgesia can reduce the incidence of postpartum depression, possibly by down-regulating plasma glutamate level and relieving of labor pain.


Asunto(s)
Analgesia Epidural , Depresión Posparto , Dolor de Parto , Trabajo de Parto , Estimulación Eléctrica Transcutánea del Nervio , Puntos de Acupuntura , Niño , Depresión Posparto/terapia , Femenino , Humanos , Dolor de Parto/tratamiento farmacológico , Embarazo
2.
Trials ; 22(1): 186, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33673867

RESUMEN

BACKGROUND: Depression and anxiety impact up to 1 in 5 pregnant and postpartum women worldwide. Yet, as few as 20% of these women are treated with frontline interventions such as evidence-based psychological treatments. Major barriers to uptake are the limited number of specialized mental health treatment providers in most settings, and problems with accessing in-person care, such as childcare or transportation. Task sharing of treatment to non-specialist providers with delivery on telemedicine platforms could address such barriers. However, the equivalence of these strategies to specialist and in-person models remains unproven. METHODS: This study protocol outlines the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) randomized trial. SUMMIT is a pragmatic, non-inferiority test of the comparable effectiveness of two types of providers (specialist vs. non-specialist) and delivery modes (telemedicine vs. in-person) of a brief, behavioral activation (BA) treatment for perinatal depressive and anxiety symptoms. Specialists (psychologists, psychiatrists, and social workers with ≥ 5 years of therapy experience) and non-specialists (nurses and midwives with no formal training in mental health care) were trained in the BA protocol, with the latter supervised by a BA expert during treatment delivery. Consenting pregnant and postpartum women with Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10 (N = 1368) will be randomized to one of four arms (telemedicine specialist, telemedicine non-specialist, in-person specialist, in-person non-specialist), stratified by pregnancy status (antenatal/postnatal) and study site. The primary outcome is participant-reported depressive symptoms (EPDS) at 3 months post-randomization. Secondary outcomes are maternal symptoms of anxiety and trauma symptoms, perceived social support, activation levels and quality of life at 3-, 6-, and 12-month post-randomization, and depressive symptoms at 6- and 12-month post-randomization. Primary analyses are per-protocol and intent-to-treat. The study has successfully continued despite the COVID-19 pandemic, with needed adaptations, including temporary suspension of the in-person arms and ongoing randomization to telemedicine arms. DISCUSSION: The SUMMIT trial is expected to generate evidence on the non-inferiority of BA delivered by a non-specialist provider compared to specialist and telemedicine compared to in-person. If confirmed, results could pave the way to a dramatic increase in access to treatment for perinatal depression and anxiety. TRIAL REGISTRATION: ClinicalTrials.gov NCT04153864 . Registered on November 6, 2019.


Asunto(s)
Ansiedad/terapia , Depresión Posparto/terapia , Depresión/terapia , Accesibilidad a los Servicios de Salud , Complicaciones del Embarazo/terapia , Psicoterapia/métodos , Telemedicina/métodos , Prestación de Atención de Salud/métodos , Estudios de Equivalencia como Asunto , Femenino , Humanos , Servicios de Salud Materna , Servicios de Salud Mental/organización & administración , Partería , Enfermeras y Enfermeros , Ensayos Clínicos Pragmáticos como Asunto , Embarazo , Escalas de Valoración Psiquiátrica , Psiquiatría , Psicología , Trabajadores Sociales , Especialización
4.
J Med Life ; 14(1): 87-92, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33767791

RESUMEN

Postpartum depression is a common disabling psychosocial disorder that could have adverse effects on the life of the mother, infant, and family. The present study was conducted to evaluate the effect of ketamine on preventing postpartum depression in women undergoing caesarian sections considering the relatively known positive effect of ketamine on major depression. The present double-blind, randomized clinical trial was conducted on 134 women undergoing scheduled caesarian sections. Participants were randomly allocated into two groups of control and intervention. To induce anesthesia, 1-2 mg/kg of body weight of Nesdonal and 0.5 mg/kg of body weight of ketamine were used in the intervention group, while only 3-5 mg/kg of body weight Nesdonal was administered in the control group. Data were gathered using the Edinburgh Postnatal Depression Scale (EPDS) in three stages: before the caesarian section and two and four weeks after the caesarian section. Data were analyzed using variance analysis with repeated measures and the Chi-square test. Results of the present study showed that the mean (± standard deviation) of the depression score in the intervention and control groups were 13.78±3.87 and 13.79±4.78(p = 0.98) before the caesarian section, 11.82±3.41 and 14.34±4.29 (p < 0.001) two weeks after and 10.84±3.48 and 13.09±3.79 (p = 0.001) four weeks after the caesarian section, respectively. Using ketamine in the induction of general anesthesia could be effective in preventing postpartum depression. However, further studies are required to strengthen these findings.


Asunto(s)
Depresión Posparto/tratamiento farmacológico , Ketamina/uso terapéutico , Adulto , Estudios de Casos y Controles , Método Doble Ciego , Femenino , Humanos , Ketamina/administración & dosificación , Madres/psicología , Embarazo
5.
Prax Kinderpsychol Kinderpsychiatr ; 70(2): 134-153, 2021 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-33565952

RESUMEN

The Role of Partnership Status and Relationship Satisfaction in Inpatient Mother-Child Treatment in Postpartum Mental Disorders The study examines the partnership status and satisfaction in connection with symptoms of postpartum mental disorders, mother-child attachment and outcome of inpatient mother-child treatment. Two sub-studies were carried out. In the first study, N = 126 mothers with postpartum mental disorders who went to a preliminary consultation for inpatient mother-child treatment stated their symptom burden (SCL-90), mother-child attachment (PBQ) and satisfaction with their partner relationship (PFB-K). Mothers with stressed relationships showed the highest level of symptom burden and impaired attachment. Mothers without a partner reported the least amount of impairment in mother-child attachment. In the second study, N = 41 mothers were examined over the course of inpatient treatment (within-subject design with a waiting-list). The initial relationship satisfaction was not predictive of symptom reduction or improvement in mother-child attachment. An increase in satisfaction during the treatment was though correlated with an improvement in mother-child attachment.


Asunto(s)
Pacientes Internos/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , Apego a Objetos , Satisfacción Personal , Periodo Posparto/psicología , Parejas Sexuales/psicología , Depresión Posparto/psicología , Femenino , Humanos , Lactante , Recién Nacido , Estado Civil/estadística & datos numéricos
6.
Cochrane Database Syst Rev ; 2: CD013560, 2021 02 13.
Artículo en Inglés | MEDLINE | ID: mdl-33580709

RESUMEN

BACKGROUND: Depression is one of the most common morbidities of the postnatal period. It has been associated with adverse outcomes for women, children, the wider family and society as a whole. Treatment is with psychosocial interventions or antidepressant medication, or both. The aim of this review is to evaluate the effectiveness of different antidepressants and to compare their effectiveness with placebo, treatment as usual or other forms of treatment. This is an update of a review last published in 2014. OBJECTIVES: To assess the effectiveness and safety of antidepressant drugs in comparison with any other treatment (psychological, psychosocial, or pharmacological), placebo, or treatment as usual for postnatal depression. SEARCH METHODS: We searched Cochrane Common Mental Disorders's Specialized Register, CENTRAL, MEDLINE, Embase and PsycINFO in May 2020. We also searched international trials registries and contacted experts in the field. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of women with depression during the first 12 months postpartum that compared antidepressant treatment (alone or in combination with another treatment) with any other treatment, placebo or treatment as usual. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data from the study reports. We requested missing information from study authors wherever possible. We sought data to allow an intention-to-treat analysis. Where we identified sufficient comparable studies we pooled data and conducted random-effects meta-analyses. MAIN RESULTS: We identified 11 RCTs (1016 women), the majority of which were from English-speaking, high-income countries; two were from middle-income countries. Women were recruited from a mix of community-based, primary care, maternity and outpatient settings. Most studies used selective serotonin reuptake inhibitors (SSRIs), with treatment duration ranging from 4 to 12 weeks. Meta-analysis showed that there may be a benefit of SSRIs over placebo in response (55% versus 43%; pooled risk ratio (RR) 1.27, 95% confidence interval (CI) 0.97 to 1.66); remission (42% versus 27%; RR 1.54, 95% CI 0.99 to 2.41); and reduced depressive symptoms (standardised mean difference (SMD) -0.30, 95% CI -0.55 to -0.05; 4 studies, 251 women), at 5 to 12 weeks' follow-up. We were unable to conduct meta-analysis for adverse events due to variation in the reporting of this between studies. There was no evidence of a difference between acceptability of SSRI and placebo (27% versus 27%; RR 1.10, 95% CI 0.74 to 1.64; 4 studies; 233 women). The certainty of all the evidence for SSRIs was low or very low due to the small number of included studies and a number of potential sources of bias, including high rates of attrition. There was insufficient evidence to assess the efficacy of SSRIs compared with other classes of antidepressants and of antidepressants compared with other pharmacological interventions, complementary medicines, psychological and psychosocial interventions or treatment as usual. A substantial proportion of women experienced adverse effects but there was no evidence of differences in the number of adverse effects between treatment groups in any of the studies. Data on effects on children, including breastfed infants, parenting, and the wider family were limited, although no adverse effects were noted. AUTHORS' CONCLUSIONS: There remains limited evidence regarding the effectiveness and safety of antidepressants in the management of postnatal depression, particularly for those with more severe depression. We found low-certainty evidence that SSRI antidepressants may be more effective in treating postnatal depression than placebo as measured by response and remission rates. However, the low certainty of the evidence suggests that further research is very likely to have an important impact on our effect estimate. There is a continued imperative to better understand whether, and for whom, antidepressants or other treatments are more effective for postnatal depression, and whether some antidepressants are more effective or better tolerated than others. In clinical practice, the findings of this review need to be contextualised by the extensive broader literature on antidepressants in the general population and perinatal clinical guidance, to inform an individualised risk-benefit clinical decision. Future RCTs should focus on larger samples, longer follow-up, comparisons with alternative treatment modalities and inclusion of child and parenting outcomes.


Asunto(s)
Antidepresivos/uso terapéutico , Depresión Posparto/tratamiento farmacológico , Inhibidores de la Captación de Serotonina/uso terapéutico , Adolescente , Adulto , Antidepresivos/efectos adversos , Sesgo , Femenino , Humanos , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Placebos/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Inhibidores de la Captación de Serotonina/efectos adversos , Resultado del Tratamiento , Adulto Joven
7.
BMC Pregnancy Childbirth ; 21(1): 114, 2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-33557768

RESUMEN

BACKGROUND: This 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. METHODS: The 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. RESULTS: A 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). CONCLUSIONS: The 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.


Asunto(s)
/epidemiología , Depresión Posparto/epidemiología , Depresión/epidemiología , Salud Materna , Pandemias , Periodo Posparto/psicología , Sistemas de Apoyo Psicosocial , Adulto , Depresión/prevención & control , Depresión/psicología , Depresión Posparto/prevención & control , Depresión Posparto/psicología , Femenino , Humanos , Recién Nacido , Salud Mental , Polonia/epidemiología , Embarazo , Escalas de Valoración Psiquiátrica , Estudios Retrospectivos , Autoinforme , Autoevaluación
8.
Nurs Res ; 70(2): 95-105, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33630532

RESUMEN

BACKGROUND: Nonpharmacological and accessible therapies that engage individuals in self-management are needed to address depressive symptoms in pregnancy. The 12-week "Mindful Moms" intervention was designed to empower pregnant women with depressive symptomatology to create personal goals and engage in mindful physical activity using prenatal yoga. OBJECTIVES: This longitudinal pilot study evaluated the feasibility, acceptability, and preliminary effects of the "Mindful Moms" intervention in pregnant women with depressive symptoms. METHODS: We evaluated enrollment and retention data (feasibility) and conducted semistructured interviews (acceptability). We evaluated the intervention's effects over time on participants' depressive symptoms, anxiety, perceived stress, self-efficacy, and maternal-child attachment, and we compared findings to an archival comparison group, also assessed longitudinally. RESULTS: Enrollment and retention rates and positive feedback from participants support the intervention's acceptability and feasibility. "Mindful Moms" participants experienced decreases in depressive symptoms, perceived stress, anxiety, ruminations, and maternal-child attachment and no change in physical activity self-efficacy from baseline to postintervention. Comparisons of the "Mindful Moms" intervention to the comparison groups over time indicated differences in depressive symptoms between all groups and a trend in differences in perceived stress. DISCUSSION: Results support the feasibility and acceptability of "Mindful Moms" for pregnant women with depressive symptoms and suggest that further research is warranted to evaluate this intervention for reducing depressive and related symptoms. Lack of a concurrent control group, with equivalent attention from study staff, and no randomization limit the generalizability of this study; yet, these preliminary findings support future large-scale randomized controlled trials to further evaluate this promising intervention.


Asunto(s)
Depresión/prevención & control , Ejercicio Físico/psicología , Atención Plena/métodos , Complicaciones del Embarazo/prevención & control , Adulto , Depresión/psicología , Depresión Posparto/prevención & control , Estudios de Factibilidad , Femenino , Humanos , Estudios Longitudinales , Proyectos Piloto , Embarazo , Complicaciones del Embarazo/psicología , Automanejo , Estrés Psicológico/prevención & control , Adulto Joven
9.
Artículo en Inglés | MEDLINE | ID: mdl-33429855

RESUMEN

We investigated the association between urinary incontinence and postpartum depression. Data were extracted from the Korean National Health Insurance Service-National Sample Cohort and included women who delivered between 2004 and 2013. Postpartum depression was determined using diagnostic codes during the six-month postpartum period. Urinary incontinence was identified as having a prescription of incontinence drugs or a diagnosis. Cox proportional hazard models were used to calculate adjusted hazard ratios. Of the 83,066 women, 5393 (6.49%) had urinary incontinence and 691 (0.83%) had postpartum depression. Postpartum depression was higher among women with urinary incontinence, aged 15-19 years, ≥40 years old, the lowest income level, and who underwent cesarean section delivery. In the combined analysis, women with urinary incontinence and cesarean section had an approximately three times higher risk of postpartum depression compared with those without urinary incontinence and with spontaneous delivery. Women without urinary incontinence and cesarean section, and those with urinary incontinence and spontaneous delivery were at higher risk of postpartum depression compared with the reference group. Urinary incontinence and cesarean section delivery were significantly associated with postpartum depression during the first six months after childbirth. Therefore, further research should be conducted to evaluate whether urinary incontinence contributes to postpartum depression.


Asunto(s)
Depresión Posparto , Incontinencia Urinaria , Adolescente , Adulto , Cesárea , Estudios de Cohortes , Parto Obstétrico , Depresión Posparto/epidemiología , Femenino , Humanos , Periodo Posparto , Embarazo , República de Corea/epidemiología , Incontinencia Urinaria/epidemiología , Adulto Joven
10.
Artículo en Inglés | MEDLINE | ID: mdl-33440857

RESUMEN

This study analyzes the moderating role of avoidant coping (in early pregnancy) in the relationship between postpartum depressive (PPD) symptoms and maternal perceptions about mother-baby relations and self-confidence. Participants were 116 low-risk obstetric mothers (mean age = 31.2 years, SD = 3.95, range 23-42) who received care and gave birth at a Spanish public hospital. Measurements were made at two points in time: at first trimester of pregnancy (maternal avoidance coping) and four months after childbirth (PPD and maternal perceptions). Avoidant coping was associated with the perception of the baby as irritable and unstable (p = 0.003), including irritability during lactation (p = 0.041). Interaction effects of avoidant coping and postpartum depression were observed on the perception of the baby as irritable (p = 0.031) and with easy temperament (p = 0.002). Regarding the mother's self-confidence, avoidant coping was related to a lack of security in caring for the baby (p < 0.001) and had a moderating effect between PPD and mother's self-confidence (i.e., lack of security in caring for the baby, p =0.027; general security, p = 0.007). Interaction effects showed that the use of avoidant coping in the mother exacerbated the impact of PPD on the early mother-infant relationship.


Asunto(s)
Depresión Posparto , Madres , Adaptación Psicológica , Adulto , Depresión , Depresión Posparto/epidemiología , Femenino , Humanos , Lactante , Relaciones Madre-Hijo , Parto , Periodo Posparto , Embarazo
11.
Matern Child Health J ; 25(3): 353-359, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33492587

RESUMEN

OBJECTIVES: To examine the mental health of women in the perinatal period prior to and during the COVID-19 pandemic. METHODS: We use provisional vital statistics data for births occurring in the central region of New Jersey. The Edinburgh Postnatal Depression Scale is employed to assess depressive symptoms. Our focal analysis uses linear regression models to test whether giving birth during the pandemic is associated with elevated depressive symptoms. All analyses are performed using time-matched (September 2019-April 2020; n = 18,531) and month-matched (January 2019-April 2019 and January 2020- April 2020; n = 18,346) samples. RESULTS: Women who gave birth in March and not in April reported higher levels of depressive symptoms than those who gave birth prior to the pandemic in our time-matched (b = 0.09) and month-matched (b = 0.09) samples. The magnitude of this association is approximately one-third the magnitude of the association between preterm birth and depressive symptoms. CONCLUSION: These findings suggest that researchers and practitioners should pay special attention to signs of postpartum depression and women's adaptive coping responses in the early stages of pandemics.


Asunto(s)
/epidemiología , Depresión Posparto/psicología , Madres/psicología , Adaptación Psicológica , Adulto , Depresión Posparto/epidemiología , Femenino , Humanos , New Jersey/epidemiología , Pandemias , Nacimiento Prematuro/epidemiología , Escalas de Valoración Psiquiátrica
12.
JMIR Mhealth Uhealth ; 9(1): e24045, 2021 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-33427680

RESUMEN

BACKGROUND: A voice assistant (VA) is inanimate audio-interfaced software augmented with artificial intelligence, capable of 2-way dialogue, and increasingly used to access health care advice. Postpartum depression (PPD) is a common perinatal mood disorder with an annual estimated cost of $14.2 billion. Only a small percentage of PPD patients seek care due to lack of screening and insufficient knowledge of the disease, and this is, therefore, a prime candidate for a VA-based digital health intervention. OBJECTIVE: In order to understand the capability of VAs, our aim was to assess VA responses to PPD questions in terms of accuracy, verbal response, and clinically appropriate advice given. METHODS: This cross-sectional study examined four VAs (Apple Siri, Amazon Alexa, Google Assistant, and Microsoft Cortana) installed on two mobile devices in early 2020. We posed 14 questions to each VA that were retrieved from the American College of Obstetricians and Gynecologists (ACOG) patient-focused Frequently Asked Questions (FAQ) on PPD. We scored the VA responses according to accuracy of speech recognition, presence of a verbal response, and clinically appropriate advice in accordance with ACOG FAQ, which were assessed by two board-certified physicians. RESULTS: Accurate recognition of the query ranged from 79% to 100%. Verbal response ranged from 36% to 79%. If no verbal response was given, queries were treated like a web search between 33% and 89% of the time. Clinically appropriate advice given by VA ranged from 14% to 29%. We compared the category proportions using the Fisher exact test. No single VA statistically outperformed other VAs in the three performance categories. Additional observations showed that two VAs (Google Assistant and Microsoft Cortana) included advertisements in their responses. CONCLUSIONS: While the best performing VA gave clinically appropriate advice to 29% of the PPD questions, all four VAs taken together achieved 64% clinically appropriate advice. All four VAs performed well in accurately recognizing a PPD query, but no VA achieved even a 30% threshold for providing clinically appropriate PPD information. Technology companies and clinical organizations should partner to improve guidance, screen patients for mental health disorders, and educate patients on potential treatment.


Asunto(s)
Comunicación , Prestación de Atención de Salud/métodos , Depresión Posparto/psicología , Telemedicina , Adulto , Inteligencia Artificial , Estudios Transversales , Depresión Posparto/terapia , Femenino , Humanos , Internet , Salud Mental , Teléfono Inteligente , Software de Reconocimiento del Habla
13.
Eur J Obstet Gynecol Reprod Biol ; 258: 162-167, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33429166

RESUMEN

OBJECTIVE: To evaluate the relation between sexual function and depressive symptoms in puerperal women during the pandemic period. STUDY DESIGN: Prospective cohort with 125 women evaluated in the immediate postpartum period (before the pandemic - T1) in Hospital de Clínicas de Porto Alegre, 3 months (pandemic onset - T2) and 6 months (pandemic peak - T3) after birth by email and WhatsApp. The Female Sexual Function Index (FSFI) and the Edinburgh Postnatal Depression Scale (EPDS) were applied. RESULTS: Fifty puerperal women participated in the three periods of the study. The median age was 25 years. There was an inverse correlation between the ​​ FSFI and EPDS values at T2 (p < 0.001) and T3 (p < 0.001), demonstrating that the worsening sexual response was secondary to the higher prevalence of depressive symptoms in the puerperium in the COVID-19 pandemic. There was an increase in EPDS scores in the three periods: at T1, the EPDS scores ​​were 5.0 (2.0-9.0), increasing to 7.0 (4.0-14.0) at T2 and 6.5 (3.0-13.0) at T3 (p = 0.004). There was no difference between the FSFI index at the three evaluated times. CONCLUSIONS: Puerperal women are a susceptible subgroup for sexual dysfunction and depressive symptoms, which are correlated to each other and worsen in periods of stress, therefore, it is mandatory to investigate depressive symptoms in puerperal women with sexual complaints, especially during the COVID-19 pandemic.


Asunto(s)
/psicología , Depresión Posparto/epidemiología , Disfunciones Sexuales Psicológicas/epidemiología , Adulto , Brasil/epidemiología , Femenino , Humanos , Pandemias , Periodo Posparto/psicología , Embarazo , Estudios Prospectivos , Aislamiento Social/psicología , Encuestas y Cuestionarios
14.
Int J Gynaecol Obstet ; 153(1): 83-88, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33368216

RESUMEN

OBJECTIVE: To understand how giving birth during the coronavirus disease 2019 (COVID-19) pandemic affected women based on birth parameters (gestational age, type of birth and body weight at birth), satisfaction with childbirth, and development of postpartum depression. METHODS: This is a cross-sectional study of 162 Spanish women. They were divided into two groups: those who gave birth before the pandemic (n = 82; from September 1, 2019 to March 1, 2020) and during the pandemic (n = 75; from April 1, 2020 to July 1, 2020). They were assessed using psychological instruments for postpartum childbirth satisfaction and postpartum depression. RESULTS: It was found that women who gave birth during the pandemic suffered higher levels of stress during childbirth (U = 2652.50; P = 0.040) and gave a worse rating of the quality of care received (U = 2703.50; P = 0.041). In addition, the percentage of postpartum depression was much higher in women who gave birth during the pandemic (χ2  = 4.31; P  = 0.038). CONCLUSION: Giving birth during the COVID-19 pandemic could have an impact on greater dissatisfaction with childbirth, as well as increasing the risk of postpartum depression.


Asunto(s)
Parto Obstétrico , Depresión Posparto , Parto/psicología , Estrés Psicológico , Adulto , /prevención & control , Estudios Transversales , Parto Obstétrico/métodos , Parto Obstétrico/psicología , Parto Obstétrico/estadística & datos numéricos , Depresión Posparto/diagnóstico , Depresión Posparto/epidemiología , Femenino , Edad Gestacional , Humanos , Satisfacción Personal , Periodo Posparto/psicología , Embarazo , España/epidemiología , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología
15.
Nursing (Säo Paulo) ; 23(271): 4999-5005, dez.2020.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1147013

RESUMEN

Objetivo: Analisar as percepções de enfermeiros sobre diagnóstico e acompanhamento da depressão pós-parto em Divinópolis-MG. Método: Estudo qualitativo, descritivo, realizado no período de setembro de 2018 através de roteiro semiestruturado e referencial Minayo, com amostra de nove enfermeiros da Estratégia de saúde da família. Resultados: Os enfermeiros não possuem suporte literário pré-definido para seguir caso deparem com mulheres em depressão pós-parto, sendo essas direcionadas para o psicólogo ou psiquiatra. Nas unidades não existem capacitação para os profissionais relacionados à temática, impactando negativamente nos atendimentos, tornando-o fragmentado. Não há um assessoramento por parte do município para auxiliar os profissionais de enfermagem a lidarem com essas mulheres. São utilizados mecanismos relacionados a busca ativa na maioria das unidades do estudo. Conclusão: É de suma importância o assessoramento municipal diretamente relacionado a temática, uma vez que contribui para um atendimento integral que vai de acordo com as diretrizes do Sistema Único de Saúde.(AU)


Objective: To analyze nurses' perceptions about the diagnosis and monitoring of postpartum depression in Divinópolis-MG. Method: Qualitative, descriptive study, carried out in the period of September 2018 through a semi-structured and referential Minayo script, with a sample of nine nurses from the Family Health Strategy. Results: Nurses do not have pre-defined literary support to follow if they encounter women in postpartum depression, and these are directed to the psychologist or psychiatrist. In the units, there is no training for professionals related to the theme, negatively impacting the service, making it fragmented. There is no advice from the municipality to assist nursing professionals in dealing with these women. Mechanisms related to active search are used in most units of the study. Conclusion: Municipal advice directly related to the topic is extremely important, since it contributes to comprehensive care that goes according to the guidelines of the Unified Health System.(AU)


Objetivo: analizar las percepciones de las enfermeras sobre el diagnóstico y seguimiento de la depresión posparto en Divinópolis-MG. Método: Estudio cualitativo, descriptivo, realizado en el período de septiembre de 2018 a través de un guión de Minayo semiestructurado y referencial, con una muestra de nueve enfermeras de la Estrategia de Salud Familiar. Resultados: Las enfermeras no tienen un apoyo literario predefinido a seguir si se encuentran con mujeres en depresión posparto, y estas están dirigidas al psicólogo o psiquiatra. En las unidades, no hay capacitación para profesionales relacionados con el tema, lo que impacta negativamente en el servicio y lo fragmenta. No hay consejos del municipio para ayudar a los profesionales de enfermería a tratar con estas mujeres. Los mecanismos relacionados con la búsqueda activa se utilizan en la mayoría de las unidades del estudio. Conclusión: El asesoramiento municipal directamente relacionado con el tema es extremadamente importante, ya que contribuye a una atención integral que se ajusta a las pautas del Sistema Único de Salud.(AU)


Asunto(s)
Humanos , Femenino , Embarazo , Diagnóstico de Enfermería , Depresión Posparto , Salud Materna , Atención Primaria de Salud , Enfermería Maternoinfantil , Periodo Posparto
16.
Artículo en Inglés | MEDLINE | ID: mdl-33327576

RESUMEN

Mental health issues during the perinatal period are common; up to 29% of pregnant and 15% of postpartum women meet psychiatric diagnostic criteria. Despite its ubiquity, little is known about the longitudinal trajectories of perinatal psychiatric illness. This paper describes a collaboration among six perinatal mental health services in Quebec, Canada, to create an electronic databank that captures longitudinal patient data over the course of the perinatal period. The collaborating sites met to identify research interests and to select a standardized set of variables to be collected during clinical appointments. Procedures were implemented for creating a databank that serves both research and clinical purposes. The resulting databank allows pregnant and postpartum patients to complete self-report questionnaires on medical and psychosocial variables during their intake appointment in conjunction with their clinicians who fill in relevant medical information. All participants are followed until 6 months postpartum. The databank represents an opportunity to examine illness trajectories and to study rare mental disorders and the relationship between biological and psychosocial variables.


Asunto(s)
Bases de Datos Factuales , Depresión Posparto , Complicaciones del Embarazo , Psiquiatría , Adulto , Femenino , Humanos , Servicios de Salud Mental/estadística & datos numéricos , Embarazo , Complicaciones del Embarazo/psicología , Psiquiatría/instrumentación , Quebec
17.
Artículo en Inglés | MEDLINE | ID: mdl-33352886

RESUMEN

This study explored how maternal and infant illness correlated with the risk of postpartum depression in the Chinese Qinba Mountains region. In total, 131 villages comprising 435 families with infants (≤6 months old) were randomly sampled. We collected data on maternal and infant illnesses and maternal health knowledge level. The Depression, Anxiety, and Stress Scale-21 was used to measure the risk of postpartum depression. We used descriptive statistics and multivariate logistic regression for the analysis. Infant overall health status was a risk factor for postpartum depression (odds ratio (OR) = 1.90, 95% Confidence Interval (95% CI) = 1.10~3.28), whereas maternal overall health status was not correlated with postpartum depression (OR = 1.36, 95% CI = 0.55~3.39). For specific illnesses, infants experiencing over two common illnesses in the past two weeks (OR = 1.98, 95% CI = 1.13~3.45) and mothers experiencing over two common pains within two weeks after delivery (OR = 1.77, 95% CI = 1.02~3.08) were risk factors for postpartum depression, whereas infants with mild and severe stunted growth, maternal C-section, and postpartum body mass index (normal or overweight) were not correlated with it (all p > 0.050). Maternal health knowledge was an important moderator of maternal and infant illnesses on the risk of postpartum depression. In conclusion, maternal and infant illness were essential factors for the risk of postpartum depression in a poor rural region in western China, which may be mainly affected by the feeling of uncertainty of illness. Improved maternal and infant health and enhanced maternal health knowledge might alleviate the risk of postpartum depression.


Asunto(s)
Depresión Posparto , Salud del Lactante/estadística & datos numéricos , China/epidemiología , Estudios Transversales , Depresión Posparto/epidemiología , Femenino , Humanos , Lactante , Madres , Periodo Posparto , Factores de Riesgo
18.
PLoS One ; 15(12): e0243936, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33315905

RESUMEN

BACKGROUND: The etiology of postpartum psychopathologies are not well understood, but folate metabolism pathways are of potential interest. Demands for folate increase dramatically during pregnancy, low folate level has been associated with psychiatric disorders, and supplementation may improve symptomatology. The MTHFR C677T variant influences folate metabolism and has been implicated in depression during pregnancy. OBJECTIVE: To conduct a prospective longitudinal study to explore the relationship between MTHFR C677T genotype, folate levels, and postpartum psychopathology in at-risk women. HYPOTHESIS: In the first three months postpartum, folate will moderate a relationship between MTHFR genotype and depression, with TT homozygous women having more symptoms than CC homozygous women. METHODS: We recruited 365 pregnant women with a history of mood or psychotic disorder, and at 3 postpartum timepoints, administered the Edinburgh Postnatal Depression Scale (EPDS); Clinician-Administered Rating Scale for Mania (CARS-M) and the Positive and Negative Symptom Scale (PANSS) and drew blood for genotype/folate level analysis. We used robust linear regression to investigate interactions between genotype and folate level on the highest EPDS and CARS-M scores, and logistic regression to explore interactions with PANSS psychosis scores above/below cut-off. RESULTS: There was no significant interaction effect between MTHFR genotype and folate level on highest EPDS (p = 0.36), but there was a significant interaction between genotype, folate level and log(CARS-M) (p = 0.02); post-hoc analyses revealed differences in the effect of folate level between CC/CT, and TT genotypes, with folate level in CC and CT having an inverse relationship with symptoms of mania, while there was no relationship in participants with TT genotype. There was no significant interaction between MTHFR genotype and folate level on the likelihood of meeting positive symptom criteria for psychosis on the PANSS (p = 0.86). DISCUSSION: These data suggest that perhaps there is a relationship between MTHFR C677T, folate level and some symptoms of postpartum psychopathology.


Asunto(s)
Depresión Posparto/genética , Ácido Fólico/genética , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Periodo Posparto/genética , Adulto , Alelos , Depresión Posparto/sangre , Depresión Posparto/patología , Depresión Posparto/psicología , Femenino , Ácido Fólico/sangre , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Genotipo , Humanos , Estudios Longitudinales , /patología , Persona de Mediana Edad , Periodo Posparto/psicología , Embarazo , Estudios Prospectivos , Trastornos Psicóticos/genética , Trastornos Psicóticos/patología , Trastornos Psicóticos/psicología , Factores de Riesgo , Adulto Joven
19.
Artículo en Inglés | MEDLINE | ID: mdl-33374665

RESUMEN

This study sought to estimate whether there is a preventative association between antidepressants during pregnancy and postpartum self-harm ideation (SHI), as this knowledge is to date unknown. Using the Multinational Medication Use in Pregnancy Study, we included a sample of mothers who were in the five weeks to one year postpartum period at the time of questionnaire completion, and reported preexisting or new onset depression and/or anxiety during pregnancy (n = 187). Frequency of postpartum SHI ('often/sometimes' = frequent, 'hardly ever' = sporadic, 'never') was measured via the Edinburgh Postnatal Depression Scale (EPDS) item 10, which reads "The thought of harming myself has occurred to me". Mothers reported their antidepressant use in pregnancy retrospectively. Overall, 52.9% of women took an antidepressant during pregnancy. Frequent SHI postpartum was reported by 15.2% of non-medicated women and 22.0% of women on past antidepressant treatment in pregnancy; this proportion was higher following a single trimester treatment compared to three trimesters (36.3% versus 18.0%). There was no preventative association of antidepressant treatment in pregnancy on reporting frequent SHI postpartum (weighted RR: 1.90, 95% CI: 0.79, 4.56), relative to never/hardly ever SHI. In a population of women with antenatal depression/anxiety, there was no preventative association between past antidepressant treatment in pregnancy and reporting frequent SHI in the postpartum year. This analysis is only a first step in providing evidence to inform psychiatric disorder treatment decisions for pregnant women.


Asunto(s)
Antidepresivos/uso terapéutico , Depresión Posparto , Conducta Autodestructiva/epidemiología , Ideación Suicida , Estudios Transversales , Depresión Posparto/tratamiento farmacológico , Depresión Posparto/epidemiología , Femenino , Humanos , Periodo Posparto , Embarazo , Escalas de Valoración Psiquiátrica , Estudios Retrospectivos
20.
Sci Rep ; 10(1): 22380, 2020 12 24.
Artículo en Inglés | MEDLINE | ID: mdl-33361797

RESUMEN

The mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Coronavirus Disease 2019 (COVID-19) pandemic on postpartum women are of increasing concern among mental health practitioners. To date, only a handful of studies have explored the emotional impact of the pandemic surrounding pregnancy and none have investigated the consequence of pandemic-related social restrictions on the postpartum mood of those living among different socioeconomic status (SES). All postpartum patients appearing to the Mount Sinai Health System for their postpartum appointment between January 2, 2020 and June 30, 2020, corresponding to before and during pandemic imposed social restrictions, were screened for mood symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Each patient's socioeconomic status (high/low) was determined by their location of clinical service. A total of 516 postpartum patients were screened. While no differences in EPDS scores were observed by SES prior to social restrictions (U = 7956.0, z = - 1.05, p = .293), a significant change in mood symptomatology was observed following COVID-19 restrictions (U = 4895.0, z = - 3.48, p < .001), with patients living in lower SES reporting significantly less depression symptomatology (U = 9209.0, z = - 4.56, p < .001). There was no change in symptomatology among patients of higher SES (U = 4045.5, z = - 1.06, p = .288). Postpartum depression, the most common complication of childbearing, is a prevalent, cross-cultural disorder with significant morbidity. The observed differences in postpartum mood between patients of different SES in the context of temporarily imposed COVID-19-related social restrictions present a unique opportunity to better understand the specific health and social support needs of postpartum patients living in urban economic poverty. Given that maternal mental illness has negative long-term developmental implications for the offspring and that poor mental health reinforces the poverty cycle, future health policy specifically directed towards supporting postpartum women living in low SES by ameliorating some of the early maternal burdens associated with balancing employment-family-childcare demands may assist in interrupting this cycle while simultaneously improving the long-term outcomes of their offspring.


Asunto(s)
Afecto , /prevención & control , Depresión Posparto/epidemiología , Pandemias/prevención & control , Periodo Posparto/psicología , Cuarentena/psicología , Clase Social , Adolescente , Adulto , Estudios de Cohortes , Depresión Posparto/diagnóstico , Femenino , Humanos , Salud Mental , Ciudad de Nueva York/epidemiología , Prevalencia , Escalas de Valoración Psiquiátrica , Adulto Joven
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