Self-harm thoughts among postpartum women - associated factors.

BACKGROUND: Even though in many countries suicide is the leading cause of maternal deaths during the postpartum period, the prevalence of thoughts of self-harm (SHTs), an important risk factor for suicide attempts, is still not well documented. AIM: We aimed to investigate the prevalence of SHTs in a Polish cohort of postpartum women and identify socio-demographic and maternal mental health factors associated with experiencing SHTs. METHOD: 1545 women took part in a midwife-led postpartum depression (PPD) screening. 337 of them reported SHTs. The Edinburgh Postpartum Depression Scale (EPDS) was administered. Specifically, we used an abbreviated 5-item version to assess depression symptoms, item 10 to assess SHTs, a composite score of items 1 and 2 - anhedonia, and a composite score of items 3, 4, and 5 - anxiety. Logistic regression analyses were performed to examine associations between variables. RESULTS: Approximately 2% (n = 337) of women self-reported experiencingSHTs. Within the group of postpartum mothers who self-reported SHTs, 65.60% (n = 221) manifested the symptoms of PPD, and 56.40% (n = 190) - of anxiety. The symptoms of PPD, a mood disorder diagnosed in the past, and younger age were predictors of SHTs. CONCLUSION: The results of this study can contribute to the development of prevention strategies: analysing separately items from PPD screening questionnaires focusing on SHTs can be an important part of prevention. The lack of the symptoms of PPD and anxiety risk does notexclude experiencing SHTs.

Relationship between social support and perinatal depression during the COVID-19 pandemic.

AIMS/BACKGROUND: This research aimed to identify the sources of social support and its relationship with perinatal depression (PPD) during the coronavirus (COVID-19) pandemic. DESIGN/METHODS: We carried out a cross-sectional study with a sample of 3,356 women during perinatal period living in Spain. We used five items from the Spanish version of the Coronavirus Perinatal Experiences - Impact Survey to assess the impact of COVID-19 on social support and, the Edinburgh Postnatal Depression Scale was used to assess depressive symptomatology. RESULTS: The results obtained identified a possible relationship between seeking in-person support (OR = 0.51; 0.67, during pregnancy and after delivery respectively) and degree of feeling social support (OR = 0.77; 0.77) during the COVID-19 pandemic with a lower prevalence of depression. Otherwise, requiring the help of a mental health professional (OR = 2.92; 2.41) and weeks of confinement (OR = 1.03; 1.01) appeared to be associated with a higher prevalence of depression. During pregnancy, a possible association was found between the degree of concern about future changes in support and involvement of family and friends (OR = 1.75) with a higher prevalence of depression. On the other hand, in the postpartum period, there seems to be a relationship between seeking social support through social media (OR = 1.32) with a higher prevalence of depression and receiving support from friends (OR = 0.70) and health professionals (OR = 0.53) with a lower prevalence of depression. CONCLUSION: These results highlighted the importance of protecting perinatal mental health during the COVID-19 pandemic by protecting and developing social support networks.

Feasibility of screening and prevalence of prenatal depression in an obstetric setting in Spain.

OBJECTIVES: Prenatal depression is a significant public health problem and one of the main risk factors for postpartum depression. Limited research in perinatal depression has been conducted in Spain. The objectives of this study was to: (1) examine the feasibility of integrating a screening program for prenatal depression in an obstetrics setting in a large urban hospital in Spain; and (2) provide an initial estimate of the prevalence rate of the severity of depressive symptoms during pregnancy. STUDY DESIGN: Screening for prenatal depression was conducted during the first trimester in an obstetrics setting in an urban hospital in Madrid, Spain 2014-2015. The Patient Health Questionnaire (PHQ-9) was used as the main screener. RESULTS: Of the 730 women asked to complete the screening protocol, 445 (60.9%) completed the PHQ-9 during the first trimester. Those who did not complete the screening were more likely to be immigrants and did not read Spanish. The prevalence of moderate to high severity of prenatal depressive symptoms prenatal depressive is 14.8% (PHQ-9≥10). CONCLUSION: It is possible to integrate screening for prenatal depression in an urban obstetrics setting, but there are significant structural barriers to implementation. The prevalence of significant prenatal depressive symptoms is similar to previous research in Spain and adds to the limited research in this area.