Biopsychosocial Predictors of Postpartum Depression: Protocol for Systematic Review and Meta-Analysis.

During the postpartum period, psychological disorders may emerge. Aims and objectives: With the current study, we aim to explore the biological determinants that act on women during labor and incur the risk for postpartum depression (PPD). To reach the aim, we will perform the following tasks: (i) identify biological peripartum risk factors and calculate pooled prevalence of PPD for each of them; (ii) explore the strength of the relationship between peripartum risk factors and PPD; (iii) rank the predictors by their prevalence and magnitude of association with PPD. The knowledge obtained will support the development and implementation of early diagnostic and preventive strategies. Methods and analysis: We will systematically go through peer-reviewed publications available in the PubMed search engine and online databases: Scopus, Web of Science, EMBASE. The scope of the review will include articles published any time in English, Arabic, or Polish. We will deduplicate literature sources with the Covidence software, evaluate heterogeneity between the study results, and critically assess credibility of selected articles with the Joanna Briggs Institute's bias evaluation tool. The information to extract is the incidence rate, prevalence, and odds ratio between each risk factor and PPD. A comprehensive analysis of the extracted data will allow us to achieve the objectives. The study findings will contribute to risk stratification and more effective management of PPD in women.

Ômega 3 na gestação e os impactos na depressão pós-parto: uma revisão narrativa / Omega 3 during pregnancy and impacts on postpartum depression: a narrative review / Omega 3 durante el embarazo e impactos en la depresión postparto: una revisión narrativa

Objetivo: Evidenciar através de uma revisão integrativa os resultados clínicos atuais do impacto do consumo de ômega 3 frente a depressão pós-parto. Método: Revisão integrativa da literatura realizada no período de Fevereiro a Julho de 2023 nas bases de dados Pubmed, LILACS, Medline e Scielo. Resultados:Foi realizada uma busca pelos descritores em saúde determinados e foram selecionadas 5 produções científicas que atenderam os critérios de inclusão. De modo geral, os trabalhos mostraram relações com a saúde do bebê e da mãe. No bebê, observou-se aumento do crescimento intrauterino, maior resposta do sistema nervoso central, melhor desenvolvimento neural, de retina, imunológico, cognitivo e físico. Já na saúde materna, observou-se aumento no processo antiinflamatório, melhor resposta imune, melhora no efeito neurotrófico do cérebro, aumento do metabolismo, melhora hormonal, menor risco cardiovascular, menores distúrbios neurológicos (incluindo a depressão) e distúrbios visuais. Conclusão:Mais estudos são necessários para elucidar os benefícios da suplementação de ômega-3 em gestantes no pós-parto

Objective: To show, through an integrative review, the current clinical results of the impact of omega 3 consumption on postpartum depression. Method:Integrative literature review carried out from February to July 2023 in the Pubmed, LILACS, Medline and Scielo databases. Results:A search was performed for specific health descriptors and 5 scientific productions that met the inclusion criteria were selected. In general, the studies showed relationships with the health of the baby and the mother. In the baby, there was an increase in intrauterine growth, greater response of the central nervous system, better neural, retinal, immunological, cognitive and physical development. In maternal health, there was an increase in the anti-inflammatory process, better immune response, improvement in the neurotrophic effect of the brain, increased metabolism, hormonal improvement, lower cardiovascular risk, lesser neurological disorders (including depression) and visual disturbances. Conclusion:More studies are needed to elucidate the benefits of omega-3 supplementation in postpartum pregnant women.

Objetivo: Mostrar, a través de una revisión integradora, los resultados clínicos actuales del impacto del consumo de omega 3 en la depresión posparto. Método:Revisión integrativa de la literatura realizada de febrero a julio de 2023 en las bases de datos Pubmed, LILACS, Medline y Scielo. Resultados:Se realizó una búsqueda de determinados descriptores de salud y se seleccionaron 5producciones científicas que cumplían con los criterios de inclusión. En general, los estudios mostraron relaciones con la salud del bebé y de la madre. En el bebé hubo un aumento del crecimiento intrauterino, mayor respuesta del sistema nervioso central,mejor desarrollo neural, retiniano, inmunológico, cognitivo y físico. En salud materna, hubo aumento del proceso antiinflamatorio, mejor respuesta inmunológica, mejora del efecto neurotrófico del cerebro, aumento del metabolismo, mejora hormonal, menor riesgo cardiovascular, menos trastornos neurológicos (incluyendo depresión) y alteraciones visuales. Conclusión:Se necesitan más estudios para dilucidar los beneficios de la suplementación con omega-3 en mujeres embarazadas posparto

Mothers' and birthing parents' experiences with 1-day cognitive behavioural therapy-based workshops for postpartum depression: A descriptive qualitative study.

WHAT IS KNOWN ABOUT THE SUBJECT?: One in five mothers and birthing parents are affected by postpartum depression (PPD), yet only a small proportion of those with PPD receive treatment. Given cost and accessibility barriers to treatment, brief therapies (e.g. 1 day) could help address PPD on a large scale, though understanding participants' unique experiences with this novel treatment will help guide its refinement and use. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper describes the experiences, perspectives and satisfaction of participants who attended a 1-day workshop for PPD. Participants appreciate being taught practical techniques and the receipt of social support from facilitators and other attendees in the group setting, while some recommended further 'booster sessions' to enhance effectiveness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: One-day CBT-based workshops may be an effective, low-intensity treatment option that provides helpful skills and builds social networks for individuals with PPD. Additional post-workshop booster sessions may enhance participant satisfaction with this new treatment by providing a reinforcement of their learning and an opportunity to re-connect with other birthing parents. ABSTRACT: INTRODUCTION: Postpartum depression (PPD) affects up to one in five mothers and birthing parents. Understanding their perceptions of therapeutic interventions is key to their effectiveness and scalability. AIM: The aim of the study was to understand participants' experiences attending an in-person or online 1-day cognitive behavioural therapy (CBT)-based workshop for PPD and compare their experiences participating in either modality. METHOD: This descriptive qualitative study was embedded in two separate randomized controlled trials evaluating the effectiveness of 1-day CBT-based workshops for PPD delivered in-person or online. Responses were provided by 94 in-person and 95 online participants about their experiences. Content analysis was used to code and categorize the data. RESULTS: Participants appreciated learning skills to improve PPD symptoms and joining a community of individuals with shared experiences. Integrating practical coping techniques after the workshop was reported to be most useful, though some wanted additional post-workshop support. Online participants identified additional barriers to workshop engagement. DISCUSSION: Participants who attended either workshop found them to be valuable and effective. Participants valued psychoeducation, social connections and applying practical CBT techniques. IMPLICATIONS FOR PRACTICE: One-day CBT-based workshops may be an accessible treatment option for individuals with PPD, providing new skills and social support, though some prefer to receive additional post-workshop support.

[Fathers' negative experience of childbirth is associated with an increased risk of paternal postpartum depression]. / L'accouchement vécu négativement par les pères est associé à une augmentation du risque de dépression paternelle en post-partum.

OBJECTIVES: The aim of this study was to investigate the influence of the childbirth experience by primiparous fathers living in France on their level of postnatal depression, parental self-efficacy, and postnatal sense of security. METHODS: Two hundred and fifty men answered sociodemographic questions and filled up the Edinburg Postnatal Depression Scale (EPDS), the First-Time Father Questionnaire (FTFQ), the Parent Expectations Survey (PES) and the Parents' Postnatal Sense of Security Instrument (PPSSi). RESULTS: A negative birth experience was associated with a higher rate of postnatal depressive symptoms (P<.001) and a lower level of postnatal security (P<.001). However, no relationship was found between childbirth experience and sense of parental efficacy (P=0.09). CONCLUSIONS: Similar to mothers, the way fathers experience the birth of their partner can have consequences for the way they go through the postpartum period. In order to prevent possible depressive affects that may impact the relationship with their child, and to strengthen their sense of security when returning home, it is important to provide fathers with appropriate support throughout the perinatal period.

[Fathers and peripartum mental illness: the neglected parent?] / Väter und peripartale psychische Erkrankungen: Das übersehene Elternteil?

Fathers also play an important role during pregnancy and the postpartum period, both for the partner and for the child. With changes in society and increasing early involvement in the care of infants, the father-child relationship has become increasingly more important in recent years. There is growing evidence that fathers can also suffer from mental illnesses during their partner's pregnancy and especially after the birth of a child. As the transition to the role of a father is a major change in a man's life, the birth of a child can be a life event that contributes to a first time mental illness or triggers a new episode of an already existing illness. For example, birth complications can also traumatize the attendant fathers and result in trauma sequelae. Peripartum anxiety disorders and depression probably affect approximately 5% of all men and can among other things have a negative impact on the development of exposed children. Specific screening or even treatment services for affected men are still very rare and little research has been performed. Much less is known about the prevalence, risk factors, and treatment of other mental illnesses in fathers, and there is still a great need for research in this respect.

Establishment of a Community Advisory Board to Address Postpartum Depression Among Indigenous Women.

In this article, we describe the process of establishing an academically and tribally supported community advisory board (CAB) to guide and inform community-engaged research about postpartum depression (PPD) among Indigenous women. Using a community-based participatory research framework, we created a CAB with stakeholders from the Chickasaw Nation because they are well situated to inform a research agenda about PPD in Indigenous women. We developed CAB roles, goals, and responsibilities; established processes for compensation and recognition; identified and recruited potential members; and conducted meetings to build rapport, brainstorm, receive feedback, and invite discussion of topics related to PPD that have been deemed important by the tribe (October 2021 through June 2022). The CAB defined specific roles, goals, and responsibilities for the academic-community partnership, including assumptions, expectations, and confidentiality. We used a standing agenda item to recognize member achievements. Members of the CAB represented many tribal departments and professional disciplines. We use a CAB framework to evaluate our process and to provide recommendations for future research and policymaking.

Folic acid supplementation during pregnancy and postpartum depressive symptoms / Suplementação de ácido fólico na gestação e sintomas depressivos pós-parto

ABSTRACT OBJECTIVE To verify whether folic acid supplementation during pregnancy is associated with the occurrence of maternal depressive symptoms at three months postpartum, in the 2015 Pelotas Birth Cohort. METHODS This study included 4,046 women, who were classified into three groups: did not use folic acid supplementation during pregnancy; used during only one trimester of pregnancy; and used for two or three trimesters. Depressive symptoms were assessed at three months postpartum using the Edinburgh Postnatal Depression Scale (EPDS), at cutoff points ≥ 10 (mild symptoms) and ≥ 13 (moderate to severe intensity). RESULTS The overall prevalence of mild symptoms was of 20.2% (95%CI 19.0-21.5), and moderate and severe was 11% (95%CI 10.0-12.0). The prevalence of EPDS ≥ 10 was of 26.8% (95%CI 24.0-29.5) among women who did not use folic acid and 18.1% for both those who used it during one trimester of pregnancy (95%CI 16.1-20.1) and those who used it for two or three trimesters (95%CI 16.0-20.2). The prevalence of EPDS ≥ 13 was of 15.7% (95%CI 13.5-17.9) in those who did not use folic acid, 9.1% (95%CI 7.5-10.6) in those who used it for one trimester, and 9.4% (95%CI 7.8-11.0) in those who used it for two or three trimesters. In the adjusted analyses, there was no statistically significant association between the use of folic acid during pregnancy and the occurrence of depressive symptoms at three months postpartum. CONCLUSION There was no association between folic acid supplementation during pregnancy and postpartum depression at three months.

RESUMO OBJETIVO Verificar se a suplementação de ácido fólico durante a gestação está associada com a ocorrência de sintomas depressivos maternos aos três meses pós-parto, na Coorte de Nascimentos de Pelotas de 2015. MÉTODOS Este estudo incluiu 4.046 mulheres, que foram classificadas em três grupos: sem suplementação de ácido fólico na gestação; uso durante apenas um trimestre da gestação;e uso durante dois ou três trimestres. Os sintomas depressivos foram avaliados aos três meses pós-parto, através da Escala de Depressão Pós-Natal de Edimburgo (EPDS), nos pontos de corte ≥ 10 (sintomas leves) e ≥ 13 (intensidade moderada a grave). RESULTADOS A prevalência geral de sintomas leves foi de 20,2% (IC95% 19,0-21,5),e moderados e graves de 11% (IC95% 10,0-12,0). Entre as mulheres que não fizeram uso de ácido fólico, a prevalência de EPDS ≥ 10 foi de 26,8% (IC95% 24,0-29,5) e 18,1% tanto entre as que utilizaram durante um trimestre da gestação (IC95% 16,1-20,1), quanto entre as que utilizaram por dois ou três trimestres (IC95% 16,0-20,2). Já a prevalência de EPDS ≥ 13 foi 15,7% (IC95% 13,5-17,9) entre as que não utilizaram ácido fólico, 9,1% (IC95% 7,5-10,6) entre as que utilizaram durante um trimestre e 9,4% (IC95% 7,8-11,0) entre as que utilizaram por dois ou três trimestres. Nas análises ajustadas, não houve associação estatisticamente significativa entre o uso de ácido fólico na gestação e a ocorrência de sintomas depressivos aos três meses pós-parto. CONCLUSÃO Não se observou associação entre a suplementação de ácido fólico na gestação e depressão pós-parto aos três meses.

Amamentação e depressão pós-parto: revisão integrativa / Breastfeeding and postpartum depression: integrative review / Lactancia materna y depresión posparto: revisión integradora

Objetivo: Sintetizar as evidências disponíveis na literatura sobre a associação entre a depressão pós-parto e amamentação. Método: Trata-se de uma revisão integrativa. Foram utilizadas as bases de dados IBECS; LILACS; e, PubMed. A questão norteadora proposta para suscitar a presente pesquisa foi: "Quais as evidências científicas sobre a Depressão Pós-Parto e Amamentação?". Resultados: Foram encontrados 564 artigos, dos quais 36 foram incluídos para leitura na íntegra, sendo que 21 foram excluídos por não responder a pergunta norteadora e dois pelo tipo de estudo, permanecendo 13 estudos. Após a análise dos estudos, foi elencada uma categoria principal denominada Depressão Pós-Parto e Amamentação, a qual engloba três subcategorias, a saber: Autoeficácia materna; Condições maternas que ajudam na amamentação; e Fatores maternos que dificultam a amamentação. Considerações finais: A presença da Depressão Pós-Parto pode influenciar no processo de amamentação. Assim, são necessárias ações para o rastreamento precoce da Depressão Pós-Parto, cabendo aos profissionais de saúde encontrarem estratégias para prevenir seus riscos, a fim de promover uma melhor qualidade da assistência, auxiliar na diminuição de sua incidência, auxiliar na promoção do apoio social à amamentação e no desenvolvimento saudável da relação mãe-bebê.

Objective: The aim of this study was to conduct an integrative review of the literature on the association between postpartum depression and breastfeeding. Method: The IBECS, LILACS, and PubMed databases were searched using the guiding question, "What is the scientific evidence on Postpartum Depression and Breastfeeding?" A total of 564 articles were identified, and 36 were selected for full reading. Of these, 21 were excluded for not addressing the guiding question and two were excluded due to the study design, resulting in a final set of 13 studies. Results: A main category was identified, Postpartum Depression and Breastfeeding, which encompassed three subcategories: maternal self-efficacy, maternal conditions that facilitate breastfeeding, and maternal factors that hinder breastfeeding. Final considerations: The findings suggest that the presence of postpartum depression can impact the breastfeeding process. Therefore, it is essential for health professionals to screen for postpartum depression early and develop strategies to prevent its risks. These actions will promote better quality of care, reduce the incidence of postpartum depression, and enhance social support for breastfeeding, leading to healthy development of the mother-baby relationship.

Objetivo: El objetivo de este estudio fue realizar una revisión integradora de la literatura sobre la asociación entre depresión postparto y lactancia materna. Método: Se realizaron búsquedas en las bases de datos IBECS, LILACS y PubMed utilizando la pregunta guía: "¿Cuál es la evidencia científica sobre la depresión posparto y la lactancia materna?" Se identificaron 564 artículos y se seleccionaron 36 para su lectura completa. De éstos, 21 fueron excluidos por no abordar la pregunta guía y dos fueron excluidos debido al diseño del estudio, resultando en un conjunto final de 13 estudios. Resultados: Se identificó una categoría principal, Depresión posparto y lactancia materna, que englobaba tres subcategorías: autoeficacia materna, condiciones maternas que facilitan la lactancia materna y factores maternos que dificultan la lactancia materna. Consideraciones finales: Los hallazgos sugieren que la presencia de depresión postparto puede impactar en el proceso de lactancia. Por lo tanto, es esencial que los profesionales de la salud realicen un cribado precoz de la depresión posparto y desarrollen estrategias para prevenir sus riesgos. Estas acciones promoverán una mejor calidad de la atención, reducirán la incidencia de la depresión posparto y aumentarán el apoyo social a la lactancia materna, lo que conducirá a un desarrollo saludable de la relación madre-bebé.

Factores de riesgo relacionados con la depresión postparto / Risk factors related to postpartum depression / Fatores de risco relacionados à depressão pós-parto

El puerperio se considera una de las etapas más importantes del término del embarazo que atraviesan el cuerpo de la una mujer, donde puede ocasionar un estado de fragilidad psicológica, con la presentación de trastornos psiquiátricos, que puede aparecer de forma leve a grave en todas las mujeres posterior al parto, y hasta un año del mismo, se caracteriza por tener efectos a corto, mediano y largo plazo, en la madre, en el recién nacido y en la familia. El objetivo del presente estudio fue analizar los factores de riesgo de mayor impacto y relevancia en la depresión postparto en Ecuador. Se realizó una revisión bibliográfica narrativa de la literatura científica, de factores de riesgo relacionados a depresión postparto. Se concluyó que la depresión en la etapa postparto ha ido en aumento en los últimos años, al igual que los factores de riesgo de mayor prevalencia, destacando; el estado civil, nivel socio económico, y antecedentes de depresión previos. Los presentes hallazgos ponen de manifiesto la magnitud del problema de la depresión postparto, así como la relevancia de continuar con esta línea de investigación, formular y proponer estrategias de prevención frente a los principales factores de riesgos mencionados con anterioridad.

The puerperium is considered one of the most important stages of the term of pregnancy that a woman's body goes through, where it can cause a state of psychological fragility, with the presentation of psychiatric disorders, which can appear from mild to severe in all women after childbirth, and up to a year of it, is characterized by having short, medium and long-term effects on the mother, the newborn and the family. The objective of this study was to analyze the risk factors with the greatest impact and relevance in postpartum depression in Ecuador. A narrative bibliographic review of the scientific literature on risk factors related to postpartum depression was carried out. It was concluded that depression in the postpartum stage has been increasing in recent years, as well as the most prevalent risk factors, highlighting; marital status, socioeconomic status, and previous history of depression. These findings highlight the magnitude of the problem of postpartum depression, as well as the relevance of continuing with this line of research, formulating and proposing prevention strategies against the main risk factors mentioned above.

O puerpério é considerado uma das fases mais importantes do termo gestacional por que passa o corpo da mulher, onde pode causar um estado de fragilidade psicológica, com a apresentação de transtornos psiquiátricos, que podem se apresentar de leve a grave em todas as mulheres após parto, e até um ano dele, caracteriza-se por ter efeitos a curto, médio e longo prazo sobre a mãe, o recém-nascido e a família. O objetivo deste estudo foi analisar os fatores de risco com maior impacto e relevância na depressão pós-parto no Equador. Foi realizada uma revisão bibliográfica narrativa da literatura científica sobre fatores de risco relacionados à depressão pós-parto. Concluiu-se que a depressão na fase puerperal vem aumentando nos últimos anos, assim como os fatores de risco mais prevalentes, destacando; estado civil, situação socioeconômica e história prévia de depressão. Esses achados destacam a magnitude do problema da depressão pós-parto, bem como a relevância de continuar com essa linha de pesquisa, formulando e propondo estratégias de prevenção contra os principais fatores de risco citados acima.

Impact of maternal neuraxial labor analgesia exposure on offspring's neurodevelopment: A longitudinal prospective cohort study with propensity score matching.

Background: Neuraxial analgesia is widely used to relieve labor pain; its effects on long-term neurodevelopment of offspring remain unclear. This study was designed to investigate the influence of maternal neuraxial labor analgesia on offspring mental development. Methods: This was a predefined secondary analysis of a 2-year prospective longitudinal study. Nulliparous women with single-term cephalic pregnancy preparing for vaginal delivery self-selected neuraxial analgesia or not during labor. Mothers and their offspring were followed up 2 years later. children's mental development was assessed with the bayley scales of infant development. A multivariable logistic model was used to identify factors associated with below-average mental development (Mental Development Index <90). Results: A Total of 508 pairs of mothers and children completed a 2-year follow-up. after propensity score matching, 387 pairs were included in the analysis. In both cohorts, the proportions with below-average mental development were slightly lower in children whose mothers received neuraxial labor analgesia, although not statistically significant [in the full cohort: 9.8 % (36/368) vs. 15.7% (22/140), P = 0.060; In the matched cohort: 8.3% (21/254) vs. 14.3% (19/133), P = 0.065]. A higher 2-year depression score (in the full cohort: Odds Ratio 1.15, 95% CI 1.08-1.22, P < 0.001; In the matched cohort: Odds Ratio 1.09, 95% CI 1.01-1.18, P = 0.037), but not neuraxial analgesia exposure, was associated with an increased risk of below-average mental development. Conclusions: Maternal depression at 2 years was associated with the risk of below-average mental development, whereas maternal exposure to neuraxial labor analgesia was not. Clinical Trial Registration: The study was registered with www.chictr.org.cn (ChiCTR-OCH-14004888) and ClinicalTrials.gov (NCT02823418).

Cross-cultural adaptation of The Postpartum Childcare Stress Checklist into Brazilian Portuguese / Adaptação transcultural da escala The Postpartum Childcare Stress Checklist para o Português-Brasileiro

Abstract Objectives: to carry out the cross-cultural adaptation of The Postpartum Childcare Stress Checklist scale to be used in Brazil. Methods: the cross-cultural adaptation process followed internationally defined guidelines: double translation, synthesis and back-translation, analysis by a committee of experts, proposal for a pre-final and pre-test version, analysis of the psychometrics properties and generation of the final version. The reliability and validity of the final version were analyzed through a cross-sectional epidemiological study involving 190 women in the postpartum period. Cronbach's α indicator for reliability analysis and exploratory factor analysis with main component extraction were estimated for validity analysis. Results: α-Cronbach's was 0.894. The tested Brazilian version proved to be one-dimensional and the factor analysis pointed to four factors that were very closely distributed and explained 57.8% of the variance. All items of the original instrument were maintained in the proposed final version. Conclusions: the proposed Brazilian version proved to be valid and reliable for application in Brazilian populations.

Resumo Objetivos: proceder a adaptação transcultural da escala The Postpartum Childcare Stress Checklist para ser utilizada no Brasil. Métodos: o processo de adaptação transcultural seguiu diretrizes definidas internacionalmente: dupla tradução, síntese e retrotradução, análise por comitê de especialistas, proposta de uma versão pré-final e pré-teste, avaliação das propriedades psicométricas e geração da versão final. A confabilidade e validade da versão final foram analisadas por meio de estudo epidemiológico transversal envolvendo 190 mulheres em período pós-parto. Foram estimados o indicador α-Cronbach para análise da confabilidade e análise fatorial exploratória com extração de componentes principais para análise da validade. Resultados: o indicador α- Cronbach foi de 0,894. A versão brasileira testada mostrou-se unidimensional e a análise fatorial apontou quatro fatores distribuídos de maneira muito próxima e que explicaram 57,8% da variância. Todos os itens do instrumento original foram mantidos na versão final proposta. Conclusão: a versão brasileira proposta mostrou-se válida e confável para aplicação em populações brasileiras.

Influencing factors of postpartum depression/anxiety in Jinping Area, Yunnan Province / 中华围产医学杂志

Objective:To investigate the positive rate of postpartum depression/anxiety screening and its associated factors in Jinping area, Yunnan Province.Methods:This cross-sectional survey involved 761 women who delivered live, singleton infants at or after 28 gestational weeks from October 2019 to February 2021 in the People's Hospital of Jinping Miao, Yao, and Dai Autonomous County, Honghe Hani and Yi Autonomous Prefecture, Yunnan Province. A questionnaire survey on childbirth and upbringing, the Edinburgh Postnatal Depression Scale (defined as positive when ≥9 score), and the Self-rating Anxiety Scale (defined as positive when ≥50 score) were conducted at postpartum day 1 to 3. General obstetric information and medical history were also retrieved from medical records. The risk factors of maternal depression and anxiety were analyzed using Chi-square test and multivariate logistic regression. Results:All 761 parturients completed the questionnaire. The total positive rate was 7.49% (57/761) for depression screening and 8.02% (61/761) for anxiety screening. Univariate analysis showed that postpartum hemorrhage, intrapartum infection and puerperal morbidity, neonates being transferred to the pediatric ward, attendance of prenatal classes during pregnancy, whether the neonatal gender was in line with the maternal and family expectations were all associated with both postpartum depression and postpartum anxiety. In addition, an association was found between gravidity, parity, delivery mode and postpartum depression, as well as accompanied delivery, breastfeeding and postpartum anxiety (all P<0.05). Multivariate analysis showed that postpartum hemorrhage ( OR=1.934, 95% CI: 1.010-3.704), neonates being transferred to the pediatric ward ( OR=1.990, 95% CI: 1.037-3.816), and not attending prenatal classes during pregnancy ( OR=3.393, 95% CI: 1.166-9.872) were the risk factors for postpartum depression; neonates being transferred to the pediatric ward ( OR=1.972, 95% CI: 1.040-3.740) and non-breastfeeding ( OR=2.174, 95% CI: 1.077-4.389) were risk factors for postpartum anxiety (all P<0.05). Conclusions:Parturients in Jinping area of Yunnan Province were at a lower risk of postpartum depression/anxiety. Active attendance at prenatal classes and breastfeeding may help reduce the risk of postpartum depression/anxiety.

Influencing factors for positive results in early postpartum depression screening / 中华围产医学杂志

Objective:To investigate the risk factors associated with the positive results of early postpartum depression screening.Methods:This study involved 2 889 women who were negative in prenatal depression screening and delivered in the Maternal and Child Health Hospital of Hubei Province from 1 March to 30 April 2021. The Edinburgh Postnatal Depression Scale (EPDS) score, Adaptation Partnership Growth Affection Resolve (APGAR) score, and related living habits of the enrolled subjects were investigated on the 5th to 7th day after delivery. All patients were divided into two groups with 2 354 in the negative group (EPDS score<13) and 535 in the positive group (EPDS score≥13), based on the EPDS scores at 5 to 7 days postpartum. Chi-square test, trend Chi-square test, and rank-sum test were used for univariate analysis. Risk factors associated with positive depression screening were analyzed using binary logistic regression. Results:Univariate analysis suggested that there were statistically significant differences between the two groups in maternal personality, marital relationship, family functioning, sleep quality during pregnancy, smoking and drinking habits during pregnancy, prenatal EPDS score, mode of delivery, whether or not to have intrapartum cesarean section and forceps delivery, duration of labor in vaginal delivery, the proportions of puerperae and neonates who were transferred to intensive care unit (ICU), twin pregnancy, placenta previa, abnormal fetal position, premature birth, postpartum hemorrhage, and having three or more complication (all P<0.05). Binary logistic regression analysis suggested that extravertion ( OR=0.483, 95% CI:0.369-0.632), good marital relations ( OR=0.540, 95% CI:0.422-0.691) and good sleep during pregnancy ( OR=0.340, 95% CI:0.245-0.471) were protective factors for early postpartum depression, while introversion ( OR=1.632, 95% CI:1.275-2.088), poor marital relations ( OR=3.495, 95% CI: 1.946-6.276), moderate family dysfuntion ( OR=4.038, 95% CI:2.667-6.114) and severe family dysfunction ( OR=20.234, 95% CI: 2.446-167.364), smoking ( OR=2.071, 95% CI:1.315-3.263) and drinking during pregnancy ( OR=1.924, 95% CI:1.142-3.243), twin pregnancy ( OR=2.680, 95% CI:1.435-5.005), placenta previa ( OR=2.567, 95% CI:1.316-5.009), having three or more complications ( OR=1.876, 95% CI: 1.316-2.674), forceps delivery ( OR=3.043, 95% CI:1.185-7.816), intrapartum cesarean section ( OR=1.917, 95% CI:1.232-2.982), postpartum hemorrhage ( OR=1.668, 95% CI:1.069-2.604), and postpartum ICU admission ( OR=2.601, 95% CI: 1.112-6.086) were risk factors for early postpartum depression. Conclusions:Healthy living habits, and good mood contribute to decreasing postpartum depression in pregnant women. Education for parturients with serious illness or complications should be strengthened to help develop a proper understanding of the disease.

Factors influencing breastfeeding in parturients admitted to intensive care unit / 中华围产医学杂志

Objective:To investigate and analyze the factors influencing breastfeeding in parturients admitted to intensive care unit (ICU).Methods:A cross-sectional survey was conducted on parturients from the ICU of Maternal and Child Health Hospital of Hubei Province from March 1 to August 31, 2020, whose delivery information and reasons for ICU admission were retrieved from the electronic medical record system. Breastfeeding Self-Efficacy Scale (BSES), Emotion Regulation Scale (ERS), and Edinburgh Postnatal Depression Scale (EPDS) scores were assessed between postpartum day 3-7. Half a year after delivery, basic information about the parturients, sources of available breastfeeding knowledge, and breastfeeding data were surveyed through Wenjuanxing, an online questionnaire platform. Wilcoxon test, t-test, Chi-square test (or calibration Chi-square, or Fisher's exact test), trend test, and binary logistic regression were adopted for statistical analysis. Results:A total of 138 parturients were enrolled and divided into the breastfeeding group ( n=117) and bottle-feeding group ( n=21). Both mixed feeding and exclusive breastfeeding women were eligible for the breastfeeding group, which were further classified as subgroup A (breastfeeding ≥6 months, n=67) and subgroup B (breastfeeding <6 months, n=50). A higher breastfeeding rate was observed in parturients with good or excellent postpartum appetite ["average", "good" and "excellent" in both groups were 21.4%(25/117), 59.8%(70/117) and 18.8%(22/117) vs 85.7%(18/21), 14.3%(3/21) and 0.0%(0/21), χ2=27.29], adequate daily sleep [defined as ≥ 6 hours per day, 87.2%(102/117) vs 57.2%(12/21), χ2=10.99], higher BSES [107.00(92.00-122.00) vs 55.00(50.00- 68.50), Z=6.41], and ERS score [52.00(45.50-59.00) vs 38.00(27.05-42.50), Z=5.05], and access to breastfeeding knowledge through hospital education [59.0%(69/117) vs 4.8%(1/21), χ2=18.82] and self-study [62.4% (73/117) vs 33.3% (7/21), χ2=6.17] (all P<0.05). At the same time, those who had postpartum hemorrhage [18.8% (22/117) vs 42.9% (9/21), χ2=5.91], pregnancy complicated by heart disease [5.1% (6/117) vs 23.8% (5/21), χ2=8.47], and EPDS score≥13 [13.7% (16/117) vs 61.9% (13/21), χ2=24.95] had a lower breastfeeding rate (all P<0.05). Patients with good postpartum appetite ["average", "good" and "excellent" in both groups were 7.5%(5/67), 68.7%(46/67) and 23.9%(16/67) vs 40.0%(20/50), 48.0%(24/50)and 12.0%(6/50), χ2=13.96], adequate daily sleep [94.0% (63/67) vs 78% (39/50), χ2=6.57], higher BSES [115.00(106.00-131.00) vs 92.50 (68.00-104.00), Z=6.29], and ERS score [57.00(54.00-60.00) vs 45.50(38.00-50.00), Z=7.80] accounted for a higher proportion in subgroup A, while those with insufficiency lactation [41.8% (28/67) vs 76.0% (38/50), χ2=13.63], postpartum hemorrhage [9.0% (6/67) vs 32.0% (16/50), χ2=9.96], and EPDS score≥13[7.5%(5/67) vs 22.0%(11/50), χ2=5.13] accounted for lower proportion (all P<0.05). Multivariate logistic regression analysis showed that good postpartum appetite ( OR=8.016, 95% CI: 1.908-33.679; OR=2.227, 95% CI: 1.059-4.682) and adequate hospital breastfeeding education ( OR=30.013, 95% CI: 3.022-298.047; OR=2.596, 95% CI: 1.035-6.512) were the promoting factors for both breastfeeding and duration more than six months, while EPDS score≥13 ( OR=0.179, 95% CI: 0.044-0.720) was a hindering factor for its ibreastfeeding and insufficient lactation ( OR=0.230, 95% CI: 0.091-0.582), and postpartum hemorrhage ( OR=0.288, 95% CI: 0.087-0.947) were barriers to breastfeeding ≥6 months. Conclusions:Appetite, sleep, access to the knowledge of breastfeeding, maternal complications, family support, and emotion can affect the rate and duration of breastfeeding in parturients admitted to ICU, for whom early assessment of basic information, active treatment of complications, breastfeeding education, and guidance from health professionals, and more family and social support can be helpful.

Therapeutic effects of venlafaxine combined with transcranial direct current stimulation on postpartum depression in 70 patients / 中国基层医药

Objective:To investigate the efficacy of venlafaxine combined with transcranial direct current stimulation in the treatment of postpartum depression and its effects on neurological function.Methods:A total of 135 patients with postpartum depression who were admitted to Wenzhou Seventh People's Hospital from November 2019 to October 2021 were included in this study. They were randomly divided into observation ( n = 70) and control ( n = 65) groups. The control group was treated with venlafaxine alone, and the observation group was treated with an IS200 intelligent electrical stimulator based on the treatment used in the control group. The two groups were treated for 4 weeks. Clinical efficacy and neurological function were compared between the two groups. Results:Total response rate in the observation group was significantly higher than that in the control group (98.57% vs. 89.23%, χ2 = 7.61, P < 0.05). After treatment, the scores of Edinburgh Postnatal Depression Scale and Hamilton Depression Scale in the observation group were (8.03 ± 0.79) points and (9.03 ± 3.98) points, respectively, which were significantly lower than (11.74 ± 0.98) points and (14.68 ± 3.79) points in the control group ( t = 3.28, 4.65, both P < 0.05). Standard deviation of heart rate variability, root mean square of successive differences between adjacent NN intervals, ratio of low frequency to high frequency, activity of the autonomic nervous system in the observation group were (32.38 ± 0.93) ms, (27.86 ± 0.78) ms, 1.79 ± 0.19, (86.65 ± 1.21) points, respectively, which were significantly higher than (27.84 ± 0.88) ms, (25.79 ± 0.81) ms, 1.38 ± 0.14, (82.94 ± 1.19) points in the control group ( t = 4.09, 3.72, 2.98, 4.09, all P < 0.05). Conclusion:Venlafaxine combined with transcranial direct current stimulation for treatment of postpartum depression can enhance clinical efficacy and remarkably improve patient's neurological function.

Common mental disorders in pregnancy and postnatal depressive symptoms in the MINA-Brazil study: occurrence and associated factors / Transtorno mental comum na gravidez e sintomas depressivos pós-natal no estudo MINA-Brasil: ocorrência e fatores associados

ABSTRACT OBJECTIVE To investigate the occurrence and factors associated with common mental disorders in pregnancy and depressive symptoms in postpartum, as well as the association between both in the Brazilian Western Amazon. METHODS This is a prospective cohort in the MINA-Brazil study with women who received primary health care in the town of Cruzeiro do Sul, Acre State. We performed two clinical evaluations during pregnancy (the first: 16-20 weeks; the second: 28 gestational weeks) and three postpartum evaluations (at 3, 6 and 12 months), in which demographic and socioeconomic, gestational, lifestyle and clinical data were collected. We used the Self-Reported Questionnaire (score ≥ 8) to screen the gestational common mental disorder and the Edinburgh Postnatal Depression Scale (score ≥ 10) to identify postpartum depressive symptoms. We used adjusted ordinal logistic regression to investigate the relationship between the covariates and the occurrence of common mental disorders in pregnancy and postpartum depressive symptomatology. RESULTS A total of 461 women completed the two clinical evaluations in pregnancy; of these, 247 completed the three postpartum evaluations. The occurrence of common mental disorder during pregnancy was 36.2% and 24.5% in the first and second evaluations, respectively, and the cumulative incidence was 9.2%. In addition, 50.3% maintained the disorder between evaluations. During postpartum, approximately 20% of the mothers presented depressive symptoms during the first year of their children's lives. Parity (≥ 2) was associated with common mental disorders, while low maternal education was associated with postpartum depressive symptoms. Women with a common mental disorder in both evaluations during pregnancy were 5.6 times more likely (95%CI: 2.50-12.60) to develop postpartum depressive symptoms. CONCLUSION The occurrence of common mental disorder at any time assessed during pregnancy, but especially its persistence from the second trimester, was strongly associated with depressive symptoms after childbirth. These findings highlight the need for early screening and monitoring of the mental health of pregnant women at the start of prenatal care in order to reduce possible negative impacts on the health of the mother-child binomial caused by such events.

RESUMO OBJETIVO Investigar a ocorrência e os fatores associados com os transtornos mentais comuns na gestação e sintomas depressivos no pós-parto, bem como a associação entre ambos na Amazônia Ocidental Brasileira. MÉTODOS Coorte prospectiva no estudo MINA-Brasil com mulheres atendidas na atenção primária à saúde de Cruzeiro do Sul, Acre. Foram realizadas duas avaliações clínicas na gestação (primeira: 16-20 semanas; segunda: 28 semanas gestacionais) e três avaliações no pós-parto (aos 3, 6 e 12 meses), nas quais foram coletados dados demográficos e socioeconômicos, gestacionais, de estilo de vida e clínicos. Utilizou-se o Self-Reported Questionnaire (escore ≥ 8) para rastreamento do transtorno mental comum gestacional e a escala de depressão pós-natal de Edimburgo (escore ≥ 10) para identificação de sintomas depressivos pós-parto. Foi utilizada regressão logística ordinal ajustada para investigar a relação entre as covariáveis e a ocorrência de transtornos mentais comuns na gravidez e a sintomatologia depressiva no pós-parto. RESULTADOS Um total de 461 mulheres completaram as duas avaliações clínicas na gestação; dessas, 247 completaram as três avaliações pós-parto. A ocorrência de transtorno mental comum durante a gestação foi de 36,2% e 24,5% na primeira e segunda avaliações, respectivamente, e a incidência cumulativa foi de 9,2%. Ademais, 50,3% mantiveram o transtorno entre as avaliações. Durante o pós-parto, aproximadamente 20% das mães apresentaram sintomatologia depressiva ao longo do primeiro ano de vida de seus filhos. A paridade (≥ 2) foi associada ao transtorno mental comum, enquanto a baixa escolaridade materna associou-se com sintoma depressivo pós-parto. Mulheres com transtorno mental comum nas duas avaliações na gravidez apresentaram 5,6 vezes mais chance (IC95% 2,50-12,60) de desenvolverem sintoma depressivo pós-parto. CONCLUSÃO A ocorrência de transtorno mental comum em qualquer momento avaliado durante a gravidez, mas principalmente sua persistência a partir do segundo trimestre, foi fortemente associado ao sintoma depressivo posterior ao parto. Tais achados evidenciam a necessidade de rastreamento precoce e monitoramento da saúde mental de gestantes no início do pré-natal, a fim de reduzir possíveis impactos negativos para a saúde do binômio mãe-filho causados por tais eventos.

Sintomas de depressão pós-parto e sua associação com as características socieconômicas e de apoio social / Síntomas de la depresión posparto y su asociación con características socioeconómicas y de apoyo social / Postpartum depression symptoms and association with socieconomic and social support characteristics

Resumo Objetivo verificar a prevalência de sintomas de depressão pós-parto em puérperas atendidas em uma maternidade pública e sua associação com características socioeconômicas e de apoio social. Método estudo epidemiológico, analítico, do tipo transversal, em uma maternidade pública conduzido de agosto a outubro de 2017. A amostra de 330 puérperas foi entrevistada por meio da aplicação de um formulário, para mensuração da presença de sintomas de depressão pós-parto. Foi utilizada a escala de depressão pós-natal de Edimburgo. Já para mensuração do apoio social, foi utilizado o instrumento Medical Outcomes Study. A medida de associação adotada foi a razão de prevalência (RP) com intervalos de confiança de 95% (IC95%), e aplicada a regressão de Poisson ajustada. Resultados a prevalência de sintomas de DPP foi de 29,7%. A idade entre 14 e 24 anos (PR:1,60; 95%CI: 1,10-2,34), ter até 8 anos de escolaridade (RP:1,39; IC95%:1,01-2,14) e o baixo nível de suporte social afetivo (RP:1,52; IC95%:1,07-2,14) e emocional (RP:2,12; IC95%:1,41-3,19) estiveram associados à maior prevalência de sintomas de DPP. Conclusão e implicações para a prática nesse contexto, os profissionais de saúde podem possuir um papel essencial no qual podem desenvolver, em conjunto, um plano de cuidados de acordo com as necessidades da mulher em período gravídico-puerperal.

Resumen Objetivo verificar la prevalencia de síntomas de depresión posparto en mujeres posparto atendidas en una maternidad pública y su asociación con características socioeconómicas y de apoyo social. Método estudio analítico transversal en una maternidad pública realizada entre agosto y octubre de 2017. La muestra de 330 puérperas fue entrevistada mediante la aplicación de un formulario, para medir la presencia de síntomas de depresión postparto. Se utilizó la Escala de Depresión Postnatal de Edimburgo. Para medir el apoyo social se utilizó el instrumento Medical Outcomes Study. La medida de asociación adoptada fue la razón de prevalencia (RP) con intervalos de confianza del 95% (IC del 95%) y se aplicó la regresión de Poisson ajustada. Resultados la prevalencia de síntomas de DPP fue de 29,7%. Edad entre 14 y 24 años (PR:1,60; 95%CI: 1,10-2,34), tener hasta 8 años de escolaridad (RP: 1,39; IC 95%: 1,01 - 2,14) y el bajo nivel de apoyo social afectivo (RP: 1,52; IC del 95%: 1,07 - 2,14) y emocional (RP: 2,12; IC del 95%: 1,41-3,19) se asociaron con una mayor prevalencia de síntomas de PPD. Conclusión e implicaciones para la práctica en este contexto, los profesionales de la salud pueden jugar un papel fundamental en el que puedan desarrollar conjuntamente un plan de cuidados acorde a las necesidades de la mujer en el período gestacional-puerperal.

Abstract Objective to verify the prevalence of postpartum depression symptoms in postpartum women assisted at a public maternity hospital and its association with socioeconomic and social support characteristics. Method this is an epidemiological, analytical, cross-sectional study in a public maternity hospital conducted from August to October 2017. A sample of 330 postpartum women was interviewed using a form to measure the presence postpartum depression symptoms. The Edinburgh Postnatal Depression Scale was used. To measure social support, the Medical Outcomes Study instrument was used. The measure of association adopted was the prevalence ratio (PR) with 95% confidence intervals (95%CI), and adjusted Poisson regression was applied. Results the prevalence of PPD symptoms was 29.7%. Age between 14 and 24 years (PR:1.60; 95%CI: 1.10-2.34), have up to 8 years of education (PR:1.39; 95%CI: 1.01-2.14) and the low level of affective (PR:1.52; 95%CI: 1.07-2.14) and emotional (PR:2.12; 95%CI: 1.41-3.19) social support were associated with higher prevalence of PPD symptoms. Conclusion and implications for practice in this context, health professionals can play an essential role in which they can jointly develop a care plan according to the needs of women in the pregnancy-puerperal period.

The first 20 weeks of pregnancy is a high-risk period for eating disorder relapse.

OBJECTIVE: Eating disorders (ED) are associated with adverse pregnancy outcome and pregnancy is associated with both relapse and remission of ED. Knowledge is lacking on the risk of ED relapse during pregnancy and the postpartum period for women in stable remission. This study examined the occurrence of perinatal ED relapse as well as obstetric and postpartum outcome in women with at least a 6-month ED remission before pregnancy. METHOD: A total of 122 women in stable remission before pregnancy were included in a prospective longitudinal study. Changes in ED symptoms based on the Eating Disorder Examination were systematically evaluated at each antenatal visit and in the postpartum period. RESULTS: A total of 30 (25%) women relapsed. Twenty women relapsed within the first 20 weeks of pregnancy and eight in the early weeks postpartum. Severe postpartum depression symptoms (33%) were frequent in women with ED relapse; hyperemesis gravidarum (30%) was frequently present independent of the woman's relapse status. DISCUSSION: To prevent relapse of ED and possible consequences, attention to relapse in women in stable remission is especially important in early pregnancy and in the postpartum period.

Migraine as a risk factor for mixed symptoms of peripartum depression and anxiety in late pregnancy: A prospective cohort study.

BACKGROUND: Migraine has been identified as a risk factor for peripartum depression. However, little is known about the contribution of anxiety to this association or potential changes throughout the peripartum period. METHODS: In a sample of 4,831 women from the Biology, Affect, Stress, Imaging and Cognition cohort in Sweden, participants were asked about history of migraine prior to pregnancy. The participants completed the Edinburgh Postnatal Depression Scale (EPDS) at gestational weeks 17 and 32 and postpartum week 6. Multinomial logistic regression analyses were used to assess associations between migraine and symptoms of depression, anxiety or mixed depression and anxiety, while adjusting for potential confounders. RESULTS: In crude estimates, migraine was associated with separate and mixed symptoms of depression and anxiety at most time points. After adjustments, migraine was associated with anxiety at week 17 (adjusted odds ratio: 1.69; 95% confidence interval: 1.11-2.54) and with mixed depression and anxiety at week 32 (adjusted odds ratio: 1.45; 95% confidence interval: 1.06-1.99). None of the other associations remained statistically significant after adjustments. LIMITATIONS: Migraine history was self-reported. Symptoms of depression and anxiety were based on the screening tool EPDS and not on clinical diagnoses. CONCLUSIONS: The results demonstrate that migraine may be a risk factor for anxiety in mid- pregnancy and mixed symptoms of peripartum depression and anxiety in late pregnancy. Inflammatory and hormonal factors may underlie the association between migraine, depression and anxiety across the peripartum period.

Postnatal depression: identification of risk factors in the short-stay maternity program in Belgium. A cross-sectional study.

BACKGROUND: Postnatal depression (PND) is one of the most frequent complications in women of childbearing age in the developed world. The onset of PND is influenced by several risk factors. In an attempt to avoid unnecessary long maternity stays, the Short Stay Maternity programme was launched, shifting care from the hospital environment to the outpatient setting. AIM: In order to develop an efficient programme to trace vulnerable women after childbirth and to provide support within primary care, the aim was to create an inventory of the risk factors for PND within the population of women participating in the short-stay programme. DESIGN & SETTING: This study is a cross-sectional study without follow-up. Women in Belgium were invited by email to participate in the Short Stay Maternity programme within 3 months of delivery. METHOD: The questionnaire addressed background features and feelings during the maternity period, supplemented with the validated Dutch version of the Edinburgh Postnatal Depression Scale (EPDS). The primary outcome measure of the questionnaire was the score on the EPDS. RESULTS: A total of 131 (27.46%) of the invited women participated. Sixteen participants (12.21%) presented with a positive score on the EPDS. The odds ratio (OR) for a positive score on the EPDS when experiencing negative feelings was 13.5 (95% confidence interval [CI] = 4.14 to 44.01). If only material support was provided, the OR for a positive EPDS score was OR 11.2 (95% CI = 2.72 to 55.5). CONCLUSION: In this study, two risk factors were identified for PND: negative feelings during pregnancy and the provision of only material support by the partner.