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2.
Int J Gynaecol Obstet ; 153(1): 83-88, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33368216

RESUMO

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.


Assuntos
Parto Obstétrico , Depressão Pós-Parto , Parto/psicologia , Estresse Psicológico , Adulto , /prevenção & controle , Estudos Transversais , Parto Obstétrico/métodos , Parto Obstétrico/psicologia , Parto Obstétrico/estatística & dados numéricos , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Idade Gestacional , Humanos , Satisfação Pessoal , Período Pós-Parto/psicologia , Gravidez , Espanha/epidemiologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia
3.
Sci Rep ; 10(1): 22380, 2020 12 24.
Artigo em Inglês | MEDLINE | ID: mdl-33361797

RESUMO

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.


Assuntos
Afeto , /prevenção & controle , Depressão Pós-Parto/epidemiologia , Pandemias/prevenção & controle , Período Pós-Parto/psicologia , Quarentena/psicologia , Classe Social , Adolescente , Adulto , Estudos de Coortes , Depressão Pós-Parto/diagnóstico , Feminino , Humanos , Saúde Mental , Cidade de Nova Iorque/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Adulto Jovem
4.
Nutr. hosp ; 37(6): 1238-1245, nov.-dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-198316

RESUMO

INTRODUCTION: vitamin D deficiency (VDD) has been associated with depressive symptoms in pregnancy and postpartum, which can result in increased adverse outcomes in the maternal-infant segment. A possible explanation in the literature is VDD relationship with genetic and neurological mechanisms. OBJECTIVE: to evaluate VDD relationship with gestational and postpartum depression. METHODS: this review followed the recommendations proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Research was conducted in electronic databases, PubMed and LILACS, including studies of the analytical type (cross-sectional and longitudinal), systematic reviews, meta-analyses, and controlled clinical trials carried out in humans; inclusion and exclusion criteria were applied. RESULTS AND CONCLUSIONS: in this systematic review, eight articles were analyzed comprising 8,583 women from seven different countries. Among the selected articles, six found an association between VDD and gestational and postpartum depression. Considering the data collection, it was possible to conclude that there is a probable relationship between VDD and a higher predisposition to gestational and postpartum depression. Also, we concluded that vitamin D supplementation has proven to be a promising strategy for reducing the risk of depressive symptoms


INTRODUCCIÓN: la deficiencia de vitamina D (VDD) se ha asociado a síntomas depresivos en el embarazo y el posparto, lo que puede resultar en un aumento de los resultados adversos en el segmento materno-infantil. Una posible explicación en la literatura es la relación de la VDD con mecanismos genéticos y neurológicos. OBJETIVO: evaluar la relación de la VDD con la depresión gestacional y posparto. MÉTODOS: esta revisión siguió las recomendaciones propuestas por los Elementos de Informes Preferidos para revisiones sistemáticas y metaanálisis. La investigación se llevó a cabo en bases de datos electrónicas, PubMed y LILACS, incluyendo estudios de tipo analítico (sección transversal y longitudinal), revisiones sistemáticas, metaanálisis y ensayos clínicos controlados realizados en seres humanos; se aplicaron criterios de inclusión y exclusión. RESULTADOS Y CONCLUSIONES: en esta revisión sistemática se analizaron ocho artículos que comprenden a 8716 mujeres de siete países diferentes. Entre los artículos seleccionados, seis encontraron asociación entre la VDD y la depresión gestacional y posparto. Teniendo en cuenta la recopilación de datos, fue posible concluir que existe una relación probable entre la VDD y una mayor predisposición a la depresión gestacional y posparto. También llegamos a la conclusión de que la suplementación con vitamina D ha demostrado ser una estrategia prometedora para reducir el riesgo de síntomas depresivos


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Vitamina D/administração & dosagem , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/diagnóstico , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/dietoterapia
5.
Lancet Psychiatry ; 7(9): 775-787, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32828167

RESUMO

BACKGROUND: Maternal depression has a recurring course that can influence offspring outcomes. Evidence on how to treat maternal depression to improve longer-term maternal outcomes and reduce intergenerational transmission of psychopathology is scarce, particularly for task-shifted, low-intensity, and scalable psychosocial interventions. We evaluated the effects of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal. METHODS: 40 village clusters in Pakistan were randomly allocated using a computerised randomisation sequence to receive a group-based, psychosocial intervention and enhanced usual care for 36 months, or enhanced usual care alone. Pregnant women (≥18 years) were screened for moderate or severe symptoms of depression (patient health questionnaire-9 [PHQ-9] score ≥10) and were recruited into the trial (570 participants), and a cohort without depression (PHQ-9 score <10) was also enrolled (584 participants). Including the non-depressed dyads enabled us to determine how much of the excess risk due to maternal depression exposure the intervention could mitigate. Research teams responsible for identifying, obtaining consent, and recruiting trial participants were blind to the allocation status throughout the duration of the study, and principal investigators, site coordinators, statisticians, and members of the trial steering committee were also blinded to the allocation status until the analysis of 6-month data for the intervention. Primary outcomes were maternal depression symptoms and remission (PHQ-9 score <10) and child socioemotional skills (strengths and difficulties questionnaire [SDQ-TD]) at 36-months postnatal. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, NCT02658994. FINDINGS: From Oct 15, 2014 to Feb 25, 2016 46 village clusters were assessed for eligibility, of which 40 (including 1910 mothers were enrolled. After exclusions, 288 women were randomly assigned to the enhanced usual care group and 284 to the intervention group, and 1159 women were included in a group without prenatal depression. At 36-months postnatal, complete data were available from 889 mother-child dyads: 206 (72·5%) in the intervention group, 216 (75·3%) in the enhanced usual care group, and 467 (80·0%) women who did not have prenatal-depression. We did not observe significant outcome differences between the intervention group and the enhanced usual care group for the primary outcomes. The standardised mean difference of PHQ-9 total score was -0·13 (95% CI -0·33 to 0·07), relative risk of patient health questionnaire-9 remission was 1·00 (95% CI 0·88 to 1·14), and the SDQ-TD treatment estimate was -0·10 (95% CI -1·39 to 1·19). INTERPRETATION: Reduced symptom severity and high remission rates were seen across both the intervention and enhanced usual care groups, possibly masking any effects of the intervention. A multi-year, psychosocial intervention can be task-shifted via peers but might be susceptible to reductions in fidelity and dosage over time (which were not among the outcomes of this trial). Early intervention efforts might need to rely on multiple models (eg, collaborative care), be of greater intensity, and potentially targeted at mothers who are at high risk for depression to reduce the intergenerational transmission of psychopathology from mothers to children. FUNDING: National Institutes of Health.


Assuntos
Desenvolvimento Infantil , Depressão Pós-Parto/terapia , Relações Mãe-Filho , Mães/psicologia , Grupo Associado , Psicoterapia de Grupo/métodos , Adolescente , Adulto , Comportamento Infantil , Pré-Escolar , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/psicologia , Feminino , Humanos , Paquistão , Escalas de Graduação Psiquiátrica , Resultado do Tratamento , Adulto Jovem
6.
Arch Womens Ment Health ; 23(5): 727-735, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32666402

RESUMO

The objective of this study is to explore the associations between the patient-reported Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ)-9 and clinician-reported 17-item Hamilton Depression Rating Scale (HAMD-17) in order to facilitate clinical decision-making. An integrated efficacy dataset of three randomized placebo-controlled trials (NCT02614547, NCT02942004, and NCT02942017) evaluating brexanolone injection, a neuroactive steroid chemically identical to allopregnanolone, in women with postpartum depression was used for this post hoc analysis. Data were pooled across treatment arms. Associations were assessed at day 30 (end-of-trial follow-up). Pearson correlation assessed the relationship between EPDS and PHQ-9 item and total scores and HAMD-17 total score. Cohen's kappa assessed agreement of EPDS remission (score < 10) and PHQ-9 remission (score < 5) with HAMD-17 remission (score ≤ 7). Ordinary least squares (OLS) regression models were used to develop equations estimating HAMD-17 total scores from EPDS and PHQ-9 scores, respectively. The total scores showed large correlations (HAMD-17/EPDS: r = 0.71, p < 0.001; HAMD-17/PHQ-9: r = 0.75, p < 0.001). Individual EPDS and PHQ-9 items significantly correlated (r= 0.35 to 0.67, all p < 0.001) with HAMD-17 total score. EPDS had 79% sensitivity and 67% specificity to detect HAMD-17 remission; corresponding estimates for PHQ-9 were 76% and 78%. OLS models yielded the following equations: HAMD-17 total = 2.66 + (EPDS total × 0.87) and HAMD-17 total = 3.99 + (PHQ-9 total × 0.97). There were large and statistically significant associations between patient-reported outcomes (EPDS, PHQ-9) and clinician-reported outcomes (HAMD-17) as clinical improvements were associated with patient-reported symptom improvement. These results provide tools to help translate clinical trial data to clinical practice, thus aiding shared decision-making for this critical population.


Assuntos
Depressão Pós-Parto/diagnóstico , Medidas de Resultados Relatados pelo Paciente , Escalas de Graduação Psiquiátrica/normas , Adulto , Combinação de Medicamentos , Feminino , Humanos , Programas de Rastreamento , Questionário de Saúde do Paciente/normas , Pregnanolona/administração & dosagem , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Inquéritos e Questionários/normas , beta-Ciclodextrinas/administração & dosagem
7.
Womens Health Issues ; 30(4): 231-239, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32527464

RESUMO

BACKGROUND: Limited research has focused on longitudinal interrelations between perceived social support, perceived stress, and depressive symptoms beyond the first postpartum months. This study tested an alternative primary hypothesis within the stress process model examining whether perceived stress mediated the association between perceived social support and depressive symptoms from 1 to 24 months postpartum. Secondary purposes examined whether these factors 1) changed from 1 to 24 months postpartum and 2) predicted depressive symptoms. METHODS: Women (N = 1,316) in a longitudinal cohort study completed validated measures of perceived social support, perceived stress, and depressive symptoms at 1, 6, 12, 18, and 24 months postpartum via telephone interviews. Analyses examined changes in psychosocial factors (repeated measures analysis of variance) and the extent to which perceived social support and perceived stress predicted depressive symptoms and supported mediation (linear regression). RESULTS: Perceived social support decreased, perceived stress increased, and depressive symptoms remained constant from 1 to 18 months, then increased at 24 months. Low perceived social support predicted 6-month depressive symptoms, whereas perceived stress predicted depressive symptoms at all time points. Perceived stress mediated the association between perceived social support and depressive symptoms across 24 months such that low perceived social support predicted perceived stress, which in turn predicted depressive symptoms. CONCLUSIONS: Intervention scientists may want to focus on strengthening perceived social support as a means to manage perceived stress in an effort to prevent a long-term trajectory of depression.


Assuntos
Depressão Pós-Parto/etiologia , Depressão/psicologia , Mães/psicologia , Apoio Social , Estresse Psicológico/etiologia , Adulto , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Estudos Longitudinais , Período Pós-Parto/psicologia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários
8.
Epidemiol Psychiatr Sci ; 29: e133, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32482189

RESUMO

Abstract. AIMS: Intimate partner violence (IPV) is an important risk factor for perinatal depression (PND). But IPV's impact on the natural prognosis of PND symptoms is not well understood. We tested two hypotheses: (1) pregnant women with IPV experiences will exhibit more severe PND symptoms than women without IPV experience; (2) IPV experience will impede the recovery prognosis of PND. We also explored the contribution of IPV to PND comparing with other risk factors. METHOD: The sample is comprised of 813 pregnant women followed through perinatal period in Hunan, China. We assessed IPV experience using items from the Short Form of the Revised Conflict Tactics Scale (CTS2S), and PND symptoms via the Edinburgh Postnatal Depression Scale (EPSD). We conducted Linear Mixed-effects Model to compare the trajectories of PND symptoms between victims and non-victims and a multistage Generalised Estimating Equations Model to explore salient factors on the trajectory of PND symptoms. RESULTS: There were 90 participants (11.07%) who reported IPV experience in the past 12 months. With respect to physical, psychological and sexual violence, the prevalence was 4.55% (37/813), 9.23% (75/813) and 2.34% (19/813). Victims reported more severe PND symptoms (t = 5.30, p < 0.01) and slower decreasing slope of trajectories (t = 28.89, p < 0.01). The PND trajectory was associated with IPV experience (OR = 3.78; 95% CI 1.39-10.26), social support (OR = 0.93; 95% CI 0.88-0.97), positive coping strategies (OR = 0.85; 95% CI 0.80-0.91), negative coping strategies (OR = 1.25; 95% CI 1.14-1.37) and monthly income of $0.15-$298.36 (compared to no income, OR = 0.0075; 95% CI 0.00052-0.11). CONCLUSIONS: The findings suggest the reported prevalence of IPV is lower in Hunan than most of the previous studies during perinatal period in other provinces of China, and IPV victimisation is associated with increased severity and slowed prognosis of PND symptoms. Future studies that screen for victimisation and establish its explicit mechanism to the poorer prognosis of PND symptoms would benefit the prevention and treatment of PND.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Vítimas de Crime/psicologia , Depressão Pós-Parto/diagnóstico , Depressão/diagnóstico , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Mães/psicologia , Delitos Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Adaptação Psicológica , Adulto , China/epidemiologia , Estudos de Coortes , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Violência por Parceiro Íntimo/etnologia , Pessoa de Meia-Idade , Assistência Perinatal , Pobreza/psicologia , Gravidez , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Delitos Sexuais/etnologia , Apoio Social , Adulto Jovem
9.
Enferm. clín. (Ed. impr.) ; 30(supl.5): 129-132, jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-196492

RESUMO

Postpartum depression (PPD) is quite large, where there are 1 in 25 postpartum women experiencing PPD who still report symptoms of PPD after six months. The highest risk of experiencing PPD is more experienced by primiparas detected in 10-19 postpartum days. For PPD to not adversely affect the mother and baby, initial screening is needed to prevent the occurrence of PPD by using an Android-based EPDS application. The research objectives are an early screening of baby blues based on Android application and to determine the factors influence of baby blues. Participants download EPDS apps to make it easier for participants to screen the baby blues at the beginning of the first week after giving birth. On fourth week, the mothers refill EPDS apps screening to compare the results of screening the first week with fourth week using the Dependent T-test. In this study also analyzed the factors that influence the baby blues such as education, employment, parity, and age using the ANOVA Test. The study sample was the first-week postpartum mothers with a total sample of 64 people. The average EPDS screening results in the first week were 6.64, with a standard deviation of 2.57. The screening results on fourth week are 6.70, with a standard deviation of 2.53. The results of statistical tests obtained p-value 0.208; it can conclude that there was no difference in the results of screening tests in the first week with the fourth week. PPD events occur mostly in primiparas and women aged <20 years with p-value 0.001, while in education p-value 0.596 and employment-value 0.784. It recommended for pregnant women and health workers to do screening in the first week of postpartum so that it can detect PPD early


No disponible


Assuntos
Humanos , Feminino , Adulto Jovem , Adulto , Diagnóstico Precoce , Transtornos Puerperais/diagnóstico , Aplicativos Móveis , Depressão Pós-Parto/diagnóstico , Análise de Variância , Período Pós-Parto
10.
Arch Gynecol Obstet ; 302(1): 53-64, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32372342

RESUMO

PURPOSE: Physical activity can reduce pregnancy-related complications and contributes substantially to improving maternal mental health. A reduction in activity encompassing exercise and daily household tasks throughout the course of pregnancy increases the risk of depression and anxiety. The following research examines the longitudinal interaction between exercise, general physical activity, and mental health outcomes in pregnant women. METHODS: This prospective longitudinal study was conducted at the maternity departments of two major university hospitals in Germany. Self-reported data of 597 women were digitally assessed every 4 weeks from the second trimester until birth as well as 3 and 6 months postnatally. Depressive and anxiety symptoms were assessed using the EPDS, PRAQ, and STAI and physical activity levels were measured using the PPAQ questionnaire. Cross-sectional and longitudinal analyses using Pearson's correlation coefficient and multiple regression models were conducted. RESULTS: We found a significant reduction in general physical activity in the period from the 20th to 32nd gestational week. Women who reported a greater decline during pregnancy showed significantly higher depression and anxiety scores. In stratified analyses, only baseline mental health scores proved to be variables with stronger impact on postnatal depression and anxiety outcomes. CONCLUSION: General physical activity and maternal mental health significantly influence each other during and after pregnancy. Both physical activity and the prevention of perinatal mental disorders should be systematically encouraged during perinatal care to prevent adverse maternal and fetal birth outcomes.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Exercício Físico/psicologia , Saúde Mental/estatística & dados numéricos , Gestantes/psicologia , Adulto , Ansiedade/diagnóstico , Ansiedade/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/psicologia , Depressão Pós-Parto/diagnóstico , Feminino , Alemanha/epidemiologia , Humanos , Estudos Longitudinais , Gravidez , Complicações na Gravidez/psicologia , Cuidado Pré-Natal , Estudos Prospectivos , Autorrelato , Autoavaliação
11.
BMC Psychiatry ; 20(1): 250, 2020 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-32434583

RESUMO

BACKGROUND: The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed the mental health of pregnant women with threatened preterm labour (TPL). This study investigated the prevalence of self-perceived burden (SPB) among Chinese women hospitalized due to TPL during pregnancy and early postpartum depressive disorders, exploring the effect of SPB and other potential risk factors on the early signs of postpartum depressive disorders. METHODS: A self-reported survey was conducted in the obstetrics department of Anhui Provincial Hospital, China. Women hospitalized with TPL were approached 1 week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. The Self-Perceived Burden Scale (SPBS) and Edinburgh Postnatal Depression Scale (EPDS) were the main measures. Descriptive statistics, Spearman correlations, and a multiple logistic regression were employed for data analysis. RESULTS: SPB and early postpartum depressive disorders were commonly experienced by Chinese women hospitalized with TPL, and SPB was positively and significantly correlated with depressive symptoms. A multiple logistic regression analysis revealed that for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.42, 95% CI = 1.11-1.83, p = 0.006), age (OR = 1.14, 95% CI = 1.02-1.27, p = 0.023), occupation (OR = 3.48, 95% CI = 1.18-10.20, p = 0.023), the history of scarred uterus (OR = 7.96, 95% CI = 1.49-42.48, p = 0.015), the delivery mode of the present birth (OR = 6.19, 95% CI = 1.72-22.30, p = 0.005), and family support during pregnancy (OR = 0.60, 95% CI = 0.45-0.82, p = 0.001) were significant factors predicting early postpartum depressive symptoms. CONCLUSION: This study indicates that SPB and early postpartum depressive disorders are prevalent mental issues among Chinese women hospitalized with TPL, and that SPB, especially perceived emotional burden, is a strong predictor of early postpartum depressive disorders. Our study suggests the necessity of paying attention to mental health issues, e.g. SPB and postpartum depressive symptoms among hospitalized women with TPL, and providing appropriate interventions at the prenatal stage to prevent adverse consequences.


Assuntos
Depressão/psicologia , Hospitalização/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Complicações na Gravidez/psicologia , Gravidez de Alto Risco/psicologia , Adulto , China , Depressão/diagnóstico , Depressão/etnologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/etnologia , Feminino , Humanos , Recém-Nascido , Transtornos Mentais/etnologia , Trabalho de Parto Prematuro/epidemiologia , Trabalho de Parto Prematuro/etiologia , Período Pós-Parto , Gravidez , Fatores de Risco
12.
MMWR Morb Mortal Wkly Rep ; 69(19): 575-581, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32407302

RESUMO

INTRODUCTION: Perinatal depression is a complication of pregnancy that can result in adverse maternal and infant outcomes. Screening to identify pregnant and postpartum women with depressive symptoms is recommended to provide diagnosis, treatment, and follow-up care to reduce poor outcomes. METHODS: CDC analyzed 2018 data from the Pregnancy Risk Assessment Monitoring System to describe postpartum depressive symptoms (PDS) among women with a recent live birth and to assess whether health care providers asked women about depression during prenatal and postpartum health care visits, by site and maternal and infant characteristics. RESULTS: Among respondents from 31 sites, the prevalence of PDS was 13.2%, ranging from 9.7% in Illinois to 23.5% in Mississippi. The prevalence of PDS exceeded 20% among women who were aged ≤19 years, were American Indian/Alaska Native, smoked during or after pregnancy, experienced intimate partner violence before or during pregnancy, self-reported depression before or during pregnancy, or whose infant had died since birth. The prevalence of women reporting that a health care provider asked about depression during prenatal care visits was 79.1% overall, ranging from 51.3% in Puerto Rico to 90.7% in Alaska. The prevalence of women reporting that a provider asked about depression during postpartum visits was 87.4% overall, ranging from 50.7% in Puerto Rico to 96.2% in Vermont. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: The prevalence of self-reported PDS varied by site and maternal and infant characteristics. Whether providers asked women about perinatal depression was not consistent across sites. Provision of recommended screenings and appropriate referrals for diagnosis, treatment, and follow-up care can ensure early and effective management of depression to reduce adverse maternal and infant outcomes.


Assuntos
Comunicação , Depressão Pós-Parto/psicologia , Pessoal de Saúde/psicologia , Programas de Rastreamento/estatística & dados numéricos , Padrões de Prática Médica , Adolescente , Adulto , Depressão Pós-Parto/diagnóstico , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Cuidado Pós-Natal , Gravidez , Cuidado Pré-Natal , Estados Unidos , Adulto Jovem
13.
BMC Womens Health ; 20(1): 99, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32393225

RESUMO

BACKGROUND: Previous studies have demonstrated that appropriate treatment for postoperative pain can lead to improvement in depressive symptoms, however the association between adequate intrapartum pain control and the development of postpartum depression is not clear. The purpose of the study was to examine the effects of labor epidural analgesia and postpartum depression. METHODS: We performed a quantitative systematic review in compliance with the PRISMA statement. We conducted a search of PubMed, Embase, the Cochrane Database of Systematic Reviews and Google Scholar databases. The primary outcome was a positive screen of postpartum depression among women who received labor epidural analgesia up to 3 months into the postpartum period. Meta-analysis was performed using the random effect model. RESULTS: Of the 148 studies available, 9 studies with 4442 patients were included in the analysis. The use of labor analgesia on positive depression screen compared to control revealed no significant effect, OR (95% CI) of 1.02 (0.62 to 1.66, P = 0.94). CONCLUSION: Based on current literature, the use of epidural analgesia for pain relief during labor doesn't appear to affect the likelihood of postpartum depression. Future studies are warranted to further investigate these findings and identity other possible preventative interventions that reduce postpartum depression.


Assuntos
Analgesia Epidural/efeitos adversos , Analgésicos/uso terapêutico , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/psicologia , Dor do Parto/terapia , Analgesia Epidural/métodos , Analgesia Epidural/psicologia , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Dor do Parto/psicologia , Manejo da Dor , Gravidez
14.
PLoS One ; 15(4): e0231940, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32343736

RESUMO

INTRODUCTION: Postnatal depression (PND) is a major cause of negative health-related behaviors and outcomes during infancy, childhood and adolescent period. In Africa, the burden of postnatal depression is high. However, it is under-investigated hence under-treated. To fill this information gap and to advise further interventions, we aimed at analyzing its epidemiology in Africa. METHODS: We searched observational studies conducted in Africa and published in between 01/01/2007 and 30/06/2018 in CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases. We assessed the quality of the studies using the Newcastle Ottawa Scale (NOS) and included studies with good quality. We evaluated the heterogeneity using the Higgins I2 statistics. We used a random-effects model to pool estimates. We assessed publication bias using the funnel plot and Egger's test statistics and adjusted using Tweedie's and Duval Trim and Fill analysis. The protocol has been registered in the PROSPERO (Protocol No. CRD42018100461). RESULTS: Nineteen studies involving 40,953 postnatal mothers were part of this systematic review and meta-analysis. The overall pooled prevalence of PND was 16.84% (95% CI: 14.49% -19.19%). The odds of having PND was higher among women with a poor obstetric condition (POR = 2.11; 95% CI: 1.11-4.01) and history of adverse birth and infant health outcomes (POR = 2.85; 95% CI: 1.29-6.25). Having a history of common mental health disorders (POR = 2.47; 95% CI: 1.51-4.04), poor social support (POR = 2.06; 95% CI: 1.05-4.05), lower economic status (POR = 2.38; 95% CI: 1.75-3.23), and those who had exposure to a different form of intimate partner violence (POR = 2.87; 95% CI: 1.60-5.16) had higher odds of PND. CONCLUSION: While robust prevalence studies are scarce, our review indicated a high prevalence rate of postnatal depression. The analysis also identified postpartum women at increased risk of PND. Therefore, there is a need to design and escalate comprehensive strategies to decrease its burden, focusing on those women at risk of PND.


Assuntos
Depressão Pós-Parto/diagnóstico , África/epidemiologia , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Violência por Parceiro Íntimo , Transtornos Mentais/patologia , Razão de Chances , Prevalência , Apoio Social , Fatores Socioeconômicos
15.
Infant Behav Dev ; 59: 101444, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32244071

RESUMO

BACKGROUND: The birth of a premature infant is both a stressful event for both parents and associated with an increased rate of postnatal depression (PND). Additionally some mothers may have delayed feelings of attachment to their babies because of the medical procedures or possible medical complications. Social support is known as an important factor for well-being in the postnatal period. However there is scarce data about these factors for fathers. We aimed to identify the impact of parental PND, attachment style and social support on premature infant development considering the prematurity degree and risk groups. METHODS: This prospective study was conducted by including 96 infants who were born preterm. Mothers and fathers were given Edinburgh Postnatal Depression Scale (EPDS), Adult Attachment Style Scale (AASS), and Multidimensional Scale of Perceived Social Support (MSPSS) to fill out when their infants' corrected age was 3 months. The developmental evaluation was conducted with Bayley III at the corrected 6 months and 18 months of age. RESULTS: Postnatal depression scores were more in mothers than fathers, the rates of secure attachment and social support were similar between mothers and fathers. Factors associated with the neurodevelopmental outcomes including prematurity degree and risk groups, EPDS, AASS and MSPSS scores were analyzed for both parents. In multivariate analysis, fathers' depression scores were inversely associated with cognitive development (p = 0.030, R2 = 0.080, B=-0.283) and mothers' anxious/ambivalent attachment style was inversely associated with language development (p = 0.011, R2 = 0.108, B=-0.329) at the age of corrected 6 months old. CONCLUSIONS: Our findings underscore that the efforts to improve developmental outcomes of premature infants should include parental well-being taking into account new fathers' depressive symptomatology and maternal anxious/ambivalent attachment.


Assuntos
Desenvolvimento Infantil , Depressão Pós-Parto/psicologia , Recém-Nascido Prematuro/psicologia , Apego ao Objeto , Pais/psicologia , Apoio Social , Adulto , Desenvolvimento Infantil/fisiologia , Depressão Pós-Parto/diagnóstico , Pai/psicologia , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro/fisiologia , Estudos Longitudinais , Masculino , Mães/psicologia , Estudos Prospectivos , Fatores de Risco
16.
Orv Hetil ; 161(10): 374-381, 2020 Mar.
Artigo em Húngaro | MEDLINE | ID: mdl-32115991

RESUMO

Introduction: Pregnancy is usually desired, yet it has its own difficulties that can be overwhelming, thus depression might occur. The prevalence of this is 6.58-26.7% in the international literature and 6.5-17.9% in Hungarian studies. Aim: The aim was to analyze the data of the perinatal depression screening program of Békéscsaba which started in 2014. We wanted to study the pathological rate and the connection between demographic data and depression symptoms. Method: Until august 2019, 1708 women took part in the program. The screening is done by perinatal nurses: they explain the aims and hand over the Edinburgh Postnatal Depression Scale three times during pregnancy and once postpartum. They also suggest women in need to attend the psychological intervention as part of the screening. Results: The prevalence of the pathological questionnaires were 15.31%, 14.29%, 11.87%, and 12.68% at the four measuring occasions. In the whole sample, 18.27% of women had pathological score at least once. The depression scores of the four measurements correlated significantly with each other. Women who did not plan their pregnancies had higher level of depression in all four measurements. In the first trimester, women who were under 21 years old and/or were single had higher depression scores. In the second trimester, multipara women tended to have higher scores. Conclusion: The high prevalence and the constant level of depression emphasize the importance of the screening and psychological intervention, as previous studies found connection between depression and some perinatal complications. Some demographic factors can indicate more vulnerable women. Orv Hetil. 2020; 161(10): 374-381.


Assuntos
Depressão Pós-Parto/psicologia , Depressão/diagnóstico , Programas de Rastreamento/métodos , Complicações na Gravidez/psicologia , Cuidado Pré-Natal/métodos , Adulto , Depressão/epidemiologia , Depressão/psicologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Hungria/epidemiologia , Idade Materna , Assistência Perinatal , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Adulto Jovem
17.
Int J Gynaecol Obstet ; 149(2): 203-210, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32078159

RESUMO

OBJECTIVE: To determine the prevalence and key predictors of perinatal depression among women in Accra. METHOD: A two-step hospital-based cross-sectional study from May to July 2016. Patient Health Questionnaire version 9 was administered to postpartum mothers, and those aged 18 years or older with scores above 5 who delivered at LEKMA, Ridge, and Korle Bu Hospitals were recruited. A modified Edinburgh Postnatal Depression Scale was used to assess depression at 2 weeks postpartum. Associations between perinatal depression and sociodemographic/obstetric variables were assessed by χ2 and multivariate logistic regression. RESULTS: Among 1456 women screened, the prevalence of mental health disorders was 27.5% (400/1456). Of 350 women recruited, perinatal depression at 2 weeks postpartum was 8.6%, 31.6%, and 41.1% at LEKMA, Ridge, and Korle Bu, respectively. Mothers younger than 20 years and older than 35 years at Korle Bu had depression. Vaginal delivery increased the odds of perinatal depression at Ridge and Korle Bu. Blood transfusion was associated with depression at all three hospitals. CONCLUSION: Blood transfusion, but not other variables, was associated with perinatal depression at 2 weeks postpartum in Accra. Understanding the prevalence of perinatal depression and its associated risk factors in Ghana will aid policy decisions, planning, and clinical management.


Assuntos
Parto Obstétrico/efeitos adversos , Depressão Pós-Parto/epidemiologia , Depressão/epidemiologia , Adolescente , Adulto , Transfusão de Sangue/estatística & dados numéricos , Estudos de Casos e Controles , Estudos Transversais , Depressão/diagnóstico , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/etiologia , Feminino , Gana/epidemiologia , Humanos , Modelos Logísticos , Gravidez , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco
18.
PLoS One ; 15(2): e0228666, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32040495

RESUMO

OBJECTIVE: Postpartum depression (PPD) is inversely correlated with women's functioning, marital and personal relationships, mother-infant interaction quality, and children's social, behavioural, and cognitive development. The purpose of this study was to determine the prevalence of postpartum depression (PPD) in Riyadh and correlate them with possible predictors by a cross-sectional approach. METHODS: In this study, 174 mothers receiving treatments in different hospitals of Riyadh completed self-administered measures of the Edinburgh Postnatal Depression Scale (EPDS) along with a list of probable predictors. The data was analyzed by logistic regression analysis using SPSS-IBM 25. RESULTS: Of 174 participants of the study, 38.50% (n = 67) reported postpartum depression. Around (115) of the participants were in an age group of 25-45 years with most of them highly educated (101) but unemployed (136). Significant association was noted between occurrence of PPD with unsupportive spouse (P value = 0.023) and recent stressful life events (P value = 0.003). The significant predictors for PPD were unsupportive spouse (OR = 4.53, P = 0.049), recent stressful life events (OR = 2.677, P = 0.005), and Caesarean section as a mode of delivery (OR = 1.958, P = 0.049). CONCLUSION: The prevalence of PPD among the study participants was high, especially those with recent stressful life event and unsupportive spouse. To promote health and wellbeing of mothers, it was recommended to screen all high-risk mothers for PPD, when they visit hospitals for postnatal follow ups. Prevention of PPD is not only essential for wellbeing of mothers but it is important to provide good conducive atmosphere for the new born.


Assuntos
Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Relações Mãe-Filho , Adolescente , Adulto , Cesárea , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Mães/psicologia , Prevalência , Escalas de Graduação Psiquiátrica , Análise de Regressão , Fatores de Risco , Arábia Saudita/epidemiologia , Inquéritos e Questionários , Adulto Jovem
19.
Depress Anxiety ; 37(5): 449-457, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32058628

RESUMO

BACKGROUND: The aim of this study was to examine the impact of watching an educational video on infant crying within 1 week of age after delivery at maternity wards to reduce the prevalence of postpartum depressive symptoms at 1 month after giving birth. METHODS: The study design was a cluster randomized controlled trial. The intervention hospitals were randomly assigned, stratified by area and function of the hospital. Participants included 47 obstetrics hospitals or clinics out of 150 hospitals or clinics in Osaka Prefecture, Japan. In total, 44 hospitals or clinics completed the trial and 2,601 (intervention group = 1,040, control group = 1,561) caregivers responded to the questionnaire on postpartum depression (response rate: 55.1%). Mothers in the intervention group watched an educational video, within 1 week of age, during hospitalization at maternity wards. Primary outcome in this study was postpartum depression assessed by the Edinburgh Postnatal Depression Scale as 9+ and assessed via questionnaire at a 1-month health checkup. RESULTS: In the intervention group, 142 (13.7%) mothers reported postpartum depression compared to 250 (16.0%) in the control group. Intention-to-treat analysis showed no significant difference in the prevalence of postpartum depression between the groups. However, among young mothers (<25 years), the analysis showed a 67.0% reduction in postpartum depression (odds ratio: 0.33, 95% CI: 0.15-0.72). CONCLUSIONS: Watching an educational video on infant crying within 1 week after delivery at maternity wards did not reduce postpartum depression at 1 month after giving birth, but it was effective for young mothers aged <25 years.


Assuntos
Choro/psicologia , Depressão Pós-Parto/prevenção & controle , Depressão/prevenção & controle , Educação em Saúde/métodos , Mães/educação , Mães/psicologia , Cuidado Pós-Natal/métodos , Gravação de Videoteipe , Adulto , Depressão/diagnóstico , Depressão Pós-Parto/diagnóstico , Feminino , Humanos , Lactente , Japão , Masculino , Gravidez , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
20.
Curr Psychiatry Rep ; 22(1): 1, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31912372

RESUMO

PURPOSE OF REVIEW: This paper reviews literature on perinatal depression prevalence, consequences, and screening among low-income women and women of color. We introduce the Warm Connections program's innovative perinatal depression screening protocol and explore perinatal depression patterns among WIC participants. RECENT FINDINGS: Perinatal depression negatively impacts maternal and child outcomes. Research shows mixed findings of perinatal depression prevalence rates among low-income women and women of color. The Warm Connections program supports the ability of WIC staff to administer the EPDS to WIC participants. Perinatal depression rates appeared lower in the Warm Connections program than in studies using less specific perinatal depression screening instruments with similar samples. Future research should continue to explore perinatal depression patterns among low-income women and women of color. Partnering with community-based settings such as WIC provides innovative opportunities to provide screening, referral, and treatment for low income women and women of color.


Assuntos
Depressão/diagnóstico , Depressão/epidemiologia , Programas de Rastreamento/métodos , Perinatologia/métodos , Pobreza/estatística & dados numéricos , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Gravidez , Prevalência
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