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1.
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
2.
Int J Gynaecol Obstet ; 148(1): 48-52, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31556455

RESUMO

OBJECTIVE: To clarify the association between postpartum depression (PPD) and anemia in each stage of pregnancy as well as in the postpartum period. METHODS: A prospective cohort study was conducted between May 2010 and November 2013 at a tertiary hospital in Japan. In total, 1128 women were assessed using the Edinburgh Postpartum Depression Scale (EPDS) at postpartum week 4 and a blood test was performed in the second trimester (24-28 weeks of gestation), third trimester (35-36 weeks of gestation), and postpartum week 1. The primary outcome was PPD, defined as an EPDS score of 9 or higher. Multivariate logistic regression analysis was used to elucidate the association between anemia and PPD for each period. Additionally, trend analysis was conducted to determine if there was a linear association between maternal hemoglobin concentration and PPD. RESULTS: Postpartum anemia was significantly associated with increased PPD risk (adjusted odds ratio 1.63, 95% confidence interval 1.17-2.26) whereas anemia in the second and third trimesters was not. Similarly, a significant inverse association was observed between the quintiles of maternal hemoglobin levels in the puerperium and the PPD risk (P value for trend 0.004). CONCLUSION: Postpartum anemia was associated with an increased risk of PPD.


Assuntos
Anemia/etiologia , Depressão Pós-Parto/complicações , Doenças do Recém-Nascido/etiologia , Adulto , Anemia/diagnóstico , Depressão Pós-Parto/diagnóstico , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Japão , Razão de Chances , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Adulto Jovem
3.
Nurs Clin North Am ; 54(4): 561-567, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31703781

RESUMO

Postpartum depression (PPD) affects10% to 20% of women within the first year after birth and 25% beyond the first year. PPD, despite advances in diagnosis and treatment, remains underdiagnosed and misunderstood. Women do not always display signs of PPD while in care for delivery of the infant and may not discuss mood changes to their primary care provider at discharge and first post-delivery appointment. Identifying screening and treatment options for non-mental health providers was the purpose of this article.


Assuntos
Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/terapia , Programas de Rastreamento , Papel do Profissional de Enfermagem/psicologia , Depressão Pós-Parto/epidemiologia , Tratamento Farmacológico , Feminino , Humanos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Fatores de Risco
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(4. Vyp. 2): 81-88, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31317920

RESUMO

Postpartum depression in ICD-10 refers to mild mental and behavioral disorders associated with physiological disorders of the postpartum period F53.0. Diagnosis is based on criteria, one of which is sleep disorders. The objective of the review is to characterize the postpartum sleep disorders and to reflect their predictor value in the development of postpartum depression. Presomnic, intrasomnic and postsomnic disorders with negative consequences for both the mother and her child were found in sleep disorders of women with postpartum depression. Depression with sleep disorders significantly affect the quality of life of the mother and infant. Sleep disorders are one of the predictors of postpartum depression. Improving of sleep quality is an effective way to prevent the effects of postpartum depression.


Assuntos
Depressão Pós-Parto , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Depressão Pós-Parto/diagnóstico , Feminino , Humanos , Período Pós-Parto , Qualidade de Vida , Sono , Distúrbios do Início e da Manutenção do Sono/etiologia , Transtornos do Sono-Vigília/etiologia
5.
MCN Am J Matern Child Nurs ; 44(4): 228-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31261300

RESUMO

PURPOSE: The purpose of this study was to explore experiences of women currently with or at high risk for developing postpartum depression (PPD) who were participating in a postpartum support group facilitated by mental health providers. STUDY DESIGN AND METHODS: Using a qualitative design, women ≥18 years of age, who had given birth within the past 2 years, and who were currently attending, or had attended the PPD support group within the past year were invited to participate. The women provided demographic data and participated in a semistructured face-to-face interview. Data were analyzed using qualitative content analysis. RESULTS: Seven women between 27 and 38 years of age participated. Most were married and college educated. At time of the interviews, participants were between 5 months and 2 years postpartum and all reported taking antidepressant medications for their symptoms. Qualitative content analysis revealed three overall themes: attendance, impact, and medication adherence, with associated subthemes. CLINICAL IMPLICATIONS: Women attending a PPD support group facilitated by mental health providers felt supported, were more likely to disclose their symptoms to other women in the same situation, and were able to share their feelings without fear of judgment. Having concerns about antidepressant medication addressed at each meeting promoted medication adherence. Nurses working with childbearing women should be aware of community support services available for women at risk for developing PPD.


Assuntos
Depressão Pós-Parto/diagnóstico , Mães/psicologia , Grupos de Autoajuda , Adulto , Depressão Pós-Parto/epidemiologia , Feminino , Pessoal de Saúde , Humanos , Entrevistas como Assunto/métodos , Serviços de Saúde Mental , Mães/estatística & dados numéricos , Pesquisa Qualitativa , Fatores de Risco , Apoio Social
6.
BMC Pregnancy Childbirth ; 19(1): 256, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331292

RESUMO

BACKGROUND: Perinatal depression, the most common pregnancy complication, is associated with negative maternal-offspring outcomes. Despite existence of effective treatments, it is under-recognized and under-treated. Professional organizations recommend universal screening, yet multi-level barriers exist to ensuring effective diagnosis, treatment, and follow-up. Integrating mental health and obstetric care holds significant promise for addressing perinatal depression. The overall study goal is to compare the effectiveness of two active interventions: (1) the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, a state-wide, population-based program, and (2) the PRogram In Support of Moms (PRISM) which includes MCPAP for Moms plus a proactive, multifaceted, practice-level intervention with intensive implementation support. METHODS: This study is conducted in two phases: (1) a run-in phase which has been completed and involved practice and patient participant recruitment to demonstrate feasibility for the second phase, and (2) a cluster randomized controlled trial (RCT), which is ongoing, and will compare two active interventions 1:1 with ten Ob/Gyn practices as the unit of randomization. In phase 1, rates of depressive symptoms and other demographic and clinical features among patients were examined to inform practice randomization. Patient participants to be recruited in phase 2 will be followed longitudinally until 13 months postpartum; they will have 3-5 total study visits depending on whether their initial recruitment and interview was at 4-24 or 32-40 weeks gestation, or 1-3 months postpartum. Sampling throughout pregnancy and postpartum will ensure participants with different depressive symptom onset times. Differences in depression symptomatology and treatment participation will be compared between patient participants by intervention arm. DISCUSSION: This manuscript describes the full two-phase study protocol. The study design is innovative because it combines effectiveness with implementation research designs and integrates critical components of participatory action research. Our approach assesses the feasibility, acceptance, efficacy, and sustainability of integrating a stepped-care approach to perinatal depression care into ambulatory obstetric settings; an approach that is flexible and can be tailored and adapted to fit unique workflows of real-world practices. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02760004, registered prospectively on May 3, 2016.


Assuntos
Depressão Pós-Parto , Depressão , Assistência Perinatal/métodos , Complicações na Gravidez , Técnicas Psicológicas , Sistemas de Apoio Psicossocial , Adulto , Análise por Conglomerados , Depressão/diagnóstico , Depressão/etiologia , Depressão/terapia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/terapia , Feminino , Humanos , Saúde Mental , Participação do Paciente , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/psicologia , Complicações na Gravidez/terapia , Projetos de Pesquisa
7.
J Obstet Gynaecol Res ; 45(9): 1876-1883, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31215159

RESUMO

AIM: Although the Edinburgh Postnatal Depression Scale (EPDS) is widely used for screening for post-partum depression (PPD), screening time point and cut-off value in the current medical environment are not sufficiently examined. In this study, we examined appropriate timing and cut-off value of EPDS for the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. METHODS: This study was a prospective cohort study of women who delivered at the Iwate Medical University Hospital from August 2016 to February 2019. The EPDS self-assessment was conducted at 4 days and at 1 month after delivery (4D-EPDS and 1M-EPDS), and the Center for Epidemiologic Studies-Depression scale (CES-D) self-assessment was conducted at 1 month after delivery (1M-CES-D) in eligible patients and the scores were tabulated. Participants were interviewed by a psychiatric specialist to identify PPD within 2 months after delivery. For each screening, a receiver operating characteristic analysis was performed to calculate the cut-off value for PPD. Sensitivity, specificity, positive predictive value, negative predictive value and correct diagnostic rate were evaluated. RESULTS: Of the 80 post-partum women, PPD was found in nine cases (11.3%). The cut-off values for PPD were ≥10 for 4D-EPDS, ≥13 for 1M-EPDS and ≥21 for 1M-CES-D. No significant difference was found in the sensitivity, positive predictive value or negative predictive value among the three screening methods. However, a significant difference was found in the specificity, and the correct diagnosis rate and these values were relatively higher in 1M-EPDS. CONCLUSION: Based on the result of this Japanese cohort, 1M-EPDS with a cut-off value of ≥13 might be appropriate for PPD screening although that of ≥9 is currently employed.


Assuntos
Depressão Pós-Parto/diagnóstico , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Escalas de Graduação Psiquiátrica/normas , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Japão , Valor Preditivo dos Testes , Gravidez , Estudos Prospectivos , Curva ROC , Padrões de Referência , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Fatores de Tempo
8.
Ceska Gynekol ; 84(1): 68-72, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31213061

RESUMO

OBJECTIVE: To bring actual summary of knowledge about diagnostics and modern trends in therapy of postpartum depression. DESIGN: Review. SETTING: National Institute of Mental Health, Klecany. METHODS: Narrative review. RESULTS: First assessment of depressive symptoms among puerperal women can be done by screening instruments. Baby blues and postpartum psychosis must be kept in mind during the differential diagnostics of postpartum depression. Both nonpharmacological and pharmacological interventions can be used for postpartum depression treatment. As for nonpharmacological interventions, cognitive behavioral therapy is the most evidence based one. Antidepressants from the selective serotonin reuptake inhibitor group (SSRI) are the first choice from pharmacological interventions. Parenting support is also an important component of modern care of women with postpartum depression. CONCLUSION: Systematic cooperation between psychiatrist and gynecologists-obstetricians is a precondition of the effective postpartum depression treatment. The therapeutic intervention is chosen according to severity of depressive symptoms.


Assuntos
Antidepressivos/uso terapêutico , Terapia Cognitivo-Comportamental , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/terapia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Período Pós-Parto , Transtornos Puerperais , Resultado do Tratamento
9.
J Adv Nurs ; 75(10): 2223-2235, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31222789

RESUMO

AIM: To determine if an electronic nursing intervention during the first 6 months postpartum was effective in improving mood and decreasing stress. BACKGROUND: Unmet needs postpartum can have a negative impact on mood and parenting stress. Technology-assisted nursing care may provide needed support and reduce risk. DESIGN: Randomized controlled trial (RCT) with three conditions. METHODS: Enrollment began on 11 May 2017. Participants were randomized into one of three groups after completion of the baseline survey. Intervention I participants received standardized electronic messages four times/week for 6 months postpartum. Intervention II participants additionally received the option for nurse contact. Depression and parenting stress as measured using the Edinburgh Postnatal Depression Scale (EPDS) and Parenting Stress Index-Short form (PSI-SF) was obtained at 3 weeks, 3 months and 6 months postpartum and results compared with a usual care group. Patient satisfaction and nursing factors were measured. RESULTS: Significantly higher satisfaction scores were found in both intervention groups as compared with control, but there were no significant changes in EPDS or PSI-SF. CONCLUSION: The interventions were perceived as helpful and not burdensome. Better nurse-sensitive outcome measures are needed to adequately assess effectiveness. IMPACT: Postpartum women report unmet needs for support and education. The interventions were perceived as being helpful but did not significantly reduce depressive symptoms or parenting stress. Nurses can use this research to inform development of innovative approaches to support postpartum women. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT02843022.


Assuntos
Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/enfermagem , Invenções , Mães/psicologia , Cuidado Pós-Natal/métodos , Adulto , Feminino , Humanos , Gravidez
10.
J Fam Pract ; 68(4): 223;224;226;228, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31226175

RESUMO

The latest recommendations include 2 topics previously unaddressed: perinatal depression prevention and EKG screening for atrial fibrillation.


Assuntos
Fibrilação Atrial/diagnóstico , Depressão Pós-Parto/diagnóstico , Eletrocardiografia , Programas de Rastreamento/normas , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Estados Unidos
11.
Midwifery ; 76: 132-141, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31207447

RESUMO

OBJECTIVE: Postpartum depression affects many women worldwide, and screening initiatives for its detection are being implemented in several places. Although perceived preparedness to carry out an intervention is essential for successful implementation, the perceived preparedness of those who conduct screening initiatives for postpartum depression has not been investigated. The aim of this study was to examine the perceived preparedness of Israeli Mother-and-Child Health Clinic public health nurses to screen postpartum women for postpartum depression symptoms, conduct an initial intervention and refer women, as well as factors associated with this perceived preparedness. DESIGN: This was a cross sectional study. SETTING: Mother-and-Child Health Clinics in Israel. PARTICIPANTS: Public health nurses (n = 219) working at these clinics participated in the study. MEASUREMENTS: Participants answered questionnaires regarding their perceived preparedness, attitudes, perceived knowledge and perceived competence to screen, intervene and refer women with PPD symptoms. FINDINGS: Formal and informal training, attitudes, perceived knowledge and perceived competence were associated with perceived preparedness to screen; attitudes, perceived knowledge and perceived competence were associated with perceived preparedness to intervene; and attitudes and perceived knowledge were associated with perceived preparedness to refer. Differences in these associations were found between nurses based on their age, academic degree and experience. KEY CONCLUSIONS: Findings suggest that training, attitudes, knowledge and perceived competence are important factors leading to perceived preparedness to conduct screening initiatives for postpartum depression. IMPLICATIONS FOR PRACTICE: In order for public health nurses to feel prepared to screen, intervene and refer in cases of postpartum depression, ongoing training, both formal and informal, focusing on enhancing knowledge, positive attitudes and competence should be provided.


Assuntos
Depressão Pós-Parto/diagnóstico , Programas de Rastreamento/psicologia , Enfermeiras e Enfermeiros/psicologia , Percepção , Adulto , Estudos Transversais , Depressão Pós-Parto/psicologia , Feminino , Humanos , Israel , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/normas , Enfermeiras e Enfermeiros/estatística & dados numéricos , Encaminhamento e Consulta , Autoeficácia , Inquéritos e Questionários
12.
BMC Pregnancy Childbirth ; 19(1): 202, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200665

RESUMO

BACKGROUND: The aim of the study was to identify trajectories of perinatal depressive symptoms and their predictors among women living in a low-resource setting in South Africa, and who present with a risk of depression during pregnancy. METHODS: This is a secondary analysis of a randomised controlled trial among 384 women living in Khayelitsha, a low income setting in South Africa, recruited at their first antenatal visit if they scored 13 or above on the Edinburgh Postnatal Depression Scale, were at least 18 years of age, less than 29 weeks pregnant and spoke isiXhosa. Participants were followed up at 8 months gestation, 3 and 12 months postpartum. Latent trajectories of depressive symptoms were identified using growth mixture modelling, based on the Hamilton Depression Rating Scale (HDRS). There were no differences in HDRS scores between the control and intervention arms, so all participants were assessed together. Health, social and economic predictors of trajectories were investigated to identify high-risk groups with greater or more chronic depressive symptoms, using univariate logistic regression. RESULTS: Two trajectories were identified: antenatal only (91.4%), with moderate to severe symptoms at baseline which later subside; and antenatal and postnatal (8.6%), with severe depressive symptoms during pregnancy and later in the postpartum period, which subside temporarily to moderate levels at 3 months postpartum. Predictors for the antenatal and postnatal trajectory include severe food insecurity, intimate partner violence, lower social support, greater functional impairment, problematic drinking and suicide risk. CONCLUSIONS: A small proportion of women who are at risk for depression antenatally remain at risk throughout the perinatal period, and can be differentiated from those who show a natural remission. Identification and referral strategies should be developed with these findings in mind, especially given the limited mental health resources in low-income settings.


Assuntos
Depressão Pós-Parto , Depressão , Pobreza , Complicações na Gravidez , Adulto , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Pobreza/psicologia , Pobreza/estatística & dados numéricos , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/psicologia , Prognóstico , Escalas de Graduação Psiquiátrica , Medição de Risco/métodos , Fatores de Risco , África do Sul/epidemiologia
14.
Nutrients ; 11(6)2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31141947

RESUMO

Taiwanese women may practice traditional confinement after childbirth, and no study has investigated the nutritional status and the effects of postpartum depression on such women. The aim of this study was to investigate the association between nutritional status and postpartum depression at 6-8 weeks postpartum. A cross-sectional study was conducted on postpartum women who returned to the obstetrics and gynecology clinic for routine examination from January 2016 to September 2017. A total of 344 women received assessments based on the Edinburgh Postnatal Depression Scale (EPDS). An EPDS score of ≥10 indicated the presence of postpartum depressive symptoms (PPDS). A total of 97 women without such symptoms and 23 with PPDS completed nutritional parameter analyses and questionnaires. The results showed that the prevalence of postpartum depression (PPD) was 8.4%. The proportion was 70% for those who practiced confinement at home, significantly higher than for those in the non-PPDS group (45%). The overall psychological stress score was significantly higher and the postpartum care satisfaction score was significantly lower in those with PPDS compared to those without. In terms of nutritional biomarkers, the plasma riboflavin levels in the PPDS group were significantly lower than those in their symptomless counterparts (13.9%). The vitamin D insufficiency and deficiency rates in the non-PPD and PPDS groups were 35%, 41%, 48%, 26%, respectively. However, compared with those in the non-PPDS group, those with PPDS had significantly higher ratios of Σn-6/Σn-3, C20:3n-6/C18:3n-6, and C20:4n-6/(C20:5n-3 + C22:6n-3) (by 8.2%, 79.7%, and 8.8%, respectively), whereas they had lower ratios of C22:6n-3/C22:5n-6 (by 15.5%). Higher plasma riboflavin and erythrocyte C16:1n-9, C24:1n-9, C18:3n-6, and C20:5n-3 levels and lower Σn-6 fatty acid and C22:5n-6 levels decreased the risk of PPD after type of confinement, overall mental stress scores, and postpartum care satisfaction scores were adjusted for the logistic regression analysis. In conclusion, the plasma riboflavin level and erythrocyte fatty acid composition are potentially major contributors to PPD development.


Assuntos
Afeto , Depressão Pós-Parto/psicologia , Fenômenos Fisiológicos da Nutrição Materna , Estado Nutricional , Período Pós-Parto , Adulto , Biomarcadores/sangue , Estudos Transversais , Depressão Pós-Parto/sangue , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Eritrócitos/metabolismo , Ácidos Graxos/sangue , Feminino , Humanos , Gravidez , Prevalência , Riboflavina/sangue , Fatores de Risco , Taiwan/epidemiologia
15.
JMIR Mhealth Uhealth ; 7(5): e12794, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31094354

RESUMO

BACKGROUND: Smartphone-based psychoeducation interventions may be a low-cost, user-friendly alternative to resource-consuming, face-to-face antenatal classes to educate expectant mothers. OBJECTIVE: This study aimed to empirically examine whether such an intervention would lead to reduced postnatal depression, anxiety, or stress and result in a better health-related quality of life. METHODS: A single-blind randomized controlled trial was conducted in Hong Kong. All first-time expectant mothers with less than 24 weeks of gestation remaining and attending the antenatal clinic at a public hospital were included. Participants were assigned to the intervention group or the control group by drawing lots. The lots, presented in sealed opaque envelopes, were randomly designated as "intervention" or "control" by stratified randomization. The intervention, a psychoeducational mobile app, was provided in addition to the treatment as usual (TAU) services from the hospital. Follow up with participants took place at 4 weeks postpartum. The primary outcome was the difference in the levels of antenatal and postnatal depression, assessed by the Edinburgh Postnatal Depression Scale (EPDS). The intention-to-treat approach was employed in the analyses. RESULTS: The final sample was 660 expectant mothers (nintervention=330 and ncontrol=330). The mean difference in EPDS scores between the two groups was -0.65 (95% CI -1.29 to 0.00; P=.049) after adjusting for confounding factors. Associations were found between participation in the intervention and reduced depression, and attendance in TAU classes and increased stress levels. CONCLUSIONS: The smartphone-based intervention plus TAU services was effective in reducing postnatal depression at 4 weeks postpartum compared with a control condition of TAU only, making this a cost-effective alternative to TAU education for expectant mothers. Limitations of the study included the short postpartum period after which the follow-up assessment was conducted and the inclusion of first-time mothers rather than all mothers. TRIAL REGISTRATION: HKU Clinical Trials Registry HKUCTR-2024; http://www.hkuctr.com/Study/Show/ 34f62a2f6d594273a290491827206384.


Assuntos
Depressão Pós-Parto/diagnóstico , Educação em Saúde/normas , Aplicativos Móveis/normas , Mães/psicologia , Adulto , Análise de Variância , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Educação em Saúde/métodos , Educação em Saúde/estatística & dados numéricos , Hong Kong/epidemiologia , Humanos , Aplicativos Móveis/estatística & dados numéricos , Mães/estatística & dados numéricos , Gravidez , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Método Simples-Cego
16.
Rev. enferm. UFPE on line ; 13(5): 1338-1344, maio 2019. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1024396

RESUMO

Objetivo: rastrear a depressão pós-parto entre mulheres jovens que estão na segunda semana e no sexto mês após o parto. Método: trata-se de estudo quantitativo, descritivo, exploratório e transversal cujas participantes foram mulheres com idades entre 18 a 26 anos, entre a segunda semana e o sexto mês após o parto. Coletaram-se os dados entre os meses de agosto/2017 a janeiro/2018, por meio da Escala de Depressão Pós-natal de Edimburgo e de um inquérito sociodemográfico. Utilizou-se, para a tabulação dos dados, o programa Microsoft Excel, digitando-os por dupla entrada e, posteriormente, transportando-os para o programa BioEstat, versão 5.0. Aplicou-se o teste qui-quadrado para a análise estatística descritiva e apresentaram-se os resultados em forma de tabela. Resultados: identificou-se uma provável depressão pósparto em 19,70% das puérperas e essa condição teve associação com os seguintes fatores: idade do bebê, multiparidade e baixo nível de escolaridade. Conclusão: evidencia-se que a depressão pós-parto precisa ser investigada na atenção primária em saúde, que deve valorizar os aspectos sociodemográficos e individuais para estabelecer um plano de cuidados integral desde o pré-natal, com vistas à prevenção desse frequente transtorno do puerpério.(AU)


Objective: to track postpartum depression among young women who are in the second week and in the sixth month postpartum. Method: it is a quantitative, descriptive, exploratory and cross-sectional study whose participants were women aged between 18 and 26 years, between the second week and the sixth month after delivery. The data was collected between August 2017 and January 2018, using the Edinburgh Postnatal Depression Scale and a sociodemographic survey. For the tabulation of data, the Microsoft Excel program was used, typing them by double entry and then transporting them to the BioEstat program, version 5.0. The chisquare test was applied for the descriptive statistical analysis and the results were presented in table form. Results: a probable postpartum depression was identified in 19.70% of the puerperae and this condition was associated with the following factors: baby age, multiparity and low level of schooling. Conclusion: it is evidenced that postpartum depression needs to be investigated in primary health care, which should value the sociodemographic and individual aspects to establish a comprehensive care plan from the prenatal period, with a view to preventing this frequent postpartum disorder.(AU)


Objetivo: rastrear la depresión posparto entre mujeres jóvenes que se encuentran en la segunda semana y en el sexto mes después del parto. Método: se trata de estudio cuantitativo, descriptivo, exploratorio y transversal, cuyas participantes fueron mujeres con edades entre 18 a 26 años, entre la segunda semana y el sexto mes después del parto. Se recolectaron los datos entre los meses de agosto / 2017 a enero / 2018, por medio de la Escala de Depresión Post-natal de Edimburgo y de una encuesta sociodemográfica. Se utilizó, para la tabulación de los datos, el programa Microsoft Excel, digitados por doble entrada y posteriormente transportados al programa BioEstat, versión 5.0. Se aplicó la prueba chi-cuadrada para el análisis estadístico descriptivo, se presentaron los resultados en forma de tabla. Resultados: se identificó una probable depresión posparto en el 19,70% de las puérperas y esa condición tuvo asociación con los siguientes factores: edad del bebé, multiparidad y bajo nivel de escolaridad. Conclusión: se evidencia que la depresión posparto necesita ser investigada en la atención primaria en salud, que se deben valorar los aspectos sociodemográficos e individuales para establecer un plan de cuidados integral desde el prenatal, con miras a la prevención de ese frecuente trastorno, del puerperio.(AU)


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Atenção Primária à Saúde , Depressão Pós-Parto , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/prevenção & controle , Serviços de Saúde Materno-Infantil , Enfermagem Psiquiátrica , Epidemiologia Descritiva , Estudos Transversais
17.
Emerg Med Clin North Am ; 37(2): 277-286, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30940372

RESUMO

The period just after delivery is a high-risk period for women with associated morbidity and even mortality. There are large variations in complication rates across various groups in the United States. This article covers complications commonly encountered in the emergency department in late pregnancy and the early postpartum period. It specifically addresses postpartum depression, peripartum cardiomyopathy, and the late pregnant or postpartum patient presenting with headache or neurologic complaints. Emergency physicians should be well versed in common and life-threatening postpartum pathologies.


Assuntos
Complicações na Gravidez/diagnóstico , Terceiro Trimestre da Gravidez , Transtornos Puerperais/diagnóstico , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/terapia , Serviço Hospitalar de Emergência , Feminino , Cefaleia/complicações , Cefaleia/diagnóstico , Cefaleia/terapia , Humanos , Período Pós-Parto , Gravidez , Complicações na Gravidez/terapia , Transtornos Puerperais/terapia
19.
BMC Psychiatry ; 19(1): 112, 2019 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975129

RESUMO

BACKGROUND: Parenthood is a life transition that can be especially demanding for vulnerable individuals. Young maternal age and maternal single status have been reported to increase the risk for adverse outcomes for both mother and child. The aim of this study was to investigate the effect of young maternal age and maternal single status on maternal and child mental health and child development at age 3. METHODS: A birth-cohort of 1723 mothers and their children were followed from birth to age 3. Sixty-one mothers (3.5%) were age 20 or younger, and 65 (4.0%) reported single status at childbirth. The mothers filled out standardized instruments and medical information was retrieved from the standardized clinical assessment of the children at Child Welfare Centers, (CWC). RESULTS: Young maternal age was associated with symptoms of postpartum depression whereas single status was not. Young mothers were more prone to report internalizing and externalizing problems in their children, while there was no association between single status and child behavioral problems. No differences were seen on child development (CWC scores). School drop-out was, however, a more influential factor on depressive symptoms postpartum than maternal age. CONCLUSION: Young mothers are at increased risk for symptoms of postpartum depression which indicates the need for attention in pre- and postnatal health care programs. Single mothers and their children were not found to be at increased risk for adverse outcomes. The importance of schooling was demonstrated, indicating the need for societal support to encourage adolescents to remain in school.


Assuntos
Comportamento Infantil/psicologia , Depressão Pós-Parto/psicologia , Saúde Mental/tendências , Relações Mãe-Filho/psicologia , Mães/psicologia , Pais Solteiros/psicologia , Adolescente , Adulto , Fatores Etários , Comportamento Infantil/fisiologia , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Gravidez , Apoio Social , Suécia/epidemiologia , Adulto Jovem
20.
J Affect Disord ; 250: 218-225, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30870771

RESUMO

BACKGROUND: As many as 20% of women will experience an anxiety disorder during the perinatal period. Women with pre-existing anxiety disorders are at increased risk of worsening during this time, yet little is known about its predictors. STUDY AIM: To investigate the psychosocial and biological risk factors for anxiety worsening in the postpartum in women with pre-existing anxiety disorders. METHODS: Thirty-five (n = 35) pregnant women with pre-existing DSM-5 anxiety disorders were enrolled in this prospective study investigating the psychosocial (e.g., childhood trauma, intolerance of uncertainty, depression) and biological risk factors (e.g. C-reactive protein, interleukin-6, tumor necrosis factor-α) for anxiety worsening in the postpartum period. Anxiety worsening was defined as an increase of ≥50% or greater on Hamilton Anxiety Rating Scale scores from the third trimester of pregnancy (32.94 ± 3.35 weeks) to six weeks postpartum. RESULTS: Intolerance of uncertainty, depressive symptom severity, and obsessive-compulsive disorder symptoms present in pregnancy were significant predictors of anxiety worsening in the postpartum. LIMITATIONS: Sample heterogeneity and limited sample size may affect study generalizability. CONCLUSIONS: To our knowledge, this is the first longitudinal study to investigate psychosocial and biological risk factors for anxiety worsening in the postpartum in women with pre-existing anxiety disorders. Continued research investigating these risk factors is needed to elucidate whether they differ from women experiencing new-onset anxiety disorders in the perinatal period, and those in non-puerperal groups. Identifying these risk factors can guide the development of screening measures for early and accurate symptom detection. This can lead to the implementation of appropriate interventions aimed at decreasing the risk of perinatal anxiety worsening.


Assuntos
Transtornos de Ansiedade/diagnóstico , Depressão Pós-Parto/diagnóstico , Adolescente , Adulto , Transtornos de Ansiedade/sangue , Transtornos de Ansiedade/psicologia , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Criança , Depressão Pós-Parto/sangue , Depressão Pós-Parto/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Interleucina-6/sangue , Estudos Longitudinais , Transtorno Obsessivo-Compulsivo/sangue , Transtorno Obsessivo-Compulsivo/diagnóstico , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/psicologia , Terceiro Trimestre da Gravidez , Gestantes/psicologia , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Fatores de Risco , Fator de Necrose Tumoral alfa/sangue , Adulto Jovem
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