Objective:To evaluate the effectiveness and safety of modified Xiaoyao powder for postpartum depression(PPD)by conducting a systematic review of randomized controlled trials(RCTs).Methods:The Chinese National Knowledg...Objective:To evaluate the effectiveness and safety of modified Xiaoyao powder for postpartum depression(PPD)by conducting a systematic review of randomized controlled trials(RCTs).Methods:The Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,Google Scholar,the SinoMed,Embase,Cochrane Library,and PubMed databases were searched from their inception to April 25,2023.The Cochrane Risk of Bias tool was used to assess the quality of the trials.We applied the risk ratio to present dichotomous data and the mean difference to present continuous data.Data with similar characteristics were pooled for meta-analysis and heterogeneity was assessed using I2.Results:This review included 35 trials involving 2848 participants.The quality of the included studies was low(unclear randomization processes and insufficient reporting of blinding).Participants treated with modified Xiaoyao powder plus Western medicine showed lower Hamilton Depression Scale(HAMD)depression score than those who used Western medicine alone(mean difference=-2.15;95%confidence interval:-2.52 to 1.78;P<.00001),and higher effective rate(relative risk=1.19;95%confidence interval:1.15 to 1.24;P<.00001),When comparing modified Xiaoyao alone with Western medicine,the HAMD depression score remained low,however,the efficacy rate was higher in the modified Xiaoyao group.Regarding adverse events,the modified Xiaoyao group reported weight gain,nausea,and diarrhea,but no severe adverse events were reported.Conclusion:Modified Xiaoyao may help relieve depression in PPD when used alone or in combination with Western medicine,with minor side effects.Therefore,future high-quality,large-sample size RCTs are warranted.展开更多
The etiological factors contributing to depression and other neuropsychiatric disorders are largely undefined. Endoplasmic reticulum stress pathways and autophagy are well-defined mechanisms that play critical functio...The etiological factors contributing to depression and other neuropsychiatric disorders are largely undefined. Endoplasmic reticulum stress pathways and autophagy are well-defined mechanisms that play critical functions in recognizing and resolving cellular stress and are possible targets for the pathophysiology and treatment of psychiatric and neurologic illnesses. An increasing number of studies indicate the involvement of endoplasmic reticulum stress and autophagy in the control of neuroinflammation, a contributing factor to multiple neuropsychiatric illnesses. Initial inflammatory triggers induce endoplasmic reticulum stress, leading to neuroinflammatory responses. Subsequently, induction of autophagy by neurosteroids and other signaling pathways that converge on autophagy induction are thought to participate in resolving neuroinflammation. The aim of this review is to summarize our current understanding of the molecular mechanisms governing the induction of endoplasmic reticulum stress, autophagy, and neuroinflammation in the central nervous system. Studies focused on innate immune factors, including neurosteroids with anti-inflammatory roles will be reviewed. In the context of depression, animal models that led to our current understanding of molecular mechanisms underlying depression will be highlighted, including the roles of sigma 1 receptors and pharmacological agents that dampen endoplasmic reticulum stress and associated neuroinflammation.展开更多
BACKGROUND Rectus abdominis separation(DRA)affects pelvic stability and body image.No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression.AIM To analyze the curative e...BACKGROUND Rectus abdominis separation(DRA)affects pelvic stability and body image.No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression.AIM To analyze the curative effect of massage on early postpartum DRA and its impact on postpartum depression and thus its ability promote the overall psychosomatic rehabilitation of postpartum women.METHODS Data were retrospectively collected on 70 primiparous women with postpartum DRA who underwent rehabilitation at the Postpartum Rehabilitation Center of Huzhou Maternal and Child Health Hospital from October 2022 to September 2023.The patients were divided into the Group S(35 cases,biomimetic electrical stimulation treatment)and Group L(35 cases,biomimetic electrical stimulation combined with manual massage treatment).Baseline data,the edinburgh postpartum depression scale(EPDS)score,and the visual analog scale(VAS)scores for rectus abdominis distance,waist circumference,and lower back pain before and after treatment were compared.RESULTS No significant differences were found in the baseline data,rectus abdominis distance,waist circumference,and VAS and EPDS scores between the two groups before treatment(P>0.05).After treatment,the distance between rectus abdominis and waist circumference in Group L were significantly smaller than those in Group S(P<0.05).Furthermore,lower back pain(VAS score)and the EPDS score in Group L were significantly lower than those in Group S(P<0.05).CONCLUSION Manual massage can significantly reduce early postpartum DRA,waist circumference,and back pain and improve the patient’s mental state and postpartum depression.展开更多
BACKGROUND Postpartum depression(PPD)not only affects the psychological and physiological aspects of maternal health but can also affect neonatal growth and development.Partners who are in close contact with parturien...BACKGROUND Postpartum depression(PPD)not only affects the psychological and physiological aspects of maternal health but can also affect neonatal growth and development.Partners who are in close contact with parturient women play a key role in communication and emotional support.This study explores the PPD support relationship with partners and its influencing factors,which is believed to establish psychological well-being and improve maternal partner support.AIM To explore the correlation between PPD and partner support during breastfeeding and its influencing factors.METHODS Convenience sampling was used to select lactating women(200 women)who underwent postpartum examinations at the Huzhou Maternity and Child Health Care Hospital from July 2022 to December 2022.A cross-sectional survey was conducted on the basic information(general information questionnaire),depression level[edinburgh postnatal depression scale(EPDS)],and partner support score[dyadic coping inventory(DCI)]of the selected subjects.Pearson’s correlation analysis was used to analyze the correlation between PPD and DCI in lactating women.Factors affecting PPD levels during lactation were analyzed using multiple linear regression.RESULTS The total average score of EPDS in 200 lactating women was(9.52±1.53),and the total average score of DCI was(115.78±14.90).Dividing the EPDS,the dimension scores were:emotional loss(1.91±0.52),anxiety(3.84±1.05),and depression(3.76±0.96).Each dimension of the DCI was subdivided into:Pressure communication(26.79±6.71),mutual support(39.76±9.63),negative support(24.97±6.68),agent support(6.87±1.92),and joint support(17.39±4.19).Pearson’s correlation analysis demonstrated that the total mean score and individual dimension scores of EPDS during breastfeeding were inversely correlated with the total score of partner support,stress communication,mutual support,and cosupport(P<0.05).The total mean score of the EPDS and its dimensions were positively correlated with negative support(P<0.05).Multiple linear regression analysis showed that the main factors affecting PPD during breastfeeding were marital harmony,newborn health,stress communication,mutual support,negative support,cosupport,and the total score of partner support(P<0.05).CONCLUSION PPD during breastfeeding was associated with marital harmony,newborn health,stress communication,mutual support,negative support,joint support,and the total DCI score.展开更多
Introduction: Postpartum depression is the most common psychiatric disorder affecting women in the perinatal period. According to the WHO, it affects 10% - 15% of women who have just given birth. In Africa, and partic...Introduction: Postpartum depression is the most common psychiatric disorder affecting women in the perinatal period. According to the WHO, it affects 10% - 15% of women who have just given birth. In Africa, and particularly in Senegal, epidemiological studies focusing exclusively on postpartum depression are rare or non-existent. For this reason, we conducted this screening study on postpartum depression to assess the socio-demographic characteristics and associated factors. Methods: This was a prospective cross- sectional study with descriptive and analytical aims. It was carried out in the twelve Dakar referral health centres during the period August 2021 to June 2022. Results: At the end of our survey we had recruited one hundred and twenty-two (122) participants with a PPD prevalence rate of 25.41%. The most common age group was 24 - 29 years. 40% of the participants were of Fulani ethnicity, followed by Wolof. Married women made up 93% of the sample. The school enrolment rate was 89%. Most participants were not in paid employment. Domestic violence was present in 14% of couples. 28% of mothers reported experiencing a stressful life event during their pregnancy. 22% of the women had a chronic medical condition, of which 55% had high blood pressure. 1% of the women reported a personal psychiatric history and 5% a family psychiatric history. Most women had between two and four healthy living children. The pregnancy was unwanted in 17% of cases and 12% of participants had a complication. 6% were dissatisfied with the quality of their antenatal care. The caesarean section rate was 18%. In terms of associated factors, eight factors were identified in a bivariate analysis: single marital status, lack of support from partner, domestic violence, conflict with in-laws, and the occurrence of a stressful life event during pregnancy, the presence of a personal medical history, lack of satisfaction with pregnancy follow-up, and mode of delivery by caesarean section. Conclusion: Our study showed the high prevalence of PPD (25.41%) and identified associated risk factors. Among these factors, two were strongly associated with postpartum depression: lack of satisfaction with pregnancy care and experiencing a stressful life event during pregnancy. Systematic screening or identification of risk factors during pregnancy is necessary for comprehensive treatment based on a biopsychosocial approach.展开更多
BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved effic...BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.AIM To investigate the correlations among mindfulness,marital quality,anxiety,and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.METHODS A cross-sectional study was conducted.The self-administered questionnaire was submitted online through smartphones.The levels of mindfulness,anxiety,depression,and marital quality were respectively investigated by the mindful attention awareness scale(MAAS),the self-rating anxiety scale(SAS),the selfrating depression scale(SDS),and the marriage perception scale(MPS)in these enrolled Han and Tujia primiparas.RESULTS No statistical significance was observed in the prevalence of postpartum anxiety and depression,nor scores of MAAS and MPS-Total in different regions or ethnicities(P>0.05).However,MPSMarital interaction(P<0.05),MPS-Family relationship(MPS-FR)(P<0.01),and MPS-Marital conflict(MPS-MC)(P<0.01)scores of urban primiparas were higher than those of rural primiparas.The MPS-MC score of Han primiparas was higher than that of Tujia primiparas(P<0.05).Negative correlations were observed between MAAS and SAS(r=-0.457,P<0.01),and MAAS and SDS(r=-0.439,P<0.01).SAS has revealed a highly positive correlation with SDS(r=0.720,P<0.01)and a weak negative correlation with MPS(r=-0.200,P<0.05).Besides,a weak negative correlation was observed between MAAS and MPS-MC(r=-0.184,P<0.05),and a weak positive correlation was noticed between SAS and MPS-MC(r=-0.225,P<0.01).Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety(P<0.05,95%CI:-0.384 to 0.033),MPS-MC and postpartum anxiety(P<0.01,95%CI:0.027-0.193),MPS-FR and postpartum depression(P<0.05,95%CI:-0.365 to 0.031),and MPS-MC and postpartum depression(P<0.01,95%CI:0.022-0.206).CONCLUSION Mindfulness demonstrates negative correlations with marital conflict,postpartum anxiety and depression,and it may have cross-ethnic and trans-regional characteristics.Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study,it demonstrates a full mediation effect on the relationships between family relationships,marital conflict,and postpartum anxiety and depression.展开更多
BACKGROUND Postpartum depression(PPD)is a common psychological disease among puerperal women,and postpartum pelvic floor dysfunction is a common disease among pregnant women.The occurrence of postpartum pelvic floor d...BACKGROUND Postpartum depression(PPD)is a common psychological disease among puerperal women,and postpartum pelvic floor dysfunction is a common disease among pregnant women.The occurrence of postpartum pelvic floor dysfunction will increase the incidence of PPD.AIM To explore the therapeutic effect of integrated traditional Chinese and Western medicine nursing combined with electrical stimulation of pelvic floor muscles and the rectus abdominis on PPD.METHODS From April 2020 to January 2022,100 parturients with a rectus abdominis muscle separation distance>2.0 cm who underwent reexamination 6 wk after delivery at our hospital were selected as the research subjects.According to the random number table method,the patients were divided into either an observation group(n=50)or a control group(n=50).There was no significant difference in the general data between the two groups(P>0.05).Both groups were treated by electrical stimulation.The observation group was additionally treated by integrated traditional Chinese and Western medicine nursing.A self-designed Depression Knowledge Questionnaire was used to evaluate the awareness of knowledge on depression in all patients 3 wk after intervention.The Hamilton Depression Scale(HAMD)was used to evaluate the depression before intervention and 1 wk and 3 wk after intervention,and the Morisky Medication Adherence Scale(MMAS-8)was used to evaluate the medication compliance.SPSS19.0 was used for statistical analyses.RESULTS The rate of awareness of knowledge on depression in the observation group was significantly higher than that of the control group(P<0.05).The scores of MMAS-8 were comparable between the two groups before intervention(P>0.05),but were significantly higher in the observation group than in the control group at 1 wk and 3 wk after intervention(P<0.05).The HAMD scores were comparable between the two groups before intervention(P>0.05),but were significantly lower in the observation group than in the control group at 1 wk and 3 wk after intervention(P<0.05).CONCLUSION Integrated traditional Chinese and Western medicine nursing combined with electrical stimulation of pelvic floor muscles and the rectus abdominis is effective in the treatment of postpartum depression and worthy of clinical promotion.展开更多
Postpartum depression affects parents across all social, economic, and racial groups. While there are many factors that may contribute to depressive symptoms in the postpartum period, under-resourced populations and e...Postpartum depression affects parents across all social, economic, and racial groups. While there are many factors that may contribute to depressive symptoms in the postpartum period, under-resourced populations and ethnic minorities are documented to experience higher rates. Traditional psychotherapeutic methods have shown success in mitigating depressive symptoms;however, these treatments are not always accessible and/or utilized, particularly in populations with the highest need. Mind-body interventions have become increasingly popular in addressing perinatal mental health, and new and innovative approaches are currently being evaluated to determine their efficacy with respect to treating postpartum depression. This scoping review highlights published clinical trials, interventions, meta-analyses, and reviews conducted in the last 20 years and examines how each method applies to meet the needs of postpartum parents, and particularly under-resourced populations.展开更多
BACKGROUND Changes in China's fertility policy have led to a significant increase in older pregnant women.At present,there is a lack of analysis of influencing factors and research on predictive models for postpar...BACKGROUND Changes in China's fertility policy have led to a significant increase in older pregnant women.At present,there is a lack of analysis of influencing factors and research on predictive models for postpartum depression(PPD)in older pregnant women.AIM To analysis the influencing factors and the construction of predictive models for PPD in older pregnant women.METHODS By adopting a cross-sectional survey research design,239 older pregnant women(≥35 years old)who underwent obstetric examinations and gave birth at Suzhou Ninth People's Hospital from February 2022 to July 2023 were selected as the research subjects.When postpartum women of advanced maternal age came to the hospital for follow-up 42 d after birth,the Edinburgh PPD Scale(EPDS)was used to assess the presence of PPD symptoms.The women were divided into a PPD group and a no-PPD group.Two sets of data were collected for analysis,and a prediction model was constructed.The performance of the predictive model was evaluated using receiver operating characteristic(ROC)analysis and the Hosmer-Lemeshow goodness-of-fit test.RESULTS On the 42nd day after delivery,51 of 239 older pregnant women were evaluated with the EPDS scale and found to have depressive symptoms.The incidence rate was 21.34%(51/239).There were statistically significant differences between the PPD group and the no-PPD group in terms of education level(P=0.004),family relationships(P=0.001),pregnancy complications(P=0.019),and mother–infant separation after birth(P=0.002).Multivariate logistic regression analysis showed that a high school education and below,poor family relationships,pregnancy complications,and the separation of the mother and baby after birth were influencing factors for PPD in older pregnant women(P<0.05).Based on the influencing factors,the following model equation was developed:Logit(P)=0.729×education level+0.942×family relationship+1.137×pregnancy complications+1.285×separation of the mother and infant after birth-6.671.The area under the ROC curve of this prediction model was 0.873(95%CI:0.821-0.924),the sensitivity was 0.871,and the specificity was 0.815.The deviation between the value predicted by the model and the actual value through the Hosmer-Lemeshow goodness-of-fit test was not statistically significant(χ^(2)=2.749,P=0.638),indicating that the model did not show an overfitting phenomenon.CONCLUSION The risk of PPD among older pregnant women is influenced by educational level,family relationships,pregnancy complications,and the separation of the mother and baby after birth.A prediction model based on these factors can effectively predict the risk of PPD in older pregnant women.展开更多
Depressive disorder is a major contributor to years lived with disability (YLD) globally. It is estimated that 13% of all women experience the disorder in the first year postpartum. Postpartum depression (PPD) has sig...Depressive disorder is a major contributor to years lived with disability (YLD) globally. It is estimated that 13% of all women experience the disorder in the first year postpartum. Postpartum depression (PPD) has significant implications to the physical and mental wellbeing of both the mother and her baby. Only non-depressed pregnant women (score of ≤ 6 on Edinburgh Postnatal Depression Scale) were recruited into this study. Data collection was done at 2 different stages;at recruitment stage (during the third trimester of pregnancy) and at the follow up stage (4<sup>th</sup> - 6<sup>th</sup> week postpartum). During the recruitment stage, intimate partner violence (IPV) and level of social support perception, among the women, were assessed using Hurt Insult Threaten Scream (HITS) and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires respectively. While at the follow up stage, the Obstetric questionnaire and Mini International Neuropsychiatric Interview (MINI-7) were used respectively to obtain obstetric-related data and to diagnose for occurrence of depression. The incidence of PPD was found to be 16.34%. Several factors such as level of education, husband’s socioeconomic status, stressful life events, low perception of social support, obstetric instrumentation and not having a baby of preferred gender were significantly associated with PPD. Positive predictors of PPD included not practicing breast feeding (OR = 186.72, 95% CI = 8.32 - 4188.35), family history of mental illness (OR = 4.95, 95% CI = 1.04 - 23.81) and pregnancy lasting beyond 40 weeks (OR = 7.26, 95% CI = 1.51 - 34.88). High incidence of PPD with numerous associated but largely modifiable risk factors call for more proactive measures, such as PPD screening among pregnant women.展开更多
BACKGROUND It is positive to integrate and evaluate the risk factors for postpartum depression in patients with pregnancy-induced hypertension syndrome and to detect highrisk patients as early as possible,which has ap...BACKGROUND It is positive to integrate and evaluate the risk factors for postpartum depression in patients with pregnancy-induced hypertension syndrome and to detect highrisk patients as early as possible,which has application value for the clinical development of personalized prevention programs and prognosis of patients.AIM To analyze factors related to postpartum depression in patients with pregnancyinduced hypertension and construct and evaluate a nomogram model.METHODS The clinical data of 276 patients with pregnancy-induced hypertension admitted to Huzhou Maternity and Child Health Care Hospital between January 2017 and April 2022 were retrospectively analyzed.We evaluated the depression incidence at 6 wk postpartum.The depression group included patients with postpartum depression,and the remainder were in the non-depression group.Multivariate logistic regression analysis and the LASSO regression model were applied to analyze the factors related to postpartum depression in patients with pregnancyinduced hypertension.After that,a risk prediction model nomogram was constructed and evaluated.RESULTS Multivariate logistic regression analysis showed that vitamin A deficiency(VAD)during pregnancy and puerperium,family history of hypertension,maternal intestinal flora imbalance,eicosapentaenoic acid(EPA),and docosahexaenoic acid(DHA)were independent risk factors for postpartum depression in patients with pregnancy-induced hypertension(P<0.05).We constructed the nomogram model based on these five risk factors.The area under the curve,specificity,and sensitivity of the model in predicting postpartum depression in patients with pregnancy-induced hypertension was 0.867(95%confidence interval:0.828–0.935),0.676,and 0.889,respectively.The average absolute error was 0.037(Hosmer-Lemeshow testχ2=10.739,P=0.217).CONCLUSION VAD during pregnancy and puerperium,family history of hypertension,maternal intestinal flora imbalance,EPA,and DHA affect postpartum depression in patients with pregnancy-induced hypertension.展开更多
The global incidence of postpartum depression is estimated at approximately 10% - 20%. A lack of partner support is a key factor associated with perinatal depression. This study examined the effects of an educational ...The global incidence of postpartum depression is estimated at approximately 10% - 20%. A lack of partner support is a key factor associated with perinatal depression. This study examined the effects of an educational intervention that provided information for the prevention and early detection of postpartum depression to first-time mothers and fathers who participated in a “First-Time Parent Class.” The study was utilized quasi-experimental research, conducted first with the control group and followed by an assessment of the intervention group. Mothers were assessed using the Edinburgh Postpartum Depression Scale and the Japan Child and Family Research Institute Child-Rearing Support Questionnaire. Fathers’ assessments were conducted using the Japan Child and Family Research Institute Child-Rearing Support Questionnaire for Fathers and were based on responses to questions regarding their coping strategies. Data were obtained from 158 data (72 interventions, 86 controls) couples analyzed. No significant difference was found between mothers’ child-rearing difficulty and depression score rates in the first month after childbirth. There was a difference among fathers in the control group and those in the intervention group regarding their responses to maternal depression: the “consult family” (p = 0.035), “consult friends” (p = 0.033), and “consult the city health center” (p = 0.047) variables were higher in the intervention group;however, the effect size was small. Providing first-time parents with information during pregnancy to prevent and detect postpartum depression will deepen parents’ understanding and help them cope with postpartum depression.展开更多
The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adapt...The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions.展开更多
Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the...Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression(PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression(MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases Pub Med, LILACS and Sci ELO using the index terms "postpartum depression" and "genetics". Literature searches for articles in peerreviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.展开更多
Objective: Anxiety is common among pregnant women. However, research attention in the area of reproductive mental health has mainly focused on postpartum depression in past decades. Given adverse outcomes of antenatal...Objective: Anxiety is common among pregnant women. However, research attention in the area of reproductive mental health has mainly focused on postpartum depression in past decades. Given adverse outcomes of antenatal anxiety, there is an urgent need to fill the research gaps. The objectives of the present study were to determine the prevalence of antenatal anxiety symptoms and examine the risk factors and effects of anxiety symptoms in early pregnancy on anxiety and depressive symptoms in later pregnancy and early postpartum period. Methodology: A prospective longitudinal design with quantitative approach was adopted. A consecutive sample of 1470 Chinese pregnant women from hospitals in Hong Kong was invited to participate in the study and was assessed using standardized instruments on 3 time points including first and third trimesters of pregnancy and 6-week postpartum. Results: The results showed that 17.7% of pregnant women manifested anxiety symptoms in the first trimester of pregnancy. Single mothers, younger mothers, mothers who smoked before pregnancy and mothers who received low education level reported significantly higher levels of anxiety symptoms in the first trimester. Unwanted pregnancy, low self esteem, low marital satisfaction and perceived low social support were significant psychosocial risk factors for anxiety symptoms in the first trimester. Anxiety symptoms in the first trimester were independent predictors for anxiety symptoms in the third trimester ( QUOTE β = 0.26, t = 5.74, p < 0.001), however anxiety symptoms in the first trimester no longer significantly predicted anxiety and depressive symptoms in 6 weeks postpartum after adjusting for the effects of potential confounders. Discussions: The present study points to the need for greater research and clinical attention to antenatal anxiety given that antenatal anxiety is a prevalent problem and has serious impacts on maternal well-being. Such findings also contribute to the understanding of maternal anxiety and have implications for the design of effective identification, prevention and treatment of these significant clinical展开更多
Introduction: Postpartum depression (PPD) affects women’s health and self-confidence, and infant’s social, emotional, cognitive and even physical development. Studies show that parents of preterm infants frequently ...Introduction: Postpartum depression (PPD) affects women’s health and self-confidence, and infant’s social, emotional, cognitive and even physical development. Studies show that parents of preterm infants frequently experience symptoms of depression and anxiety. Women with unintended pregnancy are subjected to more risk of depression than women with planned pregnancy. Unintended pregnancy may lead to increased maternal exposure to psychosocial stressors, reduced social support by the spouse, increased levels of depressive symptoms and decreased life satisfaction. Findings: No significant difference was observed between term and preterm infants’ mothers (p = 0.85) in terms of postpartum depression. However, two groups of fathers in terms of depression showed a significant difference (p = 0.045). McNemar’s test showed that parents of term infants (K = 0.322, p = 0.077), and parents of preterm infants (k = 0.17, p = 0.144) agreed with each other on unintended pregnancy. Conclusion: Fathers of preterm infants are at higher risk for mental disorders than fathers of term infants and they need more attention in future studies.展开更多
Postpartum depression is a common complication related to childbearing with an estimated prevalence of 10% - 15%. The aim of the study was to explore and synthesize qualitative empirical studies published between 2005...Postpartum depression is a common complication related to childbearing with an estimated prevalence of 10% - 15%. The aim of the study was to explore and synthesize qualitative empirical studies published between 2005 and 2016 that describe women’s experiences of postpartum depression. Ten qualitative studies describing different perspectives on women’s experiences of postpartum depression were summarized and synthesized using Noblit and Hare’s 7-step meta-ethnographical method. Four central metaphors described women’s experiences of postpartum depression: Feeling trapped by reality, Experiencing a nameless chaos, Struggling to find a way out and Being seen as a normal but suffering person. The findings resulted in the following synthesis: The women expected the transition to motherhood to be a joyous experience. Instead, they found it painful, lonely and experienced losing themselves in a nameless chaos. Motherhood is challenged when women experience losing themselves due to depression rather than building a new identity as a mother. Such a situation causes chaos, shame, anxiety and isolation. When seeking professional help, it is essential that the woman is encountered with empathy and professional knowledge, rather than a pat on the back and an underestimation of her problems.展开更多
The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental stat...The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental state of mothers in both the antepartum and postpartum period assessed by the Edinburgh Postnatal Depression Scale (EPDS) and Mother-Infant-Bonding-Scale (MIBS), and compare the results. Participants (n = 134) were recruited twice in antepartum medical checkups (20 to 36 weeks of gestation) and postpartum medical checkups (1 month after birth). Information on characteristics of participants was collected from medical records in both periods. Family function and ante-postpartum mental health were assessed by Family APGAR, EPDS, and MIBS. Antepartum depressive state was related to postpartum depressive state (p = 0.015), antepartum bonding was related to bonding in postpartum bonding (p = 0.0001), and antepartum bonding disorder was related to postpartum depressive state (relative risk = 11.7). Worries about costs and poor of family function were related to the mental health of mothers in both the antepartum and postpartum periods. Antepartum depressive state is an indicator of postpartum depression. We suggested that health professionals conduct an evaluation of mother’s mental health and related factors in the antepartum period. The present findings emphasize the importance of antepartum mental health as a predictor of postpartum depression and bonding disorder.展开更多
Transition to being a parent is a stress-producing process that involves adapting both parents and their families even in the most favorable circumstances. Information on the level of psychological adaptation of women...Transition to being a parent is a stress-producing process that involves adapting both parents and their families even in the most favorable circumstances. Information on the level of psychological adaptation of women and family before and during pregnancy is very important as anxiety and the effects of accumulated life stress can directly affect individual and family well-being in the postnatal period. Especially for women or families facing multiple stresses and limited resources, ensuring security, understanding, compassion and direction may have a significant positive effect during this phase. A sample of 91 women immediately after birth at the Obstetrics-Gynecology Clinic (KOGJ) at the University Clinical Center of Kosovo (UCCK) completed two self-administered questionnaires. Initially, literature on postpartum depression was investigated. Two instruments for this paper have been selected from the range of instruments available for postnatal depression research literature: Patient health questionnaire (PHQ-9) and Postpartum Depression Screening Scale (PDSS). The introduction and analysis of data is done with the Statistical Package of Social Sciences (SPSS), Version 21 (Statistical Package for the Social Sciences—SPSS). Failure or frustration and sleep problems are the highest mean postnatal depression indicators 1.8. Then there is fatigue or lack of energy, increased appetite or anorexia and suicidal thoughts and self-esteem with a mean attendance of 1.7 in the post-depression indicator group. Depression or loss of hope and dissatisfaction or interest in activities are in the group of indicators with an average of 1.6. Movement or speech problems and concentration problems are the least affected indicators in the post-depression indicator group, with only 1.5. Our statistics show a relatively high level of postpartum depression, which includes women of all categories without taking into account the economic situation, the level of education or the number of births, the results derived from the correlation analysis which is non-aligning during the comparison of these categories. Involvement of nurses/midwives at a time setting of this phenomenon is a necessity for which to invest?展开更多
Objective:To obtain the rules of acupoint use and compatibility methods from RCT literature of acupunctureand moxibustion in the treatment of postpartum depression through data mining,so as to provide effective acupoi...Objective:To obtain the rules of acupoint use and compatibility methods from RCT literature of acupunctureand moxibustion in the treatment of postpartum depression through data mining,so as to provide effective acupoints for clinical reference.Methods:a total of 557 clinical literatures on acupuncture and moxibustion in the treatment of postpartum depression were retrieved through China knowledge Network Database,Wanfang Database and Chongqing VIP Database,and 44 articles were obtained through inclusion and exclusion criteria.Statistical analysis was carried out with the help of SPSS20.0 and SPSS Modeler18.1.Results:the most commonly used acupuncture points for postpartum depression are Baihui,Taichong,Sanyinjiao,Zusanli,Neiguan,Governor Meridian,foot Jueyin liver Meridian and foot Sun bladder Meridian,which are closely related to the treatment of postpartum depression.most doctors'clinical acupuncture treatment sites are head,limbs and back.The correlation analysis results obtained by SPSS Modeler software are Taichong-Neiguan-Zusanli,Taichong-Neiguan and Neiguan-Zusanli.Finally,the high-frequency acupoints are clustered and classified into four clusters,namely Taichong,Neiguan,Sanyinjiao and Zusanli.Hegu,Sishencong;Baihui,Shenmen;Pishu and Guanyuan.Conclusion:the rule of acupoint use of acupuncture and moxibustion in the treatment of postpartum depression through data mining can provide some reference for the clinical treatment of postpartum depression in the future.展开更多
基金supported by the State Administration of Traditional Chinese Medicine High-level Key Discipline Construction Project of Traditional Chinese Medicine-Beijing University of Traditional Chinese Medicine Combined Fundamentals of Chinese and Western Medicine(Pharmacology Discipline,Project No.zyyzdxk-2023256).
文摘Objective:To evaluate the effectiveness and safety of modified Xiaoyao powder for postpartum depression(PPD)by conducting a systematic review of randomized controlled trials(RCTs).Methods:The Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,Google Scholar,the SinoMed,Embase,Cochrane Library,and PubMed databases were searched from their inception to April 25,2023.The Cochrane Risk of Bias tool was used to assess the quality of the trials.We applied the risk ratio to present dichotomous data and the mean difference to present continuous data.Data with similar characteristics were pooled for meta-analysis and heterogeneity was assessed using I2.Results:This review included 35 trials involving 2848 participants.The quality of the included studies was low(unclear randomization processes and insufficient reporting of blinding).Participants treated with modified Xiaoyao powder plus Western medicine showed lower Hamilton Depression Scale(HAMD)depression score than those who used Western medicine alone(mean difference=-2.15;95%confidence interval:-2.52 to 1.78;P<.00001),and higher effective rate(relative risk=1.19;95%confidence interval:1.15 to 1.24;P<.00001),When comparing modified Xiaoyao alone with Western medicine,the HAMD depression score remained low,however,the efficacy rate was higher in the modified Xiaoyao group.Regarding adverse events,the modified Xiaoyao group reported weight gain,nausea,and diarrhea,but no severe adverse events were reported.Conclusion:Modified Xiaoyao may help relieve depression in PPD when used alone or in combination with Western medicine,with minor side effects.Therefore,future high-quality,large-sample size RCTs are warranted.
基金funded by the Taylor Family Institute for Innovative Psychiatric Researchthe Bantly FoundationMH122379 from the National Institute of Mental Health (to YI)。
文摘The etiological factors contributing to depression and other neuropsychiatric disorders are largely undefined. Endoplasmic reticulum stress pathways and autophagy are well-defined mechanisms that play critical functions in recognizing and resolving cellular stress and are possible targets for the pathophysiology and treatment of psychiatric and neurologic illnesses. An increasing number of studies indicate the involvement of endoplasmic reticulum stress and autophagy in the control of neuroinflammation, a contributing factor to multiple neuropsychiatric illnesses. Initial inflammatory triggers induce endoplasmic reticulum stress, leading to neuroinflammatory responses. Subsequently, induction of autophagy by neurosteroids and other signaling pathways that converge on autophagy induction are thought to participate in resolving neuroinflammation. The aim of this review is to summarize our current understanding of the molecular mechanisms governing the induction of endoplasmic reticulum stress, autophagy, and neuroinflammation in the central nervous system. Studies focused on innate immune factors, including neurosteroids with anti-inflammatory roles will be reviewed. In the context of depression, animal models that led to our current understanding of molecular mechanisms underlying depression will be highlighted, including the roles of sigma 1 receptors and pharmacological agents that dampen endoplasmic reticulum stress and associated neuroinflammation.
基金Supported by Huzhou Science and Technology Bureau,No.2021GY39.
文摘BACKGROUND Rectus abdominis separation(DRA)affects pelvic stability and body image.No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression.AIM To analyze the curative effect of massage on early postpartum DRA and its impact on postpartum depression and thus its ability promote the overall psychosomatic rehabilitation of postpartum women.METHODS Data were retrospectively collected on 70 primiparous women with postpartum DRA who underwent rehabilitation at the Postpartum Rehabilitation Center of Huzhou Maternal and Child Health Hospital from October 2022 to September 2023.The patients were divided into the Group S(35 cases,biomimetic electrical stimulation treatment)and Group L(35 cases,biomimetic electrical stimulation combined with manual massage treatment).Baseline data,the edinburgh postpartum depression scale(EPDS)score,and the visual analog scale(VAS)scores for rectus abdominis distance,waist circumference,and lower back pain before and after treatment were compared.RESULTS No significant differences were found in the baseline data,rectus abdominis distance,waist circumference,and VAS and EPDS scores between the two groups before treatment(P>0.05).After treatment,the distance between rectus abdominis and waist circumference in Group L were significantly smaller than those in Group S(P<0.05).Furthermore,lower back pain(VAS score)and the EPDS score in Group L were significantly lower than those in Group S(P<0.05).CONCLUSION Manual massage can significantly reduce early postpartum DRA,waist circumference,and back pain and improve the patient’s mental state and postpartum depression.
基金Supported by Medical Health Science and Technology Project of Huzhou City,No.2022GY41.
文摘BACKGROUND Postpartum depression(PPD)not only affects the psychological and physiological aspects of maternal health but can also affect neonatal growth and development.Partners who are in close contact with parturient women play a key role in communication and emotional support.This study explores the PPD support relationship with partners and its influencing factors,which is believed to establish psychological well-being and improve maternal partner support.AIM To explore the correlation between PPD and partner support during breastfeeding and its influencing factors.METHODS Convenience sampling was used to select lactating women(200 women)who underwent postpartum examinations at the Huzhou Maternity and Child Health Care Hospital from July 2022 to December 2022.A cross-sectional survey was conducted on the basic information(general information questionnaire),depression level[edinburgh postnatal depression scale(EPDS)],and partner support score[dyadic coping inventory(DCI)]of the selected subjects.Pearson’s correlation analysis was used to analyze the correlation between PPD and DCI in lactating women.Factors affecting PPD levels during lactation were analyzed using multiple linear regression.RESULTS The total average score of EPDS in 200 lactating women was(9.52±1.53),and the total average score of DCI was(115.78±14.90).Dividing the EPDS,the dimension scores were:emotional loss(1.91±0.52),anxiety(3.84±1.05),and depression(3.76±0.96).Each dimension of the DCI was subdivided into:Pressure communication(26.79±6.71),mutual support(39.76±9.63),negative support(24.97±6.68),agent support(6.87±1.92),and joint support(17.39±4.19).Pearson’s correlation analysis demonstrated that the total mean score and individual dimension scores of EPDS during breastfeeding were inversely correlated with the total score of partner support,stress communication,mutual support,and cosupport(P<0.05).The total mean score of the EPDS and its dimensions were positively correlated with negative support(P<0.05).Multiple linear regression analysis showed that the main factors affecting PPD during breastfeeding were marital harmony,newborn health,stress communication,mutual support,negative support,cosupport,and the total score of partner support(P<0.05).CONCLUSION PPD during breastfeeding was associated with marital harmony,newborn health,stress communication,mutual support,negative support,joint support,and the total DCI score.
文摘Introduction: Postpartum depression is the most common psychiatric disorder affecting women in the perinatal period. According to the WHO, it affects 10% - 15% of women who have just given birth. In Africa, and particularly in Senegal, epidemiological studies focusing exclusively on postpartum depression are rare or non-existent. For this reason, we conducted this screening study on postpartum depression to assess the socio-demographic characteristics and associated factors. Methods: This was a prospective cross- sectional study with descriptive and analytical aims. It was carried out in the twelve Dakar referral health centres during the period August 2021 to June 2022. Results: At the end of our survey we had recruited one hundred and twenty-two (122) participants with a PPD prevalence rate of 25.41%. The most common age group was 24 - 29 years. 40% of the participants were of Fulani ethnicity, followed by Wolof. Married women made up 93% of the sample. The school enrolment rate was 89%. Most participants were not in paid employment. Domestic violence was present in 14% of couples. 28% of mothers reported experiencing a stressful life event during their pregnancy. 22% of the women had a chronic medical condition, of which 55% had high blood pressure. 1% of the women reported a personal psychiatric history and 5% a family psychiatric history. Most women had between two and four healthy living children. The pregnancy was unwanted in 17% of cases and 12% of participants had a complication. 6% were dissatisfied with the quality of their antenatal care. The caesarean section rate was 18%. In terms of associated factors, eight factors were identified in a bivariate analysis: single marital status, lack of support from partner, domestic violence, conflict with in-laws, and the occurrence of a stressful life event during pregnancy, the presence of a personal medical history, lack of satisfaction with pregnancy follow-up, and mode of delivery by caesarean section. Conclusion: Our study showed the high prevalence of PPD (25.41%) and identified associated risk factors. Among these factors, two were strongly associated with postpartum depression: lack of satisfaction with pregnancy care and experiencing a stressful life event during pregnancy. Systematic screening or identification of risk factors during pregnancy is necessary for comprehensive treatment based on a biopsychosocial approach.
基金Supported by Chongqing Science and Health Joint Medical Research Project,No.2021MSXM034.
文摘BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.AIM To investigate the correlations among mindfulness,marital quality,anxiety,and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.METHODS A cross-sectional study was conducted.The self-administered questionnaire was submitted online through smartphones.The levels of mindfulness,anxiety,depression,and marital quality were respectively investigated by the mindful attention awareness scale(MAAS),the self-rating anxiety scale(SAS),the selfrating depression scale(SDS),and the marriage perception scale(MPS)in these enrolled Han and Tujia primiparas.RESULTS No statistical significance was observed in the prevalence of postpartum anxiety and depression,nor scores of MAAS and MPS-Total in different regions or ethnicities(P>0.05).However,MPSMarital interaction(P<0.05),MPS-Family relationship(MPS-FR)(P<0.01),and MPS-Marital conflict(MPS-MC)(P<0.01)scores of urban primiparas were higher than those of rural primiparas.The MPS-MC score of Han primiparas was higher than that of Tujia primiparas(P<0.05).Negative correlations were observed between MAAS and SAS(r=-0.457,P<0.01),and MAAS and SDS(r=-0.439,P<0.01).SAS has revealed a highly positive correlation with SDS(r=0.720,P<0.01)and a weak negative correlation with MPS(r=-0.200,P<0.05).Besides,a weak negative correlation was observed between MAAS and MPS-MC(r=-0.184,P<0.05),and a weak positive correlation was noticed between SAS and MPS-MC(r=-0.225,P<0.01).Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety(P<0.05,95%CI:-0.384 to 0.033),MPS-MC and postpartum anxiety(P<0.01,95%CI:0.027-0.193),MPS-FR and postpartum depression(P<0.05,95%CI:-0.365 to 0.031),and MPS-MC and postpartum depression(P<0.01,95%CI:0.022-0.206).CONCLUSION Mindfulness demonstrates negative correlations with marital conflict,postpartum anxiety and depression,and it may have cross-ethnic and trans-regional characteristics.Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study,it demonstrates a full mediation effect on the relationships between family relationships,marital conflict,and postpartum anxiety and depression.
基金2017 Wuhan Medical Research Project,No.WZ17Z112021 Wuhan Medical Research Project,No.WX21Z65.
文摘BACKGROUND Postpartum depression(PPD)is a common psychological disease among puerperal women,and postpartum pelvic floor dysfunction is a common disease among pregnant women.The occurrence of postpartum pelvic floor dysfunction will increase the incidence of PPD.AIM To explore the therapeutic effect of integrated traditional Chinese and Western medicine nursing combined with electrical stimulation of pelvic floor muscles and the rectus abdominis on PPD.METHODS From April 2020 to January 2022,100 parturients with a rectus abdominis muscle separation distance>2.0 cm who underwent reexamination 6 wk after delivery at our hospital were selected as the research subjects.According to the random number table method,the patients were divided into either an observation group(n=50)or a control group(n=50).There was no significant difference in the general data between the two groups(P>0.05).Both groups were treated by electrical stimulation.The observation group was additionally treated by integrated traditional Chinese and Western medicine nursing.A self-designed Depression Knowledge Questionnaire was used to evaluate the awareness of knowledge on depression in all patients 3 wk after intervention.The Hamilton Depression Scale(HAMD)was used to evaluate the depression before intervention and 1 wk and 3 wk after intervention,and the Morisky Medication Adherence Scale(MMAS-8)was used to evaluate the medication compliance.SPSS19.0 was used for statistical analyses.RESULTS The rate of awareness of knowledge on depression in the observation group was significantly higher than that of the control group(P<0.05).The scores of MMAS-8 were comparable between the two groups before intervention(P>0.05),but were significantly higher in the observation group than in the control group at 1 wk and 3 wk after intervention(P<0.05).The HAMD scores were comparable between the two groups before intervention(P>0.05),but were significantly lower in the observation group than in the control group at 1 wk and 3 wk after intervention(P<0.05).CONCLUSION Integrated traditional Chinese and Western medicine nursing combined with electrical stimulation of pelvic floor muscles and the rectus abdominis is effective in the treatment of postpartum depression and worthy of clinical promotion.
文摘Postpartum depression affects parents across all social, economic, and racial groups. While there are many factors that may contribute to depressive symptoms in the postpartum period, under-resourced populations and ethnic minorities are documented to experience higher rates. Traditional psychotherapeutic methods have shown success in mitigating depressive symptoms;however, these treatments are not always accessible and/or utilized, particularly in populations with the highest need. Mind-body interventions have become increasingly popular in addressing perinatal mental health, and new and innovative approaches are currently being evaluated to determine their efficacy with respect to treating postpartum depression. This scoping review highlights published clinical trials, interventions, meta-analyses, and reviews conducted in the last 20 years and examines how each method applies to meet the needs of postpartum parents, and particularly under-resourced populations.
基金This study was reviewed and approved by the Ethics Committee of Suzhou Ninth People's Hospital.
文摘BACKGROUND Changes in China's fertility policy have led to a significant increase in older pregnant women.At present,there is a lack of analysis of influencing factors and research on predictive models for postpartum depression(PPD)in older pregnant women.AIM To analysis the influencing factors and the construction of predictive models for PPD in older pregnant women.METHODS By adopting a cross-sectional survey research design,239 older pregnant women(≥35 years old)who underwent obstetric examinations and gave birth at Suzhou Ninth People's Hospital from February 2022 to July 2023 were selected as the research subjects.When postpartum women of advanced maternal age came to the hospital for follow-up 42 d after birth,the Edinburgh PPD Scale(EPDS)was used to assess the presence of PPD symptoms.The women were divided into a PPD group and a no-PPD group.Two sets of data were collected for analysis,and a prediction model was constructed.The performance of the predictive model was evaluated using receiver operating characteristic(ROC)analysis and the Hosmer-Lemeshow goodness-of-fit test.RESULTS On the 42nd day after delivery,51 of 239 older pregnant women were evaluated with the EPDS scale and found to have depressive symptoms.The incidence rate was 21.34%(51/239).There were statistically significant differences between the PPD group and the no-PPD group in terms of education level(P=0.004),family relationships(P=0.001),pregnancy complications(P=0.019),and mother–infant separation after birth(P=0.002).Multivariate logistic regression analysis showed that a high school education and below,poor family relationships,pregnancy complications,and the separation of the mother and baby after birth were influencing factors for PPD in older pregnant women(P<0.05).Based on the influencing factors,the following model equation was developed:Logit(P)=0.729×education level+0.942×family relationship+1.137×pregnancy complications+1.285×separation of the mother and infant after birth-6.671.The area under the ROC curve of this prediction model was 0.873(95%CI:0.821-0.924),the sensitivity was 0.871,and the specificity was 0.815.The deviation between the value predicted by the model and the actual value through the Hosmer-Lemeshow goodness-of-fit test was not statistically significant(χ^(2)=2.749,P=0.638),indicating that the model did not show an overfitting phenomenon.CONCLUSION The risk of PPD among older pregnant women is influenced by educational level,family relationships,pregnancy complications,and the separation of the mother and baby after birth.A prediction model based on these factors can effectively predict the risk of PPD in older pregnant women.
文摘Depressive disorder is a major contributor to years lived with disability (YLD) globally. It is estimated that 13% of all women experience the disorder in the first year postpartum. Postpartum depression (PPD) has significant implications to the physical and mental wellbeing of both the mother and her baby. Only non-depressed pregnant women (score of ≤ 6 on Edinburgh Postnatal Depression Scale) were recruited into this study. Data collection was done at 2 different stages;at recruitment stage (during the third trimester of pregnancy) and at the follow up stage (4<sup>th</sup> - 6<sup>th</sup> week postpartum). During the recruitment stage, intimate partner violence (IPV) and level of social support perception, among the women, were assessed using Hurt Insult Threaten Scream (HITS) and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires respectively. While at the follow up stage, the Obstetric questionnaire and Mini International Neuropsychiatric Interview (MINI-7) were used respectively to obtain obstetric-related data and to diagnose for occurrence of depression. The incidence of PPD was found to be 16.34%. Several factors such as level of education, husband’s socioeconomic status, stressful life events, low perception of social support, obstetric instrumentation and not having a baby of preferred gender were significantly associated with PPD. Positive predictors of PPD included not practicing breast feeding (OR = 186.72, 95% CI = 8.32 - 4188.35), family history of mental illness (OR = 4.95, 95% CI = 1.04 - 23.81) and pregnancy lasting beyond 40 weeks (OR = 7.26, 95% CI = 1.51 - 34.88). High incidence of PPD with numerous associated but largely modifiable risk factors call for more proactive measures, such as PPD screening among pregnant women.
基金Supported by Medical Health Science and Technology Project of Huzhou City,No.2021GY01.
文摘BACKGROUND It is positive to integrate and evaluate the risk factors for postpartum depression in patients with pregnancy-induced hypertension syndrome and to detect highrisk patients as early as possible,which has application value for the clinical development of personalized prevention programs and prognosis of patients.AIM To analyze factors related to postpartum depression in patients with pregnancyinduced hypertension and construct and evaluate a nomogram model.METHODS The clinical data of 276 patients with pregnancy-induced hypertension admitted to Huzhou Maternity and Child Health Care Hospital between January 2017 and April 2022 were retrospectively analyzed.We evaluated the depression incidence at 6 wk postpartum.The depression group included patients with postpartum depression,and the remainder were in the non-depression group.Multivariate logistic regression analysis and the LASSO regression model were applied to analyze the factors related to postpartum depression in patients with pregnancyinduced hypertension.After that,a risk prediction model nomogram was constructed and evaluated.RESULTS Multivariate logistic regression analysis showed that vitamin A deficiency(VAD)during pregnancy and puerperium,family history of hypertension,maternal intestinal flora imbalance,eicosapentaenoic acid(EPA),and docosahexaenoic acid(DHA)were independent risk factors for postpartum depression in patients with pregnancy-induced hypertension(P<0.05).We constructed the nomogram model based on these five risk factors.The area under the curve,specificity,and sensitivity of the model in predicting postpartum depression in patients with pregnancy-induced hypertension was 0.867(95%confidence interval:0.828–0.935),0.676,and 0.889,respectively.The average absolute error was 0.037(Hosmer-Lemeshow testχ2=10.739,P=0.217).CONCLUSION VAD during pregnancy and puerperium,family history of hypertension,maternal intestinal flora imbalance,EPA,and DHA affect postpartum depression in patients with pregnancy-induced hypertension.
文摘The global incidence of postpartum depression is estimated at approximately 10% - 20%. A lack of partner support is a key factor associated with perinatal depression. This study examined the effects of an educational intervention that provided information for the prevention and early detection of postpartum depression to first-time mothers and fathers who participated in a “First-Time Parent Class.” The study was utilized quasi-experimental research, conducted first with the control group and followed by an assessment of the intervention group. Mothers were assessed using the Edinburgh Postpartum Depression Scale and the Japan Child and Family Research Institute Child-Rearing Support Questionnaire. Fathers’ assessments were conducted using the Japan Child and Family Research Institute Child-Rearing Support Questionnaire for Fathers and were based on responses to questions regarding their coping strategies. Data were obtained from 158 data (72 interventions, 86 controls) couples analyzed. No significant difference was found between mothers’ child-rearing difficulty and depression score rates in the first month after childbirth. There was a difference among fathers in the control group and those in the intervention group regarding their responses to maternal depression: the “consult family” (p = 0.035), “consult friends” (p = 0.033), and “consult the city health center” (p = 0.047) variables were higher in the intervention group;however, the effect size was small. Providing first-time parents with information during pregnancy to prevent and detect postpartum depression will deepen parents’ understanding and help them cope with postpartum depression.
基金Foundation items: The preparation of this review was partially supported by a grant from the National Institute of Mental Health (5R01 MH097718-02), U.S.A.
文摘The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions.
基金Supported by Humberto Corrêa has received research funding from Fundacao de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
文摘Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression(PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression(MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases Pub Med, LILACS and Sci ELO using the index terms "postpartum depression" and "genetics". Literature searches for articles in peerreviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.
文摘Objective: Anxiety is common among pregnant women. However, research attention in the area of reproductive mental health has mainly focused on postpartum depression in past decades. Given adverse outcomes of antenatal anxiety, there is an urgent need to fill the research gaps. The objectives of the present study were to determine the prevalence of antenatal anxiety symptoms and examine the risk factors and effects of anxiety symptoms in early pregnancy on anxiety and depressive symptoms in later pregnancy and early postpartum period. Methodology: A prospective longitudinal design with quantitative approach was adopted. A consecutive sample of 1470 Chinese pregnant women from hospitals in Hong Kong was invited to participate in the study and was assessed using standardized instruments on 3 time points including first and third trimesters of pregnancy and 6-week postpartum. Results: The results showed that 17.7% of pregnant women manifested anxiety symptoms in the first trimester of pregnancy. Single mothers, younger mothers, mothers who smoked before pregnancy and mothers who received low education level reported significantly higher levels of anxiety symptoms in the first trimester. Unwanted pregnancy, low self esteem, low marital satisfaction and perceived low social support were significant psychosocial risk factors for anxiety symptoms in the first trimester. Anxiety symptoms in the first trimester were independent predictors for anxiety symptoms in the third trimester ( QUOTE β = 0.26, t = 5.74, p < 0.001), however anxiety symptoms in the first trimester no longer significantly predicted anxiety and depressive symptoms in 6 weeks postpartum after adjusting for the effects of potential confounders. Discussions: The present study points to the need for greater research and clinical attention to antenatal anxiety given that antenatal anxiety is a prevalent problem and has serious impacts on maternal well-being. Such findings also contribute to the understanding of maternal anxiety and have implications for the design of effective identification, prevention and treatment of these significant clinical
文摘Introduction: Postpartum depression (PPD) affects women’s health and self-confidence, and infant’s social, emotional, cognitive and even physical development. Studies show that parents of preterm infants frequently experience symptoms of depression and anxiety. Women with unintended pregnancy are subjected to more risk of depression than women with planned pregnancy. Unintended pregnancy may lead to increased maternal exposure to psychosocial stressors, reduced social support by the spouse, increased levels of depressive symptoms and decreased life satisfaction. Findings: No significant difference was observed between term and preterm infants’ mothers (p = 0.85) in terms of postpartum depression. However, two groups of fathers in terms of depression showed a significant difference (p = 0.045). McNemar’s test showed that parents of term infants (K = 0.322, p = 0.077), and parents of preterm infants (k = 0.17, p = 0.144) agreed with each other on unintended pregnancy. Conclusion: Fathers of preterm infants are at higher risk for mental disorders than fathers of term infants and they need more attention in future studies.
文摘Postpartum depression is a common complication related to childbearing with an estimated prevalence of 10% - 15%. The aim of the study was to explore and synthesize qualitative empirical studies published between 2005 and 2016 that describe women’s experiences of postpartum depression. Ten qualitative studies describing different perspectives on women’s experiences of postpartum depression were summarized and synthesized using Noblit and Hare’s 7-step meta-ethnographical method. Four central metaphors described women’s experiences of postpartum depression: Feeling trapped by reality, Experiencing a nameless chaos, Struggling to find a way out and Being seen as a normal but suffering person. The findings resulted in the following synthesis: The women expected the transition to motherhood to be a joyous experience. Instead, they found it painful, lonely and experienced losing themselves in a nameless chaos. Motherhood is challenged when women experience losing themselves due to depression rather than building a new identity as a mother. Such a situation causes chaos, shame, anxiety and isolation. When seeking professional help, it is essential that the woman is encountered with empathy and professional knowledge, rather than a pat on the back and an underestimation of her problems.
文摘The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental state of mothers in both the antepartum and postpartum period assessed by the Edinburgh Postnatal Depression Scale (EPDS) and Mother-Infant-Bonding-Scale (MIBS), and compare the results. Participants (n = 134) were recruited twice in antepartum medical checkups (20 to 36 weeks of gestation) and postpartum medical checkups (1 month after birth). Information on characteristics of participants was collected from medical records in both periods. Family function and ante-postpartum mental health were assessed by Family APGAR, EPDS, and MIBS. Antepartum depressive state was related to postpartum depressive state (p = 0.015), antepartum bonding was related to bonding in postpartum bonding (p = 0.0001), and antepartum bonding disorder was related to postpartum depressive state (relative risk = 11.7). Worries about costs and poor of family function were related to the mental health of mothers in both the antepartum and postpartum periods. Antepartum depressive state is an indicator of postpartum depression. We suggested that health professionals conduct an evaluation of mother’s mental health and related factors in the antepartum period. The present findings emphasize the importance of antepartum mental health as a predictor of postpartum depression and bonding disorder.
文摘Transition to being a parent is a stress-producing process that involves adapting both parents and their families even in the most favorable circumstances. Information on the level of psychological adaptation of women and family before and during pregnancy is very important as anxiety and the effects of accumulated life stress can directly affect individual and family well-being in the postnatal period. Especially for women or families facing multiple stresses and limited resources, ensuring security, understanding, compassion and direction may have a significant positive effect during this phase. A sample of 91 women immediately after birth at the Obstetrics-Gynecology Clinic (KOGJ) at the University Clinical Center of Kosovo (UCCK) completed two self-administered questionnaires. Initially, literature on postpartum depression was investigated. Two instruments for this paper have been selected from the range of instruments available for postnatal depression research literature: Patient health questionnaire (PHQ-9) and Postpartum Depression Screening Scale (PDSS). The introduction and analysis of data is done with the Statistical Package of Social Sciences (SPSS), Version 21 (Statistical Package for the Social Sciences—SPSS). Failure or frustration and sleep problems are the highest mean postnatal depression indicators 1.8. Then there is fatigue or lack of energy, increased appetite or anorexia and suicidal thoughts and self-esteem with a mean attendance of 1.7 in the post-depression indicator group. Depression or loss of hope and dissatisfaction or interest in activities are in the group of indicators with an average of 1.6. Movement or speech problems and concentration problems are the least affected indicators in the post-depression indicator group, with only 1.5. Our statistics show a relatively high level of postpartum depression, which includes women of all categories without taking into account the economic situation, the level of education or the number of births, the results derived from the correlation analysis which is non-aligning during the comparison of these categories. Involvement of nurses/midwives at a time setting of this phenomenon is a necessity for which to invest?
基金National Natural Science Foundation of China(No.81573846)Central-Level Research Institutes'Basic Scientific Research Business Expenses Special Independent Topic Selection Project(No.YZ-1819)+1 种基金National Natural Science Foundation of China(No.81603516)Institute of Basic Theories of Traditional Chinese Medicine,China Academy of Chinese Medical Sciences Independent Topic Selection Project For Basic Scientific Research Business Expenses(No.YZ-1705)。
文摘Objective:To obtain the rules of acupoint use and compatibility methods from RCT literature of acupunctureand moxibustion in the treatment of postpartum depression through data mining,so as to provide effective acupoints for clinical reference.Methods:a total of 557 clinical literatures on acupuncture and moxibustion in the treatment of postpartum depression were retrieved through China knowledge Network Database,Wanfang Database and Chongqing VIP Database,and 44 articles were obtained through inclusion and exclusion criteria.Statistical analysis was carried out with the help of SPSS20.0 and SPSS Modeler18.1.Results:the most commonly used acupuncture points for postpartum depression are Baihui,Taichong,Sanyinjiao,Zusanli,Neiguan,Governor Meridian,foot Jueyin liver Meridian and foot Sun bladder Meridian,which are closely related to the treatment of postpartum depression.most doctors'clinical acupuncture treatment sites are head,limbs and back.The correlation analysis results obtained by SPSS Modeler software are Taichong-Neiguan-Zusanli,Taichong-Neiguan and Neiguan-Zusanli.Finally,the high-frequency acupoints are clustered and classified into four clusters,namely Taichong,Neiguan,Sanyinjiao and Zusanli.Hegu,Sishencong;Baihui,Shenmen;Pishu and Guanyuan.Conclusion:the rule of acupoint use of acupuncture and moxibustion in the treatment of postpartum depression through data mining can provide some reference for the clinical treatment of postpartum depression in the future.