Obstetric risk factors for postnatal depression in urban and rural community samples (original) (raw)
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Obstetric and sociodemographic risk of vulnerability to postnatal depression
Patient Education and Counseling, 2007
Objective: To assess the associated obstetric and sociodemographic risk of vulnerability to postnatal depression in a population-based study. Methods: All women presenting for postpartum care (n = 1656) were surveyed at pregnancy care units of southern-eastern Hungary between January 2004 and May 2006 with an anonymously completed Leverton questionnaire (LQ). The demographic characteristics, obstetric data and related variables were determined as potential correlates of vulnerability to postnatal depression. Significant predictive factors associated with vulnerability were analysed by means of linear correlation and multiple regression analysis. Results: The Leverton score significantly differed between primiparous and multiparous women [primiparous 11.3 AE 7.0 (mean AE standard deviation) and multiparous women 12.1 AE 7.1]. The univariate difference was not significant as regards previous infertility [infertility: 11.4 AE 6.2 and no infertility: 11.7 AE 7.2]. Vulnerability to depression was diagnosed in 892 (53.9%) of the postpartum women. The predictors of vulnerability to postnatal depression include an unwanted pregnancy (AOR: 5.6, 95% CI: 3.97-9.71) and an unfavourable pregnancy case history (AOR: 2.27, 95% CI: 2.912-5.76). The higher number of children represent significantly lower odds for postpartum vulnerability in the case of multiparous women (AOR: 0.11, 95% CI: 0.05-0.16). Conclusion: The risk of postnatal depression can be modified by the sociodemographic and obstetric history data. Practice implications: Our predictive data reflect that the LQ is useful screening method for postnatal vulnerability and determine the advisability of intervention/preventive therapy control the effects of the risk factors concerning vulnerability. #
Iranian journal of psychiatry and behavioral sciences, 2014
There are various attempts to confirm variables that could predict postpartum depression in advance. This study determined antenatal risk factors for postpartum depression in women at risk of developing this disorder. A prospective cohort study was conducted with 2279 eligible women who attended at Mazandaran province' primary health centers from 32-42 weeks of pregnancy to eighth postpartum weeks. The women were screened for symptoms of depression using the Iranian version of Edinburgh Postnatal Depression Scale. An Edinburgh Postnatal Depression Scale score of > 12 indicated possible postpartum depression. Univariate and multiple logistic regression models were used for data analysis. A total of 2083women during 32-42 weeks of gestation participated in this study and were followed up to 8-week postpartum. Four hundred and three (19.4%) mothers yielded scores above the threshold of 12. Depression and general health state in pregnancy based on Edinburgh Postnatal Depression S...
TURKISH JOURNAL OF MEDICAL SCIENCES, 2013
To determine the occurrences of depression experienced by women during the postpartum period and the risk factors that affect the development of this depression. Materials and methods: The study involved 330 women who had recently given birth in a hospital in 2007. The women were contacted 3 times in total: on postpartum day 1 (face to face) and in weeks 2 and 6 (by phone). The Edinburgh Scale of Postpartum Depression (EPDS) was used as the form for collecting data. According to the EPDS, women who have scored 13 points or above are sensitive to depression. Results: The EPDS scores of 16.7% of women on postpartum day 1 and 19.4% of women at postpartum weeks 2 and 6 were 13 points or above. It has been determined that the difference of the average of EPDS points is statistically significant according to the factors of educational status, age, desire for the pregnancy, and having difficulty in caring for the baby with the spouse (P < 0.05). Conclusion: It is important that nurses provide consultancy services for women about depression during postpartum period.
Antenatal risk factors for postnatal depression: A large prospective study
Journal of Affective Disorders, 2008
Background: This study measured antenatal risk factors for postnatal depression in the Australian population, both singly and in combination. Risk factor data were gathered antenatally and depressive symptoms measured via the beyondblue National Postnatal Depression Program, a large prospective cohort study into perinatal mental health, conducted in all six states of Australia, and in the Australian Capital Territory, between 2002 and 2005. Methods: Pregnant women were screened for symptoms of postnatal depression at antenatal clinics in maternity services around Australia using the Edinburgh Postnatal Depression Scale (EPDS) and a psychosocial risk factor questionnaire that covered key demographic and psychosocial information. Results: From a total of 40,333 participants, we collected antenatal EPDS data from 35,374 women and 3144 of these had a score N 12 (8.9%). Subsequently, efforts were made to follow-up 22,968 women with a postnatal EPDS. Of 12,361 women who completed postnatal EPDS forms, 925 (7.5%) had an EPDS score N12. Antenatal depression together with a prior history of depression and a low level of partner support were the strongest independent antenatal predictors of a postnatal EPDS score N 12. Limitations: The two main limitations of the study were the use of the EPDS (a self-report screening tool) as the measure of depressive symptoms rather than a clinical diagnosis, and the rate of attrition between antenatal screening and the collection of postnatal follow-up data. Conclusions: Antenatal depressive symptoms appear to be as common as postnatal depressive symptoms. Previous depression, current depression/anxiety, and low partner support are found to be key antenatal risk factors for postnatal depression in this large prospective cohort, consistent with existing meta-analytic surveys. Current depression/anxiety (and to some extent social support) may be amenable to change and can therefore be targeted for intervention. Crown
Antenatal risk factors for postpartum depression: a synthesis of recent literature
Postpartum nonpsychotic depression is the most common complication of childbearing, affecting approximately 10 –15% of women and, as such, represents a considerable health problem affecting women and their families. This systematic review provides a synthesis of the recent literature pertaining to antenatal risk factors associated with developing this condition. Databases relating to the medical, psychological , and social science literature were searched using specific inclusion criteria and search terms, in order to identify studies examining antenatal risk factors for postpartum depression. Studies were identified and critically appraised in order to synthesize the current findings. The search resulted in the identification of two major meta-analyses conducted on over 14,000 subjects, as well as newer subsequent large-scale clinical studies. The results of these studies were then summarized in terms of effect sizes as defined by Cohen. The findings from the meta-analyses of over 14,000 subjects, and subsequent studies of nearly 10,000 additional subjects found that the following factors were the strongest predictors of postpartum depression: depression during pregnancy, anxiety during pregnancy, experiencing stressful life events during pregnancy or the early puerperium, low levels of social support, and a previous history of depression. Critical appraisal of the literature revealed a number of methodological and knowledge gaps that need to be addressed in future research. These include examining specific risk factors in women of lower socioeconomic status, risk factors pertaining to teenage mothers, and the use of appropriate instruments assessing postpartum depression for use within different cultural groups.
The risk factors of antenatal depression: A cross‐sectional survey
Journal of Clinical Nursing, 2019
Aims and objectives: To investigate the prevalence of depression in the third trimester of pregnancy and identify the related demographic risk factors. Background: Antenatal depression as a disabling and treatable disease has a wide-ranging impact on perinatal women and has received extensive attention from researchers. Design: A cross-sectional survey was conducted at three public hospitals. Methods: Demographic questionnaire was developed from the literature review, and depression was assessed using the Edinburgh Postnatal Depression Scale. A binary logistic regression model was used to assess the association between depression and demographic predictors. STROBE checklist for crosssectional studies was applied in this paper (see Supplementary File 1). Result: 773 pregnant women participated in the study. 29.6% of participants scored more than 9 points on Edinburgh Postnatal Depression Scale. In the final logistic model, living in rural area, marital satisfaction, assisted reproductive technology, lacking of prenatal health knowledge and life events were strongly significantly associated with antenatal depression. Moreover, living in an extended family, without Medicare insurance, unemployed, working as civil servants or health care workers, and lower household income Accepted Article This article is protected by copyright. All rights reserved. also predicted antenatal depression. However, education level, smoking or drinking before pregnancy were found not to be associated with antenatal depression. Conclusion: Our findings suggest that the prevalence of antenatal depression was high. Satisfied with the current marital status, pregnancy without assisted reproductive technology, knowledge of perinatal care and no life events recently were considered as the protective factors for antenatal depression. Relevance to clinical practice: Antenatal psychological interventions should focus on how to improve the marital satisfaction and the relationship with their family members. More attentions should be paid to the women who have had some life events recently or received assisted reproductive technology for pregnancy.
Journal of Consulting and Clinical Psychology, 1989
Examined the prevalence of depression in a heterogeneous sample of 360 pregnant women. Subjects were assessed with respect to both depressive symptomatology and diagnostic status during pregnancy and after delivery. At both assessments, approximately 25% of the sample reported elevated levels of depressive symptomatology. In contrast, 10% of the women met diagnostic criteria for depression during pregnancy, and 6.8% were depressed postpartum. However, only half of the cases of postpartum depression were new onset (3.4%); the remaining women receivirg a diagnosis in the postpartum had also been depressed during pregnancy. Finally, depression during pregnancy was related to different sociodemographic variables than was postpartum depression, suggesting that depression at these two times may be associated with different psychological or etiological factors.
Postpartum Depression: Prevalence and Contributing Risk Factors
… Klinikleri Journal of …, 2011
To determine the prevalence and to assess the contributing risk factors of postpartum depression in an urban population. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A prospective study involving postpartum women was conducted at a tertiary medical center in order to determine the individuals with depressive symptomatology. Three different depression scales namely Edinburgh Postnatal Depression Scale, Beck Depression Inventory, and Hamilton Depression Rating Scale were used. The scales were administered twice, in the first and sixth week after the delivery. Prevalance of postpartum depression and associated risk factors such as sociodemographic, psychological, and pregnancy-labour related parameters were evaluated. R Re es su ul lt ts s: : In 123 postpartum women, the prevalence of postpartum depression according to the results of three different depression scales was 9.8-30.1% in the first week, and was reduced to 6.5-16.3% at the postpartum sixth week. Eight (6.5%) women have exhibited postpartum depression according to the scores of all three scales at the same time during the second evaluation. Low family income, severe intrafamilial conflict and personal history of psychiatric treatment were related with depressive symptomatology, and these risk factors were detected among the women who scored positively according to the scores of all three scales at the postpartum sixth week (p= 0.007, p= 0.021, p= 0.024 respectively). C Co on nc cl lu us si io on n: : Better understanding of risk factors leading to postpartum depression is mandatory for health care providers to recognize this significant psychiatric disorder at an early stage. Screening by using various scales should be encouraged for timely detection of vulnerable women.
Postpartum depression: identification of women at risk
BJOG: An International Journal of Obstetrics and Gynaecology, 2000
To identify and test the predictive power of demographic, obstetric, and psychosocial risk factors of postpartum depression. Community-based, prospective follow up study based on questionnaires on past history of psychiatric disease, psychological distress and social support during pregnancy and depression at four months after delivery. Obstetric files were collected at time of birth. Antenatal care clinic and delivery ward, Aarhus University Hospital, Denmark. 6,790 women giving birth between 1 January 1994 and 31 December 1995, who attended the antenatal clinic during pregnancy; 5,252 (78%) completed all questionnaires. The validation population comprised 528 women enrolled immediately prior to and after the study period. Postpartum depression four months after giving birth assessed by the Edinburgh Postnatal Depression Scale. 5.5% of the women suffered from postpartum depression, corresponding to a score of 13 or higher on the Edinburgh Postnatal Depression Scale. Risk factors identified by multivariate logistic regression analysis included psychological distress in late pregnancy (OR 6.3 [95% CI 4.4-9.1]), perceived social isolation during pregnancy (OR 3.6 [95% CI 1.9-7.0]); high parity (OR 3.8 [95% CI 1.8-8.0]); and a positive history of prepregnant psychiatric disease (OR 2.1 [95% CI 1.4-3.2]). No association was found between pregnancy or delivery complications, and postpartum depression. The maximum predictive power of the identified risk factors was 0.3. According to these results, one out of three women who suffers from psychological distress in late pregnancy with perceived social isolation will develop postpartum depression. Antenatal focus on psychosocial wellbeing may help to identify women at risk of postpartum depression.
From Antenatal to Postnatal Depression: Associated Factors and Mitigating Influences
Journal of Women's Health, 2013
Introduction: Postnatal depression has a serious impact on new mothers and their children and families. Risk factors identified include a history of depression, multiparity, and young age. The study aimed to investigate factors associated with experiencing antenatal depression and developing subsequent postnatal depression. Methods: The study utilized survey data from 5332 women about their experience and well-being during pregnancy, in labor, and postnatally up to 3 months. Prespecified sociodemographic and clinical variables were tabulated against the incidence of antenatal depression and postnatal depression. Binary logistic regression was used to estimate the effects of the principal underlying variables. Results: Risk factors for antenatal depression were multiparity, black and minority ethnic (BME) status, physical or mental health problems, living in a deprived area, and unplanned pregnancy. Different factors for postnatal depression were evident among women who had experienced antenatal depression: multiparity and BME status were protective, whereas being left alone in labor and experiencing poor postnatal health increased the risk of postnatal depression. Conclusion: This study confirms previous research on risk factors for antenatal depression and stresses the importance of continuous support in labor and vigilance in the postnatal period regarding the potential ill effects of continuing postnatal health problems.