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Introduction Maternal sensitivity and mentalization are fundamental for children's mental health development. These skills have been negatively associated with maternal postpartum depressive symptomatology. Moreover, its prevalence increases in low socioeconomic and psychosocial risk contexts, where the access to treatment is scarce. Even though Attachment Based Interventios, such as Video-Feedback has been internationally recognized as an effective intervention. Its cost, as well as the need for language translation and cultural adaptation makes it difficult to implement in Latinamerican countries. Aim The present study aims to assess the feasibility and acceptability of an online Video-Feedback intervention informed n mentalization aimed at mother-infant dyads with depressive symptomatology who attend Chilean public health centers. Method This is a pilot randomized clinical trial with two groups of 60 mother-infant dyads between 4 and 12 months of age. Participants will be randomly assigned to control and experimental groups in a 1:1 ratio. Even though both groups will receive usual treatment, the experimental group will also receive the present video-intervention. At the end of the study, feasibility will be assessed based on focus groups aimed at interveners and quantitative outcomes such as recruitment rate, questionnaire completion rate and intervention completeness. Acceptability will be assessed from in-depth interviews with participants. In addition, effect sizes of primary and secondary outcomes will be calculated. Expected results Results are expected to generate parameters to design a larger-scale clinical trial and to preliminary assess the effect of the reported mentalization-informed intervention on maternal sensitivity. Additionally, it seeks to contribute with a mental health intervention for low-income mother-infant dyads, which can be implemented remotely, at a low cost, and that would be suitable for implementation at a mental health care system policy. The protocol of this trial's design was registered at Clinical Trials (NCT04748731).
Introducción La sensibilidad y la mentalización materna constituyen competencias fundamentales para el desarrollo de la salud mental infantil. A su vez, dichas habilidades han sido negativamente asociadas con la presencia de sintomatología depresiva postparto, la cual aumenta su prevalencia en contextos de bajo nivel socioeconómico y riesgo psicosocial, en donde el acceso a tratamiento escasea. Paralelamente, si bien internacionalmente el video-retroalimentación constituye una herramienta efectiva en intervenciones basadas en el apego, el costo, idioma y necesidad de adaptación cultural dificultan su implementación en países latinoamericanos. Objetivo Evaluar la factibilidad y aceptabilidad de una video-intervención informada por la mentalización, dirigida a díadas madre-bebé con sintomatología depresiva, atendidas en centros públicos de atención en salud mental en Chile. Métodos Ensayo clínico aleatorio piloto con dos grupos de 60 díadas madre-bebé de entre 4 y 12 meses de edad, quienes serán asignados aleatoriamente a grupos control y experimental en una proporción de 1:1. Si bien ambos grupos recibirán el tratamiento habitual, el grupo experimental recibirá también la video-intervención. Al término del estudio se evaluará la factibilidad a partir de grupos focales dirigidos a interventores e indicadores de resultados cuantitativos tales como tasa de reclutamiento, de completación de cuestionarios y finalización de la intervención. La aceptabilidad se evaluará a partir de entrevistas en profundidad a las participantes. Adicionalmente se calculará tamaño del efecto de indicadores de resultados primarios y secundarios. Resultados esperados Se espera que los resultados del estudio generen parámetros para diseñar un ensayo clínico de mayor escala y evaluar preliminarmente el efecto de la intervención informada en la mentalización en la sensibilidad materna. Se busca además contribuir con una intervención en salud mental basada en la teoría del apego dirigida a díadas madre-bebé de bajos ingresos, que pueda ser implementada de manera remota, a bajo costo y apta para ser escalada a los sistemas de atención en salud mental.
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Context: Postpartum depression (PPD) is onset of depressive symptoms in postpartum period from 2 weeks to 1 year. It causes maternal morbidity and long?term negative effects on growth and development of infant and child. It is often unreported and underdiagnosed. Aims: (1) To estimate the prevalence of PPD,(2) To determine socio?demographic, clinical, and obstetric correlates of the same. Settings and Design: A cross-sectional study was done in urban and rural areas of District Aligarh. Methods: A total of 304 females between 6 weeks and 6 months’ postpartum period giving consent were included in this study. Sociodemographic, obstetric, and clinico-social factors were recorded using predesigned, pretested questionnaire. Edinburgh Postnatal Depression Scale (EPDS) score ?10 was used to screen for PPD and International Classification of Disease (ICD?10) criteria for confirmation. Statistical Analysis Used: Correlates of PPD were determined using logistic regression analysis. Results: The prevalence of PPD was 9.5% using EPDS and was confirmed by ICD?10 criteria. History of abortion (adjusted odds ratio [AOR]: 6.0, 95% Confidence Interval [CI] 2.2–16.5), poor relationship with in?laws(AOR: 5.1; 95% CI 1.3–20.5), marital conflict (AOR: 13.3; 95% CI 2.2–77.6), and substance abuse in husband (AOR: 3.1; 95% CI 1.1–9.0) were found to be significant correlates for PPD. Conclusions: About one in every 10 postpartum females suffered from depression but did not seek health care for the same. Women facing social pathologies such as substance abuse in husband, marital conflict, and poor relationship with in?laws are more at risk of PPD. Screening for PPD should be included in the maternal and child health care programs to ensure early diagnosis and treatment.
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Background- Antenatal depression is affecting 10% pregnant women worldwide with higher prevalence in developing countries. This causes poor maternal and foetal outcome and also affects cognitive development of the child. Aim and objective: To estimate magnitude of antenatal depression and its risk factors. Methodology- A cross-sectional survey was done at the antenatal clinic of community health department catering to an urban resettlement colony, East Delhi. Estimated sample size was 216 (including 10% non-response rate). Pregnant women attending the ANC clinic from October 2019 to February 2020 were enrolled. EPDS questionnaire was used to assess depression during pregnancy. Results-The antenatal depression was found in 11.8% subjects as per EPDS score. Working female and belonging to Muslim religion, past history of abortion, complications in previous pregnancy, financial debt, physical violence and substance use in family showed significant association with antenatal depression. Conclusion –Depression was prevalent among antenatal women and was found to be associated with various risk factors.
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Background: Postpartum depression is one of the most common, but often unrecognized, complications of childbirth and is considered as a serious psychological disorder that can affect women during or after birth and during pregnancy. Its risk increases during the ?rst 90 days and can last up to nearly two years. Objectives: To determine the prevalence of postpartum depression (PPD) and correlate it with variables of obstetric and demographic predictors among females attending primary health care centres in Arar city. Methodology: This was a cross-sectional study carried out by using Arabic version of questionnaire of Edinburgh Postnatal Depression Scale (EPDS) tool during the study period from August to September 2021. A total of 383 sample was taken by using convenience sampling method. Analysis was done by using Statistical Package for Social Sciences. Results: The prevalence of postpartum depression was 30.5%. Multiple associated factors were found to be signi?cantly increase the risk of PPD such as: females who had caesarean section delivery, unplanned pregnancy, complicated pregnancy, their baby had medical problem and had no or less husband support, had psychiatric disorders, had chronic medical problem, taking chronic medication, had life stressor, low education and low income (P < 0.05). The results of the logistic regression analysis showed that the odds of PPD signi?cantly increase in females had caesarean section delivery compared to vaginal delivery (P = .002), females had rare support from the husband (P = .002), females had psychiatric disorders (P = 0.016) and had life stressor (P = .000). Conclusions: The prevalence of postpartum depression in the city of Alar was clearly high. Our study also showed important predictors that could be used to identify high-risk females. It is advisable to provide social support to females during both prenatal and postnatal periods. Regular screening of women for postpartum depression should be encouraged for early detection and prompt intervention
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Objective:To investigate the effect of neonatal breast crawling exercise on breastfeeding and psychological state of primiparas who delivered vaginally.Methods:Using convenience sampling method, 86 pairs of normal term infants and mothers who delivered vaginally in the First People′s Hospital of Yancheng from January 2019 to January 2020 were selected as the research objects, and divided into experimental group and control group according to the random number table method, there were 43 pairs in each group. The control group was given routine postpartum care, while the experimental group was given neonatal breast crawling exercise on the basis of routine postpartum care. The time of initiation of lactation, the success rate of first breastfeeding and the score of first Breastfeeding Assessment Tool (BAT) were compared between the two groups. The rates of exclusive breastfeeding, the scores of Breastfeeding Self-efficacy Scale Short Form (BSES-SF) and the scores of Edinburgh Postnatal Depression Scale (EPDS) were compared between the two groups at 72 h and 42 d after delivery respectively.Results:The time of initiation of lactation was (48.36 ± 6.12) h in the experimental group, which was significantly earlier than that in the control group(52.86 ± 7.29) h, the difference was statistically significant (t=3.08, P<0.05). The success rate of first breastfeeding and the BAT scores of the experimental group were 88.1% (37/42) and (9.74 ± 1.33), respectively, which were significantly higher than those in the control group 69.8% (30/43) and (8.84 ± 1.60), the differences were statistically significant (χ 2=4.28, t=2.82, both P<0.05). At 72 h and 42 d after delivery, the rate of exclusive breastfeeding were 42.9%(18/42) and 86.49%(32/37) in the experimental group, significantly higher than those in the control group 20.9% (9/43) and 60.00% (24/40), the differences were statistically significant (χ 2=4.71, 3.93, both P<0.05). At 72 h and 42 d after delivery, the BSES-SF scores were (38.48 ± 6.34) and (45.43 ± 11.45) in the experimental group, which were significantly higher than those in the control group (35.21 ± 4.87) and (40.10 ± 10.82), the differences were statistically significant (t=2.66, 2.10, both P<0.05); the EPDS scores were (5.52 ± 1.53) and (7.38 ± 2.25) in the experimental group, which were significantly lower than those in the control group (6.26 ± 1.63) and (8.73 ± 2.39), the differences were statistically significant (t=2.13, 2.54, both P<0.05). Conclusions:Neonatal breast crawl is an effective way to promote the breastfeeding. It can also enhance maternal confidence and alleviate maternal psychological status.
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Resumen OBJETIVO: Estimar la prevalencia de depresión posparto y los factores asociados en usuarias del Hospital General Progreso, Acapulco, Guerrero, México. MATERIALES Y MÉTODOS: Estudio prospectivo, observacional y transversal de serie de casos. El instrumento para medir la depresión fue un cuestionario que incluyó la Escala de Depresión Posnatal de Edimburgo (EPDS por sus siglas en inglés). Además, a las pacientes se les preguntaron sus datos sociodemográficos, antecedentes de control prenatal, historial obstétrico, atención del parto y otros datos relacionados con su pareja. Mediante análisis bivariado y multivariado se estimaron los factores asociados con la depresión posparto. RESULTADOS: Se analizaron 485 pacientes con media de edad de 24.6 años y límites de 14 y 43 años. La prevalencia de depresión posparto fue de 16%. En el modelo final del análisis multivariado los factores asociados con la depresión posparto fueron: complicaciones en el parto (IC95%:1.61-6.54), antecedente de alcoholismo antes del embarazo (IC95%:1.17- 3.30) y recibir apoyo emocional del esposo durante el embarazo (IC95%: 0.17-0.68). CONCLUSIONES: El antecedente de consumo de bebidas alcohólicas, previo al embarazo, y tener alguna complicación del parto, fueron indicios de posible aparición de depresión posparto. Quienes la padecieron tuvieron la referencia temprana a los servicios de Psicología. La pareja debe estar informada que su apoyo emocional ayuda a reducir el riesgo de depresión posparto en la paciente.
Abstract OBJECTIVE: To estimate the prevalence of postpartum depression and associated factors in users of the Hospital General Progreso, Acapulco, Guerrero, Mexico. MATERIALS AND METHODS: Prospective, observational, cross-sectional case series study. The instrument to measure depression was a questionnaire that included the Edinburgh Postnatal Depression Scale (EPDS). In addition, patients were asked about their sociodemographic data, prenatal control history, obstetric history, delivery care and other data related to their partner. Factors associated with postpartum depression were estimated by bivariate and multivariate analyses. RESULTS: We analyzed 485 patients with a mean age of 24.6 years and cut-offs of 14 and 43 years. The prevalence of postpartum depression was 16%. In the final multivariate analysis model, the factors associated with postpartum depression were: delivery complications (CI95%:1.61-6.54), history of alcoholism before pregnancy (CI95%:1.17- 3.30) and receiving emotional support from husband during pregnancy (CI95%: 0.17-0.68). CONCLUSIONS: A history of alcoholic beverage consumption prior to pregnancy and having some complication of childbirth were indicative of possible occurrence of postpartum depression. Those who suffered from it had early referral to psychology services. The couple should be informed that their emotional support helps to reduce the risk of postpartum depression in the patient.
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ABSTRACT Background: Previous studies showed consistent results for associations between circulating concentrations of vitamin D and risk of antenatal, postnatal depression. Methods: Articles published in English before November 2020 were searched in databases as follows: PubMed, EMBASE, Web of Science, Medline, Google Scholar and Cochrane. These articles explored associations between circulating concentrations of vitamin D and risk of antenatal, postnatal depression.The present meta-analysis was conducted using STATA 12.0 software. Odds ratios (ORs) and 95% confidence intervals (CIs) extracted from included studies were computed using a random effects model or a fixed effects model according to heterogeneities between included studies. Q test and I2 were used to explore heterogeneities between included studies. Results: 7 cohort studies (including 1567 depression cases and 5254 controls) and 3 case-control studies (including 995 depression cases and 1265 controls) were included in the present study. The study showed that low circulating levels of 25-hydroxy (OH) vitamin D is significantly associated with a higher risk of antenatal and postnatal depression (OR = 1.02, 95% CI 1.01 to 1.04, I2 = 90.7%, p < 0.001). Conclusion: Our results have shown that the low level of vitamin D may be an adverse factor of antenatal and postnatal depression.
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Background: Pregnancy and childbirth are two most important life-changing events. Post-partum depression can affect mother and has a wide spectrum of presentation depending upon various social factors. Studies suggest that the incidence of postnatal depression among women of high social strata is 13-19% while the incidence is 11-42% among women with limited social support. The present study aims to study postnatal depression and its causes in a postnatal mother in all the aspects of social, physical, cultural and psychiatric grounds in the Indian scenario with the help of the Edinburgh postnatal depression scale (EPDS).Methods: From 1st July 2019 to 31st December 2019, a total 300 postnatal women between 1 to 6 weeks of the postpartum period participated and during their stay in the hospital responded to EPDS. The study was purposive sampling, and full consent of the study subjects was taken before the start of the study.Results: In this study, we found 20.1% of a woman affected by post-partum in South India. The higher percentage of severe depression was seen in the primary gravida (20%). The risk factors such as availability of postnatal care (with NICU admission), the woman with medical complications, late childbirth or delayed childbirth after marriage, multiparity, delivery via caesarean and nuclear family showed significant relationship (p<0.005) with depression.Conclusions: The present study, with a Post-natal depression of 20.1% along with the enumerated risk factors, suggest that the causes for postpartum depression (PPD) among working Indian woman, reflect a change to an urban-centric lifestyle. Further evaluation of these risk factors needs to be made and a routine screening of Postpartum depression (PPD) can help in improving maternal and child health.
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Esta revisão sistemática visa identificar os fatores de risco psicossociais para depressão pós-parto (DPP). Foram selecionados 11 artigos por meio das bases: Embase, Medline e SciELO. Os critérios de inclusão foram: data de publicação nos últimos cinco anos, língua inglesa ou portuguesa, delineamento observacional longitudinal e ser referente a fatores de risco psicossociais para DPP. Foram encontrados 25 fatores de risco psicossociais. Entre eles, os fatores mais citados foram: falta de apoio social/familiar, gravidez não planejada, história pessoal de doença psiquiátrica, relacionamento ruim com o parceiro, idade menor que 20 anos e baixa escolaridade. A prevalência de DPP alcançou valores de 4,5% até 50,3% nos estudos avaliados. Isso demonstra a importância da detecção precoce desses fatores de risco e de mais investimentos na área de prevenção dessa doença. Para uma visão integral da doença, uma análise envolvendo uma amostra maior de artigos de bases de dados alternativas se faz necessária.(AU)
This systematic review has the purpose of identifying psychosocial risk factors on post-partum depression (PPD). Eleven articles were selected utilizing three databases: Embase, Medline and SciELO. The inclusion criteria were: publication data in the last five years, English or Portuguese, longitudinal observational design and reference to psychosocial risk factors for Postpartum Depression.Twenty-five factors were identified. Some of them were identified more than others, such as social and/or family support, unplanned pregnancy, personal history of psychiatric diseases, bad relationship with the partner, age under 20 years old, and low levels of schooling. PPD's prevalence was between 4,5% and 50,3%. These numbers confirm the importance of both early detection of risk factors as well as more investments in the prevention of this disease. For an integral view of the disease, an analysis involving a larger sample of alternative database articles is required.(AU)
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Humans , Female , Pregnancy , Risk Factors , Depression, Postpartum , Databases, Bibliographic , Scientific and Technical Publications , Systematic Reviews as TopicABSTRACT
Resumen Introducción: La depresión posparto es un episodio depresivo no psicótico con repercusiones graves en el vínculo de la madre con su hijo, de ahí la importancia de detectarla oportunamente. Objetivo: Determinar la exactitud de la Escala de Depresión Posnatal de Edimburgo como prueba diagnóstica y analizar las consecuencias del tamizaje y la probabilidad de depresión después de aplicar la prueba. Método: Tamizaje con la Escala de Depresión Posnatal de Edimburgo a 411 mujeres durante el posparto; se utilizó el Inventario de Depresión de Beck como referencia. Resultados: En un punto de corte de 12, con la Escala de Depresión Posnatal de Edimburgo se obtuvo sensibilidad de 70.4 %, especificidad de 72.2 %, valor predictivo positivo de 36.9 % y valor predictivo negativo de 91.4 %, así como un valor del área bajo la curva de 0.729 y p = 0.0003. De 49 mujeres sin atención para depresión posparto, en cinco se identificó que la necesitaban. Conclusiones: La Escala de Depresión Posnatal de Edimburgo tiene una exactitud moderada; su aplicación es sencilla, accesible y debería ser rutinaria. Es necesario que en México se implementen estrategias para detectar y tratar la depresión posparto.
Abstract Introduction Postpartum depression is a non-psychotic depressive episode with serious repercussions on the bond between the mother and her child, hence the importance of detecting it in a timely manner. Objective: To determine the accuracy of the Edinburgh Postnatal Depression Scale as a diagnostic test and to analyze the consequences of screening and the probability of depression after applying the test. Method: Screening of 411 women with the Edinburgh Postnatal Depression Scale during the postpartum period; Beck's Depression Inventory was used as reference. Results: At a cutoff point of 12, a sensitivity of 70.4 %, specificity of 72.2 %, positive predictive value of 36.9 % and negative predictive value of 91.4 % were obtained with Edinburgh Postnatal Depression Scale, as well as an area under the curve of 0.729 and a p-value of 0.0003. Out of 49 women without treatment for postpartum depression, five were identified to require it. Conclusions: The Edinburgh Postnatal Depression Scale has moderate accuracy; its application is simple, accessible and should be routine. It is necessary for strategies to detect and treat postpartum depression to be implemented in Mexico.
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Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Psychiatric Status Rating Scales , Mass Screening/methods , Depression, Postpartum/diagnosis , Predictive Value of Tests , Sensitivity and Specificity , MexicoABSTRACT
El presente artículo profundiza en los efectos que tiene la depresión materna en el desarrollo emocional temprano. Un primer enfoque estadístico reúne los datos que la investigación exploratoria sobre depresión de la OMS proporciona. A continuación, se detallan las investigaciones que las disciplinas humanísticas y el psicoanálisis han realizado hasta el momento sobre el tema para describir y explicar el síndrome. El nudo teórico es la articulación entre los conceptos de "duelo blanco" y "complejo de la madre muerta" teorizados por André Green con el de "vacío" de Donald Winnicott y el de "posición depresiva" de Melanie Klein. El valor pragmático del recorrido teórico reside en la posibilidad de resignificar los diagnósticos en la infancia con la herramienta diagnóstica que la CFTMEA - R - 2000 y la categoría de lo "límite" en psicoanálisis ofrecen. También las adecuaciones técnicas imprescindibles para una dirección de la cura tendiente a contrarrestar los efectos de lo negativo en el desarrollo emocional infantil surgidas de la experiencia clínica con estos niños
In this article, the impacts of postnatal depression on emotional development in childhood are studied in depth. A first statistic approach gathers the data provided by the exploratory research on depression according to the WHO. Next, research on humanistic disciplines and psychoanalysis carried out up to the present is described in detail on this topic in order to define and explain the syndrome. The theoretical knot serves as the articulation between the concepts of "white grief" and "dead mother complex", both of them theorized by André Green based on Donald Winnicott's notion of "vacuum" and Melanie Klein's notion of "depressing position." The theoretical path's pragmatic value lies in the likelihood of resignifying diagnoses during childhood making use of the classifying tool offered by psychoanalysis: CFTMEA-R-2000 and the "borderline" category. Likewise, the essential technical adaptations towards a cure that might counteract the negative effect on child emotional development that emerge as a result of the clinical exploration on children are addressed
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Humans , Female , Infant, Newborn , Depression, Postpartum , Borderline Personality Disorder , Infant, Newborn/growth & development , BereavementABSTRACT
Background: Postpartum depression is a signi?cant and common health problem that causes a considerable amount of impact to both the mother and baby and distress on the family and society. The objective of this study is to find out prevalence of postnatal depression among mothers attending immunization outpatient department (OPD) for immunization of their baby in a tertiary health care center and to study some risk factors responsible for it.Methods: This cross sectional study was conducted in a tertiary care teaching hospital of Maharashtra state during period September to February 2019. Total 188 mothers were screened for postpartum depression using local version of EPDS (Edinburgh Postnatal Depression Scale).Results: 24 (12.76%) mothers were found to have a score of 10–12 indicating moderate depressive symptoms, and 18 mothers had a score of 13 and above. (9.57%). Risk factors found to be significantly associated with postnatal depression rural residence of mother, lack of support during and after pregnancy, history of domestic abuse, and stressful life events in the past year.Conclusions: Since the prevalence of EPDS score >13 was found to be high in the current study, we recommend routine screening for PPD in our population.
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Background: Pregnancy and childbirth produce a variety of physiological, psychological and social consequences. Attitudes toward pregnancy and childbirth vary from culture to culture. Prevalence estimates range from 13 to 19% in resource-rich settings and 11 to 42% in resource- limited settings PND has a significant impact on the mother, the family, her partner and mother-infant interaction. This research aims to aid the early diagnosis of postnatal depression and the socio-demographic, obstetric, family dynamics, neonatal characteristics and psychiatric determinants of depression using EPDS among postnatal women in a tertiary hospital in Kerala state, India.Methods: 119 women between 2 to 6 weeks of postpartum period were subjected to a pre-tested pre-structured standard questionnaire. Diagnosis of depression was made using the Edinburgh postnatal depression scale. Possible depression is values >13 or more are invariably associated with depression.Results: Young age at marriage (p-value 0.022), love marriage (p-value 0.040) and low social support inadequate relationship with the in-laws was significantly associated with PND (p-0.003). Low birth weight was a significant determinant of PND (p-value-0.018). Gender of the new-born, fear and preference towards any particular gender and order of female child in multiparous woman had no association in determining postnatal depression. Childcare stress (p-value-0.011), psychiatry history in family and personal history of depression and mothers with low self-esteem (p-value-0.001) had odds of developing postnatal depression in the study.Conclusions: Early screening of the women and counselling of women and their family will reduce the maternal morbidity and adverse child outcomes.
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Background: Postpartum period starts about an hour after the delivery of the placenta and followed until 6 weeks. The hormonal changes that take place during this period lead to depression, one of the silent contributors of poor maternal and child health indices in developing countries leading to increased morbidity among women. In India, postpartum depression (PPD) reports approximately 23% of women in hospital-based data and prevalence varies from 11% to 26% in community-based studies. Objective: The objective of this study was to estimate the prevalence and factors leading to PPD among women residing in urban slums. Materials and Methods: A community-based, cross-sectional study was conducted for 1 year consisting of postpartum women (2–6 weeks) of any age group in urban slums, Dharwad. Patient Health Questionnaire-9 (PHQ-9) scale was used to estimate the prevalence of PPD. Results: Of the 284 women, 45.8% were in the age group of 21–25 years, 38.4% had completed secondary education, and most of them 84.9% were housewives. 35% of women were from nuclear family and 53.2% belonged to the upper middle class. Using PHQ-9 scale, it was seen that 7.7% had minor depression and 0.4% had major depression. Increasing age (χ²âˆ’25.97, P = 0.001), unplanned pregnancy (χ²âˆ’13.51, P = 0.009), those who had pre- and post-term delivery (χ²âˆ’13.83, P = 0.008), and those who delivery through cesarean section (χ²âˆ’35.84, P < 0.0001) were found to be associated with PPD and the association was found to be statistically significant. Conclusion: Equal importance should be given for both physical and mental health of postpartum women for a healthy mother and child.
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@#The World Health Organisation recommends healthcare practitioners to equip themselves with appropriate skills to assess the psychological distress in women attending the antenatal and postnatal healthcare. Nevertheless, little is known about the healthcare practitioners’ perceptions of postnatal depression and its management. The aims of this review were: (i) to explore the experiences of healthcare practitioners in caring for women with postnatal depression in different countries and (ii) to identify any qualitative study conducted in Malaysia regarding the healthcare practitioners’ perceptions of postnatal depression. To achieve these objectives, a qualitative synthesis of studies reporting the healthcare practitioners’ experience of managing women with postnatal depression was conducted. A search in CINAHL, PubMed, MEDLINE, PsycINFO, and ASSIA databases was performed using specific keywords and published peer-reviewed articles from 2006 to 2016 were screened for inclusion criteria. A total of 15 relevant studies were identified and reviewed. The studies included were conducted in eight different countries: America, Australia, United Kingdom, Brazil, Canada, Greek, Mexico, and Slovenia. No study conducted in Malaysia was found. This review suggested that the experiences of managing women with postnatal depression were relatively similar among the healthcare professionals in different countries. The main limitations reported by the healthcare practitioners were the lack of resources on maternal mental health and the absence of policy regarding the management of postnatal depression. Further research should investigate how Malaysian healthcare practitioners perceive postnatal depression and their roles in its management to provide more insights into the current clinical practice in Malaysia for postnatal depression.
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Objective@#To explore the effect of problem-based learning (PBL) health education and nursing mode on the occurrence of depression after primiparous women and its hormone levels.@*Methods@#A total of 468 primiparas who were delivered were selected. The number of singular numbers in the order of hospitalization was the control group, and the double number was the experimental group, 234 cases each. The control group used the traditional obstetric care model, and the experimental group used PBL health education model. The Edinburgh Postnatal Depression Scale (EPDS) and Self-rating Anxiety Scale (SAS) scores were compared between the two groups of prenatal women, 7 days, 42 days, and 3 months postpartum. Estrogen, progesterone, and 5-e were also tested. Serotonin levels. Postpartum depression rates were compared between the two groups according to EPDS and SAS scores. At the same time, the satisfaction rate of women on the quality of care in the two groups was investigated.@*Results@#The EPDS scores (8.3 ± 2.5), (9.0 ± 3.8), and (8.1 ± 2.2) points at 7 days, 42 days, and 3 months after birth were significantly lower in the experimental group than in the control group (9.8 ± 2.5), (11.1 ± 3.7), and (9.2 ± 2.1) points. The difference between the two groups was statistically significant (t =2.35, 1.76, 0.26, P < 0.01). The SAS scores (45.44±4.48), (49.28±3.59), and (38.16±4.45) points at 7 days, 42 days, and 3 months after birth were significantly lower in the experimental group than in the control group (51.69±4.93), (55.79±5.72), and (44.81±3.69) points. The difference was statistically significant (t =2.51, 3.65, 9.91, P < 0.01). There were 41 patients with post-production depression at 42 days postpartum, which was significantly higher than 13 patients in the experimental group. The difference was statistically significant (χ2=1.58, P<0.01). Maternal satisfaction in the experimental group was 96.15%(233/234), and in the control group was 89.32%(228/234), the difference was statistically significant (χ2=14.13, P<0.01). Estradiol levels (14 192.26±3 187.41), (2 954.44±326.16), (702.34±46.41) pmol/L at 7 days, 42 days and 3 months after birth were significantly higher in the experimental group than those in the control group (13 694.45±3 212.18), (2 316.16±391.22), (669.47 ± 53.25) pmol/L. The difference was statistically significant (t =5.16, 1.69, 4.26, P < 0.05). The serotonin levels (434.25±8.41), (315.05±12.35) ng/L at 42 days and 3 months after delivery were significantly higher in the experimental group than those in the control group (415.96±12.35), (308.15±11.35) ng/L. The difference was statistically significant (t=1.58, 3.25, P < 0.05). Progesterone levels (28.19±2.36), (8.25±0.98) µg/L at 42 days and 3 months after delivery were significantly lower in the experimental group than those in the control group (34.25±2.44), (9.69±1.25) µg/L. The difference was statistically significant (t =2.24, 5.16, P < 0.05).@*Conclusions@#PBL health education model can significantly reduce the risk of postpartum depression in primipara, regulate estrogen, progesterone and serotonin levels, and can be applied in obstetrics.
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Objective To explore the effect of problem-based learning (PBL) health education and nursing mode on the occurrence of depression after primiparous women and its hormone levels. Methods A total of 468 primiparas who were delivered were selected. The number of singular numbers in the order of hospitalization was the control group, and the double number was the experimental group, 234 cases each. The control group used the traditional obstetric care model, and the experimental group used PBL health education model. The Edinburgh Postnatal Depression Scale (EPDS) and Self-rating Anxiety Scale (SAS) scores were compared between the two groups of prenatal women, 7 days, 42 days, and 3 months postpartum. Estrogen, progesterone, and 5-e were also tested. Serotonin levels. Postpartum depression rates were compared between the two groups according to EPDS and SAS scores. At the same time, the satisfaction rate of women on the quality of care in the two groups was investigated. ResuLts The EPDS scores (8.3 ± 2.5), ( 9.0 ± 3.8), and ( 8.1 ± 2.2) points at 7 days, 42 days, and 3 months after birth were significantly lower in the experimental group than in the control group (9.8 ± 2.5), (11.1 ± 3.7), and (9.2 ± 2.1) points. The difference between the two groups was statistically significant (t=2.35, 1.76, 0.26, P<0.01). The SAS scores (45.44±4.48), (49.28±3.59), and (38.16±4.45) points at 7 days, 42 days, and 3 months after birth were significantly lower in the experimental group than in the control group (51.69±4.93), (55.79±5.72), and (44.81±3.69) points. The difference was statistically significant (t=2.51, 3.65, 9.91, P < 0.01). There were 41 patients with post-production depression at 42 days postpartum, which was significantly higher than 13 patients in the experimental group. The difference was statistically significant (χ2=1.58, P<0.01). Maternal satisfaction in the experimental group was 96.15%(233/234), and in the control group was 89.32%(228/234), the difference was statistically significant (χ2=14.13, P<0.01). Estradiol levels (14 192.26±3 187.41), ( 2 954.44±326.16), ( 702.34±46.41) pmol/L at 7 days, 42 days and 3 months after birth were significantly higher in the experimental group than those in the control group (13 694.45 ± 3 212.18), (2 316.16 ± 391.22), (669.47 ± 53.25) pmol/L. The difference was statistically significant (t=5.16, 1.69, 4.26, P<0.05). The serotonin levels (434.25±8.41), (315.05±12.35) ng/L at 42 days and 3 months after delivery were significantly higher in the experimental group than those in the control group (415.96 ± 12.35), (308.15 ± 11.35) ng/L. The difference was statistically significant (t=1.58, 3.25, P < 0.05). Progesterone levels (28.19 ± 2.36), (8.25 ± 0.98) μg/L at 42 days and 3 months after delivery were significantly lower in the experimental group than those in the control group (34.25±2.44), (9.69 ± 1.25) μg/L. The difference was statistically significant (t =2.24, 5.16, P < 0.05). ConcLusions PBL health education model can significantly reduce the risk of postpartum depression in primipara, regulate estrogen, progesterone and serotonin levels, and can be applied in obstetrics.
ABSTRACT
Infant social, emotional and neurological development is shaped by the mother-child dyad. Dysfunction in this bond, as well as maternal mental health problems, can negatively impact child development. The family physician is well-placed to spot dysfunction in the mother-child dyad and screen for postnatal depression during well-child visits. If any issues are identified, the family physician can provide support and help the mother-child dyad to access community resources and specialist psychiatric services.
ABSTRACT
OBJECTIVE@#To observe the effect of " Acupuncture" on postpartum low back pain.@*METHODS@#A total of 98 cases of postpartum low back pain were randomly divided into a control group (45 cases, 4 cases dropping) and a treatment group (47 cases, 2 cases dropping). Conventional acupuncture was treated in the control group, and " Acupuncture" was added in the treatment group on the basis treatment in the control group, acupuncture was applied at Baihui (GV 20), Neiguan (PC 6), Taichong (LR 3). The treatment was given 30 minutes each time, 5 times a week, 10 times for a total course of treatment. Before and after treatment, pain was assessed by the short-form of McGill pain questionnaire (SF-MPQ), dysfunction was assessed by Oswestry disability index (ODI), and depression was assessed by the Edinburgh postnatal depression scale (EPDS). And the changes of various indexs were observed before and after treatment.@*RESULTS@#After treatment, the pain grade index (PRI) score, visual analog scale (VAS) score and present pain intensity (PPI) score in SF-MPQ of the control group and the treatment group were significantly lower than those before treatment (all <0.001). The ODI score and EPDS score were also significantly lower than those before treatment (all <0.001). The decline scores of the treatment group before and after treatment were significantly higher than those in the control group (<0.001, <0.01).@*CONCLUSION@#" Acupuncture" combined with conventional acupuncture and conventional acupuncture can effectively improve the symptoms of pain, dysfunction and depression in patients with postpartum low back pain, and the former is significantly better than the latter.
Subject(s)
Female , Humans , Acupuncture Points , Acupuncture Therapy , Low Back Pain , Pain Measurement , Postpartum Period , Treatment OutcomeABSTRACT
Background: Postpartum depression (PPD) is a type of clinical depression which can affect woman after childbirth. PPD is very common among women and is a major public health problem. It is estimated that overall 10 to 15% women experience PND while it ranges from 3.5 to 63.3% in Asian countries. But it is one of the most underdiagnosed conditions due to lack of adequate number of studies on the subject. Hence the current study was conducted with an objective of assessing the prevalence of postnatal depression among subjects with normal and cesarean deliveries and to compare the socio-demographic profile between normal and cesarean deliveries. Materials and methods: The study was a cross sectional study, conducted in the Department of Pediatrics, Apollo institute of medical sciences and research (AIMSR), Chittor. The data collection for the study was done between January 2015 to November 2015. The study population included people who were undergoing normal and cesarean deliveries. Post natal depression was assessed by EPDS score. Results: The highest proportion of patients belonged to 21-25 years and 26-30 years age groups in both the study groups Normal delivery and Caesarean delivery, the association of age groups between the study groups was statistically significant (P value<0.001). The maximum proportion of patients were housewives in both the study groups. The rural area patients were more in normal and caesarean deliveries as 44% and 39% respectively, the locality showed statistically significant association with the study groups (P value<0.05). All the individual EPDS scores mean values were high in cesarean group when compared to normal delivery group. The mean Total EPDS score mean in normal Dinesh P, Swetha Raghavan. A comparative study of prevalence of postnatal depression among subjects with normal and cesarean deliveries. IAIM, 2018; 5(2): 6-11. Page 7 delivery patients was 8.85 and in cesarean delivery patients 10.85 with t value=-4.766. The proportion of patients with postnatal depression prevalence was high (30%) in cesarean group where as it was only 15% in normal delivery group. The t value was 6.452. Conclusions: Prevalence of postnatal depression was comparably high in caesarean sections compared to normal deliveries with clear statistics about the same, EPDS scores also reflected the higher risk of depression in caesarean section when compare with normal deliveries knocking the alarm to concentrate on the patients more with caesarean sections by providing good counselling, better medication and positive environment in each stage during and after pregnancy from both the patient’s family side and medical staff side.