Evaluation of Mood Changes AmongPeripartum Women at PKDAS Institute of Medical Science, Vaniyamkulam, Palakkad: A Prospective, Observational, Longitudinal Study

Background: The perinatal period is well established as an increased risk for development of serious mood disorders. Maternal mental health in developing countries gets less than its due attention. The present study was undertaken to evaluate mood changes in Peripartum period in our population and to identify demographic, obstetric, social and psychosocial risk factors associated with Peripartum depression using established scales.Material & Methods:A prospective, observational, longitudinal study conducted in PK das institute of medical science, vaniyamkulam, with 387 perinatal women for 12 months (February 2018� January 2019). Various scales EPDS (Edinburgh Postnatal Depression Scale), CMSS (Couple Marital Satisfaction Scale, IMS (Index of Marital Satisfaction), LES (Life Event Scale) were studied in Peripartum Period.Results:Among a total of 387 participants about half 189 (48.8%) were in 19-25 years of Age. Almost 30% and 40% had dissatisfied married life as per the CMS and IMS scales respectively. Just above 42% were screen positive for depression antenatally with EPDS & 39% (n = 151) in the immediate postpartum period. From these 151 screen positive cases in immediate postpartum period, 138 participants were followed up at 4-6 weeks (13 were lost to follow up) and up to 115 of 138 (83.3%) were screen positive for depression (N= 387, 29.7%), which was statistically significant (p<0.001). With EPDS during antenatal period there was no statistically significant relationship of depression with Education (p = 0.195), Occupation (p = 0.651) and pregnancy planned or unplanned (p = 0.223), whereas, Joint family, participants with dissatisfied marital relationship had increased risk of depression as evidenced by IMS and CMSS (p < 0.001). Participants with a previous male gender baby had less risk of developing depression (p< 0.001) & participants with previous 2 female children had increased risk of depression (p< 0.001).Conclusions:This study highlights importance of screening for maternal mental health problems during Peripartum period. Depression in immediate postpartum period is good predictor for increased risk of depression at 4-6 weeks postpartum

Assessment of postnatal depression and some associated risk factors among mothers attending the immunisation outpatient department in a tertiary health care centre: a cross sectional study

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.

Reliability and Validity of the Malay Version of Edinburgh Postpartum Depression Scale (EPDS) When Administered to Postpartum Mothers at Two Points in Time

@#Introduction: Edinburgh Postpartum Depression Scale (EPDS) is a tool used to assess the risk of postpartum depression (PPD). In this study we determined the reliability and validity of the Malay version of EPDS when administered at two different time points in the postpartum period. Materials and Methods: This cross-sectional study design was carried out between May and September 2017 at three government primary healthcare clinics located in Batang Padang district, a suburban area of Perak state in Peninsular Malaysia. We recruited a total of 89 women; 41 women were in the early postpartum period (1-30 days) and 48 women were in the late postpartum period (31-120 days). Cronbach's alpha coefficient, inter-item correlation, and corrected item-total correlation were used to assess the internal consistency. The concurrent validity was assessed using Spearman’s correlation. The data were analyzed using SPSS version 20 and R 3.4.2. Results: The Cronbach’s alpha for the first and second group was 0.78 and 0.62, respectively, which indicated satisfactory reliability. At both time periods, removing Item 2 from the scale resulted in a significant increase in Cronbach’s alpha (to 0.847 and 0.709, respectively). As expected, the EPDS scores correlated moderately with the BDI-II scores (1−30 days: Spearman's rho = 0.65, p < 0.01; 31−120 days: Spearman's rho = 0.73, p < 0.01). Conclusion: The Malay version of the EPDS is a reliable screening instrument for detecting postpartum depression. It showed reasonability and feasibility and can be used in postpartum clinical settings or for assessing intervention effects in research studies. Furthermore, as our results indicated, removing Item 2 from the Malay version would increase the internal consistency of the EPDS.

Effect of " Acupuncture" on postpartum low back pain: a randomized controlled trial / 中国针灸

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.

Sensitivity & Specificity Of Screening Tools For Postpartum Depression: A Systematic Review

@#Postpartum depression is a depressive episode that can start at any point during the first year after childbirth. There are several tools that can be used for PPD screening. The need to define a predictive tool that is clinically useful and has acceptable sensitivity and sensitivity is important especially to be used in the primary care setting. This systematic review investigates the evidence of the sensitivity and specificity of screening tools used for PPD screening. The Standard for Reporting of Diagnostic Accuracies (STARD) guidelines were used to conduct the review as a basis for our methodology. PubMed, ScienceDirect and Springerlink databases between 2007 until 2017 were comprehensively searched EPDS and BDI instrument has sensitivity of more than 80% but findings for specificity was inconclusive. The heterogeneity across studies could be the result of methodological differences in validation of the instruments. In addition, these studies were conducted across continents and settings with different cultures, languages and resources. We have identified 5 different instruments used to screen for postpartum depression. The EPDS was the most validated instrument in the review and we found that EPDS and BDI have higher accuracy to screen postpartum depression because the sensitivity reported were more than 80%.

A comparative study of prevalence of postnatal depression among subjects with normal and cesarean deliveries

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.

Postpartum depression: bipolar or unipolar? Analysis of 434 Polish postpartum women

Objective: To assess the prevalence of soft bipolar features in a sample of women with postpartum depressive symptoms, as well as to compare the sociodemographic and obstetric characteristics of subjects with bipolar or unipolar postpartum depressive symptomatology. Methods: Four hundred and thirty-four participants were enrolled in this cross-sectional study. Postpartum depression (PPD) symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), while the Mood Disorder Questionnaire (MDQ) was used to screen for bipolarity features. Results: Of the 434 participants, 66 (15.2%) scored ≥ 13 points on the EPDS, thus fulfilling the screening criteria, and 103 scored ≥ 7 points on the MDQ. In comparison with non-depressed subjects, the women who scored positively on the EPDS were significantly more likely to exhibit symptoms of bipolar spectrum disorders (38 vs. 21%; chi-square test, p = 0.015). Women with bipolar PPD symptomatology were significantly younger than those exhibiting unipolar PPD symptoms (31.0±4.8 years vs. 28.5±4.1 years; t-test, p = 0.03). The groups did not differ in terms of obstetric characteristics. Conclusion: Our findings suggest that patients with PPD symptomatology may be more likely to exhibit soft bipolarity features as compared with non-depressed women.

A proposal for a new Brazilian six-item version of the Edinburgh Postnatal Depression Scale / Proposta para uma nova versão brasileira de seis itens da Escala de Depressão Pós-Parto de Edimburgo

Abstract Introduction: Factor analysis of the Edinburgh Postnatal Depression Scale (EPDS) could result in a shorter and easier to handle screening tool. Therefore, the aim of this study was to check and compare the metrics of two different 6-item EPDS subscales. Methods: We administered the EPDS to a total of 3,891 women who had given birth between 1 and 3 months previously. We conducted confirmatory and exploratory factor analyses and plotted receiver-operating characteristics (ROC) curves to, respectively, determine construct validity, scale items' fit to the data, and ideal cutoff scores for the short versions. Results: A previously defined 6-item scale did not exhibit construct validity for our sample. Nevertheless, we used exploratory factor analysis to derive a new 6-item scale with very good construct validity. The area under the ROC curve of the new 6-item scale was 0.986 and the ideal cutoff score was ≥ 6. Conclusions: The new 6-item scale has adequate psychometric properties and similar ROC curve values to the10-item version and offers a means of reducing the cost and time taken to administer the instrument.

Resumo Introdução: A análise fatorial da Escala de Depressão Pós-Parto de Edimburgo (Edinburgh Postnatal Depression Scale, EPDS) poderia resultar em uma ferramenta de triagem mais curta e mais fácil de aplicar. Portanto, o objetivo deste estudo foi verificar e comparar as métricas de duas subescalas EPDS de 6 itens. Métodos: Administramos a EPDS a um total de 3.891 mulheres que deram à luz entre 1 e 3 meses antes da aplicação. Foram realizadas análises fatoriais confirmatórias e exploratórias e geradas curvas ROC (receiver-operating characteristics) para determinar, respectivamente, a validade do construto, o ajuste dos itens da escala aos dados, e os pontos de corte ideais para as versões curtas. Resultados: A escala de 6 itens previamente publicada não apresentou validade de construto para nossa amostra. No entanto, utilizamos a análise fatorial exploratória para derivar uma nova escala de 6 itens, que apresentou boa validade de construto. A área sob a curva ROC da nova escala de 6 itens foi 0,986, e o ponto de corte ideal foi ≥ 6. Conclusão: A nova escala de 6 itens possui propriedades psicométricas adequadas e valores de curva ROC semelhantes à versão de 10 itens e oferece um meio de reduzir o custo e o tempo necessário para administrar o instrumento.

Prevalence of postpartum depression among mothers who delivered in a tertiary hospital in Dasmariñas, Cavite from April to May 2013

GENERAL OBJECTIVE: This study aims to determine the prevalence of postpartum depression among mothers who delivered in a tertiary hospital in Dasmariñas, Cavite from April to May 2013. Specifically, it aims to determine the proportion of mothers experiencing postpartum depression on the basis of the following socio-demographic factors: age, marital status, employment status, manner of delivery, parity, age of gestation upon delivery, gender of the newborn and breastfeeding status. METHODOLOGY: A total of 115 postpartum patients were included in this descriptive study. The Edinburgh Postnatal Depression Scale (EPDS) for screening postpartum women was used in this study. It was translated in Filipino language, back translated and validated prior to its use on the women. A score of at least 10 points indicates possible postpartum depression (PPD). A score of at least 1 point in question #10 indicates suicidal ideation. RESULTS: Out of 115 patients, 89 had an EPDS score below 10 points corresponding to 77.39% of the total population studied, while 26 participants had a score of at least 10 points corresponding to 22.61%. There were 9 respondents who scored at least 1 point in ques­tion #10 pertaining to 7.83% of the population. CONCLUSION: Postpartum depression is a universal dilemma. In this study, the prevalence of postpartum depression among mothers who delivered in a tertiary hospital in Dasmariñas, Cavite from April to May 2013 is 22.61%. Since postpartum depression is a common condition with serious consequences, screening must be done with a multidisciplinary approach from both the obstetricians and psychiatrists.

Prevalence of postpartum depression among mothers who delivered in a tertiary hospital / Philippine Journal of Obstetrics and Gynecology

GENERAL OBJECTIVE: To determine the prevalence of postpartum depression among mothers who delivered in a tertiary hospital.METHODS: A total of 115 postpartum patients were included in the study. The Edinburgh Postnatal Depression Scale (EPDS) which was developed in 1987 for screening postpartum women was used in this study. It was translated in Filipino language and has been validated. A score of at least 10 points indicates possible postpartum depression. A score of at least 1 point in question it 10 indicates suicidal ideation.RESULTS: Out of 115 patients, 89 had an EPDS score below 10 points corresponding to 77.39% of the total population studied, while 26 participants had a score of at least 10 points corresponding to 22.61%. There were 9 respondents who scored at least 1 point in ques­tion #10 pertaining to 7.83% of the population.CONCLUSION: Postpartum depression is a universal dilemma. In this study, the prevalence of postpartum depression among mothers who delivered in a tertiary hospital in Dasmariñas, Cavite from April to May 2013 is 22.61%. Since postpartum depression is a common condition with serious consequences, screening must be done with a multidisciplinary approach from both the obstetricians and psychiatrists.

Depresión y factores de riesgos asociados en embarazadas de 18 a 45 años asistentes al Hospital Niño Jesús en Barranquilla (Colombia) / Depression and risk factors in pregnant women of 18 and 45 years old who attended in the Hospital Niño Jesús in Barranquilla (Colombia)

Objetivo: Determinar la prevalencia de factores de riesgo para depresión en embarazadas atendidas en el Hospital Niño Jesús, en Barranquilla, en el primer semestre de 2012. Materiales y métodos: Estudio descriptivo transversal, en muestra de 151 embarazadas en control prenatal. Se estudiaron variables sociodemográficas, ginecobstétricas y antecedentes psicológicos y psiquiátricos. Se midió depresión con el Edinburgh Postnatal Depressión Scale, se clasificó con un punto de corte mayor o igual a 13. Se tabuló mediante los software Excel y Epi-info 2000, V 3.5.3; se presentan resultados en tablas y gráficos y se analizan con porcentajes, media y desviación estándar, Odd Rato e IC 95%, chi-cuadrado y p. Resultados: La depresión fue de 19.2 %. Edad media de 24,78 años (+/- 5,35); 57,6 % era de estrato económico bajo; 72,6 % amas de casa; 88,7 % convivía con su pareja; edad gestacional media de 28 (+/-4) y 25 % de mujeres con depresión tenía antecedente de esta. Los factores de riesgo, con tendencia a la asociación, fueron: historia de aborto anterior OR 3,39 (IC95 % 1,41-8,15), algún grado de disfunción familiar OR 2,78 (IC95 % 1,08- 7,1) y actividad fuera del hogar 2,92 (IC95%1,03 - 8,23). Conclusiones: La depresión en el embarazo se presentó cuando existió antecedente de aborto, algún grado de disfunción familiar y actividad fuera del hogar.

Objective: To determine prevalence of risk factors for depression in pregnant women of the Hospital Niño Jesus, in Barranquilla, in the first semester of 2012. Materials and Methods: Cross-sectional study in a sample of 151 pregnant women in prenatal care. We study variables: socio demographic, gynecological and obstetric, psychological and psychiatric history. Depression was measured with the Edinburgh Postnatal Depression Scale, is classified with a cutoff greater than or equal to 13. Tabulated by the software: Excel and Epi-info 2000, V 3.5.3, results are presented in tables and graphs and analyzed with: percentages, mean and standard deviation, Odd Ratio and 95%, Chisquare and p. Results: depression was 19.2 %. Average age: 24.78 years (± 5.35), 57.6 % were of lower class, housewives 72.6 % and 88.7% lived with their partners, mean gestational age of: 28 (±-4) and 25% of women with depression had a history of this. Risk factors, tending to the association were: history of previous abortion OR 3.39 (95 % CI 1.41 to 8.15), some degree of family dysfunction OR 2.78 (95 % CI 1.08 to 7,1) activity outside the home and 2.92 (95 % CI 1.03 to 8.23). Conclusions: Depression in pregnancy was appeared when exist a background of abortion, some degree of family dysfunction and activity outside the home.

Predictors of Postpartum Depression: Prospective Cohort Study

PURPOSE: This prospective cohort study was done to investigate recall bias to antepartum variables measured at postpartum periods and predictors of postpartum depression. METHODS: Participants were 215 women who answered a self-administered questionnaire which included demographics, Postpartum Depression Predictors Inventory-Revised and Korean version of Edinburgh Postpartum Depression Scale at antepartum 36-40 weeks and postpartum 2 weeks and 6 weeks. Data were analyzed using kappa, and hierarchical multiple logistic regression. RESULTS: Agreement between antepartum variables at both antepartum and two postpartum periods was relatively high (kappa=.55-.95). Postpartum depression rates were 36.3% and 36.7% at two follow-up points. In hierarchical multiple logistic regression analysis, prenatal depression (OR=4.32, 95% CI: 1.41-13.19; OR=5.19, 95% CI: 1.41-19.08), social support (OR=1.40, 95% CI: 1.18-1.66; OR=1.27, 95% CI: 1.06-1.53) and maternity blues (OR=4.75, 95% CI: 1.89-11.98; OR=4.22, 95% CI: 1.60-11.12) were commonly associated with postpartum depression at two follow-up points. Child care stress (OR=1.85, 95% CI: 1.01-3.37) was only associated with postpartum depression at 2 weeks postpartum and pregnancy intendedness (OR=1.57, 95% CI: 1.09-2.27) was only associated with postpartum depression at 6 weeks postpartum. CONCLUSIONS: The results indicate a need to apply nursing interventions such as prenatal education and counseling with families from antenatal period.

Prevalencia de depresión durante la gestación / Prevalence of depression during pregnancy

Objetivos: Estimar la prevalencia de depresión durante la gestación y estudiar posibles factores asociados a ésta. Material y Métodos: Entre los meses de marzo y julio del 2004, se incluyeron 203 pacientes embarazadas que acudían al Consultorio Externo de Obstetricia del Hospital Nacional Cayetano Heredia en Lima, Perú. Se registraron los datos personales, obstétricos, socioeconómicos y psiquiátricos de las gestantes, y se les aplicó la Escala de Depresión Postnatal de Edimburgo (EPDS). Resultados: Un 34,7% de las embarazadas tuvo puntajes de la EPDS > 13,5. La prevalencia estimada de depresión mayor en las pacientes gestantes, tomando en cuenta la sensibilidad y especificidad de la EPDS para el punto de corte 13,5, fue 22,25%. Se obtuvieron puntajes totales de EPDS con una media de 11,3 y una desviación estándar de 6,2. Los factores asociados a mayores niveles de depresión medidos con la EPDS fueron: ser soltera (p<0,001), ausencia de educación superior (p=0,039), embarazo no deseado por la pareja (p=0,004) o por la paciente (p=0,021) e historia de depresión previa a la gestación (p=0,003). Conclusión: La prevalencia estimada de depresión durante la gestación en las pacientes ambulatorias de nuestro estudio es más elevada que la encontrada en la literatura mundial en mujeres embarazadas y postparto, sin embargo, similar a la hallada en otro estudio realizado en el Perú con gestantes. Los factores asociados con mayores puntajes en la EPDS fueron ser soltera, no tener educación superior, no desear la gestación y haber presentado diagnóstico previo de depresión.

Objective: To estimate the prevalence of depression during pregnancy and to study the factors probably associated with it. Methods: We interviewed 203 pregnant women who went to Hospital Nacional Cayetano Heredia ObstetricsÆ Clinical Office in Lima, Perú, between March and July of 2004. We asked for personal, obstetric, socioeconomic and psychiatric factors; and applied the Edinburgh Postnatal Depression Scale (EPDS). Results: EPDS scores were greater than 13.5 in 34.7% of the subjects. The estimated prevalence of major depression, calculated taking into account the sensitivity and specificity of EPDS for a threshold of 13.5, was 22.25%. The average score of EPDS was 11.3, and the standard deviation 6.2. We found association between depression levels and single marital status (p<0.001), absence of superior education (p=0.039), absence of partnerÆs desire for pregnancy (p=0.004), absence of patientÆs desire for pregnancy (p=0.021) and history of previous depression (p=0.003). Conclusion: The estimated prevalence of depression during pregnancy in our outpatients was higher than that found in the literature in pregnant or postpartum women, however was similar to that found in another Peruvian study in pregnant women. The factors associated with having higher scores of EPDS were single marital status, absence of superior education, unwanted pregnancy and history of depression.

Evaluation of Risk Factors for the Postpartum Depression with Edinburgh Postnatal Depression Scale (EPDS) Score / 대한주산의학회잡지

PURPOSE: Postpartum depression is one of the serious diseases which can influence on the mother, newborn, and the family if the recognition and treatment is not immediately performed. Currently, there are lots of known factors and diagnostic methods of postpartum depression. We studied the various factors that can affect postpartum depression. METHODS: Participants were 93 mothers who delivered at our hospital between February 1st, 2007 and November 30th, 2007. We recorded their education status, occupation, parity, delivery method, obstetrical or medical problems during pregnancy, breast-feeding period, newborn admission period, and having herb intake after delivery. Relationship between the frequency of postpartum depression and the factors we recorded was studied. RESULTS: Among many factors, the frequency of postpartum depression occurrence was significantly higher in multiparity, and was associated with herb intake after delivery with borderline significance. The frequency of breast feeding was significantly higher in women without postpartum depression. CONCLUSION: Based on the result of this study, obstetricians could support better treatment and prevent postpartum depression by giving more attention to mothers who have risk factors of postpartum depression.

A study on agreements among screening tests and related factors with postpartum depression / 대한산부인과학회지

OBJECTIVE: This study was performed to assess agreements among screening tests, to estimate prevalence, and to identify related factors with postpartum depression. METHODS: For 323 women at 7 days postpartum, self-administered questionnaires were given including postpartum depression screening test such as EPDS, QIDS-SR16, BDI and questionnaires for their demographic and psycho-social information. Obstetric information were collected from medical records. Simultaneous positive cases in EPDS and BDI were defined as gold standard and used to estimate the prevalence of postpartum depression and agreements between 3 kind of screening test and gold standard. Related factors of postpartum depression were analysed by using SPSS. RESULTS: The prevalence of postpartum depression was 19.8% and the Kappa indices were 0.711 in BDI, 0.803 in EPDS, and 0.395 in QIDS-SR16. Feeding method, smoking history, antenatal anxiety/depression symptoms, residence status, marital satisfaction, relationship with husband's parents, and postpartum care method in univariate analysis and premature delivery (odds ratio: 2.9), formulated feeding (odds ratio: 3.8), marital dissatisfaction (odds ratio: 4.3), professional husband's occupation (odds ratio: 4.4), and antenatal anxiety/ depression symptoms (odds ratio: 4.4) in the logistic regression analysis were significantly related to postpartum depression (P<0.05). CONCLUSIONS: Simultaneous test of BDI and EPDS was effective to evaluate postpartum depression prevalence at 1-week postpartum and highly agree with EPDS. Significant related factors were defined and further prospective community-based studies are warranted.

Clinical Application of Korean Version of Edinburgh Postnatal Depression Scale / 신경정신의학

OBJECTIVES: The EPDS (Edinburgh Postnatal Depression Scale) is a 10-items self-report scale designed as a specific instrument to detect postnatal depression by Cox et al. (1987). This study was to determine the optimal cut-off point of the KEPDS for postpartum depression in Korea. METHODS: The 239 pregnant women assessed their own psychiatric features with the Korean version of the Edinburgh Postnatal Depression Scale (K-EPDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Rosenberg Self-Esteem Scale (RSES) and Marital Satisfaction Scale (MSS) at 6 months of pregnancy, 1 week after delivery, and 6 weeks after delivery. Subjects above 9 points of K-EPDS at 6 week after delivery were interviewed with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to confirm postpartum depression. RESULTS: The prevalence of postpartum depression was 12.6% (30/239 pregnant women) in our study. The total scores of K-EPDS at 6 weeks after delivery were higher significantly than those of normal group. The score gap of K-EPDS between the depressed pregnant group and the normal pregnant group was increased after the delivery. However, there were no differences in the epidemiological characteristics and the BDI scores at 6 weeks after delivery between groups. Using the AUC (area under the curve), the optimal point to assess the postpartum depression was revealed as 6 weeks after delivery (AUC=85.8%) or 24 weeks of pregnancy (83.7%). The cut-off point of K-EPDS to detect postpartum depression among pregnant women was 9/10 score of K-EPDS (AUC= 81.8%). CONCLUSION: In the K-EPDS, cut-off score of 9/10 was optimal to assess the postpartum depression, and K-EPDS at 6 weeks of delivery was more useful than any other point of time. K-EPDS administrated during pregnancy may be a useful tool to find the vulnerability on the postpartum depression.

Plasma Levels of Nitric Oxide Metabolites in Patients with Postpartum Depression

BACKGROUND: Some reports have suggested that decreased nitric oxide metabolites(NOx) and activity of nitric oxide synthase could be related to the pathophysiology of depression. We evaluated plasma levels of NOx in pregnant women with and without postpartum depression at prenatal and postnatal period. METHODS: The plasma concentrations of NOx were measured in 104 pregnant women in the third trimester and at 6 weeks postpartum and in 64 normal controls. The severity of depression and anxiety was measured with the Edinburgh Postnatal Depression Scale(EPDS), Beck Depression Inventory(BDI), and Beck Anxiety Scale(BAI). RESULTS: Plasma NOx levels at 6 weeks postpartum were significantly lower in cases of postpartum major depression(EDPS scores > or = 13 points) than in cases without depression(EDPS scores < or = 9 points). Plasma NOx levels had significantly negative correlation with EPDS scores at 6 weeks postpartum. CONCLUSION: We demonstrate that decreased plasma NOx is associated with postpartum depression. Further studies are required to determine whether individual serum concentration of plasma NOx alone could predict maternal depression.

The Effects of the Integrated NICU Hospitalization Education on Maternal Attachment, Maternal Self-Esteem, and Postpartum Depression in the Mothers of High-Risk Infants / 아동간호학회지

PURPOSE: The quasi-experimental study was conducted to investigate the effects of the integrated NICU hospitalization education on maternal attachment, maternal self-esteem, and EPDS in the 26 mothers of high-risk infants(HRI). METHOD: The subjects were divided into the experimental group to received the integrated NICU hospitalization education included the enforced direct education of NICU and HRI to the mothers using a booklet and the provision of the neomaternal exposure as soon as possible after delivery. The control group received the routine education of the NICU hospitalization, mostly including the admission process and the NICU rules delivering to the husband. The research variables were maternal attachment, maternal self-esteem, and EPDS. RESULTS: The results showed the increases in these variables after the integrated education in experimental group compared to the control group. CONCLUSION: It supports the benefits of the early direct NICU education and the neomaternal exposures on maternal adaptation process in the mothers of HRI.