Factors associated with late post-partum depression in Japan.

AIM: Postnatal depression is one of the life-threatening events faced by women. As the factors associated with postnatal depression have not been investigated fully in Japan, we studied the factors associated with postnatal depression. METHODS: One-hundred-and-sixty-nine women who visited the health center of a city in Aomori Prefecture, Japan, at 4 months after childbirth for regular examination fulfilled the selection criteria and completed self-reporting questionnaires on postnatal depression using the Edinburgh Postnatal Depression Scale (EPDS) and a life and social events scale. RESULTS: The primiparas showed a significantly higher EPDS score than the multiparas. The EPDS score decreased with the frequency of delivery in the groups of mothers in their twenties and thirties. For the multiparas, the number of participants who suffered obstetric events was lower, the number of participants who went back to their home was higher, and the number of participants who were taken care of by their mother was lower than for the primiparas. General health abnormalities, sociability, and worries about baby care were significantly associated with the EPDS for both the primiparas and multiparas. The cooperation of the husband was associated with a decreased EPDS score, both for the primiparas and multiparas, irrespective of the family structure. CONCLUSION: The EPDS score decreased with an increased frequency of delivery, suggesting that the experience of delivery would impact on postnatal depression, partly because of decreased obstetric events. However, a social assistance system is needed for women with general health abnormalities, less sociability, worries about baby care, and limited cooperation of the husband for both primiparas and multiparas.

[Circumstances and comparisons of child rearing burnout scales between neonatal mothers with and without home visit nursing. Analysis with a child rearing burnout scale].

OBJECTIVE: The Japanese neonate home-visit nursing guidance program for mother-and-child health administration is unique on the world scale, because it makes support for every family possible. However, very few studies have been conducted concerning the efficacy of the neonate home-visiting guidance program. The purpose of this study was to examine the utility of the program and factor out necessary questionnaire entries to sreflect mother's child-rearing anxieties. METHOD: Questionnaire survey. The subjects were 169 mothers. RESULTS: Ninety-two (54.4%) out of 169 subjects had neonate home-visit nursing guidance. Five factors and twenty-two items were abstracted by the factor analysis method. The difference in factor scores between the groups with and without guidance was analyzed byt-test. There were significant differences in the first factor (feelings change), the second factor (body tiredness), and the fourth factor (brought up a child) between the group that had guidance and the group that had not, and the score for mother's child-care anxiety in the group that had guidance was high. Among subjects who answered "no" to the question whether their husbands gave them support in rearing their child, there were significant differences concerning child-rearing anxiety questions in the questionnaire. The attributes showing meaningful differences in child-rearing anxiety questions were: first delivery, having an extended family, unemployment, and delivery at over-30 years of age. CONCLUSION: The mother's idea that her husband is cooperative in raising their children showed a relationship with the mother's child-care anxiety, so it is important for home-visit guidance to find out whether the husband is a partner in raising children. The other necessary questionnaire items were: age, having birth experience, family structure, and being employed or unemployed. As the subjects who accepted neonate home-visit nursing guidance could be said to have some child-rearing anxiety subconsciously, it is concluded that the neonate home-visit nursing guidance program is effective for determination of mother's child rearing anxiety.