Depressive symptoms during pregnancy and after birth in women living in Sweden who received treatments for fear of birth

Abstract

The aim of this study was to investigate the prevalence of depressive symptoms and associated factors in women who underwent treatments for fear of birth; internet-based cognitive therapy, counseling with midwives, continuity with a known midwife or standard care. A secondary analysis was performed using data collected from four samples of women identified with fear of birth and receiving treatment with different methods. A questionnaire was used to collect data in mid-pregnancy and at follow-up 2 months after birth. Depressive symptoms were assessed using the Edinburgh Postnatal Depressive Scale. In mid-pregnancy, 32% of the 422 women with fear of birth also reported a co-morbidity with depressive symptoms. At postpartum follow-up, 19% reported depressive symptoms 2 months after birth, and 12% showed continued or recurrent depressive symptoms identified both during pregnancy and postpartum. A history of mental health problems was the strongest risk factor for presenting with depressive symptoms. None of the treatment options in this study was superior in reducing depressive symptoms. This study showed a significant co-morbidity and overlap between fear of birth and depressive symptoms. Screening for depressive symptoms and fear of birth during pregnancy is important to identify women at risk and offer specific treatment.

Blood T‐helper 17 cells and interleukin‐17A correlate with the elevated risk of postpartum depression and anxiety

“…(2) different assessment criteria and different evaluation time points led to a different assessment result of the incidence of PPD and PPA. 5,6,21 In the current study, EPDS and STAI6 scores were used to evaluate PPD and PPA at 6 weeks after women gave birth, among which, EPDS score was the most common worldwide used screening tool for PPD, and the STAI6 score was convenient to evaluate PPA. 19,20,22 In terms of the association of T-helper cells and their related cytokines with depression and anxiety, it has been reported that Th1 and Th2 cells are dysregulated in patients with depression 23 ; besides, an interesting study illustrates that Th17 cells are increased in depressed patients 11 ; meanwhile, it also has been presented that IL-17A is elevated but IFNγ and IL-4 are normal in depressive patients.…”

“…Regarding the incidence of PPD and PPA, it has been reported that 19.2% women suffer from PPD during the first 3 months after giving birth 6 ; furthermore, 19% Sweden women experience PPD after 2 months postpartum 5 ; additionally, another interesting study also illustrated that the incidence of PPD ranges from 9% to 12% among women during postpartum 21 . In the current study, the incidence of PPD and PPA were 24.3% and 27.9%, respectively, which was numerically higher than in previous studies 5,6,21 .…”

“…Regarding the incidence of PPD and PPA, it has been reported that 19.2% women suffer from PPD during the first 3 months after giving birth 6 ; furthermore, 19% Sweden women experience PPD after 2 months postpartum 5 ; additionally, another interesting study also illustrated that the incidence of PPD ranges from 9% to 12% among women during postpartum 21 . In the current study, the incidence of PPD and PPA were 24.3% and 27.9%, respectively, which was numerically higher than in previous studies 5,6,21 . The possible explanations might be that (1) different types of participants (such as those coming from different countries and different ages) might result in the different incidence of PPD and PPA 5,21 ; (2) different assessment criteria and different evaluation time points led to a different assessment result of the incidence of PPD and PPA 5,6,21 .…”

“…From the previous studies, 5,20 PPA and PPD were commonly assessed at 6‐week postpartum, thus we also used inclusion “within 6 weeks postpartum” in the current study to make sure PPA and PPD could be assessed at 6‐week postpartum. Meanwhile, the planned maternity leave time normally was 128 days in China, thus, we applied “128 days” as the cutoff time in the current study.…”

“…Moreover, Th17 cells were independently correlated with an increased risk of PPA (OR = 1.371, p = 0.022), while annual family income (OR = 0.231, p < 0.001), previous gravidity number (OR = 0.644, p = 0.029), planned maternity leave time > 128 days (vs. ≤128 days) (OR = 0.332, p = 0.011), the satisfaction of labor experience (vs. unsatisfaction) (OR = 0.260, p = 0.001), and caregiver ≥2 (vs. <2) (OR = 0.151, p < 0.001) were independently correlated with declined risk of PPA (Table 2). after giving birth 6 ; furthermore, 19% Sweden women experience PPD after 2 months postpartum 5 ; additionally, another interesting study also illustrated that the incidence of PPD ranges from 9% to 12% among women during postpartum. 21 In the current study, the incidence of PPD and PPA were 24.3% and 27.9%, respectively, which was numerically higher than in previous studies.…”