Postpartum Anxiety and Depression: Onset and Comorbidity in a Community Sample

Stuart, Scott; Couser, Greg; Schilder, Kelly K.; O’Hara, Michael W.; Gorman, Lori

doi:10.1097/00005053-199807000-00006

Cited by 218 publications

(129 citation statements)

References 17 publications

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“…22 However, we failed to identify any link between depressive symptoms and poor contraceptive use or unintended pregnancy. There is little research that directly has assessed the relationship between depression and contraceptive use.…”

Section: Commentmentioning

confidence: 72%

Unintended rapid repeat pregnancy and low education status: Any role for depression and contraceptive use?

Bennett¹,

Culhane

McCollum

et al. 2006

American Journal of Obstetrics and Gynecology

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Objective-The purpose of this study was to assess the contribution of depressive symptoms and poor contraceptive use early in the first postpartum year to the risk of unintended repeat pregnancy at the end of that year among adults with low educational status (< 12th grade or equivalence).Study design-This was a prospective observational cohort study of 643 sexually active, lowincome, inner-city adult women (age ≥ 19) who enrolled prenatally (14.7 ± 6.9 weeks gestational age) and were followed twice after delivery (3.3 ± 1.3 months and 11.0 ± 1.3 months). Associations were assessed by multivariate logistic regression.Results-Low educational status (odds ratio, 2.32; 95% CI, 1.25-4.33) and less effective contraceptive use (odds ratio, 2.31; 95% CI, 1.05-4.51) were associated with unintended pregnancy. Neither depressive symptoms nor contraceptive use reduced the risk of pregnancy that was associated with low educational status.Conclusion-Low educational status was associated with more than twice the risk of unintended pregnancy 1 year after delivery. We found no evidence that depression or poor contraceptive use mediate this relationship. KeywordsFertility control; Postpartum period; Educational status; Contraception; Depressive symptom; Pregnancy interval A disproportionately large number of unintended pregnancies in the United States occur among women from low-income minority populations. 1 Short interpregnancy intervals that result from unintended rapid repeat pregnancy increase the risk of adverse maternal-child health outcomes. 2,3 Identifying factors that are linked to unintended pregnancy in the postpartum period may help to explain socioeconomic and racial/ethnic disparities in maternal-child outcomes and guide interventions to reduce these disparities. Low educational status (LEdS; <12th grade completion or equivalence) has been recognized as a risk factor for unintended pregnancy. 1,4 However, the mechanisms that link LEdS and pregnancy intention have not been well-defined. Effective contraceptive use is critical for reducing the rates of unintended pregnancy. 5 LEdS has been associated with nonuse of contraception, the use of less effective contraception methods, increased contraceptive failure rates, and reduced adherence to treatment regimens for chronic illnesses. 6,7 Because of its association with both LEdS and the inconsistent use of medications that include contraception, depression might also contribute to the risk of unintended pregnancy. 8,9 Despite these findings, we are not aware of any analyses that directly assess the possible causal links between depression, contraceptive use, and unintended pregnancy in the postpartum period.In this study, we sought to fill a gap in research on disparities in pregnancy intention by directly examining the contribution of postpartum depressive symptoms and contraceptive use regarding the risk of unintended repeat pregnancy among women with LEdS. The specific goals of this study were to assess whether LEdS confers increased risk of unintended repea...

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Section: Commentmentioning

confidence: 72%

Unintended rapid repeat pregnancy and low education status: Any role for depression and contraceptive use?

Bennett¹,

Culhane

McCollum

et al. 2006

American Journal of Obstetrics and Gynecology

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“…Admite-se que os distúrbios ansiosos sejam mais freqüen-tes que os quadros depressivos e que, apesar de a associação entre ansiedade e depressão ser comum, nem todos pacientes ansiosos são deprimidos 3 . No puerpério, as prevalências de ansiedade, segundo diferentes instrumentos de auto-avaliação, varia de 4,9 a 16,8% [4][5][6][7] . Admite-se a existên-cia de bases biológicas na ocorrência dos transtornos ansiosos do puerpério, o que inclui alterações na concentração de alguns mediadores da resposta imune, como interleucina 6, 1 e prolilendopeptidade, em primíparas 8 .…”

Section: Introductionunclassified

Ansiedade no puerpério: prevalência e fatores de risco

Faisal-Cury¹,

Menezes²

2006

Rev. Bras. Ginecol. Obstet.

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RESUMOObjetivos: estimar a prevalência de ansiedade puerperal (AP) e fatores de risco associados, em amostra de mulheres de clínica privada. Métodos: foi realizado estudo de corte transversal com 299 mulheres, atendidas em consulta ginecológica de rotina, durante o período de agosto de 2000 a maio de 2003. Foram utilizados o STAIT (Spielberger State-Trait Anxiety Inventory), para avaliação de ansiedade puerperal, e um questionário com dados sociodemográficos e obstétricos. Os critérios de inclusão foram: puérperas sem história atual ou passada de depressão ou tratamento psiquiátrico, alcoolismo ou abuso de drogas e cujos filhos estavam vivos. As prevalências de AP-traço e AP-estado que avaliam, respectivamente, características de personalidade e ansiedade transitória, segundo o STAIT, foram estimadas, conjuntamente com o intervalo de confiança (IC) 95%. Estimaram-se os odds ratios (OR) e os intervalos de confiança de 95%, na avaliação da associação entre AP e as variáveis explicativas. Utilizou-se o teste do χ PALAVRAS-CHAVE:Ansiedade; Transtornos puerperais; Fatores de risco; Prevalência ABSTRACT Purpose: postpartum anxiety (PPA) is highly prevalent and has important consequences on mother and newborn. The aim of the present study was to estimate the prevalence of PPA and its risk factors, in a sample of women attending a private setting. Methods: a cross-sectional study was performed with 299 women, at a routine gynecological visit, from August 2000 to May 2003. The Spielberger State-Trait Anxiety Inventory (STAIT) and a questionnaire with sociodemographic data and obstetric data were used. Inclusion criteria were: women with no past or present history of depression, psychiatric treatment, alcohol or drug abuse and whose children were alive. The prevalences of PPA-trace and PPA-state, that evaluate characteristics of personality and transitory anxiety, respectively, were estimated with 95% confiance intervals (CI). Odds ratios and 95% CI were used to examine the association between PPA and exposure variables. Hypothesis testing was done by the χ 2 test or χ 2 test for linear trend, when categories were ordered. A p value < 0.05 was considered to be statistically significant. Results: the prevalences of PPA-state and PPA-trace were 44.8% (CI 95%: 39.1 -50.7) and 46.1% (CI 95%: 40.4 -52.0, respectively). Formal agreement between scales was moderate (kappa = 0.55; p≤0.001). By univariate analysis, lower mother income and presence of newborn complications were associated with PPA-state and PPA-trace. Lower maternal age and greater number of alive children were associated with PPA-trace and PPA-state, respectively. By multivariate analysis, PPAtrace and PPA-state were associated with higher mother income (OR:0.39; IC 95%: 0.21 -0.74, p=0,005; OR:0.46; IC 95%: 0.24 -0.87, p=0.02) and presence of complications in newborns (OR:2.15; IC 95%: 1.02 -4.54, p=0.04) (OR:2.47; IC 95%: 1.16 -5.25, p=0.02), respectively. PPA-trace was associated with greater maternal age (OR:0.34; IC 95%: 0.13 -0.88, p=0.008), while PPAstate ...

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“…In addition, most studies measured depression using the EPDS without verification of high EPDS scores with a clinical diagnosis of depression, which can result in biased results since a high EPDS score can be due to anxiety as well as from depression (Stuart, Couser, Schilder, O'hara, & Gorman, 1998).…”

Section: Discussion (Narrative Synthesis: Element 3)mentioning

confidence: 99%

Role of Omega-3 Unsaturated Fatty Acids in the Postpartum Depression: Systematic Review and Narrative Synthesis

Mougharbel¹,

Deonandan²

2016

GJHS

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Background: Postpartum depression (PPD) is a complex mental health disorder that affects women during their childbearing years. It is a serious medical condition that occurs in approximately 15% of women after birth and has an adverse effect on both the mother and the infant. Hypotheses exist relating dietary deficiencies in a pregnant or postnatal woman's diet may cause postnatal depression. It is unclear whether Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are effective for treating or preventing PPD. Objectives:To assess the best available evidence to date regarding the effect of n-3 PUFAs on the etiology, prevention and treatment of postnatal depression. Methods:A systematic review and narrative synthesis was conducted in order to address the gaps in knowledge. For the systematic review, a broad search of electronic databases of published quantitative literature was conducted. The narrative synthesis consists of four elements: 1) developing a theory; 2) developing a preliminary synthesis; 3) exploring relationships in the data; 4) assessing the robustness of the synthesis. Published experimental and observational studies were accepted involving women who were pregnant or who had given birth in the previous six weeks. N-3 PUFAs was the intervention of interest and PPD was the outcome.Results: Out of 181 potential articles, a total of 17 studies met the inclusion criteria. The overwhelming majority of the studies found that n-3 PUFAs had no inverse association with PPD evaluations. Significant heterogeneity was observed among included studies. Conclusions:Overall, This systematic review and narrative synthesis failed to find a significant positive association between n-3 PUFAs intake and PPD.

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Postpartum Anxiety and Depression: Onset and Comorbidity in a Community Sample

Cited by 218 publications

References 17 publications

Unintended rapid repeat pregnancy and low education status: Any role for depression and contraceptive use?

Unintended rapid repeat pregnancy and low education status: Any role for depression and contraceptive use?

Ansiedade no puerpério: prevalência e fatores de risco

Role of Omega-3 Unsaturated Fatty Acids in the Postpartum Depression: Systematic Review and Narrative Synthesis

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