Prevalence and associated psychological risk factors of postpartum depression: a cross-sectional study

Corte, Luigi Della; Rosa, Valentina Lucia La; Cassinese, Eliana; Ciebiera, Michał; Zaręba, Kornelia; Rosa, Nicoletta De; Verrazzo, Paolo; Improda, Francesco Paolo; Vitale, Salvatore Giovanni; Giampaolino, Pierluigi; Commodari, Elena; Bifulco, Giuseppe

doi:10.1080/01443615.2021.1980512

Cited by 7 publications

(6 citation statements)

References 35 publications

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“…The results of this study first underline the crucial role of support during the perinatal period, especially from the partner. The impact of a partner's support is already well documented in terms of the impact on PNDS [34][35][36][37][38]. However, our results highlight, in line with some other studies, that more than postnatal current partner support, the quality of the couple's relationship during pregnancy may have a direct protective effect on maternal postnatal emotional stability [8].…”

Section: Discussionsupporting

confidence: 88%

Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort

Balès

Pambrun

Maguet

et al. 2023

JCM

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Objective: The risk factors for postnatal depressive symptoms (PNDS) are numerous, but little is known about the protective factors or the interactions between different exposures. The present study explored the pathways between maternal, infant and parenthood vulnerabilities or risk/protective factors and PNDS at 2 months postpartum (PP) in a large sample of women from the general population. Methods: We used data from the French ELFE cohort, a nationally representative cohort of children followed-up from birth. The available information about vulnerabilities or risk/protective factors for PNDS was collected during the maternity ward stay (mother or medical records) and at 2 months PP (mother by phone). PNDS were evaluated with the Edinburgh Postnatal Depression Scale (EPDS) at 2 months. A measurement model was built based on the psychosocial model for PNDS of Milgrom and colleagues using exploratory factor analysis. The Structural Equation Model was used to investigate the pathways between vulnerability, risk/protective factors and PNDS at 2 months PP. Results: In the study sample (n = 11,583), a lack of a partner’s perceived antenatal emotional support, consultation with a mental health specialist before pregnancy, family financial difficulties, prenatal psychological distress and a difficult pregnancy experience were directly associated with the severity of maternal PNDS at 2 months PP, as well as lack of perceived postnatal support. Family financial difficulties and consultation with a mental health specialist before pregnancy were also indirectly associated with the intensity of PNDS through a lack of perceived antenatal emotional support, a difficult pregnancy experience, prenatal psychological distress and a lack of perceived postnatal support. Regarding infant and parenthood characteristics, infant self-regulation difficulties, maternal difficulty in understanding infant crying and infant hospitalisation were directly associated with PNDS severity at 2 months PP, while maternal difficulty in understanding an infant’s cries was also indirectly associated with infant self-regulation difficulties. Conclusions: Perinatal professional support should begin antenatally and target the couple’s prenatal functioning, with particular attention to women presenting a history of psychiatric disorders, especially those of low socioeconomic status. After delivery, addressing infant and parenthood characteristics is also recommended.

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Section: Discussionsupporting

confidence: 88%

Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort

Balès

Pambrun

Maguet

et al. 2023

JCM

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“…Consequently, we suggest that elevated prenatal anxiety symptom is a prenatal risk factor for PPD. A study from Italy also found that women with anxiety showed a significant tendency to PPD ( 31 ). Our study was conducted during the coronavirus (COVID-19) pandemic.…”

Section: Discussionmentioning

confidence: 97%

Risk factors for postpartum depression in women undergoing elective cesarean section: A prospective cohort study

et al. 2022

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BackgroundPostpartum depression (PPD) has adverse effects on maternal and child health. Cesarean section (CS) is suggested to be associated with PPD, but no study has examined the risk factors for PPD in women who underwent CS. Therefore, this study aimed to investigate this association.MethodsA prospective observational study was conducted between December 2020 and September 2021. In total, 590 women who underwent elective CS participated in this study. Data were collected using a questionnaire through a face-to-face interview at three time points: 32nd week of gestation, 2 days postpartum, and 6 weeks postpartum. PPD was defined by an Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 11 at 6 weeks postpartum. Multivariate logistic regression analysis was performed to identify the risk factors for PPD.ResultsAmong the 590 women, 25.4% had PPD (142/590). After adjustment for the confounding factors, high antenatal self-rating anxiety scale score (OR = 1.10, 95% CI = 1.04–1.16), PPD symptoms (EPDS ≥ 11) at 2 days postpartum (OR = 6.17, 95% CI = 1.35–28.31), and pain at 6 weeks postpartum (OR = 2.14, 95% CI = 1.24–3.69) were independently associated with PPD.ConclusionPrenatal anxiety, PPD symptoms occurring at an early postoperative stage, and pain at 6 weeks postpartum may be associated with an increased risk of PPD among women who undergo CS.

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“…Most studies focusing on positive experiences during pregnancy have examined particular types of positive experiences, such as tangible or emotional support from partners, 22 rather than comprehensively measuring pregnancy-specific positive experiences. In our study, uplifts, or positive stressors, were measured through multiple items, including social support (eg, positive comments from others about pregnancy, discussions with spouse about childbirth issues), positive emotions (eg, thinking about the baby’s appearance or nursery arrangements) and receiving appropriate care (eg, antenatal care).…”

Section: Discussionmentioning

confidence: 99%

“…That study reported that non-depressed postpartum women exhibited significantly higher uplifts intensity during pregnancy than depressed postpartum women. 21 Most studies focusing on positive experiences during pregnancy have examined particular types of positive experiences, such as tangible or emotional support from partners, 22 uplifts, or positive stressors, were measured through multiple items, including social support (eg, positive comments from others about pregnancy, discussions with spouse about childbirth issues), positive emotions (eg, thinking about the baby's appearance or nursery arrangements) and receiving appropriate care (eg, antenatal care). Positive stressors during pregnancy could mitigate the risk of negative postpartum mental health outcomes.…”

Section: Main Findingsmentioning

confidence: 99%

Pregnancy stressors and postpartum symptoms of depression and anxiety: the moderating role of a cognitive–behavioural therapy (CBT) intervention

Sun,

Park,

Malik

et al. 2024

Gen Psych

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BackgroundLittle is known about the association between stressors (especially positive stressors) during pregnancy and postpartum depression and anxiety.AimsWe investigated the association between positive and negative stress events during different stages of pregnancy and postpartum mental health outcomes among low-income pregnant women with symptoms of anxiety in Pakistan and evaluated whether an intervention based on cognitive–behavioural therapy (CBT) had a regulatory effect.MethodsParticipants were 621 pregnant Pakistani women with mild anxiety. Using the Pregnancy Experience Scale-Brief Version, six scores were created to assess positive and negative stressors. We performed a multivariate linear regression to examine whether these six scores, measured both at baseline and in the third trimester, were associated with postpartum anxiety and depressive symptoms. The effect of the intervention on this relationship was examined by adding an interaction term to the regression model.ResultsHassles frequency measured in the third trimester was positively associated with depression (B=0.22, 95% confidence interval (CI): 0.09 to 0.36) and anxiety (B=0.19, 95% CI: 0.08to 0.30). At the same timepoint, uplifts intensity was negatively associated with symptoms of depression (B=−0.82, 95% CI: −1.46 to –0.18) and anxiety (B=−0.70, 95% CI: −1.25 to –0.15), whereas hassles intensity was positively related to symptoms of depression (B=1.02, 95% CI: 0.36 to 1.67) and anxiety (B=0.90, 95% CI: 0.34 to 1.47). The intensity ratio of hassles to uplifts reported in the third trimester was positively related to both depression (B=1.40, 95% CI: 0.59 to 2.20) and anxiety (B=1.26, 95% CI: 0.57 to 1.96). The intervention strengthened the overall positive effects of uplifts and the negative effects of hassles. Pregnancy experiences at baseline during early pregnancy to mid-pregnancy were not associated with mental health outcomes.ConclusionsStressors in the third trimester but not earlier in pregnancy were associated with postpartum symptoms of anxiety and depression. The CBT intervention modified the association between pregnancy stressors and postpartum mental health outcomes. Programmes that promote positive experiences and reduce negative experiences, especially in late pregnancy, may mitigate postpartum mental health consequences.Trial registration numberNCT03880032.

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Prevalence and associated psychological risk factors of postpartum depression: a cross-sectional study

Cited by 7 publications

References 35 publications

Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort

Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort

Risk factors for postpartum depression in women undergoing elective cesarean section: A prospective cohort study

Pregnancy stressors and postpartum symptoms of depression and anxiety: the moderating role of a cognitive–behavioural therapy (CBT) intervention

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