The Association Between Immediate Postpartum Depot Medroxyprogesterone Acetate Use and Postpartum Depressive Symptoms

2021 ◽  
Author(s):  
Carolyn M. Ross ◽  
Jessica Y. Shim ◽  
Elisabeth L. Stark ◽  
Katherine L. Wisner ◽  
Emily S. Miller
Keyword(s):  
Depressive Symptoms ◽  
Postpartum Depression ◽  
Hospital Discharge ◽  
Medroxyprogesterone Acetate ◽  
Tertiary Care ◽  
Hypertensive Disorder ◽  
Positive Screen ◽  
Depot Medroxyprogesterone Acetate ◽  
Postpartum Depressive Symptoms ◽  
Publicly Insured

Objective While postpartum depot medroxyprogesterone acetate (DMPA) is a highly effective form of contraception, some data suggest an association with depressive symptoms. Our objective was to evaluate the relationship between receipt of DMPA in the immediate postpartum period and postpartum depressive symptoms. Methods This retrospective cohort study included all women who received prenatal and postpartum care at academic obstetric clinics affiliated with a tertiary care institution between January 1, 2008 and December 31, 2014. All women were counseled on contraception prior to hospital discharge. DMPA was available in the hospital pharmacy, and its utilization was documented in the electronic health record. The Patient Health Questionnaire 9 (PHQ-9) was used to screen for postpartum depression for all women at all postpartum visits. A score of 10 or greater was categorized as positive. Bivariable and multivariable analyses were used to identify the association between immediate postpartum DMPA use and a positive postpartum depression screen. Results Of the 5,073 women who met inclusion criteria, 410 (8.1%) received DMPA prior to hospital discharge. Compared with women who did not receive DMPA, women who received DMPA prior to hospital discharge were younger, more likely to identify as Black race or Latinx ethnicity, and more likely to be publicly insured. Clinical characteristics also differed. Women who received DMPA were more likely to be obese and to have experienced prenatal depressive symptoms, been diagnosed with a hypertensive disorder of pregnancy, delivered preterm, and delivered vaginally. Receipt of immediate postpartum DMPA was not associated with having a positive screen for postpartum depression in bivariable (5.4 vs. 6.0%, p = 0.29) or multivariable (adjusted odds ratio 0.94, confidence interval 0.53–1.68) analyses. Conclusion Receipt of postpartum DMPA is not associated with a positive postpartum PHQ-9 screen. Concerns about precipitating postpartum depression should not preclude the utilization of DMPA as a contraceptive agent. Key Points

GEJALA DEPRESI POSTPARTUM MEMPENGARUHI KEBERHASILAN ASI EKSKLUSIF : Sistematik Literatur Riview

2020 ◽  
pp. 27-34
Author(s):  
Nova Arami ◽  
Surahma Asti Mulasari ◽  
Ummu Hani EN
Keyword(s):  
Depressive Symptoms ◽  
Breast Milk ◽  
Postpartum Depression ◽  
Low Income ◽  
Critical Appraisal ◽  
Previous History ◽  
Synthesis Method ◽  
Depression Scale ◽  
Postpartum Depressive Symptoms ◽  
Postpartum Mothers

Air Susu Ibu (ASI) merupakan satu-satunya makanan yang sempurna dan terbaik bagi bayi karena mengandung unsur-unsur gizi yang dibutuhkan untuk pertumbuhan dan perkembangan bayi yang optimal. Namun ada beberapa penyebab ibu tidak memberikan ASI secara eksklusif seperti tidak mendapatkan dukungan dari suami/keluarga, penghasilan, usia, pendidikan yang menyebabkan terjadinya depresi postpartum sehingga menghambat proses laktasi. Tujuan penelitian untuk menyimpulkan dan memeriksa literature (examine literature) apakah gejala depresi pada ibu postpartum berhubungan dengan  keberhasilan pemberian ASI. Metode penelitian menggunakan studi appraisal dengan Critical Appraisal Joana Brigs Institute, dan metode sintesis menggunakan PEOS. Pencarian dibatasi pada studi yang diterbitkan dalam bahasa Inggris dan menyajikan data periode 2012-2019. Studi yang terindentifikasi ditinjau menggunakan PRISMA Flowchart. Studi dengan desain kuantitatif terkait gejala depresi postpartum mempengaruhi keberhasilan ASI eksklusif. Hasil penelitian adalah depresi postpartum diukur menggunakan EPDS (Edinburgh Postpartum Depression Scale) yang dilakukan pada ibu postpartum usia 2-6 minggu pascapersalinan. Gejala depresi dapat mempengaruhi keberhasilan pemberian ASI dan beberapa faktornya karena kurangnya dukungan emosional, pendidikan, pengetahuan, pendapatan yang rendah, dan terdapat riwayat depresi sebelumnya. Namun hal yang paling dominan terjadinya depresi postpartum yaitu kurangnya dukungan suami/keluarga. Kesimpulan penelitian ini adalah gejala depresi postpartum dapat mempengaruhi keberhasilan ASI eksklusif dikarenakan ada perubahan hormon dan mood yang terjadi pada ibu seperti tidak nafsu makan, gangguan tidur, cemas, sensitif sehingga dapat menggaggu kelancaran ASI. Breastmilk (ASI) is the only perfect and best food for babies because it contains nutritional elements for optimal baby growth and development. However, there are several reasons why mothers do not exclusively breastfeed, such as not getting support from their husbands/families, stage, education which causes postpartum depression which hinders the lactation process. This study aims to conclude and examine the literature (examining the literature) whether the symptoms of depression in postpartum mothers are associated with breastfeeding. The method of the study using appraisal study using Joana Brigs Institute Critical Appraisal, and synthesis method using PEOS. Base search on studies published in English and present data for the period 2012-2019. Identified studies were reviewed using PRISMA Flowchart. A quantitative design study of postpartum depressive symptoms affects exclusive breastfeeding. The results showed postpartum depression was measured using the EPDS (Edinburgh Postpartum Depression Scale) which was performed on postpartum mothers aged 2-6 weeks postpartum. Depressive symptoms can affect the situation of offering breast milk and several factors due to emotional support, education, low income, a previous history of depression. But the worst thing that happens in postpartum depression is support from family. The conclusion was postpartum depressive symptoms can affect exclusive breast milk because there are hormonal and mood changes that occur in the mother such as lack of appetite, sleep disturbances, anxiety, sensitivity so that they can interfere with the smoothness of breast milk.  

scholarly journals The COVID-19 outbreak increases maternal stress during pregnancy, but not the risk for postpartum depression

2021 ◽  
Author(s):  
Myrthe G. B. M. Boekhorst ◽  
Lotte Muskens ◽  
Lianne P. Hulsbosch ◽  
Katrijn Van Deun ◽  
Veerle Bergink ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Depressive Symptoms ◽  
The Netherlands ◽  
Postpartum Depression ◽  
Prospective Cohort ◽  
Vulnerable Groups ◽  
Symptoms Of Depression ◽  
Postpartum Depressive Symptoms ◽  
Perinatal Women

AbstractThe COVID-19 pandemic affects society and may especially have an impact on mental health of vulnerable groups, such as perinatal women. This prospective cohort study of 669 participating women in the Netherlands compared perinatal symptoms of depression and stress during and before the pandemic. After a pilot in 2018, recruitment started on 7 January 2019. Up until 1 March 2020 (before the pandemic), 401 women completed questionnaires during pregnancy, of whom 250 also completed postpartum assessment. During the pandemic, 268 women filled out at least one questionnaire during pregnancy and 59 postpartum (1 March–14 May 2020). Pregnancy-specific stress increased significantly in women during the pandemic. We found no increase in depressive symptoms during pregnancy nor an increase in incidence of high levels of postpartum depressive symptoms during the pandemic. Clinicians should be aware of the potential for increased stress in pregnant women during the pandemic.

scholarly journals Assessing the Role of Maternal Health Care Knowledge and Practices in Postpartum Depression

2020 ◽  
pp. 811-817
Author(s):  
Faiza Anjum ◽  
Madieha Akram ◽  
Raja Shaharyar ◽  
Muhammad Yaseen ◽  
Zahira Batool ◽  
...  
Keyword(s):  
Health Care ◽  
Depressive Symptoms ◽  
Maternal Health ◽  
Postpartum Depression ◽  
Maternal Health Care ◽  
Chi Square ◽  
Postpartum Depressive Symptoms ◽  
Health Care Practices ◽  
Care Practices

The present study aims to access the role of maternal health care knowledge and practices in developing postpartum depressive symptoms among Pakistani women. The data was collected from 400 rural mothers, having a child up to one year of age in four rural towns of Faisalabad. An interview schedule approach was used for collection of data. Results showed that lack of education, income, maternal health care knowledge and health care practices were the most important predictors of postpartum depression. The values of chi-square (26.419) and (59.734) showed a highly significant association (P = 0.000) between lack of health care knowledge and postpartum depressive symptoms and health care practices as well as postpartum depressive symptoms, respectively. Additionally, the compulsion of social taboos (eat specific food, not allow to go outside home, infant care, spouse attachment) in the antenatal/postpartum period increased the level of emotional distress such as low mood, anxiety, poor concentration and stress. The study suggested that women’s consultancy with a health care professional to obtain postpartum instructions is beneficial for healthy mothers and their child.

scholarly journals Determining factors for the prevalence of depressive symptoms among postpartum mothers in lowland region in southern Nepal

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245199
Author(s):  
Devendra Raj Singh ◽  
Dev Ram Sunuwar ◽  
Shraddha Adhikari ◽  
Sunita Singh ◽  
Kshitij Karki
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Postpartum Depression ◽  
Cesarean Section ◽  
Health Facility ◽  
Walking Distance ◽  
Normal Vaginal Delivery ◽  
Postpartum Depressive Symptoms ◽  
Study Results ◽  
Postpartum Mothers

Background Postpartum depression is the most common mental health problem among women of childbearing age in resource-poor countries. Poor maternal mental health is linked with both acute and chronic negative effects on the growth and development of the child. This study aimed to assess the prevalence and factors associated with depressive symptoms among postpartum mothers in the lowland region in southern Nepal. Methods A hospital-based analytical cross-sectional study was conducted from 1st July to 25th August 2019 among 415 randomly selected postpartum mothers attending the child immunization clinic at Narayani hospital. The postpartum depressive symptoms were measured using the validated Nepalese version of the Edinburg Postnatal Depression Scale (EPDS). The data were entered into EpiData software 3.1v and transferred into Stata version 14.1 (StataCorp LP, College Station, Texas) for statistical analyses. To identify the correlates, backward stepwise binary logistic regression models were performed separately for the dichotomized outcomes: the presence of postpartum depressive symptoms. The statistical significance was considered at p-value <0.05 with 95% confidence intervals (CIs). Results Among the total 415 study participants, 33.7% (95% CI: 29.2–38.5%) of postpartum mothers had depressive symptoms. Study participant’s whose family monthly income <150 USD compared to ≥150 USD (aOR = 13.76, 95% CI: 6.54–28.95), the husband had migrated for employment compared to not migrated (aOR = 8.19, 95% CI:4.11–15.87), nearest health facility located at more than 60 minutes of walking distance (aOR = 4.52, 95% CI: 2.26–9.03), delivered their last child by cesarean section compared to normal (vaginal) delivery (aOR = 2.02, 95% CI: 1.12–3.59) and received less than four recommended antenatal care (ANC) visits (aOR = 2.28, 95% CI:1.25–4.15) had higher odds of depressive symptoms. Participants who had planned pregnancy (aOR = 0.44, 95% CI: 0.25–0.77) were associated with 56% lower odds of depressive symptoms. Conclusions One-third of the mothers suffered from postpartum depressive symptoms. The participant’s husband migrated for employment, family income, distance to reach a health facility, delivery by cesarean section, not receiving recommended ANC visits, and plan of pregnancy were independent predictors for postpartum depressive symptoms. The study results warranted the urgency for clinical diagnosis of PPD and implementation of preventive package in study settings. Mental health education to pregnant women during ANC visits and proper counseling during the antepartum and postpartum period can also play a positive role in preventing postpartum depression.

Depressive symptoms in users and non-users of depot medroxyprogesterone acetate

Contraception ◽  
2000 ◽  
Vol 61 (6) ◽  
pp. 385-390 ◽  
Author(s):  
Diane Civic ◽  
Delia Scholes ◽  
Laura Ichikawa ◽  
Andrea Z LaCroix ◽  
Cathleen K Yoshida ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Medroxyprogesterone Acetate ◽  
Depot Medroxyprogesterone Acetate

scholarly journals Preventing postpartum depression using an educational video on infant crying

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Doi ◽  
T Fujiwara ◽  
A Isumi ◽  
A Nakai ◽  
K Ogita ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Postpartum Depression ◽  
Intervention Group ◽  
Control Group ◽  
Educational Video ◽  
Young Mothers ◽  
Infant Crying ◽  
Postpartum Depressive Symptoms ◽  
Significant Difference ◽  
The Impact

Abstract Background Perception of and reactive behaviors towards infant crying is one of the modifiable risk factors for postpartum depression. The aim of this study was to examine the impact of watching an educational video on infant crying within 1 week of age after delivery at maternity wards to reduce the prevalence of postpartum depressive symptoms at 1 month after giving birth. Methods Study design was a cluster randomized controlled trial (UMIN000015558). The intervention hospitals were randomly assigned, stratified by area and function of the hospital. Participants included 47 obstetrics hospitals or clinics out of 150 hospitals or clinics in Osaka Prefecture, Japan. In total, 44 hospitals or clinics completed the trial and 2,601 (intervention group=1,040, control group=1,561) caregivers responded to the questionnaire on postpartum depression. Mothers in the intervention group watched a 11-minute educational video, within 1 week of age, during hospitalization at maternity wards. Primary outcome in this study was postpartum depression assessed by the Edinburgh Postnatal Depression Scale as 9+, and assessed via questionnaire at a 1-month health checkup. Results In the intervention group, 142 (13.7%) mothers reported postpartum depression compared to 250 (16.0%) in the control group. Intention-to-treat analysis showed no significant difference in the prevalence of postpartum depression between the groups. However, among young mothers (&lt;25 years old), the analysis showed a 67% reduction in postpartum depression (OR:0.33, 95%CI:0.15-0.72). Conclusions Watching an educational video on infant crying did not reduce postpartum depression at 1 month after giving birth, but it was effective for young mothers aged less than 25 years old. It may be easier to introduce our approach to any opportunity for meeting mothers during perinatal period because it does not require specialized manpower and a significant amount of time for the intervention. Key messages The educational video on infant crying, “Baby Doesn't Stop Crying,” had no effect in preventing postpartum depressive symptoms. Among young mothers aged &lt;25 years, the educational video had a protective effect on postpartum depressive symptoms, which was not observed for mothers aged ≥25 years.

scholarly journals Elevated Midpregnancy Corticotropin-Releasing Hormone Is Associated with Prenatal, But Not Postpartum, Maternal Depression

2008 ◽  
Vol 93 (5) ◽  
pp. 1946-1951 ◽  
Author(s):  
J. W. Rich-Edwards ◽  
A. P. Mohllajee ◽  
K. Kleinman ◽  
M. R. Hacker ◽  
J. Majzoub ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Postpartum Depression ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Depression Scale ◽  
Prenatal Depression ◽  
Depression Symptoms ◽  
Logarithmic Scale ◽  
Postpartum Depressive Symptoms ◽  
Scale Range

Abstract Context: Elevated hypothalamic CRH has been implicated in melancholic major depression in nonpregnant individuals, but the role of placental CRH in maternal prenatal and postpartum depression is largely unexplored. Objective: The objective of the study was to examine the association of maternal midpregnancy plasma CRH levels with prenatal and postpartum depression. Participants: The study included 800 participants in Project Viva, a pregnancy and childhood cohort. Methods: CRH levels were analyzed from blood samples obtained at mean 27.9 wk gestation (± 1.3 sd; range 24.6–37.4 wk) and were normalized on the logarithmic scale. Depression was assessed with the Edinburgh Postpartum Depression Scale (range 0–30 points) in midpregnancy and at 6 months postpartum. We used logistic regression to estimate the odds of scoring 13 or more points on the Edinburgh Postpartum Depression Scale as indicative of major or minor depression. Results: Seventy (8.8%) and 46 (7.5%) women had prenatal and postpartum depression symptoms, respectively. Mean log CRH was 4.93 (± 0.62 sd). After adjusting for confounders, an sd increase in log CRH was associated with nearly 50% higher odds of prenatal depression symptoms (odds ratio 1.48, 95% confidence interval 1.14–1.93). Higher CRH levels during pregnancy were unassociated with greater risk of postpartum depressive symptoms. In fact, there was a suggestion that prenatal CRH levels might be inversely associated with risk of postpartum depressive symptoms (odds ratio 0.82, 95% confidence interval 0.58–1.15). Conclusions: Elevated placental CRH levels in midpregnancy are positively associated with risk of prenatal depression symptoms but not postpartum depression symptoms.

scholarly journals Postpartum depression and associated factors among mothers in Bahir Dar Town, Northwest Ethiopia

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Amsale Abebe ◽  
Getachew Tesfaw ◽  
Haregewoine Mulat ◽  
Getahun Hibdye ◽  
kalkidan Yohannes
Keyword(s):  
Decision Making ◽  
Depressive Symptoms ◽  
Postpartum Depression ◽  
Life Events ◽  
Partner Violence ◽  
Stressful Life Events ◽  
Unplanned Pregnancy ◽  
Health Needs ◽  
Bahir Dar ◽  
Postpartum Depressive Symptoms

Abstract Background Postpartum depressive symptoms are the occurrence of major depressive episode within 4 weeks following delivery. Globally, 10%–20% of mothers suffer from depressive symptoms during their postpartum course. Therefore, assessing postpartum depressive symptoms has a pivotal role in ensuring that their mental health needs are met. Methods An institution-based cross-sectional study was conducted including 511 mothers coming for postnatal care service in public health centers in Bahir Dar Town. Data were collected using a pre-tested, structured, and interviewer-administered questionnaire, while the Edinburgh Postnatal Depression Scale (EPDS) was used to assess individuals’ depressive symptoms. The systematic random sampling technique was employed to recruit the study participants. Adjusted odds ratio with a 95% confidence interval (CI) was used to declare the statistical significance of the factors. Results Postpartum depressive symptoms among mothers were found to be 22.1 (95%, CI 18.6%, 25.8%). In multivariate logistic regression, stressful life events (AOR = 4.46, 95% CI 2.64, 7.54), domestic decision making (AOR = 4.26, 95% CI 2.54, 7.14), unplanned pregnancy (AOR = 1.86, 95% CI 1.02, 3.41), partner violence (AOR = 3.16, 95% CI 1.76, 5.67), and hospitalization of their babies (AOR = 2.24, 95% CI 1.17, 4.310) were factors significantly associated with postpartum depressive symptoms. Conclusions Postpartum depressive symptoms among mothers were common in the study area. Stressful life events, lack of empowerment in domestic decision making, intimate partner violence, unplanned pregnancy, and hospitalization of their baby were factors significantly associated with postpartum depression. The Ministry of Health needs to give training on how to screen postpartum depressive symptoms among mothers, and interventions that would address the above factors would benefit in tackling further complications.

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