Factors Associated With Maternal Depression in the Maldives: A Prospective Cohort Study

The aim of the study was to document perinatal depression in mothers in the Maldives and associated factors. A cohort of 458 mothers was recruited at the 2 major hospitals in Malé, the Maldives, and followed from 36 weeks of pregnancy to 3 months after birth. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure maternal depression. Maternal sociodemographic factors and infant’s health were also recorded. The prevalence of depressive symptoms (EPDS score ≥13) at 36 weeks of pregnancy and at 1 and 3 months postpartum were 24%, 27%, and 12%, respectively. Having experienced stressful life events is an established risk factor for maternal depression across these time points. Having depressive symptoms during the postpartum period is significantly associated with presence of antenatal depressive symptoms. Future studies may look into effectiveness of strategies that cope with stressors in the management of maternal depression.

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Metabolic Profiling Indicates Diversity in the Metabolic Physiologies Associated With Maternal Postpartum Depressive Symptoms

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.685656 ◽

2021 ◽

Vol 12 ◽

Author(s):

Emma Bränn ◽

Christina Malavaki ◽

Emma Fransson ◽

Maria-Konstantina Ioannidi ◽

Hanna E. Henriksson ◽

...

Keyword(s):

Depressive Symptoms ◽

Metabolic Profiling ◽

Edinburgh Postnatal Depression Scale ◽

Depression Scale ◽

Gas Chromatography Mass Spectrometry ◽

Future Studies ◽

Postpartum Depressive Symptoms ◽

Antenatal Depressive Symptoms ◽

Edge Method ◽

Hydroxybutanoic Acid

Background: Postpartum depression (PPD) is a devastating disease requiring improvements in diagnosis and prevention. Blood metabolomics identifies biological markers discriminatory between women with and those without antenatal depressive symptoms. Whether this cutting-edge method can be applied to postpartum depressive symptoms merits further investigation.Methods: As a substudy within the Biology, Affect, Stress, Imagine and Cognition Study, 24 women with PPD symptom (PPDS) assessment at 6 weeks postpartum were included. Controls were selected as having a score of ≤ 6 and PPDS cases as ≥12 on the Edinburgh Postnatal Depression Scale. Blood plasma was collected at 10 weeks postpartum and analyzed with gas chromatography–mass spectrometry metabolomics.Results: Variations of metabolomic profiles within the PPDS samples were identified. One cluster showed altered kidney function, whereas the other, a metabolic syndrome profile, both previously associated with depression. Five metabolites (glycerol, threonine, 2-hydroxybutanoic acid, erythritol, and phenylalanine) showed higher abundance among women with PPDSs, indicating perturbations in the serine/threonine and glycerol lipid metabolism, suggesting oxidative stress conditions.Conclusions: Alterations in certain metabolites were associated with depressive pathophysiology postpartum, whereas diversity in PPDS physiologies was revealed. Hence, plasma metabolic profiling could be considered in diagnosis and pathophysiological investigation of PPD toward providing clues for treatment. Future studies require standardization of various subgroups with respect to symptom onset, lifestyle, and comorbidities.

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Parental divorce in childhood does not independently predict maternal depressive symptoms during pregnancy

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03227-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Elviira Porthan ◽

Matti Lindberg ◽

Eeva Ekholm ◽

Noora M. Scheinin ◽

Linnea Karlsson ◽

...

Keyword(s):

Depressive Symptoms ◽

Postnatal Depression ◽

Edinburgh Postnatal Depression Scale ◽

Stressful Life Events ◽

Parental Divorce ◽

Depression Scale ◽

Ultrasound Screening ◽

Medical Birth Register ◽

Final Study ◽

Witnessing Domestic Violence

Abstract Background This study sought to investigate if parental divorce in childhood increases the risk for depressive symptoms in pregnancy. Methods Women were recruited during their ultrasound screening in gestational week (gwk) 12. The final study sample consisted of 2,899 pregnant women. Questionnaires (including the Edinburgh Postnatal Depression Scale) were completed at three measurement points (gwk 14, 24 and 34). Prenatal depressive symptoms were defined as Edinburgh Postnatal Depression Scale score ≥ 13. Parental divorce and other stressful life events in childhood were assessed at gwk 14. Parental divorce was defined as separation of parents who were married or cohabiting. Questionnaire data was supplemented with data from Statistics Finland and the Finnish Medical Birth Register. Results Parental divorce in childhood increased the risk for depressive symptoms during pregnancy (OR 1.47; 95% CI 1.02–2.13), but the connection was no longer significant after adjusting for socioeconomic status, family conflicts and witnessing domestic violence in the childhood family (OR 0.80; 95% CI 0.54–1.18). Conclusions Parental divorce alone does not predict depressive symptoms during pregnancy.

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The pregnancy intention to have a second child and antenatal depressive symptoms in Chinese women under the new two-child-per-couple policy

10.21203/rs.2.15650/v1 ◽

2019 ◽

Author(s):

Meili Xiao ◽

Bing Fu ◽

Chunmei Mi ◽

Chen Pan ◽

Shujuan Zhu ◽

...

Keyword(s):

Depressive Symptoms ◽

Pregnant Women ◽

Edinburgh Postnatal Depression Scale ◽

Chinese Women ◽

Depression Scale ◽

Pregnancy Intention ◽

Key Words Pregnancy ◽

Second Child ◽

Logistic Regression Models ◽

Antenatal Depressive Symptoms

Abstract Background: Few studies investigated the association between the pregnancy intention to have a second child and antenatal depressive symptoms.The aim of this study was to explore the association between the pregnancy intention to have a second child by pregnant women’s own desires, pregnant women’s husband own desires, parents who want to grandchild desires, couple’s concordance desires and antenatal depressive symptoms. Methods: A total of 306 participants who completed questionnaire were included in our analysis. Antenatal depressive symptom was assessed using the Chinese version of Edinburgh Postnatal Depression Scale. Logistic regression models were used to estimate the association between the pregnancy intention to have a second child by pregnant women’s own desires, pregnant women’s husband own desires, parents who want to grandchild desires and antenatal depressive symptoms. Results: the prevalence of antenatal depressive symptoms was 36.3% among the second child pregnant women. Of the 306 participants, the proportion of the pregnancy intention to have a second child by pregnant women’s own desires, pregnant women’s husband desires, parents who want to grandchild desires and couple’s concordance desires was 8.5%, 8.5%, 10.8% and 72.2% respectively. Compared with the pregnancy intention by couple’s concordance desires, pregnant women’s own desires to have a second child had higher risk of antenatal depressive symptoms after adjustment for potential confounders (OR=4.560, 95%CI: 1.603,12.973). No association was found between the pregnancy intention to have a second child by pregnant women’s husband own desires, parents who want to grandchild desires and antenatal depressive symptoms after adjustment for confounders (OR=1.996, 95%CI:0.781,5.105; OR=0.744, 95%CI: 0.306,1.811, respectively). Conclusion: These findings suggest the pregnancy intention to have a second child by pregnant women own’s desires may be a risk factors for antenatal depressive symptoms among two-child pregnant women. A qualitative study should be carried out to investigate the real reason for the intention by pregnant women’s own desires and antenatal depressive symptoms in the future, because of this study was a quantitative study. Key words: pregnancy intention; antenatal depressive symptoms; second child

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Antenatal depressive symptoms as a predictor of deterioration in perceived social support across the perinatal period: a four-wave cohort study in Turkey

Psychological Medicine ◽

10.1017/s0033291716002865 ◽

2016 ◽

Vol 47 (4) ◽

pp. 766-775 ◽

Cited By ~ 3

Author(s):

V. Senturk ◽

M. Abas ◽

M. Dewey ◽

O. Berksun ◽

R. Stewart

Keyword(s):

Social Support ◽

Depressive Symptoms ◽

Family Relationships ◽

Emotional Support ◽

Stressful Life Events ◽

Depression Scale ◽

Perinatal Period ◽

Practical Support ◽

Antenatal Depressive Symptoms

BackgroundIn a perinatal cohort of women in urban and rural Turkey, we investigated associations between antenatal depressive symptoms and subsequent changes in perceived quality of key family relationships.MethodOf 730 women recruited in their third trimester (94.6% participation), 578 (79.2%) were reassessed at a mean of 4.1 (s.d. = 3.3) months after childbirth, 488 (66.8%) were reassessed at 13.7 (s.d. = 2.9) months, and 448 (61.4%) at 20.8 (s.d. = 2.7) months. At all four examinations, self-reported quality of relationship with the husband, mother and mother-in-law was ascertained using the Close Persons Questionnaire with respect to emotional support, practical support and negative aspects of the relationship. Antenatal depressive symptoms were defined using the Edinburgh Postnatal Depression Scale. A range of covariates in mixed models was considered including age, education, number of children, family structure, physical health, past emotional problems and stressful life events.ResultsKey findings were as follows: (i) reported emotional and practical support from all three relationships declined over time in the cohort overall; (ii) reported emotional support from the husband, and emotional and practical support from the mother-in-law, declined more strongly in women with antenatal depressive symptoms; (iii) associations between depressive symptoms and worsening spouse relationship were more pronounced in traditional compared with nuclear families.ConclusionsAntenatal depressive symptoms predicted marked decline in the quality of key relationships over the postnatal period. This may account for some of the contemporaneous associations between depression and worse social support, and may compound the risk of perinatal depression in subsequent pregnancies.

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Maternal depression is associated with injuries in children aged 2–4 years: the Pelotas 2004 Birth Cohort

Injury Prevention ◽

10.1136/injuryprev-2017-042641 ◽

2018 ◽

Vol 25 (3) ◽

pp. 222-227 ◽

Cited By ~ 9

Author(s):

Raquel Siqueira Barcelos ◽

Iná da Silva dos Santos ◽

Alicia Matijasevich ◽

Luciana Anselmi ◽

Fernando Celso Barros

Keyword(s):

Depressive Symptoms ◽

Maternal Depression ◽

Birth Cohort ◽

Causes Of Death ◽

Edinburgh Postnatal Depression Scale ◽

Post Partum ◽

Depression Scale ◽

Population Based ◽

Incidence Rates ◽

Children And Young Adults

IntroductionInjuries during childhood, which mostly consist of falls, burns, drowning, poisonings and car crashes, are among the main causes of death among children and young adults in several countries.ObjectivesTo investigate the association between maternal depression and the incidence of injuries during childhood.MethodsIn 2004, children who were born in the municipality of Pelotas, Brazil, were enrolled in a population-based birth cohort, with evaluations at birth and at 3, 12, 24 and 48 months of age. Maternal depression during pregnancy was evaluated at the time of delivery. At 12 and 24 months post partum, the Edinburgh Postnatal Depression Scale (EPDS) was used. The injuries incidence rates at ages of 24–48 months and the crude and adjusted IRRs were calculated with 95% CI through Poisson’s regression.ResultsA total of 3533 children were analysed. The incidence of injuries was higher among children whose mothers presented depressive symptoms during pregnancy and at 12 and 24 months compared with those whose mothers did not present any symptoms. In the adjusted analysis, the IRR among girls whose mothers presented depressive symptoms during pregnancy and EPDS ≥13 at 12 and 24 months was 1.31 (1.15–1.50); and, among boys, 1.18 (1.03–1.36).InterpretationMaternal depression is associated with higher incidence of injuries between 24 and 48 months of age, in both sexes.

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Thirty years with the Edinburgh Postnatal Depression Scale: voices from the past and recommendations for the future

The British Journal of Psychiatry ◽

10.1192/bjp.2018.245 ◽

2019 ◽

Vol 214 (3) ◽

pp. 127-129 ◽

Cited By ~ 10

Author(s):

John Cox

Keyword(s):

Postnatal Depression ◽

Edinburgh Postnatal Depression Scale ◽

Perinatal Depression ◽

Depression Scale ◽

Self Report ◽

Future Studies ◽

The Past ◽

Financial Interest ◽

Practical Usefulness ◽

The World

SummaryThe Edinburgh Postnatal Depression Scale (EPDS) was published over 30 years ago as a ten-item self-report questionnaire to facilitate the detection of perinatal depression – and for use in research. It is widely used at the present time in many regions of the world and has been translated into over 60 languages. It is occasionally misused. In this editorial, updated recommendations for optimal use in primary and secondary care as well as research are provided. Future studies to evaluate its use and validity in naturalistic community populations are now required, and to determine the psychometric properties and practical usefulness of the EPDS when completed online.Declaration of interestJ.C. has no financial interest in the use of, or reproduction of, the EPDS.

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Trajectories of maternal depressive symptoms and offspring’s risk behavior in early adolescence: data from the 2004 Pelotas birth cohort study

BMC Psychiatry ◽

10.1186/s12888-020-03026-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ana Beatriz Bozzini ◽

Jessica Mayumi Maruyama ◽

Tiago N. Munhoz ◽

Aluísio J. D. Barros ◽

Fernando C. Barros ◽

...

Keyword(s):

Cohort Study ◽

Depressive Symptoms ◽

Alcohol Use ◽

Maternal Depression ◽

Risk Behavior ◽

Birth Cohort ◽

Depression Scale ◽

Self Report ◽

Birth Cohort Study ◽

Maternal Depressive Symptoms

Abstract Background This longitudinal study explored the relationship between trajectories of maternal depressive symptoms and offspring’s risk behavior in adolescence contributing to an extremely scarce literature about the impacts of maternal depression trajectories on offspring risk behaviors. Methods We included 3437 11-year-old adolescents from the 2004 Pelotas Birth Cohort Study. Trajectories of maternal depressive symptoms were constructed using Edinburgh Postnatal Depression Scale (EDPS) from age 3 months to 11 years. We identified five trajectories of maternal depressive symptoms: “low” “moderate low”, “increasing”, “decreasing”, and “chronic high”. The following adolescent outcomes were identified via self-report questionnaire and analyzed as binary outcome –yes/no: involvement in fights and alcohol use at age 11. We used logistic regression models to examine the effects of trajectories of maternal depressive symptoms on offspring’s risk behavior adjusting for potential confounding variable. Results Alcohol use and/or abuse as well as involvement in fights during adolescence, were not significantly associated with any specific trajectory of maternal depressive symptoms neither in the crude nor in the adjusted analyses. Conclusion Alcohol use and involvement in fights at age 11 were not associated with any specific trajectory of maternal depression.

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Effect of perinatal depression on risk of adverse infant health outcomes in mother-infant dyads in Gondar town: a causal analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03733-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abel Fekadu Dadi ◽

Emma R. Miller ◽

Richard J. Woodman ◽

Telake Azale ◽

Lillian Mwanri

Keyword(s):

Causal Inference ◽

Maternal Depression ◽

Cumulative Incidence ◽

Postnatal Depression ◽

Infant Health ◽

Perinatal Depression ◽

Integrated Management ◽

Depression Scale ◽

Gondar Town ◽

Infant Birth

Abstract Background Approximately one-third of pregnant and postnatal women in Ethiopia experience depression posing a substantial health burden for these women and their families. Although associations between postnatal depression and worse infant health have been observed, there have been no studies to date assessing the causal effects of perinatal depression on infant health in Ethiopia. We applied longitudinal data and recently developed causal inference methods that reduce the risk of bias to estimate associations between perinatal depression and infant diarrhea, Acute Respiratory Infection (ARI), and malnutrition in Gondar Town, Ethiopia. Methods A cohort of 866 mother-infant dyads were followed from infant birth for 6 months and the cumulative incidence of ARI, diarrhea, and malnutrition were assessed. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the presence of maternal depression, the Integrated Management of Newborn and Childhood Illnesses (IMNCI) guidelines were used to identify infant ARI and diarrhea, and the mid upper arm circumference (MUAC) was used to identify infant malnutrition. The risk difference (RD) due to maternal depression for each outcome was estimated using targeted maximum likelihood estimation (TMLE), a doubly robust causal inference method used to reduce bias in observational studies. Results The cumulative incidence of diarrhea, ARI and malnutrition during 6-month follow-up was 17.0% (95%CI: 14.5, 19.6), 21.6% (95%CI: 18.89, 24.49), and 14.4% (95%CI: 12.2, 16.9), respectively. There was no association between antenatal depression and ARI (RD = − 1.3%; 95%CI: − 21.0, 18.5), diarrhea (RD = 0.8%; 95%CI: − 9.2, 10.9), or malnutrition (RD = -7.3%; 95%CI: − 22.0, 21.8). Similarly, postnatal depression was not associated with diarrhea (RD = -2.4%; 95%CI: − 9.6, 4.9), ARI (RD = − 3.2%; 95%CI: − 12.4, 5.9), or malnutrition (RD = 0.9%; 95%CI: − 7.6, 9.5). Conclusion There was no evidence for an association between perinatal depression and the risk of infant diarrhea, ARI, and malnutrition amongst women in Gondar Town. Previous reports suggesting increased risks resulting from maternal depression may be due to unobserved confounding.

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The Mental Health Characteristics of Pregnant Women With Depressive Symptoms Identified by the Edinburgh Postnatal Depression Scale

The Journal of Clinical Psychiatry ◽

10.4088/jcp.13m08646 ◽

2014 ◽

Vol 75 (04) ◽

pp. 393-398 ◽

Cited By ~ 42

Author(s):

Linda B. Lydsdottir ◽

Louise M. Howard ◽

Halldora Olafsdottir ◽

Marga Thome ◽

Petur Tyrfingsson ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Pregnant Women ◽

Postnatal Depression ◽

Edinburgh Postnatal Depression Scale ◽

Depression Scale

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Maternal Depression and Breastfeeding Practices in the Maldives

Asia Pacific Journal of Public Health ◽

10.1177/1010539519836531 ◽

2019 ◽

Vol 31 (2) ◽

pp. 113-120 ◽

Cited By ~ 2

Author(s):

Raheema Abdul Raheem ◽

Hui Jun Chih ◽

Colin William Binns

Keyword(s):

Maternal Depression ◽

Postnatal Depression ◽

Edinburgh Postnatal Depression Scale ◽

Cox Regression ◽

Depression Scale ◽

Antenatal Clinic ◽

Antenatal Depression ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Breastfeeding Practices

Objectives: To assess associations between maternal depression and breastfeeding practices in mothers in the Maldives. Design: A prospective cohort study. The validated questionnaires contained information on demographics, breastfeeding initiation, breastfeeding duration, and the Edinburgh Postnatal Depression Scale. Logistic regression analyses were used to assess association between Edinburgh Postnatal Depression Scale score and breastfeeding practices while adjusting for lifestyle determinants. Cox regression was done to measure the association between maternal depression and breastfeeding duration. Settings: Antenatal clinic at Indira Gandhi Memorial and ADK Hospitals in Male’, Maldives. Subjects: A total of 458 mothers from the antennal clinics were interviewed at 36 weeks of gestation and again at 1, 3, and 6 months after birth. Results: Antenatal depression at 36 weeks of gestation was associated with late initiation of breastfeeding (adjusted odds ratio = 3.0, 95% confidence interval = 1.3-6.8). Postnatal depression was associated with shorter duration of exclusive, full, and any breastfeeding ( P < .001). Conclusion. Depression is negatively associated with breastfeeding practices. There is a need to manage antenatal postnatal depression in mothers in order to encourage them to initiate breastfeeding earlier and to breastfeed for longer.

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