Women’s Mental Health as a Factor Associated with Exclusive Breastfeeding and Breastfeeding Duration: Data from a Longitudinal Study in Greece

Background: This study investigated the relationship between exclusive breastfeeding and breastfeeding duration, and maternal psychological well-being in the perinatal period. Methods: A longitudinal study involving a retrospective follow-up of a group of 1080 women from pregnancy to the 1st year postpartum, who gave birth during the 5-year period between January 2014 and January 2019 in Athens, Greece, was designed. Women’s history and two psychometric tools—the Edinburg Postpartum Depression Scale (EPDS) and the Patient Health Questionnaire-9 (PHQ-9) administered at 5-time points—were used for data collection. Logistic regression analysis and a series of multiple analysis of variance (MANOVA) tests were performed. Results: The chance for exclusive breastfeeding (giving only breast milk) appeared to decrease (a) with an increase of the scores for psychometric tools antenatally (PHQ-9, p = 0.030) or at the 6th week postpartum (EPDS, p < 0.001 and PHQ-9, p < 0.001), (b) with an increase in the number of psychotherapeutic sessions needed antenatally (p = 0.030), and (c) when the initiation of psychotherapy was necessary postpartum (p = 0.002). Additionally, a shorter duration of any breastfeeding (with or without formula or other types of food/drink) seems to be associated with (a) the occurrence of pathological mental health symptoms (p = 0.029), (b) increased PHQ-9 scores antenatally (p = 0.018), (c) increased EPDS scores at the 6th week (p = 0.004) and the 12th month postpartum (p = 0.031), (d) the initiation of psychotherapy postpartum (p = 0.040), and e) the need for more than 13 psychotherapeutic sessions (p = 0.020). Conclusions: This study demonstrates a negative relationship between exclusive breastfeeding and breastfeeding duration, and poor maternal mental health in the perinatal period.

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Maternal mental well-being during pregnancy and glucocorticoid receptor gene promoter methylation in the neonate

Development and Psychopathology ◽

10.1017/s0954579416000183 ◽

2016 ◽

Vol 28 (4pt2) ◽

pp. 1421-1430 ◽

Cited By ~ 22

Author(s):

Toby Mansell ◽

Peter Vuillermin ◽

Anne-Louise Ponsonby ◽

Fiona Collier ◽

Richard Saffery ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Glucocorticoid Receptor ◽

Cord Blood ◽

Multiple Testing ◽

Maternal Mental Health ◽

Depression Scale ◽

Well Being ◽

Cpg Sites ◽

Glucocorticoid Receptor Gene

AbstractMaternal mental health during pregnancy has been linked to health outcomes in progeny. Mounting evidence implicates fetal “programming” in this process, possibly via epigenetic disruption. Maternal mental health has been associated with glucocorticoid receptor methylation (nuclear receptor subfamily 3, group C, member 1 [NR3C1]) in the neonate; however, most studies have been small (n < 100) and have failed to control for multiple testing in the statistical analysis. The Barwon Infant Study is a population-derived birth cohort with antenatal recruitment. Maternal depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale and psychological distress using the Perceived Stress Scale. NR3C1 cord blood methylation levels were determined using Sequenom MassArray for 481 participants. Maternal psychological distress and anxiety were associated with a small increase in neonate NR3C1 methylation at specific CpG sites, thus replicating some previous findings. However, associations were only nominally significant and did not remain after correction for the number of CpG sites and exposures investigated. As the largest study to explore the relationship between maternal well-being and offspring NR3C1 cord blood methylation, our results highlight the need for caution when interpreting previous findings in this area. Future studies must ensure they are adequately powered to detect the likely small effect sizes while controlling for multiple testing.

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Do Maternal Stress and Depressive Symptoms in Perinatal Period Predict the Lactation Mastitis Occurrence? A Retrospective Longitudinal Study in Greek Women

Diagnostics ◽

10.3390/diagnostics11091524 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1524

Author(s):

Maria Dagla ◽

Calliope Dagla ◽

Irina Mrvoljak-Theodoropoulou ◽

Dimitra Sotiropoulou ◽

Aikaterini-Taxiarchoula Kavakou ◽

...

Keyword(s):

Mental Health ◽

Longitudinal Study ◽

Depression Scale ◽

Binary Logistic Regression ◽

Perinatal Period ◽

Poor Mental Health ◽

Emotional Factors ◽

History Of ◽

Anxiety Screening ◽

D 12

Background: The aim of this study is to investigate whether symptoms of anxiety and depression disorders in women during the perinatal period predict the occurrence of lactation mastitis. Methods: This is a retrospective longitudinal study of 622 Greek women who were monitored from pregnancy until the first year postpartum (during the period January 2015–May 2018). The Edinburgh Postnatal Depression Scale (EPDS) and the Perinatal Anxiety Screening Scale (PASS) were administered at four time points: (a) 24th–28th gestation week, (b) 34th–38th gestation week, (c) 6 weeks postpartum, and (d) 12 months postpartum. Multivariate binary logistic regression analyses were performed. Results: Results showed that (a) increased EPDS (p < 0.02) and PASS (p < 0.05) scores during the last period before birth, (b) increased EPDS score at 6 weeks postpartum (p < 0.02), (c) PMS symptoms (p < 0.03), (d) traumatic life events during the last year (p < 0.03), and (e) the existence of a history of psychotherapy (before pregnancy) (p = 0.050) appear to be the psycho-emotional factors that can predict the possible occurrence of lactation mastitis in a breastfeeding mother. Conclusions: The association between women’s poor mental health and the occurrence of a physical health problem, such as lactation mastitis, is recognized. This study highlights the important role of early and timely detection of perinatal mental health disorders.

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Positive maternal mental health during pregnancy associated with specific forms of adaptive development in early childhood: Evidence from a longitudinal study

Development and Psychopathology ◽

10.1017/s0954579417001249 ◽

2017 ◽

Vol 29 (5) ◽

pp. 1573-1587 ◽

Cited By ~ 23

Author(s):

Desiree Y. Phua ◽

Michelle K. Z. L. Kee ◽

Dawn X. P. Koh ◽

Anne Rifkin-Graboi ◽

Mary Daniels ◽

...

Keyword(s):

Mental Health ◽

Longitudinal Study ◽

Maternal Mental Health ◽

Well Being ◽

Screening Tools ◽

Symptoms Of Depression ◽

Adaptive Development ◽

Mental Well Being ◽

Psychiatric Screening

AbstractThe quality of prenatal maternal mental health, from psychological stress and depressive symptoms to anxiety and other nonpsychotic mental disorders, profoundly affects fetal neurodevelopment. Despite the evidence for the influence of positive mental well-being on health, there is, to our knowledge, no research examining the possible effects of positive antenatal mental health on the development of the offspring. Using exploratory bifactor analysis, this prospective study (n = 1,066) demonstrated the feasibility of using common psychiatric screening tools to examine the effect of positive maternal mental health. Antenatal mental health was assessed during 26th week of pregnancy. The effects on offspring were assessed when the child was 12, 18, and 24 months old. Results showed that positive antenatal mental health was uniquely associated with the offspring's cognitive, language and parentally rated competences. This study shows that the effects of positive maternal mental health are likely to be specific and distinct from the sheer absence of symptoms of depression or anxiety.

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Age differences in trajectories of depressive, anxiety, and burnout symptoms in a population with a high likelihood of persistent occupational distress

International Psychogeriatrics ◽

10.1017/s1041610220001751 ◽

2020 ◽

pp. 1-12

Author(s):

Celia F. Hybels ◽

Dan G. Blazer ◽

David E. Eagle ◽

Rae Jean Proeschold-Bell

Keyword(s):

Mental Health ◽

Older Adults ◽

Depression Scale ◽

Maslach Burnout Inventory ◽

Well Being ◽

Personal Accomplishment ◽

Working Adults ◽

Spiritual Well Being ◽

Patient Health ◽

Over Time

Abstract Objectives: Work in occupations with higher levels of occupational stress can bring mental health costs. Many older adults worldwide are continuing to work past traditional retirement age, raising the question whether older adults experience depression, anxiety, or burnout at the same or greater levels as younger workers, and whether there are differences by age in these levels over time. Design/setting/participants: Longitudinal survey of 1161 currently employed US clergy followed every 6–12 months for up to 66 months. Measurements: Depression was measured with the 8-item Patient Health Questionnaire (PHQ-8). Anxiety was measured using the anxiety component of the Hospital Anxiety and Depression Scale (HADS). Burnout symptoms were assessed using the three components of the Maslach Burnout Inventory: emotional exhaustion (EE), depersonalization (DP), and sense of personal accomplishment (PA). Results: Older participants had lower scores of depression, anxiety, EE, and DP and higher levels of PA over time compared to younger adults. Levels of EE decreased for older working adults, while not significantly changing over time for those younger. DP symptoms decreased over time among those 55 years or older but increased among those 25–54 years. Conclusions: Older working adults may have higher levels of resilience and be able to balance personal life with their occupation as well as may engage in certain behaviors that increase social support and, for clergy, spiritual well-being that may decrease stress in a way that allows these older adults to appear to tolerate working longer without poorer mental health outcomes.

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Association between Breastfeeding Duration and Long-Term Midwifery-Led Support and Psychosocial Support: Outcomes from a Greek Non-Randomized Controlled Perinatal Health Intervention

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041988 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1988

Author(s):

Maria Dagla ◽

Irina Mrvoljak-Theodoropoulou ◽

Marilena Vogiatzoglou ◽

Anastasia Giamalidou ◽

Eleni Tsolaridou ◽

...

Keyword(s):

Mental Health ◽

Exclusive Breastfeeding ◽

Psychosocial Support ◽

Well Being ◽

Health Intervention ◽

Perinatal Health ◽

Breastfeeding Duration ◽

Breastfeeding Support ◽

Randomized Controlled

Background: This study investigates if a non-randomized controlled perinatal health intervention which offers (a) long-term midwife-led breastfeeding support and (b) psychosocial support of women, is associated with the initiation, exclusivity and duration of breastfeeding. Methods: A sample of 1080 women who attended a 12-month intervention before and after childbirth, during a five-year period (January 2014–January 2019) in a primary mental health care setting in Greece, was examined. Multiple analyses of variance and logistic regression analysis were conducted. Results: The vast majority of women (96.3%) initiated either exclusive breastfeeding (only breast milk) (70.7%) or any breastfeeding (with or without formula or other type of food/drink) (25.6%). At the end of the 6th month postpartum, almost half of the women (44.3%) breastfed exclusively. A greater (quantitatively) midwifery-led support to mothers seemed to correlate with increased chance of exclusive breastfeeding at the end of the 6th month postpartum (p = 0.034), and with longer any breastfeeding duration (p = 0.015). The absence of pathological mental health symptoms and of need for receiving long-term psychotherapy were associated with the longer duration of any breastfeeding (p = 0.029 and p = 0.013 respectively). Conclusions: Continuous long-term midwife-led education and support, and maternal mental well-being are associated with increased exclusive and any breastfeeding duration.

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Effectiveness of Probiotic, Prebiotic, and Synbiotic Supplementation to Improve Perinatal Mental Health in Mothers: A Systematic Review and Meta-Analysis

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.622181 ◽

2021 ◽

Vol 12 ◽

Author(s):

Vidhi Desai ◽

Anita L. Kozyrskyj ◽

Stuart Lau ◽

Omolara Sanni ◽

Liz Dennett ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Maternal Mental Health ◽

Well Being ◽

Perinatal Period ◽

Risk Of Bias ◽

Anxiety Symptoms ◽

Control Groups ◽

And Control

Introduction: There is an emerging interest in modulating the gut microbiota to target the gut-brain axis and improve maternal mental health in the perinatal period. This systematic review evaluated the effectiveness of prebiotics, probiotics, and synbiotics supplementation during pregnancy to reduce the risk of maternal mental health problems in the perinatal period.Methods: Electronic biomedical databases and clinical trial registries were searched from database inception through August 2020 to identify randomized controlled clinical trials (RCTs) evaluating the effect of probiotic, prebiotic, or synbiotic supplements administered to women during pregnancy on measures of perinatal depression, anxiety, and other mental health outcomes. Study selection, risk of bias appraisal, and data extraction were independently performed by two reviewers. Pooled mean differences (MD) and odds ratios (pOR) with 95% confidence intervals (CI) were calculated in random-effects meta-analyses for the outcomes of interest in the review.Results: From 3,868 studies identified through the search strategy, three RCTs of low risk of bias involving 713 participants were included, all three testing probiotics. There were no differences between probiotics and control groups in the mean depression scores (MD −0.46; 95% CI −2.16, 1.25) at end of follow-up. Although statistical significance was not achieved, probiotics showed an advantage in the proportion of participants scoring below an established cut-off for depression (pOR 0.68; 95% CI 0.43, 1.07). Compared to placebo, probiotics in pregnancy reduced anxiety symptoms (MD −0.99; 95% CI −1.80, −0.18); however, this advantage was not translated in a reduction in the proportion of participants scoring above an established cut-off for anxiety (pOR 0.65; 95% CI 0.23, 1.85). There were no differences between probiotics and control groups in global mental health scores at end of follow-up (MD 1.09; 95% CI −2.04, 4.22).Conclusion: There is limited but promising evidence about the effectiveness of probiotics during pregnancy to reduce anxiety symptoms and reduce the proportion of women scoring ABOVE a cut-off depression score. There is a lack of RCT evidence supporting prebiotics and synbiotics supplementation for similar purposes in the perinatal period. More research is needed before prebiotics, probiotics, and synbiotics are recommended to support maternal mental health and well-being in the perinatal period.Systematic Review Registration: PROSPERO, CRD42019137158.

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Exclusive Breastfeeding Moderates the Association Between Prenatal and Postpartum Depression

Journal of Human Lactation ◽

10.1177/0890334421991051 ◽

2021 ◽

pp. 089033442199105

Author(s):

Bárbara Figueiredo ◽

Tiago Miguel Pinto ◽

Raquel Costa

Keyword(s):

Public Health ◽

Mental Health ◽

Postpartum Depression ◽

Exclusive Breastfeeding ◽

Maternal Mental Health ◽

Prenatal Depression ◽

Depression Symptoms ◽

Public Health Services ◽

Wide Range ◽

Prospective Longitudinal

Background Exclusive breastfeeding has a wide range of benefits for maternal health. However, the benefit of exclusive breastfeeding for maternal mental health needs to be further explored. Research Aim To determine the moderating role of exclusive breastfeeding at 3 months on the association between prenatal and postpartum depression. Methods This study had a prospective, longitudinal, and comparative design with two groups and three assessment waves. The sample comprised 334 participants (70 depressed and 264 non-depressed) recruited at public health services in northern Portugal. Participants completed a measure of depression symptoms between the second and the third trimester of pregnancy and between 3 and 6 months, and a measure of breastfeeding status at 3 months. Results Exclusive breastfeeding at 3 months moderated the association between prenatal and postpartum depression. Participants with prenatal depression who were exclusively breastfeeding at 3 months showed fewer symptoms of depression and lower rates of depression between 3 and 6 months postpartum, compared to participants with prenatal depression who were not exclusively breastfeeding. Participants without prenatal depression who were exclusively breastfeeding at 3 months showed similar depression symptoms and similar rates of depression between 3 and 6 months postpartum, compared to participants without prenatal depression who were not exclusively breastfeeding. Conclusion Exclusive breastfeeding has a potential protective influence on postpartum depression among women with prenatal depression. Public health policies targeting women with prenatal depression should be implemented and include practices to promote and support exclusive breastfeeding in order to enhance women’s exclusive breastfeeding and mental health.

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Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042093 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2093

Author(s):

Tina Vilovic ◽

Josko Bozic ◽

Marino Vilovic ◽

Doris Rusic ◽

Sanja Zuzic Furlan ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Perceived Stress ◽

Depression Scale ◽

Family Physicians ◽

Knowledge Score ◽

Well Being ◽

Anxiety And Depression ◽

Event Scale ◽

The Impact

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.

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Exclusive Breastfeeding Is Not Associated with Maternal–Infant Bonding in Early Postpartum, Considering Depression, Anxiety, and Parity

Nutrients ◽

10.3390/nu13041184 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1184

Author(s):

Naoki Fukui ◽

Takaharu Motegi ◽

Yuichiro Watanabe ◽

Koyo Hashijiri ◽

Ryusuke Tsuboya ◽

...

Keyword(s):

Mental Health ◽

Path Analysis ◽

Exclusive Breastfeeding ◽

Postpartum Period ◽

Depression Scale ◽

Anxiety And Depression ◽

Women’S Mental Health ◽

Women's Mental Health ◽

Early Postpartum Period ◽

Early Postpartum

It is important to clarify how the breastfeeding method affects women’s mental health, and how women’s mental health affects the breastfeeding method in the early postpartum period when major depression and other psychiatric problems are most likely to occur. This study aimed to examine this bidirectional relationship in the early postpartum period. Participants were 2020 postpartum women who completed the Hospital Anxiety and Depression Scale (HADS) and Mother-to-Infant Bonding Scale (MIBS). We obtained data for participants’ breastfeeding method for four weeks after childbirth. We performed a path analysis with factors including breastfeeding method (exclusive breastfeeding or non-exclusive breastfeeding), parity (primipara or multipara), the two HADS subscales (anxiety and depression), and the two MIBS subscales (lack of affection and anger and rejection). The path analysis showed that breastfeeding method did not significantly affect depression, anxiety, and maternal–infant bonding in the early postpartum period. Women with higher anxiety tended to use both formula-feeding and breastfeeding. Our study suggests that exclusive breastfeeding is not associated with maternal-fetal bonding in early postpartum, considering depression, anxiety, and parity.

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Child maltreatment, cognitive functions and the mediating role of mental health problems among maltreated children and adolescents in Uganda

Child and Adolescent Psychiatry and Mental Health ◽

10.1186/s13034-021-00373-7 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Herbert E. Ainamani ◽

Godfrey Z. Rukundo ◽

Timothy Nduhukire ◽

Eunice Ndyareba ◽

Tobias Hecker

Keyword(s):

Mental Health ◽

Working Memory ◽

Child Maltreatment ◽

Executive Functions ◽

Cognitive Functioning ◽

Children And Adolescents ◽

Mental Health Problems ◽

Depression Scale ◽

Well Being ◽

Health Problems

Abstract Background Child maltreatment poses high risks to the mental health and cognitive functioning of children not only in childhood but also in later life. However, it remains unclear whether child maltreatment is directly associated with impaired cognitive functioning or whether this link is mediated by mental health problems. Our study aimed at examining this research question among children and adolescents in Uganda. Methods A sample of 232 school-going children and adolescents with a mean age of 14.03 (SD = 3.25) was assessed on multiple forms of maltreatment using the Maltreatment and Abuse Chronology Exposure—Pediatric Version (pediMACE). Executive functions were assessed by the Tower of London task and working memory by the Corsi Block Tapping task, while mental health problems were assessed using the Child PTSD Symptom Scale for PTSD and the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Results In total, 232 (100%) of the participant reported to have experienced at least one type of maltreatment in their lifetime including emotional, physical, and sexual violence as well as neglect. We found a negative association between child maltreatment and executive functions (β = − 0.487, p < 0.001) and working memory (β = − 0.242, p = 0.001). Mental health problems did not mediate this relationship. Conclusions Child maltreatment seems to be related to lower working memory and executive functioning of affected children and adolescents even after controlling for potential cofounders. Our study indicates that child maltreatment the affects children’s cognitive functionality beyond health and well-being.

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