GEJALA DEPRESI POSTPARTUM MEMPENGARUHI KEBERHASILAN ASI EKSKLUSIF : Sistematik Literatur Riview

2020 ◽  
pp. 27-34
Author(s):  
Nova Arami ◽  
Surahma Asti Mulasari ◽  
Ummu Hani EN

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.  

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Dana M. Lapato ◽  
Roxann Roberson-Nay ◽  
Robert M. Kirkpatrick ◽  
Bradley T. Webb ◽  
Timothy P. York ◽  
...  

Abstract Background Perinatal depressive symptoms have been linked to adverse maternal and infant health outcomes. The etiology associated with perinatal depressive psychopathology is poorly understood, but accumulating evidence suggests that understanding inter-individual differences in DNA methylation (DNAm) patterning may provide insight regarding the genomic regions salient to the risk liability of perinatal depressive psychopathology. Results Genome-wide DNAm was measured in maternal peripheral blood using the Infinium MethylationEPIC microarray. Ninety-two participants (46% African-American) had DNAm samples that passed all quality control metrics, and all participants were within 7 months of delivery. Linear models were constructed to identify differentially methylated sites and regions, and permutation testing was utilized to assess significance. Differentially methylated regions (DMRs) were defined as genomic regions of consistent DNAm change with at least two probes within 1 kb of each other. Maternal age, current smoking status, estimated cell-type proportions, ancestry-relevant principal components, days since delivery, and chip position served as covariates to adjust for technical and biological factors. Current postpartum depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. Ninety-eight DMRs were significant (false discovery rate < 5%) and overlapped 92 genes. Three of the regions overlap loci from the latest Psychiatric Genomics Consortium meta-analysis of depression. Conclusions Many of the genes identified in this analysis corroborate previous allelic, transcriptomic, and DNAm association results related to depressive phenotypes. Future work should integrate data from multi-omic platforms to understand the functional relevance of these DMRs and refine DNAm association results by limiting phenotypic heterogeneity and clarifying if DNAm differences relate to the timing of onset, severity, duration of perinatal mental health outcomes of the current pregnancy or to previous history of depressive psychopathology.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245199
Author(s):  
Devendra Raj Singh ◽  
Dev Ram Sunuwar ◽  
Shraddha Adhikari ◽  
Sunita Singh ◽  
Kshitij Karki

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.


2008 ◽  
Vol 93 (5) ◽  
pp. 1946-1951 ◽  
Author(s):  
J. W. Rich-Edwards ◽  
A. P. Mohllajee ◽  
K. Kleinman ◽  
M. R. Hacker ◽  
J. Majzoub ◽  
...  

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.


2019 ◽  
Author(s):  
Dana M. Lapato ◽  
Roxann Roberson-Nay ◽  
Robert M. Kirkpatrick ◽  
Bradley T. Webb ◽  
Timothy P. York ◽  
...  

AbstractBackgroundPerinatal depressive symptoms have been linked to adverse maternal and infant health outcomes. The etiology associated with perinatal depressive psychopathology is poorly understood, but accumulating evidence suggests that understanding inter-individual differences in DNA methylation (DNAm) patterning may provide insight regarding the genomic regions salient to the risk liability of perinatal depressive psychopathology.ResultsGenome-wide DNAm was measured in maternal peripheral blood using the Infinium MethylationEPIC microarray. Ninety-two participants (46% African-American) had DNAm samples that passed all quality control metrics, and all participants were within seven months of delivery. Linear models were constructed to identify differentially methylated sites and regions, and permutation testing was utilized to assess significance. Differentially methylated regions (DMRs) were defined as genomic regions of consistent DNAm change with at least two probes within 1kb of each other. Maternal age, current smoking status, estimated cell-type proportions, ancestry-relevant principal components, days since delivery, and chip position served as covariates to adjust for technical and biological factors. Current postpartum depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. Ninety-eight DMRs were significant (False Discovery Rate < 5%) and overlapped 92 genes. Synaptic signaling, neural development, and platelet formation were the most represented biological processes in gene set analysis, and comparison to the 44 loci discovered in the latest Psychiatric Genomics Consortium meta-analysis of depression revealed 3 overlapping regions and significant enrichment (p<0.03).ConclusionsMany of the genes identified in this analysis corroborate previous allelic, transcriptomic, and DNAm association results related to depressive phenotypes. Future work should integrate data from multi-omic platforms to understand the functional relevance of these DMRs and refine DNAm association results by limiting phenotypic heterogeneity and clarifying if DNAm differences relate to the timing of onset, severity, duration of perinatal mental health outcomes of the current pregnancy or to previous history of depressive psychopathology.


2021 ◽  
Vol 296 ◽  
pp. 113679
Author(s):  
Sunny H. Shin ◽  
Gabriela Ksinan Jiskrova ◽  
Tiffany Kimbrough ◽  
Karen Tabb Dina ◽  
Elizabeth Overall Lee ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Divya Mehta ◽  
Karen Grewen ◽  
Brenda Pearson ◽  
Shivangi Wani ◽  
Leanne Wallace ◽  
...  

AbstractMaternal postpartum depression (PPD) is a significant public health concern due to the severe negative impact on maternal and child health and well-being. In this study, we aimed to identify genes associated with PPD. To do this, we investigated genome-wide gene expression profiles of pregnant women during their third trimester of pregnancy and tested the association of gene expression with perinatal depressive symptoms. A total of 137 women from a cohort from the University of North Carolina, USA were assessed. The main phenotypes analysed were Edinburgh Postnatal Depression Scale (EPDS) scores at 2 months postpartum and PPD (binary yes/no) based on an EPDS cutoff of 10. Illumina NextSeq500/550 transcriptomic sequencing from whole blood was analysed using the edgeR package. We identified 71 genes significantly associated with postpartum depression scores at 2 months, after correction for multiple testing at 5% FDR. These included several interesting candidates including TNFRSF17, previously reported to be significantly upregulated in women with PPD and MMP8, a matrix metalloproteinase gene, associated with depression in a genome-wide association study. Functional annotation of differentially expressed genes revealed an enrichment of immune response-related biological processes. Additional analysis of genes associated with changes in depressive symptoms from recruitment to 2 months postpartum identified 66 genes significant at an FDR of 5%. Of these genes, 33 genes were also associated with depressive symptoms at 2 months postpartum. Comparing the results with previous studies, we observed that 15.4% of genes associated with PPD in this study overlapped with 700 core maternal genes that showed significant gene expression changes across multiple brain regions (P = 7.9e-05) and 29–53% of the genes were also associated with estradiol changes in a pharmacological model of depression (P values range = 1.2e-4–2.1e-14). In conclusion, we identified novel genes and validated genes previously associated with oestrogen sensitivity in PPD. These results point towards the role of an altered immune transcriptomic landscape as a vulnerability factor for PPD.


Author(s):  
Kortney Floyd James ◽  
Dawn M. Aycock ◽  
Jennifer L. Barkin ◽  
Kimberly A. Hires

Background: This study examined the relationship between racial identity clusters and postpartum depressive symptoms (PPDS) in Black postpartum mothers living in Georgia. Aims: A cross-sectional study design using Cross’s nigrescence theory as a framework was used to explore the relationship between Black racial identity and PPDS. Method: Black mothers were administered online questionnaires via Qualtrics. A total sample of 116 self-identified Black mothers were enrolled in the study. Participants ranged in age from 18 to 41 years ( M = 29.5 ± 5.3) and their infants were 1 to 12 months old ( M = 5.6 ± 3.5). The majority of mothers were married or cohabitating with their partner (71%), had a college degree (53%), and worked full-time (57%). Results: Hierarchical cluster analysis identified six racial identity clusters within the sample: Assimilated and Miseducated, Self-Hating, Anti-White, Multiculturalist, Low Race Salience, and Conflicted. A Kruskal-Wallis H test determined there was no difference in PPDS scores between racial identity clusters. Conclusion: This study is the first to explore the relationship between Black racial identity clusters of postpartum mothers and their mental health. Findings emphasize the complexity of Black racial identity and suggest that the current assessment tools may not adequately detect PPDS in Black mothers. The implications for these findings in nursing practice and future research are discussed.


Author(s):  
Sousan Hamwi ◽  
Elsa Lorthe ◽  
Henrique Barros

Migrant women have a higher risk of developing postpartum depressive symptoms (PPDS) than do native women. This study aimed to investigate the role of host-country language proficiency in this disparity. We analysed the data of 1475 migrant and 1415 native women who gave birth at a Portuguese public hospital between 2017 and 2019 and were participants in the baMBINO cohort study. Migrants’ language proficiency was self-rated and comprised understanding, speaking, reading, and writing skills. PPDS were assessed using the Edinburgh Postnatal Depression Scale with a cut-off score of ≥10. Multivariable logistic regression models were fitted to estimate the association between language proficiency and PPDS. PPDS were experienced by 7.2% of native women and 12.4% among migrants (p < 0.001). Increasing proportions of PPDS were observed among decreasing Portuguese proficiency levels; 11% among full, 13% among intermediate, and 18% among limited proficiency women (ptrend < 0.001). Full (aOR 1.63 (95% CI 1.21–2.19)), intermediate (aOR 1.68 (95% CI 1.16–2.42)), and limited (aOR 2.55 (95% CI 1.64–3.99)) language proficiencies were associated with increasingly higher odds of PPDS among migrant women, compared to native proficiency. Prevention measures should target migrant women at high risk of PPDS, namely those with limited language skills, and promote awareness, early detection, and help-seeking, in addition to facilitating communication in their perinatal healthcare encounters.


2021 ◽  
pp. 33-36
Author(s):  
Chandrima Maity ◽  
Debasish Sanyal ◽  
Arati Biswas ◽  
Sudarsan Saha

The investigators assessed the prevalence of Postpartum Depression (PPD), its clinical features and relationship of PPD with socio-demographical and obstetrical factors. The samples were selected from the OPD and IPD, of a Medical college in Kolkata.. Observational study was performed on 500(N=500) postpartum mothers who were selected by using Simple Random Sampling Technique within the six weeks of postpartum period. Data were collected by using the Structured Questionnaire for background information, Edinburgh Postnatal Depression Scale (Bengali Version of EPDS) for postpartum depression. Data analysis was performed using Descriptive Statistics, Chi-square, Logistic Regression and Decision Tree. A total of 112 (Prevalence Rate 22.4%) postpartum mothers had PPD. Stepwise logistic regression model correctly classied 92.2% of women who developed PPD. Using logistic regression model, postpartum depression is best predicted by: No. of Postpartum days p< 0.001***, Age of the mother p<0.024**, Religion p<0.003**, Type of family p<0.020**, Education of the mother p<0.001***, Monthly Income of the family p<0.001***, No of other living children p<0.001***, Pregnancy outcome p<0.033**, Any complication during pregnancy / delivery/ postpartum p< 0.001*** and Problems with family members p< 0.001***. The study recommends that evaluation should be carried out for Postpartum Depression and its risk factors to prevent and treat PPD in a timely manner.


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