Planned Place of Birth—Impact of Psychopathological Risk Factors on the Choice of Birthplace and Its Postpartum Effect on Psychological Adaption: An Exploratory Study

The choice of birthplace may have an important impact on a woman’s health. In this longitudinal study, we investigated the psychopathological risk factors that drive women’s choice of birthplace, since their influence is currently not well understood. The research was conducted in 2011/12 and we analyzed data of 177 women (obstetric unit, n = 121; free standing midwifery unit, n = 42; homebirth, n = 14). We focused antepartally (M = 34.3 ± 3.3) on sociodemographic and risk factors of psychopathology, such as prenatal distress (Prenatal Distress Questionnaire), depressiveness (Edinburgh Postnatal Depression Scale), birth anxiety (Birth Anxiety Scale), childhood trauma (Childhood Trauma Questionnaire), and postpartally (M = 6.65 ± 2.6) on birth experience (Salmon’s Item List), as well as psychological adaption, such as postpartum depressive symptoms (Edinburgh Postnatal Depression Scale) and birth anxiety felt during birth (modified Birth Anxiety Scale). Women with fear of childbirth and the beginning of birth were likely to plan a hospital birth. In contrast, women with fear of touching and palpation by doctors and midwives, as well as women with childhood trauma, were more likely to plan an out-of-hospital birth. Furthermore, women with planned out-of-hospital births experienced a greater relief of their birth anxiety during the birth process than women with planned hospital birth. Our results especially show that women with previous mental illnesses, as well as traumatic experiences, seem to have special needs during childbirth, such as a safe environment and supportive care.

Edinburgh Postnatal Depression Scale (EPDS) for screening for depression in the first year post delivery in a low-resourced rural setting in Kenya

Postnatal depression is one of the most common mental disorders among postnatal mothers and may have severe consequences for mothers and their children. Locally validated screening tools that can be self- or lay interviewer-administered are required to identify at-risk women, especially in settings with no mental health specialists. This study aimed to assess the validity and reliability of a culturally adapted version of the Edinburgh Postnatal Depression Scale (EPDS) in a local dialect (Kamba) in a Kenyan setting. Trained research assistants administered the local-language version of self-report scales (EPDS) to a sample of 544 Kamba-speaking women. The same scale was re-administered to the same research participants two weeks later by the same research assistants. The test scores were compared with an external ‘gold standard’ according to the DSM-IV criteria Mini-International Neuropsychiatric Interview for adults (MINI-Plus). The EPDS had an area under the curve (AUC) of 0.867 with 95% C.I of 0.836 to 0.894, with a cut-off point of ≥11, sensitivity of 81.0% (95% C.I 70.6–89.0) and specificity of 82.6% (95% CI 78.8–85.9). The positive predictive value (PPV) and negative predictive value (NPV) were 44.1% and 96.2%, respectively. The internal reliability was 0.852 and the test-retest reliability was 0.496. The EPDS showed good utility in detecting depressive disorder in Kamba-speaking postnatal women. It does not have to be administered by mental health workers (who are few in low- and middle-income countries); rather, this can be done by a trained lay interviewer.

Trầm cảm sau sinh và một số yếu tố liên quan ở phụ nữ có con dưới 6 tháng tuổi tại thành phố Cần Thơ năm 2019

Trầm cảm sau sinh tác động không chỉ đến bà mẹ mà còn đến việc chăm sóc trẻ đặc biệt là trong 6 tháng đầu. Nghiên cứu nhằm mục tiêu xác định tỷ lệ trầm cảm sau sinh và mô tả một số yếu tố liên quan ở phụ nữ có con dưới 6 tháng tuổi bị tại thành phố Cần Thơ năm 2019. Nghiên cứu mô tả cắt ngang trên 498 phụ nữ có con dưới 6 tháng tuổi tại thành phố Cần Thơ năm 2019 bằng phương pháp chọn ngẫu nhiên nhiều giai đoạn thông qua thang điểm EPDS (Edinburgh Postnatal Depression Scale) với điểm cắt là 13 điểm. Kết quả cho thấy tỷ lệ trầm cảm sau sinh (TCSS) theo thang điểm EPDS là 25,7%. Các yếu tố liên quan đến tình trạng trầm cảm sau sinh trong nghiên cứu bao gồm: Tiền sử điều trị hiếm muộn (OR = 1,5 (1,1 - 4,6); p = 0,031), số lần khám thai trong thai kì (OR = 3,7 (1,6 - 8,1); p = 0,001), đau sau sinh (OR = 10,5 (4,5 - 24,5); p = 0,003), có người tâm sự khi cần (OR = 5,3 (3,4 - 8,3); p = 0,027), áp lực thay đổi diện mạo, duy trì vóc dáng (OR = 11,5 (7,0 - 18,5); p = 0,018), gặp các biến cố sau sinh (OR = 5,9 (3,7 - 9,2) p = 0,027), thay đổi thói quen ăn uống ( OR= 4,9 (3,2 - 7,5); p = 0,047), sự phát triển của bé ( OR = 6,8 (3,2 - 14,4); p = 0,005). Tình trạng trầm cảm sau sinh ở phụ nữ có con dưới 6 tháng tuổi tại thành phố Cần Thơ hiện đang ở mức cao, cần có những biện pháp can thiệp hữu hiệu cho nhóm đối tượng này.

Living With Parents-In-Law Increased the Risk of Postpartum Depression in Chinese Women

Background: A variety of psychological and socioeconomic factors contribute to the development of postpartum depression (PPD). However, the relationship between maternal living arrangements and PPD is unclear.Objective: To assess the relationship between maternal living arrangements and PPD in Chinese population.Methods: A cross-sectional survey was conducted among puerperal women delivered in Baoan Maternal and Child Health Hospital in Shenzhen, China. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. A score of ≥10 was used as the threshold for postpartum depression.Results: A total of 4,813 women were recruited, of whom 2,535 (52.7%) lived only with their husbands, 664 (13.8%) lived with their parents, and 1,614 (33.5%) lived with their parents-in-law. Compared with women who lived with husbands, puerperal women who lived with their parents-in-law were more likely to be positive for PPD screening (14.1 vs. 10.5%, P < 0.001). After adjusting for other influencing factors, living with parents-in-law was significantly associated with the risk of PPD (OR = 1.38, 95% CI, 1.12–1.70). Additionally, stratification analyses showed that the association between living with parents-in-law and the presence of PPD was more significant in women with anxiety during pregnancy (P for interaction <0.05).Conclusions and Relevance: Our data confirms that the maternal living arrangements affect the risk of PPD, especially among women with anxiety during pregnancy. Therefore, more targeted preventive measures should be taken for postpartum depression in women who live with their parents-in-law.

Adaptation of the Edinburgh Postnatal Depression Scale in the Indonesian Version: Self-reported Anxiety and Depression Symptoms in Pregnant WomenAdaptation of the Edinburgh Postnatal Depression Scale in the Indonesian Version: Self-reported Anxiety and Depression Symptoms in Pregnant Women

BACKGROUND: Anxiety and depression disorders in pregnant women are often not identified so that early treatment is not optimal. Indonesia already has comprehensive integrated antenatal care, including services for pregnant women with mental disorders, but until now Indonesia does not yet have a standardized instrument that is valid and suitable as a screening tool to assess symptoms of anxiety and depression in pregnant women. The Edinburgh Postnatal Depression Scale (EPDS) is a screening instrument with high sensitivity and specificity, has been translated into Indonesian, but until now, the Indonesian version of the EPDS instrument has not been evaluated for validity and reliability in the population of pregnant women. AIM: this study aimed to adapt the Indonesian version of the EPDS instrument, including testing the validity and reliability of the instrument when used on pregnant women in Indonesia. METHODS: This research is a cross sectional study. The number of pregnant women who participated were 125 samples. Data were collected randomly, and the assessment of symptoms of anxiety and depression was self-reported via online. Content validity was assessed with a content validity index from 5 experts, construct validation was analyzed by Explanatory Factor Analysis and Confirmatory Factor Analysis and Convergent Validity. The reliability of the EPDS instrument was assessed by construct reliability and Cronbach's Alpha. RESULTS: Content validity index shows expert agreement with a value of .98. The Indonesian version of the EPDS shows assessing three factors, namely: Depression (5 items), Anxiety (3 items), and Anhedonia (2 items). The reliability of the Indonesian version of the EPDS instrument is good with Cronbach's Alpha .80 and the internal reliability of the 10 items (Cronbach's Alpha .767-.812). CONCLUSION: The Indonesian version of the EPDS instrument is valid and reliable to be used to assess symptoms of anxiety and depression in pregnant women in antenatal care in Indonesia. Keywords: pregnant women, EPDS, validity, reliability

Dukungan Sosial dan Postpartum Depression pada Ibu Suku Jawa

Penelitian ini bertujuan untuk menguji hubungan antara dukungan sosial dan postpartum depression pada ibu Suku Jawa pasca melahirkan. Hipotesis dalam penelitian ini adalah terdapat hubungan negatif antara dukungan sosial dengan postpartum depression pada ibu Suku Jawa pasca melahirkan. Penelitian ini menggunakan desain penelitian kuantitatif korelasional dan pengambilan sampel menggunakan teknik purposive sampling pada 34 ibu Suku Jawa pasca melahirkan. Alat ukur yang digunakan dalam penelitian ini, yaitu: Edinburgh Postnatal Depression Scale (EPDS) dan Postpartum Social Support Questionnaire (PSSQ). Hasil penelitian menunjukan koefisien korelasi (r) = 0,138 dengan nilai sig = 0,219 (p <0,05), artinya tidak terdapat hubungan negatif antara dukungan sosial dengan postpartum depression pada ibu Suku Jawa setelah melahirkan. Sehingga, hipotesis yang diajukan dalam penelitian ini tidak diterima.

Edinburgh Postnatal Depression Scale used in South Korea

Background: The Edinburgh Postnatal Depression Scale (EPDS), a validated screening tool for prenatal and postnatal depression, was included as a reimbursable item by the National Health Insurance Service of Korea in 2020. However, multiple Korean versions of the EPDS are used for public health programs and research. This study aimed to summarize the use of this scale in Korea and evaluate the distribution of validities, depression scores, and prevalence of depression according to Korean versions of the EPDS.Methods: Korean versions of the EPDS most frequently used in public health policies and programs were summarized through internet searches using snowball strategy. A systematic literature review was conducted to evaluate the prenatal and postnatal depression scores and prevalence of depression measured using different Korean versions of the scale.Results: We identified four Korean versions of the EPDS that are commonly used in public health programs and research. Among them, published evidence regarding validity and reliability was available for two versions. A review of 19 papers that assessed prenatal and postnatal depression using these versions showed large heterogeneity in scores and the prevalence of depression.Conclusion: When measuring prenatal and postnatal depression using the EPDS, characteristics of the scale must be considered when interpreting results. A standardized Korean version of the EPDS needs to be developed by comparing the validity and reliability of different Korean versions. A field manual for screening should also be developed and distributed.