Perinatal Depression
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2021 ◽  
Author(s):  
Qian Yang ◽  
Carolina Borges ◽  
Eleanor Sanderson ◽  
Maria C Magnus ◽  
Fanny Kilpi ◽  
...  

Background: Insomnia is common and associated with adverse pregnancy and perinatal outcomes in observational studies. Our aim was to test whether insomnia causes stillbirth, miscarriage, gestational diabetes, hypertensive disorders of pregnancy, perinatal depression, preterm birth, or low/high offspring birthweight (LBW/HBW). Methods and Findings: We used two-sample Mendelian randomization (MR) with 81 single nucleotide polymorphisms instrumenting for a lifelong predisposition to insomnia. We used data (N=356,069) from the UK Biobank, FinnGen, and three European birth cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), Born in Bradford, and Norwegian Mother, Father and Child Cohort Study). Main MR analyses used inverse variance weighting (IVW), with weighted median and MR-Egger as sensitivity analyses. We compared MR estimates with multivariable regression of insomnia in pregnancy on outcomes in ALSPAC (N=11,745). IVW showed evidence of an effect of genetic susceptibility to insomnia on miscarriage (odds ratio (OR): 1.60, 95% confidence interval (CI): 1.18, 2.17), perinatal depression (OR 3.56, 95% CI: 1.49, 8.54) and LBW (OR 3.17, 95% CI: 1.69, 5.96). For other outcomes IVW indicated potentially clinically important adverse effects of insomnia (OR range 1.20 to 2.43), but CIs were wide and included the null. Weighted median and MR Egger results were directionally consistent, except for MR-Egger for gestational diabetes, perinatal depression, and preterm birth. Multivariable regression showed associations of insomnia at 18 weeks of gestation with miscarriage (OR 1.30, 95% CI: 1.12, 1.51), stillbirth (OR 2.10, 95% CI: 1.20, 3.69), and perinatal depression (OR 2.96, 95% CI: 2.42, 3.63), but not with LBW (OR 0.92, 95% CI: 0.69, 1.24). Key limitations are potential horizontal pleiotropy and low statistical power in MR, and residual confounding in multivariable regression. Conclusions: There is evidence of causal effects of insomnia on miscarriage, perinatal depression, and LBW. We highlight the need for larger studies with genomic data and pregnancy outcomes.


2021 ◽  
Vol 40 (10) ◽  
pp. 1612-1617
Author(s):  
Wan-Jung Hsieh ◽  
Marissa D. Sbrilli ◽  
Wenhao David Huang ◽  
Tuyet-Mai Hoang ◽  
Brandon Meline ◽  
...  

Nursing ◽  
2021 ◽  
Vol 51 (10) ◽  
pp. 50-54
Author(s):  
Kelly Ellington

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e048764
Author(s):  
Robert David Smith ◽  
Sze Chai Hung ◽  
Joyce Goh ◽  
Hoi Lam Ip ◽  
Daniel Yee Tak Fong ◽  
...  

IntroductionPerinatal depression is common and can often lead to adverse health outcomes for mother and child. Multiple pharmacological and non-pharmacological treatments have been evaluated against usual care or placebo controls in meta-analyses for preventing and treating perinatal depression compared. It is not yet established which of these candidate treatments might be the optimal approach for prevention or treatment.Methods and analysisA systematic review and Bayesian network meta-analyses will be conducted. Eight electronic databases shall be searched for randomised controlled trials that have evaluated the effectiveness of treatments for prevention and/or treatment of perinatal depression. Screening of articles shall be conducted by two reviewers independently. One network meta-analysis shall evaluate the effectiveness of interventions in preventing depression during the perinatal period. A second network meta-analysis shall compare the effectiveness of treatments for depression symptoms in women with perinatal depression. Bayesian 95% credible intervals shall be used to estimate the pooled mean effect size of each treatment, and surface under cumulative ranking area will be used to rank the treatments’ effectiveness.Ethics and disseminationWe shall report our findings so that healthcare providers can make informed decisions on what might be the optimal approach for addressing perinatal depression to prevent cases and improve outcomes in those suffering from depression through knowledge exchange workshops, international conference presentations and journal article publications.PROSPERO registration numberCRD42020200081.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257065
Author(s):  
Rachel Vanderkruik ◽  
Edwin Raffi ◽  
Marlene P. Freeman ◽  
Rebecca Wales ◽  
Lee Cohen

Women may experience new-onset or worsening depressive disorders during pregnancy and the postpartum. If untreated, there may be detrimental consequences to the health and wellbeing of the woman and to her baby. There is a need for improved tools and approaches that can be easily and broadly implemented to effectively detect depression during the perinatal period. Early identification of depression during pregnancy is an important first step towards connecting women to treatment and preventing continued depression into the postpartum or beyond. This report provides preliminary findings from a pilot study of a digital screening app for perinatal depression expiring potential for app reach, engagement, and user demographics and mental health symptoms. With mainly passive recruitment efforts, we collected cross-sectional mental health data on over 700 women during the perinatal period, including women across over 30 countries. We report on mean depression scores among women during pregnancy and the postpartum as well as on constructs that are commonly comorbid with depression, including anxiety, sleep dysregulation, and perceived stress. Over half of the women during pregnancy and over 70% of women in the postpartum had a depression score indicative of clinical depression. Future research directions for this work and potential for public health impact are discussed, including longitudinal data collection and analyses of symptomology over time and embedding evidence-based digital therapeutics into the app as a means to increase access to mental health services.


2021 ◽  
Vol 12 ◽  
Author(s):  
Simona Iodice ◽  
Martina Di Paolo ◽  
Jennifer Lynn Barkin ◽  
Letizia Tarantini ◽  
Silvia Grassi ◽  
...  

Background: Perinatal Depression (PD) is a widespread disabling condition that is hypothesized to be associated with abnormalities in circadian rhythms and neuropeptide release including oxytocin (OXT).Methods: Fourty-four pregnant women (28 with PD, and 16 controls) were evaluated through the Edinburgh Postnatal Depression Scale (EPDS), the State/Trait Anxiety Inventory Form Y (STAI-Y), and the Prenatal Attachment Inventory (PAI). A blood sample was collected from all participants, and OXT plasma levels, DNA methylation of clock genes, as well as of FOXp3 and HERV-W were measured. Linear regression analyses were performed to assess the effect of oxytocin on the methylation of selected genes. Continuous ordinal regression models was further applied to see if the score of rating scales was associated to gene methylation, adjusting for oxytocin-methylation interaction.Results: OXT plasma levels were positively associated with CRY1 methylation. Women with higher OXT plasma levels showed an association between higher degree of CRY2 methylation (thus, reduced expression) and lower EPDS (OR = 0.21; P = 0.043) and STAI-S scores (OR = 6.96; P = 0.019). Finally, with high OXT levels, hypermethylation of CRY1 was associated to higher scores on the PAI (OR = 2.74; P = 0.029) while higher methylation of HERV-W related to lower PAI scores (OR = 0.273; P = 0.019).Conclusion: Our results suggest a possible protective role played by oxytocin in the development of PD by promoting a favorable methylation profile characterized by reduced expression of CRY1 and CRY2. Moreover, oxytocin strengthens the association between maternal prenatal attachment with a favorable pattern of methylation of clock genes and HERV-W, which is essential for pregnancy outcomes.


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