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The association between the frequency of eating ready-made meals (RMM) or eating out (EO) during pregnancy and postpartum depression remains unclear. We aimed to explore the association between the frequency of RMM or EO use during pregnancy and the incidence of postpartum depression. This study included 639 community-dwelling pregnant women who were recruited between 2019 and 2022. Data on the frequency of RMM and EO use, as well as sociodemographic, economic and lifestyle factors, were obtained using self-administered questionnaires. Data on dietary intake were obtained using a validated brief self-administered diet history questionnaire. Postpartum depression was assessed using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS). The incidence of postpartum depression (EPDS score of ≥9) based on the frequency of RMM or EO use was analysed using multiple logistic regression analysis. After adjusting for potential confounders, there was limited evidence suggesting an association between consuming RMM 3 times/week or more and the likelihood of experiencing postpartum depression, with an adjusted OR (aOR) and 95 % CI (95 % CI) of 4·16 and 1·68–10·27 (Pfor trend = 0·017) compared with consuming RMM less than 1 time/week. There was no evidence for an association between consuming EO 3 times/week or more and postpartum depression (aOR: 1·20, 95 % CI: 0·14, 10·04 and Pfor trend = 0·283). Accordingly, the present study presented weak evidence of an association between RMM and postpartum depression. Further studies with large and diverse samples are needed to overcome any potential selection bias.
Perinatal maternal depression may affect fetal neurodevelopment directly or indirectly via exposures such as smoking, alcohol, or antidepressant use. The relative contribution of these risk factors on child executive function (EF) has not been explored systematically.
Methods
A prospective pregnancy cohort of 197 women and their children was studied to determine whether maternal depression diagnosis and the trajectory of maternal depressive symptoms (MDSs) from early pregnancy to 12 months postpartum predicts child EF at age 4 (measured using the preschool age psychiatric assessment, NEPSY-II, and Shape School task) using latent growth curve modeling. Indirect effects of smoking, alcohol, and antidepressant use were also formally tested.
Results
Increasing maternal perinatal depressive symptoms over time predicted more inattentive symptoms, poorer switching, and motor inhibition, but not cognitive inhibition. When adjusted for multiple comparison, and after accounting for maternal cognition and education, the association with child inattentive symptoms remained significant. However, diagnosed depression did not predict child EF outcomes. Prenatal exposure to smoking, alcohol, and antidepressants also did not mediate pathways from depressive symptoms to EF outcomes. Our findings were limited by sample size and statistical power to detect outcome effects of smaller effect size.
Conclusions
This study suggests that increasing MDSs over the perinatal period is associated with poorer EF outcomes in children at age 4 – independent of prenatal smoking, drinking, or antidepressant use. Depressive chronicity, severity, and postpartum influences may play crucial roles in determining childhood outcomes of EF.
Fifteen percent of women worldwide experience depression in the perinatal period. Suicide is now one of the leading causes of maternal mortality in developed countries. Internationally, many healthcare systems screen post-natal women for depressive symptoms and suicidal ideation to facilitate early assessment and intervention. To our knowledge, no Irish data exists on the prevalence of suicidal ideation in this cohort.
Aims:
To evaluate the prevalence of suicidal ideation and depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) in post-natal women attending a large Dublin maternity hospital.
Methods:
A retrospective cohort study was conducted. Women were randomly selected by delivery date over a 6 month period. Demographic and medical information was collected from their booking visit and discharge summary data. EPDS results at discharge post-partum were examined.
Results:
Data was collected on 643 women. Post-partum, 19 women (3.4%) had experienced suicidal ideation in the previous 7 days. Just over half of these women also had high EPDS scores (>12). Overall, 29 women (5.2%) screened positive for depression (EPDS score > 12).
Conclusions:
The rate of suicidal ideation is in line with the published international data and emphasises the need for all clinicians to inquire about such thoughts. Training of midwifery and obstetric staff is required. Maternity units should have a policy on the management of suicidal ideation and risk. The prevalence of depressive symptoms post-partum was comparatively low in our study. This could suggest that antenatal screening and early intervention, which are integral parts of the perinatal mental health service, are effective. However, due to limitations of the study, it could also reflect an under-representation of depressive symptom burden in this cohort.
A 21-year-old G1P1 with an uncomplicated pregnancy and vaginal delivery presents to your obstetrical assessment unit one week postpartum with concerns regarding the care of her newborn. She informs the nurse of difficulty with breastfeeding, which triggers a sense of worthlessness. The patient also complains of sleeplessness, even when the baby is asleep, and thereby is constantly exhausted. She shares with the nurse that she is ‘worried all the time about everything’ and finds herself crying randomly throughout the day for no apparent reason. The patient complains of intense ‘mood swings,’ which have led to frequent argumentation with her partner.
This study explores the depressive symptoms in postpartum women during the coronavirus disease 2019 (COVID-19) crisis in Japan.
Methods:
An online survey conducted from May 31 to June 6, 2020 resulted in 3073 responses obtained from mothers with infants < 12 mo.
Results:
The point prevalence of the Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 9 was 28.66% for primipara and 25.83% for multipara. Logistic regression analysis indicated a negative association between the COVID-19 crisis and EPDS ≥ 9; specifically, decreased social support and financial concern were identified as risk factors. The COVID-19–related experiences significantly increased the score of each factor of EPDS, ie, anxiety, anhedonia, and depression.
Conclusions:
During the COVID-19 crisis, the number of mothers who faced depreciation in social support and income had increased. Moreover, spending their perinatal period during the crisis increased the propensity of facing unexpected changes, such as changes of hospitals for delivery, or cancellation of parenting classes. These multiple factors were associated with an elevated risk of depression in postpartum women. In a prolonged crisis, postpartum mental health should be treated carefully with the prevention of infection.
Depression after childbirth is a major problem affecting 10–22% of all mothers. In Italy, postnatal depression has not yet been systematically studied.
Methods
In this retrospective study we have sought to identify risk factors, assessed during pregnancy, and their importance for postnatal depression symptoms in a sample of 297 Italian women attending ante-natal classes organised by the local Consultorio Familiare Unit of the National Health Service, Italy. The Postpartum Depression Predictors Inventory – revised form (PDPI-Revised), was used to identify risk factors, 8–9 month of pregnancy. A double-test strategy using the Edinburgh Postnatal Depression Scale (EPDS) and 12-item General Health Questionnaire (GHQ12), was administered to screen women with a higher occurrence of symptoms of postnatal depression six–eight weeks after delivery. Women with high EPDS (<8) and high GHQ12 (<3) scores were compared with those who had scored below the EPDS and/or GHQ12 threshold scores.
Results
We found that 13% of the women studied showed high postnatal depressive symptomatology, which is very similar to rates of prevalence of postnatal depression in the first year after the birth of the child reported in other Western World studies. Feeling anxious during pregnancy is a strong predictor of high symptoms of depression at 6–8 weeks after delivery. However, University education and friends' support appear to be important protective factors.
Conclusion
These findings could be useful both for Italian health professionals and for researchers interested in the transcultural aspects of postnatal depression.
The 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 interest
J.C. has no financial interest in the use of, or reproduction of, the EPDS.
There is evidence to suggest that individual components of dietary intake are associated with depressive symptoms. Studying the whole diet, through dietary patterns, has become popular as a way of overcoming intercorrelations between individual dietary components; however, there are conflicting results regarding associations between dietary patterns and depressive symptoms. We examined the associations between dietary patterns extracted using principal component analysis and depressive symptoms, taking account of potential temporal relationships.
Design
Depressive symptoms in parents were assessed using the Edinburgh Postnatal Depression Scale (EPDS) when the study child was 3 and 5 years of age. Scores >12 were considered indicative of the presence of clinical depressive symptoms. Diet was assessed via FFQ when the study child was 4 years of age.
Setting
Longitudinal population-based birth cohort.
Subjects
Mothers and fathers taking part in the Avon Longitudinal Study of Parents and Children when their study child was 3–5 years old.
Results
Unadjusted results suggested that increased scores on the ‘processed’ and ‘vegetarian’ patterns in women and the ‘semi-vegetarian’ pattern in men were associated with having EPDS scores ≥13. However, after adjustment for confounders all results were attenuated. This was the case for all those with available data and when considering a sub-sample who were ‘disease free’ at baseline.
Conclusions
We found no association between dietary patterns and depressive symptoms after taking account of potential confounding factors and the potential temporal relationship between them. This suggests that previous studies reporting positive associations may have suffered from reverse causality and/or residual confounding.
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