A longitudinal study of perinatal depression among Chinese high-risk pregnant women

Background

Information is needed on the prevalence of depression in Chinese women with medically defined complications across the perinatal period, as well as key risk factors to develop appropriate perinatal mental health services and ensure the services target those most in need.

Perceived social support and prenatal wellbeing; The mediating effects of loneliness and repetitive negative thinking on anxiety and depression during the COVID-19 pandemic

ProblemPrenatal depression and anxiety are linked to poor maternal and infant outcomes. We need to understand predictors of poor mental health to identify at-risk women, and targets for support.BackgroundPrevious research has demonstrated a relationship between low levels of perceived social support, and depression and anxiety in pregnant women. However, there is a lack of research into the factors that may mediate this relationship.AimAs social distancing measures (e.g., lockdown) are likely to negatively affect women’s perceived support in the prenatal period, we investigated the relationship between perceived social support and both anxiety and depression in UK-based pregnant women during the COVID-19 pandemic. Further, we examined two potential mediators that may contribute to psychological symptoms: repetitive negative thinking and loneliness.MethodsWe administered a battery of online measures to a sample of pregnant women (N = 205) between May-June 2020, during the first peak of the pandemic in the UK, when perceived social support was likely to be low.ResultsConsistent with predictions, perceived social support was significantly negatively related to depression, anxiety, loneliness and repetitive negative thinking. Furthermore, repetitive negative thinking and loneliness mediated the relationship between perceived social support and both depression and anxiety. Moreover, perceived social support and loneliness were associated with specific types of online behaviours.ConclusionsTaken together, the findings shed light on the processes through which social support may exert its effects on depression and anxiety and highlight potential therapeutic targets for interventions which aim to prevent and treat mood disorders in perinatal cohorts.     

A peer support intervention for first-time mothers: Feasibility and preliminary efficacy of the mummy buddy program

BackgroundThe transition to motherhood, although joyous, can be highly stressful, and the availability of professional postpartum support for mothers is often limited. Peer volunteer support programs may offer a viable and cost-effective method to provide community-based support for new mothers.AimTo determine the feasibility of a peer volunteer support program—The Mummy Buddy Program—in which experienced volunteer mothers are paired with, and trained to offer social support to, first-time mothers.MethodsUsing a single-group non-randomised feasibility trial, a total of 56 experienced mothers participated in the Mummy Buddy training program, which was focused on education and practical exercises relating to the provision of various forms of social support. Experienced mothers (‘Mummy Buddies’) were subsequently paired with expectant first-time mothers (n = 47 pairs), and were encouraged to provide support until 24-weeks postpartum.FindingsIn terms of key feasibility considerations, 95.1% of Mummy Buddies felt that they were trained sufficiently to perform their role, and 85.8% of New Mothers were satisfied with the support provided by their Buddy. Analyses of preliminary efficacy (i.e., program outcomes) revealed that the first-time mothers maintained normal levels of stress and depressive symptomology, and possessed relatively strong maternal functioning, across the program duration.ConclusionThe Mummy Buddy Program appears to be a feasible and potentially valuable peer volunteer support program for first-time mothers. This study provides a foundation for program expansion and for work designed to examine program outcomes—for first-time mothers, Mummy Buddies, and entire family units—within a sufficiently-powered randomised controlled trial.     

Partner relationship,social support and perinatal distress among pregnant Icelandic women

Background

It is inferred that perinatal distress has adverse effects on the prospective mother and the health of the foetus/infant. More knowledge is needed to identify which symptoms of perinatal distress should be assessed during pregnancy and to shed light on the impact of women’s satisfaction with their partner relationship on perinatal distress.

Private support and social security

The issue is addressed whether assistance to persons in need can be left to the ‘family’ and the ‘community’. In that case people depend on their social networks. The support a person receives through a given network of social ties is examined. However, ties are diverse and subject to change. By means of a model of the dynamics of social ties, the conditions for adequate private support are analyzed. The sustainability of private support over time is examined by incorporating the impact on social ties of lending and receiving support. It is shown that support is only an effective alternative in a limited number of situations. Received: 2 January 1997 / Accepted: 2 February 1998     

Social support,parental role competence and satisfaction among Chinese mothers and fathers in the early postpartum period: A cross-sectional study

BackgroundA sense of parental competence and satisfaction during the transition to parenthood can have a tremendous impact on the quality of parenting behaviors, with social support being an important facilitator.AimTo examine parental role competence and satisfaction of Chinese mothers and fathers in the early postpartum period with regard to social support.MethodsA cross-sectional study was conducted in a regional teaching hospital in Guangzhou, China. The study was conducted between June 5 and November 16, 2015. One hundred and eighty parental pairs at 6–8 weeks after birth completed the Parenting Sense of Competence Scale, Perceived Social Support Scale, and socio-demographic questionnaires.ResultsParental role competence and satisfaction of Chinese mothers and fathers were at a moderate level, affected each other and there were no significant differences between the mothers and the fathers. The Competence Scale scores had a significant positive correlation with social support. Multiple regression analysis revealed two variables that predicted maternal Competence Scale scores: maternal social support and the paternal Competence Scale scores. Paternal social support and maternal Competence Scale scores contributed significantly to paternal Competence Scale scores.ConclusionParental role competence and satisfaction of mothers and fathers were at a moderate level and affected by the parenting partner. To improve parental role competence and satisfaction, health care professionals should develop strategies that impact the whole family and not just a single individual. Supportive parenting programs should be implemented for both mothers and fathers.     

Prenatal education program decreases postpartum depression and increases maternal confidence: A longitudinal quasi-experimental study in urban Japan

BackgroundMothers in urban Japan are at high risk for postpartum depression. Previous research indicates that parents who understand their baby’s behavior may have lower risks for postpartum depression. HUG Your Baby helps parents understand their baby’s behavior.AimThe purpose of this longitudinal study was to determine whether mothers receiving prenatal HUG Your Baby teaching would have better outcomes than a control group with respect to postpartum depression and related factors.MethodsPregnant women, after thirty weeks’ gestation, were recruited to either the intervention or the control group. The intervention group received HUG Your Baby education, which teaches how to recognize and respond to a baby’s behavior. The control group received a leaflet and regular, prenatal treatment. Participants completed the Edinburgh Postnatal Depression Scale, Karitane Parenting Confidence Scale, and three other scales at one and three months, postpartum. Questions about knowledge of baby’s behavior was administered prenatally, and at one and three months, postpartum.FindingsData derived from 221 mothers (Control 100, Intervention 121) were included in the analysis. Researchers found significant differences regarding postpartum depression at one and three months and parenting confidence at one month. Scores were favorable for the intervention group.ConclusionsThe HUG Your Baby program has a positive impact on preventing postpartum depression and increasing parenting confidence. It warrants wider implementation and evaluation in prenatal programs.     

Reimagining the General Health Questionnaire as a measure of emotional wellbeing: A study of postpartum women in Malta

BackgroundPostpartum health has been subject to a focus on psychological morbidity, despite positive associations between postpartum recovery and maternal emotional wellbeing. There are currently many validated tools to measure wellbeing and related concepts, including non-psychiatric morbidity. The General Health Questionnaire, 12 items (GHQ-12) is one such instrument, widely used and validated in several languages. Its use in postpartum settings has been documented with disagreement about the instrument's utility in this population, particularly in relation to scoring method and threshold. The GHQ-12 has never been translated into Maltese. This study explored the psychometric properties of the GHQ-12 in a Maltese postpartum population to consider if the use of a different scoring method (visual analogue scale) in the GHQ-12 can determine postpartum wellbeing.MethodsOne hundred and twenty-four postpartum women recruited from one hospital in Malta completed the translated and adapted GHQ-12 as a wellbeing measure (GHQ-12(WB)) at four postpartum time points. The psychometric properties of the GHQ-12(WB) were explored using confirmatory factor analysis, discriminant and divergent validity and reliability analysis.ResultsThe GHQ-12(WB) demonstrated good divergent and known-groups validity and internal consistency. No models offered a good fit to the data. The overall consistent best-fit to the data was an eight item, two factor model (GHQ-8). Model fit improved across all models in terms of CFI at 13 weeks.ConclusionFindings generally support the reliability and validity of the Maltese version of the GHQ-12(WB). Model fit changes over time reflect the dynamic nature of postpartum recovery. Further evaluation of the GHQ-8(WB) is recommended.     

Predictors of postpartum depression service use: A theory-informed,integrative systematic review

ProblemPostpartum depression affects many women globally, yet rates of treatment use are low. A comprehensive view of factors associated with treatment use, from women’s and providers’ perspectives, based on a theoretical model is lacking.BackgroundSeveral studies examined various factors associated with postpartum depression service use; however, each study focused on a small number of factors.AimThis study describes a systematic literature review based on the Behavioral Model of Health Service Use. The purpose of this article is to review and synthesize the available literature regarding factors associated with women’s mental health service use for postpartum depression from women’s and healthcare providers’ perspectives, and provide a comprehensive integrative view of the subject.MethodsThree electronic databases were searched, and 35 studies published up to 2018 in English language journals met inclusion criteria for review. Factors associated with postpartum depression service use were classified according to the Behavioral Model of Health Service Use’s constructs.FindingsService use for postpartum depression is a function of a woman’s predisposition to use mental health services; individual, familial, and communal factors which enable or pose barriers to use of mental health services; and the woman’s perceived or evaluated need for treatment. In addition, societal determinants impact the woman’s decision to seek help directly or through impacting the health and mental health care service system’s resources and organization.ConclusionThis review illustrates key factors for researchers and practitioners to consider when treating postpartum women and developing interventions to enhance postpartum depression treatment use.     

Level of parenting stress in mothers of singletons and mothers of twins until one year postpartum: A cross-sectional study

Problem

To date, it is unclear which factors are associated with parenting stress.

Face-to-face health professional contact for postpartum women: A systematic review

The postpartum period is a time when physical, psychological and social changes occur. Health professional contact in the first month following birth may contribute to a smoother transition, help prevent and manage infant and maternal complications and reduce health systems’ expenditure.The aim of this systematic review was to assess the effect of face-to-face health professional contact with postpartum women within the first four weeks following hospital discharge on maternal and infant health outcomes.Fifteen controlled trial reports that included 8332 women were retrieved after searching databases and reference lists of relevant trials and reviews.Although the evidence was of moderate or low quality and the effect size was small, this review suggests that at least one health professional contact within the first 4 weeks postpartum has the potential to reduce the number of women who stop breastfeeding within the first 4–6 weeks postpartum (Risk Ratio 0.86 (95% Confidence Interval 0.75–0.99)) and the number of women who cease exclusive breastfeeding by 4–6 weeks (Risk Ratio 0.84 (95% Confidence Interval 0.71–0.99)) and 6 months (Risk Ratio 0.88 (95% Confidence Interval 0.81–0.96).There was no evidence that one form of health professional contact was superior to any other. There was insufficient evidence to show that health professional contact in the first month postpartum, at a routine or universal level, had an impact on other aspects of maternal and infant health, including non-urgent or urgent use of health services.     

Psychological distress in pregnancy and postpartum

PurposeDepression, stress, and anxiety, termed ‘psychological distress,’ are common in pregnancy and postpartum periods. However, it is unclear whether prenatal psychological distress predicts postpartum psychological distress. We studied the prevalence, comorbidity and associations of maternal depression, stress, and anxiety in the prenatal period in relation to the occurrence of these same measures in the postpartum period.MethodsData originated from the MotherToBaby study of pregnant women residing in the U.S or Canada (2016–2018). Risk ratios and 95% Confidence Intervals using modified-Poisson regression models were used to investigate associations between prenatal psychological distress and postpartum psychological distress.ResultsOf the 288 women in the analysis, 21.2% and 26.7% of women had evidence of prenatal and postnatal psychological distress, respectively. Among those with prenatal psychological distress, 43 (70.5%) also had postpartum psychological distress. Twenty-five (41%) of those with prenatal and 46 (60%) of those with postpartum psychological distress had comorbidity of at least two of the measures. Prenatal measures independently predicted the same postnatal measures; prenatal anxiety also independently predicted postpartum stress. Participants who experienced more types of prenatal psychological distress were at higher risk for postpartum depression, stress, and anxiety.ConclusionDepression, stress, and anxiety are common in pregnant women and often occur together. Prenatal psychological distress measures are associated with postnatal psychological distress measures, with stronger associations among women with more than one type of psychological distress in pregnancy. Interventions during pregnancy may reduce the risk of postpartum psychological distress.     

The needs of women and their partners regarding professional smoking cessation support during pregnancy: A qualitative study

BackgroundDespite the health risks of smoking, some women continue during pregnancy. Professional smoking cessation support has shown to be effective in increasing the proportion of pregnant women who quit smoking. However, few women actually make use of professional support.AimTo investigate the needs of women and their partners for professional smoking cessation support during pregnancy.MethodsSemi-structured interviews were held with pregnant women and women who recently gave birth who smoked or quit smoking during pregnancy, and their partners, living in the north of the Netherlands. Recruitment was done via Facebook, LinkedIn, food banks, baby stores and healthcare professionals. The interviews were recorded, transcribed and thematically analysed.Results28 interviews were conducted, 23 with pregnant women and women who recently gave birth, and five with partners of the women. The following themes were identified: 1) understanding women’s needs, 2) responsibility without criticism, and 3) women and their social network. These themes reflect that women need support from an involved and understanding healthcare professional, who holds women responsible for smoking cessation but refrains from criticism. Women also prefer involvement of their social network in the professional support.ConclusionFor tailored support, the Dutch guideline for professional smoking cessation support may need some adaptations. The adaptations and recommendations, e.g. to involve women and their partners in the development of guidelines, might also be valuable for other countries. Women prefer healthcare professionals to address smoking cessation in a neutral way and to respect their autonomy in the decision to stop smoking.     

Breastfeeding experiences and perspectives among women with postnatal depression: A qualitative evidence synthesis

BackgroundStudies show that postnatal depression affects around 10–16% of women globally. It is associated with earlier cessation of breast feeding, which can negatively impact infants’ long-term development. Mechanisms underpinning associations between mental health and women’s decision to commence and continue to breastfeed are complex and poorly understood.AimThe aim of this review was to investigate breastfeeding experiences, perspectives, and support needs of women with postnatal depression. No previous reviews were identified which had addressed this aim.MethodA systematic search was conducted of six databases to identify relevant qualitative studies. Six included studies were critically appraised and synthesised using thematic synthesis.FindingsFive themes were identified: (1) desire to breastfeed and be a ‘good mother’, (2) struggles with breastfeeding, (3) mixed experiences of support from healthcare professionals, (4) importance of practical and social support, (5) support for mental health and breastfeeding. Most women with postnatal depression expressed strong intentions to breastfeed, although some perceived ‘failure’ to breastfeed triggered their mental health problems. Practical and non-judgemental support for their mental health needs and for successful breastfeeding from healthcare professionals, family and friends are needed.ConclusionMost women with postnatal depression desired to breastfeed but experienced breastfeeding difficulties that could impact on their mental health. By offering women with postnatal depression tailored and timely support, healthcare professionals could help women minimize breastfeeding problems which could consequently impact on their mental well-being and ensure they and their infants have opportunity to benefit from the advantages that breastfeeding offers.     

Sleep quality at 3 months postpartum considering maternal age: A comparative study

Background

Poor sleep quality is related to old age among the general population, but few studies have focused on postpartum women of advanced maternal age. The present study aimed to describe and compare sleep quality between women younger or older than 35 years of age at 3 months postpartum, and to examine the related factors.

Differences in levels of stress,social support,health behaviours,and stress-reduction strategies for women pregnant before and during the COVID-19 pandemic,and based on phases of pandemic restrictions,in Ireland

BackgroundThe COVID-19 pandemic and related restrictions can adversely impact antenatal maternal well-being and health behaviours.AimTo examine antenatal stress and stress-reduction strategies, social support, and health behaviours between women pregnant before and during the pandemic in Ireland.Methods210 pregnant women were recruited online and in the antenatal department of a tertiary maternity hospital before the pandemic, and 235 women recruited online during the pandemic. Only women resident in Ireland were included in this study. Women completed measures of stress, social support, health-behaviours, and self-reported stress-reduction strategies. Differences in outcomes were examined between women pregnant before and during the pandemic, and between Phase 2 and Phase 3 of the Irish Government COVID-19 restrictions.FindingsWomen pregnant during the pandemic reported lower perceived social support, including support from a significant other, friends and family, than women pregnant before the pandemic. There were no significant differences in stress in health behaviours but women reported higher stress and less physical activity during the pandemic. Women reported a range of comparable stress-reduction strategies before and during the pandemic. No differences were observed between phases of pandemic-related restrictions for any outcome.DiscussionOur findings highlight negative impacts of the pandemic on social support, stress, and physical activity, which can have implications for maternal and child health. Lack of differences between restriction phases suggests on-going negative effects for antenatal well-being and behaviours.ConclusionDevelopment of supports for pregnant women during the pandemic should include social-support and stress-reduction components.     

The effects of ego-resilience,social support,and depression on suicidal ideation among the elderly in South Korea

South Korea’s elderly suicide rate is not merely the highest among the member nations of the Organization for Economic Cooperation and Development, it is the highest in the world. This study analyzed the effect of ego-resilience and social support on depression and suicidal ideation of the elderly, providing baseline data to aid in the development of preventive programs on elder suicide. We found that ego-resilience is a strong inhibitor of suicidal ideation. Direct and indirect effects of social support on suicidal ideation were especially helpful for elders with mild depression.     

Differences between Hispanic and non-Hispanic families in social capital and child development: First-year findings from an experimental study

Disadvantages faced by Hispanic children in the U.S., compared to non-Hispanic Whites, have been widely reported. Economic differences account for some of the gaps, but the social isolation of Hispanic families also serves as a barrier to children's success. Whereas Hispanic families tend to have strong kinship networks, their social ties often do not encompass the school and other authority systems. As a result, Hispanic families may have less access to social capital, that is, relations of trust and shared expectations that foster the flow of relevant information and support social norms that contribute to children's academic and social development. To study the role of social capital in child development, we embarked on a school-randomized trial in two cities with large Hispanic populations: San Antonio, Texas, and Phoenix, Arizona. In this paper, we report on first-year data from what will be a three-year longitudinal study, including 24 of an eventual 52 schools and about 1300 of what will be a sample of over 3000 children. We aimed to manipulate social capital through an intervention called Families and Schools Together (FAST), a multi-family after-school program that enhances relations among families, between parents and schools, and between parents and children through a sequence of structured activities over 8 weekly sessions. In the first year, 12 schools were randomly assigned to participate in FAST, and 12 served as controls. Data come from district administrative records, surveys of parents prior to FAST, and surveys of parents and teachers immediately after FAST. Surveys prior to FAST confirm that Hispanic parents have less extensive parent–school networks compared to non-Hispanic Whites. Comparisons of school means on post-FAST surveys indicate that parents in FAST schools experience more extensive social networks than those in control schools, but the differences are much more apparent in Phoenix than in San Antonio. Similarly, a pattern of better behavioral outcomes for children in FAST schools is evident in Phoenix but not San Antonio. Individual-level comparisons suggest that for some outcomes, effects may be larger for non-Hispanic Whites than for Hispanics, which would undermine potential contributions to reducing inequality.