Journal articles on the topic 'Postpartum depression Australia'
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Saligheh, M., B. Mcnamara, and R. Rooney. "Exercise participation in postpartum women in Western Australia." European Psychiatry 26, S2 (March 2011): 1682. http://dx.doi.org/10.1016/s0924-9338(11)73386-7.
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IntroductionResearch evidence suggests that the prevalence rate of postpartum depression in Western countries is 10–25% (Beck, 2001; O’ Hara & Swain, 1996). Many women diagnosed with postnatal depression(PND) are reluctant to take antidepressant medication (Whitton,1996). Coupled with the limited availability of psychological therapies, the consideration of adjunctive interventions for managing PND would appear worthwhile. Physical activity(PA) has been demonstrated to both mediate and improve outcomes for depression (Dimeo, 2001; Nabkasorn et al., 2006) in the general population, and in moderating the impact of PND (Daley, 2009).ObjectivesTo describe physical activity participation in a cohort of postpartum women in Western AustraliaTo investigate the factors associated with physical activity participation in postpartum women Examine the differences between women reporting PND and those without on physical activityAimsStudy 1 was the distribution of a postpartum physical activity questionnaire through child health clinics to mothers within the 6 weeks to12 months postpartum period.MethodsCohort design was used to recruit mothers within postpartum periodResultsThe results from the study showed that mothers who were at the risk of PND had the same level of physical activity in compare to normal mothers. The T-test showed there was not any significant correlation. Analysis revealed that there was a significant correlation between the effect of PND on parental self-confidence and partner support.ConclusionFindings suggest that further exploration needs to be considered to explore mothers’ experience of physical activity, its barriers and the interaction of their partners in order to exercise after child birth.
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Nahas, V. "Postpartum depression The lived experiences of Middle Eastern Migrant women in Australia." Journal of Nurse-Midwifery 44, no. 1 (January 2, 1999): 65–74. http://dx.doi.org/10.1016/s0091-2182(98)00083-4.
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Oktaliana, Oktaliana, Aryanti Wardiyah, and Lidya Aryanti. "Hubungan Umur Dan Pendidikan Dengan Parenting Selfefficacy Score Pada Ibu Muda." Malahayati Nursing Journal 4, no. 4 (April 2, 2022): 791–96. http://dx.doi.org/10.33024/mnj.v4i4.4848.
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ABSTRACT Accounting to world health organization (WHO) figures in 2011 in the US the incidence of postpartum depression was 43%, in Asia at 30%, in the UK in 2008-2009 the morbity rate due to childbirth increased to 24% from the previous 9% and in Australia, in 2007 the morbity and mortality due to childbirth also increased to 31% from the previous 21% and in Indonesia by 9.8% parenting self-efficacy will reduce the risk of postpartum depression, stress, and anxiety and are positively related to the well-being of parents. To know maternal age, education level, and parenting self-efficacy among adolescent mothers during the period at public Health Services(Puskesmas) Panjang Bandar Lampung 2021. This research type is quantitative (Non-Experimental) The Design in this study is an analytical survey with a cross-sectional approach, population, and sample of all postpartum young mothers are 66 people. Technical sampling purposive sampling. The result of a statistical test using chi-square. Keywords: Maternal Age, Education Level, Parenting Self-Efficacy, Postpartum ABSTRAK Data World Health Organization (WHO) tahun 2011 di Amerika Serikat kejadian depresi postpartum sebesar 43%, di Asia sebesar 30%, di Inggris tahun 2008-2009 angka kesakitan akibat persalinan meningkat menjadi 24% dari sebelumnya 9% dan di Australia pada tahun 2007. angka kesakitan dan kematian akibat persalinan juga meingkat menjadi 31% daris ebelumnya 21%, dan di Indonesia sebesar 9,8% Parenting Self-efficacy yang tinggi akan menurunkan resiko terjadinya depresi post partum, stress, dan kecemasan dan berhubungan yang positif dengan kesejahteraan orang tua. Tujuan penelitian untuk mengetahui hubungan umur dan Pendidikan pada skala parenting self-efficacy pada ibu muda di Puskesmas Panjang Bandar Lampung tahun 2021. Jenis Penelitian ini adalah kuantitatif (non-eksperimen). Rancangan dalam penelitian ini Survei Analitik dengan pendekatan cross sectional, populasi dan sampel seluruh ibu muda sejumlah 66 orang. Teknik sampel purposive sampling. Hasil uji statistik menggunakan chi square. Ada hubungan antara umur terhadap parenting self-efficacy score. Kata Kunci: Umur, Pendidikan, Parenting Self-Efficacy, Post Partum
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Arshad, Adeel, Katia Foresti, Matheus Rech, Vlasios Brakoulias, and Carlos Zubaran. "Demoralization, depression and anxiety in postpartum women of culturally and linguistic diverse backgrounds in Australia." European Journal of Midwifery 5, October (October 8, 2021): 1–8. http://dx.doi.org/10.18332/ejm/140791.
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Matthey, Stephen, Bryanne E. W. Barnett, and Amanda Elliott. "Vietnamese and Arabic Women's Responses to the Diagnostic Interview Schedule (Depression) and Self-Report Questionnaires: Cause for Concern." Australian & New Zealand Journal of Psychiatry 31, no. 3 (June 1997): 360–69. http://dx.doi.org/10.3109/00048679709073845.
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Objective: The original study aimed to determine the best cut-off scores to screen for postnatal depression on translated versions of the Edinburgh Postnatal Depression Scale (EPDS) for Vietnamese and Arabic women. This research was conducted using the depression module of the Diagnostic Interview Schedule (DIS) to determine caseness. This paper reports on the suitability of this diagnostic interview as a criterion measure of depression in these women with a non-English speaking background. Method: Vietnamese and Arabic women in south-west Sydney completed the EPDS and a General Health Questionnaire (GHQ-30) antenatally. At 6–8 weeks postpartum they completed an EPDS, the GHQ-30 and a Faces Scale, and were interviewed using the depression module of the DIS. Members of a small convenience sample of women were asked about the cultural appropriateness of each of the instruments. Results: Vietnamese women admitted to few depressive symptoms on the DIS, whereas they appeared more open to reporting these on the EPDS and the GHQ-30. Arabic women responded more openly to the questionnaires and the interview, although they too were reluctant to report specific symptoms on the DIS. Conclusion: The usefulness of the DIS in determining rates of major depression in the Vietnamese and Arabic community in Australia is questionable. Further studies designed specifically to investigate this are needed.
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Thorsteinsson, Einar B., Natasha M. Loi, and Kathryn Farr. "Changes in stigma and help-seeking in relation to postpartum depression: non-clinical parenting intervention sample." PeerJ 6 (November 8, 2018): e5893. http://dx.doi.org/10.7717/peerj.5893.
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Postpartum depression (PPD) is a prevalent mental illness affecting women, and less commonly, men in the weeks and months after giving birth. Despite the high incidence of PPD in Australia, rates for help-seeking remain low, with stigma and discrimination frequently cited as the most common deterrents to seeking help from a professional source. The present study sought to investigate PPD stigma in a sample of parents and to examine the effects of an intervention on stigma and help-seeking behaviour. A total of 212 parents aged 18–71 years (M = 36.88, 194 females) completed measures of personal and perceived PPD stigma and attitudes towards seeking mental health services and were randomly assigned to one of four groups: an intervention group (video documentary or factsheet related to PPD) or a control group (video documentary or factsheet not related to PPD). Results showed that there were no effects for type of intervention on either personal or perceived PPD stigma scores. No effect was found for help-seeking propensity. Males had higher personal PPD stigma than females and older age was associated with lower personal PPD stigma. Familiarity with PPD was associated with perceived PPD stigma in others but not personal PPD stigma. More work needs to be conducted to develop interventions to reduce PPD stigma in the community.
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Boyle, Jacqueline Anne, Suzanne Willey, Rebecca Blackmore, Christine East, Jacqueline McBride, Kylie Gray, Glenn Melvin, et al. "Improving Mental Health in Pregnancy for Refugee Women: Protocol for the Implementation and Evaluation of a Screening Program in Melbourne, Australia." JMIR Research Protocols 8, no. 8 (August 19, 2019): e13271. http://dx.doi.org/10.2196/13271.
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Background Identifying mental health disorders in migrant and refugee women during pregnancy provides an opportunity for interventions that may benefit women and their families. Evidence suggests that perinatal mental health disorders impact mother-infant attachment at critical times, which can affect child development. Postnatal depression resulting in suicide is one of the leading causes of maternal mortality postpartum. Routine screening of perinatal mental health is recommended to improve the identification of depression and anxiety and to facilitate early management. However, screening is poorly implemented into routine practice. This study is the first to investigate routine screening for perinatal mental health in a maternity setting designed for refugee women. This study will determine whether symptoms of depression and anxiety are more likely to be detected by the screening program compared with routine care and will evaluate the screening program’s feasibility and acceptability to women and health care providers (HCPs). Objective The objectives of this study are (1) to assess if refugee women are more likely to screen risk-positive for depression and anxiety than nonrefugee women, using the Edinburgh Postnatal Depression Scale (EPDS); (2) to assess if screening in pregnancy using the EPDS enables better detection of symptoms of depression and anxiety in refugee women than current routine care; (3) to determine if a screening program for perinatal mental health in a maternity setting designed for refugee women is acceptable to women; and (4) to evaluate the feasibility and acceptability of the perinatal mental health screening program from the perspective of HCPs (including the barriers and enablers to implementation). Methods This study uses an internationally recommended screening measure, the EPDS, and a locally developed psychosocial questionnaire, both administered in early pregnancy and again in the third trimester. These measures have been translated into the most common languages used by the women attending the clinic and are administered via an electronic platform (iCOPE). This platform automatically calculates the EPDS score and generates reports for the HCP and woman. A total of 119 refugee women and 155 nonrefugee women have been recruited to evaluate the screening program’s ability to detect depression and anxiety symptoms and will be compared with 34 refugee women receiving routine care. A subsample of women will participate in a qualitative assessment of the screening program’s acceptability and feasibility. Health service staff have been recruited to evaluate the integration of screening into maternity care. Results The recruitment is complete, and data collection and analysis are underway. Conclusions It is anticipated that screening will increase the identification and management of depression and anxiety symptoms in pregnancy. New information will be generated on how to implement such a program in feasible and acceptable ways that will improve health outcomes for refugee women. International Registered Report Identifier (IRRID) DERR1-10.2196/13271
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Borschmann, Rohan, Emma Molyneaux, Elizabeth Spry, Paul Moran, Louise M. Howard, Jacqui A. Macdonald, Stephanie J. Brown, Margarita Moreno-Betancur, Craig A. Olsson, and George C. Patton. "Pre-conception self-harm, maternal mental health and mother–infant bonding problems: a 20-year prospective cohort study." Psychological Medicine 49, no. 16 (December 18, 2018): 2727–35. http://dx.doi.org/10.1017/s0033291718003689.
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AbstractBackgroundSelf-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother–infant bonding problems.MethodsThe Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3–9. VIHCS enrolment began in 2006 (when participants were aged 28–29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother–infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum.ResultsFive hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20–29) reported higher levels of perinatal depressive symptoms and mother–infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42–7.39; mother–infant bonding problems adjusted β = 7.51, 95% CI 3.09–11.92]. There was no evidence that self-harm in adolescence (ages 15–17) was associated with either perinatal outcome.ConclusionsSelf-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother–infant bonding problems.
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Corr, L., H. Rowe, and J. Fisher. "Mothers’ perceptions of primary health-care providers: thematic analysis of responses to open-ended survey questions." Australian Journal of Primary Health 21, no. 1 (2015): 58. http://dx.doi.org/10.1071/py12134.
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General practitioners and maternal, child and family health nurses have a central role in postpartum primary health care for women and their infants. Positive client-provider relationships are particularly important for women experiencing mental health problems or unsettled infant behaviour. However, little is known about their experiences of postnatal primary health care. The study aimed to describe views of postnatal primary health care among women completing a residential early parenting programme and to identify potential strategies to enhance provider-patient interactions. Participants (n = 138) were women admitted with their infants to a private or a public early parenting service in Melbourne, Australia. Women completed a detailed self-report survey, including open-ended questions about experiences of primary health-care services, and a structured psychiatric interview to diagnose anxiety and depression. Survey responses were analysed thematically. Womens’ experiences of primary health care were influenced by their perceptions of provider competence and the quality of interactions. While similar positive characteristics of doctor and nurse care were valued, medical and nursing practices were judged in different ways. Women described GPs who listened, understood and were thorough as providing good care, and maternal, child and family health nurses were valued for providing support, advice and encouragement. Threats to therapeutic relationships with doctors included feeling rushed during consultations, believing that GPs were not mental health-care providers and the clinician not being ‘good’ with the infant; with nurses, problems included feeling judged or given advice that was inconsistent or lacked an evidence-base. Postpartum primary health care will be improved by unhurried consultations, empathic recognition, encouragement, evidence-informed guidance and absence of criticism.
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Gartland, Deirdre, Kelsey Hegarty, Sandra Papadopoullos, and Stephanie Brown. "Patterns of health service utilisation of mothers experiencing mental health problems and intimate partner violence: Ten-year follow-up of an Australian prospective mother and child cohort." PLOS ONE 17, no. 6 (June 15, 2022): e0269626. http://dx.doi.org/10.1371/journal.pone.0269626.
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Objectives Few studies have investigated health service use of mothers experiencing mental health problems or intimate partner violence (IPV). The aim of this study was to investigate health service utilisation of mothers experiencing mental health problems and intimate partner violence ten years after having a first baby. Methods Prospective cohort of 1507 first-time mothers recruited in Melbourne, Australia. Follow-up at ten years incorporated: Center for Epidemiologic Studies Depression Scale, Beck Anxiety Inventory, Posttraumatic Stress Disorder Checklist, Composite Abuse Scale. Results At ten years postpartum, one in four mothers (26.1%) reported depressive, anxiety or posttraumatic stress symptoms, and almost one in five (19.4%) reported recent IPV. Two-fifths of mothers reporting clinically significant mental health symptoms had experienced recent IPV (Odds Ratio = 5.6, 95% CI 3.9–8.1). Less than half of mothers experiencing mental health problems at ten-year follow-up had discussed their mental health with a general practitioner and around one in three had talked to a mental health professional. Two-thirds of mothers experiencing recent IPV had not disclosed this to a general practitioner or mental health professional. Conclusions The findings highlight the extent to which many women deal with IPV and mental health problems without the support that primary health care and mental health care could provide and point to the need for more concerted efforts to strengthen health system responses to these frequently related issues.
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Jones, Cindy J., Debra K. Creedy, and Jenny A. Gamble. "Australian midwives’ awareness and management of antenatal and postpartum depression." Women and Birth 25, no. 1 (March 2012): 23–28. http://dx.doi.org/10.1016/j.wombi.2011.03.001.
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Jones, Cindy J., Debra K. Creedy, and Jenny A. Gamble. "Australian Midwives’ Knowledge of Antenatal and Postpartum Depression: A National Survey." Journal of Midwifery & Women's Health 56, no. 4 (July 2011): 353–61. http://dx.doi.org/10.1111/j.1542-2011.2011.00039.x.
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Gould, Jacqueline F., Amanda J. Anderson, Lisa N. Yelland, Lisa G. Smithers, C. Murray Skeaff, Robert A. Gibson, and Maria Makrides. "Association of cord blood vitamin D at delivery with postpartum depression in Australian women." Australian and New Zealand Journal of Obstetrics and Gynaecology 55, no. 5 (June 30, 2015): 446–52. http://dx.doi.org/10.1111/ajo.12344.
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Nahas, Violeta, and Nawal Amasheh. "Culture Care Meanings and Experiences of Postpartum Depression among Jordanian Australian Women: A Transcultural Study." Journal of Transcultural Nursing 10, no. 1 (January 1999): 37–45. http://dx.doi.org/10.1177/104365969901000113.
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Verma, Sumedha, Donna Pinnington, Rachel Manber, and Bei Bei. "225 Sleep Timing and Chronotype in Mothers: Longitudinal Changes and Associations with Wellbeing from Pregnancy to 2 Years Postpartum." Sleep 44, Supplement_2 (May 1, 2021): A90. http://dx.doi.org/10.1093/sleep/zsab072.224.
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Abstract Introduction Women experience significant changes to sleep during perinatal periods. Existing research focuses on sleep duration and quality, but not sleep timing or chronotype (i.e., preferred timing for activity and sleep). This study investigated change trajectories of sleep timing and chronotype from late pregnancy to two years postpartum, and examined longitudinal associations between chronotype and insomnia, sleep-related daytime impairment, and mood. Methods Data were from a 2-arm randomized controlled trial testing behavioral sleep and diet interventions. A community sample of nulliparous women without severe sleep/mental health conditions participated. Women self-reported bedtime, risetime, chronotype (reduced Morningness-Eveningness Questionnaire), Insomnia Severity Index, and PROMIS Depression, Anxiety, and Sleep-Related Impairment over 7 time points: 30 and 35 weeks’ gestation, and postpartum months 1.5, 3, 6, 12 and 24. Results 163 women (mean age 33.35 ± 3.42 years) took part. Mixed effects models controlling for age and group allocation showed that both bed- and risetimes became progressively earlier over time by approximately 20-30 minutes on average (p < .001); chronotype also shifted progressively towards morningness (p < .01). After controlling for covariates (sleep duration and efficiency, mental health history, social support, age, group allocation), greater morningness was significantly associated with lower symptoms of insomnia and sleep-related impairment over time (p-values < .001); longitudinal associations between chronotype and symptoms of depression and anxiety were non-significant (p-values > .65). Conclusion This is one of the first studies to examine longitudinal changes in sleep timing and chronotype from pregnancy to two years postpartum. Sleep timing and chronotype became progressively earlier over the first two postpartum years. The magnitude of changes is beyond what is expected with increasing age. Greater morningness was associated with lower sleep complaints and sleep-related daytime impairment during the postpartum period. The mechanisms underlying these associations require further research. Support (if any) Australasian Sleep Association, Monash University, Australian Government RTP Scholarship and National Health and Medical Research Council.
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Cao, Sifan, Mark Jones, Leigh Tooth, and Gita Devi Mishra. "Association between preconception cannabis use and risk of postpartum depression: Findings from an Australian longitudinal cohort." Drug and Alcohol Dependence 226 (September 2021): 108860. http://dx.doi.org/10.1016/j.drugalcdep.2021.108860.
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Verma, Sumedha, Nina Quin, Laura Astbury, Cornelia Wellecke, Joshua Wiley, Margot Davey, Shantha Rajaratnam, and Bei Bei. "365 Cognitive Behavioral Therapy and Light Dark Therapy for Postpartum Insomnia Symptoms: Findings from a Randomized Controlled Trial." Sleep 44, Supplement_2 (May 1, 2021): A145. http://dx.doi.org/10.1093/sleep/zsab072.364.
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Abstract Introduction Symptoms of insomnia are common in the postpartum period and are associated with a range of negative outcomes. Despite this, interventions to improve maternal postpartum sleep remain scarce. Cognitive Behavioral Therapy (CBT) and Light Dark Therapy (LDT) target two different mechanisms to reduce sleep disturbance. This randomized controlled trial examined the efficacy of CBT and LDT against a treatment-as-usual (TAU) condition in reducing maternal postpartum insomnia symptoms. Methods Nulliparous women 4–12 months postpartum with self-reported symptoms of insomnia (Insomnia Severity Index scores [ISI] >7) were included; excluded were those with: current severe health/psychiatric conditions, unsettled infant behaviors, sleep-affecting medication use and photosensitivity. Eligible women were randomized 1:1:1 to 6 weeks of CBT (CBT for insomnia and fatigue), LDT (morning bright light therapy, evening light hygiene), or TAU. Interventions were therapist-assisted and personalized through two telephone calls and included automated self-help intervention materials (i.e., emails) delivered over six weeks. Symptoms of insomnia (ISI; primary outcome), fatigue, sleepiness, depression, and anxiety were assessed at baseline, mid-intervention, post-intervention, and 1-month post-intervention. Analyses were intention-to-treat latent growth models. Results 114 women were randomized (mean age = 32.20 ± 4.62 years) and 108 women completed the intervention. Compared to TAU, symptoms of insomnia significantly reduced from baseline to post-intervention in both CBT and LDT groups (p-values <.001), with very large effect sizes (d > 1.5) at post-intervention; gains were maintained at follow-up. Fatigue symptoms significantly reduced in the CBT group (p<.0001; d = 0.85) but not LDT (p = 0.11) compared to TAU at post-intervention; gains were maintained for CBT at follow-up. Group differences in sleepiness, depression, and anxiety were nonsignificant (all p > 0.08). Conclusion Therapist-assisted self-help CBT and LDT with different therapeutic mechanisms are both efficacious for reducing maternal insomnia symptoms during the postpartum period. Findings were mixed for fatigue, sleepiness and mood. Future research on predictors of treatment responses is needed. Support (if any) Australian National Health and Medical Research Council, Department of Education RTP Scholarship. Lucimed SA supplied light therapy glasses. Funders had no role in design/implementation of the trial. ANZCTR: ACTRN12618000842268.
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Bei, Bei, Donna Pinnington, Nina Quin, Lin Shen, Michelle Blumfield, Joshua Wiley, Sean Drummond, Louise Newman, and Rachel Manber. "340 Improving maternal sleep via cognitive behavioral intervention: A randomised controlled trial from pregnancy to 2 years postpartum." Sleep 44, Supplement_2 (May 1, 2021): A136. http://dx.doi.org/10.1093/sleep/zsab072.339.
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Abstract Introduction Maternal sleep disturbance is common during pregnancy and postpartum periods. This study evaluated the feasibility and efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these periods. Methods This is a two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous women without major medical/psychiatric conditions were randomised 1:1 to CBT or active control of equal frequency/duration. All participants received a 1-hr telephone session and automated multimedia emails from the 3rd trimester until 6 months postpartum. Outcomes were assessed with validated instruments at gestation weeks 30 (baseline) and 35 (pregnancy endpoint), and postpartum months 1.5, 3, 6 (postpartum endpoint), 12, and 24. Results 163 eligible participants (age M +/- SD = 33.35 +/- 3.42) were randomised. The CBT intervention was well accepted, with no reported adverse effect. Intention-to-treat analyses showed that compared to active control, receiving CBT was associated with lower insomnia severity and sleep disturbance (two primary outcomes), and lower sleep-related impairment at the pregnancy endpoint (p-values ≤ .001), as well as at 24 months postpartum (p ranges .012-.052). Group differences across the first postpartum year were nonsignificant. Women with elevated insomnia symptoms at baseline benefitted substantially more from CBT (vs control), including having significantly lower insomnia symptoms throughout the first postpartum year. Group differences in symptoms of depression or anxiety were nonsignificant. Conclusion A scalable CBT sleep intervention is efficacious in buffering against sleep disturbance during pregnancy, with long-term benefits to maternal sleep, especially for women with sleep complaints during pregnancy. The intervention holds promise for implementation into routine perinatal care. Support (if any) Data collection was supported by Rob Pierce Grant-in-Aid and Helen Bearpark Scholarship from Australasian Sleep Association, Strategic Grant Scheme from Monash University, and the Royal Women’s Hospital Foundation. Intervention materials were adapted from those developed via a National Institute of Health R01 grant (NR013662). Bei (APP1140299) and Wiley (APP1178487) are supported by National Health and Medical Research Council Fellowships, and Pinnington, Quin, Shen by Australian Postgraduate Awards by Department of Education and Training. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
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Cao, Sifan, Mark Jones, Leigh Tooth, and Gita Mishra. "Does premenstrual syndrome before pregnancy increase the risk of postpartum depression? Findings from the Australian Longitudinal Study on Women's Health." Journal of Affective Disorders 279 (January 2021): 143–48. http://dx.doi.org/10.1016/j.jad.2020.09.130.
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Woolhouse, Hannah, Jennifer James, Deirdre Gartland, Ellie McDonald, and Stephanie J. Brown. "Maternal depressive symptoms at three months postpartum and breastfeeding rates at six months postpartum: Implications for primary care in a prospective cohort study of primiparous women in Australia." Women and Birth 29, no. 4 (August 2016): 381–87. http://dx.doi.org/10.1016/j.wombi.2016.05.008.
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Jin, Ying, Jane Coad, Shao J. Zhou, Sheila Skeaff, Cheryl Benn, Nicholas Kim, Rachael L. Pond, and Louise Brough. "Mother and Infant Nutrition Investigation in New Zealand (MINI Project): Protocol for an Observational Longitudinal Cohort Study." JMIR Research Protocols 9, no. 8 (August 27, 2020): e18560. http://dx.doi.org/10.2196/18560.
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Background Thyroid dysfunction is associated with cognitive impairment, mood disturbance, and postnatal depression. Sufficient thyroid hormone synthesis requires adequate intake of iodine, selenium, and iron. Iodine deficiency was historically a problem for New Zealand, and initiatives were introduced to overcome the problem: (1) mandatory fortification of all bread (except organic) with iodized salt (2009) and (2) provision of subsidized iodine supplements for pregnant and breastfeeding women (2010). Subsequent to these initiatives, most adults and children have adequate iodine status; however, status among breastfeeding women and their infants remains unclear. This paper outlines the methodology of the Mother and Infant Nutrition Investigation (MINI) study: an observational longitudinal cohort study of breastfeeding women and their infants. Objective This study will determine (1) women’s iodine intake and status among supplement users and nonusers; (2) women’s intake and status of iodine, selenium, and iron relating to thyroid function; (3) associations between women’s selenium status, thyroid function, and postnatal depression; (4) infants’ iodine and selenium status relating to first year neurodevelopment. Methods Breastfeeding women aged over 16 years with a healthy term singleton infant were recruited from Manawatu, New Zealand. Participants attended study visits 3, 6, and 12 months postpartum. Maternal questionnaires investigated supplement use before and after birth, iodine knowledge, and demographic information. Dietary assessment and urine, blood, and breast milk samples were taken to measure iodine, selenium, and iron intake/status. The Edinburgh Postnatal Depression Scale was used repeatedly to screen for postnatal depression. Thyroid hormones (free triiodothyronine, free thyroxine, thyroid stimulating hormone, thyroglobulin, antithyroglobulin antibodies, and antithyroid peroxidase) were measured in blood samples, and thyroid gland volume was measured by ultrasound at 6 months postpartum. Infant iodine and selenium concentrations were determined in urine. The Ages and Stages Questionnaire was used to assess infant development at 4, 8, and 12 months. Results Data collection was completed. Biological samples analysis, excluding nail clippings, is complete. Data analysis and presentation of the results will be available after 2020. Conclusions This study will provide data on the current iodine status of breastfeeding women. It will also provide a greater understanding of the three essential minerals required for optimal thyroid function among breastfeeding women. The prospective longitudinal design allows opportunities to examine women’s mental health and infant neurodevelopment throughout the first year, a crucial time for both mothers and their infants. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12615001028594; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369324 International Registered Report Identifier (IRRID) DERR1-10.2196/18560
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Martín-Gómez, Carmen, Patricia Moreno-Peral, Juan A. Bellón, Sonia Conejo Cerón, Henar Campos-Paino, Irene Gómez-Gómez, Alina Rigabert, Isabel Benítez, and Emma Motrico. "Effectiveness of psychological, psychoeducational and psychosocial interventions to prevent postpartum depression in adolescent and adult mothers: study protocol for a systematic review and meta-analysis of randomised controlled trials." BMJ Open 10, no. 5 (May 2020): e034424. http://dx.doi.org/10.1136/bmjopen-2019-034424.
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IntroductionThe prevalence of postpartum depression (PPD) is 17%, and the incidence is 12% worldwide. Adverse consequences for mothers and babies have been associated with this disease. To assess the effectiveness of psychological, psychoeducational and psychosocial interventions in preventing PPD, a systematic review and meta-analysis (SR/MA) will be conducted.Methods and analysisA SR/MA will be performed following the indications of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies will be identified through MEDLINE (Ovid and PubMed), PsycINFO, Web of Science, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, OpenGrey, Australian New Zealand Clinical Trial Registry, ClinicalTrials.gov and evidencebasedtherapy.org from inception until 31 January 2020. Bridging searches will be also conducted until the review is completed. The selection criteria will be as follows: (1) subjects will be pregnant females or females who have given birth in the last 12 months and who were non-depressive at baseline; (2) psychological, psychoeducational and psychosocial interventions; (3) comparator will be usual care, attention control, waiting list or no intervention; (4) outcomes will be specific results on PPD; and (5) the design of the studies will be randomised controlled trials. No restrictions regarding the year of publication, the setting of the intervention or the language of publication will be considered. Pooled standardised mean differences and 95% CIs will be calculated. The risk of bias of the studies will be assessed through the Cochrane Collaboration risk of bias tool. Heterogeneity between the studies will be determined by the I2 and Cochran’s Q statistics. Sensitivity and subgroup analyses will also be performed. Publication bias will be checked with funnel plots and Egger’s test. Heterogeneity will be explored by random-effects meta-regression analysis.Ethics and disseminationThe ethical assessment was not required. The results will be presented at conferences and disseminated through publications.PROSPERO registration numberCRD42018109981.
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Macdonald, Jacqui A., Lauren M. Francis, Helen Skouteris, George J. Youssef, Liam G. Graeme, Joanne Williams, Richard J. Fletcher, et al. "Cohort profile: the Men and Parenting Pathways (MAPP) Study: a longitudinal Australian cohort study of men’s mental health and well-being at the normative age for first-time fatherhood." BMJ Open 11, no. 7 (July 2021): e047909. http://dx.doi.org/10.1136/bmjopen-2020-047909.
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PurposeThe Men and Parenting Pathways (MAPP) Study is a prospective investigation of men’s mental health and well-being across the normative age for transitioning to fatherhood. This includes trajectories and outcomes for men who do and do not become fathers across five annual waves of the study.ParticipantsAustralian resident, English-speaking men aged 28–32 years at baseline were eligible. Recruitment was over a 2-year period (2015–2017) via social and traditional media and through engagement with study partners. Eight hundred and eighteen eligible men consented to participate. Of these, 664 men completed the first online survey of whom 608 consented to ongoing participation. Of the ongoing sample, 83% have participated in at least two of the first three annual online surveys.Findings to dateThree waves of data collection are complete. The first longitudinal analysis of MAPP data, published in 2020, identified five profiles that characterise men’s patterns of depressive symptom severity and presentations of anger. Profiles indicating pronounced anger and depressive symptoms were associated with fathers’ lack of perceived social support, and problems with coparenting and bonding with infants. In a second study, MAPP data were combined with three other Australian cohorts in a meta-analysis of associations between fathers’ self-reported sleep problems up to 3 years postpartum and symptoms of depression, anxiety and stress. Adjusted meta-analytic associations between paternal sleep and mental health risk ranged from 0.25 to 0.37.Future plansMAPP is an ongoing cohort study. Waves 4 and 5 data will be ready for analyses at the end of 2021. Future investigations will include crossed-lagged and trajectory analyses that assess inter-relatedness and changing social networks, mental health, work and family life. A nested study of COVID-19 pandemic-related mental health and coping will add two further waves of data collection in a subsample of MAPP participants.
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Astuti, Dewi Apri, and Erika B. Laconi. "Evaluasi Komposisi Tubuh dan Pemanfaatan Nutrien di Ambing Kambing Peranakan Etawah Laktasi yang Diberi Pakan Fermentasi Limbah Tempe." Jurnal Ilmu Nutrisi dan Teknologi Pakan 17, no. 3 (December 30, 2019): 59–63. http://dx.doi.org/10.29244/jintp.17.3.59-63.
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The aim of this study was to evaluate the body composition, nutrient uptake in mammary gland and milk amino acid profile of lactating Etawah Crossbred goats fed by tempeh by product. Twelve lactating goats were randomly allocated into three groups which fed by ration containing concentrate (R1), concentrate plus 25% fresh tempeh waste (R2) and concentrate plus 25% fermented tempeh waste (R3). Tempeh waste was fermented by Aspergillus niger. Kinggrass was given 50% of the total ration for all groups. Urea space technique was used to measure body composition before and after the experiment was done. Milk production was calculated two times a day during two months after giving birth (postpartum). Total milk protein and amino acid, whey and casein were analyzed by kjeldahl method and amino acid analyzer respectively. Nutrient uptake in mammary gland was calculated base on Fick principles. Result showed that there was significantly different on body weight, but on body water, protein and fat had no significant difference between the treatments. The best milk production was found in fermented tempeh waste group. Concentration of glutamic acid was dominant than other essential amino acids in whole milk and casein but there were no significant difference between groups for those essential amino acid profile. It was concluded that fermented tempeh waste could substitute 50% of total concentrate and had the highest body weight, milk yield and nutrient uptake in the mammary gland of lactating Etawah Crossbred goats.
Key words: body composition, fermentation, lactating PE goat, nutrient uptake, tempeh waste
DAFTAR PUSTAKA
Astuti DA & Sastradipradja D. 1998. Measurement of body composition using slaughter technique and urea-space in local sheep. Indonesian Journal of Veterinary Science. 3: 1-9
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Astuti DA, Sastradipradja D & Sutardi T. 2000. Nutrient balance and glucose metabolism of female growing, late pregnant and lactating ettawah crossbred goats. Asian-Australasian Journal of Animal Sciences. 13:8: 1068-1077
Astuti DA& Wina E. 2002. Protein balance and excreation of purine derivatives in urine of lactating etawah crossbred goats fed with tempe waste. Jurnal Peternakan dan Veteriner. 7(3) : 162-166
Astuti DA, Baba AS & Wibawan IWT. 2011. Rumen fermentation, blood metabolites, and performance of sheep fed tropical browse plants. Media Peternakan. 34 (3) : 201-206
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Laconi EB, & Jayanegara A. 2015. Improving nutritional quality of cocoa pod (theobroma cacao) through chemical and biological treatments for ruminant feeding: in vitro and in vivo evaluation. Asian-Australasian Journal of Animal Sciences Open Access. http://dx.doi.org/10.5713/ajas.13.0798.
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Christie, Hannah E., Kassia Beetham, Elizabeth Stratton, and Monique E. Francois. "“Worn-out but happy”: Postpartum Women's Mental Health and Well-Being During COVID-19 Restrictions in Australia." Frontiers in Global Women's Health 2 (January 7, 2022). http://dx.doi.org/10.3389/fgwh.2021.793602.
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Background: From late 2019, COVID-19 disease has infiltrated the global population causing widespread challenges to public health. One cohort that has received less attention, but who may be more vulnerable to the mental and physical health related impacts of COVID-19 restrictions are postpartum mothers. The aim of this study was to explore the mental health, well-being, and health behaviours of mothers up to 12 months postpartum whilst living in Australia under COVID-19 level 3 and 4 restrictions.Methods: 351 women in their first year postpartum residing in Australia whilst under level 3/4 social distancing restrictions (during April 13 and June 11, 2020) were recruited to participate in an online questionnaire. The survey measured symptoms of depression, anxiety, and stress (DASS), wellness (SF-36), physical activity (Godin-Shephard score), perceived value of health outcomes, diet, and sleep. Descriptive statistics and linear regressions were performed.Results: Data was analysed for 139 eligible women. Of these women, 74% scored “normal” for depression, 84% for anxiety, and 72% for stress. Over half (58%) of women reported being worn out all, most, or a good bit of the time and 77% reported being a happy person all, most, or a good bit of the time. Analysis of the perceived values of health outcome revealed women had high value for “getting out of the house,” “achieving a better overall mood,” and “to feel better physically.” Women were considered physically active according to the Godin Leisure score, however only 41% of women met the current Australian national physical activity guidelines of 150 min.week−1.Conclusions: Overall the majority of postpartum mums that were surveyed, have normal mental health symptoms, and despite being worn out most are happy at least a good bit of the time. This study highlights the importance of health values in maintaining leisure physical activity and mental health. In addition it appears women may benefit from virtual group exercise and community programs to encourage being physically active and socialising with friends simultaneously.
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Monks, David Thomas, Basavaraj Ankalagi, Preet Mohinder Singh, Ebony Carter, Michelle Doering, Meg Guard, and Shannon Lenze. "Interventions to treat and prevent postpartum depression: a protocol for systematic review of the literature and parallel network meta-analyses." Systematic Reviews 11, no. 1 (December 28, 2022). http://dx.doi.org/10.1186/s13643-022-02157-2.
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Abstract Introduction Postpartum depression has costly consequences for the mother, baby, and society. Numerous pharmacological and non-pharmacological interventions are available for the prevention and treatment of postpartum depression. To date, no attempt has been made to synthesize the evidence from comparisons of interventions both within and across these categories. Methods We will perform a systematic review of the literature and perform network meta-analysis of interventions to (a) prevent and (b) treat postpartum depression. This review will include studies of primiparous or multiparous women during pregnancy or within 12 months of delivery of their baby that assess either interventions initiated during pregnancy or within 1 year of childbirth. Comparators will be other eligible interventions or control conditions. The outcome of interests will be related to the antidepressant efficacy of the interventions as well as their acceptability. The published literature will be searched in Ovid MEDLINE 1946-, Embase.com 1947-, Scopus 1823-, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. The search will use a combination of standardized terms and keywords for postpartum depression, a sensitive search filter to limit for randomized controlled trials, and a librarian-created “humans” filter. The search results will be uploaded to the Covidence online systematic review platform (Veritas Health Information Ltd., Victoria, Australia) where two review team members will independently screen articles. We will extract data to include year of publication, language, country, participants (number, demographic data, eligibility criteria, psychiatric symptoms, and co-morbidities), characteristics of the intervention and control conditions, and reported outcomes. Risk of bias for each study will be assessed independently by two review authors using the RoB 2: A revised Cochrane risk of bias tool for randomized trials. Network meta-analysis will be performed using a Bayesian hierarchical model supplemented with a Markov chain Monte Carlo approach. Discussion Postpartum depression is a devastating disease with long-lasting consequences. Given the numerous available interventions to both prevent and treat postpartum depression and the great number of studies comparing them, it is imperative that clinicians and patients are provided with an assessment of their comparative efficacy and acceptability. Systematic review registration Prospero registration (CRD42022303247).
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Clifton, Vicki L., Sailesh Kumar, Danielle Borg, Kym M. Rae, Roslyn N. Boyd, Koa Whittingham, Karen M. Moritz, et al. "Associations between COVID-19 lockdown and post-lockdown on the mental health of pregnant women, postpartum women and their partners from the Queensland family cohort prospective study." BMC Pregnancy and Childbirth 22, no. 1 (June 4, 2022). http://dx.doi.org/10.1186/s12884-022-04795-9.
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Abstract Background There are very few developed countries where physical isolation and low community transmission has been reported for COVID-19 but this has been the experience of Australia. The impact of physical isolation combined with low disease transmission on the mental health of pregnant women is currently unknown and there have been no studies examining the psychological experience for partners of pregnant women during lockdown. The aim of the current study was to examine the impact of the first COVID-19 lockdown in March 2020 and post lockdown from August 2020 on the mental health of pregnant women or postpartum women and their partners. Methods Pregnant women and their partners were prospectively recruited to the study before 24 weeks gestation and completed various questionnaires related to mental health and general wellbeing at 24 weeks gestation and then again at 6 weeks postpartum. The Depression, Anxiety and Stress Scale (DASS-21) and the Edinburgh Postnatal Depression Scale (EPDS) were used as outcome measures for the assessment of mental health in women and DASS-21 was administered to their partners. This analysis encompasses 3 time points where families were recruited; before the pandemic (Aug 2018-Feb 2020), during lockdown (Mar-Aug 2020) and after the first lockdown was over (Sept-Dec 2020). Results There was no significant effect of COVID-19 lockdown and post lockdown on depression or postnatal depression in women when compared to a pre-COVID-19 subgroup. The odds of pregnant women or postpartum women experiencing severe anxiety was more than halved in women during lockdown relative to women in the pre-COVID-19 period (OR = 0.47; 95%CI: 0.27–0.81; P = 0.006). Following lockdown severe anxiety was comparable to the pre-COVID-19 women. Lockdown did not have any substantial effects on stress scores for pregnant and postpartum women. However, a substantial decrease of over 70% in the odds of severe stress was observed post-lockdown relative to pre-COVID-19 levels. Partner’s depression, anxiety and stress did not change significantly with lockdown or post lockdown. Conclusion A reproductive age population appear to be able to manage the impact of lockdown and the pandemic with some benefits related to reduced anxiety.
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Gow, Megan L., Chris Rossiter, Lynne Roberts, Maddison J. Henderson, Lin Yang, Judith Roche, Erin Hayes, Alison Canty, Elizabeth Denney-Wilson, and Amanda Henry. "COVID-19, lifestyle behaviors and mental health: A mixed methods study of women 6 months following a hypertensive pregnancy." Frontiers in Public Health 10 (October 18, 2022). http://dx.doi.org/10.3389/fpubh.2022.1000371.
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IntroductionThe COVID-19 pandemic introduced unprecedented challenges to both the physical and psychological health of postpartum women. The aim of this study was to determine how the COVID-19 pandemic affected the diet, physical activity and mental health of women 6 months following a hypertensive disorder of pregnancy.MethodsMixed methods sub-study of the Blood Pressure Postpartum trial, which recruited women following a hypertensive disorder of pregnancy from six Sydney metropolitan hospitals. Cross sectional analysis of baseline quantitative data, collected at 6-months postpartum from March 2019-February 2022, and qualitative data analysis from semi-structured telephone interviews, was performed. Dates of COVID-19 lockdowns for Sydney, Australia were collected from government websites. Diet (vegetable, fruit, alcohol, take away intake) and physical activity (walking, vigorous activity, strength training frequency and duration) were assessed using the self-report NSW Population Health Survey. Depression and anxiety were assessed using the Edinburgh Depression Scale and GAD-7 scale, respectively. Outcome data were compared between women who completed surveys “In Lockdown” vs. “Not in Lockdown” as well as “Prior to any Lockdown” vs. “During or Following any Lockdown”.ResultsOf 506 participants, 84 women completed the study surveys “In Lockdown,” and 149 completed the surveys “Prior to any Lockdown.” Thirty-four participants were interviewed. There were no statistically significant differences in diet, physical activity, depression and anxiety among women who completed the survey “In Lockdown” vs. “Not in Lockdown.” “Prior to any Lockdown,” participants were more likely to do any walking (95% vs. 89%, p = 0.017), any vigorous activity (43% vs. 30%, p = 0.006) or any strength training (44% vs. 33%, p = 0.024), spent more time doing vigorous activity (p = 0.003) and strength training (p = 0.047) and were more likely to drink alcohol at least monthly (54% vs. 38%, p < 0.001) compared with “During or Following any Lockdown.”ConclusionsOur findings suggest that the confinements of lockdown did not markedly influence the mental health, diet and physical activity behaviors of women 6 months following hypertensive pregnancy. However, physical activity levels were reduced following the emergence of COVID-19, suggesting targeted efforts may be necessary to re-engage postpartum women with exercise.Trial registrationhttps://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376286&isReview=true, identifier: ACTRN12618002004246.
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Verma, Sumedha, Nina Quin, Laura Astbury, Cornelia Wellecke, Joshua F. Wiley, Margot Davey, Shantha M. W. Rajaratnam, and Bei Bei. "Treating postpartum insomnia: a three arm randomised controlled trial of cognitive behavioural therapy and light dark therapy." Psychological Medicine, September 9, 2022, 1–11. http://dx.doi.org/10.1017/s0033291722002616.
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Abstract Background Insomnia symptoms are common during the postpartum period, yet interventions remain scarce. This trial aimed to simultaneously examine the efficacy of cognitive behavioural therapy (CBT) and light dark therapy (LDT), targeting different mechanisms, against treatment-as-usual (TAU), in reducing maternal postpartum insomnia symptoms. Methods This three-arm randomised controlled trial recruited from the general community in Australia. Nulliparous females 4–12 months postpartum with self-reported insomnia symptoms [Insomnia Severity Index (ISI) scores >7] were included; severe medical/psychiatric conditions were excluded. Participants were randomised 1:1:1 to CBT, LDT, or TAU stratified by ISI (< or ⩾14) and infant age (< or ⩾8 months). Participants and principal investigators were unblinded. Six-week interventions were delivered via digital materials and telephone. The primary outcome was insomnia symptoms (ISI), assessed pre-, midpoint-, post- (primary endpoint), and one-month post-intervention. Analyses were intention-to-treat using latent growth models. Results 114 participants (CBT = 39, LDT = 36, TAU = 39; Mage = 32.20 ± 4.62 years) were randomised. There were significantly greater reductions in ISI scores in CBT and LDT (effect sizes −2.01 and −1.52 respectively, p < 0.001) from baseline to post-intervention compared to TAU; improvements were maintained at follow-up. Similar effects were observed for self-reported sleep disturbance. There were greater reductions in fatigue in CBT (effect size = 0.85, p < 0.001) but not LDT (p = 0.11) compared to TAU. Changes in sleepiness, depression, and anxiety were non-significant compared to TAU (all p > 0.08). Four participants (11%) in the LDT group reported headaches, dizziness, or nausea; no others reported adverse events. Conclusions Therapist-assisted CBT and LDT were feasible during the first postpartum year; data at post-intervention and 1-month follow-up support their safety and efficacy in reducing postpartum insomnia symptoms.
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Kothari, A., G. Bruxner, J. M. Dulhunty, E. Ballard, and L. Callaway. "Dads in Distress: symptoms of depression and traumatic stress in fathers following poor fetal, neonatal, and maternal outcomes." BMC Pregnancy and Childbirth 22, no. 1 (December 22, 2022). http://dx.doi.org/10.1186/s12884-022-05288-5.
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Abstract Background This study aims to explore the prevalence of symptoms of depression and traumatic stress in fathers in the setting of poor fetal, neonatal, and maternal outcomes. Methods A prospective mixed-methods study was conducted at an outer metropolitan public teaching hospital in Brisbane, Australia, with quantitative results presented here. Subjects included 28 fathers whose male partners had experienced pregnancy or childbirth complicated by a significant congenital abnormality or aneuploidy, termination of pregnancy, fetal death in-utero, stillbirth, admission to the neonatal intensive care unit or special care nursery or significant maternal morbidity, such as a postpartum haemorrhage or an emergency postpartum hysterectomy. These experiences were classified into two groups: anticipatory (time to prepare) and sudden (no warning). The fathers were screened using the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Events Scale-Revised (IES-R) to assess subjective distress at 2-3 weeks (timepoint 1) and 3-4 months (timepoint 2) after the event. Results Data for both the EPDS and IES-R scales was available for 26 fathers (92.9%) at timepoint 1 and for 15 fathers (53.6%) at timepoint 2. High overall EPDS scores (≥10) were noted in 16/27 (59.3%) fathers at timepoint 1 and 6/15 fathers (40.0%) at timepoint 2. High overall IES-R scores ≥33 were noted in 12/26 (46.2%) fathers at timepoint 1 and 4/15 fathers (26.7%) at timepoint 2. A higher percentage of fathers who experienced anticipatory events had EPDS and IES-R score above these cut-offs at timepoint 1 (8/13 or 61.5%) compared to those experiencing sudden events (8/14 or 57.1%), however, percentages were similar between groups at time point 2 (2/7 or 28.6%% and 4/8 or 50.0%, respectively). More fathers who experienced anticipatory events had IES-R scores ≥33 at timepoint 1 (7/13 or 53.8%) compared to those experiencing sudden events (5/14 or 38.0%). Conclusion Our study indicates high rates of distress in fathers exposed to poor fetal, neonatal, and maternal outcomes, which can persist for months after the event. Increased support for fathers in this setting may be required to prevent poor mental health. Further research on the long-term effects of these adverse events is warranted.
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Modini, Caitlin, Stuart Leske, Susan Roberts, Nikki Whelan, Andrea Chitakis, David Crompton, and David Ellwood. "Maternal deaths by suicide in Queensland, Australia, 2004–2017: an analysis of maternal demographic, psychosocial and clinical characteristics." Archives of Women's Mental Health, June 22, 2021. http://dx.doi.org/10.1007/s00737-021-01107-6.
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AbstractTo characterise the demographic and clinical characteristics of women who died by suicide in the perinatal period to inform and improve suicide prevention strategies. Retrospective analysis of maternal suicides during and within 1 year after the end of pregnancy in Queensland between January 2004 and December 2017. Outcomes measured included timing of death in relation to pregnancy, sociodemographic and clinical characteristics and health service use prior to death. There were 65 deaths by suicide in the study period; six occurred during pregnancy, 30 occurred after a live birth, 22 occurred after a termination of pregnancy and seven followed a miscarriage or stillbirth. Most suicides were late maternal deaths. Women were younger, and more likely to identify as Aboriginal or Torres Strait Islander, when compared to all women giving birth for the same time period. Most women had a prior mental health diagnosis, most commonly depression. Over half of women had recent relationship separation or conflict prior to death. Perinatal women had higher rates of death by violent means than all women in Queensland who died by suicide during the same time period. The demographic, psychosocial and clinical characteristics of a group of women who died by suicide have been described, and this shows a high proportion of women with a prior mental health diagnosis. To reduce maternal mortality, psychosocial screening must be implemented broadly and continued until the end of the first year postpartum. Similar screening attention is needed for women who had a termination of pregnancy, miscarriage or stillbirth.
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Myers, Sarah, and Emily H. Emmott. "Communication Across Maternal Social Networks During England’s First National Lockdown and Its Association With Postnatal Depressive Symptoms." Frontiers in Psychology 12 (May 11, 2021). http://dx.doi.org/10.3389/fpsyg.2021.648002.
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Postnatal/postpartum depression (PND/PPD) had a pre-COVID-19 estimated prevalence ranging up to 23% in Europe, 33% in Australia, and 64% in America, and is detrimental to both mothers and their infants. Low social support is a key risk factor for developing PND. From an evolutionary perspective this is perhaps unsurprising, as humans evolved as cooperative childrearers, inherently reliant on social support to raise children. The coronavirus pandemic has created a situation in which support from social networks beyond the nuclear family is likely to be even more important to new mothers, as it poses risks and stresses for mothers to contend with; whilst at the same time, social distancing measures designed to limit transmission create unprecedented alterations to their access to such support. Using data from 162 mothers living in London with infants aged ≤6 months, we explore how communication with members of a mother’s social network related to her experience of postnatal depressive symptoms during the first “lockdown” in England. Levels of depressive symptoms, as assessed via the Edinburgh Postnatal Depression Scale, were high, with 47.5% of the participants meeting a ≥11 cut-off for PND. Quasi-Poisson regression modelling found that the number of network members seen in-person, and remote communication with a higher proportion of those not seen, was negatively associated with depressive symptoms; however, contact with a higher proportion of relatives was positively associated with symptoms, suggesting kin risked seeing mothers in need. Thematic qualitative analysis of open text responses found that mothers experienced a burden of constant mothering, inadequacy of virtual contact, and sadness and worries about lost social opportunities, while support from partners facilitated family bonding. While Western childrearing norms focus on intensive parenting, and fathers are key caregivers, our results highlight that it still “takes a village” to raise children in high-income populations and mothers are struggling in its absence.
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Roberts, Lynne, Amanda Henry, Samuel B. Harvey, Caroline S. E. Homer, and Gregory K. Davis. "Depression, anxiety and posttraumatic stress disorder six months following preeclampsia and normotensive pregnancy: a P4 study." BMC Pregnancy and Childbirth 22, no. 1 (February 7, 2022). http://dx.doi.org/10.1186/s12884-022-04439-y.
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Abstract Background Mental health is an integral part of overall health. Mental health disorders following childbirth are common and poor maternal mental health has consequences for both the mother and her infant. Preeclampsia is also relatively common in pregnancy but there is little known about the intersection between these two important conditions. Gaining a better understanding of the psychological consequences following preeclampsia is important, especially the link with depression, anxiety and posttraumatic stress disorder. If women who experience preeclampsia are recognised as being at increased risk of poor mental health, targeted screening in the postpartum period should be implemented. Aims To describe the prevalence and symptom severity of depression, anxiety and posttraumatic stress disorder at six months postpartum in women, who had a diagnosis of preeclampsia, compared to those who had normal blood pressure in pregnancy. Methods The mental health component of the prospective cohort study, the Postpartum, Physiology, Psychology and Paediatric follow-up study (P4 Study) was used. Women diagnosed with preeclampsia (n = 90) and those who were normotensive during pregnancy (n = 302) completed the Edinburgh Postnatal Depression Scale, General Anxiety Disorder Scale, and the Posttraumatic Stress Diagnostic Scale or Posttraumatic Stress Diagnostic Sclae-5 at six months postpartum. Results At six months postpartum, depressive scores were similar in both groups but a higher proportion of women from the preeclampsia group scored above the threshold for depression (2% v 7% p = 0.04). There were no differences between the groups in the prevalence or severity of anxiety or PTSD. However, more women in the preeclampsia group reported their birth experience as a traumatic event (1% vs 7%, p = 0.01). On correlation testing and modelling, booking Edinburgh Postnatal Depression Scale score, any mental health history, experiencing birth as traumatic and the General Anxiety Disorder Scale score were independent predictors of postpartum Edinburgh Postnatal Depression Scale scores. Conclusion The postpartum clinical care of women with preeclampsia often focusses on the immediate physical health issues, but these women may also benefit from mental health screening. Targeted screening of preeclamptic women in the postpartum period may lead to more timely referral and initiation of treatment. Trial registration Retrospectively registered on 18/11/2013 with the Australian and New Zealand Clinical Trials Registry. Registration Number: ACTRN12613001260718.
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Thomson, Kimberly C., Helena Romaniuk, Christopher J. Greenwood, Primrose Letcher, Elizabeth Spry, Jacqui A. Macdonald, Helena M. McAnally, et al. "Adolescent antecedents of maternal and paternal perinatal depression: a 36-year prospective cohort." Psychological Medicine, April 28, 2020, 1–8. http://dx.doi.org/10.1017/s0033291720000902.
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Abstract Background Rates of common mental health problems (depression/anxiety) rise sharply in adolescence and peak in young adulthood, often coinciding with the transition to parenthood. Little is known regarding the persistence of common mental health problems from adolescence to the perinatal period in both mothers and fathers. Methods A total of 393 mothers (686 pregnancies) and 257 fathers (357 pregnancies) from the intergenerational Australian Temperament Project Generation 3 Study completed self-report assessments of depression and anxiety in adolescence (ages 13–14, 15–16, 17–18 years) and young adulthood (ages 19–20, 23–24, 27–28 years). The Edinburgh Postnatal Depression Scale was used to assess depressive symptoms at 32 weeks pregnancy and 12 months postpartum in mothers, and at 12 months postpartum in fathers. Results Most pregnancies (81%) in which mothers reported perinatal depression were preceded by a history of mental health problems in adolescence or young adulthood. Similarly, most pregnancies (83%) in which fathers reported postnatal depression were preceded by a preconception history of mental health problems. After adjustment for potential confounders, the odds of self-reporting perinatal depression in both women and men were consistently higher in those with a history of persistent mental health problems across adolescence and young adulthood than those without (ORwomen 5.7, 95% CI 2.9–10.9; ORmen 5.5, 95% CI 1.03–29.70). Conclusions Perinatal depression, for the majority of parents, is a continuation of mental health problems with onsets well before pregnancy. Strategies to promote good perinatal mental health should start before parenthood and include both men and women.
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Aran, Pavitra, Andrew J. Lewis, Stuart J. Watson, Thinh Nguyen, and Megan Galbally. "Emotional availability in women with bipolar disorder and major depression: A longitudinal pregnancy cohort study." Australian & New Zealand Journal of Psychiatry, March 16, 2021, 000486742199879. http://dx.doi.org/10.1177/0004867421998796.
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Objective: Poorer mother–infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother–infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and no disorder (control). Methods: Data were obtained for 127 mother–infant dyads from an Australian pregnancy cohort. The Structured Clinical Interview for the DSM-5 was used to diagnose major depressive disorder ( n = 60) and bipolar disorder ( n = 12) in early pregnancy (less than 20 weeks) and review diagnosis at 6 months postpartum. Prenatal and postnatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, along with self-report psychotropic medication use. Mother and infant’s interaction quality was measured using the Emotional Availability Scales when infants reached 6 months of age. Multivariate analyses of covariance examining the effects of major depressive disorder and bipolar disorder on maternal emotional availability (sensitivity, structuring, non-intrusiveness, non-hostility) and child emotional availability (responsiveness, involvement) were conducted. Results: After controlling for maternal age and postpartum depressive symptoms, perinatal disorder (major depressive disorder, bipolar disorder) accounted for 17% of the variance in maternal and child emotional availability combined. Compared to women with major depressive disorder and their infants, women with bipolar disorder and their infants displayed lower ratings across all maternal and child emotional availability qualities, with the greatest mean difference seen in non-intrusiveness scores. Conclusions: Findings suggest that perinatal bipolar disorder may be associated with additional risk, beyond major depressive disorder alone, to a mother and her offspring’s emotional availability at 6 months postpartum, particularly in maternal intrusiveness.
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Aldridge, Emily, K. Oliver Schubert, Maleesa Pathirana, Susan Sierp, Shalem Y. Leemaqz, Claire T. Roberts, Gustaaf A. Dekker, and Margaret A. Arstall. "A prospective registry analysis of psychosocial and metabolic health between women with and without metabolic syndrome after a complicated pregnancy." BMC Women's Health 22, no. 1 (November 21, 2022). http://dx.doi.org/10.1186/s12905-022-02035-y.
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Abstract Purpose Pregnancy complications affect over one quarter of Australian pregnancies, and this group of mothers is vulnerable and more likely to experience adverse cardiometabolic health outcomes in the postpartum period. Metabolic syndrome is common in this population and may be associated with postpartum mental health issues. However, this relationship remains poorly understood. To compare the differences in psychosocial parameters and mental health outcomes between women with metabolic syndrome and women without metabolic syndrome 6 months after a complicated pregnancy. Methods This study is prospective registry analysis of women attending a postpartum healthy lifestyle clinic 6 months following a complicated pregnancy. Mental health measures included 9-item Patient Health Questionnaire (PHQ-9), 7-item Generalised Anxiety Disorder questionnaire (GAD-7), self-reported diagnosed history of depression, anxiety and/or other psychiatric condition, and current psychotropic medication use. Results Women with metabolic syndrome reported significantly more subjective mental health concerns, were more likely to have a history of depression and other psychiatric diagnoses and were more likely prescribed psychotropic medications. However, there were no significant differences in PHQ-9 and GAD-7 scores. Conclusion Amongst new mothers who experienced complications of pregnancy, those with metabolic syndrome represent a particularly vulnerable group with regards to psychosocial disadvantage and mental health outcomes. These vulnerabilities may not be apparent when using common standardised cross-sectional mental health screening tools such as PHQ-9 and GAD-7.
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Yelland, Jane, Georgina Sutherland, and Stephanie J. Brown. "Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women." BMC Public Health 10, no. 1 (December 2010). http://dx.doi.org/10.1186/1471-2458-10-771.
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Spry, Elizabeth A., Margarita Moreno-Betancur, Melissa Middleton, Louise M. Howard, Stephanie J. Brown, Emma Molyneaux, Christopher J. Greenwood, et al. "Preventing postnatal depression: a causal mediation analysis of a 20-year preconception cohort." Philosophical Transactions of the Royal Society B: Biological Sciences 376, no. 1827 (May 3, 2021). http://dx.doi.org/10.1098/rstb.2020.0028.
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Postnatal depression (PND) is common and predicts a range of adverse maternal and offspring outcomes. PND rates are highest among women with persistent mental health problems before pregnancy, and antenatal healthcare provides ideal opportunity to intervene. We examined antenatal perceived social support as a potential intervention target in preventing PND symptoms among women with prior mental health problems. A total of 398 Australian women (600 pregnancies) were assessed repeatedly for mental health problems before pregnancy (ages 14–29 years, 1992–2006), and again during pregnancy, two months postpartum and one year postpartum (2006–2014). Causal mediation analysis found that intervention on perceived antenatal social support has the potential to reduce rates of PND symptoms by up to 3% (from 15 to 12%) in women with persistent preconception symptoms. Supplementary analyses found that the role of low antenatal social support was independent of concurrent antenatal depressive symptoms. Combined, these two factors mediated up to more than half of the association between preconception mental health problems and PND symptoms. Trialling dual interventions on antenatal depressive symptoms and perceived social support represents one promising strategy to prevent PND in women with persistent preconception symptoms. Interventions promoting mental health before pregnancy may yield an even greater reduction in PND symptoms by disrupting a developmental cascade of risks via these and other pathways. This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.
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Martín-Gómez, Carmen, Patricia Moreno-Peral, Juan A. Bellón, Sonia Conejo-Cerón, Henar Campos-Paino, Irene Gómez-Gómez, Alina Rigabert, Isabel Benítez, and Emma Motrico. "Effectiveness of psychological interventions in preventing postpartum depression in non-depressed women: a systematic review and meta-analysis of randomized controlled trials." Psychological Medicine, March 8, 2022, 1–13. http://dx.doi.org/10.1017/s0033291722000071.
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Abstract Postpartum depression (PPD) is one of the most common disorders following childbirth. This systematic review and meta-analysis (SR/MA) aimed to assess the effectiveness of psychological interventions in preventing PPD in non-depressed women. PRISMA guidelines were followed. MEDLINE (Ovid and PubMed), PsycINFO, Web of Science, Scopus, CINAHL, CENTRAL, OpenGrey, Australian New Zealand Clinical Trial Registry and clinicaltrial.gov were searched. Randomized controlled trials (RCTs) conducted with pregnant or postpartum (up to 12 months) women who were non-depressed at baseline were selected. The outcomes were the incidence of PPD and/or the reduction of postpartum depressive symptoms. The standardized mean difference (SMD) using random-effect models was calculated. Sensitivity, sub-group and meta-regression analyses were performed. 17 RCTs were included in the SR and 15 in the MA, representing 4958 participants from four continents. The pooled SMD was −0.175 [95% confidence interval (CI) −0.266 to −0.083; p < 0.001] and sensitivity analyses confirmed the robustness of this result. Heterogeneity was low (I2 = 21.20%) and was fully explained by a meta-regression model including one variable (previous deliveries). The meta-regression model and MA stratified by previous deliveries indicated that interventions focused on primiparous women are more effective. There was no evidence of publication bias. Few RCTs had an overall low risk of bias. According to GRADE, the quality of evidence was moderate. Psychological interventions have very little effectiveness in preventing PPD in non-depressed women, although this effectiveness is greater in interventions focused on primiparous women. Further RCTs with a low risk of bias and more effective interventions are needed.
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Quin, Nina, Liat Tikotzky, Lesley Stafford, Jane Fisher, and Bei Bei. "Preventing postpartum insomnia by targeting maternal versus infant sleep: a protocol for a randomized controlled trial (the Study for Mother-Infant Sleep “SMILE”)." SLEEP Advances 3, no. 1 (January 1, 2022). http://dx.doi.org/10.1093/sleepadvances/zpab020.
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Abstract Symptoms of insomnia are common during the perinatal periods and are linked to adverse parent/infant outcomes. Theories on insomnia development (e.g. 3P model) suggest that significant sleep disruption (e.g. nighttime infant care) can precipitate, while unhelpful sleep-related cognitions/behaviors can perpetuate parental insomnia symptoms. This study aims to examine how two interventions, one addressing infant sleep as the precipitator, the other targeting maternal sleep-related cognitions/behaviors as the perpetuator, might prevent postpartum insomnia. Participants are 114 nulliparous females 26 to 32 weeks gestation, with self-reported insomnia symptoms (Insomnia Severity Index scores ≥ 8). Participants are randomized to one of three conditions and receive: (1) a “responsive bassinet” used until 6 months postpartum, designed to boost/consolidate infant sleep and target infant sleep as a precipitator of insomnia, (2) therapist-assisted cognitive behavioral therapy for insomnia, addressing unhelpful sleep-related cognitions/behaviors as perpetuators of insomnia, or (3) a sleep hygiene booklet (control condition). The primary outcome is maternal insomnia symptoms. Secondary outcomes include maternal sleep duration/quality, mental health (e.g. depression, anxiety), and wellbeing-related variables (e.g. sleep-related impairment). Outcomes are assessed using validated instruments at 26–32 and 35–36 weeks’ gestation, and 2, 6, and 12 months postpartum. This study adopts an early-intervention approach and longitudinally compares two distinct approaches to prevent postpartum insomnia in an at-risk population. If interventions are efficacious, findings will demonstrate how interventions targeting different mechanisms mitigate insomnia symptoms in perinatal populations. This will provide empirical evidence for future development of multi-component sleep intervention to improve mother-infant wellbeing. Clinical Trial Registration: The Study for Mother-Infant Sleep (The SMILE Project): reducing postpartum insomnia using an infant sleep intervention and a maternal sleep intervention in first-time mothers. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377927, Australian New Zealand Clinical Trials Registry: ACTRN12619001166167.
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Bryson, Hannah, Susan Perlen, Anna Price, Fiona Mensah, Lisa Gold, Penelope Dakin, and Sharon Goldfeld. "Patterns of maternal depression, anxiety, and stress symptoms from pregnancy to 5 years postpartum in an Australian cohort experiencing adversity." Archives of Women's Mental Health, May 25, 2021. http://dx.doi.org/10.1007/s00737-021-01145-0.
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Quin, Nina, Jin Joo Lee, Donna M. Pinnington, Louise Newman, Rachel Manber, and Bei Bei. "Differentiating perinatal Insomnia Disorder and sleep disruption: a longitudinal study from pregnancy to 2 years postpartum." Sleep 45, no. 2 (January 5, 2022). http://dx.doi.org/10.1093/sleep/zsab293.
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Abstract Study Objectives Insomnia Disorder diagnoses require persistent sleep complaints despite “adequate sleep opportunity.” Significant Perinatal Sleep Disruption makes this diagnosis challenging. This longitudinal study distinguished between Insomnia Disorder and Perinatal Sleep Disruption and their sleep and mental health correlates. Methods One hundred sixty-three nulliparous females (age M ± SD = 33.35 ± 3.42) participating in a randomized controlled trial repeated the Insomnia Disorder module of the Duke Structured Interview for Sleep Disorders and Patient-Reported Outcome Measurement Information System measures for sleep and mental health at 30- and 35-weeks’ gestation, and 1.5, 3, 6, 12, and 24 months postpartum (944 interviews, 1009 questionnaires completed). We compared clinical features when Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Insomnia Disorder criteria (without the Duration criterion) were: (1) met (Insomnia Disorder), (2) not met only because of the sleep opportunity criteria (Perinatal Sleep Disruption), and (3) not met due to other criteria (Low Complaint). Results Proportions of Insomnia Disorder were 16.0% and 19.8% during early and late third trimester, and ranged 5.3%–11.7% postpartum. If the sleep opportunity criteria were not considered, rates of Insomnia would be 2–4 times higher (21.4%–40.4%) across time-points. Mixed-effects models adjusting for covariates showed that compared to Low Complaint, both Insomnia Disorder and Perinatal Sleep Disruption scored significantly higher on insomnia and sleep disturbance scales, sleep effort, and sleep-related impairments (p values < .01), but depression and anxiety were comparable (p values > .12). Conclusion Assessing sleep complaints without considering sleep opportunities can result in over-diagnosis of Insomnia Disorder in the perinatal periods. Insomnia Disorder and Perinatal Sleep Disruption were both associated with adverse sleep and mood outcomes, and need to be carefully differentiated and appropriately addressed. Clinical Trial Registration: The SEED Project (Sleep, Eat, Emotions, and Development): A randomized controlled pilot study of a perinatal sleep intervention on sleep and wellbeing in mothers and infants. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371634, Australian New Zealand Clinical Trials Registry: ACTRN12616001462471.
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"HIGHLIGHTS IN THIS ISSUE." Psychological Medicine 32, no. 6 (August 2002): 953. http://dx.doi.org/10.1017/s003329170200613x.
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The editorial in this issue reviews the orexins/hypocretins, a recently recognized group of neuropeptides, involved in sleep, arousal, narcolepsy and possibly other disorders.Two articles concern epidemiology. Kessler and colleagues (pp. 959–976) report large scale development and validation of 10-item and 6-item versions of a scale with impressive performance in screening for DSM-IV psychiatric disorder in US and Australian general populations. Sacker & Wiggins (pp. 977–990) use two longitudinal cohort studies to examine gender and social class differences in psychological distress. Both narrowed over two decades with the higher rates in women and those in manual occupations falling, to become nearer males and non-manual occupations. Disadvantage is apparently lessening.In another study of gender and disorder Fergusson and colleagues in New Zealand (pp. 991–996) find that the greater exposure of females to sexual violence explains some, but not all of their greater liability to internalizing disorders. In other aetiological studies, Enns et al. (pp. 997–1008) find associations of community disorder with lack of care on the Parental Bonding Instrument, while Reichborn-Kjennerud et al. (pp. 1009–1020) in a Norwegian twin sample find genetic links between back-neck pain and anxiety and depressive symptoms.Four studies concern depression. In an important neuroendocrine study of chronic depression Watson et al. (pp. 1021–1028) find absence of the usual depressive HPA axis abnormalities, strongly suggesting that these normalize with time. Matsuo et al. (pp. 1029–1038) employ the little-used non-invasive technique of near infrared spectroscopy, to show a reduction in euthymic affective disorder patients compared with controls in the increase of oxyHb in the frontal region during a verbal fluency task and during hyperventilation, indicating persisting or antecedent abnormalities. In a controlled trial Chabrol et al. (pp. 1039–1047) find a brief cognitive-behavioural intervention reduces depression scores in postpartum mothers at risk for post-natal depression. Fava et al. (pp. 1049–1057) find personality disorder diagnoses to decline in frequency after treatment for depression, suggesting that depression contributes to and antidepressant ameliorates the behaviours and attitudes which comprise the personality disorders.Two studies interface with psychoimmunology. In an important prospective study over up to 9 years, Leserman et al. (pp. 1059–1073) find progression of HIV accelerated by stressful life events, dysphoric mood and raised cortisol. Arnold et al. (pp. 1075–1089) report effects of inducing influenza-like symptoms in patients with chronic fatigue syndrome compared with normal controls. While somatic symptoms of CFS were exacerbated, cognitive and mood symptoms were not.Three papers report findings in schizophrenia. Hooley & Campbell (pp. 1091–1099) find high expressed emotion relatives attribute more control to ill family members than do low EE relatives, but are actually themselves more controlling. Their high control predicts relapse in schizophrenia but not depression. Gooding & Tallent (pp. 1101–1107) find that schizophrenics show atypical perceptual biases in response to emotional chimeric faces. Malla et al. (pp. 1109–1119) report predictors of outcome at 1 year of first-episode psychosis, including some potential modifiable factors such as medication adherence and residual symptoms.