PREDICTORS OF POSTPARTUM DEPRESSION IN PATIENTS AT SHEIKH ZAYED HOSPITAL
Main Article Content
Keywords
Postpartum Depression, Socioeconomic, Occupational, Educational, Marital Status
Abstract
Introduction: Postpartum depression (PPD) is a common psychiatric disorder. It is usually manifested during the first 90 days of the delivery and several various predictors are associated with it including marital status, occupational status, educational status socioeconomic status, etc.
Objective: To determine the associations of various factors with postpartum depression.
Materials and Methods: This study was designed as a case-control investigation conducted in the Department of Gynecology at Sheikh Zayed Hospital in Rahim Yar Khan. The study spanned from December 9, 2019, to June 9, 2020, allowing for a comprehensive assessment of the selected cases and controls. A non-probability consecutive sampling technique was employed to recruit participants, ensuring that cases were identified and matched with appropriate controls based on specific criteria relevant to the research objectives
Methodology: In this study the cases of age 20-40 years with singleton pregnancy delivered at the Department of Gynecology & Obstetrics, SZH, RYK were included. The females with postpartum depression were labeled as cases and those with no postpartum depression (healthy females) as controls. Then these cases and controls were assessed to look for educational status (university/ illiterate), socioeconomic status (good/poor), occupational status (employed/ housewife), and marital status (married/ divorced) and looked for their association with postpartum
depression.
Results: In this study, there were a total of 60 cases (30 in each group). The mean age of the subjects in cases was 28.20±3.89 and in controls was 28.57+4.13 years. There were 18 (51.43%) vs 17 (48.57%) illiterate in cases and controls and a similar number having poor socioeconomic status in both groups. There was no significant association between postpartum depression (PPD) and educational status with an odd ratio of 1.14 (95% CI, 0.41-3.20) with p= 0.79. There was no significant association between PPD and socioeconomic status with an odd ratio of 1.14 (95% CI, 0.41-3.20) with p= 0.79. Similarly, no significant association was seen with marital status with an odd ratio of 0.82 (95% CI, 0.23-2.81) with p= 0.75. The occupational status also didn't reveal a significant association with PPD with an odd ratio of 1.14 (95% CI, 0.41-3.14) with p=0.79.
Conclusion: Postpartum depression is common in illiterate, those having poor socioeconomic status, di forced and employed women but this didn't show any significant association with any variable of the study or any particular confounder of the study.
References
2. Stein A, Pearson RM, Goodman SH, et al. Effects of perinatal mental disorders on the fetus and child. Lancet 2014; 384:1800.
3. Howard LM, Piot P, Stein A. No health without perinatal mental health. Lancet 2014; 384:1723.
4. Grigoriadis S, VonderPorten EH, Mamisashvili L, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 2013; 74
5. Committee on Obstetric Practice. The American College of Obstetricians and Gynecologists Committee Opinion no. 630. Screening for perinatal depression. Obstet Gynecol 2015; 125:1268.
6. Austin MP, Marcé Society Position Statement Advisory Committee. Marcé International Society position statement on psychosocial assessment and depression screening in perinatal women. Best Pract Res Clin Obstet Gynaecol 2014; 28:179.
7. Wisner KL, Moses-Kolko EL, Sit DK. Postpartum depression: a disorder in search of a definition. Arch Womens Ment Health 2010; 13:37.
8. O'Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol 2013; 9:379.
9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2 013.
10. World Health Organization. International Classification of Diseases (ICD). ICD-10 online version: 2016. Accessed from on February 10, 2016.
11. Munk-Olsen T, Laursen TM, Pedersen CB, et al. New parents and mental disorders: a population-based register study. JAMA 2006; 296:2582.
12. Viguera AC, Tondo L, Koukopoulos AE, et al. Episodes of mood disorders in 2,252 pregnancies and postpartum periods. Am J Psychiatry 2011; 168:1179.
13. Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. Heterogeneity of postpartum depression: a latent class analysis. Lancet Psychiatry 2015; 2:59.
14. Norhayati MN, Hazlina NH, Asrenee AR, Emilin WM. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord 2015; 175:34.
15. O'Hara MW, Wisner KL. Perinatal mental illness: definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol 2014; 28:3.
16. Vesga-López O, Blanco C, Keyes K, et al. Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry 2008; 65:805.
17. Gaillard A, Le Straty Y, Mandelbrot L, et al. Predictors of postpartum depression: prospective study of 264 women followed during pregnancy and postpartum. Psychiatry Res 2014; 215:341.
18. Banti S, Mauri M, Oppo A, et al. From the third month of pregnancy to 1 year postpartum: Prevalence, incidence, recurrence, and new onset of depression. Results from the perinatal depression-research & screening unit study. Compr Psychiatry 2011; 52:343.
19. Payne JL, Palmer JT, Joffe H. A reproductive subtype of depression: conceptualizing models and moving toward etiology. Harv Rev Psychiatry 2009; 17:72.
20. Couto TC, Brancaglion MY, Alvim-Soares A, et al. Postpartum depression: A systematic review of the genetics involved. World J Psychiatry 2015; 5:103.
21. Figueiredo FP, Parada AP, de Araujo LF, et al. The Influence of genetic factors on peripartum depression: A systematic review. J Affect Disord 2015; 172:265.
22. Bell AF, Carter CS, Steer CD, et al. Interaction between oxytocin receptor DNA
23. methylation and genotype is associated with risk of postpartum depression in women without depression in pregnancy. Front Genet 2015; 6:243.
24. Guintivano J, Arad M, Gould TD, et al. Antenatal prediction of postpartum
25. depression with blood DNA methylation biomarkers. Mol Psychiatry 2014;19:560.
26. Meltzer-Brody S. New insights into perinatal depression: pathogenesis and treatment during pregnancy and postpartum. Dialogues Clin Neurosci 2011; 13:89.
27. Viktorin A, Meltzer-Brody S, Kuja-Halkola R, et al. Heritability of Perinatal Depression and Genetic Overlap With Nonperinatal Depression. Am J Psychiatry 2016; 173:158.
28. Forty L, Jones L, Macgregor S, et al. Familiality of postpartum depression in unipolar disorder: results of a family study. Am J Psychiatry 2006; 163:1549.
29. Maurer-Spurej E, Pittendreigh C, Misri S. Platelet serotonin levels support depression scores for women with postpartum depression. J Psychiatry Neurosci 2007; 32:23.
30. Gao X, Wang J, Yao H, et al. Serum BDNF concentration after delivery is associated with development of postpartum depression: A 3-month follow up study.J Affect Disord 2016; 200:25.
31. Kim DR, Epperson CN, Weiss AR, Wisner KL. Pharmacotherapy of postpartum depression: an update. Expert Opin Pharmacother 2014; 15:1223.
32. Wisner KL, Sit DK, McShea MC, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry 2013; 70:490.
33. Zimmerman M, McGlinchey JB, Chelminski I, Young D. Diagnostic co-morbidity in 2300 psychiatric out-patients presenting for treatment evaluated with a semi-structured diagnostic interview. Psychol Med 2008; 38:199.
34. Vliegen N, Casalin S, Luyten P. The course of postpartum depression: a review of longitudinal studies. Harv Rev Psychiatry 2014; 22:1
35. Baker B, Orton E, Kendrick D, Tata LJ. Maternal depression in the 5 years after childbirth among women with and without perinatal depression: a population-based cohort study. Lancet 2015; 386:522.
36. Cuijpers P, Brännmark JG, van Straten A. Psychological treatment of postpartum depression: a meta-analysis. J Clin Psychol 2008; 64:103.
37. Ngai FW, Wong PW, Leung KY, et al. The Effect of Telephone-Based Cognitive-Behavioral Therapy on Postnatal Depression: A Randomized Controlled Trial. Psychother Psychosom 2015; 84:294.
38. Stephens S, Ford E, Paudyal P, Smith H. Effectiveness of Psychological Interventions for Postnatal Depression in Primary Care: A Meta-Analysis. Ann Fam Med 2016; 14:463.
39. Dennis CL, Hodnett E. Psychosocial and psychological interventions for treating postpartum depression. Cochrane Database Syst Rev 2007: CD006116.
40. Alhusen, J. L., Ray, E., Sharps, P., & Bullock, L. (2021). Intimate partner violence during pregnancy: Maternal and neonatal outcomes. Journal of Women's Health , 30 (4), 497-503. https://doi.org/10.1089/jwh.2020.8744
41. Borra, C., Iacovou, M., & Sevilla, A. (2021). Maternal depression and children's cognitive and non-cognitive development: Evidence from a UK cohort. Social Science & Medicine , 279 , 113939. https://doi.org/10.1016/j.socscimed.2021.113939
42. Dagher, R. K., Linares, D. E., & Shelton, R. C. (2021). Employment status and depression in postpartum women: A longitudinal analysis of the National Survey of Family Growth. American Journal of Public Health , 111 (2), 268-274. https://doi.org/10.2105/AJPH.2020.306060
43. Fiala, A., Švancara, J., Sieberová, M., & Böhm, T. (2020). Predictors of postpartum depression: An epidemiological study from the Czech Republic. Journal of Affective Disorders , 274 , 955-962. https://doi.org/10.1016/j.jad.2020.05.121
44. Ganann, R., Sword, W., Newbold, K. B., Thabane, L., & South Asian Women’s Mental Health Study Group. (2021). Mental health of South Asian women during pregnancy and postpartum: A scoping review. BMC Public Health , 21 (1), 1-19. https://doi.org/10.1186/s12889-020-10045-6
45. Giallo, R., Woolhouse, H., Gartland, D., & Brown, S. (2020). The emotional-behavioral functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: A prospective cohort study. Journal of Affective Disorders, 265, 526-533. https://doi.org/10.1016/j.jad.2020.01.127
46. Patel, S., Wisner, K. L., & Smith, T. (2021). Socioeconomic disparities in postpartum depression. Current Psychiatry Reports, 23 (7), 1-9. https://doi.org/10.1007/s11920-021-01267-3
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Habiba Kousar
Department of Obstetrics and Gynaecology Unit 1 Sheikh Zayed Medical College, Rahim Yar Khan
Amna Saeed
Department of Obstetrics and Gynaecology Unit 1 Sheikh Zayed Medical College, Rahim Yar Khan
Ayesha Munwar
Department of Obstetrics and Gynaecology Unit 1 Sheikh Zayed Medical College, Rahim Yar Khan
Noreen Nasim
Department of Obstetrics and Gynaecology Unit 1 Sheikh Zayed Medical College, Rahim Yar Khan
Khadija Saeed
Senior Registrar Fazaia Ruth Pfau Medical College (FRPMC) PAF Faisal Hospital, Karachi
Nadia Zaman
Department of Obstetrics and Gynaecology Unit 1 Sheikh Zayed Medical College, Rahim Yar Khan