Objective: To investigate the depression status of pregnant and perinatal women in early, medium-term, late pregnancy and postpartum period in China and the outcomes of depression in each period, analyze the influential factors of depression status. Methods: By using the pregnant and perinatal women mental health cohort established by National Center for Women and Children's Health of Chinese Center for Disease Control and Prevention, Haidian District Maternal and Child Health Hospital of Beijing, Women Health Center of Shanxi, Jilin Women and Children Health Hospital, Zhuhai Center for Maternal and Child Health Care and Shenzhen Maternity and Child Healthcare Hospital of Guangdong province, a follow up study was conducted at 7 time points during pregnancy and perinatal period in pregnant and perinatal women in Beijing, Shanxi, Jilin and Guangdong from August 1, 2015 to October 31, 2016. The self-filled questionnaire and Edinburgh Postpartum Depression Scale (EPDS) were used to obtain the general demographic information and depression status of the pregnant and perinatal women, and the depression status and natural outcomes of the pregnant and perinatal women were analyzed. Results: A total of 1 284 pregnant and perinatal women were recruited. In this study, a total of 1 210 subjects who completed follow-up at least 6 times and postpartum 42 day follow up were included in the final analysis. The EPDS depression score at the gestation week 13 was used to indicate the depression status in early pregnancy, the average EPDS score of gestation week 17 and 24 were used to indicate the depression status in medium-term pregnancy, and the average EPDS score of gestation week 31 and 37 were used to indicate depression in late pregnancy. The average EPDS score of postpartum day 3 and 42 were used to indicate postpartum depression status. A total of 321 (26.5%), 218 (18.0%), 189 (15.6%) and 219 (18.1%) pregnant and perinatal women were found to have depression, respectively, in early, medium-term and late pregnancy and in postpartum period. The depression status in early, medium-term and late pregnancy and postpartum period were positively correlated (P<0.001), the correlation between early and middle pregnancy was strong (r=0.678), the correlation between medium-term and late pregnancy was strong (r=0.771), and the correlation between postpartum period and late pregnancy was strong (r=0.706). Among the pregnant women with depression in early pregnancy, 26.2% were depressed during the whole study period, 42.7% were depressed during postpartum period, and the results of multifactorial analysis showed that the education level of college or above of the pregnant and perinatal women (OR=0.437, 95%CI: 0.212-0.900, P=0.025), exercise during pregnancy (OR=0.586, 95%CI: 0.348-0.987, P = 0.044), high marital satisfaction (OR = 0.370, 95%CI: 0.221-0.620, P<0.001), normal body mass index (BMI) (OR=0.516, 95%CI: 0.270-0.985, P=0.045) reduced the risk for depression. Unsatisfactory living environment (OR=1.807, 95%CI: 1.074-3.040, P=0.026) increased the risk for depression. Conclusions: In pregnant and perinatal women in China, the detection rate of depression in early pregnancy was highest compared with those in medium-term and late pregnancy. The detection rate of depression increased again in postpartum period. The depression status detected in the early pregnancy remained in the medium-term and late pregnancy and postpartum period. Exercise, BMI, educational level, living environment satisfaction and marital satisfaction can affect the incidence of depression in pregnant and perinatal women.
Child ; Depression/epidemiology* ; Depression, Postpartum/epidemiology* ; Female ; Follow-Up Studies ; Humans ; Postpartum Period ; Pregnancy ; Psychiatric Status Rating Scales

OBJECTIVETo investigate the prevalence and risk factors of postpartum depression (PPD) in Tianhe district of Guangzhou.

METHODSA total of 1428 postpartum women in 3 hospitals in Tianhe District of Guangzhou were screened with Edinburg Postnatal Depression Scale (EPDS), Social Support Rating Scale (SSRS) and a self-designed questionnaire of PPD-related factors during the period from May to September, 2013.

RESULTSThe prevalence of PPD was 20.03% in these women. Unconditional logistic regression analysis showed a significant correlation of PPD with education, delivery mode, only daughter, relationship between mother-in-law and daughter-in-law, newborn gender satisfaction and housing condition (P<0.05). Multivariate logistic regression analysis identified education, delivery mode, only daughter, relationship between mother-in-law and daughter-in-law, and newborn gender satisfaction as the risk factors for PPD, and housing condition was negatively correlated with the incidence of PPD with an OR value of 0.900. Compared with healthy postpartum women, the patients with PPD exhibited significantly reduced total score of social support rating scale, score of objective support, score of subjective support, and social utilization degree.

CONCLUSIONThe prevalence of PPD is high in Tianhe District of Guangzhou, and health education and psychosocial intervention should be offered to prevent PPD.

Adult ; China ; epidemiology ; Depression, Postpartum ; epidemiology ; Female ; Humans ; Incidence ; Postpartum Period ; psychology ; Prevalence ; Risk Factors ; Young Adult

To estimate the national prevalence of paternal postpartum depression in China and evaluate its association with maternal postpartum depression.
 Methods: Systematic literature searches were conducted in databases including PubMed, Web of Science, Embase, Medline, China National Knowledge Infrastructure (CNKI), Wangfang Database, Chinese science & technology journal database (VIP) and SinoMed database. The articles reported the prevalence of paternal postpartum depression in China were collected from inception to October 1, 2015. Random effect models were used to calculate pooled estimates and 95% confidence intervals. Subgroup analysis were undertaken by period of measurement, case identification, study location and study quality.
 Results: Fourteen studies with a total sample size of 3 819 partners were included in this study. The pooled estimate of paternal postpartum depression was 13.6% (95% CI 8.7%-21.3%). The Pearson correlation coefficien between maternal PPD and paternal PPD was 0.295 (95% CI 0.218-0.367). The subgroup analysis showed that the estimates of paternal PPD in 0-5+6 weeks postpartum, 6-8 weeks postpartum and 8+1-24 weeks postpartum were 28.7%, 11.4% and 5.5%, respectively; when the rating scale was used as case identification method, the estimate of paternal PPD was 16.8%, and it was 4.1% when interview was used. The estimate of paternal PPD in inner areas was 22.2%, in coastal areas was 13.3% and in Hongkong/Taiwan was 7.8%. In studies with lower quality, the estimate of paternal PPD was 23.0%, and it was 9.1% in studies with higher quality.
 Conclusion: The national prevalence of paternal postpartum depression in China was at a high level, particularly during the postpartum 0-5+6 weeks. Paternal postpartum depression also showed a moderate positive correlation with maternal postpartum depression.
Asian Continental Ancestry Group ; China ; epidemiology ; Depression, Postpartum ; epidemiology ; Fathers ; psychology ; Female ; Humans ; Male ; Mothers ; psychology ; Postpartum Period ; Prevalence

OBJECTIVES: To explore the application of random forest algorithm in screening the risk factors and predictive values for postpartum depression. METHODS: We recruited the participants from a tertiary hospital between June 2017 and June 2018 in Changsha City, and followed up from pregnancy up to 4-6 weeks postpartum.Demographic economics, psychosocial, biological, obstetric, and other factors were assessed at first trimesters with self-designed obstetric information questionnaire and the Chinese version of Edinburgh Postnatal Depression Scale (EPDS). During 4-6 weeks after delivery, the Chinese version of EPDS was used to score depression and self-designed questionnaire to collect data of delivery and postpartum. The data of subjects were randomly divided into the training data set and the verification data set according to the ratio of 3꞉1. The training data set was used to establish the random forest model of postpartum depression, and the verification data set was used to verify the predictive effects via the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and AUC index. RESULTS: A total of 406 participants were in final analysis. Among them, 150 of whom had EPDS score ≥9, and the incidence of postpartum depression was 36.9%. The predictive effects of random forest model in the verification data set were at accuracy of 80.10%, sensitivity of 61.40%, specificity of 89.10%, positive predictive value of 73.00%, negative predictive value of 82.80%, and AUC index of 0.833. The top 10 predictive influential factors that screening by the variable importance measure in random forest model was antenatal depression, economic worries after delivery, work worries after delivery, free triiodothyronine in first trimesters, high-density lipoprotein in third trimester, venting temper to infants, total serum cholesterol and serum triglyceride in first trimester, hematocrit and serum triglyceride in third trimester. CONCLUSIONS Random forest has a great advantage in risk prediction for postpartum depression. Through comprehensive evaluation mechanism, it can identify the important influential factors for postpartum depression from complex multi-factors and conduct quantitative analysis, which is of great significance to identify the key factors for postpartum depression and carry out timely and effective intervention.
Depression, Postpartum/epidemiology* ; Female ; Humans ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Third ; Psychiatric Status Rating Scales ; Risk Factors ; Sensitivity and Specificity

OBJECTIVEThis study aimed to investigate the depression status among high-risk pregnancy women, and to analyze its relevant social and psychological factors.

METHODSA total of 42 high-risk pregnancy women and 40 normal pregnancy women in a teaching hospital in Harbin city were followed up at time points of 32 - 36 weeks pregnancy, one week before labor, one week postpartum, and six weeks postpartum, respectively. During follow-up, the basic situation, social psychosocial factors of pregnancy women were collected and the depression of pregnancy women was measured by self-designed questionnaire and self-rating depression scale. The Edinburgh Postnatal Depression Scale (EPDS) was applied at timepoint of one week postpartum. Single factor analysis and the unconditional multivariate logistic regression were applied for analyzing the on the related social-psychosocial factors among high-risk pregnancy women.

RESULTSThe age of high-risk pregnancy women was (31.0±5.6), and the age of normal pregnancy women was (30.5±3.8) (t=0.169, P>0.05). The results showed that the depression rate in high-risk pregnancy women was 45.2% (19/42), which was 25.0% (10/40) in normal pregnancy women, the difference was significant (χ2=3.671, P=0.045). The depression rates at different time points were 30.9% (13/42), 42.9% (18/42), 23.8% (10/42), 26.2% (11/42) in high-risk pregnancy women respectively, and 25.0% (10/40), 15.0% (6/40), 20.0% (8/40), 17.5% (7/40) in the control group respectively, the difference of the depression rates among groups at one week before labor was significant (χ2=7.680, P<0.01), the difference among groups at 32-36 weeks pregnancy (χ2=0.133, P=0.80), at one week postpartum (χ2=0.174, P=0.79) and at six weeks postpartum (χ2=0.903, P=0.43) were not significant. At one week postpartum and six weeks postpartum periods, the EPDS depression rate were 12.5% (4/32), 30.4% (7/23) in case group respectively, 8.3% (3/36), 22.9% (8/35) in control group respectively, the difference were not significant (χ2=0.319, 0.416, P=0.573, 0.519). There were significantly associations between the depression mood of one week before labor and the depressive symptoms of six weeks postpartum in both groups (r=0.824, 0.677, both P values were <0.05). The risk factors for maternal depression among high-risk pregnancy women were not ready for production (OR=2.73, P<0.01) and fearing of childbirth safety (OR=2.89, P<0.01).

CONCLUSIONThe depression date of high-risk pregnancy was high, especially at the time point one week before labor. Risk factors of maternal depression among high-risk pregnancy were "not ready for production" and "fear of childbirth safety".

Adult ; China ; epidemiology ; Cohort Studies ; Depression ; epidemiology ; psychology ; Depression, Postpartum ; epidemiology ; psychology ; Female ; Humans ; Logistic Models ; Postpartum Period ; psychology ; Pregnancy ; Pregnancy Complications ; epidemiology ; psychology ; Pregnancy, High-Risk ; psychology ; Risk Factors

PURPOSE: Prenatal depression is a significant predictor for postpartum depression. However, there is a lack of research on risk factors for Korean women related to prenatal depression and the relationship between prenatal depression during the three trimesters and postpartum depression. Therefore, aims of this study were (1) to identify the prevalence of depression during all three trimesters and the postpartum period, (2) to evaluate the relationship between prenatal depression in each trimester and postpartum depression, and (3) to identify the relationship and differences in prenatal depression based on sociodemographic factors in Korean women. METHODS: One hundred and fifty three Korean women were recruited from three maternity clinics in Korea. Prenatal and postpartum depressions were evaluated in the first, second (24-26 weeks), third (32-34 weeks) trimester and 4 weeks postpartum with the Edinburgh Postnatal Depression Scalee-Korean. RESULTS: The prevalence of depression in the prenatal and postpartum period ranged from 40.5% to 61.4%. Depression in the second and the third trimester was significantly correlated with depression in the postpartum period. Unemployment and household income were risk factors for prenatal depression in the first and second trimesters. CONCLUSIONS: To assist women suffering from postpartum depression and prevent its effects, women should be screened for prenatal depression during all three trimesters. For Korean women with high risk factors for prenatal depression, we suggest that the Korean government establish healthcare policies related to depression screening as routine prenatal care and mental health referral systems.
Adult ; Depression/*epidemiology ; Depression, Postpartum/*epidemiology ; Female ; Humans ; Longitudinal Studies ; Postpartum Period/*psychology ; Pregnancy ; Pregnancy Trimesters/*psychology ; Prenatal Care ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Socioeconomic Factors ; Young Adult

The prevalence of postnatal depression (PND) was reported to be 6.8% in an obstetric setting in Singapore. Since primary care physicians are the healthcare clinicians most likely to interact with postnatal mothers in Singapore, they are in the best position to screen for PND and help new mothers. PND affects the well-being of the mother, her baby and those around her. If left untreated, depression can result in lasting adverse outcomes such as unfavourable parenting practices, impaired mother-infant bonding, impaired intellectual and emotional development of the infant, maternal suicide, and even infanticide. The Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire-2 are effective screening tools that can be easily used in primary care settings for screening at-risk mothers. Herein, we discuss the management options available in primary care settings, as well as share some local resources available to mothers and the benefits of timely intervention.
Depression, Postpartum ; diagnosis ; epidemiology ; psychology ; Family Practice ; Female ; Global Health ; Humans ; Incidence ; Mothers ; psychology ; Physician's Role ; Prevalence ; Psychometrics ; methods

To explore the correlation between kynurenine (KYN) metabolites and postpartum depression (PPD), and to provide new possible explanation for the pathogenesis of postpartum depression (PPD).
 Methods: A total of 726 Chinese women, who received cesarean section, were enrolled in this study. PPD was diagnosed with an Edinburgh Postnatal Depression Scale (EPDS) score ≥13. Twenty-four women with PPD and 48 matched women without PPD were randomly selected. The perinatal serum concentrations of KYN, quinolinic acid (QUIN) and kynurenic acid (KYNA) were measured. Subsequently, the puerperants were compared for the differences in the serum concentrations of KYN, QUIN and KYNA at the end of term, day 1 and day 3 after cesarean section, respectively.
 Results: The incidence of PPD was 7.99%. Of clinical characteristics, pressure during pregnancy was significantly different between subjects with or without PPD (P<0.01). Patients with PPD showed significantly increased serum KYN concentration (P<0.05) at the end of term, increased serum QUIN concentration (P<0.05) and decreased KYNA concentration (P<0.05) on the third day after cesarean section as compared with the control women. Furthermore, the KYNA/QUIN ratio was significantly higher in patients with PPD as compared to the control women on the third day after cesarean section (P<0.01).
 Conclusion: The contribution of alterations in plasma levels of KYN, QUIN and KYNA is closely related with the incidence of PPD, and correction of KYNA/QUIN ratio could be a new strategy for the prevention and treatment of postpartum depressive symptoms.
Biomarkers ; blood ; Cesarean Section ; psychology ; China ; epidemiology ; Depression, Postpartum ; blood ; epidemiology ; Female ; Humans ; Incidence ; Kynurenic Acid ; blood ; Kynurenine ; blood ; Pregnancy ; Quinolinic Acid ; blood

OBJECTIVE: To explore the incidence of postpartal depression in the south and north and to comprehensively analyze the changes of sex hormone and neurotransmitter,and their relationship with postpartum depression. METHODS: All published articles on case-control studies on the changes of sex hormone and neurotransmitter,and their relationship with postpartum depression were collected by literature retrieval based on the selection criteria. Meta-analysis was applied to evaluate the data in published papers from 1994 to 2004 in China. RESULTS: The incidence of postpartal depression in the south was 15.63%. The combined P-valve was 0.0874, and 95% CI was 0.14 to 0.17. The incidence of postpartum depression in the north was 7.66%. The combined P-valve was 0.0252, and 95% CI was 0.05 to 0.08. There was significant difference between the incidence of postpartum depression in the south and north (P<0.01). Estrogen and 5-HT in the plasma of the 1st week after childbirth was obviously lower than the controls. Estrogen in the plasma of the 1st week after childbirth and the 6th week after childbirth decreased more quickly than the controls. Progesterone and orphanin FQ in the plasma of the 1st week after childbirth were higher than the controls. CONCLUSION The incidence of postpartum depression in the south is higher than that of the north. Postpartum depression is related to the decrease in the plasma estrogen, 5-HT, dopamine, and noradrenaline, and to the increase in the plasma progesterone and Orphanin FQ.
Adult ; Case-Control Studies ; China ; epidemiology ; Depression, Postpartum ; blood ; epidemiology ; Estrogens ; blood ; Female ; Humans ; Incidence ; Neurotransmitter Agents ; blood ; Progesterone ; blood ; Serotonin ; blood