Postpartum depression is a condition that is commonly experienced by postpartum women after childbirth. Determination and detection of factors influencing postpartum depression will help mothers explore evidence-based strategies for early prevention and treatment. A quantitative descriptive survey design was utilized in the study. Data was collected through stratified random sampling. The childbearing mothers in four selected communities of Bontoc, Mountain Province: upland, riverside, AlBaGo, and central Bontoc were the respondents of the study. Data gathered utilized a self-made questionnaire based on journals and research studies about postpartum depression. Results of the study showed that the respondents considered the impact on the extent of factors causing postpartum depression among child bearing mothers. There is a significant difference on the extent of factors influencing postpartum depression among child bearing mothers when grouped according to civil status but no significant difference when grouped according to age, educational attainment and employment status. The respondents ranked the suggested measures to prevent postpartum depression as: 1) psychological, 2) physical and;3) social. Promoting the mental health and well-being of mothers and families through implementation of an evidence-based strategy in the Municipal and Provincial health units can prevent or reduced Postpartum depression. Early interventions on postpartum depression promoted maternal recovery and strong foundations for postpartum mothers. This includes educating mothers, planning health education programs, focusing on early detection, and distributing behavioral change communications through flyers, brochures, and training materials.

BACKGROUND

Postpartum depression (PPD) is the most common perinatal psychiatric disorder and women are at greatest risk of developing this during their first postpartum year. Extraneous factors and events indirectly related to maternity like the quarantine measures imposed during the COVID-19 pandemic can add to the already burdensome mental effects of pregnancy.

The aim of the study is to determine the prevalence of and possible risk factors for PPD during the COVID-19 pandemic using the Edinburgh Postnatal Depression Scale in Filipino (EPDS-F) in a tertiary government hospital.

This is a cross-sectional study involving patients 18 years of age and above who delivered vaginally or through cesarean section to a live or dead fetus more than 20 weeks age of gestation and more than 500 g, preterm or term during the pandemic. Patients included were those who tested positive for COVID 19 infection who delivered 48 h up to 8 week postpartum. All the patients who consented and fulfilled the inclusion criteria answered the EPDS-F questionnaire to determine the prevalence rate of PPD. A score of 13 or greater suggests the presence of major depressive symptoms.

There was a total of 61 postpartum patients who were delivered in a tertiary hospital from September 2022 to October 2022. Out of 61 patients, 20 scored 13 points and above in the EPDS-F questionnaire showing a PPD prevalence of 32.8%. Patient’s age showed a statistically significant association with the likelihood of having PPD (P = 0.0148), the highest prevalence observed at an average age of 25 and a lower prevalence at 29 years old.

Although age seems to have a significant association with PPD, direct causality is difficult to establish as the likelihood of having PPD depends on the mother’s personal qualities and traits, the societal background, and her coping mechanisms during an extraordinary circumstance such as this global COVID-19 pandemic.

Female ; Humans ; Infant ; Mothers ; Serotonin ; Object Attachment ; Surveys and Questionnaires ; Depression, Postpartum

Purpose: This study was conducted to bring together studies on the common nursing interventions for postpartum depression (PPD) and their outcomes. It aims to provide interpretation of relevant findings to help further enhance the nursing care of patients with postpartum depression. Design and Methods: A systematic literature review (SLR) approach was utilized to synthesize studies related to the management of postpartum depression and its outcomes. One hundred five studies (105) were initially retrieved from three online databases. Eventually, fifteen studies were included in this review after the screening process on quality and risk of bias assessments. Codes were identified from the included studies and were clustered into themes. A thematic map was formulated to visualize the interconnections of the nursing interventions for postpartum depression and its outcomes. Findings: Nurses caring for patients with postpartum depression usually practice PPD education, perinatal assessment, PPD counseling, nurse-delivered psychotherapy, providing social support, drug administration, complementary and alternative therapy combined with conventional management, and patient referral. These nursing practices for postpartum depression yielded the following outcomes: (1) symptom alleviation, (2) empowerment, (3) positive feedback, and (4) negative outcomes. Conclusions and Recommendations There is a range of nursing interventions for postpartum depression. This review highlights the significant roles of PPD education and nursing assessment and emphasizes these interventions to be practiced not only after childbirth but also during the prenatal period to identify at-risk patients and provide early intervention. This review also emphasizes the need for more coordinated care and a multidisciplinary approach, including patient referral, to achieve better outcomes in the care of postpartum depression patients. This relates to the acknowledgment of the various factors contributing to the development of postpartum depression and its lack of clear etiology.
Depression, Postpartum

OBJECTIVE: To explore the association between postpartum depression (PPD) and transforming growth factor-β (TGF-β) concentrations in human colostrum. METHODS: Participants were recruited from a maternal and infant cohort established in a tertiary general hospital in Guangdong Province between December, 2020 and September, 2021. In the afternoon of the second postpartum day, the women were evaluated with Edinburgh Postnatal Depression Scale (EPDS) for screening PPD (defined as a score of 10 or higher). The women with PPD were matched at a 1:1 ratio with women without PPD with maternal age difference within 5 years and the same mode of delivery. Colostrum samples were collected in morning on the third postpartum day for measurement of TGF-β concentrations using enzyme-linked immunosorbent assay (ELISA), and the association between EPDS scores and TGF-β concentrations was analyzed in the two groups. RESULTS: A total of 90 women were included in the final analysis. The mean concentrations of TGF-β1, TGF-β2 and TGF-β3 in the colostrum were 684.03 (321.22-859.25) pg/mL, 5116.50±1747.04 pg/mL and 147.84±48.68 pg/mL in women with PPD, respectively, as compared with 745.67 (596.00-964.22) pg/mL, 4912.40±1516.80 pg/mL, and 168.21±48.15 pg/mL in women without PPD, respectively. Compared with women without PPD, the women with PPD had significantly lower concentrations of TGF-β1 (P=0.026) and TGF-β3 (P=0.049) in the colostrum. Spearman correlation analysis revealed that the EPDS scores were negatively associated with the concentrations of TGF-β1 (r=-0.23, P=0.03) and TGF-β3 (r=-0.25, P=0.02) in the colostrum. CONCLUSION PPD is associated with decreased concentrations of TGF-β1 and TGF-β3 in human colostrum, suggesting the need of early PPD screening and interventions during pregnancy and the perinatal period to minimize the impact of PPD on human milk compositions.
Child, Preschool ; Cohort Studies ; Colostrum ; Depression, Postpartum/diagnosis* ; Female ; Humans ; Infant ; Postpartum Period ; Pregnancy ; Transforming Growth Factor beta1 ; Transforming Growth Factor beta2 ; Transforming Growth Factor beta3 ; Transforming Growth Factors

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

OBJECTIVE: To observe the clinical therapeutic effect on mild and moderate postpartum depression treated with acupuncture of METHODS: A total of 116 patients with mild and moderate postpartum depression were divided into an acupuncture group (103 cases) and a non-acupuncture group (13 cases) according to treatment regimen provided. In the acupuncture group, acupuncture of RESULTS: The total effective rate of the acupuncture A group was 100.0% (31/31), better than 76.9% (10/13) in the non-acupuncture group and 58.1% in the acupuncture B group (18/31) ( CONCLUSION Acupuncture of
Acupuncture Points ; Acupuncture Therapy ; Depression/therapy* ; Depression, Postpartum/therapy* ; Female ; Humans ; Needles ; Treatment Outcome

OBJECTIVE: To compare the clinical effect of acupuncture combined with wheat-grain moxibustion and oral sertraline hydrochloride dispersible tablets in the treatment of mild to moderate postpartum depression. METHODS: Sixty patients with mild to moderate postpartum depression were randomly divided into an observation group and a control group, 30 cases in each group. Both groups were treated with psychotherapy. The control group was treated with oral sertraline hydrochloride dispersible tablets, 50 mg each time, once a day; the observation group was treated with acupuncture at Qihai (CV 6), Zusanli (ST 36), Xuehai (SP 10), Hegu (LI 4), Sanyinjiao (SP 6), Taixi (KI 3), etc. combined with wheat-grain moxibustion at Xinshu (BL 15), Pishu (BL 20), Ganshu (BL 18) and Shenshu (BL 23), once every other day, 3 times a week. Both groups were treated for 4 weeks as a course, with 2 consecutive courses of treatment. Before and after treatment and follow-up of 3 months after the end of treatment, the Hamilton depression scale (HAMD), Edinburgh postnatal depression scale (EPDS) and World Health Organization quality of life-BREF (WHOQOL-BREF) score of the two groups were compared, and the clinical effect was assessed. RESULTS: After treatment and during follow-up, the HAMD and EPDS scores of the two groups were lower than before treatment ( CONCLUSION Acupuncture combined with wheat-grain moxibustion can improve the depressive symptoms of patients with mild to moderate postpartum depression and improve their quality of life, and the clinical effect is more lasting and stable than oral sertraline hydrochloride dispersible tablets.
Acupuncture Points ; Acupuncture Therapy ; Depression, Postpartum/therapy* ; Female ; Humans ; Moxibustion ; Quality of Life ; Treatment Outcome ; Triticum

OBJECTIVES: Primary health workers are the first fine to identify postpartum depression, which is important for patients with this disease to get early specialist diagnosis and treatment. The smartphone-based virtual patient is economical, convenient and effective, and has been applied extensively to evaluate the competency to detect postpartum depression, but there is no relevant application in China. This study aims to use virtual patient to assess the current status on the competency of detecting postpartum depression among primary maternal and child health workers in Hunan Province, and to explore potential influencing factors. METHODS: A total of 222 primary maternal and child health workers from 3 regions with low, medium, and high economic levels in Hunan Province were enrolled, and smartphone-based virtual patients with postpartum depression were used for the assessment from May to July in 2018, and a self-designed questionnaire was used to investigate their demographic characteristics. The competency to detect postpartum depression was measured by 2 indicators: diagnostic accuracy and treatment accuracy. Descriptive statistical methods were used to describe the competency to detect postpartum depression among them and their demographic characteristics. A logistic regression analysis was used to explore the possible influencing factors for the diagnostic accuracy and treatment accuracy. RESULTS: The diagnostic accuracy rate was 64.0%. There was no significant difference between the demographic characteristics and diagnostic accuracy rate ( CONCLUSIONS About half of the primary maternal and child health workers in Hunan Province, China have basic competency to detect postpartum depression, but the overall results are not satisfactory. The regional economic level is correlated with the competency of detecting postpartum depression, and the competency of detecting postpartum depression is stronger in more developed areas. Moreover, for the patients who have been identified as postpartum depression, the rate of correct treatment is low, which warrants particular attention in the follow-up training.
Child ; China ; Cross-Sectional Studies ; Depression, Postpartum/diagnosis* ; Female ; Health Personnel ; Humans ; Surveys and Questionnaires

Introduction: Postpartum depression (PPD) is a major health concern for child-bearing women and has its effects on her children. Advocacies for mental health have paved way for more awareness of conditions such as PPD. Currently, there is no particular screening protocol employed by attending physicians of these women. There is also a lack of data that determines the practices of obstetricians when dealing with patients with PPD or those at risk of developing it. Objective: This descriptive study evaluated the knowledge, attitudes, and practices of OB-GYN consultants and residents on the screening of PPD. Materials and Methods: A validated questionnaire was utilized with some modifications made to tailor fit the targeted population. All affiliated consultants and residents of the Philippine Obstetrical and Gynecological Society-accredited training hospitals in a Region VII were included while those retired were excluded. The Google Form link of the questionnaire was disseminated to the different institutions who gave approval to conduct the study. Anonymity and confidentiality of data acquired were maintained throughout the study. Results: A total of 110 responses were received. The key findings of the study showed that the respondents have above average knowledge on PPD including its risk factors, symptoms, complications, and treatments. They generally have positive beliefs toward their role in the screening and management of PPD. Moreover, majority of them have already tried screening for PPD although not routinely. Conclusion There is a significant relationship between the knowledge, attitude, and practices of the consultants and residents on the screening of PPD. Systems should be put in place to ensure effective treatment and follow-up of patients and thus impact good clinical outcomes.
Depression ; Postpartum Period ; Depression, Postpartum ; Mass Screening