Although postnatal depression (PND) is a worldwide public health problem, it is relatively higher in developing countries, including countries in Sub-Saharan Africa. Postnatal depression is not ...routinely screened for in primary healthcare facilities in South Africa, despite its reported compromise on mother and child health. The purpose of this study was to determine the prevalence of, as well as factors associated with, postnatal depression in a sample of clinic attendees in a sub district in Tshwane, South Africa. A quantitative and cross-sectional survey was conducted in a sample of 406 women in three healthcare facilities. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data from women who had infants between the ages of 0 and 12 months. The cut-off point for the EPDS for the depressed category was a score of 13 out of a maximum of 30. The majority of the women (57.14%,
= 232) had scores of 13 and above, which is indicative of postnatal depressive symptoms. On logistic regression, postnatal depressive symptoms were significantly associated with lack of support in difficult times (
< 0.001, 95% CI 10.57-546.51), not having the preferred sex of the baby (
= 0.001, 95% CI 0.37-0.58), low household income (
< 0.001, 95% CI 1.23-1.67), and an older baby (
= 0.005, 95% CI 1.21-1.49). The results show the high proportion of women who have postnatal depression but remain undiagnosed and untreated, and therefore confirm the need for routine screening for postnatal depressive symptoms in primary healthcare facilities, which are used by the majority of women in South Africa.
Postpartum depression is a type of mental disorder associated with childbirth during pregnancy or within the first postpartum year. It is reported as a common psychological health problem affecting ...10-15% of women worldwide. The duration of postpartum depression frequently depends on its severity and the time of initiation of treatment. This study assessed depression and its associated factors among postpartum period women of Godavari municipality, Lalitpur, Nepal.
A community-based cross-sectional study was conducted using Edinburg Postpartum Depression Scale among 195 mothers who were within six months of the postpartum period. The chi-square and logistic regression were applied to establish the association between postpartum depression and associated factors.
Out of the total 195 postpartum women, 37(19%) women suffered from depression and out of those women 2.1% had suicidal thoughts. Among the associated factors, education, occupation, the intent of pregnancy, family support and pregnancy-related problems/complications were found to be significantly associated with Postpartum depression (p<0.05).
Nearly one-fifth postpartum women suffered from some type of depression. It is one of the public health concerns which directly or indirectly corresponds to the socio-economic condition of the women. The improved education and economic status of women, intention of pregnancy, family care and support during pregnancy and the postpartum period and early diagnosis and management of health problems could reduce the magnitude of the postpartum depression.
Background:
The postnatal period represents a time of risk for the emergence of Postnatal Depression (PND), a common maternal mental health problem affecting the well-being of the mother, the newborn ...and the entire family. Previously, it was postulated that African women were not affected by PND, due to traditional rituals and other cultural factors. However, the assumption has been refuted because of the existence of empirical evidence of PND in Africa and beyond, particularly among women living in socio-economic disadvantaged regions. Despite the growing magnitude of PND reported in South Africa, the country continues to focus more on reducing maternal and infant mortality and promoting infant physical health with limited efforts made to address PND among postpartum women.
Objective:
To screen for PND and determine the associated risk factors among postpartum women in selected community health centres situated in the Nkangala District, South Africa.
Methods:
The study was cross-sectional in design and applied a quantitative approach. Random sampling was used to select the three community health centres in the Nkangala District. A sample of 228 women who had delivered a live infant within 12 weeks of the time of data collection was selected using purposive sampling from the three community health centres. Trained research assistants administered a questionnaire to obtain information on demography and obstetric history, while the Edinburgh Postnatal Depression Scale (EDPS) was used to screen for postnatal depression. An EDPS score of 13+ confirmed the probability of PND. Data was analysed using STATA 14.
Results:
The mean age of women was 28±7 years. The majority of women were single (61%), living in large households (77%), and living in households with a monthly income of less than $291.10 (63%). Most women had normal (
i.e.
, vaginal) delivery (83%) and reported unplanned pregnancies (65%). The probability of developing PND among women was 22%. The odds of developing PND were 3.17 times more likely in women with babies aged six weeks and above (AOR=3.17, CI; 1.39 - 7.23) and 4.50 times more likely in women living in households with an income of less than $115.55 (AOR=4.50, CI; 1.03 - 19.74). Partner/husband violence increased the odds of developing PND (AOR = 6.89, CI; 1.49 - 31.93), as well as a stressful life event (AOR= 3.73, CI: 1.52 - 9.17). Having partner/husband support (AOR=0.10, CI: 0.03 - 0.37) and receiving social support (AOR=0.28, CI: 0.09 - 0.93) reduced the risk of developing PND. A chi-square test showed significant associations between the EDPS scores and partner/husband support, partner/husband having another sexual partner, receiving social support, having a person who offers social support, partner/husband violence, and stressful life events.
Conclusion:
The probability of PND was high among postpartum women in the Nkangala District of the Mpumalanga Province, South Africa. The key determinants for the probability of PND were the age of a baby, household income, partner/husband violence, partner/husband support and receiving social support. Routine screening to identify women who are at risk of PND should be integrated into postnatal care settings for immediate intervention to protect the mother and her baby from different forms of morbidity.
Handedness, a complex human aspect that reflects the functional lateralization of the hemispheres, also interacts with the immune system. This study aimed to expand the knowledge of the ...lateralization of hand, foot, and eye activities in patients with immune-mediated (IM) or other (noIM) neurological diseases and to clarify the properties of the Edinburgh Handedness Inventory (EHI) in an Italian population. Three hundred thirty-four patients with IM or noIM diseases affecting the brain or spine and peripheral nervous system were interviewed about stressful events preceding the disease, subjective handedness, and familiarity for left-handedness or ambidexterity. The patients and 40 healthy subjects underwent EHI examination. In the whole group of participants, 24 items of the EHI were classified into five factors (Hand Transitive, Hand Refined, Hand Median, Foot, Eye), demonstrating good reliability and validity. Chronological age had a significant influence on hand and foot EHI factors and the laterality quotient (LQ), particularly on writing and painting. In the patient groups, EHI factors and the LQ were also predicted by age of disease onset, duration of disease, and family history of left-handedness or ambidexterity. No differences were found between patients and healthy subjects, but pencil use scored significantly lower in patients with IM diseases than in those with noIM brain diseases. These results demonstrate that the lateralization of hand and foot activities is not a fixed human aspect, but that it can change throughout life, especially for abstract and symbolic activities. Chronic neurological diseases can cause changes in handedness. This may explain why, unlike systemic immunological diseases, IM neurological diseases are not closely associated with left-handedness. In these patients, the long version of the EHI is appropriate for determining the lateralization of body activities to contextualize the neurological picture; therefore, these findings extend the Italian normative data sets.
Context: Postpartum depression (PPD) is onset of depressive symptoms in postpartum period from 2 weeks to 1 year. It causes maternal morbidity and long-term negative effects on growth and development ...of infant and child. It is often unreported and underdiagnosed. Aims: (1) To estimate the prevalence of PPD, (2) To determine socio-demographic, clinical, and obstetric correlates of the same. Settings and Design: A cross-sectional study was done in urban and rural areas of District Aligarh. Methods: A total of 304 females between 6 weeks and 6 months' postpartum period giving consent were included in this study. Sociodemographic, obstetric, and clinico-social factors were recorded using predesigned, pretested questionnaire. Edinburgh Postnatal Depression Scale (EPDS) score ≥10 was used to screen for PPD and International Classification of Disease (ICD-10) criteria for confirmation. Statistical Analysis Used: Correlates of PPD were determined using logistic regression analysis. Results: The prevalence of PPD was 9.5% using EPDS and was confirmed by ICD-10 criteria. History of abortion (adjusted odds ratio AOR: 6.0, 95% Confidence Interval CI 2.2-16.5), poor relationship with in-laws (AOR: 5.1; 95% CI 1.3-20.5), marital conflict (AOR: 13.3; 95% CI 2.2-77.6), and substance abuse in husband (AOR: 3.1; 95% CI 1.1-9.0) were found to be significant correlates for PPD. Conclusions: About one in every 10 postpartum females suffered from depression but did not seek health care for the same. Women facing social pathologies such as substance abuse in husband, marital conflict, and poor relationship with in-laws are more at risk of PPD. Screening for PPD should be included in the maternal and child health care programs to ensure early diagnosis and treatment.
This study verified the reliability and validity of the Edinburg Postpartum Depression Scale (EPDS) administered by telephone interviews. In a cross-sectional study of a cohort from Brazil (BRISA), ...the EPDS was administered by telephone to 1,083 women within 12 months postpartum, and 257 (23.7 %) participants had an EPDS score ≥10. At 67 ± 48 days after their telephone interview, 199 (EPDS ≥10 = 96; EPDS <10 = 103) participants were interviewed face-to-face using the Structured Clinical Interview for DSM-IV (SCID) and completed the EPDS again by self-report. In 90 participants, the diagnosis of major depressive episode was confirmed by the SCID (EPDS ≥10 = 65; EPDS <10 = 25). The Cronbach’s alpha coefficient was 0.861. The Spearman’s correlation between the EPDS administered by telephone and the self-reported EPDS was 0.69 (
p
< 0.001). The receiver-operating characteristic (ROC) curve for the EPDS administered by telephone was 0.78 (95 % confidence interval (CI) = 0.72 to 0.84). Scores ≥10 showed a sensitivity of 72.2 %, a specificity of 71.6 %, and a positive predictive value of 67.7 %. The application of the EPDS by telephone is a suitable alternative for clinical practice and research and represents a method to optimize the diagnosis of postpartum depression.
Abstract Background Labor induction has been associated with breastfeeding suppression, but reasons for why this association exists have not been well determined. Methods We examined the influence of ...elective labor induction by vaginal prostaglandin at gestational week 41 + 3 days on affective, cognitive, and behavioural adaptations early in puerperium and on breastfeeding pattern at 1 and 3 months. Results One hundred and eighty consecutive puerperae were assigned to two groups: mothers having received vaginal prostaglandin E2 gel (Prepidil®, dinoprostone) before labor (PGE group, n = 90) and mothers having received no treatment (unmedicated group, n = 90). The day of discharge mothers completed the Edinburg Postnatal Depression Scale, (EPDS), State and Trait Anxiety Inventory (STAI-Y), and Mother to-Infant Bonding Scale (MIBS). Later they participated in telephone interviews concerning their breastfeeding practices at 1 and 3 months, which were classified according to WHO definitions. When compared with unmedicated, PGE group puerperae scored median, (IQR) significantly higher EPDS 9 (7–13) vs 5 (3–8), p 0.003, STAI-state 46 (39–51) vs 39 (34–48), p 0.002, STAI-trait 39 (36–48) vs 34 (32–45), p 0.04, and MIBS 10 (5.25–10) vs 5 (3–4), p 0.002 scores. In addition, while the breastfeeding practices were similar at hospital discharge, at follow-up the labor induced mothers were less likely to maintain full breastfeeding with respect to untreated mothers: 1 month (p 0.001); and 3 months (p 0.003). Conclusion We present evidence that elective induction of labor by prostaglandins at gestational week 41 + 3 days is associated with reduced exclusive breastfeeding rates at 1 and 3 months after discharge and higher EPDS, STAI, and MIBS scores.
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