Maternal and Fetal Outcomes Among Women with Depression

ArticleinJournal of Women's Health 19(2):329-34 · February 2010with12 Reads
DOI: 10.1089/jwh.2009.1387 · Source: PubMed
Abstract
To compare maternal and fetal outcomes among women with and without diagnosed depression at the time of delivery. Hospital discharge data from the 1998-2005 Nationwide Inpatient Sample (NIS) were used to examine delivery-related hospitalizations for select maternal and fetal outcomes by depression diagnosis. The rate of depression per 1000 deliveries increased significantly from 2.73 in 1998 to 14.1 in 2005 (p < 0.001). Women diagnosed with depression were significantly more likely to have cesarean delivery, preterm labor, anemia, diabetes, and preeclampsia or hypertension compared with women without depression. Fetal outcomes significantly associated with maternal depression were fetal growth restriction, fetal abnormalities, fetal distress, and fetal death. These findings suggest that depression is associated with adverse maternal and fetal outcomes. Our results provide additional impetus to screen for depression among women of reproductive age, especially those who plan to become pregnant.
    • "PDD has long been associated with disruptions to the motherinfant relationship, expressed in reduced maternal behavior and diminished synchrony (Goodman et al., 2011; Stein et al., 2012). Depressed mothers exhibit lower sensitivity and responsiveness (Bansil et al., 2010; Parsons, Young, Rochat, Kringelbach, & Stein, 2012) and less maternal behavior in the gaze, affect, vocal, and touch modalities (Broth, Goodman, Hall, & Raynor, 2004; Feldman & Eidelman, 2003, 2007 Goodman et al., 2011; ). These maternal behaviors, which appear in a speciesspecific repertoire across mammals, provide critical environmental inputs for maturation of the social brain and serve as building blocks for the infant's socialemotional competencies (Feldman, 2015a; Feldman, 2015b; Meaney, 2010). "
    [Show abstract] [Hide abstract] ABSTRACT: Maternal postpartum depression (PPD) exerts long-term negative effects on infants; yet the mechanisms by which PPD disrupts emotional development are not fully clear. Utilizing an extreme-case design, 971 women reported symptoms of depression and anxiety following childbirth and 215 high and low on depressive symptomatology reported again at 6 months. Of these, mothers diagnosed with major depressive disorder (n = 22), anxiety disorders (n = 19), and controls (n = 59) were visited at 9 months. Mother-infant interaction was microcoded for maternal and infant's social behavior and synchrony. Infant negative and positive emotional expression and self-regulation were tested in 4 emotion-eliciting paradigms: anger with mother, anger with stranger, joy with mother, and joy with stranger. Infants of depressed mothers displayed less social gaze and more gaze aversion. Gaze and touch synchrony were lowest for depressed mothers, highest for anxious mothers, and midlevel among controls. Infants of control and anxious mothers expressed less negative affect with mother compared with stranger; however, maternal presence failed to buffer negative affect in the depressed group. Maternal depression chronicity predicted increased self-regulatory behavior during joy episodes, and touch synchrony moderated the effects of PPD on infant self-regulation. Findings describe subtle microlevel processes by which maternal depression across the postpartum year disrupts the development of infant emotion regulation and suggest that diminished social synchrony, low differentiation of attachment and nonattachment contexts, and increased self-regulation during positive moments may chart pathways for the cross-generational transfer of emotional maladjustment from depressed mothers to their infants. (PsycINFO Database Record
    Full-text · Article · Jul 2016
    • "Up to 25 per cent of women will experience some form of mental health problem during pregnancy (O'Keane and Marsh, 2007). Antenatal depression if unresolved can have severe consequences not only for those women affected (Bansil et al., 2010) but for the unborn child (Grote et al., 2010; Kim et al., 2013) the infant (Bauer et al., 2014b; Glover, 2014) and also for partners and families. A confidential report on the causes of maternal mortality has identified mental health problems as a leading indirect cause of maternal morbidity and mortality. "
    [Show abstract] [Hide abstract] ABSTRACT: Purpose Up to 25 percent of women will experience depression during their pregnancy. Perinatal mental health problems are a leading cause of maternal morbidity and mortality, however, care provided to women is often a low priority. The purpose of this paper is to explore women’s perspective of care from GPs and midwives when they experience symptoms of depression during pregnancy. Design/methodology/approach Women, with self-reported symptoms of depression, were invited to post comments in response to a series of on-line questions posted on two discussion forums over a nine month period. The questions were related to the care women received from GPs and midwives. Data were analysed using thematic analysis. Findings In total, 22 women responded to the on-line questions. A number of themes were identified from the data including women’s disclosure of symptoms to GPs and midwives; lack of knowledge of perinatal mental health among health providers; attitudes of staff and systemic issues as barriers to good care; anti-depressant therapy and care that women found helpful. Research limitations/implications Women often face significant emotional and psychological health issues in the transition to motherhood. This small study indicates women often experience difficulties in interacting with their GP and midwife in seeking help. This research has identified some contributing factors, however more rigorous research is needed to explore these complex issues. Originality/value This paper highlights service provision in the care of women with depression in pregnancy.
    Article · Mar 2016
    • "Earlier studies focusing on anaemia and PPD are heterogeneous . Some identified postpartum anaemia as a significant risk factor for the development of PPD2324252627. Other studies report no association [37] or even a negative association between anaemia and depression during pregnancy [52]. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: To explore the association between postpartum haemorrhage (PPH) and postpartum depression (PPD), taking into account the role of postpartum anaemia, delivery experience and psychiatric history. Methods: A nested cohort study (n = 446), based on two population-based cohorts in Uppsala, Sweden. Exposed individuals were defined as having a bleeding of ≥1000ml (n = 196) at delivery, and non-exposed individuals as having bleeding of <650ml (n = 250). Logistic regression models with PPD symptoms (Edinburgh Postnatal Depression scale (EPDS) score ≥ 12) as the outcome variable and PPH, anaemia, experience of delivery, mood during pregnancy and other confounders as exposure variables were undertaken. Path analysis using Structural Equation Modeling was also conducted. Results: There was no association between PPH and PPD symptoms. A positive association was shown between anaemia at discharge from the maternity ward and the development of PPD symptoms, even after controlling for plausible confounders (OR = 2.29, 95%CI = 1.15-4.58). Path analysis revealed significant roles for anaemia at discharge, negative self-reported delivery experience, depressed mood during pregnancy and postpartum stressors in increasing the risk for PPD. Conclusion: This study proposes important roles for postpartum anaemia, negative experience of delivery and mood during pregnancy in explaining the development of depressive symptoms after PPH.
    Full-text · Article · Jan 2016
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