This study explored a multifactorial model for the prediction of the intensity of depressive symptoms in postpartum women. Data were gathered from 213 pregnant women during the second trimester of pregnancy and at 6 months postpartum. Participants were assessed according to a number of psychosocial variables. A path analysis indicated that four variables had a direct effect on postpartum depressive symptomatology level: lower occupational status, prenatal depression level, more distal stressors and a personal psychiatric history. Eight variables, which reflected past and present experiences, showed an indirect effect. The implications of these findings are discussed.
psychosocial predictors postpartum depressive symptoms, prenatal depression predicting postpartum depression path analysis, occupational status psychiatric history postpartum mood, multifactorial model postpartum depression risk factors, stressors pregnancy second trimester depression prediction, postpartum depressive symptomatology level predictors, Bernazzani psychosocial variables postpartum depression, path analysis prenatal risk factors postpartum mood disorder, personal psychiatric history postpartum depression risk, pregnancy psychosocial assessment depression screening
PMID 9387085 9387085 DOI 10.1016/s0165-0327(97)00077-3 10.1016/s0165-0327(97)00077-3 Bernazzani et al. 1997, Bernazzani 1997
Cite this article
Bernazzani, O., Saucier, J. F., David, H., & Borgeat, F. (1997). Psychosocial predictors of depressive symptomatology level in postpartum women. Journal of affective disorders, 46(1), 39-49. https://doi.org/10.1016/s0165-0327(97)00077-3
Bernazzani O, Saucier JF, David H, Borgeat F. Psychosocial predictors of depressive symptomatology level in postpartum women. J Affect Disord. 1997;46(1):39-49. doi:10.1016/s0165-0327(97)00077-3
Bernazzani, Odette, et al. "Psychosocial predictors of depressive symptomatology level in postpartum women." Journal of affective disorders, vol. 46, no. 1, 1997, pp. 39-49.
Keywords
Adult, Depression, Postpartum/diagnosis/psychology, Female, Humans, Life Change Events, Personality Development, Personality Inventory, Pregnancy, Recurrence, Risk Factors, Social Support, Socioeconomic Factors
Yildiz PD et al., 2017·Journal of Affective Disorders
Previous reviews have provided preliminary insights into risk factors and possible prevalence of Post-traumatic Stress Disorder (PTSD) postpartum with no attempt to examine prenatal PTSD. This study aimed to assess the prevalence of PTSD during pregnancy and after birth, and the course of PTSD over this time.
PsychINFO, PubMed, Scopus and Web of Science were searched using PTSD terms crossed with perinatal terms. Studies were included if they reported the prevalence of PTSD during pregnancy or after birth using a diagnostic measure.
59 studies (N =24267) met inclusion criteria: 35 studies of prenatal
PTSD and 28 studies of postpartum PTSD (where 4 studies provided prevalence of
PTSD in pregnancy and postpartum). In community samples the mean prevalence of prenatal PTSD was 3.3% (95%, CI 2.44-4.54). The majority of postpartum studies measured PTSD in relation to childbirth with a mean prevalence of 4.0% (95%, CI 2.77-5.71) in community samples. Women in high-risk groups were at more risk of
PTSD with a mean prevalence of 18.95% (95%, CI 10.62-31.43) in pregnancy and 18.5% (95%, CI 10.6-30.38) after birth. Using clinical interviews was associated with lower prevalence rates in pregnancy and higher prevalence rates postpartum.
Limitations include use of stringent diagnostic criteria, wide variability of PTSD rates, and inadequacy of studies on prenatal PTSD measured in three trimesters.
PTSD is prevalent during pregnancy and after birth and may increase postpartum if not identified and treated. Assessment and treatment in maternity services is recommended.
Depressed new mothers usually do not seek and therefore do not receive any psychiatric help. In order to assess predictive signs of postpartum depression (PPD), an unselected sample of 570 women were seen by midwives during their pregnancy, using a questionnaire elaborated by ourselves and Derogatis' Hopkins Symptom Checklist. Three months after delivery each new mother was examined again by the same midwife using Cox' Edinburgh Postnatal Depression Scale. The medical files were also examined. Of the new mothers, 58 (10.2%) suffered from PPD. Most significant factors were socio-professional difficulties, multiparity, deleterious life events, depressive mood prior to delivery, early mother-child separation and negative birth experience. The coping abilities of the depressed mother were decreased and her vulnerability to new stress factors increased. It is possible to detect women at risk for PPD already during pregnancy. We therefore elaborated a very simple, short predictive scale which is in the process of validation. Protective factors still have to be studied. Knowledge of these factors should help all caregivers to recognize, during pregnancy, women at risk for PPD, in order to initiate preventive and/or therapeutic measures.
Thirty cases of post-partum psychotic disorders occurred between 1973 and 1987 and hospitalized at the Psychiatric Ward of Florence University were studied and followed up. A structured diagnostic interview was used, which explored DSM Ill-R diagnosis both for mood disorders and for psychotic features. The psychotic symptoms had started within 8 weeks of parturition in all cases. Only 36.7% of the patients showed no subsequent pathology after the puerperal symptoms. The diagnoses, both at the index episode and at the follow-up, revealed a great predominance of mood disorders and the absence of schizophrenia. The follow-up survey showed a greater proportion of bipolar disorders than it appeared at the puerperal onset of the disease. A high frequency of puerperal psychotic relapses has also occurred after subsequent deliveries during the follow-up period.
Hypofolatemia can cause psychiatric disturbances of a depressive nature. Pregnancy and delivery are often associated with hypofolatemia. This study was conducted to determine if hypofolatemia at day 3 post partum is a risk factor for baby blues or post partum depression. To study this hypothesis, 131 post partum women were followed prospectively for the 3 months immediately following delivery. 19% were found to have 'baby blues', as defined by a score greater than 20 on Pitt's scale (Pitt, 1968, J. Psychiatry 114, 1325-1335) and 12% had post partum depression as defined by a score greater than 7 on QD2A scale (Pichot et al., 1984, Rev. Psycholog. App. 34, 229-250, 323-340), within the three months post partum. No relationship was observed between the serum or erythrocyte folate levels on the third day following delivery and the maternal post partum depression scores. A statistically significant correlation between post partum depression and previous psychiatric disturbance was, however, observed.