Τίτλος:
Pregnancy, perinatal and postpartum complications as determinants of
postpartum depression: the Rhea mother-child cohort in Crete, Greece
Περίληψη:
Aims. Few epidemiological studies evaluated associations between
perinatal complications and maternal mood at the early postpartum period
and the findings are inconsistent. We aimed at investigating a wide
range of complications during pregnancy, at delivery, and at the early
postpartum period as determinants of postpartum depression (PPD) at 8
weeks postpartum.
Methods. A total of 1037 women who enrolled in the Rhea mother-child
cohort in Crete, Greece participated in the present study. Information
on pregnancy, perinatal and postpartum complications was obtained from
clinical records or by questionnaires. Postpartum depressive symptoms
were assessed at 8 weeks postpartum using the Edinburgh Postnatal
Depression Scale (EPDS). Multivariable linear and logistic regression
models were fit to estimate the association between pregnancy, perinatal
and postpartum complications and maternal depressive symptoms, adjusting
also for potential confounders.
Results. The prevalence of women with probable depression (EPDS score >=
13) was 13.6% at 8 weeks postpartum. Gestational hypertension and/or
preeclampsia (beta coefficient 1.86, 95% CI: 0.32, 3.41) and
breastfeeding difficulties (beta coefficient 0.77, 95% CI: 0.02, 1.53)
were significantly associated with higher PPD symptoms. Sleep patterns
during pregnancy, such as sleep deprivation (OR = 3.57, 95% CI: 1.91,
6.67) and snoring (OR = 1.81, 95% CI: 1.11, 2.93), and breastfeeding
duration less than 2 months (OR = 1.77, 95% CI: 1.19, 2.64) were
significantly associated with increase in the odds for PPD. Some other
complications, such as unplanned pregnancy and hospitalisation during
pregnancy were also associated with EPDS score, but these associations
were explained by socio-demographic characteristics of the mother.
Conclusions. We found that several pregnancy, perinatal and postpartum
complications may have an adverse effect on maternal mood at the early
postpartum period. These findings have considerable implications for
developing effective prevention and early psychoeducational intervention
strategies for women at risk of developing PPD.
Συγγραφείς:
Koutra, K.
Vassilaki, M.
Georgiou, V.
Koutis, A. and
Bitsios, P.
Kogevinas, M.
Chatzi, L.