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Background: Postpartum depression (PPD) is the most common complication after childbirth, affecting 10-15% of women. It is associated with serious long-term consequences for the mother and family. Whether or not neuraxial labor analgesia mitigates the risk is uncertain and controversial. The purpose of this review was to summarize studies investigating the association between neuraxial labor analgesia and the incidence of PPD.Methods: A systematic literature search for randomized controlled trials and cohort studies reporting the incidence of PPD among parturients who received neuraxial analgesia compared with non-neuraxial or no analgesia. The primary outcome was the incidence of PPD between 5 and 12 weeks' postpartum. Depression was diagnosed using a cutoff score of ≥10 on the Edinburgh Postnatal Depression scale, a validated screening tool. The risk of bias of each study was evaluated, and odds ratios and 95% confidence intervals calculated from raw data or reported as adjusted odds ratios.Results: Eleven observational studies involving 5717 patients were included. Three studies had a critical risk, three a serious risk, and five a moderate risk of bias. Two studies reported significantly lower odds for PPD associated with neuraxial analgesia compared with non-neuraxial or no analgesia, whereas the odds ratios in the remaining nine studies were not significantly different.Conclusions: Our systematic review did not find compelling evidence for an association between PPD and labor analgesia. Studies were heterogenous in nature and had a high risk of bias. Further research controlling for confounding factors is recommended to determine if a relationship exists. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate the relationship between the birth experience and the risk of developing postpartum depression or post-traumatic stress disorder.Methods: In this prospective, longitudinal, observational study, women were assessed at different time points for depression and post-traumatic stress disorder. The risk of depression or post-traumatic stress disorder based on patient characteristics and specific birth events was assessed within three months postpartum.Results: We enrolled 600 women; 426 were eligible for postpartum assessment. At six weeks and three months postpartum, 15.9% and 12.7% screened positive for depression respectively. Positive post-traumatic stress disorder screenings at six weeks and three months postpartum were 6.2% and 5.1% respectively. Twenty-seven women (8.3%) with a negative screening at six weeks converted to a positive depression or post-traumatic stress disorder screening at three months. A pre-existing history of anxiety or depression was associated with an increased risk of developing depression (aOR 2.12, 95% CI 1.30 to 3.47) and post-traumatic stress (aOR 3.15, 95% CI 1.42 to 7.02) within three months postpartum. The risk of developing post-traumatic stress disorder within three months postpartum was also increased among patients experiencing their first delivery (aOR 2.55, 95% CI 1.10 to 5.88) or operative management of postpartum hemorrhage (aOR 4.44, 95% CI 1.16 to 17.02).Conclusion: Depression and post-traumatic stress symptoms either persisted or had new onset at three months postpartum. Mental health screening and postpartum follow-up after six weeks should be considered in high-risk patients who have a history of psychopathology, nulliparity, or undergo operative management of postpartum hemorrhage. [ABSTRACT FROM AUTHOR]

Objectives: To investigate screening with the Edinburgh Postnatal Depression Scale (EPDS) as part of Queensland prenatal care services, as well as maternal and socio-demographic factors associated with not being screened.Design, Setting: Cross-sectional retrospective analysis of data from the Queensland population-based Perinatal Data Collection for July 2015 - December 2015.Participants: All women giving birth in Queensland during the second half of 2015.Main Outcome Measures: Screening with the EPDS, with the values "yes" (health professional recorded an EPDS score), "no" (health professional reported it was not performed), and "not stated".Results: Of 30 468 women who gave birth in Queensland, 21 735 (71.3%) completed the EPDS during pregnancy; 18 942 pregnant women were enrolled as public patients (91.0%) and 2762 as private patients (28.8%). After adjusting for other socio-demographic factors, screening was less likely for women who were aged 36 years or more (v 25 years or younger: adjusted odds ratio [OR], 0.69; 95% CI, 0.60-0.79), enrolled as private patients (aOR, 0.05; 95% CI, 0.05-0.06), born overseas (aOR, 0.75; 95% CI, 0.68-0.82), Indigenous Australians (aOR, 0.47; 95% CI, 0.39-0.56), single or separated (aOR, 0.83; 95% CI, 0.73-0.94), or of higher socio-economic status.Conclusions: Four years after clinical guidelines recommending universal screening with the EPDS were published, screening rates for private and public health care patients differed markedly. Our results may inform future comparisons and analyses of the impact on screening of recent changes to Medicare definitions intended to increase that of women in private health care. [ABSTRACT FROM AUTHOR]

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Summary: Purpose: To present the results of a study that used cognitive interviewing techniques to interview pregnant and postpartum women about their experience of completing the Edinburgh Postnatal Depression Scale. Background: Most large-scale initiatives that screen women for depression during pregnancy and the first 3–6 months postpartum use the Edinburgh Postnatal Depression Scale. The scale is a 10-item instrument that is commonly self-administered and has been extensively validated using quantitative methods. However, the authors could find no published research that applied newer in-depth methods for assessing comprehension and interpretation to the scale. Participants and methods: The design was an in-depth, qualitative instrument validation study. A total of nine pregnant and postpartum women who were referred for psychiatric care completed the Edinburgh Postnatal Depression Scale and then were interviewed about their experiences. Cognitive interviewing techniques were used to generate an in-depth examination of how women understood and interpreted the items, and to explore meaning, acceptability, and disclosure issues. Results: Overall, participants felt that the instrument was straightforward, easy to read, and relatively simple to answer. It is important to note that eight of the nine participants had completed some post-secondary education and, thus, participant''s average literacy level was relatively high. Women identified minor concerns or expressed interpretive differences on six of the ten Edinburgh Postnatal Depression Scale items. These six items are examined in detail. Conclusion: The results suggest that it may be useful for the Edinburgh Postnatal Depression Scale to be administered in the context of a discussion about a woman''s mental health concerns, which could involve asking her for more details about her responses to particular items that have been identified in this study as potentially problematic. This will help ensure that practitioners are accurately interpreting a woman''s answers to the items on the scale. [Copyright &y& Elsevier]

The 2019 coronavirus disease pandemic (COVID-19) required strict confinement measures that differentially impacted the individual's daily life. Thus, this work aimed to study postpartum women's mental health in Argentina during mandatory social isolation. A cross-sectional survey was conducted from May to July 2020, which included five validated questionnaires to assess postpartum depression (Postpartum Depression Screening Scale‐Short Form), insomnia (Insomnia Severity Index), memory complaints (Memory Complaint Scale), metacognition (Brief Metamemory and Metaconcentration Scale), and breastfeeding self-efficacy (Breastfeeding Self-Efficacy Scale-Short Form). Sociodemographic variables, social isolation characteristics, and breastfeeding practices were also collected. This study was conducted in accordance with the Declaration of Helsinki. Statistical analysis included zero-order correlations, multiple logistic regressions, and a set of structural equation models (SEM) to test direct and indirect effects. Goodness-of-fit indices were calculated for SEM. Postpartum women were recruited from public hospitals, private health clinics, and online community recruitment in the Cordoba province (Argentina). 305 postpartum women from Argentina. 37% of women reported postpartum depression, 46% insomnia, 42% memory impairment, 60% low metaconcentration, 50% low metamemory, and 23% low breastfeeding efficacy. Also, significant associations were found demonstrating that social isolation promoted postpartum depression and insomnia were reciprocally related, which compromised female cognition and efficacy. This situation was aggravated in women during late postpartum, with previous children, and by low social support (e.g., family, health professionals), with non-exclusive breastfeeding being increased. This is the first study addressing postpartum women's mental status during social isolation in Argentina, which was a promoting factor for postpartum depression and insomnia that were reciprocally related. This situation was also aggravated by reproductive factors, such as late postpartum, multiparity, breastfeeding frequency, and non-exclusive breastfeeding. Additionally, breastfeeding self-efficacy depended on mental health status, and euthymia therefore favoured the practice of exclusive breastfeeding. [ABSTRACT FROM AUTHOR]

The article offer information on mental health problems in women during the perinatal period topics including screening with the Edinburgh Postnatal Depression Scale (EPDS); harmful impact on development of children; and limitations of EPDS screening.

Many Aboriginal women find the EPDS language complex and confusing, and providers find using it with Aboriginal women challenging.[3] Screening processes need to be acceptable to patients and staff, and seen to be easy to use and helpful, or they are unlikely to be well implemented. The Kimberley Mum's Mood Scale (KMMS) is a locally designed approach to screening Aboriginal women.[3] Part 1 is an adaption of the EPDS. [Extracted from the article]

The EPDS has been extensively researched and is an accepted and valid screening tool in different cultures and languages, not only in the postnatal period but also during pregnancy.[3] Therefore, it seems to be an appropriate tool for a culturally diverse country. [Extracted from the article]

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)