Assessing Postpartum Depression and Anxiety during the Antenatal and Postpartum Period
Postpartum Depression and Anxiety
DOI:
https://doi.org/10.54393/pjhs.v5i12.2455Keywords:
Postpartum Depression, Edinburgh Postnatal Depression Scale, Hospital Anxiety and Depression Scale, Maternal Mental Health, Antenatal AnxietyAbstract
Postpartum Depression (PPD) and anxiety were common mental disorders affecting women during the antenatal and postpartum periods. Early detection and intervention were vital for improving maternal and infant health outcomes. Objective: To assess the postpartum depression and anxiety during the antenatal and postpartum period using postnatal depression scale (EPDS) and the hospital anxiety and depression scale (HADS). Methods: Total 94 patients over six months in the Department of Obstetrics and Gynecology at Divisional Headquarters Teaching Hospital in Mirpur, Azad Kashmir were enrolled in this comparative cross sectional study. The pregnant women aged 18 to 45 during third trimester were included and excluding those with pre-existing psychiatric conditions or high-risk. The study utilized the HADS and EPDS while also recording demographic and clinical information, including age, education level, socioeconomic status, marital status, parity, gestational age at delivery, gestational diabetes, and preeclampsia. Data were analyzed using SPSS version 26 with appropriate statistical methods. Results: The majority of participants were over 25 years old (71.3%) and undergraduate education (62.8%), with 67.0% being multiparous. Gestational diabetes was present in 19.1%, and 16.0% had hypertension. HADS identified 15 mild, 35 moderate, and 44 severe cases, while EPDS reported 19 mild, 30 moderate, and 45 severe cases, with both scales showing the highest prevalence in the severe category. Conclusions: EPDS and HADS were two good screening tools for postpartum depression as well as anxiety. Using both together can certainly enhance the detection procedure, leading to timely intervention and a better prognosis of maternal as well as infant health.
References
Venkatachari R. Maternal mental health and child outcomes: a human-centered design perspective on preventive mental health care. [Doctoral Dissertation]. Massachusetts Institute of Technology; 2020.
Liu X, Wang S, Wang G. Prevalence and risk factors of postpartum depression in women: A systematic review and meta‐analysis. Journal of Clinical Nursing. 2022 Oct; 31(19-20): 2665-77. doi: 10.1111/jocn.16121.
Rahman A, Patel V, Maselko J, Kirkwood B. The neglected 'm'in MCH programmes-why mental health of mothers is important for child nutrition. Tropical Medicine & International Health. 2008 Apr; 13(4): 579-83. doi: 10.1111/j.1365-3156.2008.02036.x.
van der Zee-van AI, Boere-Boonekamp MM, Groothuis-Oudshoorn CG, Reijneveld SA. Postpartum depression and anxiety: a community-based study on risk factors before, during and after pregnancy. Journal of Affective Disorders. 2021 May; 286: 158-65. doi: 10.1016/j.jad.2021.02.062.
Layton H, Owais S, Savoy CD, Van Lieshout RJ. Depression, anxiety, and mother-infant bonding in women seeking treatment for postpartum depression before and during the COVID-19 pandemic. The Journal of Clinical Psychiatry. 2021 Jul; 82(4): 35146. doi: 10.4088/JCP.21m13874.
Cheng CY, Chou YH, Chang CH, Liou SR. Trends of perinatal stress, anxiety, and depression and their prediction on postpartum depression. International journal of environmental research and public health. 2021 Sep; 18(17): 9307. doi: 10.3390/ijerph18179307.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry. 1987 Jun; 150(6): 782-6. doi: 10.1192/bjp.150.6.782.
Matthey, S., Henshaw, C., Elliot, S., & Barnett, B. (2006). The Edinburgh Postnatal Depression Scale: A review of the literature. Journal of Affective Disorders, 91(1), 3-15. https://doi.org/10.1016/j.jad.2005.11.035.
Zigmond AS and Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983 Jun; 67(6): 361-70. doi: 10.1111/j.1600-0447.1983.tb09716.x.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research. 2002 Feb; 52(2): 69-77. doi: 10.1016/S0022-3999(01)00296-3.
Matthey S, Barnett B, Howie P, Kavanagh DJ. Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety?. Journal of Affective Disorders. 2003 Apr; 74(2): 139-47. doi: 10.1016/S0165-0327(02)00012-5.
Sakina R, Khan SE, Chaudhry AG. Stigma of postpartum depression: The role of lady health workers in health care-A qualitative study. Health Care for Women International. 2022 Jul; 43(9): 1095-104. doi: 10.1080/07399332.2021.1973009.
Safi‐Keykaleh M, Aliakbari F, Safarpour H, Safari M, Tahernejad A, Sheikhbardsiri H et al. Prevalence of postpartum depression in women amid the COVID‐19 pandemic: a systematic review and meta‐analysis. International Journal of Gynecology & Obstetrics. 2022 May; 157(2): 240-7. doi: 10.1002/ijgo.14129.
Lodhi FS, Elsous AM, Irum S, Khan AA, Rabbani U. Psychometric properties of the Urdu version of the Hospital Anxiety and Depression Scale (HADS) among pregnant women in Abbottabad, Pakistan. General Psychiatry. 2020 Aug; 33(5). doi: 10.1136/gpsych-2020-100276.
Levis B, Negeri Z, Sun Y, Benedetti A, Thombs BD. Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. British Medical Journal. 2020 Nov; 371. doi: 10.1136/bmj.m4022.
Saeed A, Raana T, Saeed AM, Humayun A. Effect of antenatal depression on maternal dietary intake and neonatal outcome: a prospective cohort. Nutrition Journal. 2015 Dec; 15: 1-9. doi: 10.1186/s12937-016-0184-7.
Edinburgh Postnatal Depression Scale (EPDS) – A Review. (2016). Journal of Affective Disorders, 202, 9-17. https://doi.org/10.1016/j.jad.2016.04.037.
El-Hachem C, Rohayem J, Bou Khalil R, Richa S, Kesrouani A, Gemayel R et al. Early identification of women at risk of postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) in a sample of Lebanese women. BioMed Central Psychiatry. 2014 Dec; 14: 1-9. doi: 10.1186/s12888-014-0242-7.
Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: A systematic review of prevalence and incidence. Obstet Gynecol. 2005;106(5):1071-1083. doi: 10.1097/01.AOG.0000183597.31630.d2.
Park SH and Kim JI. Predictive validity of the Edinburgh postnatal depression scale and other tools for screening depression in pregnant and postpartum women: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics. 2023 May; 307(5): 1331-45. doi: 10.1007/s00404-022-06525-0.
Schoretsanitis G, Gastaldon C, Ochsenbein‐Koelble N, Olbrich S, Barbui C, Seifritz E. Postpartum hemorrhage and postpartum depression: a systematic review and meta‐analysis of observational studies. Acta Psychiatrica Scandinavica. 2024 Nov; 150(5): 274-83. doi: 10.1111/acps.13583.
Agbaje OS, Anyanwu JI, Umoke PI, Iwuagwu TE, Iweama CN, Ozoemena EL et al. Depressive and anxiety symptoms and associated factors among postnatal women in Enugu-North Senatorial District, South-East Nigeria: a cross-sectional study. Archives of Public Health. 2019 Dec; 77: 1-6. doi: 10.1186/s13690-018-0329-6.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments