TY - JOUR
T1 - Pregnancy, perinatal and postpartum complications as determinants of postpartum depression
T2 - The Rhea mother-child cohort in Crete, Greece
AU - Koutra, K.
AU - Vassilaki, M.
AU - Georgiou, V.
AU - Koutis, A.
AU - Bitsios, P.
AU - Kogevinas, M.
AU - Chatzi, L.
N1 - Funding Information:
The Rhea project was financially supported by European projects (EU FP6-003-Food-3-NewGeneris-Contract no. 16320, EU FP6 STREP Hiwate-Contract no. 36224, EU FP7 ENV.2007.1.2.2.2.-Project no. 211250 Escape, EU FP7-2008-ENV-1.2.1.4 Envirogenomarkers-Contract no. 226756, EU FP7-HEALTH-2009-single stage CHICOS-Contract no. 241604, EU FP7 ENV.2008.1.2.1.6.-Proposal no. 226285 ENRIECO, EUFP7-Proposal no. 264357 MeDALL, EU-FP7-HEALTH-2012-Proposal no. 308333 HELIX) and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011-2014; 'Rhea Plus': Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012-2015).
Publisher Copyright:
Copyright © Cambridge University Press 2016.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - 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 (β coefficient 1.86, 95% CI: 0.32, 3.41) and breastfeeding difficulties (β 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.
AB - 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 (β coefficient 1.86, 95% CI: 0.32, 3.41) and breastfeeding difficulties (β 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.
KW - Perinatal
KW - postpartum complications
KW - postpartum depression
KW - pregnancy
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U2 - 10.1017/S2045796016001062
DO - 10.1017/S2045796016001062
M3 - Article
C2 - 28004625
AN - SCOPUS:85007210858
SN - 2045-7960
VL - 27
SP - 244
EP - 255
JO - Epidemiology and Psychiatric Sciences
JF - Epidemiology and Psychiatric Sciences
IS - 3
ER -