Araştırma Makalesi
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Peripartum depression and contributing factors: An observational study

Yıl 2025, Cilt: 16 Sayı: 1, 102 - 111, 25.04.2025

Emre Zafer , Tuğçe Okkuşcu , Seda Kırcı Ercan , Alper Seyhan

https://doi.org/10.22312/sdusbed.1653821

Öz

Objective: Peripartum depression (PD) is a common public health problem. Timely diagnosis and management are crucial and require careful attention from healthcare providers. This study aims to identify demographic, clinical, and laboratory factors associated with PD risk using the Edinburgh Postnatal Depression Scale (EPDS). Materials and Methods: A total of two hundred and twenty-nine pregnant and postpartum subjects were recruited from our university hospital’s inpatient and outpatient clinics to evaluate peripartum depression development risk and contributing factors. Demographic and clinical characteristics, along with certain laboratory values (hemoglobin, thyroid hormones, and vitamin D levels) were analyzed. Results: Among the 229 subjects (137 pregnant, 92 postpartum), 30.1% had abnormal EPDS scores (≥13). Statistical analysis showed that maternal obstetric risk factors, fetal and neonatal health issues, and low vitamin D levels were significantly associated with an increased risk of perinatal depression. Conclusions: EPDS is a practical tool for screening PD risk in busy obstetrics inpatient and outpatient settings. Obstetric maternal health issues, fetal or neonatal health problems, and low vitamin D levels may contribute to a higher risk of PD. Pregnant or postpartum women with these risk factors should be closely monitored for PD progression and referred to a psychiatric professional when indicated.

Anahtar Kelimeler

Perinatal depression Postnatal Pregnancy Depression Vitamin D

Etik Beyan

Ethical approval from the Institution’s Review Board has been obtained prior to the beginning of the study (Aydin Adnan Menderes University Ethical Board for Non-Invasive Clinical Research, Decision number 12, Protocol number 1024/152, and date of 29/11/2024). The study was conducted in line with the principles of the "Helsinki Declaration". Written informed consent to participate and publish was obtained from all individual participants or legal guardians included in the study.

Destekleyen Kurum

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Proje Numarası

N/A

Kaynakça

  • 1. MW, Wisner KL. Perinatal mental illness: definition, description, and etiology. Best Pract Res Clin Obstet Gynaecol. 2014 Jan;28(1):3-12.
  • 2. Liu X, Wang S, Wang G. Prevalence and Risk Factors of Postpartum Depression in Women: A Systematic Review and Meta-analysis. J Clin Nurs. 2022;31(19-20):2665.
  • 3. Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS. Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry. 2008;65(7):805.
  • 4. Yurdakul FE, Karataş Eray İ. The Relationship Between Mode of Delivery and Postpartum Depressive Symptoms in Women. Türk Aile Hek Derg 2024;28(2):55-62 doi:10.54308/tahd.2024.47965
  • 5. Durukan E, İlhan M, Bumin MA, Aycan S. 2 Hafta-18 Aylık Bebeği Olan Annelerde Postpartum Depresyon Sıklığı ve Yaşam Kalitesi. Balkan Medical Journal. 2011;28:385-93. 5.
  • 6. Inandi T, Bugdayci R, Dundar P, Sumer H, Sasmaz T. Risk factors for depression in the first postnatal year: a Turkish study. Soc Psychiatry Psychiatry Epidemiol. 2005;40(9):725-30. 6.
  • 7. Danaci AE, Dinç G, Deveci A, Sen FS, Içelli I. Postnatal depression in Turkey: epidemiological and cultural aspects. Soc Psychiatry Psychiatr Epidemiol. 2002;37(3):125-9.
  • 8. Tahaoğlu AE, Toğrul C, Külahçıoğlu Mİ. Diyarbakır’da postpartum depresyonu etkileyen faktörler. Perinatoloji Dergisi. 2015;23(1):26-9
  • 9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013.
  • 10. World Health Organization. International Classification of Diseases (ICD) [Internet]. ICD-10 online version: 2016. [Accessed on 2025 Mar 7]. Accessed to: http://www.who.int/classifications/icd/en/
  • 11. Fisher SD, Wisner KL, Clark CT, Sit DK, Luther JF, Wisniewski S. Factors associated with onset timing, symptoms, and severity of depression identified in the postpartum period. J Affect Disord. 2016;203:111.
  • 12. O'Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013;9:379-407.
  • 13. Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800.
  • 14. Raposa E, Hammen C, Brennan P, Najman J. The long-term effects of maternal depression: early childhood physical health as a pathway to offspring depression. J Adolesc Health. 2014 Jan;54(1):88-93.
  • 15. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782.
  • 16. Rubertsson C, Börjesson K, Berglund A, Josefsson A, Sydsjö G. The Swedish validation of Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Nord J Psychiatry. 2011 Dec;65(6):414-8.
  • 17. Aydin N, Inandi T, Yigit A, Sahin Hodoglugil NN. Validation of the Turkish version of the Edinburgh Postnatal Depression Scale among women within their first postpartum year. 2004 Jun;39(6):483-6. Soc Psychiatry Psychiatr Epidemiol. doi: 10.1007/s00127-004-0770-4.
  • 18. Dietz PM, Williams SB, Callaghan WM, Bachman DJ, Whitlock EP, Hornbrook MC. Clinically identified maternal depression before, during, and after pregnancies ending in live births. Am J Psychiatry. 2007 Oct;164(10):1515-20.
  • 19. Wisner KL, Sit DKY, McShea MC, Rizzo DM, Zoretich RA, Hughes CL, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry. 2013;70(5):490.
  • 20. Levis B, Negeri Z, Sun Y, Depression Screening Data (DEPRESSD) EPDS Group. 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. BMJ. 2020;371:m4022.
  • 21. Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, et al. Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG. 2011 Mar:118 Suppl 1:1-203. doi: 10.1111/j.1471-0528.2010.02847.x.
  • 22. Cattarinussi G, Aarabi MH, Sanjari Moghaddam H, Homayoun M, Ashrafi M, Soltanian-Zadeh H, et al. Effect of parental depressive symptoms on offspring's brain structure and function: A systematic review of neuroimaging studies. Neurosci Biobehav Rev. 2021;131:451.
  • 23. ACOG Committee Opinion No. 757: Screening for Perinatal Depression. Obstetrics & Gynecology 132(5):p e208-e212, November 2018. | DOI: 10.1097/AOG.0000000000002927
  • 24. Robinson M, Whitehouse AJ, Newnham J, Gorman S, Jacoby P, Holt BJ, et al. Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms. Archives of Women's Mental Health. 2014;17:213-9.
  • 25. Kınık E, Özcan H. Comparison of Health Practices and Depression in Planned and Unplanned Pregnancies. Ankara Sağlık Bilimleri Dergisi. 2024;13(2):94-102.
  • 26. Goodman JH. Postpartum depression beyond the early postpartum period. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2004;33(4):410-20.
  • 27. Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal stress, anxiety and depression in early pregnancy among women in Chongqing, China. Journal of Affective Disorders. 2019;253:292-302.
  • 28. Elsenbruch S, Benson S, Rücke M, Rose M, Dudenhausen J, Pincus-Knackstedt MK et al. Social support during pregnancy: effects on maternal depressive symptoms, smoking, and pregnancy outcome. Human reproduction. 2007;22(3):869-77.
  • 29. Nwafor CE, Ojiako A, Ugwu PC. Impact of Gravida and Level of Psycho-Education on Antenatal Anxiety. Social Science Research. 2024;10(3).
  • 30. Smedberg J, Lupattelli A, Mårdby A-C, Øverland S, Nordeng H. The relationship between maternal depression and smoking cessation during pregnancy—a cross-sectional study of pregnant women from 15 European countries. Archives of Women's Mental Health. 2015;18:73-84.
  • 31. Sundström Poromaa I, Comasco E, Georgakis MK, Skalkidou A. Sex differences in depression during pregnancy and the postpartum period. Journal of neuroscience research. 2017;95(1-2):719-30.
  • 32. Becker M, Weinberger T, Chandy A, Schmukler S. Depression during pregnancy and postpartum. Current psychiatry reports. 2016;18:1-9.
  • 33. Bansil P, Kuklina EV, Meikle SF, Posner SF, Kourtis AP, Ellington SR, et al. Maternal and fetal outcomes among women with depression. Journal of Women's Health. 2010;19(2):329-34.
  • 34. Huang JY, Arnold D, Qiu CF, Miller RS, Williams MA, Enquobahrie DA, et al. Association of serum vitamin D with symptoms of depression and anxiety in early pregnancy. Journal of women's health. 2014;23(7):588-95.
  • 35. Vaziri F, Nasiri S, Tavana Z, Dabbaghmanesh MH, Sharif F, Jafari P, et al. A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers. BMC pregnancy and childbirth. 2016;16:1-12.

Peripartum depresyon ve etki eden faktörler: Bir gözlemsel çalışma

Yıl 2025, Cilt: 16 Sayı: 1, 102 - 111, 25.04.2025

Emre Zafer , Tuğçe Okkuşcu , Seda Kırcı Ercan , Alper Seyhan

https://doi.org/10.22312/sdusbed.1653821

Öz

Amaç: Peripartum depresyon (PD) yaygın bir halk sağlığı sorunudur. Zamanında tanı ve tedavi çok önemlidir ve sağlık hizmeti sağlayıcılarının dikkatli bir şekilde ilgilenmesini gerektirir. Bu çalışma, Edinburgh Doğum Sonrası Depresyon Ölçeği'ni (EPDS) kullanarak peripartum depresyon riskiyle ilişkili demografik, klinik ve laboratuvar faktörlerini belirlemeyi amaçlamaktadır. Gereç ve Yöntem: Üniversite hastanemizin kadın doğum servis ve ayakta tedavi polikliniklerinden toplam iki yüz yirmi dokuz gebe ve doğum sonrası olgu, peripartum depresyon gelişme riskini ve katkıda bulunan faktörleri değerlendirmek için çalışmaya alındı. Demografik ve klinik özellikler, belirlenen laboratuvar değerleriyle (hemoglobin, tiroid hormonları ve D vitamini düzeyleri) birlikte analiz edildi. Bulgular: iki yüz yirmi dokuz olgu arasında (137 gebe, 92 doğum sonrası), %30,1'inin anormal Edinburgh Edinburgh Doğum Sonrası Depresyon Ölçeği puanları (13 ve üzeri) idi. İstatistiksel analiz, maternal obstetrik risk faktörlerinin, fetal ve neonatal sağlık sorunlarının ve düşük D vitamini düzeylerinin perinatal depresyon riskinin artmasıyla önemli ölçüde ilişkili olduğunu gösterdi. Sonuçlar: EPDS, yoğun kadın doğum servis ve polikliniklerinde peripartum depresyon riskini taramak için pratik bir araçtır. Obstetrik anne sağlık sorunları, fetal veya neonatal sağlık sorunları ve düşük D vitamini seviyeleri daha yüksek PD riskine katkıda bulunabilir. Bu risk faktörlerine sahip hamile veya lohusa kadınlar peripartum depresyonuna ilerlemesi açısından yakından izlenmeli ve endike olduğunda bir psikiyatri uzmanına yönlendirilmelidir.

Anahtar Kelimeler

Perinatal depresyon Doğum sonrası Gebelik Depresyon D vitamini

Proje Numarası

N/A

Kaynakça

  • 1. MW, Wisner KL. Perinatal mental illness: definition, description, and etiology. Best Pract Res Clin Obstet Gynaecol. 2014 Jan;28(1):3-12.
  • 2. Liu X, Wang S, Wang G. Prevalence and Risk Factors of Postpartum Depression in Women: A Systematic Review and Meta-analysis. J Clin Nurs. 2022;31(19-20):2665.
  • 3. Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS. Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry. 2008;65(7):805.
  • 4. Yurdakul FE, Karataş Eray İ. The Relationship Between Mode of Delivery and Postpartum Depressive Symptoms in Women. Türk Aile Hek Derg 2024;28(2):55-62 doi:10.54308/tahd.2024.47965
  • 5. Durukan E, İlhan M, Bumin MA, Aycan S. 2 Hafta-18 Aylık Bebeği Olan Annelerde Postpartum Depresyon Sıklığı ve Yaşam Kalitesi. Balkan Medical Journal. 2011;28:385-93. 5.
  • 6. Inandi T, Bugdayci R, Dundar P, Sumer H, Sasmaz T. Risk factors for depression in the first postnatal year: a Turkish study. Soc Psychiatry Psychiatry Epidemiol. 2005;40(9):725-30. 6.
  • 7. Danaci AE, Dinç G, Deveci A, Sen FS, Içelli I. Postnatal depression in Turkey: epidemiological and cultural aspects. Soc Psychiatry Psychiatr Epidemiol. 2002;37(3):125-9.
  • 8. Tahaoğlu AE, Toğrul C, Külahçıoğlu Mİ. Diyarbakır’da postpartum depresyonu etkileyen faktörler. Perinatoloji Dergisi. 2015;23(1):26-9
  • 9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013.
  • 10. World Health Organization. International Classification of Diseases (ICD) [Internet]. ICD-10 online version: 2016. [Accessed on 2025 Mar 7]. Accessed to: http://www.who.int/classifications/icd/en/
  • 11. Fisher SD, Wisner KL, Clark CT, Sit DK, Luther JF, Wisniewski S. Factors associated with onset timing, symptoms, and severity of depression identified in the postpartum period. J Affect Disord. 2016;203:111.
  • 12. O'Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013;9:379-407.
  • 13. Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800.
  • 14. Raposa E, Hammen C, Brennan P, Najman J. The long-term effects of maternal depression: early childhood physical health as a pathway to offspring depression. J Adolesc Health. 2014 Jan;54(1):88-93.
  • 15. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782.
  • 16. Rubertsson C, Börjesson K, Berglund A, Josefsson A, Sydsjö G. The Swedish validation of Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Nord J Psychiatry. 2011 Dec;65(6):414-8.
  • 17. Aydin N, Inandi T, Yigit A, Sahin Hodoglugil NN. Validation of the Turkish version of the Edinburgh Postnatal Depression Scale among women within their first postpartum year. 2004 Jun;39(6):483-6. Soc Psychiatry Psychiatr Epidemiol. doi: 10.1007/s00127-004-0770-4.
  • 18. Dietz PM, Williams SB, Callaghan WM, Bachman DJ, Whitlock EP, Hornbrook MC. Clinically identified maternal depression before, during, and after pregnancies ending in live births. Am J Psychiatry. 2007 Oct;164(10):1515-20.
  • 19. Wisner KL, Sit DKY, McShea MC, Rizzo DM, Zoretich RA, Hughes CL, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry. 2013;70(5):490.
  • 20. Levis B, Negeri Z, Sun Y, Depression Screening Data (DEPRESSD) EPDS Group. 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. BMJ. 2020;371:m4022.
  • 21. Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, et al. Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG. 2011 Mar:118 Suppl 1:1-203. doi: 10.1111/j.1471-0528.2010.02847.x.
  • 22. Cattarinussi G, Aarabi MH, Sanjari Moghaddam H, Homayoun M, Ashrafi M, Soltanian-Zadeh H, et al. Effect of parental depressive symptoms on offspring's brain structure and function: A systematic review of neuroimaging studies. Neurosci Biobehav Rev. 2021;131:451.
  • 23. ACOG Committee Opinion No. 757: Screening for Perinatal Depression. Obstetrics & Gynecology 132(5):p e208-e212, November 2018. | DOI: 10.1097/AOG.0000000000002927
  • 24. Robinson M, Whitehouse AJ, Newnham J, Gorman S, Jacoby P, Holt BJ, et al. Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms. Archives of Women's Mental Health. 2014;17:213-9.
  • 25. Kınık E, Özcan H. Comparison of Health Practices and Depression in Planned and Unplanned Pregnancies. Ankara Sağlık Bilimleri Dergisi. 2024;13(2):94-102.
  • 26. Goodman JH. Postpartum depression beyond the early postpartum period. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2004;33(4):410-20.
  • 27. Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal stress, anxiety and depression in early pregnancy among women in Chongqing, China. Journal of Affective Disorders. 2019;253:292-302.
  • 28. Elsenbruch S, Benson S, Rücke M, Rose M, Dudenhausen J, Pincus-Knackstedt MK et al. Social support during pregnancy: effects on maternal depressive symptoms, smoking, and pregnancy outcome. Human reproduction. 2007;22(3):869-77.
  • 29. Nwafor CE, Ojiako A, Ugwu PC. Impact of Gravida and Level of Psycho-Education on Antenatal Anxiety. Social Science Research. 2024;10(3).
  • 30. Smedberg J, Lupattelli A, Mårdby A-C, Øverland S, Nordeng H. The relationship between maternal depression and smoking cessation during pregnancy—a cross-sectional study of pregnant women from 15 European countries. Archives of Women's Mental Health. 2015;18:73-84.
  • 31. Sundström Poromaa I, Comasco E, Georgakis MK, Skalkidou A. Sex differences in depression during pregnancy and the postpartum period. Journal of neuroscience research. 2017;95(1-2):719-30.
  • 32. Becker M, Weinberger T, Chandy A, Schmukler S. Depression during pregnancy and postpartum. Current psychiatry reports. 2016;18:1-9.
  • 33. Bansil P, Kuklina EV, Meikle SF, Posner SF, Kourtis AP, Ellington SR, et al. Maternal and fetal outcomes among women with depression. Journal of Women's Health. 2010;19(2):329-34.
  • 34. Huang JY, Arnold D, Qiu CF, Miller RS, Williams MA, Enquobahrie DA, et al. Association of serum vitamin D with symptoms of depression and anxiety in early pregnancy. Journal of women's health. 2014;23(7):588-95.
  • 35. Vaziri F, Nasiri S, Tavana Z, Dabbaghmanesh MH, Sharif F, Jafari P, et al. A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers. BMC pregnancy and childbirth. 2016;16:1-12.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Doğumun Psikososyal Yönleri ve Perinatal Ruh Sağlığı, Doğum ve Kadın Hastalıkları Hemşireliği
Bölüm Araştırma Makaleleri
Yazarlar

Emre Zafer 0000-0001-9262-2947

Tuğçe Okkuşcu 0000-0002-7783-4869

Seda Kırcı Ercan 0000-0002-1363-0349

Alper Seyhan 0000-0003-0543-6180

Proje Numarası N/A
Yayımlanma Tarihi 25 Nisan 2025
Gönderilme Tarihi 8 Mart 2025
Kabul Tarihi 21 Nisan 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 16 Sayı: 1

Kaynak Göster

Vancouver Zafer E, Okkuşcu T, Kırcı Ercan S, Seyhan A. Peripartum depression and contributing factors: An observational study. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2025;16(1):102-11.
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