Objectives: Postpartum depression(PPD) is a kind of serious problem which influences on the postpartum woman, her family and infant. It has been known to be caused by many factors and some depression scales have been used to assess the degree of PPD. Edinburgh Postpartum Depression Scale(EPDS) recently began to be used for screening for PPD.Methods: The subjects were 46 women who admitted for postpartum treatment in Oriental Hospital of Woosuk University from May 2000 to December 2000. In this study, we used EPDS and Beck Depression Inventory(BDI) to assess the degree of PPD, and we researched the related factors of PPD. Results: 13 women(28.3%) in the high risk group by EPDS and 7 women(15.2%) in depression - severe depression group by BDI were diagnosed as PPD among the 46 women. There was significant correlation between Epds score and BDI score. The mean score of EPDS was higher in normal delivery group than caesarean delivery group, higher in primiparae group than multiparae group, and higher in the group who delivered female infants than male infants. But there were not significant differences. And there was not significant correlation between EPDS score and age.Conclusions: These results suggest that PPD is quite frequent at postpartum period and it is necessary to treat for PPD. It is important for clinicians to pay attention to the related factors of PPD as well as to recognize and treat PPD.
The purpose of this study was to provide the basic, data for developing a program for effective prevention for Postpartum Depression (PPD) by investigating the level of PPD in postpartum 2 weeks women. The subjects were 384 women who visited obstetrical clinics for postnatal care. The data were collected from June 29. 1999 to April. 2000, using a 46-item questionnaire related to PPD, and analyzed by SAS program for t-test, ANOVA, Scheffe test, stepwise multiple regressions. The results were as follows : 1. The level of PPD according to general characteristics Women had mild PPD (Min score; 46.0, Max score; 124.0). The PPD levels were significantly differences according to religion and marital satisfaction (p<0.05). 2. The level of PPD according to obstetrical characteristics 1) Characteristics related to pregnancy The PPD levels were significantly differences according to mood change, confidence of body weight recovery, depression related to appearance change, husband's help to housework, and husband's emotional support (p<0.05). 2) Stressful events during pregnancy The PPD levels were significantly differences according to financial problem, conflict between partners, conflict between family, and husband's job change (p<0.05). 3) Characteristics related to delivery and post natal period The PPD levels were significantly differences according to baby's health state, parenting confidence, and difficulties related to postpartum care (p<0.05). 3. The variables to predict postpartum depression in postpartum women are depression related to appearance change (10.4%), parenting confidence (8.8%), husband's help to housework (2.7%), confidence of body weight recovery (2.4%), husband's job change (1.9%), baby's health state (1.9%), difficulties related to postpartum care (1.6%), mood change (1.2%), conflict between partners (0.6%), marital satisfaction (0.5%), financial problem (0.4%). The sum total of all the above variables can account for 32.4% of postpartum depression. 4. The level of PPD according to PPD factors. Women had the highest degree of PPD in biophysiological phenomena-disturbance of physical functioning factor. The factors of relationship to baby-negative feeling and cognitive phenomena-self concept disturbance were showed the lowest degree of PPD. As a result of the above findings, a systemic and individualized program is strongly recommended for PPD prevention, diagnosis, and care for PPD in postpartum women. In near future, this study should be expanded to investigate the coping skills according to the PPD levels in postpartum women.
Purpose: This study aimed to determine the level of postpartum posttraumatic stress disorder (PTSD) and postpartum depression (PPD) in Korean mothers with healthy babies and to explore the factors related to postpartum PTSD. Methods: This study used a longitudinal survey design to explore the levels and association of PPD and PTSD. Two hundred women were recruited during pregnancy and the data were collected via online survey from 166 mothers (84% retained) who gave birth to healthy babies, at two postpartum periods: Fear of childbirth was assessed at the 1st week; and spousal support, PPD, and postpartum PTSD were surveyed at the 4th week postpartum. Descriptive statistics, t-test, one-way analysis of variance, Chi square test, and multiple regression were done. Results: The mean age of mothers was 33.12 (±3.97) years old. Postpartum PTSD was low (8.95±6.49) with 1.8% (n=3) at risk (≥19). PPD was also low (6.68±5.28) and 30.1% (n=50) were identified at risk (≥10). The comorbid rate of PPD with PTSD was 6%. Mothers who did not have a planned pregnancy had higher scores of PPD (t=-2.78, p=.008), whereas spousal support and PPD had negative relationship (r=-.21, p=.006). The overall explanatory power for postpartum PTSD was 55.2%, of which PPD was the only significant variable (β=. 76, t=13.76, p<.001). Conclusion: While only 1.8% was at risk of postpartum PTSD at 4 weeks postpartum, PPD prevalence was 30.1% and PPD was the only influential factor of postpartum PTSD. Assessment and counseling of PPD are required as well as screening for postpartum PTSD. More research is also needed on postpartum PTSD in Korean women.
The purpose of this study was to provide the basic data for developing a program for effective prevention for postpartum depression (PPD) by investigate the level of PPD in postpartum women. The subjects were 104 women. The data were collected from march, 2003 to June, using a 36 item questionnaire and analyzed by SPSS program for t-test, ANOVA, multiple regression. The results were as follow 1. The score of Postpartum depression was 44.1. The level of PPD according to General Characteristics was significantly difference according to home care need. 2. The level of PPD according to obstetrical characteristics was significantly differences according to postpartum complication(p<.05). depression in pregnancy(p<.01), baby's health state(p<.01). 3. The variables to predict postpartum depression in postpartum women are depression related to depression during pregnancy, complication after delivery, and a baby's condition. As the result of multiple regression analysis, variables bringing about postpartum discomfort were depression during pregnancy, complication after delivery, and a baby's condition, and this model showed the explanatory power at 28.8%. In conclusion, it is necessary to care mothers belonging to a risk group more concentrically by taking the factors causing postpartum depression into account, and to keep on studying repeatedly in order to raise the number of objects and to find related variables because this study has more or less limited objects not enough to generalize a bit. It is also necessary to study to make a program of arbitration in nursing of postpartum depression actually.
Purpose: The purpose of this review was to describe a psychoneuroimmunology (PNI) framework for postpartum depression (PPD) and discuss its implications for nursing research and practice for postpartum women. Methods: This study explored the role of hypothalamic-pituitary-adrenal (HPA) axis and inflammation as possible mediators of risk factors for PPD through literature review. Results: From this PNI view, human bodies are designed to respond with the reciprocal interactions among the neuro-endocrine and immune system when they are faced with physical or psychological stressors. Chronic stress induces alterations in the function of HPA axis, and a chronic low-grade inflammatory response is associated with depression. The dysfunctions of cytokines and HPA axis have been observed during the postpartum period. Stress promotes glucocorticoid receptor resistance, which can promote inflammatory responses. This, in turn, can contribute to the pathophysiology of depression. This can especially affect populations at vulnerable time-points, such as women in the postpartum. Conclusion: From a PNI perspective, well-designed prospective research evaluating the role of stress and inflammation as an etiology of PPD and the effect of stress reduction is warranted to prevent PPD.
Objectives: Since early developed measurement of Postpartum depression(PPD) doesn't reflect physical symptoms, we need to find out how PPD and related physical disorders are expressed in functional medical methods. The study was conducted to find out characteristics of 7 Zone diagnosis and postpartum physical symptoms on PPD. Methods: To 216 postpartum women who did normal delivery, we measured 7-zone-diagnosis Factor AA's height on 5th day and 15th day postpartum. And we surveyed EPDS and postpartum physical symptoms question on 15th day postpartum. Subjects were divided into normal and depression group by EPDS score. And we compared Factor AA's height between two groups and Factor AA's height change in each group. Results: In depression group, Factor AA's height was higher than normal group on 5th day and 15th day postpartum. In both groups Factor AA's height was decreased on 15th day compared to 5th day postpartum. In normal group 2, 6, 7 zone were significantly decreased and in depression group only 6 zone was significantly decreased. Conclusions: These results demonstrate that postpartum depression group has low recuperative power. And these can be judged by Factor AA's height change.
Purpose: This study aimed to identify the scores of postpartum depression(PPD) on the first day, 1st week, and 6th week after the delivery and to explore their related factors before and after delivery in postpartum women. Methods: With a survey design, 293 postpartum women were recruited from a postpartum unit, Ilsin Christian hospital in Pusan via convenience sampling and were followed at 1st week and 6th week in the outpatient clinic. Results: Results showed that the scores of PPD(EPDS score) were low at postpartum 1st day, 1st week and 6th week but prevalence of PPD(EPDS ${\geq}13$)was 3.1%at 1st day, 8.2%at 1st week and 7.5%at 6th week, respectively. The pre-delivery factors were experience of depression, and the post-delivery factors were baby's sex(1st day), no caregiver for baby(1st week), and no help and concern for taking care of baby from husband and family(1st day and 6th week). The greater satisfaction with becoming a mother and her life, and greater maternal attachment were related to lower level of PPD at the three time points. Conclusion: Regular screening for postpartum depression and supportive and informative education is needed for postpartum women visiting the outpatient clinic for follow-up.
Objective : Postpartum depression(PPD) was known to be caused by many factors including various psychosocial risk factors. This study was performed to identify the psychosocial risk factors for ppd, preliminarily in Korea. Methods : A group of 119 postpartum women, each of whom was at 6 to 8 weeks after delivery was identified at the time when they visited to the child health clinic or postnatal check-up clinic. The risk factors were surveyed by the self-reported questionnaire. The items of questionnaire were consisted of known risk factors in other studies and other possible stress-related factors. PPD was assessed by the Edinburgh Postnatal Depression Scale(EPDS) and the degree of postpartum depression was determined by its score. Results : 16 women(13.45%) in the high risk group were diagnosed as PPD among the 119 women. Risk factors including past experience of depressive symptoms and low level of marital satisfaction were founded more frequently in women in the high risk group than in the low risk group. The score of EPDS was significantly high in the group who experienced depressive symptoms in the past, anxiety or depression during pregnancy, stressful life event during the period of recent pregnancy and postpartum, and who had low level of marital satisfaction. There was a positive correlation between age and the score of EPDS. However, the postpartum depressive symptoms were not influenced by the level of education, job, retirement due to pregnancy and delivery, wanted or unwanted pregnancy, delivery method, feeding method, the hospitalization of infant, expected and real gender of infant. Conclusion : These results suggest that PPD is quite frequent at postpartum period. Various risk factors contribute to the development of PPD. If clinicians pay attention to the risk factors of PPD and give appropriate psychiatric intervention to the mothers during pregnancy and postpartum, it will be easy for the clinicians to recognize and treat PPD in the early stage.
Postpartum depression(PPD) of women with depression increased frequency of thyroid disease, and so the correlations for depression and thyroid disease has been the subject of discussed whether. The purpose of this study was to predict the prevalence of PPD and the correlation between PPD and thyroid disease through ultrasonography. January 2010 to November 2011, Obstetrics & Gynecology in M-clinical center admitted 230 patients within 1 year postpartum were enrolled. EPDS by PPD scale depression screening and general characteristics of subjects were investigated and thyroid was examined that ultrasonography and thyroid blood tests. A total of 230 patients non PPD group were 53.0% and PPD group were 47.0%. In ultrasonography, among 27 patients who changed in size of thyroid, non PPD group were 14.8% and PPD group were 85.2%. Among 124 patients who thyroid nodules were presence, non PPD were 35.8% and PPD group were 64.2%. In ultrasonography, PPD group were higher incidence than non PPD group were changes in size of thyroid and the presence of nodules. There was significant difference between the changed in size of thyroid and thyroid nodules were presence the two group. Definitive histopathological diagnosis was benign in 33 patients (non PPD group were 45.5%, PPD group were 54.5%), malignancy in 5 patients (only PPD group were 100%), thyroiditis in 3 patients (non PPD group were 33.3%, PPD group were 66.7%). The results of thyroid blood tests, abnormal TSH level were 7 patients (non PPD group were 28.6%, PPD group were 71.4%) and abnormal Free T4 level were 9 patients (non PPD group were 44.4%, PPD group were 55.6%). There was no significant difference between the abnormal TSH level and Free T4 level of the two group. 5 patients were diagnosed as thyroid dysfunction. Of these, 2 patients were subclinical hyperthyroidism in non PPD group, 2 patients were subclinical hyperthyroidism and 1 patient was subclinical hyperthyroidism in PPD group. This study was significant the correlation between PPD and thyroid gland disease through ultrasonography. And the objective results of this study might be able to provide guideline that understanding, prevention and treatment for PPD and thyroid disease.
Depression is the leading cause of disease-related disability among women. Postpartal depression (PPD) can produce substantial clinical, economic, and psychosocial impairment, not only for the women experiencing it but also for the women's children and family. Therefore, a comprehensive understanding the accurate detection and appropriate treatment of depression is mandatory in women of childbearing age. This review focused on the current knowledge of PPD.
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