• Child Health Nursing Research
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• v.21 no.1
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• pp.1-10
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• 2015

Purpose: This study was conducted to explore relationships of postpartum depression with socio-demographic and clinical characteristics of preterm infants and mothers. Methods: Participants were the mothers of 80 premature infants admitted to neonatal intensive care units. Postpartum depression was measured using the Edinburg Postnatal Depression Scale (EPDS). Clinical characteristics were examined through the medical records. The physiological state for the infants was evaluated using the revised Neurobiologic Risk Score (NBRS). Data were analyzed using the t-test, ANOVA, and Pearson correlation coefficients. Results: Average for EPDS was $9.75{\pm}5.06$, and 30% of the participants were at high risk for postpartum depression. There were significant differences in postpartum depression according to mother's education level (F=3.493, p=.035), economic state (F=5.828, p=.004), multiple pregnancy (t=2.141, p=.037), chorioamnionitis (t=2.349, p=.021), oligohydramnios (t=-2.226, p=.029), broncho-pulmonary dysplasia (t=2.085, p=.040), germinal matrix hemorrhage (t=2.259, p=.027), and revised NBRS (t=-2.772, p=.007). There was a significant positive correlation between postpartum depression and number of health problem of infants (r=.252, p=.024) and revised NBRS (r=.316, p=.004). Conclusion: As 30% of the mothers with preterm infants were at high risk for postpartum depression, they require attention. When providing interventions, socioeconomic status as well as the physiological state of premature infants should be considered.

• Journal of Life Science
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• v.28 no.12
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• pp.1536-1544
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• 2018

Depression is a common, serious, and recurring mental disorder. The pathogenesis of depression involves many factors such as environmental factor, genetic factor and alteration of structure and function in neurobiological systems. Increasing evidence supports that epigenetic alteration may be associated with depression. The epigenetics is explained as the mechanisms by which environmental factor causes changes in chromatin structure and alters gene expression without changing DNA base sequence. DNA methylation and histone modification involving histone acetylation and methylation are the main epigenetic mechanisms. Animal studies have shown that stressful environment such as early life stress can leave persistent epigenetic marks in the genome, which alter gene expression and influence neural and behavioral function through adulthood. A potentially important gene in depression is brain-derived neurotrophic factor (BDNF). BDNF plays a central role in depression and antidepressant action. In studies of the rodent, exposure to stress at prenatal, postnatal, and adult stages alters BDNF expression through histone modification and DNA methylation of the BDNF gene which results in anxiety and depressive-like behavior. This review discusses recent advances in the study of the epigenetic mechanisms that contribute to depression, particularly histone modification and DNA methylation of the BDNF gene, that may help in the development of new targets for depression treatment.

• Women's Health Nursing
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• v.6 no.3
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• pp.358-371
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• 2000

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.

• Women's Health Nursing
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• v.24 no.3
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• pp.322-332
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• 2018

Purpose: To investigate the effect of a maternal role adjustment program on first-time mothers. Methods: The research was quasi-experimental with a non-equivalent control group non-synchronized design. Participants were first-time mothers admitted to two postpartum clinics at women's hospitals. The experimental group had 38 mothers and the control group had 35 mothers. A maternal role adjustment program was applied individually to the experimental group between the 1st and 2nd weeks after childbirth. Assessing Adaptation to Motherhood, Semantic Differential Scale-Myself as Mother, and Edinburgh Postnatal Depression Scale were used to measure effects of the program. A pre-test was conducted in the 1st week after childbirth while post-tests were conducted in the 4th and 6th weeks. Data were analyzed with $x^2$ test, Fisher's exact test, t-test, and repeated measures ANOVA using SPSS 24.0. Results: Maternal role adjustment (F=6.17, p=.015) and maternal identity (F=6.63, p=.012) were significantly increased in the experimental group compared to those in the control group. However, the difference in postpartum depression (F=1.11, p=.335) was not statistically significant between the two groups. Conclusions: The maternal role adjustment program can be utilized as an effective nursing intervention program to enhance maternal role adjustment and maternal identity for first-time mothers.

• Women's Health Nursing
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• v.24 no.1
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• pp.49-57
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• 2018

Purpose: Postpartum fatigue can impact maternal well-being and has been associated with levels of perceived self-care. This study aimed to examine the relationship among fatigue, depressive mood, self-care agency, and self-care action among postpartum women in Bangladesh. Methods: A descriptive cross sectional survey was done with 124 first-time mothers from two tertiary hospitals in Dhaka, Bangladesh. The Modified Fatigue Symptoms checklist, Denyes' Self Care Instrument, the Edinburgh Postnatal Depression Scale, and items on sociodemographic and delivery-related characteristics, were used in Bengali via translation and back-translation process. Results: High fatigue levels were found in 18.5% (n=23) and 73.4% had possible depression (n=91). There was a significant negative relationship between fatigue and self-care agency (r=-.31, p<.001), and self-care action (r=-.21, p<.05). Fatigue differed by level of self-care agency (t=4.06, p<.001), self-care action (t=2.36, p=.023), newborn's APGAR score (t=-2.93, p=.004), parental preparation class participation (F=15.53, p<.001), and postpartum depressive mood (t=-4.64, p<.001). Conclusion: Findings suggest that high level of self-care efficacy and behaviors can contribute to fatigue management, and highlight the need for practical interventions to better prepare mothers for postpartum self-care, which may, in turn, alleviate postpartum fatigue.

• Korean Journal of Acupuncture
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• v.29 no.2
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• pp.260-270
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• 2012

Objectives : Hippocampus, a region of temporal lobe, plays an important role in the pathogenic mechanisms of brain diseases such as Alzheimer's disease, depression and temporal lobe epilepsy. This research is designed to investigate hippocampal changes after acupuncture stimulation at Shinmun(HT7) using 2-dimensional gel electrophoresis(2-DE). Methods : On postnatal-day 15, rat pups were randomly devided into Normal(NOR) or HT7 group. All of Pups kept with their mothers for 7 days, but pups in HT7 group received acupuncture stimulation at HT7 daily. On postnatal-day 21, hippocampus of each rat pup was dissceted 30 minutes after last acupuncture stimulation and the protein expressions were investigated using 2-DE. Results : After acupuncture stimulation at HT7, expression of 20 proteins were significantly increased. Succinate semialdehyde dehydrogenase, glyceraldehyde-3-phosphate dehydrogenase-like, transketolase, aconitate hydratase and phosphoglucomutase-1 were related to glucose methabolism. Eukaryotic initiation factor(eIF) 4A-II, eIF 4A-III, mitochondrial Tu translation elongation factor and chain A of crystal structure of the 70-Kda heat shock cognate protein involve in the protein synthesis in ribosome. Tubulin ${\beta}$-4 chain, tubulin T ${\beta}$-15 and tubulin ${\alpha}$-1B chain comprise cytoskeleton. Glutathione S-transferase(GST) ${\omega}$-1, GST P and GST Yb-3 can reduce oxidative stress. ${\beta}$-soluble N-ethylmaleimide-sensitive fusion protein attachment protein is required for vesicular transport between the endoplasmic reticulum and the Golgi apparatus, glycerol-3-phosphate dehydrogenase plays a major role in lipid biosynthesis, creatine kinase U-type catalyses the conversion of creatine and consumes adenosine triphosphate to create phosphocreatine and adenosine diphosphate. Platelet-activating factor acetylhydrolase IB subunit alpha and voltage depedent anion-selective channel protein 2 were also increased. Conclusions : The results suggest that acupuncture stimulation at HT7 may enhance glucose and lipid metabolism, protein synthesis, cytoskeletal substance and anti-oxidative stress in hippocampus.

• Journal of Korean Academy of Nursing
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• v.46 no.1
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• pp.29-38
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• 2016

Purpose: The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was designed to measure post-traumatic symptoms related to childbirth and symptoms during postnatal period. The purpose of this study was to develop a translated Korean version of the PPQ and to evaluate reliability and validity of the Korean PPQ. Methods: Participants were 196 mothers at one to 18 months after giving childbirth and data were collected through e-mails. The PPQ was translated into Korean using translation guideline from World Health Organization. For this study Cronbach's alpha and split-half reliability were used to evaluate the reliability of the PPQ. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and known-group validity were conducted to examine construct validity. Correlations of the PPQ with Impact of Event Scale (IES), Beck Depression Inventory II (BDI-II), and Beck Anxiety Inventory (BAI) were used to test a criterion validity of the PPQ. Results: Cronbach's alpha and Spearman-Brown split-half correlation coefficient were 0.91 and 0.77, respectively. EFA identified a 3-factor solution including arousal, avoidance, and intrusion factors and CFA revealed the strongest support for the 3-factor model. The correlations of the PPQ with IES, BDI-II, and BAI were .99, .60, and .72, respectively, pointing to criterion validity of a high level. Conclusion: The Korean version PPQ is a useful tool for screening and assessing mothers' experiencing emotional distress related to child birth and during the postnatal period. The PPQ also reflects Post Traumatic Stress Disorder's diagnostic standards well.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.6
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• pp.4011-4020
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• 2015

The purpose of this study was to determine the self efficacy, body image and family support affect on postpartum depression in early postpartum mothers. The data was collected 306 mothers on the first week after delivery from one hospital located in B city. The instruments were a survey of general characteristics, obstetrical characteristics, the Edinburgh Postnatal Depression Scale(EPDS), self-efficacy, body image and family support. Data was analysed using descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression. The results revealed that the average item score of the EPDS was 6.09. The significant predictors of postpartum depression were body image, emotional state in pregnancy, and family support. These variables had a 38.4% explainability. The results indicate that the postpartum mothers should be screened for postpartum depression early in the postpartum period and it's necessary to implement nursing intervention focused on to enhance the body image and family support, especially the weak emotional state mothers in pregnancy.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.177-184
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• 2020

Objectives : Postpartum depression is known to occur in 10-15% of mothers. The concentration of cytokine varies depending on stress, depression, pregnancy and general medical conditions. We hypothesized that the concentration of cytokines may be related to reproduction and childbirth, and that women with postpartum depression would show alterations in cytokines levels. Methods : A total of 104 pregnant women were selected as subjects, and 60 non-pregnant women were selected as normal controls. Symptoms of depression were evaluated in the pregnant study subjects using the diagnostic criteria outlined in the Edinburgh Postnatal Depression Scale (EPDS). The pregnant subjects were divided into three groups perinatal non-depression controls (n=61), postpartum depression-recovery (n=18), and postpartum depression (n=25). Results : The plasma concentration of TGF-β1, IGF-1 was higher in the pregnant group than in non-pregnant controls (TGF-β1 ; p<0.01, IGF-1 ; p=0.026). At 24 weeks of pregnancy and 6 weeks of delivery, there were no significant differences in the plasma concentration of TGF-β1, IGF-1, β-NGF, IL-2, IL-4, IL-6, IFN-γ, TNF-α between the three groups. There was no statistically significant difference in all three groups during the course of depression in pregnant women. Conclusions : This study found significant difference in plasma cytokines concentrations between non-pregnant controls and perinatal non-depression controls.

• The Korean Journal of Community Living Science
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• v.17 no.3
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• pp.109-121
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• 2006

This study examines the relationship between mother's stress and cortisol level during late pregnancy and how it changes into postpartum periods. Thirty one families were recruited from Daejeon and Incheon in South Korea. The major findings were as follows: (1) The level of mothers' cortisol followed the typical diurnal pattern of decline throughout the day. Further longitudinal analysis revealed that the level of Korean mothers' cortisol steadily lowered from the 8th prenatal month to the 6th postnatal month. (2) During pregnancy, mothers reported to experience changes in physical activities, daily routines, eating habits, types or amount of social activities and sleeping habits. Among these they were stressed the most by changes in physical activities and social activities. (3) The results of postpartum depression tests conducted at two months after giving birth showed mothers at this time were mostly stressed from difficulty sleeping and unnecessary self criticism. (4) The level of psycho social stress in mothers at six months after giving birth was mainly on social roles and the questions about self reliance marked the highest points. (5) Overall, there was a tendency for the level of maternal stress to decrease definitely from before and after the delivery and even though the level of stress was steadily decreasing up to 6th postpartum month it was not as sharp as those of before and after the birth of the babies. The level of cortisol analysis also showed the same obvious tendency.