Antenatal risk factors for postnatal depression: a prospective study of chinese women at maternal and child health centres

BMC Psychiatry

Michael W O'Hara¹  Se Fong Hung⁵  Patrick Ip³  Shirley SL Leung²  Bonnie WM Siu⁴ 

[1] Department of Psychology, The University of Iowa, Iowa City, USA;Department of Health, Hong Kong SAR, China;Community Child Health Unit, Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China;Department of Psychiatry, Castle Peak Hospital, Hong Kong SAR, China;Department of Psychiatry, Kwai Chung Hospital, Hong Kong SAR, China

关键词: Chinese;    Risk factors;    Antenatal;    Depression;    Postnatal;   

Others  :  1124409
DOI  :  10.1186/1471-244X-12-22

 received in 2011-11-25, accepted in 2012-03-22,  发布年份 2012

【 摘 要 】

Background

Risk factors for postnatal depression (PND) are under-explored in the Chinese populations. There is increasing recognition of the importance of identifying predictive factors during the antenatal period for PND. The present study aimed to identify the risk factors for postnatal depression in a community cohort of Chinese women with special focus on the antenatal risk factors.

Methods

Eight hundred and five Chinese women were interviewed during their third trimester of pregnancy and at around 2 months postnatally. Putative risk factors for PND were collected and the diagnosis of PND was confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders. The 2-month postnatal depression status was used as the dependent variable for univariate and multivariate analyses against putative risk factors.

Results

Marital dissatisfaction (Relative Risk = 8.27), dissatisfied relationship with mother-in-law (Relative Risk = 3.93), antenatal depressive symptomatology (Relative Risk = 3.90), and anxiety-prone personality (Relative Risk = 2.14) predicted PND in Chinese women independently.

Conclusions

Chinese women tend to keep their own feelings and emotions and it is important to monitor Chinese pregnant women with these predictive risk factors so that PND can be identified early.

【 授权许可】

   
2012 Siu et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Weinberg MK, Tronick EZ: The impact of maternal psychiatric illness on infant development. J Clin Psychiatry 1998, 59:53-61.
• [2]de Tychey C, Briancon S, Lighezzolo J, Spitz E, Kabuth B, de Luigi V, et al.: Quality of life, postnatal depression and baby gender. J Clin Nurs 2008, 17:312-322.
• [3]Siu BWM, Ip P, Chow HMT, Kwok SSP, Li OL, Koo ML, et al.: Impairment of mother-infant relationship: validation of the Chinese version of Postpartum Bonding Questionnaire. J Nerv Ment Dis 2010, 198:174-179.
• [4]Beck CT: A Meta-analysis of predictors of postpartum depression. Nurs Res 1996, 45:297-303.
• [5]Reid AJ, Biringer A, Carroll JD, Midmer D, Wilson LM, Chalmers B, et al.: Using the ALPHA form in practice to assess antenatal psychosocial health. Can Med Assoc J 1998, 159:677-684.
• [6]Carroll JC, Reid AJ, Biringer A, Deana Midmer D, Glazier RH, Wilson L, et al.: Effectiveness of the Antenatal Psychosocial Health Assessment (ALPHA) form in detecting psychosocial concerns: a randomized controlled trial. Can Med Assoc J 2005, 173:253-259.
• [7]Culpepper L, Jack B: Psychosocial issues in pregnancy. Prim care 1993, 20:599-619.
• [8]Cox JL, Conner Y, Kendel RE: Prospective study of the psychiatric disorders of childbirth. Br J Psychiatry 1982, 140:111-117.
• [9]Lee DTS, Yip ASK, Leung TYS, Chung TKH: Ethnoepidemiology of postnatal depression: prospective multivariate study of sociocultural risk factors in a Chinese population in Hong Kong. Br J Psychiatry 2004, 184:34-40.
• [10]O'Hara MW: Social support, life events and depression during pregnancy and the puerperium. Arch Gen Psychiatry 1986, 43:567-573.
• [11]Boyce P, Hickey A: Psychosocial risk factors to major depression after childbirth. Soc Psychiat Epidemiol 2005, 40:605-612.
• [12]Kozinszky Z, Dudas RB, Csatordai S, Devosa I, Tóth E, et al.: Social dynamics of postpartum depression: a population-based screening in South-Eastern Hungary. Soc Psychiat Epidemiol 2011, 46:413-423.
• [13]Buist AE, Austin M-PV, Hayes BA, et al.: Postnatal mental health of women giving birth in Australia 2002-2004: findings from the beyondblue National Postnatal Depression Program. Aust N Z J Psychiatry 2008, 42:66-73.
• [14]Lee DTS, Yip ASK, Leung TYS, Chung TKH: Identifying women at risk of postnatal depression: prospective longitudinal study. HKMJ 2000, 6:349-354.
• [15]Siu BWM, Chow HMT, Kwok SSP, Koo ML, Poon PW: The Comprehensive Child Development Service for early identification and management of postnatal depression: service data of a regional hospital in Hong Kong. Hong Kong Journal of Mental Health 2010, 36:14-20.
• [16]Siu BWM, Chow HMT, Kwok SSP, Li OL, Koo ML, Poon PW: The pathway to care for postnatal depression after implementation of the Comprehensive Child Development Service in a regional hospital in Hong Kong. Asia-Pacific Psychiatry 2011, 3:54-60.
• [17]Leung SSL: The Child Health Program for Hong Kong. HK J Paediatr 2008, 13:275-278.
• [18]Leung SSL, Leung C, Lam TH, Hung SF, Chan R, Yeung T, et al.: Outcome of a postnatal depression screening programme using the Edinburgh Postnatal Depression Scale: a randomized controlled trial. Journal of Public Health. [http:/ / jpubhealth.oxfordjournals.org/ content/ early/ 2010/ 09/ 29/ pubmed.fdq075.abstract.] webcite 2010. Accessed 21 September 2011
• [19]Miao MYK, Wong GPK, Szeto WL, Yiu MGC: Symptoms of anxiety and depression in the perinatal period: referrals to the Comprehensive Child Development Service in a Hong Kong Regional Hospital. Hong Kong J Psychiatry 2009, 19:112-116.
• [20]Lee DTS, Yip ASK, Chiu HFK, Leung TYS, Chan KP, Chau IOL, et al.: Detecting postnatal depression in Chinese women: validation of the Chinese version of the Edinburgh postnatal depression scale. Br J Psychiatry 1998, 172:433-437.
• [21]So E, Kam I, Leung CM, Chung D, Liu Z, Fong S: The Chinese-bilingual SCID-I/P Project: Stage 1-Reliability for Mood Disorders and Schizophrenia. Hong Kong J Psychiatry 2003, 13:7-18.
• [22]Shek DT: Reliability and factorial structure of the Chinese version of the Beck Depression Inventory. Journal Clin Psychol 1990, 46:35-43.
• [23]Cox JL, Holden JM, Sagovsky R: Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987, 150:782-786.
• [24]First MB, Spitzer Robert L, Gibbon Miriam, Williams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition. (SCID-I/NP). New York: Biometrics Research, New York State Psychiatric Institute; 2002.
• [25]Beck AT, Ward CH, Mendelson M: An inventory for measuring depression. Arch Gen Psychiatry 1961, 4:561-571.
• [26]Pillsbury BLK: "Doing the month": confinement and convalescence of Chinese women after childbirth. Soc Sci Med 1978, 12:11-22.
• [27]Appleby L, Kumar R, Warner R: Perinatal psychiatry. Int Rev Psychiatry 1996, 8:5-7.
• [28]Thio IM, Oakley Browne MA, Coverdale JH, Argyle N: Postnatal depressive symptoms go largely untreated: a probability study in urban New Zealand. Soc Psychiat Epidemiol 2006, 41:814-818.
• [29]O'Hara MW, Neunaber DJ, Zekowski EM: Prospective study of postpartum depression: prevalence, course and predictive factors. J Abnorm Psychol 1984, 93:158-171.
• [30]Paykel ES, Emms E, Fletcher J, Rassaby ES: Life events and social support in puerperal depression. Br J Psychiatry 1980, 136:339-346.
• [31]Wang S, Jiang X, Jan W, Chen C: A comparative study of postnatal depression and its predictors in Taiwan and Mainland China. Am J Obstetrics and Gynaecology 2003, 189:1407-1412.
• [32]Department of National Health and Welfare: Family-centred maternity and newborn care. Ottawa: Department of National Health and Welfare; 1987.
• [33]Boyce P, Parker G, Barnett B, Cooney M, Smith K: Personality as a vulnerability factor to depression. Br J Psychiatry 1991, 159:106-114.
• [34]Hirschfeld RMA, Klerman GL, Lavori PW, Keller MB, Griffith P, Coryell W: Premorbid personality assessments of first onset of major depression. Arch Gen Psychiatry 1989, 46:345-350.
• [35]Kendell RE, Discipio WJ: Eysenck Personality Inventory Scores of patients with depressive illnesses. Br J Psychiatry 1968, 114:767-770.
• [36]Bair MJ, Robinson RL, Katon W, Kroenke K: Depression and pain comorbidity: a literature review. Arch Intern Med 2003, 163:2433-2445.
• [37]Ohayon MM, Schatzberg AF: Using chronic pain to predict depressive morbidity in the general population. Arch Gen Psychiatry 2003, 60:39-47.
• [38]Peveler R, Katona C, Wessely S, Dowrick C: Painful symptoms in depression: under-recognised and under-treated? Br J Psychiatry 2006, 188:202-203.