Pregnancy, perinatal and postpartum complications as determinants of postpartum depression

The Rhea mother-child cohort in Crete, Greece

K. Koutra, Maria Vassilaki, V. Georgiou, A. Koutis, P. Bitsios, M. Kogevinas, L. Chatzi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)244-255
Number of pages12
JournalEpidemiology and Psychiatric Sciences
Volume27
Issue number3
DOIs
StatePublished - Jun 1 2018

Fingerprint

Rheiformes
Postpartum Depression
Greece
Postpartum Period
Mothers
Pregnancy
Depression
Breast Feeding
Logistic Models
Unplanned Pregnancy
Pregnancy Induced Hypertension
Snoring
Sleep Deprivation
Pregnancy Complications
Pre-Eclampsia
Epidemiologic Studies
Linear Models
Sleep
Hospitalization

Keywords

  • Perinatal
  • postpartum complications
  • postpartum depression
  • pregnancy

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Cite this

Pregnancy, perinatal and postpartum complications as determinants of postpartum depression : The Rhea mother-child cohort in Crete, Greece. / Koutra, K.; Vassilaki, Maria; Georgiou, V.; Koutis, A.; Bitsios, P.; Kogevinas, M.; Chatzi, L.

In: Epidemiology and Psychiatric Sciences, Vol. 27, No. 3, 01.06.2018, p. 244-255.

Research output: Contribution to journalArticle

@article{36110a378b5a45bf929564552cc7cbab,
title = "Pregnancy, perinatal and postpartum complications as determinants of postpartum depression: The Rhea mother-child cohort in Crete, Greece",
abstract = "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.",
keywords = "Perinatal, postpartum complications, postpartum depression, pregnancy",
author = "K. Koutra and Maria Vassilaki and V. Georgiou and A. Koutis and P. Bitsios and M. Kogevinas and L. Chatzi",
year = "2018",
month = "6",
day = "1",
doi = "10.1017/S2045796016001062",
language = "English (US)",
volume = "27",
pages = "244--255",
journal = "Epidemiology and Psychiatric Sciences",
issn = "2045-7960",
publisher = "Cambridge University Press",
number = "3",

}

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, Maria

AU - Georgiou, V.

AU - Koutis, A.

AU - Bitsios, P.

AU - Kogevinas, M.

AU - Chatzi, L.

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

UR - http://www.scopus.com/inward/record.url?scp=85007210858&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85007210858&partnerID=8YFLogxK

U2 - 10.1017/S2045796016001062

DO - 10.1017/S2045796016001062

M3 - Article

VL - 27

SP - 244

EP - 255

JO - Epidemiology and Psychiatric Sciences

JF - Epidemiology and Psychiatric Sciences

SN - 2045-7960

IS - 3

ER -