Effects of antenatal depression screening and intervention among Chinese high‐risk pregnant women with medically defined complications: A randomized controlled trial

Zhao, Ying; Munro‐Kramer, Michelle L.; Shi, Sheng; Wang, Jing; Zhao, Qi

doi:10.1111/eip.12731

Cited by 16 publications

(17 citation statements)

References 28 publications

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Section: Discussionsupporting

confidence: 91%

“…We found that awareness of antenatal depression increased, not only among the intervention group, but also among the control group, due to the implementation of antenatal depression screening and follow‐up, in line with our previous study (Zhao et al, 2019). For most women enrolled in the study, concern for their psychological health and potential negative effects on their foetus led to proactive adjustments to unstable emotions during the perinatal period.…”

Section: Discussionsupporting

confidence: 91%

“…Additionally, research has shown that initial breastfeeding experience may change the outcome of intentional breastfeeding behaviour and that women need to be prepared for breastfeeding challenges while they are pregnant (Alianmoghaddam et al, 2017). This intervention was developed in our previous study, in which we demonstrated the effectiveness of the psycho‐educational intervention at targeting management of psychological status (Zhao et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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An evaluation of a prenatal individualised mixed management intervention addressing breastfeeding outcomes and postpartum depression: A randomised controlled trial

Zhao

Lin

Wang

2021

Journal of Clinical Nursing

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Aims and objectives: To determine the effects of an individualised mixed management combined lactation education and psychoeducation intervention on breastfeeding outcomes and postpartum depression (PPD) at 3 and 42 days postpartum. Background: Pregnant women with antenatal depression are prone to postpartum depression and failure in breastfeeding. Design: Eligible women participated in a randomised single-blind controlled trial. Results are reported as per the CONSORT 2010 statement. Methods: Participants were recruited from December 2017-August 2018 at a major teaching hospital located in Shanghai. Primiparous women (n = 182) with an Edinburgh Postnatal Depression Scale score ≥9 were randomly enrolled in the intervention group (n = 91) or the control group (n = 91). The intervention group participated in a 4-session face-to-face mixed management intervention targeting perinatal depression and breastfeeding. The control group received usual care. Breastfeeding and psychological outcomes were measured during the third trimester (≥28 weeks and <35 weeks), and at 3 and 42 days postpartum.Results: There were statistically significant differences in rates of overall and exclusive breastfeeding, initial breastfeeding experience, breastfeeding behaviour and self-efficacy between the two groups at 3 and 42 days postpartum (p < .05). Intentionto-treat linear mixed model analysis showed that EPDS scores were statistically significantly different between groups over time (F = 20.42, p < .001). Intervention group were more satisfied with their husbands' care and care received during the first month postpartum (p < .05). Conclusions:The results demonstrate the effectiveness and feasibility of delivering an individualised mixed management intervention combining lactation guidance with psychological support during pregnancy. Relevance to clinical practice:This study supports the need to identify pregnant women at risk of perinatal depression and indicates that the prenatal individualised mixed management intervention has the potential to reduce PPD and help achieve better breastfeeding outcomes.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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An evaluation of a prenatal individualised mixed management intervention addressing breastfeeding outcomes and postpartum depression: A randomised controlled trial

Zhao

Lin

Wang

2021

Journal of Clinical Nursing

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“…After the announcement of the human-to-human transmission, and the declaration of lockdown policy on 23rd January, 2020 in Wuhan, China, there was a significant rise in the prevalence of anxiety, and depressive symptoms amongst pregnant women ( 1 , 14 ). To reduce the adverse consequences of psychological disturbances reported within this population, experts suggested that screening should be implemented with adequate systems to ensure accurate diagnosis, effective treatment, and appropriate follow-up ( 34 ). In late February, the national health authorities and Chinese academic societies published specific expert consensus and intervention guidelines, appropriately labeled, “The Manual of Novel Coronavirus Pneumonia Prevention and Control for Children and Pregnant Women” ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

Mental Health Outcomes in Perinatal Women During the Remission Phase of COVID-19 in China

Zeng

Sun

et al. 2020

Front. Psychiatry

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Background Since the middle of March, the COVID-19 outbreak has been well contained in China. The prevention and control measures for the outbreak have been downgraded to a normalized level. However, until now, the change in level of psychological health amongst perinatal women during the remission phase of the COVID-19 outbreak has not been investigated in China. The aim of this current study was to assess the symptoms of anxiety, depression, insomnia and quality of life (QOL) in perinatal women and to identify potential risk factors associated with these symptoms. Methods This was a cross-sectional, hospital-based survey conducted between March 25 th till June 5 th , 2020 in southern China. Convenient sampling method was adopted. Women’s anxiety, depression, insomnia symptoms and QOL was examined through standardized measurements. Multivariate logistic regression and Analysis of Covariance (ANCOVA) was conducted for the same. Results A total of 625 perinatal women completed the study; of them, 195 women (31.2%, 95%CI=27.56%–34.84%) reported anxiety, 120 (19.2%, 95%CI=16.10%–22.30%) reported depression, and 87 (13.9%, 95%CI=11.20%–16.64%) experienced symptoms of insomnia. Previous adverse experiences during pregnancy was a significant risk factor for anxiety (OR=1.628, 95%CI=1.069–2.480, P=0.023), depression (OR=1.853, 95%CI=1.153–2.977, P=0.011), and insomnia (OR=2.160, 95%CI=1.290-3.616, P=0.003). Participants having infected friends/families/colleagues were more likely to report anxiety (OR=2.195, 95%CI=1.245–3.871, P=0.007) and depression (OR=2.666, 95%CI=1.482–4.794, P=0.001). Those women whose regular check-ups were severely interrupted by the COVID-19 were also more likely to experience symptoms of anxiety (OR=2.935, 95%CI=1.701–5.062, P<0.001) and insomnia (OR=2.195, 95%CI=1.098–4.390, P=0.026). Conclusion The COVID-19 pandemic does affect the mental health and well being of perinatal women. Increased attention should be paid to women who have infected friends/families/colleagues and those with previous adverse experiences during pregnancy. Coping strategies that relieve psychological stress during the COVID-19 outbreak should be provided to prevent adverse outcomes for women and their infants.

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“…More research is needed to evaluate the efficacy of breastfeeding interventions (Franco-Antonio et al, 2019). Because perinatal depression is under-diagnosed in China, and many women do not receive sufficient support (Zhao et al, 2019), there is a great need to increase health care providers’ awareness of risk for perinatal depression and improve access to efficient and acceptable interventions to enhance breastfeeding and promote postpartum psychological adjustment.…”

Section: Introductionmentioning

confidence: 99%

Randomized Clinical Trial of a Prenatal Breastfeeding and Mental Health Mixed Management Intervention

et al. 2021

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Background The continuity of maternal depressive symptoms throughout the perinatal period and breastfeeding problems have adverse influences on breastfeeding. Research aim To compare the feeding patterns and breastfeeding experiences, maternal health and mental health, and breastfeeding self-efficacy between women with depressive symptoms who participated in a prenatal individualized mixed management intervention and those who received usual care. Methods Chinese primigravida ( N = 182) with an Edinburgh Postnatal Depression Scale score ≥ 9 in late pregnancy (≥ 28 weeks and < 35 weeks) were randomly assigned to the intervention group ( n = 84) or the control group ( n = 84). Intervention group participants received four sessions of individualized mixed management combining psycho-education and breastfeeding education. Breastfeeding self-efficacy, feeding patterns, maternal depression, and health status were evaluated in both groups. Results Significant differences were noted between the groups in breastfeeding self-efficacy at 42 days postpartum ( p < .05) and feeding patterns at 3 months and 6 months postpartum ( p < .05). Repeated measures analysis of variance showed significant differences in the EPDS scores between groups at three postpartum time points ( p < .05). The intervention group had significantly lower postpartum depression as diagnosed by the MINI ( p < .05). Conclusions A prenatal individualized mixed management intervention holds promise as an effective prevention and health promotion program addressing breastfeeding outcomes and maternal mental health. This RCT was registered (ChiCTR-IOR-17013761) with Chinese Clinical Trial Registry, http://www.chictr.org.cn/enIndex.aspx on 12/7/2017.

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Effects of antenatal depression screening and intervention among Chinese high‐risk pregnant women with medically defined complications: A randomized controlled trial

Abstract: This study highlights the effectiveness of the screening and the targeted management of antenatal depression in Chinese high-risk pregnant women.

Cited by 16 publications

References 28 publications

An evaluation of a prenatal individualised mixed management intervention addressing breastfeeding outcomes and postpartum depression: A randomised controlled trial

An evaluation of a prenatal individualised mixed management intervention addressing breastfeeding outcomes and postpartum depression: A randomised controlled trial

Mental Health Outcomes in Perinatal Women During the Remission Phase of COVID-19 in China

Randomized Clinical Trial of a Prenatal Breastfeeding and Mental Health Mixed Management Intervention

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