Peripartum Predictors of the Risk of Postpartum Depressive Disorder: Results of a Case-Control Study

Abstract

Background: The study aimed at the identification of the risk factors present during delivery, which might be present in prophylactic programs concerning postpartum mood disorders. Material and Method: This was a retrospective comparative study. The study material included data retrieved from the medical records of patients hospitalized in the Teaching Department of Gynecology and Obstetrics of Professor Orłowski Hospital in Warsaw, in the years 2010–2017. The EPDS data of 604 patients were analyzed. The study group included 75 women who obtained at least 12 points in the EPDS and the control group was made up of 75 women who obtained no more than 5 points in the EPDS. Results: The women in whom we noted an increased risk of developing mood disorders had blood loss >1000 mL and had a significantly longer stage II and III of labor than the control group. Other risk factors were cesarean section, vaginal delivery with the curettage of the uterine cavity, slightly lower APGAR scores (0.4 pts), and lower birth weight (approximately 350 g) of the child. Women at a low risk of postpartum mood disorders more commonly underwent episiotomy during delivery (76%). Conclusions: Increased supervision and support should be offered to women who experienced the above-mentioned risk factors.

The Transition From Maternity Blues to Full-Blown Perinatal Depression: Results From a Longitudinal Study

“…The majority of studies have focused on the presence of previous affective episodes as risk factors for MB, while the finding that the presence of anxiety disorders is a risk factors for MB is rather new, although the impact of anxiety disorders on the onset of PPD had already been reported ( 41 ). It may be that women with anxiety disorders may perceive as more stressful the changes in their lifestyle behaviors imposed by the motherhood and feel less ready to take over the new role of mother ( 42 ). It has to be noted that, when assessing EPDS subscales immediately after the delivery, the levels of anxiety symptoms are notably higher compared to the levels of affective symptoms.…”

Fatores de risco e cuidados à mulher com baby blues

“…Mulheres que foram submetidas a cesarianas, além daquelas que passaram por partos com utilização de fórceps, espátulas ou ventosas foram mais suscetíveis a desenvolver baby blues do que mulheres que passaram por parto natural. 15 Além disso, apesar da analgesia peridural auxiliar na diminuição da dor durante o parto, pode estar diretamente correlacionada à liberação de cortisol, no desenvolvimento de sintomatologia depressiva e do aparecimento do baby blues. 18 Outro fator de risco para o baby blues está relacionado à internação da mulher para o parto.…”

“…Tal fato se explica pela ansiedade materna vivenciada durante a hospitalização e o sentimento de impotência de reverter tal situação do recém-nascido. 15 Gravidezes de alto risco e partos prematuros também podem aumentar o sofrimen-to psíquico da mulher. Estudos demonstraram que a perda sanguínea acima de 400ml durante o parto aumentou a ansiedade, o medo e o estresse da mulher.…”

“…Essa situação foi um fator importante para o desenvolvimento da tristeza materna. 15,21 A impossibilidade de realizarem a amamentação também foi um fator de risco relevante para o aparecimento do baby blues. Mulheres que não amamentaram foram mais suscetíveis a apresentarem alterações psicológicas durante o período puerperal, pois, durante a amamentação, ocorre a liberação de ocitocina e prolactina.…”

Factor Structure of the Edinburgh Postnatal Depression Scale in a Sample of Postpartum Slovak Women

“…The association between the mode of delivery and postpartum depression remains unclear. Whereas some studies reported elevated levels of postpartum depressive symptoms amongst women who underwent operative birth or had perinatal factors such as significant blood loss or longer duration of stage II or III of labor [ 10 ]; other studies, including systematic reviews, found no significant association [ 11 , 12 ]. However, subjective perception of the birth experience and level of birth satisfaction might be more important risk factors of postpartum depression than the objective mode of delivery.…”