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Objective: Covid-19 infection was first diagnosed in Wuhan, China, and became a pandemic. Afterward, it had a devastating effect on mental and physical health. Postpartum depression (PPD) is a common health problem that needs attention to improve women’s healthcare. Herein, we aim to search for the PPD incidence in the pandemic period.
Methods: A prospective cross-sectional study was conducted. A total of 126 pregnant women were included for the study. None of the patients had Covid-19 infection. Inclusion criteria included; women were aged 18 or over and ability to communicate fluently provided informed consent to participate. Women who had late fetal loss and stillbirth or neonatal death were excluded. Patients age, gravida, medical history, previous or ongoing psychological disease, and drug use, alcohol use and smoking, obstetric follow-up regarding any complication for the fetus or mother, socio-economic status, spouse support, sleep disorder, hyperemesis gravidarum, type of delivery, fetal birth weight, height, AGGAR scores 1-5th min, neonatal intensive care unit (NICU) admissions were recorded. Postpartum depression diagnosis was evaluated via Edinburgh Postpartum Depression Scale (EPDS). Patients were grouped into two, group 1 consisted of patients who are at low risk for postpartum depression and group 2 was at high risk for depression according to their EPDS scores.
Results: The mean age of the patients was 28.90±5.26 (18-41). 68 (54%) of the patients had vaginal deliveries and 58 (46%) of them had cesarean section. The average weight of newborn babies was 3324±586.11 grams (2750-4950), 1st minute APGAR score was 7.75±0.9 (4-8), 5th minute APGAR score was 8.88±0.45 (7-9). 23 (18.3%) of the newborns were admitted to neonatal intensive care (Table 1). According to the EDPS scores, only 12% of the patients were classified as having high risk group for depression. Lower income, previous psychiatric illness, higher education levels and having newborn needs NICU were found to significantly related to PPD (p = 0.029, p = 0.034, p=0.046 and p = 0.001 respectively) (Table 2). The other parameters were not found to be significantly related to PPD scores.
Conclusion: Covid-19 was not found to increase the rate of PPD in short term notice in our center, which was affected seriously. Studies with a higher number of patients and in different regions are necessary to state a precise conclusion.
2 Lei L, Huang X, Zhang S, Yang J, Yang L, Xu M. Comparison of Prevalence and Associated Factors of Anxiety and Depression Among People Affected by versus People Unaffected by Quarantine During the COVID-19 Epidemic in Southwestern China. Med Sci Monit. 2020;26:e924609. Published 2020 Apr 26. doi: 10. 12659/MSM.924609.
3 Hao F, Tan W, Jiang L, et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry (published online ahead of print, 2020 Apr 27). Brain Behav Immun. 2020;S0889-1591(20)30626-7. doi:10.1016/j.bbi.2020.04.069
4 Li W, Yang Y, Liu ZH, et al. Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J Biol Sci. 2020;16(10):1732‐1738. Published 2020 Mar 15. doi:10.7150/ijbs.45120
5 Wang C, Pan R, Wan X, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China (published online ahead of print, 2020 Apr 13). Brain Behav Immun. 2020;S0889-1591(20)30511-0. doi:10.1016/j.bbi.2020.04.028
6 Liu, N., Zhang, F., Wei, C., Jia, Y., Shang, Z., Sun, L., et al. Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Research. 2020; 287: 112921. https:// doi.org/ 10.1016/ j.psychres.2020.112921
7 Chew, N., Lee, L.G., Tan, B.Y., Jing, M., Goh, Y., Ngiam, N., et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav. 2020. Immun.
8 Mukhtar, S. Mental health and emotional impact of COVID-19: applying health belief model for medical staff to general public of Pakistan. Brain Behav. Immun. 2020. https://doi.org/10.1016/j.bbi.2020.04.012.
9 Shi, Y., Wang, J., Yang, Y., Wang, Z., Wang, G., Hashimoto, K., et al. Knowledge and attitudes of medical staff in Chinese psychiatric hospitals regarding COVID-19. Brain Behav. Immun. Health 4. 2020: 100064. https:// doi.org/ 10.1016/ j.bbih.2020. 100064.
10 Tan, B.Y.Q., Chew, N.W.S., Lee, G.K.H., Jing, M., Goh, Y., Yeo, L.L.L., et al. Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Ann. Intern. Med. 2020a. https://doi.org/10.7326/m20-1083.
11 Rajkumar RP. COVID-19 and mental health: A review of the existing literature (published online ahead of print, 2020 Apr 10). Asian J Psychiatr. 2020;52:102066. doi:10.1016/j.ajp.2020.102066
12 ACOG Committee Opinion No. 757: Screening for Perinatal Depression. Obstet Gynecol. 2018;132(5):e208‐e212. doi:10.1097/AOG.0000000000002927
13 Turkcapar AF, Kadıoğlu N, Aslan E, Tunc S, Zayıfoğlu M, Mollamahmutoğlu L. Sociodemographic and clinical features of postpartum depression among Turkish women: a prospective study. BMC Pregnancy Childbirth. 2015;15:108. Published 2015 May 3. doi:10.1186/s12884-015-0532-1
14 Slavin V, Creedy DK, Gamble J. Comparison of screening accuracy of the Patient Health Questionnaire-2 using two case-identification methods during pregnancy and postpartum. BMC Pregnancy Childbirth. 2020;20(1):211. Published 2020 Apr 14. doi:10.1186/s12884-020-02891.
15 Cox JL, Holden JM, Sagousky R. Detection of postpartum depression. Development of the 10 item Edinburgh postpartum depression scale. Br J Psychiatr. 1987;150:782‐786.
16 Unsal Atan Ş, Ozturk R, Gulec Satir D, et al. Relation between mothers' types of labor, birth interventions, birth experiences and postpartum depression: A multicentre follow-up study. Sex Reprod Healthc. 2018;18:13‐18. doi:10.1016/j.srhc.2018.08.001
17 Oztora S, Arslan A, Caylan A, Dagdeviren HN. Postpartum depression and affecting factors in primary care. Niger J Clin Pract. 2019;22(1):85‐91. doi:10.4103/njcp.njcp_193_17
18 Liberto TL. Screening for depression and help-seeking in postpartum women during well-baby pediatric visits: an integrated review. J Pediatr Health Care. 2012;26(2):109‐117. doi:10.1016/j.pedhc.2010.06.012
19 Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. General Psychiatry. 2020: 33(2), Article e100213. https:// doi.org/ 10.1136/ gpsych-2020-100213
20 Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288:112954. doi:10.1016/j.psychres.2020.112954
21 Li Q, Yang S, Xie M, et al. Impact of some social and clinical factors on the development of postpartum depression in Chinese women. BMC Pregnancy Childbirth. 2020;20(1):226. Published 2020 Apr 16. doi:10.1186/s12884-020-02906-y
22 Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Cartlehner G, Brody S, Miller WC. Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (Summ). 2005;119:1–8.
23 Gelaye, B.; Rondon, M.B.; Araya, R.; Williams, M.A. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry 2016, 3, 973–982.
24 Śliwerski A, Kossakowska K, Jarecka K, Świtalska J, Bielawska-Batorowicz E. The Effect of Maternal Depression on Infant Attachment: A Systematic Review. Int J Environ Res Public Health. 2020;17(8):E2675. Published 2020 Apr 14. doi:10.3390/ijerph17082675 Parsons CE, Young KS, Rochat TJ, Kringelbach ML,
25 Stein A. Postnatal depression and its effects on child development: a review of evidence from low-and middle-income countries. Br Med Bull. 2011; 101: 57-79.
26 Helle N, Barkmann C, Bartz-Seel J, et al. Very low birth-weight as a risk factor for postpartum depression four to six weeks postbirth in mothers and fathers: Crosssectional results from a controlled multicentre cohort study. J Affect Disord. 2015; 180: 154-161.
27 O'Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013; 9: 379-407.
28 Eastwood JG, Jalaludin BB, Kemp LA, Phung HN, Barnett BE. Relationship of postnatal depressive symptoms to infant temperament, maternal expectations, social support and other potential risk factors: findings from a large Australian cross-sectional study. BMC Pregnancy and Childbirth. 2012; 12: 1-11.
29 Danaci AE, Dinc¸ G, Deveci A, S. Postnatal depression in Turkey: epidemiological and cultural aspects. Soc Psychiatry Psychiatr Epidemiol. 2020:37:125–129.
30 Inandı T, Elci OC, Ozturk A, Egri M, Polat A, Sahin TK. Risk factors for depression in postnatal first year, in eastern Turkey. Int J Epidemiol 2020:31;1201–1207.